The Health Issues of an Ageing Workforce

Dr Shane TellamConsultant Occupational

PhysicianOccupational Health South

West Ltd

Aims To understand the demographics

To consider the health issues of ageing

To consider the impact on work capability and the possible need for adjustments

To consider the possible legal aspects

Demographics

Demographics The UK population is projected

to continue ageing with the average (median) age rising from 39.7 years in 2010 to 39.9 years in 2020 and 42.2 by 2035 (Office for National Statistics 2011a).

Demographics 3x number of people aged 90+

by 2035 4x age 95+ by 2035 Age 100+ is projected to rise

from 13,000 in 2010 to 110,000 by 2035

(Office for National Statistics 2011a)

Key Facts

We are running out of workers: current employer plans suggest that we will need to fill 13.5 million job vacancies in the next ten years, but only 7 million young people will leave school and college (UKCES 2010/GADa).

Key Facts

Immigration will not fill the gap: current net immigration is around 200,000 people per year (ONS 2011b) and the Government is committed to reducing this.

Key Facts

Older people are the main untapped source of labour: unlike migrants, they already live here, and their numbers are growing. By 2020, 36% of the working population will be over 50 (Government Actuary’s Department).

Key Facts

People are living and keeping fit for longer: most of today’s 65-year-olds will live beyond 80, and some will live beyond 110 (Government Actuary’s Department).

Key Facts The dependency ratio is deteriorating: whether retirement is paid for through occupational or state pensions, the money to pay for it comes from the current workforce. In 2008, there was a ratio of adults under and over pensionable age of 3.2. By 2033 this will be 2.8 (ONS 2009).

Key Facts

More and more people want to work longer if the conditions are right: surveys regularly show that most older workers would work longer if they enjoy their work and could work more flexibly (McNair et al 2004).

Key Facts

The proportion of older workers aged 55 and above planning to work beyond the state pension age is 54%, according to a recent survey (CIPD 2010b).

Common Age Related Health Problems

Heart conditions (hypertension, vascular disease, congestive heart failure, high blood pressure and coronary artery disease)

Dementia, including Alzheimer's disease Depression Incontinence (urine and stool) Arthritis Osteoporosis Diabetes Breathing problems Frequent falls, which can lead to fractures Parkinson's disease Cancer Eye problems (cataracts, glaucoma, Macular Degeneration)

Cardiovascular High blood pressure High cholesterol Reduced cardio respiratory fitness Obesity Increased risk of ischaemic heart

disease and stroke

Diabetes Certain factors can increase the risk

of developing type 2 diabetes (which is most common in older people).

Over 80 percent of people with type 2 diabetes are overweight. The more overweight you are, with a body mass index (BMI) of 25 or more, the greater your risk of diabetes.

Diabetes Physical inactivity has been shown to

contribute to diabetes. Impaired Glucose Tolerance (IGT) African Americans, American Indians,

Alaskan Natives, Asian Americans, Pacific Islanders and Latinos are at higher risk for developing Type 2 diabetes.

Age - Approximately 18.4% of Americans over age 65 have type 2 diabetes.

Musculoskeletal

Arthritic conditions: OA, Rheumatoid, Gout

Lasting joint pain and tenderness Joint swelling Joint stiffness Problems using or moving a joint

normally Reduced functional capability and

exertion tolerance

Cognitive Ability Cognitive decline is a deterioration in

cognitive function. There is a normal process of age related cognitive decline across the life-span characterised by increasing difficulties with memory (new learning) speed of infomation processing, language and other cognitive functions. This normal process of age related decline.

Cognitive decline mild cognitive impairment increases with

age. The prevalence is 10% in those aged 70-79 years and 25% in those aged 80-89 years.

cerebrovascular disease, Lewy body dementia, Parkinson's disease, fronto-temporal dementias (alcohol related),Alzheimer's disease, or no specific underlying pathology (Dementia).

Vision There are four major age-related eye

diseases glaucoma, cataracts, age-related

macular degeneration and diabetic retinopathy

By age 65, 1-in-3 people have some form of vision-impairing eye disease.

Presbyopia - the lens of the eye loses its ability to focus

Hearing Presbycusis-is the loss of hearing that

gradually occurs in most individuals as they grow older.

Tinnitus-common in older people. Sensorineural-damage to the inner ear or

the auditory nerve. This type of hearing loss is permanent.

Conductive-when sound waves cannot reach the inner ear e.g. Earwax, fluid, or a punctured eardrum. Treatable.

Other Ageing Effects A slowed reaction time, which is especially

important when judging if a person can drive.

Thinner skin, which can lead to breakdowns and wounds that don't heal quickly

A weakened immune system Diminished sense of taste or smell,

especially for smokers, which can lead to diminished appetite and dehydration

Legal Equality Act 2010 Disability discrimination – need to

consider reasonable adjustments Age discrimination Forced retirement

Employers Flexible working

Part-time working

Adjustments

Redeployment

Why continue Studies of older people show clearly

that those who stay in work are healthier and often happier than those who retire early (Waddell and Burton 2006, Black 2008).