Post on 08-Apr-2018
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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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Active AgingActive Aging
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
Active AgingActive Aging
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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
Philippine Plan of Action forPhilippine Plan of Action for
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
Philippine Plan of Action forPhilippine Plan of Action for
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!