From the Guidelines
The shift from a declining to a stable population growth trend with an increased proportion of elderly individuals is primarily caused by a decrease in birth rates and an increase in life expectancy, rather than any specific medical intervention or demographic change. This demographic transition is characterized by a change in the population structure from a wide base with many young people and a narrow top with few elderly, to a more stable, rectangular structure with a higher proportion of elderly individuals. According to a study published in the Journal of the American College of Cardiology 1, the short-term risk of atherosclerotic cardiovascular disease (ASCVD) increases with elderly age, and the prevalence of coronary heart disease is projected to increase by as much as 43% by 2030 due to demographic changes alone.
Some key factors contributing to this shift include:
- Decrease in birth rates, which directly reduces the number of young people in the population
- Increase in life expectancy, which leads to a higher proportion of elderly individuals
- Improvements in healthcare and living standards, which contribute to increased life expectancy and a decrease in mortality rates
- Changes in population demographics, such as an increase in the proportion of elderly individuals, which can be influenced by factors such as migration and urbanization. A study published in Circulation 1 highlights the importance of measuring patient-reported health status in the elderly, particularly in the context of cardiovascular disease, and notes that health status assessment is crucial in this population due to the presence of significant comorbidities and cognitive dysfunction.
However, the primary driver of this demographic shift is the decrease in birth rates, which is a key factor in determining population growth and structure. This is because birth rates have a direct impact on the number of young people in the population, and a decrease in birth rates leads to a narrowing of the base of the population pyramid. In contrast, medical interventions such as the use of statins in the elderly 1 or revascularization procedures 1 may improve health outcomes and quality of life for individual patients, but they do not directly affect birth rates or population growth.
From the Research
Demographic Transition and Population Growth
- The demographic transition theory suggests that societies progress from a pre-modern regime of high fertility and high mortality to a post-modern regime of low fertility and low mortality 2.
- This transition is caused by the reduction of the death rate, modernization, and cultural changes that weaken the importance of children, leading to smaller families 2.
- As a result, the population growth trend shifts from declining to stable, with an increased proportion of elderly individuals.
Factors Contributing to the Shift
- The increasing empowerment of women to make their own reproductive decisions leads to smaller families, contributing to the shift in population growth trend 2.
- Improvements in life expectancy and declines in fertility rates also contribute to population aging, as seen in China's demographic transition 3.
- The growing population scale and accelerating process of population aging pose challenges for public health practice, including managing disability prevalence and life expectancy with disability 3.
Implications for Public Health
- The shift in population growth trend and increased proportion of elderly individuals require dynamic evaluations, timely adjustments, and innovations in population health strategy design and management 3.
- Collaboration at local, national, and international levels is key to fostering a platform for learning and information sharing to improve preparedness for global aging 4.
- Health systems need to adapt to the changing demography, providing education and resources for long-term conditions and recognizing the contributions of older people to society 4.