‘Older Australians’can be defined as the heterogenous group of older adults who are members of our society. The National Strategy for an Ageing Australia, with its four themes, aims to optimise independence and self provision amongst older Australians, promote positive attitudes, lifestyles and access to community support in order to enable healthy ageing and delivery of world class care, as required.
Although there are difficulties in ascribing a particular chronological age to define “older people”, and while it is recognised that there is wide variability in health status, function and wellbeing at any age, for the purposes of this document the term “older people” primarily refers to those aged over 65 years. Chronological age was not the only criteria for consideration of the applicability of the evidence and recommendations in this document. Furthermore, many of the issues considered may have applicability for other age groups, for example, younger people with disability.
For Aboriginal and Torres Strait Islanders, the age of 55 years and above is used.
Ageing‘Ageing of the individual in the strictest sense means growing old. It can also signify life-long growth and development in physical, economic, psychological cultural spiritual and other ways’ (United Nations General Assembly 1995).
‘Active ageing’ is defined by the World Health Organisation as “the process of optimizing opportunities for health, participation and security in order to enhance quality of life as people age” (World Health Organisation 2002)(p 12).
‘Successful ageing’ is ‘ones ability to maintain a physically healthy state, mental and physical functioning and social engagement’ (Rowe and Kahn 1998).
The WHO Heidelberg guidelines (1997) identify three groups of older people along the health-fitness gradient: the physically fit-healthy; the physically unfit-unhealthy but independent living; and the physically unfit- unhealthy and dependent individuals. Within each of these categories, people may be either sedentary or physically active.
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Physical activityThe US National Institutes of Health (NIH) Consensus Statement defined physical activity as
‘any bodily movement produced by skeletal muscles that requires energy expenditure and produces progressive health benefits’ (NIH, pg 3).
Physical activity encompasses exercise, which was defined as
‘planned physical activity with bodily movements that are structured and repetitive, performed for the purpose of improving or maintaining physical fitness’ (NIH, pg 3).
Bouchard and Shepard (1994) define physical activity more physiologically as ‘any body of movement provided by skeletal muscles that results in a substantial increase over the resting energy expenditure. Under this broad rubric we consider active physical leisure, exercise, sport, occupational work and chores, together with other factors modifying the total daily energy expenditure’ (pg 77).
Moderate level physical activities: Physical activity at a level that causes the heart to beat faster and some shortness of breath, but during which a person can still talk comfortably.
Vigorous physical activities: Physical activity at a level that causes the heart to beat a lot faster and shortness of breath that makes talking difficult between deep breaths (Glasgow, Ory et al. 2005).
Incidental physical activity
Incidental physical activity is unstructured activity taken during the day, such as walking for transport, housework and the performance of activities of daily living.
Sufficient physical activity
The term ‘sufficient physical activity to produce health benefit’ is found in the National Physical Activity Guidelines. ‘Sufficient’ is defined as 150 minutes or more of moderate and/or vigorous activity per week.
Aerobic or endurance exercise is defined as continuous movement involving large muscle groups that is sustained for a minimum of 10 minutes.(Pate, Pratt et al. 1995)
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Physical disability, handicap and participation limitationsThe International Classification of Impairment, Disability and Handicap (ICIDH) uses three classifications to describe the consequences of disease: impairments, disabilities and handicaps.
The ICIDH defines impairment as “a loss or abnormality of psychological or anatomical function”. Impairment occurred at the level of the body organ.
Disability is defined as “any restriction or lack of ability to perform an activity in the manner considered to be normal for a human being” (World Health Organisation 2001). Disability occurs at the level of the individual.
Handicap is defined as “a disadvantage for a given individual from an impairment or disability that limits or prevents the fulfilment of a role that is ‘normal’ for that individual.” Six roles considered central to social existence were identified by the ICIDH: orientation, physical independence, mobility, occupation, social integration and economic self-sufficiency. Handicap occurred at the level of society.
With regard to physical activity, the more recent ICIDH2 and the International Classification of Functioning, Disability and Health (ICF) definitions of participation are also relevant (World Health Organisation, 2001):
Participation describes an individual’s involvement in life situations in relation to health conditions, body functions and structure, activities and contextual factors.
Participation restrictions are problems an individual may experience in involvement in life situations. Participation restriction is assessed by comparing the participation in life activity of persons with and without disability in that society. The classification of participation restriction is made by placing the observed involvement in a life activity in 1 of 9 participation domains that include: personal maintenance; mobility; exchange of information; social relationships; home life and assistance to others; education; work and employment; economic life; and community, social and civic life.
Mental disabilityThe Mental Health Act (2001) defines mental health as:
‘A dynamic process in which a person's physical, cognitive, affective, behavioural and social dimensions interact functionally with one another and with the environment’.
The National Health Data Dictionary (version 11) defines mental disorder as ‘disturbance of mood or thought that can affect behaviour and distress the person and those around them, so the person cannot function normally’.
People from culturally and linguistically diverse backgroundsA range of definitions have been used to classify people of different ethnic and cultural backgrounds. For example, race is used to describe a biologically distinct group, with shared genetic patterns. In contrast, ethnicity relates to a culturally distinct group, who may share common culturally determined phenotypes, e.g. habits.
The term ‘culturally and linguistically diverse backgrounds’ (CLDB) was developed given the limitations of the term ‘non-English speaking background’. There are many migrants who may speak English well, e.g. Singaporeans, Malaysians, Indians, yet have cultural backgrounds that can differ greatly from those of Anglo-Celtic Australians. In this document the Australian Institute of Health and Welfare’s (AIHW) definition of older people from culturally and linguistically diverse backgrounds is used:
.. ‘persons aged 65 or over, born overseas in countries where English is not the main language spoken’ (Gibson, Braun et al. 2001) pg 1.
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