Positive Aging and Life Expectancy

Positive Aging: Promoting Health and Well-being in Older People

• The course focuses on promoting health and well-being in older adults.
• Learning outcomes include describing health-related quality of life, discussing health promotion priorities for older adults, discussing health interventions for older adults and their benefits, and appraising the role of factors such as health promotion and physical activity in maintaining function.

Life Expectancy Changes

• Average human life expectancy has doubled in most developed countries over the past 200 years.
• The increase is due to declining mortality in both early/mid-life and late-life.
• Life expectancy increases by approximately 2 years every decade or 3 months per year, according to Oeppen & Vaupel (2002).

Future Life Expectancy Estimations

• WHO Projections:
  • Proportion of 60+ years old will double from 12% to 22% (approximately 2.1 billion) between 2015 and 2050.
  • Proportion of 80+ years old will triple to 426 million between 2020 and 2050.
  • Proportion of 100+ years old will quadruple.
• EU Projections (2040):
  • 65+ years: 90 million
  • Under 16: 80 million
• Ireland Projections:
  • 2020: 65+ years: 637,000; 80+: 150,000
  • 2036: 65+: 1.1 million; 2050: 80+: 1.5 million

Why Does Positive Aging Matter?

• Factors contributing to longer lifespans include better health care (immunization, antibiotics), better home care and hygiene, and better lifestyles (food and water quality).
• Additionally, the retirement age has been revised in Ireland (recently proposed to remove mandatory retirement at 65).

Definition of Aging

• Biological Aging: An age-dependent or age-progressive decline in intrinsic physiological function, leading to an increase in age-specific mortality rate and decrease in reproductive rate (Flatt, 2012).
• Positive Aging: Avoidance of disease and disability, maintenance of high physical and cognitive function, and sustained engagement in social and productive activities (Rowe and Kahn, 1997).

Important Diseases for Older Adults

• Type II diabetes
• Cardiovascular disease (CVD)
• Chronic Obstructive Pulmonary Disease (COPD)
• Chronic Comorbidity
• Dementia (Alzheimer's, vascular dementia, frontotemporal dementia, mild cognitive impairment, acute cerebrovascular)
• Arthritis, osteoporosis, and sarcopenia
• Low social engagement, loneliness, depression, and other mental health conditions

Prevalence of Positive Aging

• McLaughlin et al. (2010): 11% of US adults (aged over 65) in their study met criteria for successful aging.
• HANK (2011 - SHARE study): 9% of the non-institutionalized population (aged >50 years) in Europe and Israel met criteria for successful aging.
• Metrics included in successful aging: Freedom from disease, no disability, and high cognitive and physical functioning, and active engagement.

Large Inter-Individual Variation in Aging

• Individual variation exists in aging process.
• Digital composite images of adult faces used to illustrate individual variation.

Chronological Age vs. Biological Age

• Chronological age: Time lived since birth.
• Biological age: Age-dependent or age-progressive decline in intrinsic physiological function.

Dunedin Study

• Longitudinal study of aging in New Zealand.
• Assesses multiple physical systems (cardiovascular, metabolic, renal, immune, dental, pulmonary) at different ages.

Are Biological and Chronological Age the Same?

• A review of the difference between biological and chronological age in 2015 and 2021.

Relationship Between Biological Age and Other Outcomes

• Unsurprisingly, biological age is associated with poorer self-rated health, increased risk of chronic disease, mortality, stroke, TIA. and new disabilities.

Learning Outcomes 2,3 and 4

• Health promotion priorities for older adults, health interventions for older adults and their benefits, and appraise the role of factors such as health promotion and physical activity in maintaining function

Health Promotion Strategies

• Enabling individuals to increase control over and improve their health.
• Three key strategies: advocacy for health, enabling full health potential, and mediating between societal interests.
• National Positive Aging Strategy aims to prevent disability, chronic disease, and premature mortality, while promoting health education & policy implementation.

Health Interventions for Older Adults and Their Benefits

• Prevent falls, promote physical activity, influenza vaccination, and publicly support informal care (home care and self-care).
• Interventions (including balanced diet, physical exercise, and sleep) play a significant role in improving physical and mental health outcomes of older adults.

Physical Activity Effects

• Interventions like exercise (any type), exercise intervention by professionals, control or functional exercises (balance or functional exercise), Tai chi, have positive effects on maintaining physical functioning and reducing falls frequency in older adults.
• Studies show that physical activity also affects mental well-being (self esteem and mental health scores).

Health Promotion & Cost Effectiveness

• Physical inactivity costs society approximately $78 billion in healthcare costs & lost productivity.
• Cost-effective interventions for physical activity can significantly decrease health care burden (approximate costs 66to66 to 66to683 per inactive adult converted to active).

Genetic Effects of Aging and Longevity

• Genes play a role in longevity, but only to a moderate extent (20-30%) before age 60.
• There are environmental factors beyond genes also critical for influencing lifespan.

Blue Zones

• Geographic areas where longevity is exceptionally high due to lifestyle and environmental factors.
• Lifestyle themes include natural movement; purpose; downshift of stress; 80% rule; plant-slant diet; wine; belonging, loved ones first, and right tribe.

Summary

• Positive aging involves disease avoidance, high physical, cognitive, and social functioning.
• Promoting health and interventions play a key role in improving health outcomes for older adults.
• Blue Zones model suggests how environmental and lifestyle factors contribute to longevity.
• There's a role for modifiable factors like lifestyle behaviours in preserving health & preventing falls and cardiovascular risks among the elderly.