Читать книгу Pathy's Principles and Practice of Geriatric Medicine - Группа авторов - Страница 98

Increases in life expectancy around the world have led to absolute ageing of the global population. Improved sanitation, nutrition, and living conditions, as well as major healthcare innovations such as effective treatments for infectious diseases, vaccinations, and advances in neonatal care, have led to significant advances in global life expectancy and increases in the absolute number of people who live to old age. In 1950, the average life expectancy was 49 years (68 in developed countries), as compared to 72 (79 in developed countries) in 2019 (www.un.org).

Management of chronic diseases, particularly cardiovascular and oncologic diseases, has also led to extended life expectancy in adulthood and older age. The United Nations projects modest increases in lifespan through the next several decades, although due to biologically and physiologically fixed mechanisms, it seems unlikely that, as a species, human life expectancy will ever exceed approximately 115 years of age.⁴

Declining fertility rates are also leading to a phenomenon of relative ageing, or an increased proportion of older adults. Data from the United Nations demonstrates declining fertility rates globally due to various factors, including improved access to birth control, declining numbers of teenage pregnancies, increased female engagement in the workforce, a higher percentage of women pursuing advanced education, and delays in the average age of marriage. The decline in fertility rates is more pronounced in developed countries, but the trend is seen globally.

Figure 4.1 The societal and community factors that influence an older adult's health and well‐being are complex.