THE NEW ENGLAND JOURNAL OF MEDICINE

SPECIAL ARTICLE

AGING, NATURAL DEATH, AND THE COMPRESSION OF MORBIDITY

JAMES F. FRIES, M.D.

Abstract The average length of life has risen from 47 to 73 years in this century, but the maximum life span has not increased. Therefore, survival curves have assumed an ever more rectangular form. Eighty per cent of the years of life lost to nontraumatic, premature death have been eliminated, and most premature deaths are now due to the chronic diseases of the later years. Present data allow calculation of the ideal average life span, aproximately 85 years. Chronic illness may presumably be postponed by changes in life style, and it has been shown that the physiologic and psycologic markers of aging may be modified. Thus, the average age at first infirmity can be raised, thereby making the morbidity curve more rectangular. Extension of adult vigor far into a fixed life span compresses the period of senescence near the end of life. Health-research strategies to improve the quality of life require careful study of the variability of the phenomena of aging and how they may be modified. (N Engl J Med. 1980; 303:130-5.)

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