active aging plenary nast 07.08.09_dela vega

8/7/2019 Active Aging Plenary NAST 07.08.09_dela vega

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Active AgingActive Aging

Shelley de la Vega, MD, MSc, FPSGMShelley de la Vega, MD, MSc, FPSGMChair, Committee on AgingChair, Committee on Aging

UP ManilaUP Manila-- NIHNIH

Institute of Health PolicyInstitute of Health Policy


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BackgroundBackground

Total number of senior citizens (60Total number of senior citizens (60years old and over) was 4.6 million,years old and over) was 4.6 million,accounting for 5.97 percent of theaccounting for 5.97 percent of the2000 Philippine population2000 Philippine population

Number of senior citizens is expectedNumber of senior citizens is expected

to reach seven million in 2010 and toto reach seven million in 2010 and todouble in approximately 16 yearsdouble in approximately 16 years

(NSO 2000 Census of Population and Housing)(NSO 2000 Census of Population and Housing)


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What is Active Aging?

What is Active Aging?


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Active ageingis the process of optimizing

opportunities for health,

participation and securityin order to enhance

quality of life

as people age.


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NOTNOT only physically active/labor forceonly physically active/labor force

Retired people, people with illness orRetired people, people with illness ordisability candisability can actively contributeactively contribute

AIM: extend life expectancy andAIM: extend life expectancy andQuality Of LifeQuality Of Life


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Determinants ofDeterminants of



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CultureCulture

shapes the way in which we ageshapes the way in which we agebecause it influences all of thebecause it influences all of the

other determinants of active agingother determinants of active aging


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GenderGender

is the lens through which to consideris the lens through which to considerthe appropriateness of variousthe appropriateness of various

policy options andpolicy options and

how they will affect the well being ofhow they will affect the well being ofboth men and women.both men and women.


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Determinant:Determinant:

Healthand Social ServiceHealthand Social Service

Life course perspectiveLife course perspective

Focus on health promotion andFocus on health promotion anddisease preventiondisease prevention

Equitable access to quality primaryEquitable access to quality primaryand longand long--term health careterm health care


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HealthHealth

Broader definition of healthBroader definition of health

(WHO):(WHO):

B

ODY, MIND AND SPIRITB

ODY, MIND AND SPIRIT


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Factors Affecting HealthFactors Affecting Health

of Adults of all Agesof Adults of all Ages NutritionNutrition

ExerciseExercise

SmokingSmoking

Alcohol IntakeAlcohol Intake

Substance Use and AbuseSubstance Use and Abuse Socioeconomic StatusSocioeconomic Status

GenderGender


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For many elderly in the developing world,For many elderly in the developing world,

the most urgent nutritional issue isthe most urgent nutritional issue is

HUNGERHUNGER


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Baseline SurveyBaseline Surveyon theon the

National Objectives of HealthNational Objectives of HealthBSNOHBSNOH

OLDER PERSONSOLDER PERSONSNIHNIH--DOH 2000DOH 2000


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Physical DisabilityPhysical Disabilityn=149n=149BSNOH 2000BSNOH 2000

DisabilityDisability %%

1. Impaired1. Impairedhearinghearing

30.130.1

2. Blind2. Blind 1010

3. Unable to3. Unable to

walkwalk

3.43.4

4. Difficult4. Difficult

walkingwalking

0.70.7

OthersOthers 53.553.5


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Behavioral DeterminantsBehavioral Determinants

Lifestyle changesLifestyle changes

at any age, can delay or deter the onsetat any age, can delay or deter the onsetof disease, and can reduce or delayof disease, and can reduce or delayfunctional declines and can promotefunctional declines and can promote

the quality of life.the quality of life.


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Underlying Risk FactorsUnderlying Risk Factors The Actual Causes of Death USAThe Actual Causes of Death USA

BehaviorBehavior % of deaths, 2000% of deaths, 2000

SmokingSmoking 19%19%

Poor diet & nutrition/Poor diet & nutrition/ 14%14%Physical inactivityPhysical inactivity

AlcoholAlcohol 5%5%

Infections, pneumoniaInfections, pneumonia 4%4%

Racial, ethnic, economicRacial, ethnic, economic ??disparitiesdisparities

McGinnis and Foege 1993


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Never too late to change!Never too late to change!

