The compression of morbidity.

The nature of the international health burden, its changes, its problems, and even its solutions over the next quarter century are surprisingly apparent at this time and are more positive than often supposed. The average period of lessened physical status is likely to shorten, and the need for and cost of hospitalization in the later life of the individual is likely to decrease. The period of infirm physical status will become increasingly compressed between the increasing age at onset of infirmity and the genetically determined lifespan of the individual. Illness at the end of life will come relatively suddenly, be multi-factorial in cause, will be highly resistant to further medical intervention, and will be characterized by increasing inevitability. Implications for retirement age, availability of useful work for older individuals, and programmes designed to stimulate rather than support are discussed.