Non-communicable diseases, COVID-19, and the elderly

In 1960, life expectancy in the Philippines was 62 years. By 2019, the average Filipino living in the country could expect to live up to 71. Worldwide, 900 million people are aged 60 years and older; seniors now outnumber children younger than 5 years.

By 2050, one in five people will be 60 years and older, and 80% of them will be living in low- and middle-income countries, according to the World Health Organization (WHO). “Growing old” has become the norm — thanks to breakthroughs in healthcare, nutrition, and sanitation, said the International Federation of Pharmaceutical Manufacturers & Associations (IFPMA).

Unfortunately, population ageing is a key driver of the rise of non-communicable diseases (NCDs). About two-thirds of people affected by NCDs are aged over 60. NCDs such as heart disease, stroke, cancers, diabetes, chronic respiratory diseases, and dementia, among others, have increasing impacts on functional health and demand for health services.

The WHO attributes the increasing burden of NCDs to both an increase in risk factor prevalence and growing numbers of older people. It considers NCDs as the greatest threat to healthy ageing, contributing to death, disability, and dependency among older people.

With the rate of both NCDs and population ageing expected to rise rapidly in the next two to three decades, particularly in low- and middle-income countries, the WHO is urging governments to plan for health services that are responsive to both more elderly patients and more NCD cases as people live longer.

While NCDs develop progressively over the life span, the WHO pointed out that many risk factors are amenable to prevention and amelioration. Four major risk factors are the primary drivers of the rise of NCDs: tobacco use, physical inactivity, the harmful use of alcohol, and unhealthy diets.

The global health agency recommended strengthening health promotion and disease prevention and screening to enable a healthier environment and to promote behavioral change on risk factors. These measures should target populations earlier in the life course, the WHO stressed.

Citing the growing costs of NCDs to health systems in countries with limited resources, the WHO emphasized the need to prioritize the strengthening of primary health services and the focusing of hospital acute care towards cost-effective responses to chronic conditions and comorbidities through middle and later life.

The WHO recommended intermediate and long-term reform strategies to respond to NCDs and ageing populations in the future. These included the need to train health professionals in elderly care, make services more responsive to elderly patients, design age-friendly facilities, integrate the different levels and types of health services, develop rehabilitative services, and link health services to community care.

Oct. 1–7 of every year is Elderly Filipino Week. Apart from the NCDs, older people are also vulnerable to coronavirus disease 2019 (COVID-19). Older people are among the groups that are at risk of developing serious disease more often than others. The Centers for Disease Control and Prevention (CDC) said that the risk for severe illness with COVID-19 increases with age. In fact, they might need hospitalization, intensive care or they might even die as a result of the virus.

The CDC strongly recommended that older adults get vaccinated as soon as possible. If they are among those who have a weakened immune system, they must also take further precautions even if they have already been vaccinated.

“COVID-19 is changing people’s daily routine, the care and support they receive, their ability to stay socially connected and how they are perceived,” explained the WHO. Opportunities must therefore be created for the older ones who are being confronted with the daily challenges of staying at home, lack of physical and social activities, and the anxiety of getting sick or dying due to the pandemic.

The WHO said that it is important for older people to equip themselves with information about their community and the services they provide. The elderly may also keep basic supplies, including prescription medicines, for at least two weeks. They may also make a list of emergency numbers and support contacts primarily consisting of family members and friends. The elderly may likewise discuss with their doctors on how their health needs may be addressed during the pandemic. This may include a medical teleconsultation for non-emergency cases.

It is absolutely crucial that healthy ageing is given the attention it deserves. Pharmaceutical research and development, meanwhile, continues for both NCDs and infectious diseases to make a significant dent in the disproportionate impact of NCDs and the COVID-19 pandemic on the elderly.

Teodoro B. Padilla is the executive director of Pharmaceutical and Healthcare Association of the Philippines (PHAP), which represents the biopharmaceutical medicines and vaccines industry in the country. Its members are at the forefront of research and development efforts for COVID-19 and other diseases that affect Filipinos.