The challenge of an ageing population requires a paradigmatic shift in the way we provide social and healthcare services, demanding the need to prioritize the functionality and independence of older adults. The risk and subsequent fear of falling is one of the most high-risk states for older adults, as it generates a destabilizing effect on their health that is often hard to recover. It is essential to thoroughly address their risk factors and mitigators. This discussion needs to be made in light of a person-centered perspective that goes beyond fragilities to capitalize on the strengths of the older adults. The chapter provides examples of how to connect assessment, interventions, and monitoring to a coherent framework approach that mitigates the risks and the impact of falls on an ageing society. The authors explore how technological innovation, urban planning, and regional policies that are culturally relevant can be incorporated in creating a circular economy while meeting the needs of an aging population and preventing falls and cognitive decline.
Top1. The Challenge Of Ageing In Europe: An Overview Of Sociodemographic Changes In The Eu
The Ageing Report published by the European Commission in 2021 (European Commission, 2020) highlighted the total population in the EU is projected to shrink by 5% between 2019 (447 million) and 2070 (424 million), with differences in national population trends, that show in 11 Member States and falls in the others. Further reading of the Report highlights that the EU’s demographic old-age dependency ratio (i.e. the ratio between people aged 65 years and over and those aged 20-64) is projected to increase significantly in the coming decades: From about 29% in 2010, it had risen to 34% in 2019 and is projected to rise further, to 59% in 2070. This will result in a shift from less than four working-age people for every person aged 65 years and over in 2010 to below two in 2070.
Life expectancy at birth for males is expected to increase by 7.4 years over the projection period, from 78.7 in 2019 to 86.1 in 2070 in the EU. For females, it is projected to increase by 6.1 years, from 84.2 in 2019 to 90.3 in 2070, implying continued convergence between males and females. the EU population is projected to decline from 447 million people in 2019 to 424 million in 2070, with a dramatic ageing process whereby the median age would rise by five years over the next decades.
The total cost of ageing (public spending on pensions, health care, long-term care, education and unemployment benefits), is expected to increase by 1.7 percentage points to 26.7% of GDP between 2016 and 2070. Within this scenario, long-term care and health costs are expected to contribute the most to age related spending rising by 2.1 percentage points between 2016 and 2070 (United Nations, 2019).
Demographic changes in the next 50 years not only mean that the population is getting older but also there will be less people contributing to the economic and financial prosperity of European countries, and State support to retired people will substantially increase. These demographic trends represent a multifaceted sustainability challenge for our societies: indeed, in Europe current policies will be faced with an increase by 4.1 percentage points of GDP between 2010 and 2060, from 25% to 29% that are age-related (pensions, health, and long-term care), with significant differences between countries (United Nations, 2019), thus threatening health equity. Raising the labour market participation of women and older workers could neutralise the effects of population ageing on the weight of pensions in the GDP. Currently, the COVID-19 crisis is still running and its full medium/long-term consequences are uncertain, with the need to adapt economic policies to mitigate its short-, medium- and long-term impact.
In order to meet these challenges, it is pivotal supporting longer working lives by providing better access to lifelong learning, adapting workplaces to a more diverse workforce, developing employment opportunities for older workers and supporting active and healthy ageing.