Nutrition interventions for healthy ageing across the lifespan: a conference report.

Thanks to advances in modern medicine over the past century, the world's population has experienced a marked increase in longevity. However, disparities exist that lead to groups with both shorter lifespan and significantly diminished health, especially in the aged. Unequal access to proper nutrition, healthcare services, and information to make informed health and nutrition decisions all contribute to these concerns. This in turn has hastened the ageing process in some and adversely affected others' ability to age healthfully. Many in developing as well as developed societies are plagued with the dichotomy of simultaneous calorie excess and nutrient inadequacy. This has resulted in mental and physical deterioration, increased non-communicable disease rates, lost productivity and quality of life, and increased medical costs. While adequate nutrition is fundamental to good health, it remains unclear what impact various dietary interventions may have on improving healthspan and quality of life with age. With a rapidly ageing global population, there is an urgent need for innovative approaches to health promotion as individual's age. Successful research, education, and interventions should include the development of both qualitative and quantitative biomarkers and other tools which can measure improvements in physiological integrity throughout life. Data-driven health policy shifts should be aimed at reducing the socio-economic inequalities that lead to premature ageing. A framework for progress has been proposed and published by the World Health Organization in its Global Strategy and Action Plan on Ageing and Health. This symposium focused on the impact of nutrition on this framework, stressing the need to better understand an individual's balance of intrinsic capacity and functional abilities at various life stages, and the impact this balance has on their mental and physical health in the environments they inhabit.

Large noncollinearity and spin reorientation in the novel Mn2RhSn Heusler magnet.

Noncollinear magnets provide essential ingredients for the next generation memory technology. It is a new prospect for the Heusler materials, already well known due to the diverse range of other fundamental characteristics. Here, we present a combined experimental and theoretical study of novel noncollinear tetragonal Mn(2)RhSn Heusler material exhibiting unusually strong canting of its magnetic sublattices. It undergoes a spin-reorientation transition, induced by a temperature change and suppressed by an external magnetic field. Because of the presence of Dzyaloshinskii-Moriya exchange and magnetic anisotropy, Mn(2)RhSn is suggested to be a promising candidate for realizing the Skyrmion state in the Heusler family.

Active ageing: a policy framework.

The paper reflects the message of the WHO Policy Framework on Active Ageing. The Policy Framework is intended to inform discussion and the formation of action plans that promote healthy and active ageing. It was developed by WHO's Ageing and Life Course Programme as a contribution to the Second United Nations World Assembly on Ageing held in April 2002. The paper presents the challenge of rapid ageing population, especially in developing countries. And it discusses the concept and the rational of the active ageing. Policy Responses to this challenge are identify in the final part of the paper.

Health status of the rural elderly.

An enormous proportion of the worlds elderly live in rural areas and show wide variations in health status. Many, particularly those in the developing countries, are vulnerable to greater socioeconomic and health marginalization mainly due to inadequate provision of services and economic deprivation. As with the urban elderly, locomotor, visual and hearing disabilities, as well as life-threatening conditions of coronary heart disease, diabetes and hypertension are common among rural elders also. Infections continue to take a heavy toll in many parts of the world. Higher prevalence of health and functioning impairments and of risk factors like sedentarism and current smoking have been reported for the rural elderly in developed countries like the United States, where less frequent use of certain preventive services also has been observed among the rural elderly. The positive association of well-being and health with variables such as living with family, having children, and community involvement, which has been reported from developing countries like Ghana and India, supports the usefulness of the time-honored value of joint family systems and lifelong social and physical activity--all known to foster healthy aging. Such traditional virtues therefore need to be preserved and strengthened. Effective geriatric health care services need to stress a community approach to primary health care, with provision of support and training for both family caregivers and professionals. In addition, emphasis on health promotion, cost-effective indigenous systems of medicine and gender-sensitive programs is needed.

The greying world: a challenge for the twenty-first century.

