An integrative approach to align the needs of elderly as well as older adults in programmes and policies is the need of hour
India is considered a young country. But the United Nations projects that Indians over the age of 60 years will double by 2050, constituting almost 19.6 per cent of the total population.
The rising number of senior citizens globally has led to concerns regarding their health. According to the World Health Organization (WHO), health refers to “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”.
On the same lines, in 2015, WHO floated the concept of ‘healthy ageing’ to achieve health and well-being as a lifelong process; not just maintaining physical and mental health but also creating an environment that enables it.
Here, we highlight the different dimensions of ‘healthy ageing’ so that the elderly population becomes an asset of the country rather than a liability.
Life expectancy at birth: One must understand as to how many years do seniors survive on average so that those years can be converted into healthy years. According to the Sample Registration Report (SRS) 2014-18, the average life expectancy at birth in India is 69.4 years. Rural populations have a life expectancy of 68 years while it is 72.6 years for urban populations. The average life expectancy at birth in India for women is 70.7 years and men is 68.2 years.
Self-reported health condition: According to Longitudinal Ageing Study in India (LASI) 2017-18, there are 24.2 per cent people aged 60 years and above and 12.1 per cent people aged 45-59 years of age who have claimed poor self-rated health conditions. The proportion of people aged 45 years and above having poor self-rated health is higher in rural areas than in urban, with 18.7 per cent and 15.2 per cent respectively. It is slightly higher in females (17.9 per cent) than males (17.1 per cent).
Functional limitation: Functional Limitations can be understood through Activities of Daily Living (ADL), which include dressing, putting on slippers or shoes, walking across a room, bathing, eating difficulties, getting in or out of bed and Instrumental Activities of Daily Living (IADL).
IADL includes preparing a hot meal, shopping for groceries, making telephone calls, taking medications, doing work around the house or garden, managing money and getting around or finding address in unfamiliar places.
In India, there are 23.8 per cent of people aged 60 years and above who have any ADL limitation and 48 per cent have any IADL limitation. The functional limitation is comparatively lower at age 45-59, with 9.3 per cent having any ADL limitation and 25.7 per cent having any IADL limitation.
There is a strong gap visible between males and females and rural and urban populations of age 45 years and above in both ADL and IADL limitations. The functional limitation is higher among females and rural populations.
Mental Health: LASI has pointed out two domains to understand mental health. One is cognition and the other is depression. In the cognition domain, the mean score for immediate word recall is 5.5 among people aged 45-59 years and 4.7 among people aged 60 years and above.
There is not much difference among males and females of 45 years and above at 5.2 and 5.1 respectively, but the difference is clearly visible among rural and urban populations of the same age group at 4.9 and 5.6 respectively.
The prevalence of depression is 7.2 per cent among people aged 45-59 years and above and 8.3 per cent among people aged 60 years and above.
There are seven per cent males and 8.2 per cent females afflicted with depression in the 45 years and above age group. Rural populations of the same age group have a much higher prevalence of depression than urban populations at 8.5 per cent and 5.8 per cent respectively.
Currently working: There are nearly 61.9 per cent of people aged 45-59 years and 35.7 per cent of age 60 years and above who are currently working. They are mostly engaged in agricultural and allied activities. The percentage of working population aged 45 years and above is higher for male and rural respondents.
Seeking a job: According to LASI, there are 4.4 per cent people aged 45-59 years and 1.5 per cent of age 60 years and above, who are seeking jobs.
Living arrangement: There are around 5.7 per cent of people aged 60 years and above who live alone. This percentage is only 1.4 per cent for people in the 45-59 years age group. It is higher for females and rural areas.
Perceived life satisfaction with social status: Life satisfaction among the elderly is less than 50 per cent. Only 43.9 per cent of people aged 60 years and above are satisfied with their own life. The life satisfaction is higher for males than females. Similarly, it is higher for urban residents than rural.
Substance abuse: Substance abuse increases with increase in age according to the LASI findings. It is 13.8 per cent for people aged 60 and above in contrast to 10.8 per cent for 45-59 years age.
Tobacco consumption is even higher, reaching 21.5 per cent for the 60 and above age group and 18.3 per cent for 45-59 years. The prevalence of heavy episodic drinking is 2.6 per cent for the above 60 population and 3.1 per cent for 45-49 years age.
Physically Active: Physical activity reduces with age and practicing yoga asanas, meditation and yoga increases. Both the indicators are higher for males than females. Practicing yoga, asanas, etc is higher among rural residents.
Environmental factors also influence the health of the older population. The household survey reveals that are 72.3 per cent households have improved sanitation, 27.5 per cent households practice open defection and 94 per cent have improved drinking water sources. There are 14 per cent households exposed to indoor pollution.
Healthy ageing is a broad concept having a wide range of implications. The empirical analysis of the first countrywide survey on older adults and the elderly ie LASI presents a picture of the various dimensions of healthy ageing achieved in India and where we lag behind.
Life expectancy has shown considerable improvement. But if these added years are dominated by declines in physical and mental capacities, the implications for the older population and society will be much more negative.
Hence, an integrative approach to align the needs of elderly as well as older adults in programmes and policies is the need of hour.
Anjali Sharma is currently a PhD scholar at Institute for Social and Economic Change (ISEC), Bengaluru
Saif Nihal is currently working as a consultant for Delhi State AIDS Control Society
Views expressed are the authors’ own and don’t necessarily reflect those of Down To Earth
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