The DOI matches its Crossref record; 52 of the 52 references it cites were found in a registry or an index; none of the 43 sources its claims cite is checked for support yet.
The Compression of Morbidity
Open accessAbstract
I n this century we are progressing through three separate eras with dramatically different characteristics of health and illness.We entered the century in an era of infectious disease, with tuberculosis the number one killer of our population, and smallpox, diphtheria, tetanus, and other infectious illnesses extremely prevalent.A reduction in mortality from these diseases of over 99 percent (Fries and Crapo 1981;Cooper 1982) has led to the present era, where the major burdens of illness of the United States are the chronic diseases.Atherosclerosis and its complications, neoplasia, emphysema, diabetes, cirrhosis, and osteoarthritis have increased in prevalence even as the infectious illnesses which preceded them declined.It is one thesis of this discussion that this chronic disease era in its turn will slowly decline in significance, leaving a third era in which the major health problems of the United States will be directly related to the process of senescence, and where the aging process itself, independent of specific disease, will constitute a major burden of illness for the United States.The ultimate constraint within which we must develop health policy for the future is, of course, the limit of life itself.Man is mortal, and the limits to what presently may be accomplished in decreasing mortality are set by the life span of our species.In the following discussion, we will This paper was first delivered as a keynote address to the Institute of Medicine, National Academy of Sciences, Washington, October 20, 1982.
Overview
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Written from the paper’s full text.
TL;DR
Fries argues that chronic disease and senescence can be postponed, compressing morbidity into a shorter period before a finite human life span. He synthesizes mortality, physiologic, and epidemiologic evidence to claim that the period of infirmity can shrink even as life expectancy rises modestly.
Key findings
- U.S. life expectancy from birth rose from 47 to 73 years over the century, but gains were much smaller at older ages: +13 years from age 20, +8 from age 40, +5 from age 60, +2.5 from age 80, and +0.7 from age 100.
- The human life span appears to be approximately 85 years, with 99% of natural longevity between ages 70 and 100; maximum life potential was 113 years, 214 days, and Gompertz’s law implies mortality doubles about every eight years.
- Organ reserve declines about 1.5% per year, and natural death may occur when reserve falls to roughly 20% above basal needs; chronic diseases are described as universal, early-onset, progressive, multifactorial, and marked by a symptom threshold.
- Compression of morbidity is already suggested by data: average age at first heart attack for men increased about four years in sixteen, while life expectancy from age 40 increased only about two years over twenty; heart attack hospital discharges over age 65 rose from 47% to 52% of the total from 1968 to 1978.
Methods
- Conceptual/keynote synthesis rather than a primary empirical study; the text states it was first delivered as a keynote address to the Institute of Medicine, National Academy of Sciences, in October 1982.
- Uses national mortality and life-expectancy statistics, Gompertz’s law, physiologic studies of organ reserve decline, chronic disease epidemiology, athletic age-group records, and cited literature.
- Main analysis builds an incremental model of chronic disease and aging, defines absolute and relative compression of morbidity, and interprets rectangularization of survival curves.
Limitations
- The paper states that data on incidence of morbidity markers have not been systematically collected, there are no cross-sectional prevalence figures for “quality of life,” and it is not even clear what morbidity measures should be used.
- The paper states that demographic projections may be faulty if they use a competing-risk model without a hazard function for natural death, and that natural deaths are hidden in categories such as bronchopneumonia, heart failure, and generalized atherosclerosis.
- The paper notes that the Hayflick phenomenon of cellular senescence may be allegorical or a laboratory artifact and says its discussion is not based on it; evident from the text, the argument relies on selected evidence and illustrative examples rather than a systematic review or meta-analysis.
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Claims the paper makes
48 Own interpretation · 21 No basis given · 19 Sources not found · 11 No full text of the sources · 9 Not checked yet · 2 Own result
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In the paper
“The point on the age axis at which the curves intersect has remained approximately the same, the differences lying within the width of the lines used to plot such curves.”
