Author: Global Health Aging

A Call to Reclaim Aging Today

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Anti-aging! It’s everywhere.

There’s lotions, potions, creams, and make-up. Shampoo, moisturizers, face masks and toothpaste. There are anti-aging diets promoting superfoods, revitalizing drinks, vitamins, herbal mixes, homeopathic remedies and juicing whilst at the same time we read the latest story about the oldest person on the planet reaching that age on wine, chocolate, and a maverick attitude!

We’re told about anti-aging exercises, treatments, laser surgery, sun lamps, and cosmetic procedures. We’re advised on clothes, underwear, hairstyle, hair color, and even eyebrow shape!

There are books, magazines, DVDs, radio programmes, tv programmes, youtube channels, Facebook pages, Twitter accounts, Snaps, Insta influencers, podcasts, and blogs all dedicated to anti-aging.

We can even go on retreats, workshops, and seminars to learn, discuss and discover the best ways to beat aging.

Why?

Aging is a sign of survival- what’s the alternative? Not surviving? Not a great option. We need to celebrate having survived, realizing that the wrinkles, the lines, the grey hairs are a mark of success, of having reached a point in life that is your new record and you beat that record every day by getting older day by day. A ‘personal best’ you might say.

Whilst there appears to be a huge industry in ‘anti-aging’ and there is a myriad of ways that are promoted to be able to ‘stay young’, it cannot be denied that we are, all of us, not staying young! And that surely is the point.

We are all getting older and that is a good thing, we should stop trying to defy aging and, instead, live positively. Shake off the dreadful, negative, old age stereotypes and ask yourself what is so bad about aging that it has created such an ‘anti’ industry?

Let’s all be pro-age and let’s call out and challenge all the age discrimination that exists out there which has led to this huge ‘anti-aging’ phenomenon.

Let’s do it today.

Morna O’May is the Head of Service for Scotland at Contact the Elderly, the national charity dedicated to tackling loneliness and social isolation amongst older people living in the United Kingdom. Morna also writes the Goodstuffgreatideas blog about all things Third Sector. Follow Morna on Twitter.

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Social and Financial Costs of Millennial Dementia Caregivers

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A report by the Center for Healthcare Innovation.

Abstract

With the prevalence of Alzheimer’s disease expected to impact 16 million individuals by 2050, younger generations will increasingly assume caregiving responsibilities. More than a third of today’s caregivers are employed full-time. As millennials take on informal caregiving responsibilities, public and workplace policies must consider financial assistance or other support (e.g., family leave or allocated time off). This report explores the economic impact of the shift to millennial caregivers and the higher rate of incidence of Alzheimer’s disease in minority groups. The report concludes with a discussion of strategies at the organizational-and system-level to support millennial caregivers.

Calls for Action

  1. Define public policy in supporting family caregivers in providing care.
  2. Address how universities can better support student caregivers.
  3. Companies and employers take the lead in supporting working caregivers.
  4. Caregiver supports begin in communities.
Figure 1. U.S. population 65+ (in millions)

To view the white paper, click here.
To view the best practice, click here.

Interview with Cognitive Neuroscientist Judy Lobo

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Judy Lobo is a cognitive neuroscience graduate student at the University of Miami. She uses functional magnetic resonance imaging (fMRI) and cell staining methods to study the links between health and cognitive abilities. fMRI is a technique for measuring brain activity and cell staining is used to better visualize cells and cell components under a microscope. Her Master’s project was one of the first fMRI investigations into Successful Cognitive Aging or “SuperAgers”. As a part of the BREATH Lab at the University of Miami, she also works with HIV populations. Their current work focuses on the mind-body interactions between chronic inflammation and the disruption of functional brain activity. We are excited to interview Judy about her research, fighting Alzheimer’s disease (AD) and the role of exercise in cognitive decline. Follow her on Twitter @judi_diane

Can you tell us about your journey in science?

I am an unlikely member of the academic community. I am a mixed-race, Honduran American student and I do notice that I rarely see students like me (much less faculty) that understand where and what I come from. I am now in my third year of graduate school and finally feeling like I can catch the flow of research life, however, this was after an intensive cultural immersion into the academic environment. I must admit that I do love it, I love learning about the brain and rubbing elbows with people who are equally passionate about my field. This was a world I waited for years to be admitted into.

What areas of research are you currently pursuing?

