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A Decade of Healthy Ageing? What good looks like and how we get there
- 1. A Decade of Healthy Ageing? What good looks like and how we get there Join the conversation: @ilcuk #DecadeOfHealthyAgeing
- 2. Welcome and introduction from Chair Lily Parsey, Global Policy and Influencing Manager, ILC Join the conversation: @ilcuk #DecadeOfHealthyAgeing
- 3. Amal Abou Rafeh Chief of Programme, Ageing Unit, United Nations Join the conversation: @ilcuk #DecadeOfHealthyAgeing
- 12. Thank you.
- 13. Dr Jane Barratt Secretary General, International Federation on Ageing Join the conversation: @ilcuk #DecadeOfHealthyAgeing
- 14. July 23, 2020 Decade of Healthy Ageing? What good looks like and how do we get there.
- 15. 15 / INTERNATIONAL FEDERATION ON AGEING Healthy Ageing “as the process of developing and maintaining the functional ability that enables wellbeing in older age”
- 16. UN Vienna International Plan on Ageing, 1982 ** UN Madrid International Plan of Action on Ageing, 2002 UN Millenium Development Goals, 2000-2015 UN Sustainable Development Goals, 2015-2030 **UN Sustainable Development Goals, 2020-2030 ** UN High Level Political Forums ** UN Open-ended Working Group (Convention) WHO World Report on Ageing and Health, 2015 **WHO Global Strategy and Action Plan, 2016 **WHO / UN Decade of Healthy Ageing, 2020-2030 **WHO Global Priorities ** WHO Immunization Strategy 2021-2030 ** WHO Vision 2020 Strategy
- 17. 17 / INTERNATIONAL FEDERATION ON AGEING Decade Action Areas and key Sustainable Development Goals
- 18. 18 / INTERNATIONAL FEDERATION ON AGEING Strategic Priorities and Interventions Prevention Access Equity
- 19. 60% older adults have 2 or more underlying medical conditions COPD and diabetes are predictors of hospitalisation Diabetes mellitus (1.4x) COPD, asthma (1.3-13.5x) Chronic heart disease (3.3x) Torres, A., Blasi, F., Dartois, N. and Akova, M. 2015. Which individuals are at increased risk of pneumococcal disease and why? Impact of COPD, asthma, smoking, diabetes, and/or chronic heart disease on community-acquired pneumonia and invasive pneumococcal. Thorax, 0: 1-6.
- 20. 20 / INTERNATIONAL FEDERATION ON AGEING Brain mechanisms for preventive strategies in dementia
- 21. July 23, 2020 With thanks jbarratt@ifa.ngo www.ifa.ngo
- 22. James Appleby Chief Executive Officer, Gerontological Society of America Join the conversation: @ilcuk #DecadeOfHealthyAgeing
- 23. Ken Bluestone Head of Policy and Influencing, Age International Join the conversation: @ilcuk #DecadeOfHealthyAgeing
- 24. Prof Julie Byles Global Innovations Chair in Responsive Transitions in Health and Ageing, Newcastle University Head, ILC Australia Join the conversation: @ilcuk #DecadeOfHealthyAgeing
- 25. A decade of heathy ageing: What does it look like and how do we get there?. Professor Julie Byles Global Innovation Chair in Responsive Transitions in Health and Ageing 1946-51 1921-26 1996 45-50 70-75 2020 69-74 94-99 2030 79-84 Australian Longitudinal Study on Women’s Health
- 26. Healthy life expectancy at age 70 with and without diabetes TLE: 16.2 years HLE: 13.1 years ULE: 3.1 years HLE/TLE 81% TLE: 15.1 years HLE: 10.1 years ULE: 5.1 years HLE/TLE 67% 1946-51 cohort 16% Diabetes (around age 70) Better educated Higher BMI Past smokers 1921-26 cohort 8.4% Diabetes 70-75 21% Diabetes 80-85 Multiple morbidities Less educated Lower BMI Few past smokers 1921-26 cohort Wubishet, Harris, Forder, Byles. Age and cohort rise in diabetes prevalence among older Australian women. PLOS ONE 2020 15(6): Wubishet, Byles, Harris, Jagger. Impact of Diabetes on Life and Healthy Life Expectancy among Older Women, The Journals of Gerontology: Series A, advanced publication 2020
- 27. What does heathy ageing look like and how do we get there?. 1989-94 1973-78 1946-51 1921-26 2020 24-29 42-47 69-74 94-99 2030 34-39 52-57 79-84 Smoke less, higher BMI, more diabetes. Luo, Hodge, Hendryx, Byles. Diabetologia. 2020;63(3):519-527.
