Transcript Document

Ageing & Decline
How Much? How Soon?
How Inevitable?
What Does the Research Say?
AHIA Conference
November 2005
The Ageing Demographic
Successful Ageing
Contemporary Perspectives
The Ageing
of the
Population
By the end of the 20th century, the
global population aged over 60
years was approximately 600
million.
In only 25 years, this number will
double and by 2025 there will be
1200 million people in this age
group.
The number of Australians
over 65 years of age has
increased by 67% in the last
20 years.
Between 2002 and 2022, the number
of 15 to 19 year olds in Western
Australia will increase by 10,000.
In the same period of time, the
increase in the number of individuals
aged between 50 and 59 years of
age will be 110,000.
(Australian Bureau of Statistics)
In terms of workforce growth – the
working age population currently
grows by around 170,000 per year.
By the decade of the 2020’s, that
increase will drop to an average of
less than 13,000 per year.
(Access Economics)
Australia first set the retirement age in
1909, at 65 years of age.
The average life expectancy for the
Australian male was 58.
If public policy had kept pace with
medical advances and the increase
in life expectancy, by the year 2000
our retirement age would have been
around 80 years.
 The
increase in lifespan was one of
the triumphs of the 20th century.
 This
increase in lifespan in this 100
years was greater than what was
attained in the previous 5000 years of
human history.
 Until
the 1970’s most research
into ageing looked at negative
impacts such as disease and
cognitive decline.
 There
is now research emerging
on the positive impacts on
ageing.
The emerging research is overwhelming
in its evidence that a positive approach
and investment in ageing well can
improve the quality and the quantity of
later years.
The WHO states that the challenge in
this century is to decrease the period of
morbidity at the end of the lifespan.
“No one is terrified about
growing old in itself, but the
terror is in becoming clinically
dependant.”
Prof. Suresh Rattan, DSc, PhD. Research Professor,
University of Aarhus, Denmark
LEB
HALE
Life Expectancy at Birth
Healthy Life Expectancy (Health Adjusted Life
Expectancy)
LEB
Australia:
Male:
Female:
80.4 years
77.9
83.0
HALE
Australia:
Male:
Female:
72.6
70.9
74.3
Lifespan lost to ill-health:
Australia:
Male:
Female:
9.7%
9.0%
10.5%
WHO 2003
What
Is
Successful
Ageing?
Successful Ageing concerns itself
with:
How you can maximise function as you
age
Minimising the ‘period of morbidity’
A risk-management strategy for one’s
own well-being
Healthspan in relation to lifespan
Successful Ageing is not a denial of the
ageing process
“Successful Ageing is defined as the
ability to maintain low risk of
disease or disability, high mental &
physical function, and active
engagement with life.”
MacArthur Foundation Study
Maintaining Low Risk of
Disease & Disability
Emerging research data concludes:
As we grow older, the influence of
environmental factors on our health
become more important, and the
influence of genetic factors becomes
less important
Our course in older age is not
predetermined as we have
understood it
The frailty of old age is essentially
avoidable and largely reversible
Harvard Medical School Report 2001
The human body essentially lives in
a hostile environment, both
externally and internally.
Modern medicine has developed
as a repair response to
‘breakdown’ or damage, rather
than as a preventative action.
Many of the chronic diseases of
mature age are preceded by signs
(albeit silent signs) For example:

