Healthy Ageing N245:22
Winter 2012
Ageing in the 21st Century
Mrs. Matsu Yamasaki, 103 years old
http://wisdom.unu.edu/en/ageing-societies/
10 facts on ageing (WHO)
http://www.who.int/features/factfiles/ageing/ageing_facts/en/index.html
10 facts on ageing (WHO, 2011)1
The ageing of the world's population is an indicator of improving global health.
The world's elderly population - people 60 years of age and older - is 650 million.
By 2050, the "greying" population is forecast to reach 2 billion.
Trends & Issues in Ageing: A Global Perspective
7 % of the world’s population is 60 or over
Minority World--15%
Majority World — 5%
Projected that the % Minority World will triple over next 25 yrs or so
Due to ↓ fertility rates (6.2 births / women projected to 1.9---3.3 / women in 2025
About 60% of the world’s senior population live in Minority World developed countries, projected
to be 85% by 2050
The numbers of the ‘oldest old’ (>80), are increasing at the fastest rate
Annual growth rate of 3-4%
(>60 total group is ↑ @ 2% annually)
Projected to increase fivefold by 2050 (largest increase in Japan)
Trends & Issues in ageing
(Statistics Canada, Canada Year Book 2010, p. 365)
13.9% of population is 65 yrs and older
1 of every 7 a senior
2021:18%
2039: 25%
(2009) 1.3 million aged 80 and older in Canada
4% of population
(2009) 6000 Canadians aged 100 and over
Geographical Variation
15.8% in
PEI
NB
1
Nova Scotia
15.3%
15.5 %
http://www.who.int/features/factfiles/ageing/ageing_facts/en/index.html
2
NL 14.8
Maritime provinces has largest proportion of seniors
# 10. AB
1% in Nunavut
The evidence is clear.2
Older adults can live longer, healthier lives by
staying socially connected,
increasing their levels of physical activity,
eating in a healthy way,
taking steps to minimize their risks for falls,
and refraining from smoking.
There are real environmental, systemic and social barriers to adopting these healthy behaviours. Some
relate to inequities as a result of
gender,
culture,
ability,
income,
geography,
ageism and
living situations.
Resources examined and discussed:
Turcotte, M., & Schellenberg, G. (2007). A portrait of seniors in Canada 2006. Ottawa, ON: Statistics
Canada.
Nova Scotia. Department of Seniors. (2009). Seniors statistical profile 2009. Halifax, Canada: Author.
International Perspective3
 From 1950 to 2010, the share of Canada’s population aged 65 and older increased from 8% to 14%
 Japan recorded the highest proportion of people aged 65 and older among OECD countries in 2010,
at 23%.
 Mexico recorded the lowest proportion at 6%.
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2
Gender ratio globally
majority of older adults = women
82 men : 100 women
among oldest old 55 ♂ : 100 ♀
in the Majority World, the differences in life expectancy is less than in the Minority World
Public Health Agency of Canada. (2009). A vision for healthy aging. A new vision (Chapter 3).
Ottawa, Canada: Author. Retrieved from http://www.phac-aspc.gc.ca/
3
Statistics Canada. (2011). Canada year book, p. 409
3
If desired, more info on Global issues and trends re. ageing4
Topics include:
Married
Living alone
Labour force
Retirement age, etc.
Aging, Health & Nursing in the 21st Century
Older Canadians (p. 7)
↓ in hospitalization for hip fractures
improvements in functional health—particularly in older men
 in number of seniors who never smoked
perceive themselves quite healthy—physically & mentally
still face many complex health challenges assoc with aging
quality of life tends to ↓ with age
prevalence of chronic disease is 
more limited in activities than younger Canadians
7% need help with ADL
24% need help with IADL
 disabilities  with age
are at higher risk of injuries that will limit mobility & independence
~ 16% of Canadians >65 yr will experience some cognitive impairment
 Risk  with age
Strategic Priorities
Healthy and successful aging
The biological mechanisms of aging
Cognitive impairment in aging
Aging and maintenance of functional autonomy
Health services and policy relating to older people
Definitions
Geriatrics - deals with the medical problems associated with aging as well as disease processes
that affect older adults. It is a term with the medical focus, a sub-specialty of internal medicine
Gerontology – study of the possible causes of aging and the physical, psychological and social
results of the aging process
Wellness: The best achievable balance between one’s environment, internal & external, and one’s
emotional, spiritual, social, cultural, and physical processes” (Ebersole et al., 2008, pp. 45-46)
What is old? [Chronological Definition]
65-74
75-84
85-95
>95
4
Young - old
(middle) old
Old - old
Elite - old
World Health Organization. (2007). Global age-friendly cities: A guide. Retrieved from
http://www.who.int/ageing/publications/Global_age_friendly_cities_Guide_English.pdf
4
Types of Aging
Chronological age
Biological age
Psychological age
Social age
“Active ageing is the process of optimizing opportunities for health, participation and security in
order to enhance quality of life as people age.” 5
Emerging issues (WHO)6
Older persons and HIV/AIDS
Abuse of older people
Developing countries will become old before they become rich while industrialized countries
became rich before they were growing old.7
Strategy: Age-friendly cities
Housing
Public transportation
Well-lit streets that encourage walking
Traffic lights with sufficient time
Recreational activities
Opportunities for income-generating activity
Increase access to cost-effective procedures that help maintain activity
Canadian Scene
Gerontologic Nursing Association was constituted in 1985
Canadian gerontologic nurses wrote the first certification exam in 1999 (330 nurses passed)
Certification is valid for 5 years
CNA certification
16,260 RNs held CNA certification8 (p.2)
gerontology is the specialty with the most certified nurses in Canada
2118 GNC(C) in Canada (2010)
126 in NS (6 in 2005)
5
World Health Organization. (2002). Active ageing: A policy framework. Retrieved from
http://whqlibdoc.who.int/hq/2002/WHO_NMH_NPH_02.8.pdf
6
WHO. (2005). International plan of action on ageing: Report on implementation. Retrieved
from http://www.who.int/gb/ebwha/pdf_files/WHA58/A58_19-en.pdf
7
WHO. (n.d.) Older people and Primary Health Care. Retrieved January 29, 2008
http://www.who.int/ageing/primary_health_care/en/index.html
8
CNA. (2011, Spring/Summer). Certification Bulletin. 11.
