Active Aging towards

Healthy Longevity Shelley de la Vega, MD, MSc, FPSGM

President Philippine College of Geriatric Medicine

Director, Institute on Aging National Institutes of Health

The older population is the fastest growing sector of the Philippine population since the 60s. (UP POP INST) growth rate by population sector

0

0.5

1

1.5

2

2.5

3

3.5

4

4.5

5

1948-60 1960-70 1970-80 1980-90 1990-95 1995-2000

period

pop.

gro

wth

rate

total pop 60+

<15 15-59

Healthy Life Expectancy

steadily increasing throughout most countries, including the Philippines.

60 year old Filipino female, 11.7 more years vs. Japanese female 20 years

60 year-old Filipino male can expect 8 more years vs. Japanese male 17 yrs.

UP Population Institute

S de la Vega, MD 2012

Life Expectancy

The biggest contributor to the

increase in life expectancy is

the reduction in maternal and

child mortality

Why are we living longer and healthier?

Improving nutrition and sanitation Disease management and medicine

– Antibiotic, – Vaccines – Drugs for hypertension, diabetes – Improved surgical techniques – Early screening and diagnosis

Safety – Roads, Workplace

Lifestyle

de la Vega 2012

Challenges to Health and Longevity Rising health costs and lack of effective and

preventive care Double Burden Chronic Degenerative Infections

Persistent Maternal and Child Health Challenges Increasing proportions of elderly Declining health workforce availability

Adapted from: National Science Foundation 2011

What is Active Aging?

Active ageing is the process of optimizing

opportunities for health, participation and security

in order to enhance quality of life

as people age.

Active Aging

NOT only physically active/labor force

Retired people, people with illness or disability can actively contribute

AIM: extend life expectancy and Quality Of Life

Determinants of Active Aging

Culture

shapes the way in which we age because it influences all of the

other determinants of active aging

Gender

is the “lens” through which to consider

the appropriateness of various policy options and

how they will affect the well being of both men and women.

Determinant: Health and Social Service

Life course perspective Focus on health promotion and

disease prevention Equitable access to quality primary

and long-term health care

Factors Affecting Health of Adults of all Ages Nutrition Exercise Smoking Alcohol Intake Substance Use and Abuse Socioeconomic Status Gender

Behavioral Determinants

Lifestyle changes at any age, can delay or deter the onset

of disease, and can reduce or delay functional declines and can promote

the quality of life.

Underlying Risk Factors – “The Actual Causes of Death” USA

Behavior % of deaths, 2000 – Smoking 19% – Poor diet & nutrition/ 14%

Physical inactivity – Alcohol 5% – Infections, pneumonia 4% – Racial, ethnic, economic ?

disparities

McGinnis and Foege 1993

de la Vega S

Patterns of Smoking Filipino OP Tobacco

– Current: 20.2% – Past: 15.2% – Never: 64.7%

BSNOH 2000-2002

de la Vega S

Patterns of Drinking Filipino OP

Alcohol – Current: 22.1% – Past: 11.7% – Never: 66.2%

BSNOH 2000-2002

de la Vega S

Exercise

77% (n=2690) had some form of exercise

This is higher as compared with the adult population,

i.e. 53-54%. BSNOH 2000-2002

Never too late to change! EX. STOP SMOKING

– Prevent children from smoking – Older adults also benefit from quitting

EX. PHYSICAL ACTIVITY – Prevent heart disease, falling, diabetes

Physical Activity = $3.2 medical cost saved per $1 investment in measures that encourage moderate physical activity Influenza Vaccination = $30-60 medical cost saved per $1 on vaccine

Strategies Active Aging Toolkit

Assess physical activity level Elicit fears about exercise Form groups/COMMUNITY CENTERS Recommend activities incorporated in

daily life ex. – DOH CD – Pedometer 10,000 steps a day

Individualize Follow up

Personal Factors

Biology and Genetics – 30% of how we age and our

predisposition to disease Psychological factors

– Learning speed declines – Wisdom, experience increase – Resilience

Determinants Related to the Physical Environment Physical Environment

– Access to health and social services – Urbanization, women’s migration

Housing Environment that encourages Physical

Activity ex. parks, bike lanes Clean air and water Safe foods

What is an Age-Friendly Environment? Enabling work environment

– ALLOWS FLEXIBILITY FOR PEOPLE WHO CARE FOR ELDERLY

Life-long learning and literacy Hearing aids and Low vision aids Barrier-free access Access to cost-effective medical procedures Long-term care

Determinants Related to the Social Environment Social Support

– Social Isolation increases risk of death and dementia

Protection from Violence and Abuse Education and Literacy Elder participation in volunteerism,

mentoring, visiting – Ex. COSE Home Care Volunteers

Economic Determinants

Income Social Protection

– Decline due to migration, nuclear family – National old age pension

Work – Informal sector

Outcome of Successful Active Aging Policies and Programs More people participating actively as

they age in social, cultural, economic and political aspects of society, in paid and unpaid roles and in domestic, family and community life

Lower costs related to medical treatment and care services.

ANTI-AGING WELLNESS

Anti-aging: Live long

Reduction of disease: reduction of morbidity rates

Improvement of mortality rates

Longevity

Anti-Aging The Fountain of Youth?

S de la Vega, MD 2011

Comparative Effects Intervention for Healthy

Adults

Look Young

Feel Young

Live Longer

Vitamin E + = ?

Vitamin A ? ? ?

Vitamin D ? ? +?

Omega 3 ? ? +?

Healthy Diet and Lifestyle

+ + +

Comparative Effects Intervention for Healthy

Adults

Look Young

Feel Young

Live Longer

Gene Therapy

? ? ?

Stem Cells ? ? ?

Estrogen + + cancer; CVD

Growth Hormone

+ = cancer

Lifestyle modification

+ + +

Why are we living longer and healthier?

Improving nutrition and sanitation Disease management and medicine

– Antibiotic – Vaccines – Drugs for hypertension, diabetes – Improved surgical techniques – Early screening and diagnosis

Safety – Roads, Workplace

Lifestyle

de la Vega 2012

The supreme criterion by which the success of a government can be

judged is the quality of life its citizens

experience from birth to death. US National Academy of Sciences