Ageing and health

1 October 2022

Key facts
 All countries face major challenges to ensure that their health and social
systems are ready to make the most of this demographic shift.
 In 2050, 80% of older people will be living in low- and middle-income
countries.
 The pace of population ageing is much faster than in the past.
 In 2020, the number of people aged 60 years and older outnumbered
children younger than 5 years.
 Between 2015 and 2050, the proportion of the world's population over 60
years will nearly double from 12% to 22%.

Overview

People worldwide are living longer. Today most people can expect to live into their
sixties and beyond. Every country in the world is experiencing growth in both the size
and the proportion of older persons in the population.

By 2030, 1 in 6 people in the world will be aged 60 years or over. At this time the
share of the population aged 60 years and over will increase from 1 billion in 2020 to
1.4 billion. By 2050, the world’s population of people aged 60 years and older will
double (2.1 billion). The number of persons aged 80 years or older is expected to
triple between 2020 and 2050 to reach 426 million.

While this shift in distribution of a country's population towards older ages – known as
population ageing – started in high-income countries (for example in Japan 30% of
the population is already over 60 years old), it is now low- and middle-income
countries that are experiencing the greatest change. By 2050, two-thirds of the
world’s population over 60 years will live in low- and middle-income countries.

Ageing explained

At the biological level, ageing results from the impact of the accumulation of a wide
variety of molecular and cellular damage over time. This leads to a gradual decrease
in physical and mental capacity, a growing risk of disease and ultimately death.
These changes are neither linear nor consistent, and they are only loosely
associated with a person’s age in years. The diversity seen in older age is not
random. Beyond biological changes, ageing is often associated with other life
transitions such as retirement, relocation to more appropriate housing and the death
of friends and partners.

Common health conditions associated with ageing

Common conditions in older age include hearing loss, cataracts and refractive errors,
back and neck pain and osteoarthritis, chronic obstructive pulmonary disease,
diabetes, depression and dementia. As people age, they are more likely to
experience several conditions at the same time.

Older age is also characterized by the emergence of several complex health states
commonly called geriatric syndromes. They are often the consequence of multiple
underlying factors and include frailty, urinary incontinence, falls, delirium and
pressure ulcers.

Factors influencing healthy ageing

A longer life brings with it opportunities, not only for older people and their families,
but also for societies as a whole. Additional years provide the chance to pursue new
activities such as further education, a new career or a long-neglected passion. Older
people also contribute in many ways to their families and communities. Yet the extent
of these opportunities and contributions depends heavily on one factor: health.

Evidence suggests that the proportion of life in good health has remained broadly
constant, implying that the additional years are in poor health. If people can
experience these extra years of life in good health and if they live in a supportive
environment, their ability to do the things they value will be little different from that of
a younger person. If these added years are dominated by declines in physical and
mental capacity, the implications for older people and for society are more negative.

Although some of the variations in older people’s health are genetic, most is due to
people’s physical and social environments – including their homes, neighbourhoods,
and communities, as well as their personal characteristics – such as their sex,
ethnicity, or socioeconomic status. The environments that people live in as children –
or even as developing fetuses – combined with their personal characteristics, have
long-term effects on how they age.

Physical and social environments can affect health directly or through barriers or
incentives that affect opportunities, decisions and health behaviour. Maintaining
healthy behaviours throughout life, particularly eating a balanced diet, engaging in
regular physical activity and refraining from tobacco use, all contribute to reducing
the risk of non-communicable diseases, improving physical and mental capacity and
delaying care dependency.

Supportive physical and social environments also enable people to do what is

important to them, despite losses in capacity. The availability of safe and accessible
public buildings and transport, and places that are easy to walk around, are
examples of supportive environments. In developing a public-health response to
ageing, it is important not just to consider individual and environmental approaches
that ameliorate the losses associated with older age, but also those that may
reinforce recovery, adaptation and psychosocial growth.

Challenges in responding to population ageing

There is no typical older person. Some 80-year-olds have physical and mental
capacities similar to many 30-year-olds. Other people experience significant declines
in capacities at much younger ages. A comprehensive public health response must
address this wide range of older people’s experiences and needs.

The diversity seen in older age is not random. A large part arises from people’s
physical and social environments and the impact of these environments on their
opportunities and health behaviour. The relationship we have with our environments
is skewed by personal characteristics such as the family we were born into, our sex
and our ethnicity, leading to inequalities in health.

Older people are often assumed to be frail or dependent and a burden to society.
Public health professionals, and society as a whole, need to address these and other
ageist attitudes, which can lead to discrimination, affect the way policies are
developed and the opportunities older people have to experience healthy aging.

Globalization, technological developments (e.g., in transport and communication),

urbanization, migration and changing gender norms are influencing the lives of older
people in direct and indirect ways. A public health response must take stock of these
current and projected trends and frame policies accordingly.

WHO response

The United Nations (UN) General Assembly declared 2021–2030 the UN Decade of
Healthy Ageing and asked WHO to lead the implementation. The UN Decade of
Healthy Ageing is a global collaboration bringing together governments, civil society,
international agencies, professionals, academia, the media and the private sector for
10 years of concerted, catalytic and collaborative action to foster longer and healthier
lives.

The Decade builds on the WHO Global Strategy and Action Plan and the United
Nations Madrid International Plan of Action on Ageing and supports the realization of
the United Nations Agenda 2030 on Sustainable Development and the Sustainable
Development Goals.

The UN Decade of Healthy Ageing (2021–2030) seeks to reduce health inequities

and improve the lives of older people, their families and communities through
collective action in four areas: changing how we think, feel and act towards age and
ageism; developing communities in ways that foster the abilities of older people;
delivering person-centred integrated care and primary health services responsive to
older people; and providing older people who need it with access to quality long-term
care.
Vienna

Committed To Becoming More Age-Friendly

Vienna Austria
Print this pageCity population: 190000022 % over 60Joined Network in 2023

Vienna has nearly two million residents, with over 400,000 aged 60 and over. A wealth of green space,
social housing, an excellent health-care system, extensive social welfare services and its pursuit of
innovative and sustainable development characterize Vienna. The city makes every effort not to leave
anybody behind – independent of their gender, ethnic background, sexual orientation, financial means, or
age.
Senior citizens are an important target group in all areas of life in Vienna, such as housing, mobility, safety,
and health. Vienna’s goal is to enable older people to live a self-determined life and strengthen senior
citizens’ participation.
Numerous measures show Vienna’s commitment to creating an age-friendly environment: a densely-woven
network of nursing and care services, comprehensive recreational activities, affordable housing, support
and social benefits, low-threshold information, a well-developed, accessible public transport network and
many more.
With its own Senior Citizens’ Advocate, the city of Vienna shows particular attention to the older
generation. In her capacity as the city’s Senior Citizens’ Advocate, Sabine Hofer-Gruber looks after the
target group’s needs and requirements and ensures the further development of Vienna as a liveable city for
the older generation.
Together with her team “Vienna for Seniors”, the City of Vienna’s Senior Citizens‘ Advocate initiates and
coordinates projects and events and closely cooperates with district chairpersons, municipal departments,
organisations and all district senior citizens‘ Advisor to specifically address the needs of Vienna’s senior
citizens.
“Vienna for Seniors” coordinates the further development of the “Dementia-Friendly Vienna” platform and
the operationalisation of Vienna’s dementia strategy, and is responsible for the strategic development of the
City of Vienna’s elderly home visiting service. In addition, the team organises the Senior Citizens Month, a
series of events for older people which is held every year in October.
Cardiff

Committed To Becoming More Age-Friendly

Cardiff Wales
Print this pageCity population: 36424814 % over 60Joined Network in 2022

Cardiff is committed to being a great place to grow older and a place where older people are more
empowered, healthy and happy.

The Wellbeing of Future Generations (Wales) Act 2015 required each local authority area to undertake an
assessment of wellbeing; encompassing social, economic and cultural factors, to inform a local wellbeing
plan.

