Our world is changing

Key facts

• The number of people today aged 60 and over has doubled since 1980.
• The number of people aged 80 years will almost quadruple to 395 million between now and 2050.
• Within the next five years, the number of adults aged 65 and over will outnumber children under the age of 5.
• By 2050, these older adults will outnumber all children under the age of 14.
• The majority of older people live in low- or middle-income countries. By, 2050, this number will have increased to 80%.

 

In the 21st century, health is determined by and contributes to broad social trends. Economies are globalizing, more and more people live and work in cities, family patterns are changing and technology is evolving rapidly. One of the biggest social transformations is population ageing. Soon, the world will have more older people than children and more people of very old age than ever before.

1. The world will have more people who live to see their 80s or 90s than ever before
The number of people aged 80 years or older, for example, will have almost quadrupled to 395 million between 2000 and 2050. There is no historical precedent for a majority of middle-aged and older adults having living parents, as is already the case today. More children will know their grandparents and even their great-grandparents, especially their great-grandmothers. On average, women live six to eight years longer than men.

2. The past century has seen remarkable improvements in life expectancy
In 1910, the life expectancy for a Chilean female was 33 years; today, a mere century later, it is 82 years. This represents a remarkable gain of almost 50 years of life in one century, and is largely due to improvements in public health.

3. Soon, the world will have more older people than children
Within the next five years, for the first time in human history, the number of adults aged 65 and over will outnumber children under the age of 5. By 2050, these older adults will outnumber children under the age of 14.

4. The world population is rapidly ageing
Between 2000 and 2050, the proportion of the world’s population over 60 years will double from about 11% to 22%. The absolute number of people aged 60 years and over is expected to increase from 605 million to 2 billion over the same period.

5. Low- and middle-income countries will experience the most rapid and dramatic demographic change
For example, it took more than 100 years for the share of France’s population aged 65 or older to double from 7 to 14%. In contrast, it will take countries like Brazil and China less than 25 years to reach the same growth.

 

Determinants of healthy ageing

1. Healthy ageing is linked to health in earlier stages of life
Undernutrition in the womb, for example, may increase the risk of disease in adult life, such as circulatory diseases and diabetes. Respiratory infections in childhood may increase the risk of chronic bronchitis in adult life. Obese, or overweight, adolescents run the risk of developing chronic diseases, such as diabetes, circulatory disease, cancer, respiratory and musculo-skeletal disorders, in adult life.

2. Yet, how well we age depends on many factors
The functional capacity of an individual’s biological system increases during the first years of life, reaches its peak in early adulthood and naturally declines thereafter. The rate of decline is determined, at least in part, by our behaviours and exposures across the whole life course. These include what we eat, how physically active we are and our exposure to health risks such as those caused by smoking, harmful consumption of alcohol, or exposure to toxic substances.

 

Demographic changes are accompanied by new challenges

1. Even in poor countries, most older people die of noncommunicable diseases
Even in poor countries, most older people die of noncommunicable diseases such as heart disease, cancer and diabetes, rather than from infectious and parasitic diseases. In addition, older people often have several health problems at the same time, such as diabetes and heart disease.

2. The number of people living with disability is increasing due to population ageing and because of the greater risk of chronic health problems in older age
For example, about 65% of all people who are visually impaired are aged 50 and older, with this age group comprising about 20% of the world’s population. With an increasing elderly population in many countries, more people will be at risk of age-related visual impairment.

3. Globally, many older people are at risk of maltreatment
Around 4-6% of older people in developed countries have experienced some form of maltreatment at home. Abusive acts in institutions include physically restraining patients, depriving them of dignity (by for instance leaving them in soiled clothes) and intentionally providing insufficient care (such as allowing them to develop pressure sores). The maltreatment of older people can lead to serious physical injuries and long-term psychological consequences.

4. The need for long-term care is rising
The number of older people who are no longer able to look after themselves in developing countries is forecast to quadruple by 2050. Many of the very old lose their ability to live independently because of limited mobility, frailty or other physical or mental health problems. Many require some form of long-term care, which can include home nursing, community care and assisted living, residential care and long stays in hospitals.

