Christian Schweizer presentation for Age UK

WHO’s perspective on healthy and
active ageing
Christian Schweizer, Manfred Huber
WHO Regional Office for Europe, Copenhagen

The world ages at different speeds: old-age
dependency ratios, 1995-2045

Source: Scherbov et al.

Fit as a fiddle - A Lasting Legacy for Healthy Ageing
London, 15 March 2012

Demystifying the myths of ageing: a prime
goal of our work
• “Older persons are at
the recipient end of
society; they
increasingly need to be
cared for”
• “Burden on public
budgets” will become
the main issue
• Developed countries will
face the biggest
challenges

Healthy and active ageing in Europe:
Four strategic areas for action


Strategic area 1: Healthy ageing over the life
course


What is active ageing?
• “Active ageing is the process
of optimizing opportunities for
health, participation and
security in order to enhance
quality of life as people age.”
• Postponement of retirement
and an ageing workforce
globally, only part of the story
• “Healthy ageing” and “active
ageing” reinforce each other


Active & healthy ageing: where are the
limits?

Fauja Singh, oldest
Person ever to run
a marathon,
Toronto, 16 Oct 2011
aged 100


Human rights, gender, and health
inequalities among older persons
• Human rights concerns, poverty
of older persons, discrimination
in quality and access to
services
• Men and women age differently
• Inequalities in health
accumulate over the life-course
• An example: elder
maltreatment often a neglected
issue

Strategic Area 2: Supportive environments
• WHO supports the fast
growing networks of age-
friendly initiatives at
community level
• “Age-friendly cities” illustrate
that “Health in all Policies” is
key to healthy ageing at
community level
• WHO tools and initiatives
stand ready to support EU
initiatives on healthy ageing


Strategic Area 3: Health systems fit for
ageing populations
• Wider health system & coordination
between health and social services (most
diverse pillar of modern welfare systems)
• Issues of adequate workforce and quality
of care
• Multiple barriers to access and gaps in
services
• Public support to informal care
• Adapt palliative care to needs
• The role of technology


Strategic Area 4: Address gaps in evidence
and research
• Important gaps in the evidence for
policy about trends in population health
of ageing societies
• International comparisons of health and
social services for older persons
• WHO has a role as clearing house on
evidence for policy in this area (transfer
of knowledge)
• European Advisory Committee on
Health Research to play a stronger role
in the future


Population is ageing... Does this mean there is an
increased need for institutional care?
Age-standardised rates of institutionalisation (65+ living in institutions)

Source: Facts & Figures on Healthy Ageing and LTC (forthcoming); Rodrigues & Schmidt (2011).


The importance of physical activity for people
in later life

Physical inactivity is a leading risk factor for health in
Europe, associated to nearly 1 million deaths/year

Disability adjusted life years lost due to risk
factors in EURO, 2004

Source: Global Health Risks.. Geneva, World Health Organization, 2009
(http://www.who.int/healthinfo/global_burden_disease/global_health_risks/en/index.html/).


Health effects of physical activity in adults
 Life expectancy  Coronary heart disease
 Cardiorespiratory fitness  High blood pressure
 Muscular fitness  Stroke
 Healthy body weight  Diabetes type II
 Healthy body composition  Metabolic syndrome
 Bone health  Colon cancer
 Sleep quality  Breast cancer
 Health-related quality of life  Depression
 Strong evidence
Additionally in older adults:  Medium evidence

 Functional health / independence  Risk of falls
 Cognitive functions Physical Activity Guidelines Advisory Committee. Physical Activity Guidelines
Advisory Committee Report, 2008. Washington, DC: U.S. Department of
Health and Human Services, 2008.


