在20世纪伊始,美国只有0.5%的人口超过80岁。肺结核和脊髓灰质炎等传染性疾病在工业化国家发病率很高。骨质疏松等普通的老年疾病在当时甚至不被视为疾病。
Today, 3.6 percent of the population is over 80, and life is heavily prescribed not only with the behaviors we should avoid, but the medications we ought to take. More than half of adults age 65 and older are taking five or more prescription medications, over-the-counter medications or dietary supplements, many of them designed not to treat acute suffering, but instead, to reduce the chances of future suffering. Stroke, heart attacks, heart failure, kidney failure, hip fracture — the list is long, and with the United States Department of Health and Human Services’ plan to prevent Alzheimer’s disease by 2025, it grows ever more ambitious.
如今,美国3.6%的人口年过八旬,而我们的生活也被严格地规定了:不仅要注意避免某些行为,还要注意吃药。65岁以上的人之中,有一半人以上要吃五种乃至更多处方药、非处方药或膳食补充剂,其中很多并非用来治疗急性病,而是为了降低未来的发病率。中风、心脏病、心力衰竭、肾衰、髋关节骨折……这个名单很长,而且美国卫生和公众服务部计划到2025年实现预防阿兹海默症,这个名单还会变得更庞大。
Aging in the 21st century is all about risk and its reduction. Insurers reward customers for regular attendance at a gym or punish them if they smoke. Physicians are warned by pharmaceutical companies that even after they have prescribed drugs to reduce their patients’ risk of heart disease, a “residual risk” remains — more drugs are often prescribed. One fitness product tagline captures the zeitgeist: “Your health account is your wealth account! Long live living long!”
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