Ageing report finds wealth equals health

Nearly 80% of people between the ages of 50 and 64 say their health is excellent, very good or good but this falls to 66% in those aged over 75.

However, three out of four people over 50 are overweight or obese and poorer people in this age group have the highest levels of obesity, according to a major new TCD-led study on ageing – Fifty Plus in Ireland 2011.

The study found the proportion of people with high blood pressure increases from 29.7% for those aged 50-64 years to 53.7% for those aged 75 years and over.

The Irish Longitudinal Study on Ageing (TILDA) surveyed 8,000 people in Ireland over the age of 50. and is the largest survey the largest study of its kind ever undertaken in Ireland, covering health status and other aspects of ageing.

The study found marked differences between people’s estimates of their own general health status and their actual state of health and it found that often, greater wealth and better education equals good health in older people.

A constant finding across the TILDA report is that those with higher levels of education and wealth are likely to enjoy better outcomes later in life, the researchers said.

For example, those with only a primary level of education or in the lowest wealth category reported higher levels of chronic lung disease than those with a higher level of education and higher incomes.

The study found a high level of heart disease in people over 50, with hypertension, angina and stroke more common in men, and osteoporosis, arthritis and high cholesterol more common in women.

One-in-five older adults takes five or more medications. This rises to almost one-in-two for those aged 75 years and older.

The study found that 10% of over 50s report clinically significant depressive symptoms, with a further 18% reporting ‘sub-threshold’ symptoms of depression.

TILDA found that anxiety is more common than depression among older adults – 13% reported clinically significant anxiety symptoms while 29% reported sub-threshold levels of anxiety.

The study found evidence of under-diagnosis and under-treatment of depression and anxiety among older people.

Of older adults with objective evidence of depression, 78% did not report a doctor’s diagnosis of the condition, while 85% with objective evidence of anxiety did not report a doctor’s diagnosis of the condition.

Nearly two-thirds of older adults with depression have a longstanding illness or disability. Fifty-six per cent of people aged 75 and over with depression are taking five or more medications.

Depressed adults over 75 have an average of seven visits to their GP in the past year compared to four among the non-depressed older population.

There was a high level of memory impairment among older people. Of adults over 80, 42% forgot to carry out an action they had earlier been instructed to perform, raising concerns, according to the study, about activities such as remembering to take medication, pay bills or take safety precautions.

The TILDA study found that one-in-five older Irish adults is a current smoker and the highest rates of smoking are seen in the poorest and in those with lowest education levels. Wealthier and better-educated adults had the highest physical activity levels.

Older, poorer and less educated adults were less likely to go for screening for prostate or breast cancer.

The TILDA study also found that 97% of those over 80 have medical cards, compared to 30% of those in their fifties.

Nearly 60% of people between 50 and 69 have private health insurance, dropping to 46% for those in their 70s and 32% in those over 80.

Only 3.5% of people over 50 receive State-provided home help services.

The study found that overall, over 50s experience a high quality of life.

However, the group of older people who have the lowest quality of life are those who rate their health as fair or poor.

TILDA found that older people on the whole perceive the ageing process positively, believing they have considerable control over the positive experiences of ageing, but less over the negative aspects.

Older people in the highest wealth category are least aware of the negative aspects of ageing and least aware of the ageing process.

Further health assessments will be undertaken on the study participants in 2014 and 2018.

Principal Investigator with TILDA, Prof Rose Anne Kenny of TCD, said by collecting this data we will  be able to develop a much deeper understanding of the lives and circumstances of older people and of the factors which lead to good health and good quality of life in older ages.

“This will mean that Ireland will be better-placed to plan for the ageing of our population and to help policy makers ensure that limited resources are correctly targeted to those in need.”

Commenting on the study results, Eamon Timmins of Age Action noted that of those with objective evidence of depression, 78% did not report a doctor’s diagnosis of depression and that 85% of older adults with objective evidence of anxiety did not report a doctor’s diagnosis of anxiety.

He said this was an issue which has to be looked at by the medical profession, so that we can learn why these cases of depression or anxiety were not being picked up at an early stage.

Health Minister James Reilly, launching the study results, said TILDA’s high quality objective and subjective measurements of health will provide a truly unique knowledge base that will inform policies for older people in the years ahead.

The study was carried out by TCD in collaboration with an interdisciplinary panel of scientific researchers from a number of institutions around the country.

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