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  • Print publication year: 2012
  • Online publication date: August 2012

14 - Public health and ageing


Key points

The population of older people has been increasing in number and as a proportion of populations worldwide.

The prevalence of physical and cognitive frailty increases with age and as a result older people develop disabilities that prevent them from living independently as they age.

Primary, secondary and tertiary prevention strategies can be effective for specific conditions that are common among older people.

Where the scope for prevention is limited, as for example in dementia, provision needs to be made to provide support through health and social care.

Informal carers, who are often relatives, provide the majority of social care for older people with more formal arrangements possibly becoming necessary as disability levels or health status deteriorate.

Policy responses to ageing populations need to promote independent living, financial and physical security, as well as health- and social-care provision, in order to encourage older people to be active participants in society.


At the start of the twentieth century a child born in the United Kingdom could expect to live for less than 50 years. In the UK, life expectancy at birth was 77.7 years for males and 81.9 years for females in 2009. This substantial change, typical of other developed countries, could well be seen as proof of the triumph of public health (broadly defined); but the success has also brought challenges.

Wilmoth, J. R.Deegan, L. J.Lundstrom, H.Horiuchi, S.Increase of maximum lifespan in Sweden, 1861–1999Science 289 2000 2366
Marmot, M.Banks, J.Blundell, R.Lessof, C.Nazroo, J.Health, Wealth and Lifestyles of the Older Population in England: The 2002 English Longitudinal Study of AgeingLondonInstitute of Fiscal Studies 2002
Office of National Statistics 2010
Yen, I. H.Michael, Y. L.Perdue, L.Neighborhood environment in studies of health of older adults: A systematic reviewAmerican Journal of Preventive Medicine 37 2009 455
Fried, L. P.Kronmal, R. A.Newman, A. B.Risk factors for 5-year mortality in older adults: the Cardiovascular Health StudyJournal of the American Medical Association 279 1998 585
Schonberg, M. A.Davis, R. B.McCarthy, E. P.Marcantonio, E. R.Index to predict 5-year mortality of community-dwelling adults aged 65 and older using data from the National Health Interview SurveyJournal of General Internal Medicine 24 2009 1115
Gillespie, L D.Robertson, M. C.Gillespie, W. J.Interventions for preventing falls in older people living in the communityCochrane Database of Systematic Reviews 2 2009
Handoll, H. H.Cameron, I. D.Mak, J. C.Finnegan, T. P.Multidisciplinary rehabilitation for older patients with hip fracturesCochrane Database of Systematic Reviews 4 2009
Birks, J.Cholinesterase inhibitors for Alzheimer’s diseaseCochrane Database of Systematic Reviews 1 2006
Olazarán, J.Reisberg, B.Clare, L.Nonpharmacological therapies in Alzheimer’s disease: A systematic review of efficacyDementia and Geriatric Cognitive Disorders 30 2010 161
Brayne, C.Matthews, F. E.McGee, M. A.Jagger, C.Health and ill-health in the older population in England and Wales. The Medical Research Council Cognitive Function and Ageing Study (MRC CFAS)Age and Ageing 30 2001 53
The Health and Social Care Information Center 2009
Luppa, M.Luck, T.Brähler, E.König, H. H.Riedel-Heller, S. G.Prediction of institutionalisation in dementia. A systematic reviewDementia and Geriatric Cognitive Disorders 26 2008 65
Luppa, M.Luck, T.Weyerer, S.Prediction of institutionalisation in the elderly. A systematic reviewAge and Ageing 39 2010 31
Department of HealthEnd of Life Care StrategyLondonDepartment of Health 2008
World, Health Organization 2002
Matthews, F. E.Chatfield, M.Freeman, C.Attrition and bias in the MRC cognitive function and ageing study: an epidemiological investigationBioMed Central Public Health 4 2004 12