This Old World

Report says 800,000 turn 65 each month worldwide

FRIDAY, Dec. 14, 2001 (HealthDayNews) -- The ranks of senior citizens are swelling at a rate of 800,000 a month worldwide, more than double the population of Miami and the fastest pace ever, a new U.S. Census Bureau report says.

Last year, Italy eclipsed Sweden as the country with the oldest population. Roughly one in six Italians, or 18 percent, are 65 or older. The United States, where 13 percent of people are over 65, is 32nd on the list of nations with the highest share of seniors, thanks largely to its appeal to young immigrant workers from other countries.

Three countries -- China, the United States and India -- are home to a third of the world's oldest people, those over 80. Of these, 11.5 million live in China, 9.2 million in America and 6.2 million in India.

Demographers say populations start aging as birth rates drop and life-spans increase. Japan leads the world in longevity, with an average life expectancy of 81 years, followed by Singapore at 80. Australia, Canada, Italy and a few other developed nations are close behind, at 79 years, while the United States hovers at about 77 years.

In general, women account for most of the graying, though a few countries, including India, Iran and Bangladesh, buck that trend, says the report, An Aging World: 2001, prepared by Census Bureau demographers Victoria Velkoff and Kevin Kinsella.

Developing regions are aging faster than more economically and politically stable nations, accounting for 75 percent of the growth in the number of elderly between 1999 and 2000, the study shows. Caribbean countries lead the developing world with a senior population of 7.2 percent.

Velkoff projects the strong aging trend will continue, and, by 2030, people over 65 will make up about 12 percent of the world's population, compared with 6.9 percent now. Whether they can safely be called "old," however, is a different matter.

"What is elderly? Does it change by where you live and what your health status is?" she says. "If you're 65, and you're healthy and you want to keep working, are you old?" Conversely, if you're 50 and infirm and can't work, are you still young?

Semantics aside, experts say all that aging has serious consequences for societies, forcing changes in everything from family structures to health-care expenditures.

Retirement pensions are an example. Although the U.S. Social Security system is facing a funding crisis in the near future, its basic machinery was cast during a time when the program could comfortably cover the older, non-working population. Developing countries don't have such a luxury, says Cynthia Buckley, a population expert at the University of Texas, in Austin. "They're trying to build a system in a crisis situation," Buckley says.

In the absence of a solid state-sponsored pension, families must fill in the gaps. Likewise, long-term health care presents another problem for less advanced nations and their citizens. As difficult as it is for older Americans to afford such treatments, Buckley says it's even harder for those in poorer countries -- when such treatments exist.

Just as with finances, in many cultures women and children are duty-bound to care for their ailing parents and grandparents at home. This relationship puts a strain on their ability to work and could drive down incomes and exacerbate poverty.

Americans are living in good health longer, and recent studies show that the rate of disability among the elderly is declining.

Why that's the case isn't perfectly clear, says Richard Suzman, a researcher at the National Institute on Aging. It is likely a combination of several factors, including better prenatal care, lower exposure to childhood infections and more education, he says. A drop in elderly smokers and the "relative sophistication" of the Medicare system also may account for some of the reduction.

Yet although the United States can do better by its elderly than nearly everywhere else in the world, the aging trend is putting "tremendous strain" on the nation's health-care system, says Dr. Kenneth Brummel-Smith, president of the American Geriatrics Society.

"The numbers [of elderly] are increasing so fast, it's overwhelming people's ability to care for them," Brummel-Smith says. But the impetus to slash health-care costs is undercut by the equally strong desire for access to the latest and the best -- and usually the most expensive -- medical technology, he says.

Ironically, while the elderly consume the most medication, the bulk of the drugs they take were never tested in people their age, Brummel-Smith says. As the aging trend continues, that particular trend cannot, he says.

What To Do

To find out more about healthy aging, try the National Institute on Aging or the American Geriatrics Society.

For more on getting old, visit the U.S. government's Administration on Aging.

To learn more about demographics, click on the Population Association of America. And for a look at the nation's most populous cities, try the Learning Network.

SOURCES: Interviews with Victoria Velkoff, Ph.D., chief, aging studies branch, U.S. Census Bureau, Upper Marlboro, Md.; Cynthia Buckley, Ph.D., associate professor of sociology and graduate training director, Population Research Center, University of Texas, Austin; Kenneth Brummel-Smith, M.D., president, American Geriatrics Society; Richard Suzman, Ph.D., associate director, behavioral and social research program, National Institute on Aging, Bethesda, Md.; U.S. Census Bureau An Aging World: 2001
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