In this issue of the Archives, 2 different assessments are presented as ways of identifying favorable outcomes in aging. In the article by Sarnak et al,1 a definition of successful aging encompasses a clinical state in which major chronic diseases, cognitive impairment, and physical disability are absent, while in the article by Cherkas and colleagues,2 longer telomere length is proposed as a potential positive outcome in evaluating the aging process. Although these outcomes may not have anything in common, they do raise the question of whether, in aging research, we should be considering alternatives to the medical model of diagnosing and treating well-defined diseases.3 Are there laboratory measures or health states that we should focus on when trying to learn more about how risk factors and protective factors affect the whole older individual? In the case of the 2 articles featured herein, a marker of kidney disease, cystatin C, and physical activity are evaluated for their relationships with successful aging and telomere length. Ultimately, outcomes such as these may serve a useful role in research on improving health status in our increasingly older population.
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The Rational Clinical Examination
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