WHO on ageing and life course
WHO
Populations around the world are rapidly ageing. Ageing presents both challenges and opportunities. It will increase demand for primary health care and long-term care, require a larger and better trained workforce and intensify the need for environments to be made more age-friendly. Yet, these investments can enable the many contributions of older people whether it be within their family, to their local community (e.g. as volunteers or within the formal or informal workforce) or to society more broadly.
Societies that adapt to this changing demographic and invest in Healthy Ageing can enable individuals to live both longer and healthier lives and for societies to reap the dividends.
What is healthy ageing?
Every person in every country in the world should have the opportunity to live a long and healthy life. Yet, the environments in which we live can favour health or be harmful to it. Environments are highly influential on our behaviour, our exposure to health risks (for example air pollution, violence), our access to quality health and social care and the opportunities that ageing brings.
Healthy Ageing is about creating the environments and opportunities that enable people to be and do what they value throughout their lives. Everybody can experience Healthy Ageing. Being free of disease or infirmity is not a requirement for Healthy Ageing as many older adults have one or more health conditions that, when well controlled, have little influence on their wellbeing.
Healthy ageing and functional ability
WHO defines Healthy Ageing as the process of developing and maintaining the functional ability that enables wellbeing in older age. Functional ability is about having the capabilities that enable all people to be and do what they have reason to value.
This includes a persons ability to:
meet their basic needs;
to learn, grow and make decisions;
to be mobile;
to build and maintain relationships; and
to contribute to society.
Functional ability is made up of the intrinsic capacity of the individual, relevant environmental characteristics and the interaction between them.
Intrinsic capacity comprises all the mental and physical capacities that a person can draw on and includes their ability to walk, think, see, hear and remember. The level of intrinsic capacity is influenced by a number of factors such as the presence of diseases, injuries and age-related changes.
Environments include the home, community and broader society, and all the factors within them such as the built environment, people and their relationships, attitudes and values, health and social policies, the systems that support them and the services that they implement. Being able to live in environments that support and maintain your intrinsic capacity and functional ability is key to Healthy Ageing.
Key considerations of healthy ageing
Diversity: There is no typical older person. Some 80-year-olds have levels of physical and mental capacity that compare favourably with 30-year-olds.
Others of the same age may require extensive care and support for basic activities like dressing and eating. Policy should be framed to improve the functional ability of all older people, whether they are robust, care dependent or in between.
Inequity: A large proportion (approximately 75%) of the diversity in capacity and circumstance observed in older age is the result of the cumulative impact of advantage and disadvantage across peoples lives. Importantly, the relationships we have with our environments are shaped by factors such as the family we were born into, our sex, our ethnicity, level of education and financial resources.
Healthy ageing and active ageing
Healthy Ageing is the focus of WHOs work on ageing between 2015 2030. Healthy Ageing replaces the World Health Organizations previous Active ageing: a policy framework developed in 2002. Healthy Ageing, like Active Ageing, emphasizes the need for action across multiple sectors and enabling older people to remain a resource to their families, communities and economies.
Age-friendly environments
Akita City
Health and well-being are determined not only by our genes and personal characteristics but also by the physical and social environments in which we live our lives.
Environments play an important role in determining our physical and mental capacity across a persons life course and into older age and also how well we adjust to loss of function and other forms of adversity that we may experience at different stages of life, and in particular in later years. Both older people and the environments in which they live are diverse, dynamic and changing. In interaction with each other they hold incredible potential for enabling or constraining Healthy Ageing.
Health systems that meet the needs of older people
As people age, their health needs tend to become more complex with a general trend towards declining capacity and the increased likelihood of having one or more chronic diseases. Health services are often designed to cure acute conditions or symptoms and tend to manage health issues in disconnected and fragmented ways that lack coordination across care providers, settings and time.
Health systems need to be transformed so that they can ensure affordable access to evidence-based medical interventions that respond to the needs of older people and can help prevent care dependency later in life.
Long-term-care systems
Older people continue to have aspirations to well-being and respect regardless of declines in physical and mental capacity. Long-term-care systems enable older people, who experience significant declines in capacity, to receive the care and support of others consistent with their basic rights, fundamental freedoms and human dignity.
These services can also help reduce the inappropriate use of acute health-care services, help families avoid catastrophic care expenditures and free women usually the main caregivers to have broader social roles.
While global data on the need and unmet need for long-term care do not exist, national-level data reveal large gaps in the provision of and access to such services in many low- and middle-income countries.
Data and research
Focused research, new metrics and methods could give a far better understanding of Healthy Ageing and are essential for evidence-informed policy and evaluation.
To achieve this, appropriate measures of Healthy Ageing need to be agreed on and collected through vital statistics, health and social care services, and population surveys across countries. Research in a range of fields contributing to Healthy Ageing across the life course is also required, as are mechanisms to ensure its rapid translation into clinical practice, systems strengthening, population-based health interventions, and shaping of health and broader socio-economic policies.
Credit:Judith Escribano/ Age International
HelpAge International/Antonio Olmos
