Ageing and Disability: Definitions, Classifications, and Epidemiology
Definizioni, classificazioni,epidemiologia: persone anziane e disabilità
Prof. M. Leonardi (Italia)
ABSTRACT
The world is ageing rapidly and will continue to do so over the coming century. A sustainable and prosperous world will be one where people of all ages and all levels of functioning are supported throughout their lives. Globally, more people are over the age of 60 than children under 5; by 2030, people aged over 60 will outnumber children under the age of 10. The fastest demographic transition is happening in developing countries with profound implications for older people, households, community infrastructure, and social policy. Though statistics about demographic change have value in highlighting the changing formation of our population, it is important to distinguish chronological age as a statistical fact from the process of ageing as a complex phenomenon with physical, psychological, cultural and social aspects Widespread toleration of age discrimination leads to human rights abuse in older age and often older people face age discrimination which constrains their access to essential services.. The UN Convention on the Rights of Persons with Disabilities sets out the rights of persons with disabilities, irrespective of age, and sets the biopsychosocial definition of disability as a result of an interaction between a person with a health condition and his/her environmental factors, that can have a facilitating or hindering effect. Disability disproportionately affects vulnerable populations. Results from the WHO World Health Survey indicate a higher disability prevalence in lower income countries than in higher income countries. People from the poorest wealth quintile, women, and older people also have a higher prevalence of disability. Further, the number of people with disabilities is growing. Ageing, in fact, is also associated with a higher probability of living with a disability. Worldwide, more than 46 per cent of people aged 60 years and over live with disabilities, and in some low income countries 43 per cent of people aged 60 or above live with a disability. This is because populations are ageing – older people have a higher risk of disability – and because of the global increase in chronic health conditions associated with disability. Ageing is one of the key drivers of Non Communicable Diseases, NCDs, with three quarters of NCDs occurring in the over 60 age group, and 71 per cent of total deaths from these diseases occurring in people over 70. The World Report on Disability of the WHO finds that more than a billion people, about 15 per cent of the world's population, are estimated to live with some form of disability and more than 250 million older people experience moderate to severe disability. There are many barriers to participation for people with disabilities particularly if they are old. These include inadequate policies and standards, prejudice, inadequate services and funding, insufficient consultation, lack of accessibility in built environments, and a lack of data on disability. Currently there is no agreed definition of disability as a basis for data collection. Definitions differ between services within a country, between services, legislation and survey research, and between countries. The lack of data and monitoring mechanisms on ageing and disability means that the situation of older people and people with disabilities is often invisible. Therefore, disaggregation of data by disability and age group, and to not forget gender, should be required to ensure that both younger and older people with disabilities benefit equally from future development progress. Better data gathering will also allow better monitoring of the distributional impact of policies and budget allocations on different populations. Equity would be strengthened by ensuring health-related goals are relevant for people at all ages of their life. The adoption of a life course perspective, by recognising the universality and continuous nature of the ageing process, leads to the development of an inclusive society where it is recognized that ageing and disability are common experiences of all of us as we are all human beings sharing the fragility of our human condition .