In these days when there is so much talk of racism, xenophobia or machismo as attitudes that undermine the people who suffer from it, few make reference to another type of attitude, even more prevalent than the previous ones, and which causes many deaths or, at least, accelerates the end of life: ageism. The discrimination and rejection felt by older people due to the fact that they are years old has consequences on their health. In fact, the negative perception of old age by young people and adults, and which is assumed by the elderly, increases by 20% the chances of dying before citizens of the same age and who refuse to be cataloged and processed based on date of birth.
This was stated by Vânia de la Fuente-Núñez, a graduate in Medicine and Social and Cultural Anthropology, and a consultant on healthy aging at the eleventh joint conference of the National Epidemiology Center (CNE) and the Spanish Epidemiology Society (SEE), in which has made it clear that ageism, the rejection of old age, is a public health problem because it affects a large number of people, implies a cost for the health system, harms physical and mental health, and generates health inequities , raises public interest and can be addressed through preventive measures.
But this discrimination may have its days numbered, or at least reduce its influence. The new citizens who are entering retirement refuse to be considered a burden to society, nor do they conceive this new stage of life as an eternal vacation without meaning, as the doctor in psychology and director of scientist from the La Caixa Foundation's program for the elderly, Javier Yanguas, or the doctor and president of the health and socio-sanitary coordination commission of the Platform for the Elderly and Pensioners (PMP), José Manuel Freire. The new seniors and those who will come (in 2030, 25% of the population will be over 65; in 2040, this group will be made up of 14 million people), more prepared, more educated, with technological knowledge, with more financial resources, they are not willing to be cornered, experts agree. They are going to redefine old age. The fight will not be easy. Ageism is present everywhere: in institutions, decreeing norms and laws that restrict their rights; in social relationships, every time one speaks to the elderly as if they were children or preventing them from making their own decisions, and in relationships with oneself, by limiting oneself from doing certain activities because of their age, says De la Fuente.
For Pilar Gayoso, general deputy director of cell therapy and regenerative medicine at the Carlos III Health Institute (ISCIII), ageism is widespread (one in three people in Europe suffers from it) and has consequences for the citizen who suffers from it and for the society in which he lives. “Age prejudices condition both the attention of the health services and the conditions of these services”, she explains.
In this sense, De la Fuente mentioned a study in Germany on mental health where young patients and older ones were treated. The former were treated and followed up, while the latter were not. “Ageism not only affects the diagnosis, but also the treatment,” she points out.
Ageism is associated with poorer physical and mental health, greater social isolation and loneliness, greater financial insecurity, lower quality of life, and higher rates of premature death. This is due, among other things, to biases in medical care, including the rationing of health resources based on age, according to 85% of 149 studies that analyzed this association.
Medical personnel are more likely not to use ventilators, surgery, or dialysis as the age of the patient increases. "With each decade of age, the rate of decisions to suspend the intervention increased by 15% in the case of respirators, 19% for surgical interventions and 12% for dialysis," lists De la Fuente.
Ageism is also seen in the exclusion of older people from clinical trials. Not only in drugs and trials aimed at the general population, but also in those who are the most affected. The representation in trials on Alzheimer's or Parkinson's of the elderly population is very low, as has been revealed by numerous international studies.
They were also not represented in the trials that were carried out to combat the covid, despite being a vulnerable population. Without forgetting the covid pandemic, in which action protocols were implemented that excluded the elderly from basic care or care in intensive care units.
Even in screenings. "It is not acceptable. Public health is discriminating against the elderly, exercising a sanitary ageism by rejecting the elderly in cancer screenings, when precisely the chances of having a tumor increase with age because it is a degenerative disease ”, cries Mercedes Carreras, nurse and former deputy general director of Health Care Development and Security at the Galician Health Service, in the Congress of Deputies, where she attended together 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 the approach to cancer.
Carreras recalled that the majority of deaths from cancer occur after the age of 70, and, despite this, this population group is not included in current screenings.