One in four of us will be pensioners by 2050. Sylvia Thompson looks at the effects of an ageing population.
One in four people in Ireland will be over 65 in about 25 years. Put simply, many people in their 40s now (who, incidentally, were also an interesting statistic in the 1980s when one in two Irish people were under 25) will be living with a much larger number of their peers than in the past.
Internationally, figures are similar. In Germany, for instance, more than 20 per cent of the population will be over 65 by 2050. In Spain and Austria, it is predicted that 40 per cent of the population will be over 65 by 2050.
When these figures are bandied about, the first concerns are always related to pensions and healthcare. How will governments and private companies afford to pay pensions to such a large segment of the population?
How will healthcare systems cope with the increasing number of chronic and acute illnesses that will inevitably come with an ageing population? And how will economies remain buoyant if large numbers of these older people become poor and can't maintain the standard of living they have become accustomed to?
A conference in Switzerland recently opted to look more broadly at how we should adapt to such a demographic shift. Focusing on how this generation of older people will differ from its predecessors, the second annual conference of the World Demographic Society viewed the scenario both at a societal level and an individual level.
Of course, pensions and healthcare issues were discussed, but so too were the concepts of active or successful ageing, lifelong learning, flexible work models for older, experienced employees, volunteering, age-friendly cities and primary health clinics.
The need for cities to make public spaces more age-friendly was highlighted by Alexandre Kalache, head of the ageing and life course programme at the World Health Organisation (WHO) in Geneva, Switzerland. He spoke about the WHO age-friendly cities initiative in South America, in which older people are consulted about what changes would make it easier for them to get around.
"We've concentrated on urban areas because over 50 per cent of the world's population now lives in cities. We are also sensitising police forces to help them understand age-related disabilities so that people can continue to live in their communities for as long as possible," he told The Irish Times.
The WHO has also developed a model for age-friendly primary care centres with older people working as monitors of the accessibility of the physical environment and increased training for staff on the needs of older people. "Healthcare centres know lots about mothers and babies but often not very much about the needs of older people," said Kalache.
Speaking by satellite connection from Berlin, the German minister for family affairs, senior citizens, women and youth, Ursula Von Der Leyen, expressed her fears and hopes for an ageing population. She emphasised the need for countries such as Germany to develop family-friendly working conditions and good childcare services to allow women to combine work and family commitments.
She also spoke of how demographic change will be the focus of the German presidency of the European Union next year. Themes such as "experience is the future" will emphasise the value of older workers.
Another initiative promised is the "Houses of Generations" project which will offer people of all ages opportunities to take part in social and learning activities at local level.
A speaker from the not-for-profit organisation, the American Elder Hostel, echoed these sentiments in his talk on the current educational programme throughout the world for older and young people.
What constitutes quality of life for older people received a lot of discussion at the conference. "What is most striking is that older people rate social relationships and friendships above income in terms of important quality of life indicators," said Alan Walker, director of the European Research Area on Ageing and professor of social policy and social gerontology at the University of Sheffield in England.
Walker added that other significant predictors of quality of life in old age include how much personal control people have over their living environment, their perception of their economic security and the social dimension of their physical activities. One area which he believed required more attention is better design of information communications technology and domestic and public equipment to accommodate an ageing population.
Throughout the conference, there was a prevailing view that the perception of older people will have to change as more older people will be healthier than ever before. Older people will also be more active in work, political and social activities.
The need for inter-generational solidarity and for solidarity between the developed and developing world was expressed. However, to foster better health in old age, academics, health professionals and policymakers agreed that national healthcare agencies must commit themselves to a life-span approach to physical and mental health, nutrition and social activities.
The changing patterns of chronic and infectious diseases were the focus of some attention. Also discussed was the fact that many of our healthcare systems are still organised around the treatment of acute conditions and not the management of chronic conditions.
The expected rise in cancers, heart disease, stroke, depression and HIV/Aids is matched by an expected decline in perinatal conditions, respiratory diseases and other infectious diseases, according to Jeffery Sturchio, vice-president of external affairs at Merck pharmaceutical company in the US.
"This will require government policy and patients as partners in their healthcare. As people live longer, the increasing numbers of people with chronic disease and disability will put a strain on health budgets," he added. He and others suggested that there wasn't enough investment in prevention and health promotion by national governments.
According to Sturchio, active, informed patients are the natural partners in preventing and managing chronic disease more efficiently, and that only by putting in place policies now will we be able to celebrate the new demographic profile of our populations in 2050.
See www.wdassociation.org for papers presented at the World Ageing and Generations Congress 2006, which took place in Switzerland from September 27th-29th.