Having a chronic disease does not mean that one becomes incapacitated. Even though the type and severity of chronic conditions vary across peo­ple, most older adults manage to figure out how to accomplish the necessary tasks of daily living despite having a chronic condition.

Although most people manage to accomplish the necessary tasks of daily living, they may experience limitations in functioning. Chronic conditions can make life unpleasant and in some cases can increase susceptibility to other diseases. Understanding chronic conditions requires understanding how the four developmental forces interact. We saw in Chapter 3 that researchers are beginning to understand genetic connections with such chronic conditions as cardiovascular disease and cancer. Other biological aspects include the changes in

physical systems with age, including the immune system, that can set the stage for chronic conditions. Psychological aspects key to chronic disease include the coping skills people bring to bear on their conditions; we consider some of these later in this chapter. Sociocultural factors include the lack of adequate health care, which creates barriers to treat­ment. The ethnic group differences in some chronic conditions, such as hypertension, are also important to keep in mind. Finally, life-cycle factors help us understand why reactions to the same chronic con­dition vary with the age of onset. Moreover, some conditions, such as rheumatoid arthritis, can occur at any point in adulthood, whereas others, such as prostate cancer, tend to occur most after midlife. As the number of older adults increases rapidly, so will the extent of chronic conditions as health problems. This will necessitate a fundamental change in health care, reflecting a shift from an acute care focus to one that focuses much more on managing chronic conditions. Let’s consider some of the most com­mon chronic conditions.