that in developing research priorities all five of the research areas were felt to be of first-rank importance, and the committee emphasizes that support should extend across all five of the fields of age-related research described in this report. Within each field of research, priorities are ranked according to their importance to the understanding of aging and their potential to improve the quality of life for older persons.

A national research agenda on aging has a broad multidisciplinary view, but it must be selective. The charge by the IOM dictated an agenda with the most promise for substantial impact on the individual during the next two decades—that is, research on the health and functioning of older individuals.

BACKGROUND

Support for Training and Research in Geriatrics and Gerontology

At the heart of health care for the older population are the educational programs that train the professionals who can respond to the health problems of elderly persons and make the scientific discoveries that will improve the quality of life of the later years. A 1980 study predicted that by the year 1990 training would be needed to produce 7,000 to 10,300 geriatricians to provide care for older persons having the most complex geriatric problems—those 75 years of age and over (Kane et al., 1980).

Programs for training have not met this goal, as shown by the finding that by the mid-1990s there will be only 5,000 certified geriatricians in this country (Reuben et al., 1990). To train an adequate number of geriatricians, Kane et al. (1980) estimated a fulltime geriatric faculty of 1,230 to supervise hospital training programs in internal medicine or family practice, plus 370 to staff medical schools, and 450 for geropsychiatry, totaling about 2,100 faculty members and comprising both academic clinicians and researchers.

A 1987 IOM study, commenting on the small number of geriatric training programs (under 5 percent of all postgraduate medical programs), found that these programs graduated about 100 fellows per year and recommended that to meet needs for biomedical faculty by the year 2000 the number of graduates per year should be raised to at least 200 (IOM, 1987). Another study found training programs far short of goals for the year 2000 to develop nonbiomedical (mainly behavioral and social scientists) faculty in aging (National Institute on Aging, 1987). The serious shortage of faculty and researchers in



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