Læknablaðið : fylgirit - 01.03.1983, Qupperneq 97
there was a great difference in the incidence of myocardial infarcts,
these being less frequent in subjects over 90 years of age. We have
no definite explanation for this difference but will suggest two
possibilities. In the first place it is possible that the risk
factors for coronary artery disease were less active at the time
when the older group was in its early life. Secondly the older
group could be regarded as survivors from an age related epidemic
with a peak incidence at younger age.
The comparative disease patterns of the elderly and the very old
show a rising incidence of gallstones and diverticulosis with age.
More demanding to health and social services are the diseases
causing brain failure in old age. Judging from the descriptions
in the autopsy reports, 9% of males and females aged 70 years and
younger had gross signs of dementia. These figures had increased
to 31% for males and 43% for females aged 90 years and older.
The medical care for the very old will need to be directed more
towards brain failure and respiratory diseases and less towards
ischemic heart disease compared with the younger age groups. How-
ever the provision of fuller diagnostic facilities for the elderly
will need to be emphazised.
References
1. Cutler R.G.: Evolution of longevity in primates. J. Hum. Evolution 1975, 5,
169-202.
2. Fries J.F.: Aging, natural death and compression of morbidity. N. Eng.
Joum. Medicine 1980, 3, 130-135.
3. Hagtíöindi, Stat. Bull. Iceland 1981, p. 202.
4. Hallgrimsson J.: Den hóe obductionsfrekvens gir viktigt materiale for
forskning. Nordisk Medicine 1981, 5, 134-136.
5. International Classification of diseases 1965 revision, vol 1. WHO,
Geneva, 1967.
6. Heilbrigðisskýrslur: Public Health in Iceland. Office of the Director of
Public Health, 1965-1977.
7. Sigurjónsson J.: Causes of death in old age. Geriatrics 1968, 23, 152-157.
8. Britton M.: Diagnostic errors discovered at autopsy. Acta med. scand. 1974,
196, 203-210.
9. Anderson R.E., Weston J.T., Craighead J.E., Lacy P.E., Wissler R.W., Hill R.B.:
The autopsy, past, present and future. JAMA 1979, 242, 1056-1059.
10. Halvik R.J.: Understanding the decline in coronary heart disease mortality.
JAMA Ed. 1982, 247, 1605-1606.
11. Thjodleifsson B.: Dauösföll af völdum kransæóasjúkdóma á íslandi 1951-1976.
Læknablaðiö (Icelandic Medical Journal) 1978, 64, 55-64.
12. Petch M.C.: The progression of coronary artery disease. Brit. Med. J.,
1981, Ed. 283, 1073-1074.
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