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.

Health needs of older adults displaced to Sudan by war and famine: questioning current targeting practices in health relief.

The high rates of death, disability and illness and the scarcity of resources associated with relief operations for victims of oppression, war and famine have led to some support systems of triage for health and nutritional care in relief. Two vulnerable groups have often been given priority for targeting in health relief--young children and their mothers. This paper reports the findings of a study of the health needs of another vulnerable group, older adults, among those who had been recently displaced to Sudan in 1984-1985 by the war and famine in Tigray region of Ethiopia. The study attempted to determine the extent to which morbidity events and migration affected the life-style of older adults and the socio-economic support mechanisms which were available to them. The findings indicate that older adults (those over 45 years of age) were a very small proportion of the population and that over half of those aged 60 years and over (defined as 'elderly' in this paper) had been left behind in Tigray. This may well indicate that disability, illness or both, forced many older adults, particularly those most in need, to remain in Tigray. Among older adults living in Sudan, high levels of minor disability, social isolation and total economic dependency indicated vulnerability, but older adults had not been specifically considered in health policies and plans. Their primary needs were basic--for cloth, food, shelter, transport, seeds, oxen and farming tools. We conclude that priority in relief should be to support individuals, families and entire communities by adequately providing for basic needs. Furthermore, international relief agencies should give equal consideration to those who remain in their homes and those who migrate for assistance. This approach would take into consideration quality of life, not just the number of lives saved among those who reach the camps and shelters, and would assume responsibility for 'Health for All', not just for selected 'vulnerable groups'.

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.

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.

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.

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.

Community hospitals: cornerstone of care for the future health service.

What is the impact of the changing pattern of care in community hospitals and what are the implications for staff? Dr Alex Gatherer, Oxfordshire AHA(T) area medical officer, with the help of Katrina Bishop and Alexandre Kalache, a clinical lecturer in community medicine at Oxford University, tried to answer these and other questions.

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.

Breast cancer: views of general practitioners on its detection and treatment.

A considerable proportion of women with breast cancer in this country present for treatment in late stages of the disease; Britain's primary health-care system means that in most cases the possible diagnosis of breast cancer is first made in general practice. This offers ample opportunity for early diagnosis and a better understanding about the way the general practitioners perceive the problems associated with the disease. With that specific aim, the present article reports on a survey conducted simultaneously in Oxford and in Edinburgh. Results show that general practitioners in the survey are deeply concerned about breast cancer and see a definite role for themselves in its early detection and long-term management. They also see a need for more health education that includes the encourgement of breast self-examination programmes. Most are in favour of open-access breast clinics for women and, in general, they feel positive about self-education programmes.