These days when racism, xenophobia or sexism are talked about as much as attitudes that undermine the people who suffer from them, few refer to another type of attitude that is even more prevalent than the previous ones and that causes many deaths or, at least accelerates the end of life: ageism. The discrimination and rejection experienced by older people due to their age has consequences for their health. In fact, the negative perception of old age that young people and adults have and that is assumed by the elderly increases by 20% the chances of dying, compared to citizens of the same age who refuse to be cataloged and treated in function of date of birth.
This is indicated by Vânia de la Fuente-Núñez, graduate in Medicine and Social and Cultural Anthropology and consultant on healthy aging, at the 11th joint conference of the National Center of Epidemiology (CNE) and the Spanish Society of Epidemiology (SEE), in which makes it clear that ageism, the rejection of old age, is a public health problem, because it affects a large number of people, involves a cost to the health system, damages physical and mental health, generates health inequities, it raises public interest and can be addressed through preventive measures.
But the days of this discrimination may be numbered, or at least its influence may be reduced. The new citizens who are entering retirement refuse to be considered a burden on society and to conceive of this new stage of life as a meaningless eternal vacation, as indicated in separate days on aging by the doctor of Psychology and director scientist at the La Caixa Foundation’s Elderly Program, Javier Yanguas, and doctor and president of the health and socio-health coordination committee of the Platform for Senior Citizens and Pensioners (PMP), José Manuel Freire. The new elderly and those to come (in 2030 25% of the population will be over 65 and in 2040 this group will be made up of 14 million people), better prepared, more educated, with more technological knowledge and with more resources financiers, is not prepared to allow them to be cornered, experts agree. They will redefine old age.
The fight will not be easy. Ageism is present everywhere: in institutions, with rules and laws that restrict their rights; in social relationships, whenever elderly people are spoken to as if they were children or preventing them from making their own decisions, and in relationships with oneself, in the fact of limiting oneself to certain activities to his age, De la Fuente indicates.
For Pilar Gayoso, deputy general director of cell therapy and regenerative medicine at the ISCIII, ageism is widespread (one in three people in Europe suffers from it) and has consequences for the citizen who is a victim and for in the society in which he lives. “Prejudices due to age condition both the attention of health services and the conditions of these services”, he explained.
In this regard, De la Fuente mentioned a study done in Germany on mental health in which young and older patients were treated. The former were treated and followed up, while the latter were not. “Ageism not only affects the diagnosis, but also the treatment”, he points out.
Ageism is associated with poorer physical and mental health, more social isolation and loneliness, more financial insecurity, less quality of life and higher rates of premature death.
This is due, among other factors, to biases in medical care, including the rationing of health resources based on age, according to 85% of the 149 studies analyzed by this association. Medical staff are more likely not to use ventilators or not to perform surgery or dialysis as the patient’s age increases. “With each decade of age, the rate of decisions to suspend the intervention increases: 15% in the case of respirators, 19% in surgical interventions and 12% in dialysis,” says De la Fuente.
Ageism is also seen in the exclusion of elderly people from clinical trials. Not only with drugs and in trials aimed at the population in general, but also in those in which the affected are them. The representation in Alzheimer’s or Parkinson’s trials of the elderly population is very poor, according to numerous international studies.
Nor were they represented in the trials that were carried out to combat covid, despite being a vulnerable population; without forgetting the pandemic itself, during which action protocols were implemented that excluded the elderly from basic care or care in UCIs.
Even in screenings. “It is not acceptable. Public health is discriminating against the elderly by practicing health ageism, because it rejects them in cancer screenings, when precisely the probabilities of having a tumor increase with age, since it is a degenerative disease”, cries Mercedes Carreras, nurse and former deputy general director of development and healthcare security of the Galician Health Service. He said this at the Congress of Deputies, where he went, along with other cancer experts, to present a scientific document that includes the different initiatives that, according to the multidisciplinary committee of experts (OnTarget), should be prioritized in Spain to improve cancer treatment.
Carreras recalled that most cancer deaths occur after the age of 70, and despite this, this population group is not included in current screenings.
