PRESS BRIEFING BY WORLD HEALTH ORGANIZATION

29 April 1996

Press Briefing

19960429 FOR INFORMATION OF UNITED NATIONS SECRETARIAT ONLY

The First Joint Conference on Healthy Ageing was being held as part of the lead-up to 1999 which had been proclaimed the International Year of Older Persons, Dr. Alexandre Sidorenko, Officer-In-Charge, United Nations Programme on Ageing, Department of Policy Coordination and Sustainable Development, told correspondents at a Headquarters press briefing today. He was joined by Dr. Alexandre Kalache, Chief, Ageing and Health for the World Health Organization (WHO). Today's one-day Conference is being jointly sponsored by the United Nations and the WHO.

Dr. Sidorenko said that healthy ageing was one of the major issues to be addressed in the years leading up to 1999, and it had both an individual and public dimension. Individuals were responsible for seeing that they lived healthy, longer lives and governments had to ensure that policies which promoted healthy ageing were put in place.

He then introduced the panellists taking part in the Conference as follows: Dr. Charles Hennekens from Harvard Medical School, Dr. Lester Packer of the University of California at Berkeley, Dr. David Dranove of Northwestern University, Bruce Ames of the University of California, Berkeley, Jeffrey Blumberg from Tufts University, Julie Buring, Harvard Medical School, Hellmut Mehnert of the Diabetes Research Institute at Munich, Germany, and Ursula Lehr of the University of Heidelberg, Germany.

Dr. Kalache told the correspondents that healthy ageing was a challenge for the twenty-first century because there would be more than 1,200 billion people over the age of 65 years worldwide by the year 2020. It was important to make sure the elderly of tomorrow enjoyed an environment where old age was graceful and not miserable and that people had access to information that would permit them to have a healthy lifestyle. Failure to promote the health of individuals who were ageing would strain health services in the developed countries, where there were a lot of older people. In the United States and most high income countries, the very old -- 75 years and over -- were the fastest growing segment of the population and had very important social and health demands.

In the developing world, where over three quarters of the elderly population would live in 2020, the issue of ageing was one of many other social challenges such as infant mortality and illiteracy, he continued. Diseases like arthritis, diabetes and dementia would further strain countries without resources. Ageing had become a development issue and the only way things would improve would be through investment in the healthy ageing movement.

Many questions remained unanswered and scientific evidence was needed on which to base interventions, he said. Some of the evidence would be presented at the Conference today and would be followed up during a WHO-organized two- day workshop after the Conference. The workshop would focus on such issues as current knowledge about healthy ageing, how the research agenda could help develop policies which were responsive to needs and how current knowledge of disease in old age could be applied. The joint initiative had worked closely with the private sector, he said and thanked ASTA Medica and Henkel Fine Chemicals which had been very generous sponsors. Given the United Nations financial crisis, it was important to establish new partnerships and this first experience was working very well, he added.

A correspondent asked who had selected the speakers on nutrition. Dr. Sidorenko replied that they had been selected in consultation with the United Nations Programme on the Ageing. There had been some changes and new speakers. The workshop participants had been chosen exclusively by the WHO.

The correspondent then asked what other dimensions would be brought to bear on the issue. Dr. Sidorenko said other important aspects, such as diet and how to maintain a socially integrated person and what was meant by physical activity, would be examined. Physical activity meant different things to different people and the message had to be conveyed so people of different social classes and educational levels would understand and change their behaviour.

The correspondent asked how the responsibility of society to facilitate those changes would be considered. There were plenty of places such as abandoned railway tracks which could be perfect places for walking but society had not made an investment in keeping people healthy, she added. Dr. Sidorenko said society had to make that investment in keeping older people healthy. Health professionals could not provide the right response unless the message was magnified through the media. It was important to think not only about the message and the research agenda but also about how to persuade the urban planner, the policy maker, the educator, the architect and all sectors who were responsible for ensuring the right environment and that information was available so people could make the right health choices as they aged.

Another correspondent asked about the nutritional requirements for old people, noting that in the United States, the recommended dietary allowances ended at 51 years of age. Dr. Sidorenko replied that the gap in information was due to the fact that the scientific community had only recently examined diet requirements. Knowledge was important so the right recommendations could be made, and the research community must be stimulated to try to get the right answers.

He said it was incorrect to refer to "the elderly" as a group because there would be many variations as people aged which reflected different lifestyles. People 65 to 74 years old were very different from people 85

WHO Briefing - 3 - 29 April 1996

years and over. Some older persons might be very active, and others with disabilities would not be and would therefore have different nutritional requirements. Women would outnumber men and their nutritional requirements in very old age were very different from those of older people in other age groups. Such considerations must be examined carefully so that the right recommendations could be adapted to different age groups.

A correspondent asked if there would be an equal focus on optimum nutrition. Dr. Sidorenko said that issue had received attention only recently and there was a lack of good information for recommendations on diet and healthy ageing. The right kind of research was being stimulated. The workshop hoped to generate a research agenda which would examine dietary aspects. As the Conference was only a one-day event it was decided that the speakers who were addressing the important issues of diet would be fairly homogenous.

Another correspondent asked Dr. Kalache if the new partnership with the private sector was a trend-setting effort. He said that his Department had an annual budget of only $18,000 to run a global programme on ageing and health. The budget had been cut repeatedly because some Member States had not contributed to the United Nations budget. So, different ways to forge new partnerships were needed. Non-governmental organizations were one possibility. They were flexible, very active and good advocates but were usually very poor. Member States could also be partners. However, third world countries were swamped by development issues and it was difficult to bring the issue of ageing into their agendas. The media and the academic sector were also partners. The private sector had been missing in the past, but a partnership based on mutual respect had to be forged with that sector, which had the money.

Dr. Sidorenko added that the private sector would not just be sponsors of programmes but equal partners in dealing with social issues at a national and international level.

A correspondent asked about the talk this morning on lipoic acid as an anti-oxidant and how it could be rated. Dr. Packer said lipoic acid was always present in the body as part of the machinery for energy metabolism. Lipoic acid regenerated vitamin C which in turn regenerated vitamin E. So, if for example there was a deficiency of vitamin C, as in diabetes, perhaps lipoic acid could bolster activity of vitamin C. Whenever the balance between oxidants and anti-oxidants was upset, external help was needed. Lipoic acid was a natural anti-oxidant which was readily absorbed and seemed to have a lot of promise for prevention and perhaps for treatment.

A correspondent asked what would be the outcome of the discussions. Dr. Kalache said that, since he joined WHO a year ago, it had been decided that, instead of a programme which compartmentalized the elderly, the emphasis would be on ageing and health which was life-course oriented and would bring health

WHO Briefing - 4 - 29 April 1996

promotion and healthy ageing to the forefront. However, much information was not reaching the elderly. The primary health care worker must also be reached. The Conference would aim to take stock, specifically in relation to diet and how to stimulate the academic community in partnership with the private sector. That process was part of a strategy, so that by 1999, countries could be advised on developing policies which could equip older people to deal better with ageing.

* *** *