Nutrition for older persons

Ageing and nutrition: a growing global challenge

Both the number and the proportion of older persons - defined as aged 60 and over - are growing in virtually all countries, and worldwide trends are likely to continue unabated. In 2002 there were an estimated 605 million older persons in the world, nearly 400 million of whom were living in low-income countries. Greece and Italy had the highest proportion of older persons (both 24% in 2000). By 2025, the number of older persons worldwide is expected to reach more than 1.2 billion, with about 840 million of these in low-income countries.

In order to achieve the ultimate goal of health ageing and active ageing, WHO has developed a policy framework, which focuses on such areas as:

The challenge of a sex-differential imbalance

  • preventing and reducing the burden of disabilities, chronic disease and premature mortality;
  • reducing the risk factors associated with noncommunicable diseases and functional decline as individual age, while increasing factors that protect health;
  • enacting policies and strategies that provide a continuum of care for people with chronic illness or disabilities;
  • providing training and education to formal and informal carers;
  • ensuring the protection, safety and dignity of ageing individuals;
  • enabling people as they age to maintain their contribution to economic development, to activity in the formal and informal sectors, and to their communities and families.

Women comprise the majority of the older population in virtually all countries, largely because globally women live longer than men. By 2025, both the proportion and number of older women are expected to soar from 107 to 373 million in Asia, and from 13 to 46 million in Africa. This pattern involves its own special nutritional needs, emphases and patterns of malnutrition, including for example the incidence of osteoporosis in older women.

Osteoporosis and associated fractures are a major cause of illness, disability and death, and are a huge medical expense. It is estimated that the annual number of hip fractures worldwide will rise from 1.7 million in 1990 to around 6.3 million by 2050. Women suffer 80% of hip fractures; their lifetime risk for osteoporotic fractures is at least 30%, and probably closer to 40%. In contrast, the risk is only 13% for men.

Women are at greater risk because their bone loss accelerates after menopause. Prevention is possible with hormone therapy at menopause. Lifestyle factors – especially diet, but also physical activity and smoking – are also associated with osteoporosis, which opens the way for primary prevention. The main aim is to prevent fractures; this can be achieved by increasing bone mass at maturity, by preventing subsequent bone loss, or by restoring bone mineral. Particularly important are adequate calcium intake and physical activity, especially in adolescence and young adulthood.