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Abstract
In 1999, in France over 2,3 million people celebrated their 80th birthday, in other words, 4% of the total population. This age group, expanding greatly over the long term, has remained stable over the past ten years. Within this group, the 90 years of age and over section has been expanding continuously and the average age of the very elderly particularly increased between the last two population censuses. This period of life is marked by widowhood, especially for women, even if this is lessening. Intergenerational co-habitation is in decline in favour of isolated living and to a lesser degree of living as a couple or in an institution which happens later and later.© Fondation Nationale de Gérontologie.
Social gerontology, as a distinct discipline, has been slower to develop in France than in Anglo-Saxon countries. Gerontological discourses have been dominated by the medical and physical sciences. At the same time, France has a long tradition of research on ageing that incorporates important social dimensions, particularly in demographic and economic fields. Current developments include research on pensions and related issues such as early-retirement or older people in the labour force; inter-generational relations or family solidarity; disabled elderly people and caring; and ageing among ethnic minority populations. These developments point in the direction of co-ordinated, multi-disciplinary approaches to the life course and ageing in the future.
The main theories on population aging based on recent data on human longevity, life expectancy, morbidity changes, disability trends, and mortality decrease are presented and discussed within their own geographic, cultural, socioeconomic, and medical contexts. The complex interactions between all these components do not facilitate trend forecasting of aging population (healthy aging versus disability pandemic). In the context of population aging, four elements were introduced with their implications: 1) an increase in the survival rates of sick persons, which would explain the expansion of morbidity, 2) a control of the progression of chronic diseases, which would explain a subtle equilibrium between the decrease in mortality and the increase in disability, 3) an improvement of the health status and health behaviors of new cohorts of elderly people, which would explain the compression of morbidity, and eventually 4) an emergence of very old and frail populations, which would explain a new expansion of morbidity. Obviously, all these elements coexist today, and future trend scenarios-expansion or compression of disability-depend on their respective weights leading to the need of elaborating "a general theory on population aging." This theory has to be based on a world harmonization of functional decline measurements and a periodic "International Aging Survey" to monitor global aging through a sample of carefully selected countries.
The main theories of population ageing based on recent data on human longevity, life expectancy, morbidity changes, disability trends and fall in mortality show co-existing contradictory tendencies in disability and functioning. These contradictions reflect differences in geographic, cultural, socio-economic, political and medical contexts, for instance:• an increase in the survival rates of sick persons which would explain the expansion of morbidity and/or disability that is now taking place in Taiwan,• control of the progression of chronic diseases which would explain the subtle equilibrium between the fall in mortality and the increase in disability currently observed in the U.K.,• an improvement in the health status and health behaviours of the new cohorts of old people which would explain the reduction in morbidity and/or disability now found in France, Switzerland and the U.S. The Geneva Papers on Risk and Insurance (2004) 29, 667–678. doi:10.1111/j.1468-0440.2004.00309.x
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