Key findings from the Wellbeing Assessment:

– Rapid growth in population age 65+

– The number of citizens over the age of 85 is anticipated to double by 2030

– Older people are more likely to have long term conditions and complex care needs, and therefore require
additional primary care services

– Health, affordability of housing, public transport and access to services are significant factors that
contribute to the wellbeing of older citizens
– By 2035, it is predicted that over 6,000 people in Cardiff will be living with dementia

Cardiff Well-being Plan 2018-2023

Cardiff’s Public Services Board (Cardiff PSB) brings together the city’s public service leadership and
decision makers, including those from the Council, Health Board, Natural Resources Wales, Welsh
Government, The Third Sector and the Fire, Police and Probation Services. The purpose of the PSB is to
improve the economic, social, environmental and cultural wellbeing of Cardiff by strengthening joint
working across the city’s public services.

Cardiff’s wellbeing plan sets out the priorities of the Public Services Board and focuses on areas of public
service delivery that requires partnership working between the city’s public and community services, in
collaboration with the citizens of the city.

Actions related to older people are encapsulated within Wellbeing Objective 6 – Cardiff is a great place to
grow older.

Wellbeing Objective 6

How a society treats people as they get older reflects its values and principles, and sends an important
message to future generations. Cardiff’s ambition is for the city to be a great place to grow older, where
older people are more empowered, healthy and happy, supported by excellent public and community
services and integrated within all areas of community life.

Older people will increasingly become an asset to the city, making a significant contribution to the
economy, the life of the city and its communities. As the city grows, it will also be important that new
communities are designed in a way that accommodates the needs of older people. This will require joint
planning alongside the provision of a range of future accommodation options to meet the demand for
housing and enable people to remain at home and active in the community.

A preventative approach will be of central importance. Accelerating the integration of services for older
people, and joining up our resources and services at a community level, will ensure that as many people as
possible are able to receive care in their communities. Meanwhile, investment can be focused on prevention
and the promotion of independent living. This will not only deliver better health outcomes, it is also a more
sustainable approach to meeting an individual’s needs in later life, by reducing pressures and costs on the
city’s health and care services.

Voluntary sector groups and organisations are developed and run by the people whose interests they
represent. The ageing population, together with growing pressure on the NHS and other public services,
will make the voluntary sector’s role even more important. The sector already provides a range of
preventative and responsive services that contribute to the wellbeing of the population, including older
people. From formal services aligned to statutory sector provision, through to informal activities and
services, the sector helps to connect people – including older people – within our communities. In doing so,
it assists in meeting strategic priorities – such as increasing social cohesion, reducing loneliness and
improving levels of activity.

Being an Age Friendly City, and being Dementia Friendly, will mean adapting the city’s structure and
services to be accessible to, and inclusive of older people with varying needs and capacities. This means
ensuring that policies and programmes of work which focus on the needs of older citizens, particularly the
most disadvantaged or excluded, are central to the work of service providers. Planning practices will
require genuine collaboration with older people, their carers and their families. This will help to ensure that
information, support, assessment, diagnosis and care plans are citizen-led, reflecting what is important to
them and achieves the outcomes they value. This will include drawing on all of the assets within the public
and community sectors, and working in partnership on the basis of an equitable distribution of influence
and resources, to ensure this approach is developed sustainably.

Cardiff’s Commitments to Older People

We Will:

– Ensure that our citizens can live independently, and are connected to their communities, taking into
account what matters to them

– Create resilient communities and develop strong community networks that can support older people to
live well

– Deliver services in a locality setting, close to citizens homes as a foundation for the provision of
seamless, person-centred services

– Work towards a Dementia Friendly City which helps people living with dementia and their families to
thrive

– Ensure that older people are able to enjoy all aspects of city life and are provided with opportunities to
participate in activities and events to improve wellbeing and enrich their lives

– Deliver a city that is open and accessible to all, and work towards a transport system that everyone has
the confidence to use

– Deliver the best housing outcomes for all older people in Cardiff
– Collaborate with older people, their carers, support workers and families to improve assessment,
diagnosis and care planning practices so that their plan reflects what is important to them and achieves the
outcomes they seek

Cardiff aspires to membership of the Network as an opportunity to:

– Inspire change by showing what can be done and how it can be done

– Contribute to the connecting of cities and communities worldwide to facilitate the exchange of
information, knowledge and experience

– Discover appropriate innovative and evidence based solutions to challenges