Download PDF
Gesundheitswesen 2015; 77(06): 442-446
DOI: 10.1055/s-0034-1387781
Zur Diskussion
© Georg Thieme Verlag KG Stuttgart · New York

Die Morbiditätskompressionsthese und ihre Alternativen

The Morbidity Compression Hypothesis and its Alternatives
S. Geyer
1   Medizinische Soziologie, Medizinische Hochschule Hannover, Hannover
› Author Affiliations
Further Information

Publication History

Publication Date:
30 September 2014 (online)

Also available at
    Permissions and Reprints

Zusammenfassung

Ziel: Nach Fries’ Morbiditätskompressionsthese nehmen die Zeiten, die Menschen im Zustand von chronischer Krankheit und Behinderung verbringen, ab. Dies wird erklärt durch verbesserte Lebens- und Arbeitsbedingungen sowie durch Erfolge der primären Prävention.

Methodik: Anhand der vorliegenden Studien zur Morbiditätskompression wird untersucht, ob sich das Morbiditätsgeschehen in den letzten Jahrzehnten im Sinn der These verändert hat.

Ergebnisse: Für Multimorbidität, manifeste chronische Erkrankungen, kognitive Beeinträchtigungen sowie für subjektive Gesundheit verkürzen sich die Leidenszeiten in Übereinstimmung mit der Kompressionsthese, Variationen ergeben sich in Abhängigkeit von der betrachteten Erkrankung.

Schlussfolgerung: Es gibt Belege dafür, dass in den letzten Jahren neben Morbiditätskompression auch Morbiditätsexpansion und dynamisches Equilibrium eingetreten sind. Eine Gesamtbeurteilung der Entwicklung ist jedoch erst dann möglich, wenn weitere Erkrankungen untersucht werden. Es gibt zudem Hinweise, dass sich die Morbiditätsmuster außerhalb Europas und der USA in andere Richtungen entwickeln.

Abstract

Aim: Fries’ hypothesis of morbidity compression asserts that the length of lifetime spent in states of chronic disease and disability is decreasing. This can be explained by improved living and working conditions and by successful primary prevention.

Method: Using the available studies on morbidity compression it is examined whether the lengths of periods spent in states of morbidity have changed in the last decades.

Results: For multimorbidity, chronic diseases, cognitive impairment, and for subjective health the developments are in favour of the morbidity compression hypothesis. The conclusions are nevertheless dependent on the type of health impairment considered.

Conclusion: There is evidence that morbidity compression has taken place in the last decades. Depending on the disease, morbidity expansion and dynamic equilibrium may also have occurred. A comprehensive assessment of the development of morbidities is only possible if more diseases are considered. In addition, there is evidence that outside of Europe and the USA morbidity patterns may also develop in other directions.

Schlüsselwörter

Morbiditätskompression - Morbiditätsexpansion - Dynamisches Equilibrium - Altern - Morbidität - Gesundheit

Key words

morbidity compression - morbidity expansion - dynamic equilibrium - aging - morbidity - health
 

