Ageing and Life Course

Functional decline and dependence in ageing populations

Panel side event at 66th World Health Assembly

The panel, a side event to the 66th World Health Assembly, focused on functional decline and dependence in ageing populations. This issue, discussed also in a recent meeting in The Hague, has become a concern for many governments, due to the fact that populations around the world are rapidly ageing.

Population ageing

In her introduction, Dr Flavia Bustreo, Assistant Director General for Family, Women’s and Children’s Health at the WHO, pointed out that currently, one in every nine people in the world is 60 years of age or older. This is expected to increase to one in five people by 2050. Population ageing is not just an issue for high income countries. The majority of older people already live in low- and middle-income countries, and this is where some of the fastest rates of ageing are occurring.

Ageing in itself is a success story, though. People are now more likely to survive childhood and child birth and are less likely to die from poverty-related diseases. However, current patterns in developed countries show many people will experience functional decline towards the end of life and may require some form of long-term support. Much of the burden is now with families and especially women.

Elderly care

Assistant Secretary for Aging, Kathy Greenlee from the United States, shared some of the experiences in the US. She emphasized the need to use language that is recognized by older people; for example, by using terms such as “functional limitations” and “independence”. She discussed specific issues of importance when referring to elderly care, such as: fall prevention, medication management, assessment mechanisms, case management and housing & transportation. The Assistant Secretary mentioned the huge challenge facing the US government in relation to long-term care, with many people still relying on families and informal support.

Noncommunicable diseases

Vice Minister for Health Surveillance, Jarbas Barbosa from Brazil, shared Brazil’s current epidemiological, demographic and nutritional transition. Noncommunicable diseases (NCDs) now account for 72% of mortality, affecting the older people.

Sharing experiences from his country, he mentioned the role of special legislation and the role of primary health care when caring for old people. Taking care of older people has an important impact on families and communities, and he commented on the response required from the health sector and the need for intersectoral actions. With increasing years of life expectancy, it is now time to ensure better quality of life for these additional years.


The representatives from Japan, Dr Hiroyuki Hori and the Netherlands, Mr Rene Prijkel, gave an overview of long-term care in their countries. Sharing their experiences, they both agreed their systems have become more expensive in the last decade, with The Netherlands explaining its currently transition from a formal public system to a system that is more based on social networks to control costs.

Quality of care

In giving an overview long-term care in low- and middle-income countries, Dr Peter Lloyd Sherlock explained how a growing care gap due to social change and changing family structures is resulting in increased private provision, which is often unregulated and of poor quality. He called for support systems for home provided care, with a view to integration with health services, prioritization and resourcing in the future.


Dr John Beard closed the session sharing the recently agreed agenda for action in The Hague meeting. The agenda will identify priority actions in the fields of research, models of care and resourcing as well as the actors who can move this agenda forward.

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