Ageing is a natural and inevitable process. For the past century, mankind has been adding years to life. More people now survive the challenges of childbirth and childhood to reach old age.
This trend is not restricted to the resource-rich countries but has become a global phenomenon, including the countries of South-East Asia. It has been estimated that around 142 million people or 8 per cent of the population of the World Health Organisation’s South-East Asia Region are above the age of 60 years.
In India, the proportion of the population aged 60 years and above had grown consistently to 77 million people or 7.4 per cent in 2001 and is expected to reach 160 million by 2025 and to more than 300 million by 2050, translating to 17 per cent of the total population, of which a large proportion would live in rural areas. There is an urgent need to focus attention on the ageing population because of the increasing percentage of elderly people in the total population.
Traditional values
Development and progress have brought about improved quality of life and increased life expectancy. Longer life is associated with chronic diseases and disabilities in old age.
This affects the overall quality of life and poses a challenge for families, communities and national governments. Traditional values and practices still occupy a key position where long-term care of the very old is concerned. With nuclear families replacing the joint families, however, and with large rural to urban migrations, often the old and the infirm are left at home. These changing patterns of society are now affecting the age-old balance of care of the old and very old persons at home.
On World Health Day, WHO highlighted ageing as a rapidly emerging priority that most countries have yet to realize and address adequately. Improving health in the cycle of ageing will require saving lives, protecting health and removing disability and pain. This can be achieved through a combination of healthy lifestyle throughout the life-course, age-friendly environment and improved detection and prevention of disease, which also includes appropriate research.
The journey into the uncharted realms of old age is an adventure of continual learning, adjustments and, most important of all, mentoring what is good and admirable. This journey begins even before a person is born, right from the mother’s womb. The nourishment and care that the mother and her unborn baby receive will determine how the newborn will fare in the world. An encouraging physical, social and mental environment that ensures the wellbeing and growth of the infant will lead to healthy adolescence, adulthood and eventually, old age.
Promoting and living a healthy lifestyle across the life-course means that an elderly population will continue to participate in social, economic, cultural, spiritual and civic affairs, in addition to being physically active and economically independent. A continuum of care and support, including health following the life-course, will ensure that ageing remains a healthy and fruitful experience and a journey of self-transformation, education and contribution. Creating age-friendly environments and policies to engage the elderly population and utilizing their vast potentials will result in dignified ageing, allowing the elderly population to participate actively in family, community and political life, irrespective of their functional ability.
Healthy ageing requires a significant paradigm shift in the way care is provided to the elderly population. Age-friendly primary health care minimizes the consequences of non-communicable or chronic diseases through early detection, prevention and quality of care, and provides long-term palliative care for those with advanced disease. Such interventions would need to be supplemented by affordable long-term care for those who can no longer retain their independence.
Building an age-friendly society requires actions in a variety of sectors other than health and includes education, employment, labour, finance, social security, transportation, justice, housing and rural-urban development. This will involve policy-makers at the national governments, cities and municipalities; civil society groups and senior citizens forum; academic and research institutions; private sector enterprises; community leaders and youth groups.
(The writer is WHO regional director for South-East Asia region)
