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Health and ageing

Health Issues Related to Ageing

an old person looking out the window

According to the World Health Organization (WHO), the global percentage of people aged 60 and over will almost double from 12% to 22% between 2015 and 2050, and by 2020 it will surpass the population of people under 5. In Canada, seniors (people over 65) account for the largest proportion of the Canadian population and will increase from 3.5 million in 1996 to an estimated 6.9 million in 2021.

But while living longer offers many personal and professional opportunities, our biological evolution does not always allow us to enjoy an ideal quality of life. The gradual deterioration of our physical and mental abilities and increased risk of illness can affect our well-being and lead to significant complications.

Although age is not always synonymous with bad health, several health problems are common as we age and some are inevitable: hearing impairments, cataracts, hypertension, osteoarthritis, chronic obstructive pulmonary disease, diabetes, certain cancers, heart problems, metabolic syndrome. All these health problems can have a significant impact on your quality of life.

In addition, advanced age gives rise to geriatric syndrome, a number of complex health conditions that typically occur later in life. Fragility, urinary incontinence, sleep disorders, falls, osteoporosis, Alzheimer’s and Parkinson’s disease pose significant challenges for seniors and their families.

Cancer: Risk Increases with Age

Seniors are more likely to develop different types of cancer. According to the Canadian Cancer Society, nearly 90% of Canadians who develop cancer are over age 50, but certain cancers are more prevalent such as breast cancer in women, prostate cancer in men, certain skin cancers, lung cancer and colorectal cancer.

Mental Illnesses Related to Ageing

Certain specific factors can have an impact on mental illness in seniors, namely seniors who have been affected in adulthood by a chronic mental illness or one that manifested later in life or those living with chronic health problems associated with mental illness (e.g. Parkinson’s Disease, cerebrovascular disease, obstructive pulmonary disease).

In addition, many seniors have several chronic conditions that are related to mental illness (e.g. 40% of acute stroke victims develop major depression). The most common mental illnesses among people aged 65 and over are:

  • mood disorders
  • anxiety
  • clinical depression
  • suicidal behaviours
  • cognitive problems (dementia and delirium)
  • personality disorders
  • alcohol and prescription drug abuse
  • psychotic disorders

Social Isolation

According to online consultations conducted by the National Seniors Council, social isolation and loneliness have a significant impact on the health and well-being of seniors.

Seniors who have little social contact are more likely to engage in negative health behaviours such as alcohol use, smoking, sedentary lifestyle and lack of proper nutrition. They are more likely to fall, and they are four to five times more likely to be hospitalized. Research also shows that social isolation is an indicator of death from coronary heart disease or stroke.

Respondents to the online consultation noted that mental health contributes to social isolation and impacts their quality of life. More specifically, they indicated that social isolation increases the risk of suffering from mental health problems and impairs self-esteem and confidence.

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Factors that contribute to the social isolation of seniors

Several risk factors increase the possibility of seniors becoming socially isolated. Many of them (80 years of age or older) live alone, are in a compromised state of health that limits their activities and have no children or contact with their family. Lack of access to transportation, place of residence (e.g., urban, rural or remote), and low income are also contributing factors to social isolation.

Prevention: Medical Follow-up From Age 50

Regular and early screening after age 50 can save your life! The following are the assessments recommended by most health professionals.

Diabetes Screening

To detect type 2 diabetes, which accounts for 40% of kidney failure and 50% of non-traumatic amputations. It is also the leading cause of visual impairment in adults under the age of 65.

Lipid Profile

According to the Canadian Cardiovascular Society, a lipid profile should be done every 3 to 5 years for men and women aged 40 to 75. However, people with known cardiovascular disease or high risk factors should do this annually, and diabetics should do this every 1 to 3 years.

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Colorectal Cancer Screening Test

Colorectal cancer is the second leading cause of cancer mortality. This cancer generally develops slowly, but when the first symptoms appear, the disease is already advanced. This is why screening is important.

The Canadian Association of Gastroenterology recommends a fecal blood test every two years for people 50 to 75 who do not have any risk factors (age, family history, presence of polyps on the inner wall of the colon or rectum, inflammatory bowel diseases, obesity, smoking, sedentary lifestyle, alcohol).

It is also interesting to note that the American Cancer Society recently (May 2018) lowered the recommended age to start colorectal cancer screening to 45. Among the tests suggested is an annual fecal occult blood test.

Coloscopy and rectosigmoidoscopy are not indicated for front-line screening, unless the fecal blood test is positive or the risk factors are significant. In the presence of polyps or family history of colorectal cancer, sigmoidoscopy is generally recommended every 5 years and colonoscopy every 10 years. A polyp is not a cancerous tumour, but it can indicate a predisposition to cancer.

Mammogram

To discover breast cancer (the most common cancer in women) before you can even palpate a mass.

The Quebec Breast Screening Program (PQDCS) recommends women aged 50 to 69 be screened every 2 years unless they present a risk. If suspicious lesions are detected on a mammogram, the physician will follow up with an ultrasound and, if necessary, a biopsy. For women over the age of 70, a screening mammogram is only given if deemed appropriate by the physician.

Prostate Cancer Screening Test

The prostate specific antigen (PSA) test measures the amount of PSA in the blood and detects prostate cancer. APS is a protein made by prostate cells found mainly in sperm, but it can also be detected in small amounts in the blood of healthy men.

PSA tests are not routinely offered to all men. Rather, they are done on an individual basis among men aged 55 to 70, after consultation with a physician. Only those most at risk, due to their family history of prostate cancer or African-American origin, are given regular testing.

Osteodensimetry

To identify osteoporosis and prevent fractures.

Osteoporosis is responsible for over 80% of fractures in people over the age of 50, including hip fractures, which often result in a significant loss of independence. Bone mass loss is asymptomatic. Osteopodensitometry is an X-ray of the hips and lumbar spine (lower back) that measures bone mineral density.

The Osteoporosis Society of Canada recommends osteoporosis risk factors (e.g., early menopause, fragility fracture, family history of osteoporotic fractures, corticosteroid use, smoking, hyperthyroidism) be assessed beginning at age 50. If the risk is high, your doctor will prescribe an osteopodensitometry. If not, an osteopodensitometry is recommended starting at age 65 every 2 to 3 years.

For more information on ageing:

Mental Health Commission of Canada

Quebec Breast Cancer Screening Program

Public Health Agency of Canada

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