As global population aging accelerates, new research highlights how poor oral health affects older adults and suggests integrated healthcare solutions to improve their quality of life. is required.
Review: Healthy aging and oral health: priorities, policy, and public health. Image credit: Drazen Zigic / Shutterstock
In a recent review published in the journal BDJ Open, Rakhi Patel and Jennifer Gallagher of King’s College London discuss the World Health Organization’s (WHO) Public Health Review on Healthy Aging and Global Policy. We considered the framework of They proposed an integrated model to address the effects of aging on oral health and health systems, using the UK as a case study.
background
The world’s population is aging rapidly, with predictions that one in six people will be over 60 by 2030, representing a major demographic shift, with the number expected to reach 2.1 billion by 2050. It is expected to increase. This accelerating pace of population aging poses complex challenges, especially in many regions. How aging is defined in different regions and cultures. Additionally, as the elderly population becomes more diverse across the region, the need for individualized support is increasing. A more comprehensive understanding of biological, social, and psychological changes is essential for effective policymaking. Further research is essential to understand these complexities and provide effective policies that address the unique needs of this growing demographic.
aging population
The world’s population is aging at an accelerating pace, and the WHO’s 2022 report predicts that by 2030, one in six people will be over 60 years old, increasing from 1 billion in 2020 to 1.4 billion. There is. By 2050, this number is expected to double to 2.1 billion people and the number of people aged 80 and over to triple to 426 million. Aging involves complex biological, social, and psychological changes that occur at different rates for each individual, resulting in a highly diverse population of older adults. The definition of “elderly” differs around the world. The World Health Organization and the United Nations (UN) define 60 years and older as 60 years or older, although some countries, such as the UK, have traditionally adopted the age of 65 to keep pace with increases in life expectancy. These distinctions are increasingly important because the needs of individuals over the age of 65 can vary widely depending on their functional abilities.
Understanding the aging process
Aging populations are often seen as a sign of improved health and longevity. Countries like Japan, where a significant proportion of the population is over the age of 60, exhibit this trend. By 2050, East and Southeast Asia are expected to continue to have the largest elderly population at 37%, while Europe and North America are expected to see their share decline from 29% to 19%. The global distribution of aging populations poses unique challenges to local health systems, especially in countries with low potential support.
The potential support ratio, defined as the number of working-age adults (25-64 years) per older person (65 years and older), highlights the impact of population aging. By 2050, support ratings will fall below 2 in many countries, especially in Europe and Asia, indicating an increasing burden on health and social security systems. This trend highlights the urgent need for innovative public health strategies to manage population aging.
Addressing ageism and diversity in an aging population
As the population ages, negative stereotypes, often referred to as ‘ageism’, emerge, framing older people as a burden on society. However, there is considerable diversity among older adults. WHO defines ageism as encompassing stereotypes, prejudice and discrimination based on age, which has a global impact on both older and younger people. In Europe, younger people report experiencing more age discrimination than older people. Age discrimination also intersects with other forms of disadvantage, such as those related to gender, race, and disability, further exacerbating inequalities.
In the UK, the aging population is steadily increasing, with 18.6% of the population aged 65 and over increasing from 16.4% in 2011 to 18.6% in 2021. Predictions show that by 2066, one in four people in the UK will be aged 65 or over. Although life expectancy has improved, concerns remain about disability-free life expectancy (DFLE). Disability-free life expectancy (DFLE) after age 65 is approximately 9.9 years for men and 9.8 years for women, indicating that a significant proportion of older adults may be living with health problems. It shows.
10 years of healthy aging
The United Nations’ Decade of Healthy Aging focuses on four areas: combating ageism, supporting older communities, providing integrated and person-centred care, and ensuring access to quality long-term care. The aim is to address the challenges of population aging through collective action. Healthy aging focuses on maintaining functional capacity for health and categorizes older adults as functionally independent, frail, or dependent. Two important factors that influence aging are intrinsic abilities, including physical and mental health, and environmental factors, including social and community support. Together, these factors determine an older adult’s ability to function effectively and lead a fulfilling life.
Relationship between oral health and aging
Poor oral health is a significant problem for older adults, with high levels of dental disease prevalent in this population. The Global Burden of Disease Study ranks oral disorders as the leading cause of disability-adjusted life years (DALYs) worldwide, affecting millions of older people. Recent estimates indicate that untreated dental conditions affect more than 57% of older adults. In particular, dental caries is often not treated and is a huge burden, especially in institutional facilities.
Oral health problems, especially tooth decay and periodontal disease, have a significant impact on the quality of life of older adults. Despite the common belief that tooth loss is a normal part of aging, the aging process itself is not an independent risk factor for poor oral health. Instead, general health, medications, and access to dental care play important roles in oral health.
Long-term symptoms and oral health
It is increasingly recognized that the relationship between general health and oral health is bidirectional, with poor oral health worsening chronic diseases such as diabetes, cardiovascular disease, and respiratory disease. For example, poor oral hygiene can increase the risk of pneumonia in the frail population, and periodontal disease can worsen diabetes management. Recent research has also highlighted the link between cognitive decline and poor oral health, and people with dementia face significant challenges when accessing care.
Furthermore, nutrition is closely related to oral health. Older adults with compromised dentition may struggle to get proper nutrition, which can lead to a cycle of declining health. Conversely, malnutrition can increase the risk of dental disease, highlighting the need for an integrated approach to health that considers both oral and systemic health.
Case study: Oral health in the UK
In the UK, epidemiological data reveals that an increasing number of older people are retaining their natural teeth. For example, 53% of adults age 85 and older reported having some teeth of their own. This change indicates that a growing population is benefiting from preventive oral health strategies. Despite this, disparities persist, with significantly higher rates of edentulism and untreated dental conditions, particularly among people in care homes. Current policy in the UK, particularly in Scotland and Wales, emphasizes the need to improve oral health in older people, but the situation in England lags behind.
Policy recommendations for healthy aging and oral health
A multifaceted policy approach is essential to promoting healthy aging and oral health. This should include lifelong early prevention strategies, improved training of care staff, and stronger integration of health and social care systems. Prevention strategies such as fluoride treatment, integrated health and social care, and improved access to dental services, especially for vulnerable older people, are important.
conclusion
In summary, healthy aging is an issue of global importance, requiring urgent attention to the impact of aging on oral health and healthcare systems. Efforts to integrate oral health into broader health policy are essential to enabling older people to lead healthier and more fulfilling lives. Effective, patient-centered, and prevention-focused services are essential to improve quality of life, address the interrelationship between oral and systemic health, and prioritize oral health in policy and research.
