1. 26.Nov.10 | Paula Santana Paula Santana CARE OF OLDER PEOPLE IN PORTUGAL TIME FOR GERIATRIC MEDICINE 26.November.2010 The challenges of ageing Demographic changes in Portugal

2. 26.Nov.10 | Paula Santana The challenges of ageing Health and Disease Health Services utilisation Demographic changes (ageing)

3. 26.Nov.10 | Paula Santana Health and Disease Health Services utilisation Demographic changes (ageing) Ageing is a privilege The challenges of ageing

4. 26.Nov.10 | Paula Santana Demographic changes Life expectancy without incapcity Isolation (lonely old people) Saúde e doença Utilização de Serviços de Saúde Social Conditions (scholarity) Evolution The challenges of ageing

5. 26.Nov.10 | Paula Santana Source: United Nations, Demographic Causes and Economic Consequences of Population Ageing. Economic Studies No. 3, Annex Table 1B pp. 35±38 Population distribution >60 years, ECE region, Southern Europe and Portugal 1950 -2025 (%)

6. 26.Nov.10 | Paula Santana Old-age dependency Ratio Europe 27 and Portugal 2008 -2060 Source: The 2009 Ageing Report. European Union

7. 26.Nov.10 | Paula Santana Old-age dependency Ratio Portugal, Belgium, Sweden and Europe 27 - 2008 -2060 Source: The 2009 Ageing Report. European Union

8. 26.Nov.10 | Paula Santana Sourcee: Elaborado a partir de INE young and old population proportion evolution over total population (%), Portugal, 1960 - 2050

9. 26.Nov.10 | Paula Santana Sourcee: Elaborado a partir de INE 8% 31,8% 13,1% 29,2% 2001: young= 15,6%; old= 17,1% young and old population proportion evolution over total population (%), Portugal, 1960 - 2050

10. 26.Nov.10 | Paula Santana Sourcee: Elaborado a partir de INE 8% 31,8% 13,1% 29,2% Variation: old + 0,23%/year young – 0,16%/year young and old population proportion evolution over total population (%), Portugal, 1960 - 2050

11. 26.Nov.10 | Paula Santana 2009

12. 26.Nov.10 | Paula Santana 2009 e 2040

13. 26.Nov.10 | Paula Santana Source: INE (2009) age 65 years population proportion, 2009 Highest values = 30,3 Pinhal Interior Sul 27,4 Beira Interior Sul 18,1% (1.838.327 people) (1,9% > 85 anos) 23,1% = Highest value in Alentejo

14. 26.Nov.10 | Paula Santana Source: INE (2009) age 65 years population proportion, 2009 Highest values = 30,3 Pinhal Interior Sul 27,4 Beira Interior Sul 18,1% (1.838.327 people) (1,9% > 85 anos) 23,1% = Highest value in Alentejo Grande Lisboa = 365.399 (18,0%) Grande Porto= 202.229 (15,7%)

15. 26.Nov.10 | Paula Santana Highest values = 40,8 Idanha-a-Nova 40,5 Penamacor 38,9 Alcoutim Grande Lisboa = 365.399 (18,0%) Lisboa = 116.022 (24,2%) Grande Porto= 202.229 (15,7%) Porto= 44.086 (20,9%) age 65 years population proportion, 2009 Source: INE (2009) 18,1% (1.838.327 people) (1,9% > 85 anos) 23,1% = Highest value in Alentejo

16. 26.Nov.10 | Paula Santana Older population concentration ( longevity ) 2009 Highest values = 58,6 Pinhal Interior Sul 56,4 Beira Interior Sul Continent = 46,9% (highest value in Alentejo = 51% Source: INE (2009) Longevity (>74/>64)

17. 26.Nov.10 | Paula Santana Highest values = 64,6 Idanha-a-Nova 63,1 Mação Older population concentration ( longevity ) 2009 Sourcee: Elaborado a partir das estimativas da população residente a 31/5/2010. INE (2009) Continent = 46,9% (highest value in Alentejo = 51% Longevity (>74/>64)

18. 26.Nov.10 | Paula Santana Life Expectancy at 65 years (2007-2009) Variations NUTS II: Lisbon (18,51 years) the best Alentejo (17,95 anos) the worst Difference: 0,56 years Variations NUTS III: Entre Douro e Vouga (19,09 anos) the best Baixo Alentejo (17,05 anos) the worst Difference: 2,04 years Source: INE (2009)

