Older people
Overview
The JSNA evidence specifically grouped under older people is currently limited and is being enhanced by our work in relation to Adult Social Care Prevention. Note the work on frailty and multimorbidity in area based needs assessments described in the whole population section and on Unpaid carers in the vulnerable groups section.
The remaining health needs assessments and analysis relate to physical activity, Chronic Obstructive Pulmonary Disease (COPD) and Dementia. They show interactions between ageing, disability, long-term conditions, mental health, independence, falls, frailty, and service use. There are also pronounced geographical and demographic inequalities.
Physical inactivity contributes to preventable illness, disability, and service costs. According to the Sport England Active Lives Survey, the proportion of Kent residents aged 55 and above meeting recommended activity levels has been gradually increasing since the 2015/16 baseline year. Activity among people aged 75 and above has also increased. However, only 15% of older adults undertake recommended muscle-strengthening and balance activity. This restricts opportunities to delay disability, prevent falls, and maintain independence. Overall progress therefore conceals an important gap within activity type.
Activity varies by sex, place, ethnicity, socioeconomic circumstances, disability, and long-term conditions. Women in Thanet, men in Gravesend, and women in urban areas show particularly low muscle-strengthening and balance participation. North Kent districts record the lowest overall activity levels. National evidence within the assessment identifies lower activity among women, Asian and Black populations, deprived communities, disabled people, and people with long-term conditions. These inequalities require accessible and attractive local opportunities.
Physical inactivity also interacts with mental health and social isolation. Older adults have greater isolation risks, while physical activity can support both physical and mental wellbeing. People with severe mental illness experience substantially shortened life expectancy. Preventable physical illness accounts for much of this difference. Embedding Intervention and Brief Advice for Physical Activity across professional practice could strengthen routine prevention. Workforce health literacy, policy, infrastructure, and investment require aligned improvement.
Chronic Obstructive Pulmonary Disease (COPD) analysis identifies historical geographical inequalities across Kent. Thanet, South Kent Coast, and Swale recorded the poorest prevalence measures. Areas with higher deprivation and smoking prevalence also experience greater respiratory burden. Emergency admission rates are highest among the older age groups.
Dementia creates complex and increasing needs involving cognition, mobility, behaviour, nutrition, continence, falls, and dependence. Personal circumstances, bereavement, housing, and finances can compound its effects. A JSNA chapter published in 2017 estimated more than 20,000 Kent residents aged over 65 had dementia during 2013/14. Recorded diagnosis rates were below the contemporary targets stated within the report. The evidence predates current service arrangements but remains relevant to historical direction and system complexity.
The reports discussed above have substantial implications for carers, primary care, hospitals, community support, and social care. Preventive physical activity can delay disability and reduce falls risks. Smoking prevention and cessation remain central to respiratory health. Dementia requires earlier identification and coordinated support.
Key themes and issues
- Physical activity supports independence, mental wellbeing, balance, and delayed disability. Physical Activity in Adults and Older Adults identifies low muscle-strengthening and balance participation.
- Activity inequalities affect women, deprived communities, disabled people, minority ethnic communities, and people with long-term conditions. Overall levels of activity are lower in North Kent.
- Accessible local activities and routine professional advice offer prevention opportunities. Intervention and Brief Advice for Physical Activity requires wider workforce adoption.
- COPD burden reflects smoking, deprivation, occupation, geography, and population ageing. Chronic Obstructive Pulmonary Disease Chapter identifies high prevalence and mortality in Swale and Thanet.
- Dementia involves progressive dependency and complex physical, behavioural, emotional, housing, and financial needs. Dementia Chapter highlights low diagnosis rates.
- Dementia can increase falls, fractures, mobility difficulties, and pressure upon carers and social care. Changing accommodation or a personal bereavement may compound need.