§ The Compression of Morbidity > Abstract
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“In turn, the major medical problems are now well-known to be chronic illnesses: atherosclerosis in all of its guises, cancer in its many forms, emphysema, diabetes, cirrhosis, osteoarthritis.”
§ The Compression of Morbidity > The Characteristics of Chronic Disease
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In the paper
“Life expectancy from birth in this century in the United States has increased from 47 to 73 years (Fries 1980)-an increase of 26 years (Figure 3).”
§ The Compression of Morbidity > Abstract
What the sources say
- Not checked — no full text of the sourcecites Fries 1980 source
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In the paper
“The acute infectious diseases have ceased to be statistically major causes of mortality in the United States.”
§ The Compression of Morbidity > The Characteristics of Chronic Disease
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In the paper
“Tuberculosis, small pox, diphtheria, tetanus, polio, typhoid fever, and others have declined by 99 percent to 100 percent in this century (Fries and Ehrlich 1980).”
§ The Compression of Morbidity > The Characteristics of Chronic Disease
What the sources say
- Not matchedcites Fries and Ehrlich 1980
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
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In the paper
“Even the most optimistic calculations (Faber 1982) project that life expectancy at age 85 will increase by only two years by the year 2020.”
§ The Compression of Morbidity > Abstract
What the sources say
- Not matchedcites Faber 1982
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“There has been no historical change over several centuries of observation with regard to maximum life potential, as underscored by studies of centenarians; this observation has been repeatedly made in the United States with good data since 1939 or earlier (Bowerman 1939;Faber 1982).”
§ The Compression of Morbidity > Abstract
What the sources say
- Not matchedcites Bowerman 1939
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites Faber 1982
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
boosted- Asserted: passes — The authors put it forward as true.
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In the paper
“Clinical observation suggests that a significant number of deaths, perhaps as many as one-fourth, presently occur in individuals with minimal organ reserve, and hence are essentially natural deaths, occurring within a few months of ultimate physiologic limits.”
§ The Compression of Morbidity > Abstract
hedgeddirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Absolute changes in life expectancy, as above, show a progressive decline at higher ages.”
§ The Compression of Morbidity > Abstract
plaincorrelational- Asserted: passes — The authors put it forward as true.
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The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The severity of the conditions increases progressively with age (Figure 7).”
§ The Compression of Morbidity > The Characteristics of Chronic Disease
plaindirect- Asserted: passes — The authors put it forward as true.
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- It may state two separate claims as one. 42
- Probably not a substantial claim. 27
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“This rate may be very low (as in atherosclerosis in native Japanese on native diets) or higher (as in Japanese on American diets).”
§ The Compression of Morbidity > The Characteristics of Chronic Disease
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It may state two separate claims as one.
In the paper
“life expectancy from age 20, which has increased only some 13 years; life expectancy from age 40, which has increased eight years; life expectancy from age 60, which has increased 5 years; from age 80, 2.5 years; or from age 100, 0.7 years (Faber 1982).”
§ The Compression of Morbidity > Abstract
What the sources say
- Not matchedcites Faber 1982
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
hedged- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
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The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Moreover, the chronic illnesses have their onset early in life; signs of such problems may be found in autopsy studies of individuals in their twenties.”
§ The Compression of Morbidity > The Characteristics of Chronic Disease
hedged- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In 1900 mortality occurred at a relatively steady rate throughout the life span.In successive decades, the curves have begun to bend upwards and to the right, each considerably different from the last.The form of the curve is increasingly rectangular, having an increasingly flat top and an increasingly sharp downslope.”
§ The Compression of Morbidity > Abstract
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“National mortality figures demonstrate a smooth decline in number of deaths and a smooth increase in mortality rates as we move toward higher ages (Fries and Crapo 1981).”