  • Literatur

  • 1 Doblhammer G, Kreft D, Dethloff A. Gewonnene Lebensjahre. Bundesgesundheitsblatt – Gesundheitsforschung – Gesundheitsschutz 2012; 55: 448-458
    CrossrefPubMedGoogle Scholar
  • 2 Crimmins EM, Beltran-Sanchez H. Mortality and Morbidity Trends: Is There Compression of Morbidity?. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences 2011; 66B: 75-86
    CrossrefPubMedGoogle Scholar
  • 3 Fries JF. Aging, natural death and the compression of morbidity. N Engl J Med 1980; 303: 130-135
    CrossrefPubMedGoogle Scholar
  • 4 Gruenberg EM. The failure of success. Milbank Memorial Fund, Health and Society 1977; 55: 3-24
    PubMedGoogle Scholar
  • 5 Manton KG. Changing concepts of morbidity and mortality in the elderly population. Milbank Memorial Fund, Health and Society 1982; 60: 183-244
    PubMedGoogle Scholar
  • 6 Fries JF, Bruce B, Chakravarty E. Compression of Morbidity 1980–2011: A Focused Review of Paradigms and Progress. Journal of Aging Research 2011; 2011: 261702
    PubMedGoogle Scholar
  • 7 Whalley LJ, Deary IJ, Appleton CL et al. Cognitive reserve and the neurobiology of cognitive aging. Ageing Research Reviews 2004; 3: 369-382
    CrossrefPubMedGoogle Scholar
  • 8 Manton KG, Gu X, Lowrimore GR. Cohort Changes in Active Life Expectancy in the U.S. Elderly Population: Experience From the 1982–2004 National Long-Term Care Survey. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences 2008; 63: S269-S281
    CrossrefPubMedGoogle Scholar
  • 9 Chakravarty E, Hubert HB, Lingala VB et al. Reduced Disability and Mortality Among Aging Runners: A 21-Year Longitudinal Study. Archives of Internal Medicine 2008; 168: 1638-1646
    CrossrefPubMedGoogle Scholar
  • 10 Chakravarty EF, Hubert HB, Krishnan E et al. Lifestyle Risk Factors Predict Disability and Death in Healthy Aging Adults. Am J Med 2012; 125: 190-197
    CrossrefPubMedGoogle Scholar
  • 11 Heilbrun LK, Nomura A, Stemmermann GN. The effects of non-response in a prospective study of cancer: 15-year follow-up. Int J Epidemiol 1991; 20: 328-338
    CrossrefPubMedGoogle Scholar
  • 12 Panser LA, Chute CG, Guess HA et al. The natural history of prostatism: The effects of non-response bias. Int J Epidemiol 1994; 23: 1198-1205
    CrossrefPubMedGoogle Scholar
  • 13 Fogel RW. Changes in the Process of Aging during the Twentieth Century: Findings and Procedures of the Early Indicators Project. In: Waite LJ. (ed.) Aging, Health and Public Policy: Demographic and Economic Perspectives, Supplement to Population and Development Review. 30. New York: The Population Council; 2004: 19-47
    Google Scholar
  • 14 Willis BL, Gao A, Leonard D et al. Midlife fitness and the development of chronic conditions in later life. Archives of Internal Medicine 2012; 172: 1333-1340
    CrossrefPubMedGoogle Scholar
  • 15 Astrup A. Healthy lifestyles in Europe: prevention of obesity and type II diabetes by diet and physical activity. Public Health Nutrition 2012; 4: 499-515
    PubMedGoogle Scholar
  • 16 Brinks R, Tamayo T, Kowall B et al. Prevalence of type 2 diabetes in Germany in 2040: estimates from an epidemiological model. European Journal of Epidemiology 2012; 27: 791-797
    CrossrefPubMedGoogle Scholar
  • 17 Gillum RF, Obisesan TO. Physical Activity, Cognitive Function, and Mortality in a US National Cohort. Annals of Epidemiology 2010; 20: 251-257
    CrossrefPubMedGoogle Scholar
  • 18 Langa KM, Larson EB, Karlawish JH et al. Trends in the prevalence and mortality of cognitive impairment in the United States: Is there evidence of a compression of cognitive morbidity?. Alzheimer‘s & Dementia 2008; 4: 134-144
    PubMedGoogle Scholar
  • 19 Marioni RE, Valenzuela MJ, van den Hout A et al. Active Cognitive Lifestyle Is Associated with Positive Cognitive Health Transitions and Compression of Morbidity from Age Sixty-Five. PLOS ONE 2012; 7: e50940
    CrossrefPubMedGoogle Scholar
  • 20 Jylhä M. What is self-rated health and why does it predict mortality? Towards a unified conceptual model. Social Science & Medicine 2009; 69: 307-316
    CrossrefPubMedGoogle Scholar
  • 21 Kroll L-E, Ziese T. Kompression oder Expansion der Morbidität?. In: Böhm K, Tesch-Römer C, Ziese T. (eds.) Gesundheit und Krankheit im Alter. Berlin: Robert Koch-Institut; 2009
    Google Scholar
  • 22 Trachte F, Sperlich S, Geyer S. Kompression oder Expansion der Morbidität? Entwicklung der Gesundheit in der älteren Bevölkerung. Zeitschrift für Gerontologie und Geriatrie. 2014 DOI: 10.1007/s00391-014-0644-7
    PubMedGoogle Scholar
  • 23 Doblhammer G, Kytir J. Compression or expansion of morbidity? Trends in healthy-life expectancy in the elderly Austrian population between 1978 and 1998. Social Science & Medicine 2001; 52: 385-391
    CrossrefPubMedGoogle Scholar
  • 24 Hubert HB, Bloch DA, Oehlert JW et al. Lifestyle Habits and Compression of Morbidity. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 2002; 57: M347-M351
    CrossrefPubMedGoogle Scholar
  • 25 Doblhammer G, van den Berg GJ, Fritze T. Economic Conditions at the Time of Birth and Cognitive Abilities Late in Life: Evidence from Ten European Countries. PLOS ONE 2013; 8: e74915
    CrossrefPubMedGoogle Scholar
  • 26 Cagney KA, Lauderdale DS. Education, Wealth, and Cognitive Function in Later Life. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences 2002; 57: P163-P172
    CrossrefPubMedGoogle Scholar
  • 27 Salomon JA, Wang H, Freeman MK et al. Healthy life expectancy for 187 countries, 1990–2010: a systematic analysis for the Global Burden Disease Study 2010. The Lancet 2012; 380: 2144-2162
    CrossrefPubMedGoogle Scholar
  • 28 Karcharnubarn R, Rees P, Gould M. Healthy life expectancy changes in Thailand, 2002–2007. Health & Place 2013; 24: 1-10
    CrossrefPubMedGoogle Scholar
  • 29 Lynch C, Holman CD, Moorin RE. Use of Western Australian linked hospital morbidity and mortality data to explore theories of compression, expansion and dynamic equilibrium. Aust Health Review 2007; 31: 571-581
    CrossrefPubMedGoogle Scholar
  • 30 Graham P, Blakely T, Davis P et al. Compression, expansion, or dynamic equilibrium? The evolution of health expectancy in New Zealand. J Epidemiol Community Health 2004; 58: 659-666
    CrossrefPubMedGoogle Scholar
  • 31 Nusselder WJ, Looman CWN, de Mheen PJM et al. Smoking and the compression of morbidity. J Epidemiol Community Health 2000; 54: 566-574
    CrossrefPubMedGoogle Scholar