Ageing well - the health of older people

This chapter will present the key factors for older people, aged over 65 years, in Hampshire

Who's the population?

The number of people living in Hampshire is increasing and the population is getting older. Across Hampshire, just over 1 in 5 people are 65 years and over compared to nearly 1 in 6 nationally. In real terms this means there are more than 286,000 people who are over 65 years old, living in Hampshire.

What's the issue?

Growing old with good health is something to be celebrated, but as we grow older we can develop health problems, such as heart or lung disease or dementia or disabilities that limit our daily activities.

Age is one of the biggest risk factors for having a long-term condition. Life expectancy is increasing; we are living longer but increasingly these extra years are lived in poorer health. Dementia is one of the major challenges for care services for older people and is an important cause of needing social care and of carer breakdown.

Social relationships are vital for the maintenance of good health and wellbeing. Although social isolation and loneliness can affect people of any age, many of the risk factors, such as bereavement, transport issues and poor physical health are more common in older people making them more susceptible. Social isolation and loneliness in older people are associated with a significant increased risk of death; poor social relationships are comparable with smoking as a risk factor for mortality.

Older people with physical disabilities face social, environmental and attitudinal barriers. However, a significant proportion of disability is preventable. For example, sight loss is a major cause of disability and research suggests 50% of sight loss can be considered preventable if diagnosed and treated early.

Falls can lead to significant disability and reduced mobility and independence. One in three people over 65 years, and half of those aged 80 years and over fall at least once a year. On average there are 1,500 emergency admissions for hip fractures a year. Half of those with hip fractures never regain their former mobility which can have a significant impact on their quality of life, requiring support from health and care services. One in five people die within 3 months of a hip fracture.

Older people are particularly at risk of dying during the winter months compared to the rest of the population. This increased vulnerability to winter deaths is influenced by underlying health conditions and frailty, a state where the body gradually loses its in-built reserves. Respiratory and circulatory diseases each account for around one third of excess winter deaths.

What does this mean for Hampshire?

Life expectancy at birth for both Hampshire men and women is better than England. Men can be expected to live for 81.1 years (compared to 79.5 years nationally) and women for 84.3 years (compared to 83.1 years nationally). However, the last 17 years for women and 14 years for men are spent in poorer health.

The proportion of people with dementia in Hampshire is significantly higher than England and is increasing. Women with dementia outnumber men by two to one.

Social isolation and loneliness prevalence in the County is predicted to be higher in urban areas and areas of greater deprivation. Over one in ten of Hampshire residents aged 65 years and over live alone.

Within Hampshire the rate of flu vaccinations for the over 65 year olds is generally better than the national average, but the rate is still below the national target of 75%.

What's the trend/projection?

Recent population projection data suggest that Hampshire’s total population will grow by 7% between now and 2023.

The population of Hampshire is ageing with increases predicted mainly amongst the older age groups. The 65 years and over population is projected to increase to over 333,000 people by 2023. The proportion of the 85 years and over population is expected to increase by almost 30%, to 54,600.

Recorded dementia prevalence in primary care is increasing, however, this is within a context of improved detection and diagnosis.

Recommendations

A strategic approach to falls prevention across Hampshire should be developed.

There should be a focus on establishing a coordinated plan to enable social connectivity in at-risk groups through the Ageing Well sub group of the Health and Wellbeing Board.

Through the new Hampshire Carers' Strategy, priority actions should be identified to reduce social isolation for people providing unpaid care.

The ongoing work and commitment to build dementia friendly communities should continue through raising awareness and improving access for people with dementia in the built and natural environment.

Consider how to support the implementation of the national flu campaign to increase vaccination rates for older people and increase focus on health and care staff.

Older people should be supported to have a healthy lifestyle and their access to appropriate lifestyle services should be maximised.