§ The Compression of Morbidity > Abstract
What the sources say
- Not matchedcites Fries and Crapo 1981
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
boostedcorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“The 41,000 deaths per year in the United States in the eighty-fifth year of age has decreased to 24 by age 110, in a smooth progression which shows no exceptions.”
§ The Compression of Morbidity > Abstract
plaincorrelational- Asserted: passes — The authors put it forward as true.
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A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“Alzheimer's disease, a major problem currently increasing in prevalence, is difficult to classify, and clearly deserves both preventive and curative study.This condition is heavily age dependent, and has a specific pathology (Beck et al. 1982;Blass and Weksler 1983).”
§ The Compression of Morbidity > The Characteristics of Chronic Disease
What the sources say
boostedcorrelational- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“Life expectancy at age 100 is projected to increase from 2.45 years in 1980 to only 3.01 years in 2000, and 3.35 years in 2020.”
§ The Compression of Morbidity > Abstract
What the sources say
- Not matchedcites Faber 1982
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaindirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
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The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Such patients appear to require, not surprisingly, up to four times the medical resources of the average individual.”
§ The Compression of Morbidity > The Characteristics of Chronic Disease
hedgedcorrelationalSingle case- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
In the paper
“Life expectancy at age 100 has changed at most 0.7 years over 80 years (Faber 1982), and much of this improvement must have been due to reduction of premature death, not change in life span.”
§ The Compression of Morbidity > Abstract
What the sources say
- Not matchedcites Faber 1982
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
hedgedconditional- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“It is one thesis of this discussion that this chronic disease era in its turn will slowly decline in significance, leaving a third era in which the major health problems of the United States will be directly related to the process of senescence, and where the aging process itself, independent of specific disease, will constitute a major burden of illness for the United States.”
§ The Compression of Morbidity > Abstract
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: unclear — It is unclear why the paper says it holds.
It may state two separate claims as one.
In the paper
“Different species, on the other hand, have very different life spans; the obvious fact that we tend to outlive our pets is not due to increased disease or accident among the animals, but rather to the difference in species life span (Rockstein 1958).”
§ The Compression of Morbidity > Abstract
What the sources say
- Not checked — no full text of the sourcecites Rockstein 1958 source
plaindirect- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“As the slope decreases, the date of crossing the symptomatic threshold (Figure 7) can be postponed; death due to the disease can be postponed or even prevented; and the severity of symptoms experienced can be decreased.”
§ The Compression of Morbidity > The Characteristics of Chronic Disease
plaindirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
- The authors state this as an assumption: In the multiple risk factor, universal susceptibility model, modifying risk factors decreases the slope of chronic disease progression.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Both the absolute amount and the percentage of life spent in less than good health may, thus, be decreased.”
§ The Compression of Morbidity > The Characteristics of Chronic Disease
hedgedconditional- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
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It may state two separate claims as one.
- The authors state this as an assumption: In the multiple risk factor, universal susceptibility model, modifying risk factors decreases the slope of chronic disease progression.
In the paper
“Thus, our presently most important illnesses are universal, have early onset, are progressive, are generally characterized by a symptom threshold at which time they become clinically obvious, and are multifactorial in cause (Fries and Crapo 1981).”
§ The Compression of Morbidity > The Characteristics of Chronic Disease
What the sources say
- Not matchedcites Fries and Crapo 1981
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
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- Not matched
None of the sources cited for this claim have been checked yet.
In the paper
“Studies of this physiologic decline, about 1.5 percent per year, uniformly indicate that the decline begins early in life in healthy individuals-well before it is reasonable to postulate any specific chronic disease effects (Figure 1).”
§ The Compression of Morbidity > Abstract
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It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Present gains, accruing by postponement of chronic disease, are reflected in life expectancy increases at all ages; hence, the historically more slowly rising life expectancy from advanced ages will show a larger percentage, although smaller absolute, gain.”