I am part of a very interdisciplinary lab. I concentrate my efforts on fMRI analysis and how we can use it to understand and treat memory loss. I am interested in the mysterious phenomena of “SuperAgers”, older adults that are still as sharp as individuals who are 20 to 30 years old. I study their brain activity and how that contributes to their “special” abilities. However, there is another side to my research. I study brain activity changes due to exposure of HIV-disease as well as cell staining and cell cultures. I use these methods to investigate how inflammation relates to brain activity and memory abilities. *Cell culture is the process of obtaining cells from a plant or animal and then growing them in an artificial environment.

What’s one piece of advice you would give early career researchers?

Broadly, learn to work and study with others. As you get to advanced stages of your academic career, two heads truly are better than one.

How can science communication contribute to fighting against AD?

I think this is a vital piece that AD research needs right now. First of all, awareness of what AD is and how it can be prevented. Prevention is our best weapon against AD right now and it is possible to do so with simple life changes. Greater awareness also has a feedback effect; if more people knew about our research I also think more of them would volunteer for the studies and support our efforts.

What’s one recommendation you’d give people wanting to reduce their risk of AD?

Exercise. It’s the best intervention or treatment we have so far for cognitive decline.

What are you most proud of in your life?

At the moment, I am most proud of my current position. I would have been a happy teenager if someone told me that I would be doing fMRI research as a part of the University of Miami. I am a part of amazing research groups, such as the McKnight Research group which is a team of neurologists, neuropsychologist, radiologists all at the same investigating treatments for age-related neurodegeneration.  I am also a regular at the Brain Connectivity and Cognition Laboratory, which is one of the research laboratories that I looked up to earlier in my career.

What are your future career goals?

I hope to take fMRI research as far as I can. It has been a rewarding experience and it is such an impressive community. However, students like me have lower chances to move on to direct their own laboratory, so I remain open to prospects in the industry.

What do you like to do for fun?

I love making art. I have film cameras and paint canvases all stashed in my home for the rare moments when there is time to make something or shoot pictures.

Is there any other information that you would like to add?

To an early career researcher that is also an underrepresented minority, I would say: You are not alone. It’s a challenging life path, which is made more challenging if you blame yourself for a lot of the challenges that you encounter in academia.

Interview with Alzheimer’s researcher, blogger, and advocate Maya Gosztyla

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Maya Gosztyla is the creator of AlzScience. Her passion for Alzheimer’s disease began at a young age when her grandmother was diagnosed with vascular dementia following a stroke. She currently works in a lab at the National Institutes of Health, where she’s researching a rare neurodegenerative disorder called Niemann-Pick Disease. In addition to her love of research, Maya has a passion for science writing and hopes to continue educating the public about the ways we can keep our brains healthy as we age. We are excited to interview Maya about her research, fighting Alzheimer’s and the role of diet in brain health. Follow her on Twitter @AlzScience

Can you tell us about your journey in science?

I’ve pretty much always known that I wanted to be a scientist, but the exact field of science has varied quite a bit. For most of my high school, I wanted to be an astrophysicist. But then I took an advanced biology course in my senior year, and I was hooked! I ended up going to college at the Ohio State University and double-majoring in Neuroscience and Molecular Genetics. I knew I wanted to get involved with research, so I joined a lab that was studying how axons (the long projections that neurons use to send electrochemical signals) are guided to their proper destinations during the development of the nervous system. This research was fascinating work, but over time, my interests began to drift more toward studying human diseases. I spent some time in Switzerland doing a research project on Alzheimer’s disease, which convinced me that this was the area of research that I wanted to focus on. After I graduated, I secured a research fellowship at the National Institutes of Health (NIH), where my research has a biomedical focus. I’m now applying to Ph.D. programs in Neuroscience, and I hope to begin my enrollment this fall. I plan to research the underlying mechanisms of neurodegenerative diseases (including Alzheimer’s) and develop new strategies for treatment.

What areas of research are you currently pursuing?

My section of the NIH is called the National Center for Advancing Translational Sciences. We are interested in the “bench to bedside” research, which involves taking scientific discoveries and trying to apply them to treating diseases. One of my projects is to develop a method to quantify how much cholesterol is inside of neurons that are growing in a dish. There are several diseases caused by the accumulation of too much cholesterol, including Niemann Pick Disease (also known as “childhood Alzheimer’s disease”). We are hoping that this new method will allow us to quickly screen thousands of different chemicals to see if any of them can reduce how much cholesterol is inside these cells. After that, we can investigate those chemicals further and try to develop them into a new treatment.

