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Learning Objectives

  • What is the nature of population aging worldwide?

  • What are the implications of population aging among the world’s nations?

  • How are the world’s nations responding to population aging?

  • What is the role of geriatric medicine, and how is it organized among the world’s nations?

  • To what extent do older people receive consistent health care even among nations with similar economic circumstances?



Population aging is a pervasive, unprecedented global phenomenon. The trend toward population aging is expected to continue well into the twenty-first century. The older population is itself aging; the fastest growing age group is the oldest-old, those aged 80 years or older.

The chapter begins by highlighting the consequences and implications of the global population aging. In the economic area, population aging will have an impact on economic growth, savings, investments, consumption, labor markets, pensions, and taxation. This phenomenon will also have a direct bearing on the intergenerational and intragenerational equity and solidarity that are the foundations of our societies. In the social sphere, population aging will affect health and health care, family composition and living arrangements, housing, and migration. Some of the inadequacies of health professional education and health care delivery systems in meeting the chronic health care needs of aging populations around the world are discussed.

Geriatric medicine is an important ingredient in the delivery of health care to older people, particularly those with physical or cognitive functional limitations. The place of geriatric medicine across the world’s nations is reviewed.

The second section of the chapter describes how health care systems around the world are preparing to deal with patients with multiple chronic, degenerative diseases. Information is provided about developed countries in four continents including Canada and the United States of America for North America; Brazil for South America; France, Iceland, Italy, and the United Kingdom for Europe; China, India, and Japan for Asia; and Australia for Oceania. The current situations in Brazil, China, and India provide examples of emerging nations with significant challenges associated with rapid population aging without a substantial legacy of aged care systems or a geriatric medicine workforce. For each country, the following information is presented: the principal characteristics of the health care system; the organizational approaches and the services available for older adults; the current status of geriatric medical practice; and unique features that might be instructive to other nations. Each nation’s profile concludes with a description of how the prevailing “system” would respond to a hypothetical example of an 87-year-old widow hoping to return home after suffering a stroke with motor and speech deficits.

The third section of the chapter provides a brief example of how a systems approach to assessment of older people might not only enhance clinical care, but also improve ...

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