Dr Briony Dow, Emma Renehan and Xiaoping LinNational Ageing Research Institute (NARI)

Sue Hendy, Stephanie Harper and Dr Kathleen BrasherCouncil on the Ageing (COTA)

IFA Conference Prague May 2012

Health Promotion for older men and women: 10 years on

Overview

– Madrid Plan and Active Ageing Framework– Older people’s views of healthy ageing– Main NCDs in Australia and risk/protective

factors– Evidence re health promotion for older people

• Education• Physical activity• Volunteering• Age friendly cities

– Summary and directions

WHO Madrid International Plan of Action on Ageing

• Adopted at 2nd World Assembly on Ageing April 2002– “build a society for all ages”– method for “mainstreaming ageing into

national policy agendas”• Involve older people• Needs assessment• Policy and program formulation• Implementation and evaluation

Active ageing

• Active Ageing Framework also launched in 2001

• “the process of optimising opportunities for health, participation and security in order to enhance quality of life as people age”

The Active Ageing framework– Health

• Prevention of chronic disease and disability• Reducing risk factors and increasing protective factors throughout

the life course• Health and social services• Education and training to caregivers.

– Participation • Life long education and learning opportunities• active participation in economic development• formal and informal work and voluntary activities• full participation in family & community life

– Security (social, financial and physical) & rights

Older people’s views• Can have health problems and still “age well”• Keeping active (mentally and physically)• Enjoying life• Keeping engaged• Positive attitude• Meaningful engagement• Good relationships with

family and friends• Physical activity important• Financial security

COTA volunteers discussing healthy ageing

What do we need to avoid?• Leading causes of death 85+:

– Cardiovascular disease– Respiratory disease– Cancer– Mental disorders (including dementia)

• Leading burden of disease (whole Pop)– Coronary heart disease– Depression and anxiety– Type 2 diabetes

• Leading burden of disease (disability) 75+ – Dementia

Modifiable Lifestyle Risk factors• Smoking• Physical inactivity• Inadequate diet• Alcohol abuse• Social isolation

Good evidence that modification of lifestyle factors even at later life can reduce risk of NCDs

Health Promotion and older people• Health = physical and mental health,

participation and security– Active ageing framework– Older people’s views– Scientific evidence

– Active Ageing Framework provides useful framework for broad based health promotion for older people

Social determinants of healthy ageing• Education• Income/employment

opportunities• Gender• Cultural diversity• Capacity to participate

in physical activity• Environment

WHO Active Ageing Framework

Health Promotion • Education• Physical activity programs• Volunteering• Age friendly cities

What is the evidence?

Health Education• Most common form of health promotion• Relies on health literacy• Delivery methods

– Health professional (variable)– Peer education (preferred)– Mass media (effective <smoking)

Physical activity programs• Physical activity guidelines• Group based programs

– Benefit of social component– Higher participation rates– Increased physical activity

• Barriers – ageism, ageist stereotypes, built environment, hard to reach groups

PA recommendations for older AustraliansOlder people should:

1.Do some form of PA regardless of – age, weight, health problems, abilities2.Be active every day in as many ways as possible 3.Accumulate at least 30 minutes of moderate intensity PA on most, preferably all, days.4.Start at a level that is easily manageable and gradually increase.5.But older people who have undertaken vigorous PA throughout their lives can continue to do so in a manner suited to their capability.

Volunteering

• Benefits:– Morbidity– Functional health– Self reported health– Life satisfaction

• Not all volunteering has equal benefit– Benefit to others– Supported (formal rather than informal)– Social connection

Age Friendly Cities• Started in 2005 by WHO, 33 cities• Inclusion of older people in planning and

development (focus groups)• Global Age Friendly Cities Guide• Global Network

“to help cities see themselves from the perspective of older

people in order to identify where and how they can become more

age-friendly”

Summary • Active Ageing Framework useful for understanding health

and older people• Health promotion for older people still developing field -

needs– Policy– Programs– Evaluation and research– Older people led

• Evidence so far suggests that programs that are multi-factorial (social, educational, activity based, enable meaningful participation) have most benefit