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Healthy Ageing Project Healthy Ageing Be a Particularly Rapid Increase in the Number of Aims to Promote Healthy Ageing Among People People Aged 80 Years and Older

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Healthy Ageing Project Healthy Ageing Be a Particularly Rapid Increase in the Number of Aims to Promote Healthy Ageing Among People People Aged 80 Years and Older BY 2025 ABOUT one-third of Europe’s popula- Co-funded by the European Commission, the tion will be aged 60 years and over and there will three-year (2004–2007) Healthy Ageing project Healthy Ageing be a particularly rapid increase in the number of aims to promote healthy ageing among people people aged 80 years and older. The countries aged 50 years and over. It involves ten coun- A CHALLENGE FOR EUROPE of Europe must develop strategies to meet this tries, the World Health Organisation (WHO), the challenge. Promoting good health and active European Older People’s Platform (AGE) and societal participation among the older citizens EuroHealthNet. The goal is exchange of know- HEALTHY AGEING – will be crucial in these strategies. ledge and experience among the European TheHealthy Ageing – a Challenge for Europe Union Member States and EFTA-EEA countries. report presents an overview of interventions The main aims have been to review and analyse on ageing and health. It includes suggested existing data on health and ageing, to produce a recommendations to decision makers, NGOs report with recommendations and to develop and practitioners on how to get into action to a comprehensive strategy for implementation of promote healthy ageing among the growing the report findings and the recommendations. number of older people. The report also presents different countries’ A CHALLENGE FOR EUROPE policies/strategies for older people’s health, summaries of reviews on the effectiveness of interventions for later life, and a number of ex- amples on good practice projects promoting healthy ageing. Data about the health of older people is presented. Swedish National Fax +46 8 566 135 05 Report R 2006:29 Institute of Public Health E-mail [email protected] ISSN: 1651-8624 Distribution Internet www.fhi.se ISBN: 91-7257-481-X SE-120 88 Stockholm Healthy Ageing – A Challenge for Europe PROJECT PARTNERS: CONTRIBUTORS TO THE HEALTHY AGEING PROJECT: AGE, European Older People’s Platform healthPROelderly, Austrian Red Cross, Austria EuroHealthNet SPF Santé Publique, Sécurité de la chaîne alimentaire WHO, World Health Organization, Ageing and Life Course et Environnement, Belgium Austrian Health Promotion Foundation, Austria VIG VZW, Vlaams Instituut voor Gezondheidspromotie, Belgium National Institute of Public Health, the Czech Republic Ministry of Health, Bulgaria The Health Development Agency, England (until July 14th 2005) Ministry of Health, the Czech Republic Middlesex University, England (from October 19th 2005) Ministry of Health, Cyprus Folkhälsan – an NGO for public health and health promotion, Age Institute, Finland Finland Finnish Centre for Health Promotion, Finland Università Degli Studi Di Perguia, Italy Finnish Institute of Occupational Health, Finland NIGZ, Netherlands Institute for Health promotion and Disease, GeroCenter Foundation for Research and Development, Finland the Netherlands Ministry of Social Affairs and Health,Finland The Norwegian Directorate for Health and Social Affairs, Norway National Research and Development Centre for Welfare and (until July 21st 2005) Health, STAKES, Finland Norwegian Knowledge Centre for the Health Services, Norway University Of Jyväskylä, Finland (from October 1st 2005) Direction Générale de la santé, France Ministério da Saúde Direcção Geral da Saúde, Portugal Bundeszentrale für gesundheitliche Aufklärung,Germany NHS Health Scotland, Scotland Federal Ministry of Health, Germany SNIPH, The Swedish National Institute of Public Health, Sweden Social Science Research Center Berlin, Germany Ministry of Health, Hungary Icelandic Institute of Public Health, Iceland Ministry of Health and Social Security, Iceland National Council on Ageing and Older People, Ireland Institute for Cognitive Science & Technology – National Research Centre of Italy, Italy Health Promotion State agency, Latvia Ministry of Health, Latvia National Centre for Health Promotion and Education, Lithuania Ministry of Health, Welfare and Sport, the Netherlands Verwey-Jonker Institute, the Netherlands National Council for Senior Citizens, Norway Health General Directorate, Portugal Ministry of Health, Poland National Institute of Hygiene, Poland Public Health Authority, the Slovak Republic Ministry of Health, the Republic of Slovenia National Institute of Public Health of the Republic of Slovenia, the Republic of Slovenia Stockholm County Council, Centre for Public Health, Sweden Ministry of Health and Social Affairs,Sweden Stockholm Gerontology Research Center, Sweden Umeå University, Sweden THE HEALTHY AGEING PROJECT IS Department of