In his annual report, England’s Chief Medical Officer, Professor Chris Whitty, highlights the need to adapt healthcare policies and practices to address the challenges posed by an ageing population. The report underscores the need to improve the quality of life for older citizens, positioning it as a central goal for both policy and medical strategies. One key observation is the geographical concentration of the older population in areas away from large urban centres, urging a focused effort in these regions.
The rise of multiple health conditions in older individuals, termed multimorbidity, is identified as a significant concern necessitating changes in medical training, NHS services, and research. Professor Whitty contends that while increased life expectancy is a testament to medical and public health achievements, the extension of the period spent in ill health is not inevitable. To maximise independence and minimise time in ill health, the report advocates for a dual approach: reducing diseases that contribute to disability and frailty and modifying environments to support prolonged independence.
The report highlights the current underservice of older people in healthcare, pointing out challenges such as limited transport options and inadequate infrastructure tailored for older adults, including housing. It stresses the urgency of providing suitable services and environments, particularly in areas where the concentration of older citizens is higher, to maximise their period of independence.Furthermore, the report calls for accelerated research into multimorbidity, frailty, and social care. It argues against the increasing specialisation within the medical profession, emphasising the need for clinicians to maintain generalist skills, as the lived reality for the majority of older adults involves managing multiple health conditions simultaneously.
Several prominent figures in the healthcare sector support the report’s findings and recommendations. Greg Fell, President of the Association of Directors of Public Health, emphasises the importance of creating healthy spaces and places to support ageing citizens. Professor Dame Carol Black of the Centre for Ageing Better applauds the report’s focus on the diversity of experiences in older age and calls for improvements in areas such as wealth, work, housing, and discrimination to reduce disparities in healthy life expectancy.
The report receives backing from various experts and organisations, including Professor Dame Linda Partridge of The Royal Society, Dr Sarah Clarke of the Royal College of Physicians, and Professor Adam Gordon of the British Geriatrics Society. They highlight the challenges and opportunities associated with an ageing population, emphasising the need for a concerted effort to enable older individuals to live healthy, independent lives for as long as possible. The report’s call to recognise this as a major national priority resonates as a timely and essential directive for policymakers and healthcare professionals alike.
What does the report say about physical activity?
The report stresses the critical role of physical activity in maintaining health throughout life, with particular emphasis on its clear benefits for preserving mobility and functional independence in older age. Regular physical activity is shown to reduce the risk of major conditions such as cardiovascular disease, type 2 diabetes, and various cancers, while also enhancing mental well-being and overall quality of life in older adults. The UK Chief Medical Officers recommend specific guidelines for physical activity at different life stages, advising older adults to accumulate 150 minutes of moderate-intensity aerobic activity per week, along with strength and balance activities twice a week.
Despite the well-established health benefits, the report notes a concerning trend of decreasing physical activity levels in England across all age groups, particularly among older citizens. A significant percentage of individuals aged 75 and above are physically inactive, posing a risk to their health. The text stresses the importance of promoting physical activity among older adults, emphasising that any amount of activity is better than none, and the most substantial health gains come from transitioning from a physically inactive status to a more active one.
Healthcare professionals play a pivotal role in promoting physical activity, addressing potential risks, and highlighting the diverse ways it can be incorporated into daily routines. The report advocates for relevant training for healthcare professionals to facilitate informed conversations with older patients about the benefits of physical activity, especially in managing age-related conditions such as arthritis. [Our online RSPH level 2 Award in Understanding Health Improvement covers these issues (and many more). For more details see here >>]
The report acknowledges external barriers that older adults may face in becoming physically active and emphasises the need for policy action to remove these obstacles. It calls for the design of environments that consider accessibility and usefulness for older adults, such as well-connected active travel routes and walking paths. The concluding message underlines the importance of policy efforts focused on eliminating barriers to physical activity and creating environments that encourage and facilitate activity across all age groups, contributing to healthy ageing and delaying the onset of ill health. [Our online RSPH level 2 Award in Encouraging Physical Activity covers these issues (and many more). For more details see here >>]
Falls prevention
The report highlights the significant health issue of falls among older people in England, particularly those aged 65 and above, with around one-third of this age group and half of those aged 80 and over experiencing at least one fall annually. Falls pose distress, pain, injury, loss of confidence, loss of independence, and mortality. Emergency admissions for falls in people aged 65 have increased over the last decade, emphasising the growing prevalence of falls-related injuries.
Falls prevention is identified as a complex societal challenge requiring collaboration across various sectors, including medical, environmental, behavioural, and human factors. Gait and balance impairment are highlighted as key predictors of future falls.
Exercise programmes are deemed effective for fall prevention, particularly those including balance and strength exercises of sufficient intensity and duration. Trained professionals are recommended for delivering these programmes. [Our Seated Exercise and Activity Course range provides skills to run classes. For more details see here >>]
The report acknowledges that falls are often multifactorial, and while some factors may be challenging to reverse, simple measures undertaken by health and social care professionals can contribute significantly to preventing harm caused by falls. It concludes by stressing the achievable goal of preventing harm through acknowledging the risk of falls in older adults and adopting recommended principles.
Report Reference:
Chief Medical Officer’s Annual Report 2023 Health in an Ageing Society