As we approach the next millennium, an unprecedented rapid increase of total and relative numbers of older persons in both the developed and the developing world is being observed. The total aged population (aged more than 60 years) world-wide will rise from 605 million in the year 2000 to 1.2 billion in 2025. Population ageing is due to two factors: increased life expectancy and decreasing fertility rates. Public health interventions are major contributor to both. A significant consequence of ageing is the shift from communicable to non-communicable diseases. The World Health Organization (WHO) is addressing the multiple challenges posed by population ageing through integrated activities that include consolidation of databases, capacity building (research and training), advocacy and policy development. These are all approached through WHO perspectives on ageing and health: life-course, health promotion, socio-economic, community based, intergenerational, cultural, gender and ethical.

Promoting healthy aging in cities: the Healthy Cities project in Europe.

Health promotion is a growing field, spreading into various settings. This paper focuses on the city as a setting for health promotion and on the "Healthy Cities project" (HCP) of the Regional Office for Europe of the World Health Organization in particular. In the context of the HCP, various activities to promote the health of older citizens have been carried out in recent years. These are illustrated in this paper through case studies.

Stroke: the global burden.

Stroke is a major global health problem. It is a major cause of mortality, morbidity and disability in developed and increasingly in less developed countries. Worldwide, it is the leading cause of healthy years lost in late adulthood, and evidence indicates that the burden of stroke, particularly in terms of morbidity and disability, will almost certainly increase in the foreseeable future. This review aims to generate a better understanding of the present and projected future global burden of stroke, with particular emphasis on the non-established market economy countries (NEMEC). The first part summarizes and interprets the currently available evidence on stroke mortality, incidence, case-fatality and related disability rates from both established and non-established market economy countries. The second part reviews the main risk factors for stroke. For the modifiable factors, it examines current prevalence rates in NEMEC with a view towards identifying patterns that are relevant for predicting future rates of the disease. Reversing the consequences of stroke is difficult, thus primary prevention is of utmost importance. The potential for prevention is illustrated by the experience of Japan, which in the last two decades has seen substantial declines in stroke mortality--mostly due to reductions in dietary salt intake. The last section discusses potential strategies and approaches to effective stroke prevention and highlights other areas that need to be addressed if stroke management in the coming decades is to be effective.

Age at last full-term pregnancy and risk of breast cancer.

Age at first full-term pregnancy (FTP) has long been thought to be the major reproductive risk factor in breast cancer but a Norwegian study suggested that age at last FTP might be more important. In Norway "high parity" means 4 or more deliveries. Does this finding hold in an area with a much broader distribution of parity? Data from a case-control study done in 1980-82 in Fortaleza and Recife, two cities in Brazil's impoverished north-east, have been used to explore further the influence of age at last FTP. The cases were 509 women with histologically diagnosed breast cancer who were matched with hospital controls for age and area of residence. The analysis was based on case-control pairs interviewed by the same person. High breast cancer risk was associated with low parity; after adjustment for parity, breast cancer risk was related both to late age at first FTP (odds ratio [OR] 1.21 for each 5 year increase, p = 0.008) and to late age at last FTP (OR 1.24, p = 0.0007). However, multivariate analysis revealed that the effect of age at last FTP dominated that of age at first FTP: once age at last FTP was taken into account the effect of age at first FTP was no longer significant (OR 1.08, p = 0.38) while the association with parity became more striking. These results challenge the view that age at first FTP is the principal reproductive variable related to breast cancer risk. Moreover, they suggest that high parity is protective independent of ages at first and last FTP. Given recent worldwide reductions in fertility rates, breast cancer incidence may be expected to increase. Balancing that may be the willingness of some women to complete their families by, say, age 35 if they were to be told that this might reduce their risk of breast cancer.

Significance and management of disability among urban elderly residents in Brazil.

Brazil's population is aging very rapidly, and the care for the elderly is an emerging priority. The results of a multidimensional functional assessment of elderly residents in Sao Paulo showed extreme poverty and massive cohabitation in multigenerational households. The health profile showed a high prevalence of chronic illnesses, mental disorders, and disability. Using a Guttman scale, a set of activities of daily living was validated as an indicator of dependency. Attention was given to the dependency associated factors, and in particular to the association between chronic illness and loss of independence among the aged. Fortunately, for the existing health care system in Brazil, cultural values are still keeping the family in the front line of caregiving, but this situation is not likely to withstand the increasing burden of a growing elderly population with an ever higher rate of disability.