Grey matter: ageing in developing countries

The developing world is going grey. By 2050, one in fi ve people in poor nations will be over 60 years old. Falling fertility rates, and increased life expectancy from improvements in health care, especially in Asia, has led to a rapidly ageing population. In part, this refl ects a worldwide trend—in the next 5 years, for the fi rst time ever, the number of people aged 65 years and older will outnumber children younger than 5 years of age. But we are set to witness a seismic demographic shift of ageing to the developing world. By 2050, 80% of the 2 billion elderly people on this planet will live in the developing world (table, fi gure). Countries in Asia are set to see some of the biggest rises—by 2050, one in four Asians will be older than 60 years of age. Yet even countries in sub-Saharan Africa, where fertility and mortality (both of which keep a population young) are still high, “the number of people aged over 60 is set to triple from 53 million in 2009 to 150 million by 2050”, says Sebastiana Kalula, director of the International Longevity Centre, University of Cape Town, South Africa. The health systems of many developing countries have over the past two decades been engaged in a precarious juggling act, trying to balance the fi ght against the existing burden of infectious diseases with the growing epidemic of chronic diseases such as heart disease and diabetes. For many in low-resource countries, longevity comes with a cruel twist. An increasingly ageing population is bringing a new tide of illness associated with old age, such as dementia and Alzheimer’s disease. Clearly, the problems of old age are not confi ned to the developing world. In even the richest countries, elderly people must face ailing health, and the fact that they may not be physically independent, but many developed countries have policies in place for their care, even though these are far from perfect. Yet, blindsided by battling diseases in youth and middle age, many developing countries are simply unprepared for the fact that in just two decades, they will have a large number of people whose health needs will not be adequately met.