Ageing

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• Ageing Decline
• How Much? How Soon?
• How Inevitable?
• What Does the Research Say?
• AHIA Conference
• November 2005

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• The Ageing Demographic
• Successful Ageing
• Contemporary Perspectives

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• The Ageing
• of the
• Population

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• 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.

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The number of Australians over 65 years of age
has increased by 67 in the last 20 years.
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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)
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In terms of workforce growth the working age
population currently grows by around 170,000 per
year. By the decade of the 2020s, that
increase will drop to an average of less than
13,000 per year.
(Access Economics)
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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.
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• 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.

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• Until the 1970s 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.

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• 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.

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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
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LEB Life Expectancy at BirthHALE Healthy Life
Expectancy (Health Adjusted Life Expectancy)
LEB Australia 80.4 years Male 77.9
Female 83.0 HALE Australia 72.6 Male
70.9 Female 74.3 Lifespan lost to
ill-health Australia 9.7 Male 9.0 F
emale 10.5
WHO 2003
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What Is Successful Ageing?
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• Successful Ageing concerns itself with
• How you can maximise function as you age
• Minimising the period of morbidity
• A risk-management strategy for ones own
  well-being
• Healthspan in relation to lifespan
• Successful Ageing is not a denial of the ageing
  process

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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
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Maintaining Low Risk of Disease Disability
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• 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

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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.
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• 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.

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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.
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Maintaining Physical Cognitive Function
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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.
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It is now increasingly clear that it doesnt
have to be that way. The 1 rule applies only to
those who lead a sedentary life.
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• 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
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New research establishes that a moderate PA
level has a powerful capacity to improve the
overall health outlook.
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Cardio respiratory Fitness, Risk Factors and
All-Cause Mortality, Men, ACLS
(Steven N. Blair, Cooper Institute, Dallas, Texas)
of risk factors
Risk Factors current smoking SBP gt140 mmHg Chol
gt240 mg/dl
Cardiorespiratory Fitness Groups
Adjusted for age, exam year, and other risk
factors
Blair SN et al. JAMA 1996 276205-10
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• 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)
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Maintaining Cognitive Function
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• 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.

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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.
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• 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.

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• Research has established the following as direct
  contributors to maintaining cognitive function

• Learning
• Physical Activity
• Self-Efficacy
• Complex Environments
• Mild Stress
• Nutrition

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Maintaining Meaningful Engagement
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Freud asserted that love work are the
essentials of human life.
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• Many successful agers cite friendship as the key
  factor that keeps them going
• Others cite involvement
• Berlin Study on Ageing

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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)

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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)
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A Common Assumption about Ageing
Older people are unhappy miserable Wellbeing
(happiness) improves after the age of 55 years

Deakin University Survey Nov 2003
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• Economic Health Profile
• The over 55s 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)

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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
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Any company that has a low or falling market
share amongst people over 50 is likely to
stagnate because it wont participate in the
spending boom associated with the ageing of the
population. (GreyGold Research)
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• 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

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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
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• 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.

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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
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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

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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.

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