19. 26.Nov.10 | Paula Santana Old people living alone, 2001 Total = 310.860 (17,4%) (2001) 241.608 Women 69.252 Men Source: Censo, 2001 INE Legend: Old men living alone (%)

20. 26.Nov.10 | Paula Santana Highest values = 6.036 Lisboa (12,2%) 1.800 Porto (9,7%) 138 Alcoutim (19,1%) 239 Mértola (18,8%) Men Sourcee: Elaborado a partir do Censo, 2001 INE Old people living alone, 2001 Legend: Old men living alone (%)

21. 26.Nov.10 | Paula Santana Women Old people living alone, 2001 Legend: Old men living alone (%) Legend: Old women living alone (%) Highest values= 27.734 Lisboa (33,1%) 9.269 Porto (28,7%) 187 Penedono (35,2%M)

22. 26.Nov.10 | Paula Santana 1991 – 2006 variation (1991=100) Life expectancy at birth and at 65 years Growth of LE65 years is almost 3 times bigger than LF at birth

23. 26.Nov.10 | Paula Santana Life Expectancy e Esperança de Vida sem nenhum tipo de Incapacidade – both genders, 2005/06 Source: INE (óbitos e estimativas de população residente, em 2005 e 2006) e do INS 2005/2006

24. 26.Nov.10 | Paula Santana Life Expectancy and Life Expectancy without any kind of disability – both genders, 2005/06 Source: INE (óbitos e estimativas de população residente, em 2005 e 2006) e do INS 2005/2006

25. 26.Nov.10 | Paula Santana Sourcee: INE (óbitos e estimativas de população residente, em 2005 e 2006) e do INS 2005/2006 Life Expectancy without disability by age and gender 2006

26. 26.Nov.10 | Paula Santana Life Expectancy without disability by age and gender 2006

27. 26.Nov.10 | Paula Santana Source: INE, Censos 2001 Scholarity, 2001

28. 26.Nov.10 | Paula Santana Source: INE, Projecções Demográficas Scholarity (prevision), 2026

29. 26.Nov.10 | Paula Santana Source: INE, Projecções Demográficas Scholarity (prevision), 2026

30. 26.Nov.10 | Paula Santana Source: INE, Censos 1991 e 2001 Immigrants living in Portugal, 1991 and 2001

31. 26.Nov.10 | Paula Santana Source: INE, Censos 1991 e 2001 Immigrants living in Portugal, 1991 and 2001

32. 26.Nov.10 | Paula Santana Ageing | Impacts assessment Health and disease Utilização de Serviços de Saúde Envelhecimento

33. 26.Nov.10 | Paula Santana Source: INSA/INE – 4º INS (2005-2006) * In this two weeks, how many days you left doing something that usually you do due to a desiase, accident, violance or other motive related with heath? % of individuals with temporary incapacity*

34. 26.Nov.10 | Paula Santana Source: INSA/INE – 4º INS (2005-2006) % of individuals with temporary incapacity * and days (average), 2005/06 * In this two weeks, how many days you left doing something that usually you do due to a desiase, accident, violance or other motive related with heath?

35. 26.Nov.10 | Paula Santana Source: Santana (2000) e INSA/INE – 3º e 4º INS Evolution of the % of the population with 65 years reporting temporary incapacity 1996, 1999 e 2006

36. 26.Nov.10 | Paula Santana Source: INSA/INE – 3º e 4º INS 65 – 74 years People (%) Days Individuals (%) staying in bed and days (average), 1999 and 2006 People in bed (%) Number of days

37. 26.Nov.10 | Paula Santana Source: INSA/INE – 3º e 4º INS Days 65 – 74 years > 74 years People (%) Days People (%) Individuals (%) staying in bed and days (average), 1999 and 2006 People in bed (%) Number of days

38. 26.Nov.10 | Paula Santana Activities performed by individuals with more than 65 years 1999 e 2006 Sourcee: INSA/INE – 3º e 4º INS 65 – 74 years Walk in a flat place Lie dowm and get out from bed Dress and Undress

39. 26.Nov.10 | Paula Santana Source: INSA/INE – 3º e 4º INS 65 – 74 years > 74 years Activities performed by individuals with more than 65 years 1999 e 2006 Walk in a flat place Lie dowm and get out from bed Dress and Undress

40. 26.Nov.10 | Paula Santana Diabetes Source: INSA/INE – 3º e 4º INS Individuals with Chronicle Diseases, 1999 and 2006

41. 26.Nov.10 | Paula Santana Source: INSA/INE – 3º e 4º INS Individuals with Chronicle Diseases, 1999 and 2006 Diabetes Asthma

