By Constantinos N. Phellas
The World Health Organization once asked (2002): “As people are living longer, how can the quality of life in old age be improved? How do we help people remain active and independent as they age? How do we strengthen health promotion and prevention policies especially those directed to older people?” (“Active Ageing”, pp.5, WHO)*
If by 2025 one third of Europe will be aged 60 and over, and by 2050 half the population of Europe will be 50 or older, it is vital to construct questions such as those imposed by the World Health Organization as the aging population is one of the main contributors in shaping today and tomorrows economic and social developments of Europe. It is inevitably true that the demographic state of Europe is changing and can be characterized by the shrinking number of young people; an increase in life expectancy and a dramatic drop in infant mortality. The consequences of such a demographic transition will have a tremendous impact on the economy, care, social development; welfare and well-being in European societies (Agent et al. 2006). To prevent such costly impacts on the population as a whole special attention needs to be placed on promoting health and good quality of life in older age. Investing in both are important determinants of economic growth, competitiveness, labor supply and the decreasing likelihood of early retirement.
Older people have their own population-specific health challenges, such as Alzheimer’s disease, osteoporosis, diabetes, prostate cancer, menopause, and hypertension. Human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) are seldom discussed within this community. Prevention, counselling, testing and education efforts are not being directed their way. In addition, few practitioners are experts both in HIV and health problems associated with ageing, resulting in misdiagnosis – especially in the early stages when AIDS symptoms such as fatigue, weight loss, night sweats, and diminished appetite are dismissed as part of the ageing process.
Additionally, since AIDS education, social services, and prevention programmes have generally been aimed at younger populations, older people are less informed about their risk status and modes of protection. Furthermore, very few HIV-related social support services have targeted the needs of the elderly, perhaps because older People over 50 are not considered to be sexually active or are assumed to be in monogamous, heterosexual relationships. Nevertheless, many are sexually active, often demonstrating risky sexual behaviour that may be combined with the use of alcohol, drugs and other illegal substances.
Research Project: The Case of Cyprus
23 Older Cypriot People Living with HIV (OCPLWH) were recruited in order to take part in a self-completed questionnaire examining their experience of living with HIV, their needs and how they had addressed their needs (The questionnaire used was developed by the Terrence Higgins Trust in a similar type of research)
(1) OCPLWH face extreme difficulty they face on a daily basis, most crucially the fear of facing rejection if their HIV status were to be discovered by other people, (2) Many older people live in assisted living communities, where there is still great stigma attached to HIV/AIDS, often associated with homosexuality and/or substance abuse. Management may be resistant to providing HIV/AIDS educational materials or presentations in their facilities, (3) The majority of the participants remain constrained by their immediate circumstances – by poor housing, illness and disability, treatment side effects, discrimination and poverty, (4) On a small island like Cyprus, where “everybody know everything about everybody”, and visibly, not being able to speak openly about one’s HIV status is a very tough burden for OPLWH, (5) There was a very strong consensus among all the people that took part in the research there is a great need for social and psychological support for OCPLWH, (6) Doctors and nurses often do not consider HIV to be a risk for their older patients. Doctors in Cyprus rarely or never ask patients older than 50 years questions about HIV/AIDS or discussed risk factor reduction
* Active Ageing: A Policy Framework
Editors: WHO, Number of pages: 59, Publication date: April 2002,
WHO reference number: WHO/NMH/NPH/02.8
Professor Constantinos N. Phellas is Vice Rector for Faculty & Research at the University of Nicosia and Visiting Professor at the Hellenic Observatory, LSE
An event around this topic was organised on Monday 13 November. For more information click here