We tell you about the care this population group requires.
Thanks to improved living conditions, more people survive to advanced ages, i.e. reach the fourth age.
The World Health Organization (WHO) defines the elderly as those people aged 60 and up in developing countries; and the even smaller group that reaches the age of 80 and up as the fourth age.
“The definition of fourth age refers to this group of people who are 80 years old and older, who have some kind of limitation in their functionality or some degree of dependence in their daily lives and require more social or family support,” says Dr. Jorge Orozco Gaytan.
The WHO predicts that people over 60 will make up 22% of the total population by 2050, meaning there will be 2 billion of them.
Of that category, there will be 434 million people aged 80 and above around the world.
Although in Mexico the average life expectancy is 74 years, there’s still a statistically small group that reaches the fourth age.
There are approximately 2.5 million of them, making up 1.7% of the total Mexican population, according to the latest 2020 Population and Housing Census by the National Institute of Statistics and Geography (INEGI).
Geriatrician Diana Chávez Moreno is clear that being an older adult is not synonymous with dependence or disease.
There are people who live to their old age with lucidity, in perfect mental condition and physical health.
“And the same can be said of the fourth age. Being 80 is not the end; however, it’s much more likely that you have a cluster of diseases and a dependence on others to carry out instrumental, economic, and social activities.”
In the fourth age, people usually present different losses, adds the specialist.
Things such as hearing, vision, and vitality in the elderly are known to become slower or more limited. In addition, they’re often economically dependent on other people.
There are also affective losses: friends, partners, family have died, so it’s important that they’re added to the family nucleus and other recreational or religious groups to try to compensate for these losses.
Orozco Gaytan, who specializes in integrated disease management of the elderly, adds that they shouldn’t be seen as sick nor patients but as people, which implies listening to them, respecting their opinions, encouraging them, and accommodating their needs.
“If I’m 80 years old, I can still see my friends, I can decide for myself, I can lead my life. I don’t have to lose anything. We often offer to help our older loved ones, but we try to give them what we want and not what they want.”
It’s important that people in this population group go to the doctor, especially a geriatrician, to monitor their physical and mental health, especially if geriatric syndromes such as immobility, incontinence, various types of dementia, or chronic pain occur after the age of 60.
Orozco Gaytan, geriatrician at San Ángel Inn Universidad Hospital, says that chronic diseases such as diabetes or hypertension are controllable but other diseases require greater specialty and observation.
“If we help a person with chronic pain reduce their pain by 30%, it’s going to represent a big change in the perception of their own health.”
Sometimes gerontoprophylaxes are detected, which mean details seen in a patient that could indicate a problem in the future. However, as they’re detected in advance, problems can be prevented with better nutrition or exercise, thus favoring their independence.
According to the specialist, the most important thing is to have permanent care throughout life, so going to the doctor for preventive medical review becomes a habit from a young age.
In this way, the monitoring of food and emotional and physical health is continued into the fourth age.
“If adults are healthy, they could go for preventive treatment only once a year. However, if elderly people have controlled diseases, they could go twice a year, and if these are not under control, they should go more often based on the diseases they’ve accumulated, “says Chávez Moreno.
There’s a situation called polypharmacy, which is when a patient uses many drugs to treat various diseases, so care must be taken to handle adverse reactions resulting from taking them.
Chávez Moreno, who is also an internist, says that cognitive stimulation, mind exercises, and physical activity are more important in the fourth age.
To exercise memory, he recommends socializing activities, playing board games, dominoes, snakes and ladders, lottery, memory games, sudoku, doing crosswords, listening to music, and reading.
As for physical activity, it’s quite common for people to have osteoarticular diseases that place certain limitations on the musculoskeletal system and lead to a loss of muscle mass.