Aging leads to decrease in mental and physical capacity, risk of disease and eventually death. Older people are sometimes seen as a burden to society and the onus rests on the public health systems and society as a whole to look into these issues which have led to discrimination. This article describes about the impact of aging on healthcare.
With long term trends of an aging population and with an increase in people perpetrated with chronic diseases, we see a greater need for health care services in developed and emerging economies in 2016 and beyond. The aging population is expected to triple in the next half-century and this increase in life expectancy will place a huge burden on the health care system in all countries. The other shared demographic among countries is the trend wherein the spread of these chronic diseases like heart disease, stroke, cancer, respiratory disease, diabetes and mental illness, among others, have been seen as the leading cause of mortality in the world which may be attributed to an aging population, diet changes, increased obesity levels and improved diagnostics.
Biology of Aging
Aging occurs due to the wide range of cellular and molecular damage happening over time. This leads to decrease in mental and physical capacity, risk of disease and eventually death. While this is neither linear nor consistent, these changes are loosely associated with a person’s age. This relates to the discrepancy we see in the fact that a few 70 year-olds seem to enjoy good health, while there are others in the same age who seem to have become frail and require significant help from others for sustenance.
Other than biological causes, there are other life transitions which are also causes for aging, such as retirement, relocation, better housing requirements and death of partners or friends. Therefore while looking at developing a public health system it is important that we look into reinforcing recovery, psychological growth as well as adaptation of the individuals rather than just ameliorating the losses associated with old age.
Health conditions associated with aging
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Hearing loss, refractive errors, back and neck pain, cataracts, neck pain, osteoarthritis, chronic pulmonary disease, diabetes, dementia and depression are some of the common ailments afflicting people as they age. As people age they also experience several of these conditions simultaneously.
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There are the complications brought on by the geriatric syndrome which leads to the emergence of several complex health states which do not fall into any specific disease category. These arise due to underlying issues such as urinary incontinence, frailty, falls and pressure ulcers.
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Geriatric syndromes are better predictors of death than the number of specific diseases present. In spite of these, traditional structured health services often overlook geriatric medicine as a speciality.
What are the challenges faced by nations trying to deal with an aging population
Diversity in older age
There is no specific “older age” that one can benchmark and there are a few “80 year-olds having the physical as well as mental capacity of 20 year-olds, where as there are others who experience significant lowering of mental and physical capabilities at a much lesser age. If there is to be an all-inclusive public health response, all these wide ranging experiences of the aging population have to be taken into consideration.
Inequalities in Health
With the inequalities in health being due to several factors such as the family we were born into, our ethnicity, sex etc. these also have a cumulative effect on the impact across our life course. Therefore there is a greater need for public health policies to be created to reduce these inequalities rather than reinforce them.
Changing world and its impact on healthcare
Older people, being old and frail are sometimes seen as a burden to society and the onus rests on the public health systems and society as a whole to look into these issues which have led to discrimination, the way policies are being created and the many difficulties older people have to experience. With technological advancements, globalization, changing gender norms and migration the lives of older people is being affected in indirect and direct ways. The public health systems should take stock of these changing trends and frame policies accordingly.
Health care expenses associated with aging
In the year immediately before death is when a large proportion of health care costs attendant with advanced aging is incurred. With people surviving to increasingly older ages, there is a high cost of prolonging life which is shifted to older ages. The extent and nature of medical treatment at very old ages has become a contentious issue. Statistics and data from the United States suggest that there is great increase in healthcare spending at the end of life as compared to spending in general. International organizations as well as governments are emphasising on the need for cost-of-illness studies particularly relevant to age-related diseases which will aid in the assessment of the burden expensive chronic conditions – Alzheimer’s disease for instance.