ABSTRACT
EARLIER IN this century, acute infectious conditions were the major causes of death. In contrast, conditions such as heart disease, cancer, and stroke are the leading causes of morbidity and mortality in the late 1990s. Accompanying this shift, a new emphasis is being placed on chronic illness and disability and on understanding the complex interactions among social, psychological, and biological factors that contribute to health and well-being in later life (Ory, Abeles, &Lipman, 1992). The decrease in mortality over the latter part of this century has also resulted in an increase in life expectancy and a significant growth in the ageband known as the oldest old. Recent predictions indicate that the age group of 75 years and older will increase by 76% in the 1990s alone (U.S. Bureau of the Census, 1991). This rate of increase is expected to continue, with the largest expansion predicted between 2010 and 2030 as the “baby boom” generation reaches age 65 (American Association of Retired Persons, 1987).
