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For the first time in history, residents of high-, middle-, and low-income countries are likely to live to 60 years of age and beyond. Longevity is one of the greatest achievements of our modern era — the United Nations calls it one of the most significant social transformations of the 21st century.

Worldwide, 901 million people are over the age of 60 today. That number is projected to reach 1.4 billion by 2030 and nearly 2.1 billion by 2050.


But the success story of longer lives is a worthless prize if the quality of those lives is compromised because of poor health and a loss of autonomy. To ensure that people of all ages, but particularly older people, can do what they value, national health care systems must be able to respond to those with age-related chronic conditions such as type II diabetes to ensure timely access to education, screening, and appropriate treatment.

In 2002, the United Nation’s Madrid International Plan of Action on Ageing drew attention to the importance of planning to ensure that “persons everywhere are able to age with security and dignity and continue to participate in their societies as citizens with full rights.” Fifteen years after this resolution was signed by 159 member states, how far have we come and to what extent has that goal become a reality?

According to the World Health Organization’s World Report on Ageing and Health, we still have a way to go. While we may be living longer, older individuals are not necessarily living healthier, more active lives. The report shines a light on the need for governments around the world to develop policies and programs to better meet the health and social care needs of citizens throughout their lives.


Population aging is a major concern for many governments around the world, but perhaps even more so for those whose populations are projected to be among the oldest in 2050, such as Japan, South Korea, and Germany. According to a global study conducted by the Pew Research Center, achieving an adequate standard of living in old age is directly influenced by the extent to which a country’s population is expected to age healthfully.

While there may be cause for optimism about population aging in some countries, the Pew survey reveals that residents of countries such as Japan, Italy, and Russia are the least confident about achieving an adequate standard of living in old age. Interestingly, when asked who should bear the greatest responsibility for the well-being of older people, Americans, along with residents of South Korea, Germany, and the United Kingdom were the most likely to say that the family or the government should take responsibility, rather than older people themselves.

Watch the world's population age

Over the last 50 years, much of the world's population has grown older — and lived longer. Each color below represents one of 28 different countries. Click on the timeline to choose a year first, then hover and/or click on the colored rectangles to see how populations in each have aged over time.

Talia Bronshtein/STAT Source: The Human Mortality Database

Improving quality of life and functional ability among older people must be geared toward helping them effectively manage chronic diseases and complex coexisting conditions. By their very nature, these conditions — heart disease, diabetes, and chronic obstructive pulmonary disease, to name a few — place a burden on individuals, their families, and health systems.

Diabetes, for example, now affects 415 million adults around the world and often brings potentially life-altering complications such as vision loss and blindness, cardiovascular disease, and amputations. Unfortunately, many older adults are being put at greater risk of these complications due to barriers such as long waiting times to see a specialist, a lack of education about the management of chronic conditions, lack of access to adequate screening and treatment, and high costs.

These issues were highlighted in a recent international survey known as the Diabetic Retinopathy (DR) Barometer Study, which my organization, the International Federation on Ageing, helped conduct. Diabetic retinopathy, which is largely preventable, can cause vision loss or blindness by damaging blood vessels in the eye’s light-sensitive retina.

We surveyed nearly 7,000 people with diabetes and health care professionals in 41 countries. Almost 80 percent of patients completing the survey reported that vision loss made their everyday activities such as driving, going to work, and completing household tasks difficult, if not impossible. The study identified numerous barriers that prevented people with diabetes from accessing timely screening, diagnosis, and treatment for diabetic retinopathy.

The three sponsors of the study are calling on governments to recognize the social and economic contributions that older people can make to family and society by developing management programs for lifestyle-related chronic conditions, such as diabetes, that often affect the most vulnerable in our society. These management programs are but one element of a broader agenda around healthy ageing across the course of the lifespan that governments around the world could build for healthier nations. Combating ageism is also central to affecting real, measureable change to enable people around the globe to live both longer and better.

Jane Barratt, PhD, is secretary general of the International Federation on Ageing.

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