CHANGES WITH AGING 



423 



lire 1, or a discussion of age-related diseases. And so it must be in my 

 discussion. 



In terms of the number of people affected and the social and eco- 

 nomic costs, the great bulk of our health problems in the United States 

 today are strongly age-related: heart disease, vascvilar disorders of the 

 central nervous system, cancer and other neoplasms, mental disease, 

 arthritis. The United States mortality from various causes is summa- 

 rized in Table I. All of these major causes of death except "accidents, 

 poisonings, and violence" and "certain diseases of early infancy" are 

 strongly age-related; their incidence and mortality rise sharply with 

 age, especially in the years beyond the forties. 



To a considerable extent this age-related mortality may be xiewed 

 as an expression of aging— a result of aging if not actually caused by it. 

 What other explanation can be oflFered at the present time? In the ab- 

 sence of evidence that external or environmental factors are respon- 

 sible, we are forced to conclude that internal factors, inherent in the 

 tissues or the complex we call the organism, operate spontaneously 

 over time to bring about the end result: for example, death frorrt* coro- 

 nary heart disease. This means that the tendency to develop and die 

 from these diseases is inborn, that each disease appears when the as- 

 pect of aging invoKed progresses far enough to reach some critical 

 level. Individuals may differ in their rates of aging in the various tis- 

 sues, but the eventual outcome is predetermined. ' •' " ' 



This, of course, is the fatalistic argument that so long hindered re- 

 search efforts directed toward the goal of prevention of these non- 



TABLE I " 



'..{% 



Peatbs from X'ari.ous Causes of White. Persons 

 ,in the United States in 1957 



(In thousands) 



Cause 



Male 



Female 



Coronary heart disease • ; . \ . . - ■ 



All neoplasms *' 



Cerebro\ascular lesions ■ - 



All other heart diseases 



Accidents, poisonings, violence 



Certain diseases of earl\- infancx 



Pneuinonia 



Genei al arteriosclerosis 



Diabetes 



Cirrhosis of the li\er 



All infectious and parasitic diseases 



All other diseases 



