1. Dr Briony Dow, Emma Renehan and Xiaoping Lin National Ageing Research Institute (NARI) Sue Hendy, Stephanie Harper and Dr Kathleen Brasher Council on the Ageing (COTA) IFA Conference Prague May 2012 Health Promotion for older men and women: 10 years on

2. Overview –Madrid Plan and Active Ageing Framework –Older people’s views of healthy ageing –Main NCDs in Australia and risk/protective factors –Evidence re health promotion for older people Education Physical activity Volunteering Age friendly cities –Summary and directions

3. WHO Madrid International Plan of Action on Ageing Adopted at 2 nd World Assembly on Ageing April 2002 –“build a society for all ages” –method for “mainstreaming ageing into national policy agendas” Involve older people Needs assessment Policy and program formulation Implementation and evaluation

4. Active ageing Active Ageing Framework also launched in 2001 “the process of optimising opportunities for health, participation and security in order to enhance quality of life as people age”

5. The Active Ageing framework – Health Prevention of chronic disease and disability Reducing risk factors and increasing protective factors throughout the life course Health and social services Education and training to caregivers. – Participation Life long education and learning opportunities active participation in economic development formal and informal work and voluntary activities full participation in family & community life – Security (social, financial and physical) & rights

6. Older people’s views Can have health problems and still “age well” Keeping active (mentally and physically) Enjoying life Keeping engaged Positive attitude Meaningful engagement Good relationships with family and friends Physical activity important Financial security COTA volunteers discussing healthy ageing

7. What do we need to avoid? Leading causes of death 85+: – Cardiovascular disease – Respiratory disease – Cancer – Mental disorders (including dementia) Leading burden of disease (whole Pop) – Coronary heart disease – Depression and anxiety – Type 2 diabetes Leading burden of disease (disability) 75+ – Dementia

8. Modifiable Lifestyle Risk factors Smoking Physical inactivity Inadequate diet Alcohol abuse Social isolation Good evidence that modification of lifestyle factors even at later life can reduce risk of NCDs

9. Health Promotion and older people Health = physical and mental health, participation and security – Active ageing framework – Older people’s views – Scientific evidence – Active Ageing Framework provides useful framework for broad based health promotion for older people

10. Social determinants of healthy ageing Education Income/employment opportunities Gender Cultural diversity Capacity to participate in physical activity Environment WHO Active Ageing Framework

11. Health Promotion Education Physical activity programs Volunteering Age friendly cities What is the evidence?

12. Health Education Most common form of health promotion Relies on health literacy Delivery methods – Health professional (variable) – Peer education (preferred) – Mass media (effective <smoking)

13. Physical activity programs Physical activity guidelines Group based programs – Benefit of social component – Higher participation rates – Increased physical activity Barriers – ageism, ageist stereotypes, built environment, hard to reach groups

14. PA recommendations for older Australians Older people should: 1.Do some form of PA regardless of – age, weight, health problems, abilities 2.Be active every day in as many ways as possible 3.Accumulate at least 30 minutes of moderate intensity PA on most, preferably all, days. 4.Start at a level that is easily manageable and gradually increase. 5.But older people who have undertaken vigorous PA throughout their lives can continue to do so in a manner suited to their capability.

15. Volunteering Benefits: – Morbidity – Functional health – Self reported health – Life satisfaction Not all volunteering has equal benefit – Benefit to others – Supported (formal rather than informal) – Social connection

16. Age Friendly Cities Started in 2005 by WHO, 33 cities Inclusion of older people in planning and development (focus groups) Global Age Friendly Cities Guide Global Network “to help cities see themselves from the perspective of older people in order to identify where and how they can become more age-friendly”

17. Summary Active Ageing Framework useful for understanding health and older people Health promotion for older people still developing field - needs – Policy – Programs – Evaluation and research – Older people led Evidence so far suggests that programs that are multi-factorial (social, educational, activity based, enable meaningful participation) have most benefit