Abstract
In 1962, Leonard W. Larson, MD, then president of the American Medical Association, called for a ‘revolution in aging’. He charged physicians to reformulate medicine from ‘defence to offence’ by emphasising healthy behaviour in the individual throughout the life course (Larson, 2003). Dr. Larson recognised that these changes in medicine were especially important in the context of an ageing society. Since then, the US population has aged significantly, and technological advances have changed the length and nature of the aging process. Chronic, disabling illnesses dominate the landscape of health care needs, while the delivery system remains devoted to acute care. ‘The role of (acute) medical care in preventing sickness and premature death is secondary to that of other influences; yet society’s investment in health care is based on the premise that it is the major determinant’ (McKeown, 1979).