Active Aging

Shelley de la Vega, MD, MSc, FPSGM

Chair, Committee on Aging
UP Manila- NIH
Institute of Health Policy
Background

 Total number of senior citizens (60

years old and over) was 4.6 million,
accounting for 5.97 percent of the
2000 Philippine population
 Number of senior citizens is expected
to reach seven million in 2010 and to
double in approximately 16 years
(NSO 2000 Census of Population and Housing)
What is Active Aging?
 Active ageing
is the process of optimizing
opportunities for health,
participation and security
in order to enhance
quality of life
as people age.
Active Aging

 NOT only physically active/labor force

 Retired people, people with illness or

disability can actively contribute

 AIM: extend life expectancy and

Quality Of Life
Determinants of
Active Aging
 Culture

shapes the way in which we age

because it influences all of the
other determinants of active aging
Gender

is the “lens” through which to consider

the appropriateness of various
policy options and
how they will affect the well being of
both men and women.
Determinant:
Health and Social Service
 Life course perspective
 Focus on health promotion and
disease prevention
 Equitable access to quality primary
and long-term health care
Health

Broader definition of health

(WHO):

BODY, MIND AND SPIRIT

Factors Affecting Health
of Adults of all Ages
 Nutrition
 Exercise
 Smoking
 Alcohol Intake
 Substance Use and Abuse
 Socioeconomic Status
 Gender
For many elderly in the developing world,
the most urgent nutritional issue is
HUNGER
 Baseline Survey
on the
National Objectives of Health
BSNOH
OLDER PERSONS
NIH-DOH 2000
 Age Distribution, 60+
Total Population
n=2,690

Age %
60-64 28.4
65-69 31.3
60% young –old 70-74 20.7
(age 60-69 years)
Mean age: 68.4 (6.8) 75-79 11.2
80-84 5.7
85+ 2.6
Physical Disability
n=149
BSNOH 2000
Disability %

1. Impaired 30.1
hearing
2. Blind 10

3. Unable to 3.4
walk
4. Difficult 0.7
walking
Others 53.5
Behavioral Determinants

Lifestyle changes
at any age, can delay or deter the onset
of disease, and can reduce or delay
functional declines and can promote
the quality of life.
Underlying Risk Factors –
“The Actual Causes of Death” USA

Behavior % of deaths, 2000

– Smoking 19%
– Poor diet & nutrition/ 14%
Physical inactivity
– Alcohol 5%
– Infections, pneumonia 4%
– Racial, ethnic, economic ?
disparities

McGinnis and Foege 1993

 Never too late to change!
 EX. STOP SMOKING
– Prevent children from smoking
– Older adults also benefit from quitting
 EX. PHYSICAL ACTIVITY
– Prevent heart disease, falling, diabetes
Physical Activity
= $3.2 medical cost saved per
$1 investment in measures that encourage moderate
physical activity
Influenza Vaccination
= $30-60 medical cost saved per $1 on vaccine
Vaccination
BSNOH 2000
Vaccine Total Pop
n=2690
%
Influenza 3.4

Pneumococcal 1.4

Tetanus 14.0

Hepatitis B 6.9
Personal Factors
 Biology and Genetics
– 30% of how we age and our
predisposition to disease
 Psychological factors
– Learning speed declines
– Wisdom, experience increase
– Resilience
Determinants Related to
the Physical Environment
 Physical Environment
– Access o health and social services
– Urbanization, women’s migration
 Housing
 Clean air and water
 Safe foods
Geriatric Health Services
BSNOH 2000
Service Total Pop
n=2690
%
Geriatric Screening 0.3

Urinary Incontinence 5.2

Memory Disorders 0.5

Depression/ 0.1
Affective Illness
Dental 54.9
 Obstacles to Immediate
Consultation
BSNOH 2000
Obstacle Total Pop
n=2690
%
No money 61.4
Too weak 8
No time, too busy 6.8
Too far 4.5
Transport problems 3.3

