It is a pleasure for me to be with you at this most important sympo-sium and to address you at its opening ceremony. I am particularly pleased that our host, President Ryoichi Sasakawa, WHO Goodwill Ambassador, is here with us, looking so well and active.
Perhaps the greatest success story of this century is the fact that most people, in most parts of the world, can look forward to living out much of their natural life expectancy. Clearly this is in sharp contrast to previ-ous eras, when plagues, a host of acute diseases, inadequate scientific knowledge, and economic hardship, resulted in great number of human beings dying prematurely, mostly from diseases that now can be avoided.
However, as that proportion of the population which is elderly in-creases, society must take cognizance of the special needs of all of us as we age, and of the projected costs associated with providing appropriate health and social services. Surely it is especially appropriate for this symposium to be in Japan, where current life expectancy is approximately 80 years. Furthermore, it is estimated that, by the year 2025, the per-centage of the population which, in traditional terms, is deemed elderly will have doubled in Japan. Similar demographic trends are mirrored throughout most of the world.
It is therefore essential for us to plan for future needs. To be most successful in doing this, we must first come to appreciate what has been accomplished in the past 30 years, during which the process of aging has been separated out from the accumulation of disease. This was an essen-tial step. Prior to it being taken, an elderly person afflcted with multiple illnesses was presumed to be just old. We now know that such a person is both old and afflicted with disease. This understanding allows us to address scientifically both the process of aging and the chronic illnesses that we tend to accumulate with age. Furthermore, this understanding forms the foundation for preserving the human rights of all of us as we age. The international community at least no longer refers, in a dispar-aging way, to "old" men or "old" women, as isolated individuals, but to the elderly collectively as respected and accomplished members of the community.
Certainly the health problems of most concern encountered in theelderly is the group of dementias represented by both Alzheimer's dis-ease and the sequelae of cerebrovascular disease. These, characterized by a decline in intellectual abilities, have extraordinary repercussions for the individual, his or her family, and society as a whole. The prevalence of dementia increases strikingly with age. I am especially pleased to report that WHO is carrying out a cross-national study on Alzheimer's disease, in an attempt to understand its scientific basis and its social ramifications. Epidemiological studies carried out in Japan, and in other developed countries, reveal that approximately 5% of those over the age of 65 years have some significant degree of incapacity as a result of this distressing illness.
Furthermore, this disease, and other chronic and acute illnesses, result in a markedly disproportionate expenditure of health care resources for older individuals. Increasing quantities of sophisticated, and often very expensive, technology are being used to provide appropriate health care for the elderly, and this results in markedly increased costs. In Japan, for example, the cost of treating an elderly patient is about five times that of treating an individual under 65 years of age. Similarly, in Denmark the ratio is about 4 and in Finland about 5.5.
In addition to cost considerations, special programmes must be estab-lished, and appropriate legislation enacted, to ensure that the human rights of all of us are respected as we age. Clearly the elderly - especially those afflicted by the dementing illnesses - are at special risk. In such cases, local legislation should provide for legal representation for anyone deemed to be incompetent. To the greatest extent possible, the person appointed should present the point of view of the elderly individual rep-resented. The basic right to fulfilment of human potential, dignity, au-tonomy and individuality should not be denied simply on the basis of a medical diagnosis. Every effort should be made to ensure that elderly individuals who are competent continue to exercise their civil, political, economic, social and cultural rights, as recognized in several international declarations and covenants.
The World Health Organization strongly endorses research at the basic and clinical levels, directed to diseases that afflict human beings as they age. In addition to the cross-national study on the incidence and prevalence of Alzheimer's disease, and studies on the prevention of dementia linked to cerebrovascular disease which may result from certain lifestyles, the organization is directing its attention to the immunological changes associated with aging, osteoporosis (a most disabling and costly illness which affects especially women), and successful aging. Furthermore, it supports efforts to educate and guide policy-makers, health professionals and the lay public about the needs of this segment of the population; about the programmes directed to those needs and the associated costs for care;
and about the rights of individuals who are designated "elderly". As we consider the characteristics and needs of the older population, we must always bear in mind that we are in fact considering our own needs; after all, we all hope to join the ranks of the elderly, free from disease or disability, so that we can have a better and more prosperous life, as part of the community, than those who have gone before us.
Indeed, care of the elderly by their communities should be integrated within primary health care. In this way our common goal of "health for all" can be achieved through "health for all the elderly".