What’s one fact that you’ve learned about the brain?

During the day, your neurons are working hard sending lots of signals, and in the process, they release a lot of waste products into your brain. One of these waste products is amyloid-beta, a toxic protein that’s believed to be responsible for Alzheimer’s disease. Luckily, when we sleep, all the gunk inside your brain gets cleared away. That’s why getting enough sleep is so important!

What’s one piece of advice you would give to early career researchers?

One of the best things I ever did was start a science blog. It’s a great way to get more familiar with your field of research while helping other people to understand. It’s also great for networking; so far two people at my Ph.D. interviews have told me that they are regular readers of my blog!

How can science communication contribute to fighting against Alzheimer’s disease (AD)?

There’s a lot of misinformation surrounding Alzheimer’s disease. A lot of people don’t realize that only one-third of your overall risk is due to genetics—the rest is all determined by your lifestyle choices! A balanced diet, regular exercise, and lifelong learning can dramatically reduce your risk of getting this disease. I’m hoping that my efforts in science communication can help more people learn how to start taking better care of their brains.

What’s one recommendation you’d give people wanting to reduce their AD risk?

Probably the number one best thing you can do for your brain is to improve your diet. A lot of research has shown that the Mediterranean diet, which is also great for heart health, dramatically reduces the risk of Alzheimer’s disease. This diet minimizes saturated fat and red meats while consuming lots of vegetables, legumes, and whole grains. Even if you take a small step toward improving your diet, like cutting out all sugary beverages, it can make a big difference in your brain health, not to mention your body!

What are you most proud of in your life?

I started my blog AlzScience about three years ago, and I’m so proud of how far it’s come. Last year the site had nearly 15,000 readers and also won a Science Seeker Award. It’s fantastic when people comment that they are grateful to learn the information.

What are your future career goals?

This fall, I’m planning to start a Ph.D. program in Neuroscience. My goal is to pursue a career in research either as a professor or in the pharmaceutical industry. I hope I can play a key part in bringing Alzheimer’s cure research to fruition.

What do you like to do for fun?

I love jogging; it’s my favorite way to clear my head. I also read a lot, and occasionally play around on my violin.

Four Key Questions When Choosing A Residential Care Facility

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Does the facility offer memory care options?

Not all aged care facilities are created alike. Some offer memory care options, while others do not. Independent living facilities, for example, are geared toward older adults who are able to live an active lifestyle. Assisted living facilities and skilled nursing facilities (also known as nursing homes) may offer memory care options for people with dementia. Before choosing a care facility, ask the facility director if the institution provides specialized care or not.

What is the cost?

Caring for a person with dementia is expensive. According to an analysis conducted in 2016, the cost of health and residential care of people living with dementia can reach up AU $88,000  annually. Before committing to a facility, ensure that the facility and their services are up to or above par. Check the facility’s basic daily fee, plus its means-tested care fee and accommodation cost. Some facilities also charge fees for additional services.

What activity programs are available?

Mental stimulation can have physical benefits for people with dementia. Thus, an ideal aged care facility should provide inclusive programming, as well as specific recreational activities for residents with dementia. Some examples of activities include:

  • Reading and solving puzzles
  • Exercise and meditation
  • Playing a musical instrument/ listening to music/ sing-a-long
  • Movie screenings
  • Painting and crafts

What kind of training has the nursing staff received?

Thoroughly check ALL nursing staff credentials to make sure that they are adequately trained. Observe how the staff deals with the residents. Do they treat the residents with compassion and respect, or do they raise their voices or are rude when they communicate? Do you see signs of abuse or neglect? What is the staff-to-resident ratio per shift?

Also, make sure that a registered nurse is on duty 8 hours a day, and the facility is operated by licensed nursing staff 24 hours a day. Many dementia patients are unable to eat or drink by themselves, so check whether the staff is willing to assist residents who are unable to do so.

Healthy Brain, Healthy Heart

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FirstCare Nursing Homes are leading nursing homes in Ireland. FirstCare has provided nursing home care for older adults and frail patients for over 14 years. A project coordinator for dementia care, Jane Bryne, discusses improving brain and heart health.

How are the brain and heart connected?

