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Foundations of
Public Health
Lecture 7 - Gerontology
Phua Kai Lit, PhD (Johns Hopkins)
Retired public health professor
(Monash University Malaysia School
of Medicine and Health Sciences)
Lecture Objectives
 What is “Gerontology”
 Classification of the elderly - young-old, old-old,
oldest-old
 Individual ageing versus population ageing
 Population pyramid
 Health and other challenges associated with ageing
e.g. multiple illnesses, fragmented care,
polypharmacy
 Geriatrics - branch of medicine that treats the
health problems of the elderly
 Long term care - price, quality
What is “Gerontology”?
• Gerontology can be defined as the multi-
disciplinary study of the elderly and the process of
growing old (especially of the young-old into the
old-old and oldest-old categories)
• The focus would be on the social, psychological
and physical/mental aspects of life as an elderly
person.
Classification of the Elderly in Terms
of Age
 The classifications are arbitrary to some
extent
 Young-old: 60-70 years of age? Note that
people aged 60 onwards are considered old
in Japan while people who are 65 and above
are considered old in the USA.
 Old-old: 70-eighty?
 Oldest-old: Eighty and above? The oldest-old
tend to consume more health care
resources.
Individual Ageing versus
Population Ageing
Individual ageing -- increasing chronological age of
an individual over time. Note that some people age
faster physically than others. This is affected by
whether the person has a healthy lifestyle or not. The
job that one does can also speed up physical ageing.
Population ageing -- the percentage of elderly people
in a population increases over time, from around 15%
to 25% and above. This is largely due to falling birth
rates and only secondarily due to increasing life
expectancy of people in the older age groups.
Population Pyramid
A population pyramid depicts the age and sex
composition of the population of a particular
geographical location (e.g. country) at a certain point
in time.
A country with a high birth rate will have a more
triangular-looking population pyramid while a country
with a low birth rate will have a more rectangular-
looking one.
Population Pyramid
Ageing Challenges
Physical: decline in physical functioning as one ages.
Decline in mental functioning for some people too.
Need for home modifications for “ageing in place”.
Social: for some people, loss of social prestige after
retirement (“I am just a retiree”), loss of power (if one
used to be the CEO of a big company), loss of
spouse or relatives or friends if one lives a long life
Psychological: for some people, loss of identity or
meaning in life after retirement. Dealing with free
time.
Economic: drop in income after stopping paid work.
Loss of employer-supplied medical insurance.
Working class people have little savings upon
retirement. Housewives may not be covered by social
welfare schemes (i.e. employment-linked schemes) in
old age. Financial scams are a threat to the elderly
Health Care Issues
 Paying for care in old age - hospital care,
long term care, drugs for chronic diseases
 Multiple health problems - common in the
elderly (e.g. having hypertension, arthritis
and diabetes at the same time)
 Fragmented care - care provided by multiple
doctors (can result in polypharmacy i.e.
taking many medical drugs at the same time)
 Polypharmacy - side-effects of drugs, risk of
adverse drug interactions
 Long term care - price, quality can be
problematic (elder abuse in nursing homes)
Thank You
Additional Resources:
phuakl.tripod.com/age.html

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Ageing, the Elderly, Gerontology and Public Health

  • 1. Foundations of Public Health Lecture 7 - Gerontology Phua Kai Lit, PhD (Johns Hopkins) Retired public health professor (Monash University Malaysia School of Medicine and Health Sciences)
  • 2. Lecture Objectives  What is “Gerontology”  Classification of the elderly - young-old, old-old, oldest-old  Individual ageing versus population ageing  Population pyramid  Health and other challenges associated with ageing e.g. multiple illnesses, fragmented care, polypharmacy  Geriatrics - branch of medicine that treats the health problems of the elderly  Long term care - price, quality
  • 3. What is “Gerontology”? • Gerontology can be defined as the multi- disciplinary study of the elderly and the process of growing old (especially of the young-old into the old-old and oldest-old categories) • The focus would be on the social, psychological and physical/mental aspects of life as an elderly person.
  • 4. Classification of the Elderly in Terms of Age  The classifications are arbitrary to some extent  Young-old: 60-70 years of age? Note that people aged 60 onwards are considered old in Japan while people who are 65 and above are considered old in the USA.  Old-old: 70-eighty?  Oldest-old: Eighty and above? The oldest-old tend to consume more health care resources.
  • 5. Individual Ageing versus Population Ageing Individual ageing -- increasing chronological age of an individual over time. Note that some people age faster physically than others. This is affected by whether the person has a healthy lifestyle or not. The job that one does can also speed up physical ageing. Population ageing -- the percentage of elderly people in a population increases over time, from around 15% to 25% and above. This is largely due to falling birth rates and only secondarily due to increasing life expectancy of people in the older age groups.
  • 6. Population Pyramid A population pyramid depicts the age and sex composition of the population of a particular geographical location (e.g. country) at a certain point in time. A country with a high birth rate will have a more triangular-looking population pyramid while a country with a low birth rate will have a more rectangular- looking one.
  • 8.
  • 9. Ageing Challenges Physical: decline in physical functioning as one ages. Decline in mental functioning for some people too. Need for home modifications for “ageing in place”. Social: for some people, loss of social prestige after retirement (“I am just a retiree”), loss of power (if one used to be the CEO of a big company), loss of spouse or relatives or friends if one lives a long life Psychological: for some people, loss of identity or meaning in life after retirement. Dealing with free time. Economic: drop in income after stopping paid work. Loss of employer-supplied medical insurance. Working class people have little savings upon retirement. Housewives may not be covered by social welfare schemes (i.e. employment-linked schemes) in old age. Financial scams are a threat to the elderly
  • 10. Health Care Issues  Paying for care in old age - hospital care, long term care, drugs for chronic diseases  Multiple health problems - common in the elderly (e.g. having hypertension, arthritis and diabetes at the same time)  Fragmented care - care provided by multiple doctors (can result in polypharmacy i.e. taking many medical drugs at the same time)  Polypharmacy - side-effects of drugs, risk of adverse drug interactions  Long term care - price, quality can be problematic (elder abuse in nursing homes)
  翻译: