Want better mileage?
The pilot for The Irish Longitudinal Study on Ageing is now complete and aims to make Ireland a better place to grow older, writes JOANNE HUNT
IF YOU’RE aged 50 or more, you may already have had a visit from Tilda. Inquiring about such things as your physical and mental health, your family, alcohol intake and income, Tilda is the name given to The Irish Longitudinal Study on Ageing. With the pilot for this 10-year project now complete, some interesting insights on ageing in Ireland have emerged.
“The aim of the study is to get a better understanding of what it’s like to get older in Ireland and to be older in Ireland,” says professor of gerontology at Trinity College Dublin, Rose Anne Kenny, the principal investigator for the €29 million Department of Health project.
“The study will inform society and policymakers about issues so that we can make Ireland a better place to grow older.”
Comprising home visits and health assessments of 8,400 people, the findings from the first wave of the study will not be revealed until May. The data now available from the study’s pilot, however, already holds a mirror up to what it’s like to be older in Ireland.
One of the most startling findings of the Tilda pilot, which comprised 500 people, is “undesirable poly-pharmacy”, or a very high use of medications among older people. “For people over 65, using multiple medications is common, with at least 20 per cent of people being on five or more medications,” says Kenny.
She says it’s the first time the Department of Health has collected such data on this scale. “The study gives us the opportunity to look at those medications, compare them to the disorders that people have and identify any unnecessary and inappropriate medications,” she says.
“We’ll also be able to identify those people who have diseases for which they are not on the appropriate medication.”
When it comes to how those medications – and healthcare in general – is afforded by older people, the pilot confirms that more than 80 per cent of the over 70s use a medical card, according to Kenny.
“But we’ve found there’s quite a number of people in the 50-65 age bracket who have no coverage – no medical card and no private health insurance.”
Lack of awareness of diseases is another factor emerging from the Tilda pilot. “There’s around a 30 per cent gap in awareness between people who think they have high blood pressure, high cholesterol and osteoporosis and those who actually have it,” says Kenny. “Many men who had osteoporosis according to our tests were unaware they had it,” she says.
With the majority of those surveyed having visited a GP in the previous year, Kenny says there are opportunities to improve patient awareness of such diseases.
In the area of cardiovascular health and body mass index (BMI), Kenny says there are few surprises in the Tilda pilot results. While it is known from existing studies that Irish adults are among the most overweight in Europe, the pilot reveals that older Irish men in particular “underestimate their weight and overestimate their height”.
When it comes to the mental health of those aged 50 and over, the pilot study found that depression is common. “Depression is particularly high among the 50-64 age group,” says Kenny, affecting one in five people in this cohort.
“The majority of people who have depression, according to our objective tests in the pilot, are not aware or have never been told they had depression and are not in treatment for depression,” says Kenny.
Of those surveyed, levels of loneliness were very similar for both urban and rural dwellers, and was common in both older men and women.
Despite the existence of programmes to engage older men living in rural areas such as the GAA Social Initiative supported by President McAleese, Kenny says the Tilda pilot shows loneliness among older men living in cities is just as high.
The finding is no surprise to Alone chief executive, Seán Moynihan. The charity, which provides befriending services to vulnerable older people in Dublin, deals with more than 200 calls for help each month.
Last year, the charity reported increasing demand for its befriending programme, with 35 isolated older persons on a waiting list for visits.
“As people get older, they expect physical changes like getting a bit slower, but I don’t think they expect the pain and heartache that can come from being on your own,” says Moynihan.
“If you’re on your own, it doesn’t matter where you are – the feelings and the worry or the stress that can come from being lonely are the same.”
For older people with extended family however, the Tilda pilot found that the levels of informal care from family – “dropping in to say hello, help with meals, dressing, washing, shopping to living with family members” – were high, says Kenny.
On the issue of home ownership, Tilda found that while most of those over 70 own their own home, reliance on the State pension was very high and was, in many cases, the sole source of income.
However, Moynihan says that a finding of high home ownership among older people can be misleading.
“For some older people, the house itself can become a poverty trap. If a person can’t meet a big expense like rewiring, their home can fall into disrepair,” he says.
“We could come across people reliant on the State pension, and they are heating and using just two rooms in their home because they can’t manage the house. Owing a home can create poverty.”
The contribution of older people to the community was another key finding in the pilot, says Kenny.
“We found high rates of volunteerism among older people. About 15 per cent of those aged 50 and above frequently engage in volunteering activities at least once a week – helping in education programmes, social programmes or church programmes.”