The brain and heart are two vital organs in the human body. Unknown to many, the brain and heart are more connected to one another than previously thought. A study confirmed that ensuring optimal health of the two organs will lead to the efficiency of the other. This means that having a healthy heart is related to lower dementia risk and a slower rate of cognitive decline.

It was also found that the cardiovascular system, operating in peak performance, supports the proper functioning of the brain, thus leading to sharper memory and best use of one’s intellectual capability. Also, failing to maintain optimal cardiovascular health damages the brain’s fundamental anatomic structure, which can eventually lead to various mental health conditions like dementia.

What’s the link between dementia and heart health?

A new study found that people who have good cardiovascular health are less likely to get dementia. The study concluded that leading a physically active lifestyle, maintaining a healthy diet, and avoiding alcohol and smoking, are sure-fire ways to reducing the tendency of suffering from dementia later in life.

In another study published in the journal Neurology, doctors researched 1,200 older adults who gave consent to brain autopsies after death. The findings were surprising because those who had high blood pressure showed signs of dementia.

Is there hope for people with dementia?

Dementia is not a dead end for older adults who have the condition. They can live the healthiest life possible even with dementia.

How can older adults have a good quality of life?

Housing has a huge effect on older adults’ mental health. Easy access to health infrastructure and recreation centers have been shown to be crucial to physical and mental health.

What’s your take on embracing the aging process?

A change of mindset is needed and research has shown that those who have positive views of aging are less likely to develop later the brain changes associated with Alzheimer’s disease.

Growing Younger Gracefully: Your Guide to Aging with Vitality, Resilience, and Pizzazz

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Sheena Nancy Sarles writes about her new book titled Growing Younger Gracefully. The book is a full-spectrum exploration and curation of simple tips to navigate and celebrate the gift of aging. 

My intention for writing “Growing Younger Gracefully: Your Guide to Aging with Vitality, Resilience, and Pizzazz” is for you to be inspired to appreciate your gift of aging, and to be motivated to incorporate daily, weekly, monthly, or once-in-a-lifetime rituals that enhance your well-being regardless of your chronological age. Growing Younger Gracefully is not about looking younger, but about the positive attitude and vibrant energy, we can choose as our foundation, as we navigate this journey in body, mind, and spirit.

This book springs from many sources that came about at the same time. First, I am aging, and I really want to face my aging without panicking. And, not long ago, I was panicking! I want to look and feel my best. Yet, it is time to acknowledge that I am in transition. My body doesn’t respond the way it used to. My face looks different. I care less about some things and more about others. There suddenly seem to be more people around who are younger than me than who are older. I get notices on hearing aids and retirement needs instead of ads for gym memberships. Yikes!

I have always been interested in being active, healthy, and living well. I want to enjoy all the aspects of my life. A few years ago, I began picking up books and articles with terrific ideas on well-being, yoga, nutrition, meditation, health products, and pretty much everything in this area. I’ve kept notes and tried whatever tips interested me. That compilation grew and grew, and is now this book.

“Growing Younger Gracefully: Your Guide to Aging with Vitality, Resilience, and Pizzazz” is my curation of the various elements that offer well-being at any and every age. We actually can enhance our well-being, or as I like to say, “grow younger gracefully,” with a commitment to the pillars of well-being: nourishment, movement, and attitude. Each relies upon the other, yet each holds great significance independently.

“Growing” is our constant cellular state. Our cells are ever-changing. “Younger” is the notion that youth is about creating new experiences, gaining new perspectives, and exploring life’s mysteries. Let’s keep doing that, no matter our physical age. “Gracefully” is the way in which we want to explore these mysteries of life—with elegance, ease, and respect.

Aging is identified in our culture as something to fear, deny, resent, remedy, cure, and most of all, regret. As we age, we can feel great. As we age, we can feel awful. As we age, we can feel it all. Our aging is real, and it’s all ours. Most of all, how we age is all about our choice and our perspective.

These tips are organized by topic, but it is not recommended that you start at the beginning and read through in order. I suggest you find one randomly and take that tip into your routine for a day. Or, if you are looking for something specific to address a current interest or struggle, do just that.

Welcome to “Growing Younger Gracefully: Your Guide to Aging with Vitality, Resilience, and Pizzazz”!

Join Growing Younger Grace communities on Facebook, Instagram, YouTube and subscribe to the newsletter!