Doctor rarely comes to town 2.3

Others 20.0
What is an Age-Friendly
Environment?
 Enabling work environment
– ALLOWS FLEXIBILITY FOR PEOPLE WHO CARE
FOR ELDERLY
 Life-long learning and literacy
 Hearing aids and Low vision aids
 Barrier-free access
 Access to cost-effective medical procedures
 Long-term care
Venues of Care

 Family/home based care

 Community care
 Hospital/Acute
 Long-term Care
– Community
– Mental Health Care
– Hospice/palliative
PGH Geriatric Clinic

 Geriatric evaluation and management

 Multidisciplinary
Healthy Aging Club,
The Medical City

S de la Vega, MD, MSc, FPSGM

2009
Determinants Related to
the Social Environment
 Social Support
– Social Isolation increases risk of death
and dementia
 Protection from Violence and Abuse
 Education and Literacy
 Elder participation in volunteerism,
mentoring, visiting
– Ex. COSE Home Care Volunteers
Economic Determinants

 Income
 Social Protection
– Decline due to migration, nuclear family
– National old age pension
 Work
– Informal sector
Health Insurance
BSNOH 2000

Without 92.5%
With 7.5%

BSNOH 2000
Philippine Elderly Study
(UP Pop Inst 1996)
Most of those who felt that they had a
poor health status were:
Women
Rural residents
Widowed/Separated
With low educational attainment
Quality of Life
of Filipino Older Persons
A Conceptual Framework S de la Vega 2005
Physical

Psychological Economic

QOL

Environmental Spiritual

Social
How can you improve your
QOL and Well-being ?
S de la Vega WHOQOL-BREF FIL OP 2005

 finding a source of income

 finding a job
 Pera “para sa mga apo”
QOL of Older Filipinos
and Alleviation of Poverty
S de la Vega WHOQOL-BREF FIL OP 2005
 Improve access to various assets
 Employment beyond retirement age
(financial capital)
 Improve health care access and provide a
greater national health insurance system
(human capital)
 Encourage participation in family,
community and national organizations
(social capital)
 Philippine Plan of Action for
Senior Citizens (2006-2010)

Areas of concerns per priority direction:

 Senior Citizens and Development

– Mainstreaming ageing into development policy

and promoting full integration and participation
of SCs
– Provision of social protection and security
– Alleviation of poverty in old age

From: Bala, A. COMADD Postgrad 06

Philippine Plan of Action for
Senior Citizens (2006-2010)

Advancing Health and Well-Being into

Old Age
 Ensuring the quality of life at all ages,
including independent living, health and
well-being
 Providing quality health and long-term
care
Philippine Plan of Action for
Senior Citizens (2006-2010)

Ensuring Enabling and Supportive

Environments
 SC and the family

 Social service and community support

 Housing and enabling environments

 Care and support for caregivers

 Protection of the rights of SCs

Outcome of Successful
Active Aging Policies and
Programs
When health, labor market, employment,
education and social policies support active
ageing, there will potentially be:
 Fewer premature deaths in the highly productive
stages of life
 Fewer disabilities associated with chronic diseases
in older age
 More people enjoying a positive QOL as they grow
older
Outcome of Successful
Active Aging Policies and
Programs
 More people participating actively as
they age in social, cultural, economic
and political aspects of society, in paid
and unpaid roles and in domestic,
family and community life
 Lower costs related to medical
treatment and care services.
ACTs of Active Aging
 Academe and Scientific Community
– RESEARCH what works? How can we make it work? Is it
equitable and just?
– DOST and NAST role?
 Coordination with Government and NGOs
– Implementation of Plan of Action for Senior Citizens, RA
9257
– Grassroots
 Track Progress
– Is it working?
The supreme criterion by which the
success of a government can be
judged is the
quality of life its citizens
experience from birth to death.
US National Academy of Sciences
NAST Philippines

 ASM Theme:
– Active Aging to Achieve Quality Life

 Senior Scientists aware of issues

concerning the AGING FILIPINO
– NOW actively participating in this national
issue
THANK YOU!