Ministry of Health, Monjitas 565, Santiago 8320070, Chile.
Programa Centro de Salud Pública, Universidad de Santiago, Av. Libertador Bernardo O'Higgins 3363, Santiago 717835, Chile.
Health Policy Plan. 2021 Feb 16;35(10):1347-1353. doi: 10.1093/heapol/czaa113.
The concept of older adult is extensively used in day-to-day discussions and public policy. Nonetheless, concrete operational definitions are scarce. This poses a challenge for policymakers when designing initiatives targeted to this population. Chronological age has been traditionally used as the sole criteria for identifying older people (OP). However, there is no consensus about what is the age that should define an elderly. The issue became evident when, in 2018, the Chilean Ministry of Health started a planning process to coordinate health initiatives for OP. Two thresholds had been commonly used-60 and 65 years-and the differences between choosing one and the other were significant. This article intends to structure the debate around age thresholds and the definition of OP in Chile, presenting information and evidence to guide decision-makers when deciding about the issue. Information was based on international guidelines and definitions, laws and practice in the country and epidemiological data. The analysis shows a lack of consensus when dealing with the definition of OP using age thresholds at every level. Results highlight the difficulty of using age as a guide for designing policies for OP and call for a more holistic way for identifying OP as beneficiaries of targeted programmes, considering the heterogeneity of this population and the availability of information. This debate is much needed in many countries that, like Chile, will experience significant demographic changes and face the challenges of healthy ageing.
老年的概念在日常讨论和公共政策中被广泛使用。然而，具体的操作定义却很少。这给政策制定者在为这一人群设计计划时带来了挑战。传统上，年龄被用作识别老年人（OP）的唯一标准。然而，对于界定老年人的年龄标准，目前还没有达成共识。2018 年，智利卫生部开始协调针对 OP 的卫生倡议的规划进程，这一问题变得明显起来。当时，60 岁和 65 岁是两个常用的门槛，选择其中一个和另一个的区别是显著的。本文旨在围绕智利的年龄门槛和 OP 的定义展开辩论，提供信息和证据，为决策者在决定这个问题时提供指导。信息基于国际准则和定义、国家的法律和实践以及流行病学数据。分析表明，在每个层面上使用年龄门槛来定义 OP 时，都存在缺乏共识的情况。结果突出了使用年龄作为 OP 政策设计指南的困难，并呼吁采取更全面的方法来识别作为目标计划受益人的 OP，同时考虑到这一人群的异质性和信息的可用性。在许多像智利这样将经历重大人口变化并面临健康老龄化挑战的国家，这场辩论是非常必要的。