EX. STOP SMOKINGEX. STOP SMOKING

Prevent children from smokingPrevent children from smoking

Older adults also benefit from quittingOlder adults also benefit from quitting

EX. PHYSICAL ACTIVITYEX. PHYSICAL ACTIVITY

Prevent heart disease, falling, diabetesPrevent heart disease, falling, diabetes


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Physical ActivityPhysical Activity

= $3.2 medical cost saved per= $3.2 medical cost saved per

$1 investment in measures that encourage moderate$1 investment in measures that encourage moderatephysical activityphysical activity

Influenza VaccinationInfluenza Vaccination

= $30= $30--60 medical cost saved per $1 on vaccine60 medical cost saved per $1 on vaccine


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VaccinationVaccination

BSNOH 2000BSNOH 2000

VaccineVaccine Total PopTotal Pop

n=2690n=2690

%%

InfluenzaInfluenza 3.43.4

PneumococcalPneumococcal 1.41.4

TetanusTetanus 14.014.0

Hepatitis BHepatitis B 6.96.9


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Personal FactorsPersonal Factors

Biology and GeneticsBiology and Genetics 30% of how we age and our30% of how we age and our

predisposition to diseasepredisposition to disease Psychological factorsPsychological factors

Learning speed declinesLearning speed declines

Wisdom, experience increaseWisdom, experience increase

ResilienceResilience


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Determinants Related toDeterminants Related to

the Physical Environmentthe Physical Environment Physical EnvironmentPhysical Environment

Access o health and social servicesAccess o health and social services

Urbanization, womens migrationUrbanization, womens migration

HousingHousing

Clean air and waterClean air and water

Safe foodsSafe foods


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Geriatric Health ServicesGeriatric Health Services

BSNOH 2000BSNOH 2000ServiceService Total PopTotal Pop

n=2690n=2690

%%

Geriatric ScreeningGeriatric Screening 0.30.3

Urinary IncontinenceUrinary Incontinence 5.25.2

Memory DisordersMemory Disorders 0.50.5

Depression/Depression/

Affective IllnessAffective Illness

0.10.1

DentalDental 54.954.9


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Obstacles to ImmediateObstacles to ImmediateConsultationConsultationBSNOH 2000BSNOH 2000

ObstacleObstacle Total PopTotal Pop

n=2690n=2690

%%

No moneyNo money 61.461.4

Too weakToo weak 88

No time, too busyNo time, too busy 6.86.8

Too farToo far 4.54.5

Transport problemsTransport problems 3.33.3

Doctor rarely comes to townDoctor rarely comes to town 2.32.3

OthersOthers 20.020.0


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What is an AgeWhat is an Age--FriendlyFriendly

Environment?Environment? Enabling work environmentEnabling work environment

ALLOWS FLEXIBILITY FOR PEOPLE WHO CAREALLOWS FLEXIBILITY FOR PEOPLE WHO CARE

FOR ELDERLYFOR ELDERLY LifeLife--long learning and literacylong learning and literacy

Hearing aids and Low vision aidsHearing aids and Low vision aids

BarrierBarrier--free accessfree access

Access to costAccess to cost--effective medical procedureseffective medical procedures

LongLong--term careterm care


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Venues of CareVenues of Care

Family/home based careFamily/home based care

Community careCommunity care

Hospital/AcuteHospital/Acute

LongLong--term Careterm Care

CommunityCommunity

Mental Health CareMental Health Care

Hospice/palliativeHospice/palliative


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PGH Geriatric ClinicPGH Geriatric Clinic

Geriatric evaluation and managementGeriatric evaluation and management

MultidisciplinaryMultidisciplinary


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Healthy Aging Club,Healthy Aging Club,

The Medical CityThe Medical City

S de la Vega, MD, MSc, FPSGM

2009


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Determinants Related toDeterminants Related to

the Social Environmentthe Social Environment Social SupportSocial Support

Social Isolation increases risk of deathSocial Isolation increases risk of death

and dementiaand dementia Protection from Violence and AbuseProtection from Violence and Abuse

Education and LiteracyEducation and Literacy

Elder participation in volunteerism,Elder participation in volunteerism,mentoring, visitingmentoring, visiting Ex. COSE Home Care VolunteersEx. COSE Home Care Volunteers


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Economic DeterminantsEconomic Determinants

IncomeIncome

Social ProtectionSocial Protection

Decline due to migration, nuclear familyDecline due to migration, nuclear family

National old age pensionNational old age pension

WorkWork

Informal sectorInformal sector


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Health InsuranceHealth Insurance

BSNOH 2000BSNOH 2000

Without 92.5%Without 92.5%With 7.5%With 7.5%

BSNOH 2000


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Philippine Elderly StudyPhilippine Elderly Study

(UP Pop Inst 1996)(UP Pop Inst 1996)

Most of those who felt that they had aMost of those who felt that they had apoor health status were:poor health status were:

WomenWomen

Rural residentsRural residents

Widowed/SeparatedWidowed/Separated

With low educational attainmentWith low educational attainment


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Quality of Lifeof Filipino Older Persons