5
Gerontological Nursing Competencies & Standards for Practice (2010)9
Standard I: Physiological health
Standard II: Optimizing Functional Health
Standard III: Responsive Care
Standard IV: Relationship Care
Standard V: Health System
Standard VI: Safety and Security
Influence of Myths of Ageing on nursing
ageism
reduced healthcare services
segregation of older adults from mainstream society
nurse recruitment difficulties
Implications for nursing
education
basic
continuing
practice
research
Theories of ageing
Active Ageing: 10
The process of optimizing opportunities for health, participation and security in order to enhance
quality of life as people age.
The Ageing Process
The ageing process is multifactorial & includes:
Benign changes, such as graying hair
Nonbenign changes, such as senescence
Individualized ageing progression
Modifiable changes related to lifestyle
Normal or universal ageing processes
Prominent Theories of Ageing
Biological Theories
Stochastic (Error) theories
Nonstochastic theories
Emerging biological theories
Neuroendocrine control or pacemaker
Caloric restriction (metabolic)
Telomere function (genetic research)
Biological Ageing Theories
Stochastic (Error) Theories
Wear-and-Tear
9
Canadian Gerontological Nursing Association. (2010). Gerontological nursing competencies and
standards of practice. In course text, p. 16 Box 2-6.
10
WHO, 2002, Retrieved from http://whqlibdoc.who.int/hq/2002/WHO_NMH_NPH_02.8.pd
6
Cross-Link
Free Radical & antioxidants
Nonstochastic (Programmed) Theories
Neuroendocrine-immunological
Lifespan Development Approach
Development is lifelong.
Development depends on history and context.
Development is multidimensional and multidirectional and involves a balance of growth and
decline.
Development is plastic rather than rigid.
Sociological Ageing Theories
Disengagement
Activity
Continuity
Age-stratification
Social exchange
Modernization
Symbolic interaction
Sociological Theories of Aging
Disengagement Theory
Old age is a time when both the older person and society engage in mutual separation, as in
the case of retirement.
Sociological Theories of Aging
Activity Theory
Based on the belief that remaining as active as possible contributes to successful aging
Sociological Theories of Aging
Continuity Theory
Continuity strategies are used to adapt to the changes of normal aging.
People are motivated toward inner psychological continuity as well as outward
continuity of social behaviour and circumstances.
Continuity is a fluid concept and does not imply that people do not change; rather
there is coherence and consistency of patterns over time.
Sociological Theories of Aging
Age-Stratification Theory
Goes beyond the individual to the age structure of society
Social institutions such as workplaces or families are partly organized by age, with
segregation of older and younger people within these social institutions.
Older people can be understood as members of specific “birth” cohorts (e.g., baby
boomers), in which people of the same cohort have shared similar historical periods
in their lives.
Sociological Theories of Aging
Social Exchange Theory
Based on consideration of cost-benefit model of social participation
Withdrawal or social isolation is the result of an imbalance in the social exchanges
between older persons and younger members of society.
7
The balance determines the older person’s personal satisfaction and social support at
any time.
Sociological Theories of Aging
Modernization Theory
Attempts to explain social changes result in devaluing of both contributions of elders
and of older people themselves
The status, and therefore the value, of older people is lost in society when their
labours are no longer considered useful.
Sociological Theories of Aging
Symbolic Interaction Theories
Propose that the kind of aging process people experience is a result of interactions
between the environment, the individual, and the meaning the person attributes to his
or her activities
Psychological Theories
Jung’s Theory of Personality
developmental Theories (Erikson & Peck)
gerotranscendence
Maslow’s Hierarchy of Human Needs*