Sheena Nancy Sarles is the founder of Growing Younger Gracefully™ (GYG) workshops and creator of GYG Organic Facial and Body Serums. A certified yoga instructor, holistic life coach, and Reiki practitioner, she has curated her studies and practice of well-being in her newly released book, Growing Younger Gracefully: Your Guide to Aging with Vitality, Resilience, and Pizzazz. Follow Sheena on Twitter.

What’s on the Minds of Top Aquatic Experts?

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The excitement and the anticipation of attending the fifth International Conference on Evidence-Based Aquatic Therapies (ICEBAT) had been growing inside of me for months.  Unsure who I’d meet, but, certain I needed to be there, my excitement multiplied when names like Bruce Becker and Johan Lambeck appeared in the “line-up” of keynote speakers.

For me, best possible outcomes for my patients/patrons meant I would have significant opportunity to learn empirical evidence from the some of the latest published studies and have face-to-face conversations with aquatic leaders like these two industry icons. Not only would I learn but, as in past professional aquatic conferences, I could reaffirm what I’d already put into practice with my patrons.

Keynote speakers from various countries presented their findings on such matters as end-stage dementia, neural plasticity, and motor learning, therapies for the end of life quality, appropriate applications for children with CP and cartilage health and repair.  Oral presenters and poster presentations were intermingled with pool practicums and equipment demonstrations that, in some cases were new to many and in some cases familiar to me.  What wasn’t familiar were vendors from other countries offering products and services like dolphin encounters as a therapy or in-water photography.

What I gleaned from all the presentations and research was simple:  the industry requires unification and some concrete basis of “assumed competency” and “common knowledge” that bridges between the practitioner (me), the trainer like Mary Wykle and Kiki Dickinson and the researchers like Ben Waller and Johan Lambeck.

To start, Paula Geigle’s opening keynote address emphasized a need for recording the specific parameters of dosing: a consistent and comprehensive documentation of what is taught in the water and how.  Specifically, each professional needs to record the following:

  • Cadence
  • Duration
  • Frequency
  • Intensity
  • Mode
  • Water Depth and temperature

At the top of this list, “cadence.”  Is it a coincidence that Geigle referenced it first and I find it THE most prominent controllable parameter of consistency for the participant? Geigle’s leading bullet was an affirmation for me that I continue to “set the pace” for my participant(s) by establishing the rhythm or speed either by music or verbal counting cue and sometimes both when cueing half-speed or double time.

Other keynotes spoke about using a metronome, but as a practitioner, in a true natatorium like a YMCA or Community Center, a metronome would likely be inaudible…especially to older adults!  The bass thump of 135 bpm Dynamix CD, however, would ultimately serve as my backdrop for tempo, half-tempo and double or even quadruple time, depending upon the moves.

As an Ai Chi instructor, I have grown so holistically through this practice of coordinating breath with a movement that I now incorporate it in ALL my teachings from personal training to boot camp or HIIT and deep water running or arthritis and mobility instruction.

Another practicum leader stated that he didn’t believe in stretching.  It has been an integral part of my cool-down phase of instruction in virtually every class or personal training I have led in 27 years of practice. I have no clinical data to back up my experience in leading arthritis classes, but, I feel certain that a stretch is imperative in the older population.  Where is the evidence to support such a belief that it isn’t important?

Bottom line:  This conference will reconvene in two years in China.  Start saving now. In a worldwide perspective, all can contribute, learn and be made stronger in the profession.  The intimacy of the gathering makes it somewhat elitist but also empowering.  In this setting, relationships can be established that foster progress for the industry in the world, not just in our country or region. For us in the U.S., it seems we need to ‘catch up’ with some other countries who are leading our industry.  Also, I hope that 2020 vendors will include new players in the field like float therapy pools and AquaBase. With the advent of full face mask snorkels, how many non-swimmers could overcome their fear of water?

Felecia Fischell is a certified aquatic practitioner with 27 years experience in aquatic personal training and group exercise.  She is passionate about water and it’s pain relief and healing properties. Fischell is currently in the process of relocating to the island of Ambergris Caye in Belize where she is setting up an aquatic practice. She continues to maintain an active interest and perhaps role in creating the 2020 ICEBAT Conference to be held in Beijing. Find her on Facebook at FunLife Aquatic Consulting, LLC. 

