Ageing and Disabilities

Introductions

According to the World Health Organization (WHO), there were 600 million persons aged 60 and more in the year 2000, with that number expected to rise to 1.2 billion by 2025 and 2 billion by 2050. Aging can be viewed as a societal accomplishment, but it also poses a challenge in terms of health care and continuing healthy functioning for this rapidly growing population. As a result, it's critical to ensure that these extra years are not only free of chronic disease or disability, but also that mental and physical functionality is maintained. This will lessen the population's massive economic and social responsibilities. Nearly half of all health-care spending occurs after the age of 65, according to estimates.

One of the most often used expressions to describe a healthy old age is "successful aging," which was coined in the 1960s by R. J. Havighurst and defined as "adding life to the years." Throughout the decades, there was a growing recognition among biomedical experts that the quality of life may be just as significant as the number of years added to life. While a specific definition of successful aging has yet to be agreed upon, it is widely agreed that it comprises the freedom from chronic disease and the ability to operate well in old age, both physically and cognitively. Ageing is a complex phenomenon, related to genetics, constitutional variables, lifestyles, and environmental variables. During the human life, there are different phases of development: in the first phases of life, there is a progressive increasing of functioning (from infancy to adolescence),there is a sort of plateau during adult life, and then there is a physiological reduction of functioning in ageing. The speediness and the quantity and quality of this reduction are related to genetic variables (about 25%), but most of all they are related to lifestyles and environmental variables (about75%) . A progressive reduction of functioning (related to genetics, to constitutional variables and to lifestyles),together with negative environmental factors, could lead to diseases, to disorders, to functional limitations, and to disability.

Nowadays, according to the vision proposed by International Classification of Functioning, disability and Health of the World Health Organization , and other conceptual models of disability and approved by the United Convention of the Rights of the People with Disabilities disability is viewed in a dynamic way and as a process. According to this vision, disability is the consequence of the relation-ship of the person, with his/her health conditions, and the environment . There is also an international agreement in the view that “health and active ageing” is not with out disorders or without diseases, but it refers to wellbeing from a bio-psychosocial point of view: so it refers to wellbeing and quality of life, even in the presence of a disease or a disorder. These topics are strictly subjective and individually and socio culturally defined. From the more recent conceptual models of ageing and disability, the aim of each kind of intervention is to prevent pathological to reduce the risk of age-related health condition sand their consequences, to promote active and health ageing, and to prevent the changing from usual to pathological ageing

Relationship between disability and ageing

There are two kind of relationship between disability and ageing:

1. Ageing with disability -Individuals with disabilities can age with preexisting health disabling conditions, and because to improvements in the quality of socio sanitary and sanitary services, people with disabilities today have a longer life expectancy, allowing them to age and enjoy longer lives.
2. Disability with ageing- which refer to ageing people that become people with disability only during his/her ageing process, mainly due to age-related conditions.

Consequences between ageing and disability

Three kinds of consequences between ageing and disability.

1. Disability-related secondary conditions-People with disabilities are more likely to develop secondary conditions, either directly or indirectly (any additional physical or mental health conditions that may arise as a result of a primary disabling condition but are not a specific feature of it), which are similar to those that ageing people experience in general, but they occur 20-25 years earlier and are often referred to as premature or atypical.
2. Age-related conditions—these conditions are related to ageing and the long-term consequences of exposure to environmental risks, as well as the effects of poor health behaviors—that may be experienced by ageing persons and also by ageing people with disabilities. Hypertension, high cholesterol, diabetes, osteoarthritis, heart disease, gait and mobility issues, falls, respiratory infections/chronic obstructive pulmonary disease, urine incontinence, osteoporosis, skin disease, hearing and vision loss, and dementia are examples of these conditions.
3. Multiple Chronic Conditions- the risk of having two or more chronic conditions at the same time, either in dyads (hypertension and diabetes) or in triads (hypertension and diabetes) (cholesterol, hypertension, and diabetes).

These three kinds of relationships between ageing and disability are very closely related to one another and they have clear influences on health, quality of life, daily life, participation for ageing people and social costs, and subjective and objective burden for family and relatives. The following three types of consequences could occur in persons with disabilities or those who are getting older, with qualitative and quantitative variations but also similarities: Persons ageing with disabilities and older adults share a variety of chronic conditions, both as secondary conditions to their disability and as age-related chronic conditions. Furthermore, people with disabilities may develop age-related chronic conditions as well as disability-related secondary conditions, and both the elderly and the disabled may have many chronic ailments. As a result, the similarities between the two groups outnumber the differences.

Behavioral risk factors

Physical and social exposures, including behaviors, during the life period have a significant impact on disabilities that appear later in life. resulting in an accumulation of risks as one gets older. The four main behavioral risk factors includes: smoking, excessive consumption of alcohol, poor diet and low levels of physical activity. Behavioral risk factors in midlife have been linked to good ageing and the primary prevention or delay of disability, according to research.