Quantification of effects of physical
inactivity
• 21–25% of breast and colon
Magnitude of benefits from reaching
cancer burden minimum recommendations for physical
• 27% of diabetes burden activity. Risk reductions:
• 30% of ischaemic heart disease • 20-30% for CHD and CVD morbidity and mortality
burden
• Cancer risks:
– 30% for colon cancer
– 20% - 40% for breast cancer
– 20% for lung cancer
– 30% for endometrial cancer
– 20% for ovarian cancer
Physical Activity Guidelines Advisory Committee. • 30% for developing functional limitations
Physical Activity Guidelines Advisory Committee
Report, 2008. Washington, DC: U.S. Department of • 30% for premature all-cause mortality
Health and Human Services, 2008.


Focus: regular walking saves lives


Source: Hamer and Chida, 2008

Inactivity status in the European Region
• WHO estimates that in adults :
– 63% are not reaching the minimum
recommended level of physical activity
– 20% of those are rated as “inactive”
– 38% are sufficiently/highly active

• Citizens of Mediterranean and central
European countries tend to exercise
less

• In England only 17% of men and 13% Global Health Risk Report, World Health Organization, 2009

of women aged 65-74 are physically Eurobarometer 72.3. Special Eurobarometer 334: Sport and PA
National Centre for Social Research et al (2004) Health Survey for
active. England 2003


WHO Global Recommendations on
Physical Activity for Health

How much physical activity do we need?
WHO Global Recommendations
• Main aim: providing
guidance on dose response
relation between frequency,
duration, type and total
amount of PA needed for
prevention of NCD’s
• Three age-groups; 5-17
year olds; 18-64; and 65+
• Main target audience;
national and local policy
makers


Global Recommendations
Intensity of activity Domains of activity

recreation and sports
moderate

transportation

How often?
vigorous How long? household
How much in
total? work/school
Type of activity

Aerobic Strength Balance Flexibility


Adults aged 18-64
• At least 150 minutes of Moderate
intensity PA spread throughout the
week
OR
at least 75 minutes of Vigorous PA
spread throughout the week
OR
an equivalent combination of those
two
• Bouts of at least 10 minutes.


Older adults – >64 years old
• Same recommendations as for adults

Specific recommendations:
• perform PA to enhance balance and
prevent falls on 3 or more days/ week.
• Muscle-strengthening activities on 2 or
more days a week.
• be as physically active as their
abilities and conditions allow.


Main points to keep in mind
• The more physical activity, the less disease
• Some physical activity is better than none
• Minimum recommendation of 150 minutes
(or 5x30) per week of at least moderate
intensity
• All bouts of physical activity of at least about
10 minutes duration count
• More physical activity is good for health,
most of all in inacitve and low-active
individuals


Strategy and Action Plan on healthy aging
2012-16
Priority interventions:
• Falls prevention
• Environments & social activities for physical
activity
• Vaccination of older persons and of care staff
• A basic support package for home care
• Improved training of staff in geriatrics and
gerontology

Strategy and Action Plan on healthy aging
2012-16
Supportive interventions:
• Prevention of social isolation and social
exclusion
• Quality of care strategies for older people
• Prevention of elder maltreatment


Lets keep the momentum:
2012 , the year of “Ageing & Health”
• World Health Day 2012 on
Ageing and Health: 7 April
• EU Year of active and healthy
ageing and intergenerational
solidarity
• WHO “Strategy and Action Plan
on Healthy Ageing in Europe”
• 10th Anniversary of Madrid
International Plan of Action on
Ageing


Denmark: City of all Generations

• Competition for most attractive
city for all generations to live in
• Award ($$$) by the Danish
Ministry of Social Affairs and
Integration to further develop
local projects
• Focus on how the built
environment can promote active
Danish Ministry of Social Affairs and Integration living

Good health adds life to years
‫الصحة الجيدة تضيف حيا ة ً إلى السنين‬
健康有益长寿
Une bonne santé pour mieux vieillir
Хорошее здоровье прибавляет жизни к годам
La buena salud añade vida a los años
Gesundheit erfüllt die Jahre mit Leben

For more information:
www.euro.who.int/ageing


Christian Schweizer presentation for Age UK

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