 

 

Alcohol and Ageing: The International Trends Worrying Health Researchers

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Risky drinking – defined as drinking at levels that put a person at risk of medical or social problems – has for centuries been viewed as an affliction of youth and immaturity. Yet, as the first wave of baby boomers reach retirement age, a startling trend is revealing itself: older adults are now drinking more than any previous cohort of retirees, with over 40 percent of older drinkers in some Western countries being classified as ‘hazardous drinkers.’

Our international research team recently explored patterns of drinking in older populations in nine different countries, including the United States, England, New Zealand, China, Mexico, Russia, Ghana, South Africa, and India. These countries span different political approaches, distinct continents, and various development levels, and the results were startling.

Drinking in older adults appears to be closely tied to wealth. We found that the proportion of older adults that drink is much higher in Western countries (e.g., the U.S., England and New Zealand) than non-Western countries. Additionally, while evidence shows that older men are more likely to drink than older women, this disparity is far smaller in Western countries than it is in non-Western countries.

When we explored the patterns of drinking across countries, we found that older drinkers in Western countries also seem to drink more frequently than older drinkers in non-Western countries. However, we also found that frequent (2-3 days per week) or very frequent (4+ days per week) heavy drinking occurs in both Western or non-Western countries, as with China and South Africa show an alarming number of older adults consuming alcohol heavily.

There are three key reasons why rising rates of drinking among older adults should spark international concern.

  1. Aging increases the risk of alcohol-related harm: Alcohol use merely is much riskier for an older adult than it is for a younger adult. The physiological aging process reduces our ability to process and detoxify alcohol, meaning we are more sensitive to its effects as we age even at the same level of consumption. Combined with this rising sensitivity to alcohol, aging itself also raises the risk of alcohol-related harm. As we age we are more likely to develop chronic conditions associated with (or exacerbated by) alcohol use or use medication that alcohol may interfere with, and to experience symptoms (e.g., nausea, sleeplessness, frailty, falls, depression) that alcohol can make worse. Unsurprisingly, older adults are far more likely to experience alcohol-related injuries and mortality than younger age groups.
  2. Older drinkers are neglected: Despite being at a heightened risk of alcohol-related harm, older drinkers are very likely to remain undetected in our communities. Research shows that older adults are much less likely than younger adults to be screened for alcohol use by health professionals. Furthermore, health conditions potentially underpinned by alcohol use are often misattributed to the aging process. Lastly, a recent report titled ‘Calling Time’ by Dr. Sarah Wadd and the British organization Drink Wise Age Well illustrates consistent neglect of older adults in alcohol policy, research on alcohol trends and harms, and availability of alcohol and addiction services.
  3. There are no benefits of drinking for older adults: A long-held assumption is that alcohol may be beneficial to heart health, and many older drinkers consume alcohol based on this belief. However, a growing body of international research now shows that the assumed health benefits of alcohol use were the result of poorly analyzed data and that there are no health benefits of drinking for older adults.

Unfortunately, our current health systems are ill-equipped to cope with this trend: in an era of rapid population ageing, a wave of older adults drinking at risky levels places considerable pressures on current health systems. Alcohol is the principle choice of drug for the ageing population and, although many do not meet the criteria for a substance use disorder, a large proportion will still require intervention to address the adverse consequences of excessive alcohol consumption (REF: Savage). Indeed, the number of older adults requiring substance misuse treatment services in the United States alone was expected to triple in the first two decades of this century (REF: Gfroerer). Given a rising rate of risky drinking despite the increased risk of harm and reduced likelihood of detection by health professionals, it is little wonder that the UK Royal Society of Psychiatrists now refers to older drinkers as ‘our silent addicts’.

What can we do? Fortunately, there is one key way in which we can collectively help mitigate this public health challenge.  As former American supreme court justice, American Lawyer Louis D. Brandeis (1856-1941) once said “Publicity is justly commended as a remedy for social and industrial diseases. Sunlight is said to be the best of disinfectants.” This sums up the critical issue here: many older drinkers are just unaware of their risk levels because society does not realize that there is an issue to address. We have the evidence that shows many older adults are now drinking hazardously, despite the risks this poses, so now it is up to each of us to start talking to friends, family members, colleagues, health professionals and policymakers about it.

Dr. Andy Towers is a senior lecturer in the School of Health Science at Massey University (New Zealand). His teaching and research focus primarily on alcohol and drug use trends, policy and outcomes. In conjunction with colleagues at the University of Auckland (New Zealand), he leads a collaboration of researchers from the United States, Europe and the World Health Organisation in an international study of the global prevalence of older adults drinking patterns and health-related outcomes.

