The environment is an important determinant of health. It is associated with healthy living or causes an adverse effect on health. For decades, countries throughout the world have seen an increase in life expectancy owing to improvements in public health infrastructure and practices. Although aging is a biological phenomenon, it has demographic, social, economic, and humanitarian implications and every country should invest in it for the welfare of its citizens.
It was estimated that the world population of people aged 60 and above was 962 million in 2017 and is expected to reach nearly 2.1 billion by 2050. By 2030, older persons are expected to outnumber children under age 10 and by 2050, the population of elderly people will be greater than adolescents and youth combined (UN, 2017). More than 80 per cent of all older people are expected to live in low- and middle-income countries in 2050 where public health infrastructure is not supportive of their healthy living perspective. A total of 61.2 per cent of the world population corresponding to 1.3 billion people are expected to live in Asia by 2050 which is more than twofold increase. A similar trend is seen in Nepal where people aged 65 and higher are expected to reach 7 per cent by 2028 and 14 per cent by 2054 (CBS, 2019).
Non-communicable diseases such as heart disease, chronic respiratory disease, diabetes, cancer, depression, and dementia are the main cause of disability or death in older people. At the same time, complications resulting from the loss of movement, sight, and hearing are immense. Increased risk of multiple diseases is increasing among the elderly population which has raised several other issues. The use of multiple drugs has been shown to increase drug interactions and adverse drug reactions leading to longer hospital stays and treatment costs.
The consequence of demographic change with the continuously growing older population is a huge challenge, particularly for low- and middle-income countries where public health spending for their welfare is limited. In this background, knowledge on how to promote healthy aging becomes imperative in order to enhance health and quality of life among older people. This not only prevents costly and negative impacts on the population as a whole but also promotes quality of life among them.
The first and most important component of a healthy lifestyle among the elderly as the general population is healthy eating. Dietary needs change as people age owing to changes in physiological functions. However, enough nutrients are essential for their well-being. Diets comprising more fruits and vegetables, whole grains, lean meats, low-fat dairy, nuts, and seeds give enough nutrients with fewer calories. Similarly, avoiding processed food and alcohol is equally important as eating foods that are low in cholesterol and fat is essential.
Drinking enough liquids helps prevent dehydration among older people. A healthy lifestyle is deeply integrated with physical activity. Maintaining a healthy weight and reducing the chances of chronic health-related issues are equally important for all age groups including older people. However, the amount of physical activity depends on age and current health status.
Healthy aging calls for maintaining the mind active in order to improve memory such as reading, playing games, and learning new skills. There have been evidences that yoga, meditation, and relaxation technique improve mental health and well-being. Similarly, social and leisure activities need to be carried out as those activities are associated with lower chances of some health problems. Activities that give happiness should be continued which improves thinking abilities and lower the chances of dementia.
Smoking is associated with multiple diseases so does heavy alcohol use. Quitting smoking at any age has significant health benefits and moderate or avoiding heavy alcohol use has positive effects. Thus, the benefits of quitting smoking programmes cannot be overlooked. It is important to actively participate in health care with regular health checkups and keep adequate information on the dose, duration, and timing of any medications to avoid complications from drug interactions. Falls are the leading cause of injury among the elderly population throughout the world. Old people are also more likely to fracture a bone when they fall. Getting regular eye checkups, carrying out regular physical activities, and making the house safer can lower the risk of falling.
Currently, the Nepal government provides social security allowances to older people and monthly allowances for some medical conditions. However, adequate access to good-quality health services for older people needs considerable impetus. Although there is a provision of geriatric wards in hospitals having more than 100 beds, the implementation is not yet noticeable in most hospitals even in state-run facilities.
The family members, society, and the country should now focus their attention on the health promotion of elderly people as the population is aging rapidly. Now, we have an improved understanding of healthy living practices, and with elder-friendly healthcare facilities and preventive measures, we can provide better opportunities for older people. Therefore, there is an urgent need to initiate the provisions to improve the physical environment and social support for older people in the form of safety, mobility, transport, recreation, and lifestyles besides the availability of good quality healthcare services for treatment and rehabilitation.
(Dr. Lohani is the clinical director at the Nepal Drug and Poison Information Center. firstname.lastname@example.org)