A Conceptual Framework S de la Vega 2005Physical

Economic

Spiritual

Social

Environmental

Psychological

QOL


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How can you improve yourHow can you improve yourQOL and WellQOL and Well--being ?being ?S de la Vega WHOQOLS de la Vega WHOQOL--BREF FIL OP 2005BREF FIL OP 2005

finding a source of incomefinding a source of income

finding a jobfinding a job

Pera Pera para sa mga apopara sa mga apo


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QOL and WellQOL and Well--being ofbeing ofF

ilipino Older PersonsF

ilipino Older PersonsS de la Vega WHOQOLS de la Vega WHOQOL--BREF FIL OP 2005BREF FIL OP 2005

The Filipino older persons quest for wellThe Filipino older persons quest for well--beingbeingis closely linked to his or her role, status, andis closely linked to his or her role, status, andcontinued service to familycontinued service to family


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Areas of concerns per priority direction:Areas of concerns per priority direction:

Senior Citizens and DevelopmentSenior Citizens and Development Mainstreaming ageing into development policyMainstreaming ageing into development policy

and promoting full integration and participationand promoting full integration and participationof SCsof SCs

Provision of social protection and securityProvision of social protection and security

Alleviation of poverty in old ageAlleviation of poverty in old age

From: Bala, A. COMADD Postgrad 06From: Bala, A. COMADD Postgrad 06

Philippine Plan of Action forPhilippine Plan of Action for

Senior Citizens (2006Senior Citizens (2006--2010)2010)


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Advancing Healthand WellAdvancing Healthand Well--Being intoBeing into

Old AgeOld Age Ensuring the quality of life at all ages,Ensuring the quality of life at all ages,

including independent living, health andincluding independent living, health andwellwell--beingbeing

Providing quality health and longProviding quality health and long--termtermcarecare


Senior Citizens (2006Senior Citizens (2006--2010)2010)


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Ensuring Enabling and SupportiveEnsuring Enabling and SupportiveE

nvironmentsE

nvironments SC and the familySC and the family

Social service and community supportSocial service and community support

Housing and enabling environmentsHousing and enabling environments Care and support for caregiversCare and support for caregivers

Protection of the rights of SCsProtection of the rights of SCs


SeniorC

itizens (2006SeniorC

itizens (2006--2010)2010)


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Outcome of SuccessfulOutcome of SuccessfulActive Aging Policies andActive Aging Policies and

ProgramsProgramsWhen health, labor market, employment,When health, labor market, employment,

education and social policies support activeeducation and social policies support active

ageing, there will potentially be:ageing, there will potentially be: Fewer premature deaths in the highly productiveFewer premature deaths in the highly productive

stages of lifestages of life

Fewer disabilities associated with chronic diseasesFewer disabilities associated with chronic diseases

in older agein older age More people enjoying a positive QOL as they growMore people enjoying a positive QOL as they grow

olderolder


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Outcome of SuccessfulOutcome of SuccessfulActive Aging Policies andActive Aging Policies and

ProgramsPrograms

More people participating actively asMore people participating actively asthey age in social, cultural, economicthey age in social, cultural, economic

and political aspects of society, in paidand political aspects of society, in paidand unpaid roles and in domestic,and unpaid roles and in domestic,family and community lifefamily and community life

Lower costs related to medicalLower costs related to medicaltreatment and care services.treatment and care services.


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AAcademe and Scientific Communitycademe and Scientific Community

RESEARCH what works? How can we make itRESEARCH what works? How can we make itwork? Is it equitable and just?work? Is it equitable and just?

DOST and NAST role?DOST and NAST role?

CCoordination with Government and NGOsoordination with Government and NGOs

Implementation of Plan of Action for SeniorImplementation of Plan of Action for Senior

Citizens, RA 9257Citizens, RA 9257 GrassrootsGrassroots

TTrack Progressrack Progress

Is it working?Is it working?

ACTs of Active AgingACTs of Active Aging


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The supreme criterion by which thesuccess of a government can be

judged is the

quality of life its citizens

experience from birth to death.

US National Academy of SciencesUS National Academy of Sciences


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NAST PhilippinesNAST Philippines

ASM Theme:ASM Theme:

Active Aging to Achieve Quality LifeActive Aging to Achieve Quality Life

Senior Scientists aware of issuesSenior Scientists aware of issuesconcerning the AGING FILIPINOconcerning the AGING FILIPINO

NOW actively participating in this nationalNOW actively participating in this nationalissueissue


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THANKYOU!THANKYOU!

active aging plenary nast 07.08.09_dela vega

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