Adding life to the years: why it’s important that aging is also healthy

Increasing life expectancy and decreasing fertility are causing the average age of the world’s population and the proportion of the elderly population to become increasingly high. Spaniards have one of the highest life expectancies in Europe: for every four people of working age, there is one person over 65 years of age.

This increase in life expectancy is not always accompanied by quality of life and good health. With age, physical and mental abilities are gradually lost and the risk of disease increases. In fact, the level of addiction is also increasing year by year. For this reason, population aging poses an unprecedented challenge to healthcare systems in all countries.

Healthy aging is often understood as a positive, disease-free state in which healthy and sick individuals can be distinguished. But understanding it this way is usually problematic in older age, since most older people have one or more medical conditions but can keep them under control and have little impact on their daily lives.

For this reason, the World Health Organization has shifted the paradigm and defined healthy aging as the process of developing and maintaining over many years the functional capacity to ensure well-being in old age.

The Foundation of Healthy Aging

Functional ability is defined as “the health-related qualities that enable a person to be and do the things that are important to him.” It consists of a person’s individual abilities (the combination of his physical and mental abilities), his environment (including the physical, social and political environment) and the interaction between the person and the environment.

An optimal aging process is one that maintains high internal capacity over many years. However, if a person’s own performance declines during this process, a supportive environment can compensate for these deficits and maintain functionality.

However, some people may experience such loss of energy that, even under favorable conditions, they are unable to independently perform basic tasks of daily life. Then they need another person, which is called care dependency.

This care can take place in the home itself, perhaps with some adaptation or by moving to a more prepared environment. 80% of older adults prefer to live in their own home or community, likely because they feel connected, safe, and close.

However, aging in place may not be the best option for those who are isolated, live in hostile environments, or have too high a level of care. It is in these cases that the ability to enter the living space becomes necessary.

Health systems can’t keep up

Although we are facing a rapid transition to an aging population, healthcare systems are not keeping pace and are not prepared to achieve the goals of healthy aging.

The main purpose of the traditional system of care was to control or treat diseases of people. This system worked relatively well: it increased the life expectancy of the population, but resulted in the population living longer with less health and quality of life.

Prolonging long-term health and reducing the gap between life expectancy and healthy life years should be the new goal of health systems. To do this, it is necessary to increase the functionality of people. In fact, focusing on developing older adults’ individual potential is more effective than prioritizing treatment for specific chronic conditions. It may even help avoid unnecessary treatment, polypharmacy and its side effects.

Likewise, traditional residential care is based on a medical model of service delivery that is more similar to a hospital than a home. This is likely because geriatric residents are an extremely complex and vulnerable population with high rates of physical dependency, cognitive impairment, multimorbidity, and polypharmacy. Thus, care has focused primarily on keeping older adults alive and meeting their basic needs, such as bathing or dressing, at the expense of the goals of healthy aging.

However, we know that residents’ functional abilities decline very quickly and that care dependency may be the most important financial cost of these facilities. Likewise, residential settings need to be rethought towards a more positive and proactive role, where care is aimed at optimizing people’s individual capacity and creating a supportive environment to compensate for possible lack of capacity.

What kind of health policy do we need?

To meet these needs of an aging population, significant changes in our health care policies are needed. Prevention, education and health promotion strategies need to be applied to the entire population, not just older people. Healthy aging spans the entire life cycle.

One of the keys to promoting long-term health is promoting a healthy lifestyle. This includes encouraging regular physical activity, a balanced diet, reducing toxic habits such as smoking or drinking alcohol, and even non-physical factors such as stress management, sleep, optimism, laughter, learning, social connections or having a purpose in life. .

Therefore, patients must move from passive recipients of health care to active participants in planning their health and care. To do this, they must be knowledgeable about lifestyle optimization, have sufficient medical knowledge, and be in control of their health goals.

Pau Moreno MartinPhysiotherapy, University of Vic – Central University of Catalonia

This article was originally published in Talk. read original.