Geriatric education for PHC physicians – 1 st congress of the EU Geriatric Medicine society Paris, August 29 th -Sept.1 st, 2001 Dr. Rüdiger Krech A/Regional Adviser, Healthy Ageing World Health Organization

Increasing Burden of Noncommunicable Diseases and Injuries Change in rank order of DALYs for the 15 leading causes 1999 Disease or Injury 2020 Disease or Injury 1. Acute lower respiratory infections 2. HIV/AIDS 3. Perinatal conditions 4. Diarrhoeal diseases 5. Unipolar major depression 6. Ischaemic heart disease 7. Cerebrovascular disease 8. Malaria 9. Road traffic injuries 10. Chronic obstructive pulmonary disease 11. Congenital anomalies 12. Tuberculosis 13. Falls 14. Measles 15. Anaemias 1. Ischaemic heart disease 2. Unipolar major depression 3. Road traffic injuries 4. Cerebrovascular disease 5. Chronic obstructive pulmonary disease 6. Lower respiratory infections 7. Tuberculosis 8. War 9. Diarrhoeal diseases 10. HIV 11. Perinatal conditions 12. Violence 13. Congenital anomalies 14. Self-inflicted injuries 15. Trachea, bronchus and lung cancers

DALYS, by broad cause group and WHO Region, 1999 AFREMREURSEARWPRAMR DALY = Disability adjusted life-year Communicable diseases, maternal and perinatal conditions and nutritional deficiencies Non communicable conditions Injuries %

Mental Problems and Neurological Disorders Number of cases (millions) Major depressive disorders340 Alcohol related problems288 Mental retardation 60 Epilepsy 40 Dementia (including Alzheimer’s disease) 29 Schizophrenia 45 Attempted suicides Completed suicides 1

Geriatric education should follow the concept of Active Ageing Ageing should be put higher on the political agendas Promote healthy lifestyles Reduce health risks that would increase dependency Increase quality of life

Quality of Life Individual’s perception of their position in life Context of the culture and value systems in which these individuals live Relation to their goals, expectations, standards and concerns

Quality of Life, continued Broad ranging concept –Physical health –Psychological state –Level of independence –Social relationships –Relationship to salient features of their environment

Delivery of health intervention Health systems functions Effective coverage (Quality) Accessibility coverage Availability coverage Target population (population in need) Unmet needs (who and why?) Contact coverage (Utilization) Acceptability coverage Coverage pyramid Population covered