Taking the long view of ageing in Ireland

 

Initial findings of the most comprehensive study of older people in the Republic shows they are enjoying a good quality of life, writes JAMIE SMYTH, Social Affairs Correspondent

THREE-QUARTERS of people aged 50 years and over rate their health as excellent or good and are enjoying their lives. But the most comprehensive study of older people ever undertaken in the Republic shows high levels of obesity and significant numbers fighting depression.

The study’s initial findings also show a number of undiagnosed illnesses among the 8,000 men and women surveyed, as well as high medication levels, particularly among those aged 75 and over.

The Irish Longitudinal Study on Ageing, which is being carried out by Trinity College Dublin in collaboration with researchers from other colleges, is assessing the health of the over-50s during a 10-year period until 2018.

Its initial findings, which are based on health assessments and interviews between 2009 and 2011, provide a generally positive picture of the health, lifestyle and quality of life of older adults.

They also show higher levels of education and wealth are likely to lead to better outcomes in later life.

Four out of five people over 50 years say they feel “life is full of opportunities” and 79 per cent of those aged 50-65 years say their health is excellent. This falls to 66 per cent for those aged 75 years and over, but this still suggests most older people are living healthy and fulfilling lives in Ireland.

The study found cardiovascular and non-cardiovascular diseases are common in older adults with the prevalence of most chronic conditions increasing with age.

Hypertension, angina and stroke are most common in men. Osteoporosis, arthritis and high cholesterol are more common in women.

One in 20 older adults report angina or a prior heart attack, while one in three report doctor diagnosis of high blood pressure.

The groundbreaking nature of the study, which for the first time in Ireland includes health screening as well as in-depth interviews, is underlined by its ability to pinpoint a number of undiagnosed health problems among participants.

In the case of hypertension, for example, 58 per cent of cases in men went undiagnosed. The rate for women was slightly lower at 49 per cent.

Similar problems were detected in a large number of undiagnosed cases of osteoporosis, a worrying finding that will give policymakers food for thought.

The study has also uncovered high medication use among older adults. One in five people over 50 years are taking five or more medications regularly. This rises to half of all people over 75 years, increasing the risk of drug-drug interaction.

Older adults with medical cards are more than twice as likely to be in the polypharmacy category – taking five or more drugs regularly – as adults without cover or with medical insurance.

This finding should provide policymakers and health professionals with opportunities to improve drug safety among older adults.

The study shows the obesity crisis in Ireland is impacting on older adults as much as the younger generation. Three-quarters of people aged over 50 years are either objectively overweight (44 per cent) or obese (34 per cent).

Poorer individuals and those with lower levels of education have the highest levels of obesity. They also exercise less than wealthy and educated people, according to the study, which shows half of those aged 75 years and over report low levels of physical activity.

Despite the positive outlook of most older adults, depression is common among the over-50s, with one in 10 reporting clinically depressive symptoms. Some 13 per cent of older adults also report clinically significant anxiety symptoms.

Failure to diagnose depression is a big problem, with 78 per cent of older adults displaying objective evidence of depression not reporting a doctor’s diagnosis of it.

Depression is associated with disability, increased use of medication and unemployment. Nearly two-thirds of older adults with depression have a disability or long-standing illness.

The study shows cognitive impairment rises sharply with age, with 35 per cent of people aged over 80 years reporting being affected by this. This compares to 4 per cent of 50-64 year olds.

The survey highlights high levels of memory impairment with 42 per cent of adults over 80 years of age forgetting to carry out actions they had been instructed to perform. This finding raises concerns about activities such as remembering to take medication, pay bills or take safety precautions.

The prevalence of disabilities rises with age from less than 10 per cent of those between 50 and 64 years to nearly 30 per cent of those over 75 years. The most common primary helper for people with disabilities is their spouse.

Widespread fears expressed about the breakdown of family and increasing isolation of older people in recent decades may be somewhat overdone.

The survey highlights the important care and support role played by the children of elderly parents, as well as the high level of financial and childcare support provided by the elderly to their adult children.

Three-quarters of people aged over 50 years live in close proximity to at least one of their children, while some 70 per cent of those most in need of support – aged over 75 years – have a child living in the country.

Three-quarters of adults aged over 50 years, who have elderly parents who are still alive, visit them at least several times a month.

Half of 50-64 year olds with surviving parents help them with household tasks and a quarter of all 50-64 year olds provide personal care to elderly parents.

The average amount of time spent on providing help to elderly parents is 10 hours per week, according to the survey.

The critical importance of family support for older people is highlighted by the low levels of State support, with just 3.5 per cent of people over 50 receiving State-provided home help services.

But care and support within families works both ways, particularly when it comes to finance.

Nearly a quarter (24 per cent) of older households have given large financial or material gifts worth more than €5,000 to their children in the past 10 years. In contrast, just 9 per cent of people aged over 50 years have received financial transfers from their children.

Older people also provide a range of non-financial help to their adult children.

Almost half of all 50-64 year olds provide care to grandchildren and a third provide practical help such as shopping and household chores.

The elderly provide a great deal of voluntary help within their communities, with almost a quarter giving some form of help to neighbours and friends, on average for eight hours per month.

A minority (6 per cent of women and 7 per cent of men) of people aged over 50 years suffer from social isolation. This is most prominent among people who have poor health.

The survey charts a link between loneliness and a wide variety of negative mental and physical health outcomes, such as depression, nursing home admission and mortality.

42%

of adults over

80

years of age forget to carry out actions they had been instructed to perform