As people across the world live longer, soaring levels of chronic illness and diminished wellbeing are poised to become a major global public health challenge.
A major investigation on health and ageing, published in the medical journal The Lancet, warns that unless health systems find effective strategies to address the problems faced by an ageing world population, the growing burden of chronic disease will greatly affect the quality of life.
By 2020, for the first time in history, the number of people aged 60 years and older will outnumber children younger than 5 years.
By 2050, the world’s population aged 60 years and older is expected to total 2 billion, up from 841 million today. 80% of these older people will be living in low-income and middle-income countries
The increase in longevity, especially in high-income countries, has been largely due to the decline in deaths from cardiovascular disease such as stroke and heart disease, mainly because of strategies to reduce tobacco use and high blood pressure.
However, although people are living longer, they are not necessarily healthier than before.
Nearly a quarter (23%) of the overall global burden of death and illness is in people aged over 60.
And much of this burden is attributable to long-term illness caused by diseases such as cancer, chronic respiratory diseases, heart disease, arthritis, osteoporosis, and mental and neurological disorders.
This long-term burden of illness and diminished wellbeing affects patients, their families, health system, and economies, and is forecast to accelerate.
The latest estimates indicate that the number of people with dementia is expected to rise from 44 million now to 135 million by 2050.
“Deep and fundamental reforms of health and social care systems will be required,” says Dr John Beard, Director of the Department of Ageing and Life Course at the World Health Organization (WHO).
“But we must be careful that these reforms do not reinforce the inequities that drive much of the poor health and functional limitation we see in older age.”
However, the responsibility for improving quality of life for the world’s older people goes beyond the health sector.
Strategies are needed that better prevent and manage chronic conditions by extending affordable health care to all older adults and take into consideration the physical and social environment.
Examples include changing policies to encourage older adults to remain part of the work force for longer, emphasising low-cost disease prevention and early detection rather than treatment such reducing salt intake, making better use of technology (mobile clinics for rural populations), and training health-care staff in the management of multiple chronic conditions.
The world needs to look beyond the costs commonly associated with ageing to think about the benefits that an older, healthier, happier and more productive older population can bring to society as a whole.
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