increase in blood pressure

increase in BMI or abdominal fat

blood sugar increase

decrease in function of lung, kidneys

decrease in bone density & muscle
mass.
These signs of ageing are often
accepted as ‘usual’ in the mature
individual, however, research has
now established these ‘usual’
conditions are caused in large part
by our pathology – how we live – and
not only by our biology – our genes.
Maintaining Physical
&
Cognitive Function
The 1% Rule
Medical scientists have previously
agreed that after age 25, we lose
1% per year in aerobic capacity,
strength, speed and other physical
attributes.
It is now increasingly clear that it
doesn’t have to be that way.
The 1% rule applies only to those
who lead a sedentary life.
Physical activity is at the crux of
successful ageing, regardless of
other factors.
Couch potatoes are now being
grouped with cigarette smokers as
taking their lives in their own hands.
MacArthur Foundation Study
New research establishes that
a moderate PA level has a
powerful capacity to improve
the overall health outlook.
Cardio respiratory Fitness, Risk Factors
and All-Cause Mortality, Men, ACLS
Deaths/10,000 MY*
(Steven N. Blair, Cooper Institute, Dallas, Texas)
60
50
40
30
2 or 3
20
# of risk factors
1
10
0
0
Risk Factors
current smoking
Cardiorespiratory Fitness Groups
SBP >140 mmHg
*Adjusted for age, exam year, and other risk factors Chol >240 mg/dl
Low
Mod
High
Blair SN et al. JAMA 1996; 276:205-10
The dominant effect of fitness over other
risk factors, and its apparent effect as an
antidote for other risk factors, makes
physical fitness perhaps the single most
important thing an older person can do
to remain healthy.
(MacArthur Foundation Study)
Maintaining
Cognitive Function
The Facts
Cognitive ability is not one
function.
Research indicates 2 areas of change in
cognitive performance as we age:
Speed
of processing information
Certain
types of memory.
Explicit memory is affected with
ageing ie memory which involves the
intention to remember & the
subsequent ability to recall
information on demand.
Research shows other kinds of
memory show little change in
capacity with age.
More than 50% of decline of
cognitive function in older age is
determined by genetic factors (more
than other functions).
However, this still leaves considerable
influence for lifestyle factors.
Research has established the following as
direct contributors to maintaining cognitive
function:
Learning
 Physical Activity
 Self-Efficacy
 Complex Environments
 Mild Stress
 Nutrition

Maintaining Meaningful
Engagement
Freud asserted that ‘love &
work are the essentials of
human life.’
Many successful agers cite
friendship as the key factor that
keeps them going
Others cite ‘involvement’
Berlin Study on Ageing
Social & Emotional Richness
Harvard, Yale & Rush Institute for Healthy
Ageing found that social and
productive activities are as effective as
fitness activities in lowering the risk of
death.
This research suggests activity may
confer survival benefits through
psychosocial pathways.
(Glass et al)
“As a rule, for people whose relationships to
others are fewer and weaker, the risk of
death is two to four times as great,
irrespective of age and other factors such
as race, socioeconomic status, physical
health, smoking use of alcohol, physical
activity, obesity, and the use of health
services.”
(Successful Aging,
John Rowe & Robert Kahn, 2000)
A Common Assumption about Ageing
Older people are unhappy & miserable
“Wellbeing (happiness) improves after the age of
55 years …”
78
77
Strength
76
of
75
satisfaction
74
(PWI)
73
72
18-25
26-35
36-45
46-55
56-65
66-75
76+
Age
Deakin University Survey Nov 2003
Economic Health Profile
The over 55’s market in Australia accounts for:
 21% of the population
 25% of the disposable income
 39% of household wealth, and
 will be responsible for 43% of total growth in
spending in the next decade.
(Access Economics)
“The mature segment of our society
continues to shift from being the
poorest to the richest in the
marketplace.”
Dr Ken Dychtwald
Age Wave Communications
USA
“Any company that has a low or falling
market share amongst people over 50
is likely to stagnate because it won’t
participate in the spending boom
associated with the ageing of the
population.”
(GreyGold Research)
Lifestyle Health Profiles
 14% consumed at risk or high risk
levels of alcohol
 25% were current smokers
 66% were sedentary
 51% were overweight or obese
Australian Bureau of Statistics
“Rebalancing (the health system)
to preventative medicine would
represent value for money in a
health system facing rising costs
and an ageing population.”
Federal Treasurer, March 2004
“Ageing does not prescribe
decline as we have previously
understood it. In fact, recent
research has shown that only 30%
of physical ageing can be
traced to our genes – the rest is
down to our lifestyle choices.”
“Changes that a doctor or scientist
once might have labelled an
inevitable part of growing older are
now considered pathology not
biology.”
Harvard Medical School Report, 2001
Individuals Achieving Well Beyond
their ‘Use-By’ Date
Michelangelo painted the Sistine Chapel
between 71 & 89
Frank Lloyd Wright completed the
Guggenheim Museum at 90
Joseph Rotblat won the Nobel Prize in
1995 at 87
George Burns won an Oscar at the age
of
80
Golda Meir became Prime Minister of
Israel at 71
Individuals Achieving Well Beyond
their ‘Use-By’ Date
Konrad Adenaur became Chancellor of
West Germany at 73 and retired at 87
At 77, Alan Greenspan was appointed to
another 5 year term as Chairman of the
US Federal Reserve
At 72, Rupert Murdoch stated he planned
to stay as the head of News Corp until
he is 100.