Implementation of an active aging model in Mexico for prevention and control of chronic diseases in the elderly

Abstract

Background: World Health Organization cites among the main challenges of populational aging the dual disease burden: the greater risk of disability, and the need for care. In this sense, the most frequent chronic diseases during old age worldwide are high blood pressure, type 2 diabetes mellitus, cancer, arthritis, osteoporosis, depression, and dementia. Chronic disease-associated dependency represents an onerous sanitary and financial burden for the older adult, the family, and the health care system. Thus, it is necessary to propose community-level models for chronic disease prevention and control in old age. The aim of the present work is to show our experience in the development and implementation of a model for chronic disease prevention and control in old age at the community level under the active aging paradigm.

Methods/design: A longitudinal study will be carried out in a sample of 400 elderly urban and rural-dwelling individuals residing in Hidalgo State, Mexico during five years. All participants will be enrolled in the model active aging. This establishes the formation of 40 gerontological promoters (GPs) from among the older adults themselves. The GPs function as mutual-help group coordinators (gerontological nuclei) and establish self-care and self-promotion actions for elderly well-being and social development. It will be conformed a big-net of social network of 40 mutual-help groups of ten elderly adults each one, in which self-care is a daily practice for chronic disease prevention and control, as well as for achieving maximal well-being and life quality in old age. Indicators of the model's impact will be (i) therapeutic adherence; (ii) the incidence of the main chronic diseases in old age; (iii) life expectancy without chronic diseases at 60 years of age; (iv) disability adjusted life years lost; (v) years of life lost due to premature mortality, and (vi) years lived with disability.

Discussion: We propose that the implementation of the model active aging framework will permits the empowerment of older adults, which constitutes basic social capital for chronic disease prevention and control in old age.

Figure 1

Active aging as paradigm, policy framework, and strategy for healthy aging.

Figure 2

Types of support that elderly individuals can offer through social networks of social support in Community Gerontology programs.

Figure 3

Gerontological care model. Primary Gerontological Health Care Unit linked to Institutions of Higher Education in Gerontology is responsible for the design and implementation of educational programs and guides the training of the gerontological promoters for the development of mutual-help groups (gerontological nucleus). A gerontological nuclei is a group integrated by 10 to 15 older adults of nearby communities with similar interests. They are mainly involved in the practice of self-care, mutal-help, and self-promotion guidelines established by the program. The model is addressed toward the following objectives: (i) the supervision of the gerontological health status of participants in the program; (ii) the training of qualified gerontological health care promoters, certified on the basis of a formal continuous education program offered by a renowned academic institution; (iii) to provide orientation and guidance to families with regard to basic care practices with both healthy and sick older adults; (iv) to promote the social and gerontological development of the older populations in Mexico.

Figure 4

Lifestyles for healthy aging for elderly individuals with successful, usual, and fragile aging.

Figure 5

Gerontological social capital and active aging.