Long life is a sign of good health. The ageing of the world's population - in developing and developed countries - 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.
Along with this positive trend, however, come special health challenges for the 21st century. Preparing health providers and societies to meet the needs of elderly people is essential: training for health professionals on old-age care; preventing and managing age-associated chronic diseases; designing sustainable policies on long-term care; and developing age-friendly services and settings.
Ageing is a global phenomenon. The world's elderly population - people 60 years of age and older - is the fastest growing age group. By 2050 about 80% of the elderly will be living in developing countries. Population ageing is occurring in parallel with rapid urbanization: in 2007 more than half of the world's population live in cities. By 2030 that figure is expected to rise to more than 60%.
Population ageing is a triumph of modern society. It reflects improving global health, but also raises special challenges for the 21st century in both developing and developed countries. In 2005, life expectancy in countries like Japan and France was already more than 80 years. Life expectancy is also rising in developing countries: a child born today in Chile, Costa Rica, Jamaica, Lebanon, Sri Lanka or Thailand can expect to live for more than 70 years.
Vast health inequalities persist, as is clear from differences in life expectancy at birth. For example, while Japan has the highest life expectancy in the world at 82.2 years, in several countries in Africa the figure is as much as 40 years lower.
Within countries, health inequalities are also significant. For example, in the United States of America higher socioeconomic groups can expect to live up to 20 years longer than those from lower socioeconomic groups.
By 2050, close to 80% of all deaths are expected to occur in people older than 60. Health expenditure increases with age and is concentrated in the last year of life - but the older a person dies, the less costs are concentrated in that period. Postponing the age of death through healthy ageing combined with appropriate end-of-life policies could lead to major health care savings.
Healthy older people also represent a resource for their families, communities and economies. Investing in health throughout life produces dividends for societies everywhere. It is rarely too late to change risky behaviours to promote health: for example, the risk of premature death decreases by 50% if someone gives up smoking between 60 and 75 years of age.
Effective, community-level primary health care for older people is crucial to promote health, prevent disease and manage chronic illnesses in dependent and frail patients. In general, training for health professionals includes little if any instruction about care for the elderly. However, they will increasingly spend time caring for this section of the population. WHO maintains that all health providers should be trained on ageing issues, regardless of their specialism.
Disasters and emergencies severely impact the most vulnerable, including older people. As examples: the highest percentage of fatalities in Indonesia caused by the 2004 Indian Ocean tsunami was in people 60 years of age and older, and the majority of the 2003 heat wave victims in Europe were people 70 years of age and older. Policies to protect older persons during emergencies are urgently required.
In older age, the risk of falls increases and consequences of injuries are far more serious. This leads to significant health, human and economic costs. In Australia, the average health system cost per one fall-related injury for people 65 years of age and older was US$ 3611 in 2001-2002.
Elder abuse is on the increase as the population ages and social dynamics change. WHO estimates that between 4% and 6% of older persons worldwide have suffered from a form of elder abuse - either physical, psychological, emotional, financial or due to neglect. Elder abuse is an infringement of human rights.