§ The Compression of Morbidity > Abstract
plaindirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“The organ reserve potential, greatest in early life, shows a functional decline which is essentially linear and which is roughly parallel for all major organs.”
§ The Compression of Morbidity > Abstract
plaincorrelational- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“All suggest an average life span of approximately 85 years, with a distribution which includes 99 percent of individuals between the ages of 70 and 100 (Figure 5).”
§ The Compression of Morbidity > Abstract
plain- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The model presented here predicts that the male-female gap eventually may decrease, but does not anticipate dramatic change to occur in the next few years; such change requires that premature death in males decreases more rapidly than in females, and may occur if the present cardiovascular disease decline broadens, lung cancer rates follow anticipated trends, and traumatic deaths of males in early”
§ The Compression of Morbidity > Abstract
hedgedconditional- Asserted: passes — The authors put it forward as true.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Every individual has, to a greater or lesser degree, the potential for increasing atherosclerosis, an increasing statistical possibility of malignant change, and slow degeneration of the articular cartilage.”
§ The Compression of Morbidity > The Characteristics of Chronic Disease
plain- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“World-class performance is optimal in the twenties and early thirties and then shows a linear decline (Fries 1980), up to the point where sample size is inadequate for estimation.”
§ The Compression of Morbidity > The Plasticity of Many Senescent Phenomena
What the sources say
- Not checked — no full text of the sourcecites Fries 1980 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“These capacities appear to be insidiously and irreversibly lost with age, according to present data (Fries and Crapo 1981).”
§ The Compression of Morbidity > The Plasticity of Many Senescent Phenomena
What the sources say
- Not matchedcites Fries and Crapo 1981
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
hedgeddirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Importantly, this model may be used to describe the senescent changes of aging in multiple organ systems as well as the accelerated decrepitude in a particular organ associated with a chronic disease.”
§ The Compression of Morbidity > The Characteristics of Chronic Disease
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one.
- The authors state this as an assumption: In the multiple risk factor, universal susceptibility model, modifying risk factors decreases the slope of chronic disease progression.
In the paper
“Gompertz noted a linear increase in mortality rates with age when rates were plotted on a logarithmic scale.That is, the mortality rate increases exponentially with age, doubling approximately every eight years of age.”
§ The Compression of Morbidity > Abstract
What the sources say
- Not matchedcites Gompertz (1825)
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaindirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
- Not matched
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Another significant attribute of this model is that any reduction in the average slope of lines representing individuals in a population will result in a decrease in age-specific mortality rates.And, it will also result in an increase in the average age at which the first symptom is experienced.”
§ The Compression of Morbidity > The Characteristics of Chronic Disease
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: unclear — It is unclear why the paper says it holds.
It may state two separate claims as one.
- The authors state this as an assumption: In the multiple risk factor, universal susceptibility model, modifying risk factors decreases the slope of chronic disease progression.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The human life span appears to be approximately 85 years, with a broad distribution in which natural longevity for individuals falls nearly entirely within the range of from 70 to 100 years.”
§ The Compression of Morbidity > Abstract
hedged- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“Anthropological analyses (Cutler 1979) suggest a formula by which mammalian life spans may be predicted by the brain size/body weight ratio; such models suggest an approximately constant life span for the human species for the past 100,000 years.”
§ The Compression of Morbidity > Abstract
What the sources say
- Not checked — no full text of the sourcecites Cutler 1979 source
hedgedconditional- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Utopias may be envisioned, but not totally achieved.”
§ The Compression of Morbidity > Policy Implications
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
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Probably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Studies of plasticity suggest strongly the health and vitality benefits of continuing challenge, problem solving, perception of productivity, continued activity, and more money; for some, these features will be best obtained by continued employment.”
§ The Compression of Morbidity > Policy Implications
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Aging programs directed only at the aged will have less impact than those addressing the same problems earlier.”