5. Worldwide, there will be a dramatic increase in the number of people with dementias such as Alzheimer’s disease, as people live longer
The risk of dementia rises sharply with age with an estimated 25-30% of people aged 85 or older having some degree of cognitive decline. Older people with dementia in low- and middle-income countries generally do not have access to the affordable long-term care their condition may warrant. Often their families do not often have publicly funded support to help with care at home.

6. In emergency situations, older people can be especially vulnerable
When communities are displaced by natural disasters or armed conflict, older people may be unable to flee or travel long distances and may be left behind. Yet, in many situations they can also be a valuable resource for their communities as well as for the humanitarian aid process when they are involved as community leaders.

 

Fighting stereotypes

We all generally value and respect the older people we love or know well. But our attitudes to other older people within the broader community can be different. In many traditional societies, older people are respected as “elders”. However, in other societies, older women and men may be less respected. The marginalization can be structural, for example enforced retirement ages, or informal, such as older people being viewed as less energetic and less valuable to a potential employer. These attitudes are examples of “ageism” — the stereotyping of, and discrimination against, individuals or groups because of their age. Ageist attitudes can portray older people as frail, “past their sell-by date”, unable to work, physically weak, mentally slow, disabled or helpless. Ageism serves as a social divider between young and old.

These stereotypes can prevent older men and women from fully participating in social, political, economic, cultural, spiritual, civic and other activities. Younger people may also influence these decisions in the attitudes they convey to older people, or even by building barriers to their participation.

We can escape this vicious cycle by breaking down stereotypes and change our attitudes about older people. Here are a few examples.

Stereotype 1: Older people are “past their sell-by date”
While older workers are often presumed to be less productive than younger workers and studies show slight declines in information processing and attention with age, most individuals maintain mental competence and learning abilities well into older age. They also have the advantage of possessing experience and institutional memory. Deterioration in physical abilities may be much less than presumed. On 16 October 2011, British national Fauja Singh became the first 100 year-old to complete a marathon by running the Toronto Waterfront Marathon in Canada.

Stereotype 2: Older people are helpless
The fact that older people are particularly vulnerable in emergencies does not mean that older people in general are helpless. After the 2007 Cyclone Sidr in Bangladesh, older people’s committees took an active role, disseminating early warning messages to people and families most at risk, identifying those who were worst hit, compiling beneficiary lists and notifying them when and where to receive relief goods. After the 2011 earthquake and Tsunami in Japan, older people and retirees came forward to volunteer at the nuclear disaster sites, saying they were not afraid of becoming contaminated with radiation. Advanced in years, they were less worried about the long term impacts of the exposure.

Stereotype 3: Older people will eventually become senile
Occasional memory lapses are common at any age. And although the risk of developing dementia symptoms rises steeply with age in people over 60, possible signs of dementia (a loss of intellectual abilities), such as uncertainty about how to perform simple tasks, difficulty in completing sentences and confusion about the month or season, are not normal signs of ageing. Most older people are able to manage their financial affairs and their day-to-day lives. They can give informed consent for treatment or medical interventions they may need. In fact, some types of our memory stay the same or even continue to improve with age, as for example our semantic memory, which is the ability to recall concepts and general facts that are not related to specific experiences.

Stereotype 4: Older women have less value than younger women
People often equate women’s worth with beauty, youth and the ability to have children. The role older women play in their families and communities, caring for their partners, parents, children and grandchildren is often overlooked. In most countries, women tend to be the family caregivers. Many take care of more than one generation. These women are often themselves at advanced ages. For example, in sub-Saharan Africa, 20% of rural women aged 60 and older are the main carers for their grandchildren.

Stereotype 5: Older people don’t deserve health care
Treatable conditions and illnesses in older people are often overlooked or dismissed as being a “normal part of ageing”. Age does not necessarily cause pain, and only extreme old age is associated with limitation of bodily function. The right to the best possible health does not diminish as we age: It is mainly society that sets age limits for access to complex treatments or proper rehabilitation and secondary prevention of disease and disability.

It is not age that limits the health and participation of older people. Rather, it is individual and societal misconceptions, discrimination and abuse that prevent active and dignified ageing.

 

Source: http://www.who.int/world-health-day/2012/toolkit/background/en/