Healthy ageing

'Population ageing is one of humanity’s greatest achievements…'

The question now is how do we add life to the years rather than simply adding years to life? This question is the centre of the growing focus on healthy ageing. The World Health Organization (WHO) defines healthy ageing:

‘...as the process of developing and maintaining the functional ability that enables wellbeing in older age’.

Functional ability means being able to be and do the things that we see as important, and so looks at more than just how ageing affects physical and mental health. It means people’s basic needs are met, that they can learn, grow and make their own decisions, are mobile, are able to make and keep their relationships and be a part of society. To do this we need to consider more than just the person and what they can do – we also need to make sure that people’s surroundings allow what is needed to age healthily.

Promoting healthy ageing benefits individuals, people close to them, and society as a whole. Active older people are more likely to keep on working, volunteering and caring. We know older people contribute to the economy directly, through employment, and indirectly, through looking after grandchildren which allows parents to work. Healthier older people are also less likely to need health and social care.

Healthy Ageing is the focus of WHO's work on ageing between 2015–2030. Healthy Ageing replaces the WHO's previous ‘Active ageing: a policy framework’ developed in 2002. Healthy Ageing, like Active Ageing, emphasises the need for action across multiple sectors and enabling older people to remain a resource to their families, communities and economies.

The ‘add "life to years" through healthy ageing’ video by the WHO outlines their approach to Healthy Ageing.

In this podcast, Lord Geoffrey Filkin, chair and founder of the UK’s Centre for Ageing Better foundation, discusses his manifesto for better longer lives, why employers need to quit chucking workers out the door after 50, and the importance of bounding up escalators. It’s quite long at 27 mins, but a very good listen. Manifesto for better longer lives - podcast.

While it is one thing to know about what healthy ageing is, it is another to know how you can achieve it. This practical guide to healthy ageing has steps that you or others can take to help maintain a healthy later life.

The ‘Centre for Ageing Better’ report gives a snapshot of ageing today and in the future, focusing on the areas we know make a difference to people’s later lives. How prepared is society for our longer lives? Their new report, 'The State of Ageing in 2019', uses publicly available data to give a snapshot of what life is like for people aged 65 and older today.

The WHO global strategy and action plan on ageing and health was adopted by WHO’s Member States in 2016. The Strategy is built on the new WHO's conceptualisation of Healthy Ageing outlined in the World report on ageing and health 2015. Rather than focusing on the absence of disease, this considers Healthy Ageing from the perspective of the functional ability that enables older people to be, and to do, what they have reason to value.

The Strategy commits to action in areas where evidence is strong, but also points out many crucial gaps in knowledge and capacity. It therefore proposes four years of work to prepare the world for a decade of concerted global action – the Decade of Healthy Ageing – from 2020 to 2030.

This report sets out WHO’s 10 priorities towards a decade of healthy ageing for promoting Healthy Ageing around the world, which include the following priorities:

1. establishing a platform for innovation and change
2. supporting country planning and action
3. collecting better global data on healthy ageing
4. promoting research that addresses the current and future needs of older people
5. aligning health systems to the needs of older people
6. laying the foundations for a long-term-care system in every country
7. ensuring the human resources necessary for integrated care
8. undertaking a global campaign to combat ageism
9. defining the economic case for investment
10. enhancing the global network for age-friendly cities and communities.

The report also gives clear examples of how to achieve each of the various priorities.

A good, accessible overview of some of the evidence review that impact on Healthy Ageing from Age UK is the evidence review on Healthy Ageing from AgeUK. It draws on the WHO definitions and research from around the world. However, they also provide examples of healthy ageing interventions from across the UK.

The healthyageing.eu website was developed in 2012 showcasing practical examples of health promotion interventions to make healthy ageing a reality. This section highlights actions from across Europe that aim to improve the health and wellbeing of older people. The examples highlight national health promotion initiatives from 27 European countries ranging from nutrition and physical activity, to actions dedicated to promoting independent living and tackling social exclusion.

Ensuring that we can all enjoy a healthy later life means more than just changing our lifestyles. In this edition of Bulletin of the WHO, it is discussed in healthy ageing: moving forward that we also need to change the way we think, feel and act on age and ageing to combat negative ageist stereotypes that can harm our health.

The World Report on Ageing and Health 2015 is currently the most comprehensive report on the state of healthy ageing around the world. It covers the context for action and the challenges for policy development as well as detailing evidence on the state of healthy ageing from around the world.

In response to the publication of the World Report on Ageing and Health, The Gerontologist journal published a special issue – these three articles are the editor’s top picks:

• Linda Fried argues that the the benefits to society that having healthier and active older people could lay the basis for future economic growth, what is sometimes referred to as the third demographic dividend.
• McPhee and colleagues (2016) review the evidence for the benefits of regular physical activity for healthy and for frail older people in reducing the risks of developing major cardiovascular and metabolic diseases, obesity, falls, cognitive impairments, osteoporosis and muscular weakness. However, they note that levels of physical activity are relatively low in the older population.
• Daskalopoulou and colleagues (2017) conducted a systematic review and meta-analysis of 23 studies covering 174,114 participants from various countries. The result show that higher levels of physical activity is associated with an increased likelihood of healthy ageing. However, the authors note that the way in which healthy ageing (and physical exercise) is measured differs between studies.

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