§ The Compression of Morbidity > Policy Implications
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“There is a level of optimal human performance in each faculty, approximated by world-class performance at each age.”
§ The Compression of Morbidity > The Plasticity of Many Senescent Phenomena
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Our health insurance programs take money from those with good health habits and give it to those with poor health habits.”
§ The Compression of Morbidity > Policy Implications
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The same individual, untrained and expending less than maximal effort, will show a similar curve but at a lower level of performance.”
§ The Compression of Morbidity > The Plasticity of Many Senescent Phenomena
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The paradigm of increasing vitality and finite life, with the consequent compression of morbidity into a shorter period prior to the end of life, offers a framework within which to view these problems, and within which we may begin to develop some constructive solutions.”
§ The Compression of Morbidity > Policy Implications
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper may give no reason why it holds. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Increasing birth cohorts will continue to discharge ever larger numbers of individuals into the older age groups until equilibrium is reached after some 50 years, and the problems we have been experiencing will grow worse before they grow better.”
§ The Compression of Morbidity > Policy Implications
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“For example, the average age at first heart attack for men appears to have increased approximately four years in the past sixteen, while life expectancy from age 40 increased but two years over the past 20.”
§ The Compression of Morbidity > The Plasticity of Many Senescent Phenomena
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“As an additional factor tending to reduce the effects of biological senescence, it should be observed that many psychologists favor a life span concept with regard to cognitive and social functions (Labouvie-Vief and Blanchard-Fields 1982).”
§ The Compression of Morbidity > The Plasticity of Many Senescent Phenomena
What the sources say
- Not checked — no full text of the sourcecites Labouvie-Vief and Blanchard-Fields 1982 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“The rectangular morbidity curve represents, in many ways, a social ideal-a long, vigorous life culminating, as in Oliver Wendell Holmes's One-Hoss Shay (1908), with a sudden terminal collapse; vitality until the end, and death coming without fear or fury at the natural end of the individual life span.”
§ The Compression of Morbidity > Policy Implications
What the sources say
- Not matchedcites Holmes 1908
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it.
- Not matched
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The decline in optimal performance is linear.”
§ The Compression of Morbidity > The Plasticity of Many Senescent Phenomena
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“That is, with maximum training and effort, there is a theoretically optimum performance for each individual, and this curve should be expected to have the same characteristics as do the measurable curves.”
§ The Compression of Morbidity > The Plasticity of Many Senescent Phenomena
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The compression of morbidity and the plasticity of aging are related concepts, and are applicable both to the problems of chronic disease and to the problems of senescence.”
§ The Compression of Morbidity > The Plasticity of Many Senescent Phenomena
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“But the compression of morbidity is an achievable phenomenon; it is already occurring in some areas, and it can be made to grow importantly.”
§ The Compression of Morbidity > Policy Implications
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Indeed, it is not even clear what measures of morbidity should be used.”
§ The Compression of Morbidity > The Plasticity of Many Senescent Phenomena
plain- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“In these models, a variety of stages occur, one following the other.”
§ The Compression of Morbidity > The Plasticity of Many Senescent Phenomena
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“The stroke data are more equivocal, but appear to show the same thing (Kramer, Diamond, and Lilienfeld 1982;Robins and Baum 1981).”
§ The Compression of Morbidity > The Plasticity of Many Senescent Phenomena
What the sources say
- Not checked — no full text of the sourcecites Kramer, Diamond, and Lilienfeld 1982 source
- Not checked — no full text of the sourcecites Robins and Baum 1981
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“With time and age, one may improve, regress, or stay the same within surprisingly broad limits of performance; the limits are evidenced by the wide variation in interindividual performances, and by the increase in such variation with age (Dittman-Kohli and Baltes 1983).”
§ The Compression of Morbidity > The Plasticity of Many Senescent Phenomena
What the sources say
- Not matchedcites Dittman-Kohli and Baltes 1983
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Some emerging data suggest that the compression of morbidity may be a present, as well as a future, phenomenon.”
