or health span should be the focus of much of the next phase of aging research. Such an effort must avoid the simple generalization of health promotion/disease prevention research in middle age to older populations. Instead, it should take into account the special physiological characteristics of the elderly and should focus in particular on such disorders as dementia, incontinence, and falls, which are particularly common and disabling in elderly populations.

  1. Studies of the role of genetics, social, and environmental factors as modifiers of aging: The effects of the aging process itself have been exaggerated; the modifying effects of the individual's genetic background, nutritional status, exercise, personal habits, and psychosocial factors have been underestimated.

  2. The psychological and sociological context of the individual: Interdisciplinary approaches that consider both the influence of the individual's behavior and environment and social interactions and support systems will be crucial. Equally important is the need to explain specific age-related findings.

  3. Expansion of health services delivery research: Many of the issues discussed in this section (e.g., the study of the effectiveness of interventions and the investigation of financing of care) may be implemented by the techniques and mechanisms special to the field of health services delivery. This discipline often serves as the interface between scientific application and political policy decisions affecting the delivery of health care to millions of Americans. Health services delivery research can provide objective information to policymakers, assisting them in developing their programs on a more scientific basis and providing tools for analyzing the usefulness of these programs.

  4. Ethical considerations in the care of the elderly as a research focus: Previous agendas for research on aging have seriously neglected ethical issues, such as the rationing of health care and the provision of care to and the conduct of research on demented and irreversibly ill older persons, especially with regard to the application of life-sustaining technologies.

One of the major scientific challenges for the United States over the next decade will be to enlarge our research capacity in aging so that we gain the knowledge necessary to deal with the health, social, and psychological needs of a rapidly aging society. This plan provides a prioritized and rational blueprint for that research development.

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