Hong Kong plans for a city that’s growing older

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Today, about 16 percent of Hong Kong’s population is age 65 or older. By 2064, that is expected to be 36 percent.
HONG KONG — For decades, this city of more than 7 million has been one of Asia’s most dynamic places, filled with a youthful energy that drove rapid growth in both the population and the local economy.

Planners here still see Hong Kong that way. But they also are looking at the long-term trends, and grappling with a force they cannot stop: Hong Kong is getting older. That’s true of both the city’s people and its built environment — a phenomenon planners here call “double ageing”.

Today, about 16 percent of Hong Kong’s population is age 65 and over. By 2064, that’s expected to be 36 percent — and one in ten residents will be over the age of 85.

Meanwhile, housing stock that appears middle-aged today will become outdated tomorrow. By 2047, some 326,000 private housing units will be more than 70 years old. Many of them feature long flights of stairs unfriendly to older people. More than a third of seniors live in public housing, but the two-year wait list is bound to grow longer as citizens age.

The double-ageing problem is just one issue that Hong Kong’s planners are trying to figure out as they write a comprehensive plan called Hong Kong 2030+. The plan aims to take future demographic and economic trends into account while charting a path for improving quality of life in one of the world’s most densely settled cities.

Phyllis Li Chi Miu, deputy director of the city’s territorial planning department, says buildings, roads, parks and public transport all will need rejuvenation to make the city age-friendly. “It’s a challenging task,” she says.

Alignment with New Urban Agenda

Planners are also looking at how they can align the 2030+ plan with the New Urban Agenda. That’s the 20-year plan for sustainable urbanization that nations agreed to last October at the U. N.’s Habitat III conference in Quito, Ecuador.

Alignment was the main topic of conversation at a recent “Urban Thinkers Campus” conference here. At the event, Li noted that the 2030+ plan already stresses key elements of the New Urban Agenda such as social inclusion and environmental protection.

However, there was some debate about the New Urban Agenda’s relevance in the context of a city-state like Hong Kong. Paul Zimmerman, an environmentalist and elected councilor, said that some notable issues mentioned in the New Urban Agenda, such as increasing numbers of cars on the road, growth of slums and poor utility services, are not problems in Hong Kong.

“Hong Kong is a city and also a country,” Zimmerman said. “It’s a city in which hyper-density and wilderness co-exist. Other mega-cities have no space in their periphery, while Hong Kong has a massive open space in its periphery.”

However, Professor NG Mee Kam of the urban studies programme at the Chinese University of Hong Kong, told Citiscope that the 2030+ plan “needs to strongly align with the New Urban Agenda to plug in crucial policy gaps.” For example, she said, Hong Kong’s plan could take a cue from the New Urban Agenda’s focus on the informal sector and the importance of cultural heritage.

Retrofitting and reclaiming

The 2030+ plan proposes three “building blocks” for implementation — planning for a liveable high-density city, embracing new economic challenges, and creating capacity for sustainable growth.

A major focus, particularly when it comes to dealing with the double-ageing problem, is retrofitting districts with the most old buildings. Tall buildings are likely to be renovated, while many smaller buildings will likely be demolished to make way for new construction and open space. Retrofitting public spaces is also a priority. The city intends to add curb-cuts at sidewalks to make it easier for seniors to walk, and aims to increase the amount of public space from 2 square metres per person to 3.5 square metres.

The plan also aims for compact urban growth that is highly integrated with public transport. Homes and offices are to be within 200 to 300 metres of transit; open spaces within 400 metres; and community facilities, railway stations and educational institutes within a range of 500 metres.

“We are looking at optimum land use through retrofitting,” Li said.

The plan also envisions reclaiming a good bit of land from the sea. That’s a strategy that Hong Kong has long relied on to create room for the city to grow — the city’s airport and Hong Kong Disneyland resort are both located on reclaimed land.

Under the 2030+ Plan, Hong Kong would add another 4,800 hectares (nearly 12,000 acres) of land — a little less than the area of Manhattan. The land would be used for housing, industry, transport facilities and open space. These would include a few large urban extensions such as the East Lantau Metropolis, which is to be home to as many as 700,000 people.

Work on the 2030+ plan started in 2015 and is in the fourth of six phases of public consultation. The final plan is expected to be released next year.