§ The Compression of Morbidity > The Plasticity of Many Senescent Phenomena
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Projection of health needs under the scenario presented are more favorable than sometimes supposed.”
§ The Compression of Morbidity > Policy Implications
plain- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“By inference, each individual must have his or her own particular curve of optimum performance.”
§ The Compression of Morbidity > The Plasticity of Many Senescent Phenomena
plain- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“But the many problems of our increasingly elderly population continue to exist and require vigorous attack from many directions.”
§ The Compression of Morbidity > Policy Implications
plain- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Athletic performance is only the most measurable faculty; optimal performance is possible for almost any endeavor, from shopping to playing chess.”
§ The Compression of Morbidity > The Plasticity of Many Senescent Phenomena
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Clinical observation of our most vital older citizens suggests a usual terminal decline of months to even a few years, not an abrupt collapse as that of the one-hoss shay.”
§ The Compression of Morbidity > Policy Implications
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Fourth, the means for affecting positive change in an aging population are to be found in the variability of the population, as well as in the average values.”
§ The Compression of Morbidity > Policy Implications
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Finally, solutions are hampered by the existence of certain adverse incentives within our society.”
§ The Compression of Morbidity > Policy Implications
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We subsidize bad health habits and we encourage disuse of the mental and physical faculties of older individuals.”
§ The Compression of Morbidity > Policy Implications
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one.
In the paper
“Studies showing declines in cognitive function with age are felt by those workers as due largely to the use of youth-oriented measurements of factual cognitive function which do not account for the more complex and less easily measurable manifestations of mature wisdom (Dittman-Kohli and Baltes 1983).”
§ The Compression of Morbidity > The Plasticity of Many Senescent Phenomena
What the sources say
- Not matchedcites Dittman-Kohli and Baltes 1983
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Not matched
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Lung cancer age-specific incidence rates appear to have similarly changed and the risk-factor model based heavily on cigarette smoking (pack/years) suggests that as smoking decreases the effect will first be postponement of onset; that is, the requisite number of pack/years will be reached later in life.”
§ The Compression of Morbidity > The Plasticity of Many Senescent Phenomena
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Rests on an assumption: The risk-factor model based heavily on cigarette smoking (pack/years) is valid for predicting lung cancer onset.
None of the sources cited for this claim could be matched to a paper in Crossref, so there is nothing to check it against.
In the paper
“Despite the decreasing prevalence of heart attack over the period of 1968 to 1978, the percentage of hospital discharges for this condition over the age of 65 has risen from 47 to 52 percent of the total (National Center for Health Statistics 1965Statistics , 1968Statistics , 1974Statistics , 1978;;Faber 1982;Elvebach, Connolly, and Kurland 1981;Connolly et al. 1981).”
§ The Compression of Morbidity > The Plasticity of Many Senescent Phenomena
What the sources say
- Not matchedcites National Center for Health Statistics 1965
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites Faber 1982
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites Elvebach, Connolly, and Kurland 1981
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
The authors state this as an assumption.
In the multiple risk factor, universal susceptibility model, modifying risk factors decreases the slope of chronic disease progression.
“In this model, as risk factors are modified, the slope of the progression is decreased.”
The authors state this as an assumption.
The age at first heart attack, the age at development of identifiable lung cancer, and the average age at admission to nursing homes are valid measures of morbidity.
“If we accept as such measures the age at first heart attack or the age at development of identifiable lung cancer or the average age at admission to nursing homes, available data suggest that the onset age of these markers may be increasing more rapidly than is life expectancy from age 40 in the United States.”
The paper relies on this without support.
The risk-factor model based heavily on cigarette smoking (pack/years) is valid for predicting lung cancer onset.
