The world is aging. Already in 2003, the US Census Bureau
reported that 35.9 million persons in the United States were 65
years or older, 12%of the population.1 The first baby boomers
turn 65 years old in 2011, and the next 25 years will witness
the most rapid increase in the number of older adults. The
oldest of the old, those aged 85 years and older, are the fastestgrowing
segment of the American population. This, coupled
with further advances in chronic disease management, diffusion
of “best practices,” increased attention to maintaining
physical, cognitive, and psychological function, and availability
of improved treatments for the most common causes of death
and disability, is likely to continue to extend both the average
life expectancy and years of active life. Increasing awareness
of persistent inequalities in our health care system, a decreasing
ratio of working adults to support dependent children and
retirees, and an increasing burden on family caregivers are just
some of the countervailing forces that continue to limit the
promise of healthy, productive aging.