42. 26.Nov.10 | Paula Santana DiabetesAsthma Hipertension Source: INSA/INE – 3º e 4º INS Individuals with Chronicle Diseases, 1999 and 2006

43. 26.Nov.10 | Paula Santana Source: INSA/INE – 3º e 4º INS Overweight (IMC >27) Other risk factors, 2006

44. 26.Nov.10 | Paula Santana Source: INSA/INE – 3º e 4º INS Overweight (IMC >27) Age > 86 Years: 6,8% H 7,8% M Low-weight (IMC <18,5) Other risk factors, 2006

45. 26.Nov.10 | Paula Santana Source: INSA/INE – 3º e 4º INS Variation (99/06) Low- weight (IMC <18,5) Overweight (IMC >27) Age > 86 Years: 6,8% H 7,8% M Low-weight (IMC <18,5) Other risk factors, 2006

46. 26.Nov.10 | Paula Santana Tobacco Consumtion Phisical Inactivity (walk) Source: INSA/INE – 3º e 4º INS Other risk factors, 2006

47. 26.Nov.10 | Paula Santana Sourcee: INSA/INE – 3º e 4º INS (very good and good) evaluation of Health Status Source: INSA/INE – 4º INS (2005-2006) 1999 e 2006

48. 26.Nov.10 | Paula Santana Ageing| Impacts assessment Saúde e doença Health Services utilisation Envelhecimento

49. 26.Nov.10 | Paula Santana Medicines consumption of individuals =>65 years Source: INSA/INE – 4º INS * Tomou medicamentos receitados (incluindo pílulas contraceptivas ou outras hormonas, pomadas, cremes, injecções, vacinas, etc.) nestas duas semanas?

50. 26.Nov.10 | Paula Santana Sourcee: Elaborado a partir de Santana (2000) e INSA/INE – 3º e 4º INS Outpatient visits (%) Evolution 1996, 1999 and 2006 of population 65-74 & > 74 years Source: Santana (2000) e INSA/INE – 3º e 4º INS

51. 26.Nov.10 | Paula Santana Source: INSA/INE – 3º e 4º INS % Variation (1995/96 – 2005/06) of consultations per speciallity * * Do you went to any general clinic consultation or other speciality in the last 3 mouths? Outpatient visits, Variation 1998/99 and 2005/06

52. 26.Nov.10 | Paula Santana Sourcee: ACSS, GDH 2007 e INE (2006) Hospital Utilisation: inpatien (%) Ages and months (2007)

53. 26.Nov.10 | Paula Santana Sourcee: ACSS, GDH 2007 e INE (2006) Hospital Utilisation: inpatien (%) Ages and months (2007)

54. 26.Nov.10 | Paula Santana OFFER : Social equipments for old people Formal care Source: www.cartasocial.pt Total in 2009 = 6.823 Capacity = 87.322

55. 26.Nov.10 | Paula Santana Source: UMCCI, 2010 (518,3%) 1286 (128,2%) 655 (653,8%) 2053 416,9% growth 287 208 279 Beds offer evolution (contracted number of beds ) 797 4120

56. 26.Nov.10 | Paula Santana Sourcee: UMCCI, 2008 (518,3%) 1286 (128,2%) 655 (653,8%) 2053 (416,9%) 3.323 287 208 279 23 Beds offer evolution (contracted number of beds ) (447,8%) 126

57. 26.Nov.10 | Paula Santana Some initial issues We live longer Como se ajuda as pessoas a permanecerem independentes e activas? Como se fortalecem as políticas de promoção da saúde e de prevenção da doença? Como pode ser melhorada a qualidade de vida nas idades mais avançadas?

58. 26.Nov.10 | Paula Santana Some initial issues We live longer How can we live more years independently and activly? Como se fortalecem as políticas de promoção da saúde e de prevenção da doença? Como pode ser melhorada a qualidade de vida nas idades mais avançadas?

59. 26.Nov.10 | Paula Santana We live longer How can we live more years independently and activly? How to strengthen health promotion and disease prevention? How to improve quality of live of older people?

60. 26.Nov.10 | Paula Santana Health and Disease Health Services utilisation Demographic changes (ageing) Active Ageing The challenges of ageing

61. 26.Nov.10 | Paula Santana Health and Disease Health Services utilisation Demographic changes (ageing) Ageing is a privilege The challenges of ageing

62. 26.Nov.10 | Paula Santana paulasantana.coimbra@gmail.pt