The WHO’s recommendations for ageing well.
A 2002 WHO report Active Ageing: a Policy Framework lists the measures people can take individually or collectively to promote healthy ageing. These measures aim to reinforce communication efforts for the promotion of healthy behaviors, the prevention of chronic diseases and a fair and equal access to healthcare for all. The focus is placed on the necessary re-organization of long-term healthcare.
The Report Rationale
The proportion of people over 60 is increasing faster than any other age group in the world. Between 1970 and 2025, their number should increase by 694 million people, marking a 223% increase. In 2025, nearly 1.2 billion people will be over 60 years old. Meeting the specific needs of this population has become a health, social and economic priority. Accordingly, the WHO introduced the concept of active ageing, a process of “optimizing opportunities for health, participation and security in order to enhance quality of life as people age”. The elderly should be able to use their physical, mental and social potential to get involved in the life of the community according to their means and aspirations, while being provided the protection, security and healthcare they deserve. Therefore, “being active” is not limited to having a job or regularly engaging in a physical activity. It also refers to a large set of social, spiritual, cultural and civic activities. Thus, the ultimate goal is to maximize, on both individual and collective levels, healthy life expectancy (in other words, life without disability).
“In 2025, nearly 1.2 billion people will be over 60 years old in the world” (WHO, 2002).
What measures can be taken to promote active ageing?
In a 2002 report based on the work of experts, the WHO itemized several individual and collective strategies to enhance active ageing. From health promotion to disease prevention and equal access to long-term healthcare, the authors listed proven measures to reduce the number of premature deaths, alleviate the suffering associated with the consequences of chronic disease, improve quality of life, facilitate active participation in family, social, cultural, economic and political activities and optimize healthcare management.
En entire chapter was devoted to the prevention of chronic diseases, which will constitute a major economic and social burden for states and citizens in the coming years. These diseases include cardio-vascular diseases, hypertension, stroke, diabetes, cancer, chronic obstructive pulmonary disease, musculoskeletal conditions (e.g., arthritis), mental health conditions, dementia and visual impairment. They are due to risk-taking behaviors rather than hereditary factors (of genetic origin and present at birth). They are very costly and represent the greatest portion of health expenses for people over 60.
Successful ageing should limit the impact of chronic diseases. The global evolution of the health and social consequences of ageing makes the fight against chronic diseases a third millennium priority. It requires us to move from a health reparation model to one of coordinated, long-term and comprehensive care. This will also require a reorientation of healthcare systems, which are currently designed to handle the acute instances of diseases, and are therefore inadequately organized to meet the needs of ageing populations. To be efficacious, these modifications must be implemented jointly by healthcare and health prevention professionals, employers and social organizations.
« 1. Prevent and reduce the burden of excess disabilities, chronic disease and premature mortality.
2. Reduce risk factors associated with major diseases and increase factors that protect health throughout the life course (physical activity, nutrition, smoking cessation, moderate alcohol consumption, oral health, developing cognitive resources, sound use of medications).
3. Develop a continuum of affordable, accessible, high quality and age-friendly health and social services that address the needs and rights of women and men as they age.”
4. Provide training and education to caregivers.”
« 1. Provide education and learning opportunities throughout the life course.
2. Recognize and enable the active participation of people in economic development activities, formal and informal work and voluntary activities as they age, according to their individual needs, preferences and capacities.
3. Encourage people to participate fully in family community life, as they grow older.”
“1. Ensure the protection, safety and dignity of older people by addressing the social, financial and physical security rights and needs of people as they age.
2. Reduce inequities in the security rights and needs of older women.”
The necessary re-organization of healthcare, from a curative model to a preventive and comprehensive care model.
What it means for Patients
Adopting a healthy lifestyle and actively contributing to one’s own health is critical at any age. The assumption that, after a certain age, it is too late to make positive changes is erroneous. Regular and adequate exercise, healthy eating, not smoking, abstaining from alcohol or drinking moderately, and using medication reasonably can all help prevent disease, limit functional decline and increase longevity and quality of life.
What it means for Healthcare Professionals
A high-fat (saturated fats), sodium-rich, fruit- and vegetable-poor diet which does not provide sufficient fibers and vitamins, combined with a sedentary lifestyle, represents a high-risk factor for chronic diseases such as diabetes, cardiovascular diseases, hypertension, obesity, arthritis and some cancers. By adopting simple behaviors to avoid these diseases, people optimize their chances of ageing successfully.
What it means for Researchers
It is possible to prevent or delay age-related disabilities. Thus, in the last 20 years, thanks to lifestyle changes, disability rates have fallen in the U.S., in Great Britain and in Sweden. According to forecasters, increasing the ability of people over 60 to live independently will reduce medical costs by 20% in the next 50 years. Each dollar spent on promoting regular, moderate physical activity saves 3.2 dollars of medical expenses.
What it means for Policymakers
By Focusing solely on employment, we fail to take into account seniors’ informal participation in the economy (small jobs, crafts, domestic work, gardening, handiwork, etc.). A new model must be put in place, which will view the elderly as integrated, active participants in the life of the community, who contribute to, as well as benefit from, its development.
World Health Organization (2002). Active Ageing: a Policy Framework. WHO: Geneva.
To reference this Blog en Sante © article.
Ninot G (2014). Successful Ageing: the Great Challenge of the Third Millennium. Blog en Santé, A25.
© Copyright 2014 Grégory Ninot. All rights reserved.
Thanks to Syl Billere for the English Revision.