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1 Introduction
Pages 19-40

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From page 19...
... The promise of extending the number of years lived in good health to accord with the increased life span achieved globally over the past century is closer to being realized than ever before. To achieve healthy longevity, a universal goal all societies need to be redesigned to support longer, healthier lives.
From page 20...
... 1 This report uses the term "chronic conditions" to encompass distinct chronic diseases, multimor bidity (multiple chronic conditions in the same person) , and geriatric syndromes (frailty, sarcopenia, polypharmacy, cognitive decline, disability, and falls)
From page 21...
... Countries are also facing socioeconomic changes that are altering family structures and living arrangements, potentially putting older people at risk. Changes in fertility levels, 2 "Older people" applies to people in the second half of their life, depending on the life expectancy where they reside.
From page 22...
... NOTE: Blue = male population; yellow = female population.
From page 23...
... NOTE: Red = male population; dark blue = female population.
From page 24...
... NOTE: Green = male population; purple = female population.
From page 25...
... Thus, while disease, disability, and dependency increase with advancing age, especially after age 75, differential exposures across the life course to risk factors, such as social and economic factors, cause health outcomes of older people to differ markedly. Many older people have physical and cognitive impairments as well as chronic conditions, but an increasingly large proportion of older persons function at notably high levels into advanced ages.
From page 26...
... . Finally, evidence indicates that as people age, they prioritize emotional meaning, giving greater priority to important social relationships, which in turn leads to greater prosociality, whereby older people are more likely to help others and give back to society.
From page 27...
... . The risk for the most common chronic conditions increases exponentially with age (St Sauver et al., 2015)
From page 28...
... . Many people in the later stages of life experience prolonged periods of debilitating chronic conditions, functional decline, and diminished well-being (Diehl et al., 2020)
From page 29...
... Nonetheless, because ageism leads to discrimination and unequal treatment, "ageism shortens lives; leads to poorer physical health and worse health behaviours; impedes recovery from disability; results in poorer mental health; exacerbates social isolation and loneliness; and reduces quality of life" (WHO, 2021a, p.
From page 30...
... If ageism is overcome at the same time that health and function in older people improve, the inevitable shifts in population age structure and changing family structures can become drivers of a thriving society with the many positive characteristics described in this report. REFRAMING THE CHALLENGE OF AGING SOCIETIES Healthy longevity reframes the false assumptions that aging societies reduce workforce productivity and increase burdens on families and that older people disproportionately consume resources.
From page 31...
... By aligning efforts, activating all parts of society, and intentionally focusing on the interactions and relationships among these systems, the commission believes progress can be made toward developing healthier, longer lives for people around the world. THE NATIONAL ACADEMY OF MEDICINE'S HEALTHY LONGEVITY GLOBAL GRAND CHALLENGE: CHARGE AND APPROACH The National Academy of Medicine's (NAM's)
From page 32...
... In choosing to focus on healthy longevity, NAM recognized the convergence of multiple factors that have placed society on a precipice between an optimistic future of healthy longevity and avoidable disability and social challenges. These factors include the following: • rising numbers of older adults globally compared with other age seg ments within the population, with rapidly rising numbers of older adults in many countries; • rising rates of age-related chronic illnesses that, absent changes from the current trajectory, will increasingly burden individuals, families, and governments with rising health care costs; • loss of human value, well-being, function, and dignity to disability caused by chronic illness, frailty, and cognitive decline; • shifting family structures, dynamics, and norms within contexts of glo balization, economic development, and crises and trends in urbanization and migration; • a growing recognition that the current system of retirement, for those who are able to retire, is suboptimal for many individuals, organizations and institutions, and society as a whole; • increasing social fraying, in some contexts, between younger and older generations; • identification of social determinants of healthy longevity and the role of the built environment; • evidence of the significant impacts of climate change and pollution on people across the life course; and • a growing body of evidence demonstrating how to promote healthy longevity.
From page 33...
... 2. Identify and analyze potential approaches and reforms across the entire spectrum of institutions and systems that provide health-related services to aging populations, including clinical settings providing health care and treatment; community and home health care, including family and informal caregivers; and public health systems, health promotion, and preventive services.
From page 34...
... Second, the commission sought information from experts in economics about how the economy and government spending affect healthy longevity and, conversely, how healthy longevity has the potential to affect the economy and government spending. Commissioners and NAM staff identified and invited experts to provide responses to targeted questions either in writing or during a brief discussion with staff (see Appendix C)
From page 35...
... . Countries with the largest proportion of older people are experiencing many undesirable outcomes related to aging, including negative economic impacts, with increasing numbers of people leaving the workforce and rapidly rising health and social care costs, as well as increases in social isolation, loneliness, and suicide rates (Bloom et al., 2015; Holt-Lunstad et al., 2010; NASEM, 2020)
From page 36...
... It provides evidence-based recommendations for how countries can pursue an optimistic vision of healthy longevity for individuals and societies, a vision whereby prolonged periods of functional and cognitive decline as people age are no longer viewed as inevitable. This is also a vision of a cohesive, productive society that supports the aspirations of people in the first and second halves of life.
From page 37...
... This report is offered as a roadmap for all countries to begin a process of engagement and shared learning across all sectors and all actors in the global community as they develop plans and programs to ensure healthy longevity. The report necessarily relies heavily on evidence from and experience of high-income countries.
From page 38...
... Presentation at the Global Roadmap for Healthy Longevity: Science and Technology Work shop. https://nam.edu/event/international-workshop-on-science-technology-for-healthy-longev ity-day-1 (accessed April 25, 2022)
From page 39...
... 2016. The emergence of geroscience as an interdisciplinary approach to the enhancement of health span and life span.
From page 40...
... 2021. Science and technology for healthy longevity: A workshop for the global roadmap for healthy aging.


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