“Lung cancer age-specific incidence rates appear to have similarly changed and the risk-factor model based heavily on cigarette smoking (pack/years) suggests that as smoking decreases the effect will first be postponement of onset; that is, the requisite number of pack/years will be reached later in life.”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ The Compression of Morbidity > Policy Implications
“Two health-lives are diagrammed, the upper with poor health habits and the lower with better health habits.The period of adult vigor prior to infirmity is reduced in the lower example.”
§ The Compression of Morbidity > The Characteristics of Chronic Disease
“This individual is more vigorous, with a higher quality of life, for a longer period of time, and represents socially a much smaller burden on society.”
Citations
Cites
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Research works printed but not linked: 4
- Baltes P.B., 1980, Determining the Effects of Aging on the Central Nervous System
- Bowerman W.G, 1939, Centenarians, Transactions of the Actuarial Society of America, 40, 360
- Dittman‐Kohli F., 1983, Beyond Formal Operations: Alternative Endpoints to Human Development
- Robins M., 1981, Incidence of Stroke, Stroke, 12, 145
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On ne vieillit plus aujourd’hui de la même façon
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Payne, C., & Kobayashi, L. C. (2021) · American Journal of Epidemiology · doi:10.1093/aje/kwab241 · Cited by 11
HEALTH PROMOTION, HEALTH PROTECTION, AND PREVENTIVE SERVICES
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The urban–rural gap in older Americans’ healthy life expectancy
Chapel, J. M., Currid‐Halkett, E., & Tysinger, B. (2024) · The Journal of Rural Health · doi:10.1111/jrh.12875 · Cited by 10
Devicing future populations: Problematizing the relationship between quantity and quality of life
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Aging, Equality and the Human Healthspan
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U.S. Burden of Disease–Past, Present and Future
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Enjoyment and Success: Reciprocal Factors in Behavior Change
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Toward a Developmentally Informed Theory of Mental Disorder in Older Adults
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Die besonderen Anforderungen des hohen Alters im Hinblick auf das Sterben
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Health expectancy indicators: what do they measure?
di Lego, V. (2021) · Cadernos Saúde Coletiva · doi:10.1590/1414-462x202199010376 · Cited by 9
Silberman, J., Wang, C., Mason, S. T., Schwartz, S. M., Hall, M., Morrissette, J. L., Tu, X. M., & Greenhut, J. (2015) · PLoS ONE · doi:10.1371/journal.pone.0123910 · Cited by 9
Toward Reducing the Prevalence of Chronic Disease: A Life Course Perspective on Health Preservation
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Metadata
- Authors
- FRIES, J. F.
- Affiliations
- Stanford Medicine (US)
- Corresponding author
- FRIES, JAMES F.
- Venue
- The Milbank Quarterly
- Publisher
- Wiley
- Published
- 2005-11-09
- Volume
- 83
- Issue
- 4
- Pages
- 801-823
- ISSN
- 0887-378X (ISSN-L)
- 1468-0009
- PMC
- PMC2690269
- OpenAlex
- W2110353535
- Cited by
- 449
- References
- 50
- Citations by year
- 2026: 6 · 2025: 19 · 2024: 13 · 2023: 12 · 2022: 11 · 2021: 23 · 2020: 13 · 2019: 22 · 2018: 22 · 2017: 15 · 2016: 16 · 2015: 19 · 2014: 15 · 2013: 19 · 2012: 18
- FWCI
- 36.72
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Milbank Quarterly (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Demography › Insurance, Mortality, Demography, Risk Management
- Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Global Health Care Issues
- Keywords
- compression of morbidity, chronic disease, infectious disease decline, aging, senescence, lifespan, mortality trends, health policy, atherosclerosis, cancer, diabetes mellitus, osteoarthritis, emphysema, liver cirrhosis
- MeSH terms
- Aging, Chronic Disease, Health Services for the Aged, Health Status, Humans, Life Expectancy, Morbidity, Primary Prevention, Public Health, Public Health Administration, United States, History, 20th Century
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