Ageing Explained
Ageing Explained
Ageing Explained
Today, for the first time in history, most people can expect to
live into their sixties and beyond. By 2050, the world’s population aged 60 years and older is
expected to total 2 billion, up from 900 million in 2015. Today, 125 million people are aged 80
years or older. By 2050, there will be almost this many (120 million) living in China alone, and
434 million people in this age group worldwide. By 2050, 80% of all older people will live in low-
and middle-income countries.
The pace of population ageing around the world is also increasing dramatically. France
had almost 150 years to adapt to a change from 10% to 20% in the proportion of the
population that was older than 60 years .However, places such as Brazil, China and
India will have slightly more than 20 years to make the same adaptation.
While this shift in distribution of a country's population towards older ages – known as
population ageing - started in high-income countries (for example in Japan 30% of the
population are already over 60 years old), it is now low- and middle-income countries
that are experiencing the greatest change. By the middle of the century many countries
for e.g. Chile, China, the Islamic Republic of Iran and the Russian Federation will have a
similar proportion of older people to Japan.
A longer life brings with it opportunities, not only for older people and their families, but
also for societies as a whole. Additional years provide the chance to pursue new
activities such as further education, a new career or pursuing a long neglected passion.
Older people also contribute in many ways to their families and communities. Yet the
extent of these opportunities and contributions depends heavily on one factor: health.
There is, however, little evidence to suggest that older people today are experiencing
their later years in better health than their parents. While rates of severe disability have
declined in high-income countries over the past 30 years, there has been no significant
change in mild to moderate disability over the same period.
If people can experience these extra years of life in good health and if they live in a
supportive environment, their ability to do the things they value will be little different from
that of a younger person. If these added years are dominated by declines in physical
and mental capacity, the implications for older people and for society are more negative.
Ageing explained
At the biological level, ageing results from the impact of the accumulation of a wide
variety of molecular and cellular damage over time. This leads to a gradual decrease in
physical and mental capacity, a growing risk of disease, and ultimately, death. But these
changes are neither linear nor consistent, and they are only loosely associated with a
person’s age in years. While some 70 year-olds enjoy extremely good health and
functioning, other 70 year-olds are frail and require significant help from others.
Beyond biological changes, ageing is also associated with other life transitions such as
retirement, relocation to more appropriate housing, and the death of friends and
partners. In developing a public-health response to ageing, it is important not just to
consider approaches that ameliorate the losses associated with older age, but also
those that may reinforce recovery, adaptation and psychosocial growth.
Older age is also characterized by the emergence of several complex health states that
tend to occur only later in life and that do not fall into discrete disease categories. These
are commonly called geriatric syndromes. They are often the consequence of multiple
underlying factors and include frailty, urinary incontinence, falls, delirium and pressure
ulcers.
Although some of the variations in older people’s health are genetic, much is due to
people’s physical and social environments – including their homes, neighbourhoods,
and communities, as well as their personal characteristics – such as their sex, ethnicity,
or socioeconomic status.
These factors start to influence the ageing process at an early stage. The environments
that people live in as children – or even as developing foetuses – combined with their
personal characteristics, have long-term effects on how they age.
There is no ‘typical’ older person. Some 80 year-olds have physical and mental
capacities similar to many 20 year-olds. Other people experience significant declines in
physical and mental capacities at much younger ages. A comprehensive public health
response must address this wide range of older people’s experiences and needs.
Health inequities
The diversity seen in older age is not random. A large part arises from people’s physical
and social environments and the impact of these environments on their opportunities
and health behaviour. The relationship we have with our environments is skewed by
personal characteristics such as the family we were born into, our sex and our ethnicity,
leading to inequalities in health. A significant proportion of the diversity in older age is
due to the cumulative impact of these health inequities across the life course. Public
health policy must be crafted to reduce, rather than reinforce, these inequities.
Older people are often assumed to be frail or dependent, and a burden to society.
Public health, and society as a whole, need to address these and other ageist attitudes,
which can lead to discrimination, affect the way policies are developed and the
opportunities older people have to experience Healthy Aging.
WHO’s response
In accordance with a recent World Health Resolution (67/13), a comprehensive Global
Strategy and Action Plan on Ageing and Health is being developed by WHO in
consultation with Member States and other partners. The Strategy and Action Plan
draws on the evidence of the World report on ageing and health and builds on
existing activities to address 5 priority areas for action.
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