Ageing and health

By 2030, one in six 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 one 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 – which started in high-income countries (for example in Japan 30 per cent 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 such as Ghana.

Ageing-biological level

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.

Ageing-Chronic disease conditions

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 characterised 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.

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 furthering 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 foetuses – 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.

Ageing is a well-established risk factor for several diseases – neurodegenerative, depression, cognitive decline, atherosclerosis, type 2 diabetes.

Ageing populations are defined by chronic conditions. According to National Council on Ageing (NCOA) of the USA, around 95 per cent of patients aged 65 or older have a minimum of one chronic condition, and 80 per cent have two or more.

A study conducted in Ghana among the elderly showed that major health problems for which older adults sought care in health centres were hypertension, stroke, diabetes and arthritis.
(Developing Integrated Response of Health Care Systems to Rapid Population Ageing: Intra II Ghana National Report. 2004.)

WHO response

The 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 realisation 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.

Anti-ageing

It is estimated that the proportion of people aged 60 and above will increase from 12 per cent in 2015 to 22 per cent in 2050.

Thus, delaying or preventing the onset of ageing-related diseases due to cellular damage and functional decline would greatly improve life quality and expectancy, as well as mitigate the burden on the current healthcare system.

It is widely acknowledged that disrupted homeostasis between oxidants and antioxidants would cause cellular damage and even organ dysfunction.

Consumption of polyphenol-rich foods counteract the abnormal oxidative stress and accumulation of excess oxidants such as reactive oxygen species (ROS), which cause DNA damage and cellular senescence.

Antioxidants mop up free radicals and neutralise the hazardous effects of oxidants. Oxidative stress plays an important role in ageing process and various ageing-associated chronic diseases. Reducing ROS has been shown to alleviate oxidative damage and extend lifespan (anti-ageing).

Polyphenols are the largest, most studied group of naturally occurring antioxidants, and are structurally categorised into phenolic acids, flavonoids, stilbenes, lignans, and other polyphenols with hydroxyl group(s) attached to the carbon atom on the aromatic ring (Luo et al.) Dietary Anti-Ageing Polyphenols and Potential Mechanisms. Antioxidants (Basel). 2021 Feb; 10(2): 283).

Cocoa is an excellent source of polyphenols.

The writer is Chief Pharmacist,
Cocoa Clinic.