Prévention de la dépendance : le défi de la longévité

Longevity can only be considered a privilege if the majority of the elderly population is active and in good health. In contrast to certain statistical interpretations, the HID study gives cause for optimism. It showed that only 7% of subjects aged 60 years and over suffer from dependency and, therefore, that 93% of the population remains independent. Of course, the rate of dependency increases with age, particularly in women and after 90 years of age. Dependency is mostly due to age-related diseases. The second cause is "frailty" and the third is inactivity, or more generally, lifestyle. All age-related diseases have modifiable risk factors and are thus accessible to prevention. Prevention must be started as soon as possible. It has been demonstrated that a mother's educational level influences her children's health in adulthood. It is never too late. The Hyvet study recently showed that the treatment of hypertension after 80 years of age is still able to significantly reduce the risk of death, stroke, heart failure and other cardiovascular complications. Inadequate disease management may also lead to avoidable dependency. This is the case of congestive heart failure and osteoporosis, which are not always treated in very old patients according to evidence-based principles. Another means of prevention is the detection and management of the frailty syndrome, which carries a measurable risk of loss of independence. In addition to these medical approaches, occupational activity involving strong cognitive stimulation has been shown to postpone the onset of cognitive impairment.