Health, United Kingdom CO-FUNDED BY THE EUROPEAN COMMISSION. Wales Centre for Health, Wales, United Kingdom The views expressed by the individuals who have contributed to this Report do not necessarily reflect official policy of the participating organisations. © The Swedish National Institute of Public Health R 2006:29 ISSN: 1651-8624 ISBN: 91-7257-481-X Illustrator: Ninni Oljemark, Kombinera Graphic design: Typoform AB All figure layouts redesigned by Typoform AB Print: NRS Tryckeri AB, Huskvarna 2007 Contents 7 PREFACE Environment 44 Lifestyle factors 45 8 EXECUTIVE SUMMARY Physical activity and nutrition 45 Injury prevention 47 13 CHAPTER 1. INTRODUCTION Substance use/misuse 50 Health promotion can improve older Use of medication 53 people’s health 15 Forthcoming European statistics 54 Improved health – a determinant Country codes 56 of economic growth 16 References 56 Definition of healthy ageing 16 Aspects of becoming older 16 61 MaJOR TOPICS Autonomy late in life to achieve personal control 16 Major Topics of the Healthy Ageing Project 62 Maintaining balance in a changing life situation 17 Disability in ageing 17 63 CHAPTER 3. RETIREMENT AND PRE-RETIREMENT Health promotion 18 Increased participation of older workers needed 65 Involving older people 18 Work ability – a holistic concept 66 Ethical aspects 19 General recommendations 66 Cultural aspects 19 Methods to prolong working life 67 Inequality in health 20 Preparing for retirement 68 Gender and ageing 21 References 68 Framework for the Healthy Ageing project 22 References 27 69 CHAPTER 4. SOCIAL CAPITAL Effectiveness of interventions 72 29 CHAPTER 2. Volunteer work 72 STATISTICS ON OLDER PEOPLE AND HEALTH Social support 72 Challenges due to demographic change 31 Interventions for preventing social isolation Demographic change 31 and loneliness 73 Migration 32 Summary of findings 73 Average life expectancy 34 References 74 Healthy life expectancy at 60 years 34 Health status in the EU countries 35 75 CHAPTER 5. MENTAL HEALTH Health among older people in the European Union 35 Those affected often neglected 78 Fewer working people to support more older people 36 Effectiveness of interventions 79 Health and inequality 36 Psychotherapeutic and psychosocial interventions 79 Inequalities between age groups 36 Prevention or reduction of depression 79 Statistics concerning the major topics 37 Interventions for caregivers 80 Retirement and pre-retirement 37 Summary of findings 81 Social capital 40 References 82 Mental health 43 83 CHAPTER 6. ENVIRONMENT 113 CHAPTER 10. SUBSTANCE USE/MISUSE Outdoor mobility 85 Tobacco 115 The technological environment 85 Health effects 115 Climate changes 85 Oral smokeless tobacco 115 Excessive cold and excessive heat 86 The benefits of stopping smoking 115 Air quality 86 Effectiveness of interventions 116 Effectiveness of interventions 87 Summary of findings 117 Housing improvement and health gain 87 Alcohol 117 Housing improvement and reduction of injuries 87 Effectiveness of interventions 118 Summary of findings 88 Risk of coronary heart disease 118 References 88 Falls/fall injuries, functional and cognitive impairment 118 89 CHAPTER 7. NUTRITION Injuries and health benefits 119 Factors that may influence eating habits 91 Summary of findings 119 A positive attitude to food 92 References 119 Effectiveness of interventions 93 Prevention of osteoporosis 121 CHAPTER 11. USE OF MEDICATION and cholesterol concentrations 93 AND ASSOCIATED PROBLEMS Dietary patterns and cancer risk 95 Medication error or non-compliance 123 Long-term weight loss 95 Inappropriate prescribing 124 Summary of findings 96 Interactions 124 References 96 Adverse drug reactions 124 Other drug-related problems 124 97 CHAPTER 8. PHYSICAL ACTIVITY How to improve the quality of medication use 124 Effectiveness of interventions 100 Conclusions 125 Interventions to increase physical activity 100 References 126 Exercise and its health effects 100 Progressive resistance training 100 127 CHAPTER 12. PREVENTIVE HEALTH SERVICES Primary care-based interventions 101 Health literacy 130 Summary of findings 101 Effectiveness of interventions 130 References 102 Vaccination 130 Home visits 130 103 CHAPTER 9. INJURY PREVENTION Summary of findings 132 Community interventions 105 References 132 Violence towards older people 106 Effectiveness of interventions 107 135 CHAPTER 13. GOOD PRACTICE Multi-factorial fall risk assessment Examples of good practice 137 and management 107 Experience from good practice 140 Physical activity in relation to injuries/falls 108 Conclusions 142 Community interventions against falls 108 List of good practice examples 143 Withdrawal of psychotropic drugs 109 Austria 143 Preventive medical devices 109 England 143 Summary of findings 110 The Czech Republic 143 References 110 Finland 144 Italy 144 Netherlands 145 Norway 146 Scotland 146 Sweden 147 Mental Health Well-being in Later Life Programme, Scotland 148 Three interlocking strands 148 Family
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