COMMON conditions in older age include hearing loss, cataracts and refractive errors, back and neck pain and osteoarthritis, chronic obstructive pulmonary disease, diabetes, depression, and dementia. Furthermore, as people age they are more likely to experience several conditions at the same time, according to the World Health Organization (WHO).

Older age is also characterised by the emergence of several complex health states that tend to occur only later in life and that do not fall into discrete disease categories. These are commonly called geriatric syndromes. They are often the consequence of multiple underlying factors and include frailty, urinary incontinence, falls, delirium, and pressure ulcers.

Geriatric syndromes appear to be better predictors of death than the presence or number of specific diseases. Yet outside of countries that have developed geriatric medicine as a speciality, they are often overlooked in traditionally structured health services and in epidemiological research.

Factors influencing healthy ageing

Although some of the variations in older people's health are genetic, much is due to people's physical and social environments — including their homes, neighbourhoods, and communities, as well as their personal characteristics — such as their sex, ethnicity, or socio-economic status.

These factors start to influence the ageing process at an early stage. The environments that people live in as children — or even as developing foetuses — combined with their personal characteristics, have long-term effects on how they age.

Environments also have an important influence on the development and maintenance of healthy behaviours. Maintaining healthy behaviours throughout life, particularly eating a balanced diet, engaging in regular physical activity, and refraining from tobacco use all contribute to reducing the risk of non-communicable diseases and improving physical and mental capacity.

Behaviours also remain important in older age. Strength training to maintain muscle mass and good nutrition can both help to preserve cognitive function, delay care dependency, and reverse frailty.

Supportive environments enable people to do what is important to them, despite losses in capacity. The availability of safe and accessible public buildings and transport, as well as conditions that are easy to walk around are examples of supportive environments.