- 28. Q&A Please submit your questions via the Q&A tab at the bottom of your screen Join the conversation: @ilcuk #DecadeOfHealthyAgeing
- 29. Closing remarks Lily Parsey, Global Policy and Influencing Manager, ILC Join the conversation: @ilcuk #DecadeOfHealthyAgeing
- 30. Work with us Business intelligence: we’ll give you advance notice of our latest research, ad hoc briefings on areas of specific interest to your organisation, as well as a discount on any research you commission from us. Networks and connections: our Partners events have included visits to Number 10, briefings with prominent influencers, as well as the opportunity to meet ministers, policy experts and fellow Partners. Brand benefits: as a Partner your brand will be visible through our numerous events, press releases and presentations, and give you the opportunity to be positioned at the heart of the debate on longevity. For more information contact Redvers Lee: redverslee@ilcuk.org.uk
- 31. What happens next Delivering prevention across the world Identifying the challenges and solutions to an ageing workforce Date: Thursday, 20 August 2020 Time: 3.00pm – 5.00pm BST (10.00am – 12.00pm EDT)
- 32. Future of Ageing 2020: Together for tomorrow Date: Thursday, 3 December 2020 Time: 9.00am (for 9.30am) - 5.30pm Speakers include: Andrew Dilnot, Sir Jonathon Porritt, Will Moy and more. Register at: futureofageing.org.uk Join the conversation: @ilcuk #FutureOfAgeing
- 33. Thank you ilcuk.org.uk Join the conversation: @ilcuk #DecadeOfHealthyAgeing
Hinweis der Redaktion
- My view of what healthy ageing might look like in 2020 is shaped by my work with the Australian Longitudinal Study of Women’s Health, where we have been following cohorts of women since 1996 to determining factors affecting their health and wellbeing. The oldest cohort were aged 70-75 when we started, and the surviving women are now aged in their late 90’s. They have provided a picture of healthy ageing, as well as an understanding of the development of disease and disability and some of the factors affecting this progression. They also provide a window into what ageing might look like for the next cohort who were born in 1946-51. These women were aged in their 40’s when we started and are now in their 70’s. Compared to the older women, they grew up in a time of relative prosperity being born in the post-war boom; they had a much higher life expectancy at birth and higher lE at age 60; they had higher educational advantage as children and some have continued to advance their education throughout their lives; they had fewer children on average; they are less likely to be widowed, but more likely to be divorced; they are more likely to have smoked; they have had higher BMI across their life course; and they are more likely to drink regular alcohol and more likely to drink to excess. They are also ageing in a time of greater access to medical care and better health technology. Overall they have many health advantages over the previous cohort, but some greater health risks.
- This increase in risk can be seen in the prevalence of diabetes, and the impact of diabetes on HLE. If we look to the 1921-26 cohort, Around 8% of these women had diabetes in their 70s, with the prevalence of diabetes increasing rapidly in their later years and around 21% having diabetes in their late 80s. The impact of diabetes on the TLE, HLE, ULE can be seen in this figure produced by one of my PhD students Befikadu Wubishet with the expert advice from Carol Jagger. Without diabetes the women could expect to live 16.2 years from age 70, compared to 15.1 years for those with diabetes. For women without diabetes 81% of LE is expected to be in Ex/VG/good health, whereas for women with diabetes only 67% of their remaining life is expected to be in good health. TLE and HLE are further reduced for women with lower levels of education, comorbidities, obesity, smoking. And ULE is increased by most of these factors. Women in the 1946-51 cohort have an advantage of a longer TLE, and higher levels of education. But they are heavier than their mothers’ generation, and more likely to have smoked (although most have given up). The greater prevalence of diabetes at age 70 in this cohort may reflect a true increase in the prevalence of this condition, coincident with the higher BMI which is a major risk factor for diabetes, or it may indicate better and earlier detection and greater opportunities to manage this disease and prevent it’s progression. How these women age over the next decade can be mitigated by attention to their health risks esp. diet, exercise and alcohol; quality health care to monitor and health manage their condition; and an investment in their health literacy and skills in managing their own well being, predict their needs, and proactively plan for their later life. While the women may already have developed a chronic condition of diabetes, and may have other comorbidities, there is still a large window of opportunity to promote their health and prevent the onset of disability. How they age over the next decade will also be substantially influenced by their earlier years.
- How they age over the next decade will also be substantially influenced by their earlier years. So while it is very important to optimize the health opportunities for these women in their 70s, we must also look to the health of the cohorts coming behind them. In ALSWH we are also following the health of women now in their 20’s and now in their 40s. Comparing these cohorts on just two risk factors, we see that the younger cohorts are much less likely to smoke (and to give up more quickly if they do); but are heavier, from an earlier age, and for a longer period of their life. We are already seeing this longer exposure to high BMI translating into higher incidence of diabetes, at an earlier age. (Luo et al. 2020). The younger women are also more stressed and have higher levels of psychological distress. To some extent this may be a factor of age with mental health tending to improve as women move through their 40s and declining again slightly in their 80s in association with increased pain and disability, and with increasing isolation and loneliness. However we are also seeing a strong generational gradient, with worse mental health for the youngest cohorts. These younger women have also expressed the greatest levels of stress and poor mental health in relation to COVID-19, but recognizing that in Australia to date the impact of actual COVID-19 infection has been less than the social disruption of the lockdowns. This may seem all very pessimistic, but looking forward to a decade of healthy ageing I take courage and inspiration from the lessons already taught to me by the oldest women in the study who have mostly shown resilience in the face of adversity including major life shocks such as the loss of their husbands, the demands of caring for their husbands when they were ill, and managed multiple chronic conditions of their own Mostly they maintained relatively high levels of physical and social functioning and good mental health. Interviewing these women in their 90s we see a strong theme of resilience and resourcefulness in the women’s abilities to make adjustments and to use support systems to continue to live a fulfilled life. If I could go into the past and change anything for these women, I would increase their engagement in physical activity, increase their access to quality health care to manage conditions such as diabetes and correct conditions such as cataract, better integrate health care to streamline and improve the management of multiple conditions, and I would advance and enhance their access to late life care that has a focus on helping them to maintain their abilities to do the things they chose to do and have reason to value.