Aging and Global health Flashcards
What is the difference between population aging and old?
- Population aging:
- The process by which older individuals make up a proportionally larger share of the total population over a period of time
- Defining Old:
- Over pensionable age
- Males >65 years
- Females> 60 years
- Over pensionable age
- N.B. chronological age does not equate to biological age
What are the Global demographics?
- Elderly population increasing by 2.4% per year
- 1950: 8/100 population >60yrs
- 2050:22/100 population >60yrs
- Old old’ (>85yrs) ageing fastest
- By 2045, global population >60yrs will exceed children <15yrs
- ‘Mass ageing’ a result of;
- Low fertility rates
- Reducing adult mortality rates
- International migration
- Medical & technological advances
- Most of worlds older population in developing countries
- Most of older population are women
What is the change in demographic in developed nations (aging)?
•Since 19th century
- –Life expectancy increased
- –Reduced fertility rates
- –Decreased adult mortality
Percentage of the population:
- ~20% population >60yrs (2000)
- ~33% population >60yrs (2050)
- 70% >60yrs in urban areas
•More elderly Females than males
What are the social implications for this change in population demographic?
Remember that implications means the conclusions that could be drawn from this change
Social
-
Marital status
- >65 yrs: most males married, ~1/2 females widowed
- >80 yrs: ¾ or more widowed
-
Living arrangements
- Increased proportion of older people living alone or in institutions
-
Education
- Decreased levels educational attainment in ‘old old’
What are the economic implications for an aging population (change in demographic)?
Remember that implications means the conclusions that could be drawn from this change
Health
- 1960: 3.2% GDP → 1996: 8.2% GDP
- Increased expenditure on healthcare with age
- Acute care costs decrease with extremes of age
Labour Force/ Retirement
- Decline in retirement age in many developed countries
- Increased economic vulnerability with retirement
- Increased pension expenditure: >9% GDP (OECD Nations)
What does the England and Wales 2011 Census state about the population and demographics?
- The population has reached 56.1 million, up by 3.7 million in a decade.
- The percentage of the population aged 65 and over was the highest seen in any census - at 16.4%
- There were 430,000 residents aged 90 and over in 2011 compared with 340,000 in 2001 and 13,000 in 1911
What are contributors to the ageing of the UK population?
- Decreased infant mortality
- Increased standard of living
- Improvements in public health
- Improvements in sanitation
- Improved diet-1842 abolition of corn laws allowed importation of cheap American Food.
What are the demographic trends in the first 50 years of the NHS?
In terms of infant mortality/1000 live births
1948:
Girls: 39 mortalities
Boys 30 mortalities
1996
Girls : 7 mortalities
Boys: 5 mortalities
-
Can you describe the demographic trends in the first 50 years of the NHS in reference to the proportion of deaths below 65 in England and Wales
- In 1948, there were 40% of deaths below 65
- In 1996, there were 7% of deaths below 65
Can you describe the life expectancy at birth in the UK?
LIFE EXPECTANCY HAS INCREASED
Can you describe LE over 60 and 80 in the UK
What is the theoretical gloom?
- Exponential relationship between age and prevalence of disability
- Exponential relationship between age and chronic disabling diseases
Is there room for ‘compression of morbidity’
What are some chronically disabling diseases that have a steep relationship to age?
- Stroke
- Alzheimer’s disease
- Parkinson’s disease
- Osteoarthritis
Describe the graph of shifting demograhics
- Epilepsy is the third most common neurological disorder affecting older adults after stroke and dementia, and the incidence of epilepsy is increasing rapidly in this population.
- A further increase in the incidence and prevalence of epilepsy is expected in aging societies
- The establishment of a differential diagnosis between epilepsy and other seizure disorders that are common in the elderly is crucial.
- symptoms of seizures in the elderly may be different from those in younger populations.
- The diagnosis is difficult, probably because of nonspecific characteristics, short-term symptoms, and absence of witnesses
What are the causes of disability in old people?
Poverty/isolation
Physiological ageing bringing clinical threshold closer
Acute illness Global Impact
Chronic illness
Describe the age dependency profile of elderly people by age
With the declining size of the average family, the numbers of children moving into adulthood and employment has reduced, and this combined with the rising proportion of those of post-retirement age in a population, results a widening ‘dependency-ratio’.
The dependency ratio measures the percentage of dependent people (not of working age) divided by the number of people of working age (economically active).
The ‘old age dependency-ratio’ OADR is the number of people over 65 years old for every 1,000 people aged between 16 and 64 years old (Fig 2).
This widening OADR (as well as various other social changes) has created pressures around the fiscal sustainability of health and long-term care systems (including - personal care, community care and institutional care provided in individual’s own homes or nursing homes and assisted living facilities in residential accommodation).
Compressional morbidity
- Compressional morbidity-> people were living longer, therefore it was assumed that people would live longer with morbidity, however healthcare systems are improving. So the time (years) that people are living with morbidity is decreasing (people are healthier than their parents)
By delaying the onset of disabling diseases to later ages when intrinsic ageing has raised fatality by reducing adaptability, the average duration of disability before death will be shortened. In brief, we will spend a longer time living and a shorter time dying
What are the trends in the geriatric handicap scale (GHS) between 1980 and 2001?
No overall change in proportion of elderly people reporting their health as good (37%) fairly good (38%) and not good (25%)
Proportion of people reporting long-standing illness has not changed significantly
Describe pattens of dependant life before death
What does the management of older people require?
Disease prevention programmes
Sometimes spending on machinary that helps in surgeries.
Comprehensive Geriatric Assessment when illness strikes
Further research into the causes of and management of frailty
Aging in developing nations
Life expectancy increasing
Fertility rates diminishing
Increased median age
e.g. Indonesia 23→31 (2020)
Uganda 15→20 (2020)
Older people account for:
◦8% population (2007)
◦20% population (2050)
Less time to adjust to rapid changes
Lower Socio-economic development
