The ageing population
Population ageing is a global phenomenon that poses formidable challenges associated with the health and quality of life of seniors. The older population is growing faster than any other population in virtually all regions of the world. It is projected that by 2025-2030, the population aged over 60 will be growing 3.5 times as rapidly as the total population. Currently there are 150 million Europeans aged 50+, and this figure is expected to increase exponentially over the coming decades. In Ireland, the proportion of the population aged 65+, which was steady at 11% for the last 40 years, is predicted to reach 25% by 2036.
Unfortunately, while the quantity of life is increasing, failing cognitive function frequently impairs the quality of those extra years. As our population ages, the incidence of cognitive impairment increases. The number of people with dementia in Ireland is set to increase from the current 44,000 to 104,000 by 2036. Cognition is crucial, not only for mental health, but also for physical health, psychological health and degree of social engagement. In turn, physical health, psychological health and degree of social engagement affect cognitive health. Age-related cognitive decline is associated with reduced quality of life, increased disability, increased neuropsychiatric symptoms, increased risk for dementia and increased health care costs.
The health and social cost of dementia disorders is considerable, with dementia care currently costing more than stroke, heart disease and cancer care combined. Current cost of dementia services is estimated at 160 billion euro in Europe and 1.69 billion euro in Ireland. These estimates do not account for the concomitant psychological and social impact that dementia disorders have on individuals and caregivers.
Impaired or poorly developed mental function is one of the most important determinants of poverty, poor health, and social disadvantage across all ages. This relationship is greatly magnified as people get older. The disempowerment that arises from these inequalities further impairs mental function, and the motivation, planning and initiative that depend on intact mental capacity.
Failure to understand and develop effective strategies to promote healthy ageing among the general population, and to delay or prevent dementia, will have devastating economic and social consequences.
- Mental functions decrease with disuse - 'Use it or lose it' is a fact.
- Decreased mental functions, lower mood, and reduced initiative lead to isolation, disempowerment and disengagement.
- Poverty, inequity, disempowerment, and poor mental health are consistently related. Low mood, lack of initiative, reduced engagement and poor mental health further decrease brain stimulation.
- Impaired cognitive functions are the main cause of loss of independence - including institutionalization - in elders.
- Disempowerment degrades mental functions associated with initiative, planning and assertive action.