Use ‘old fashioned’ methods to stay healthy into old age – Sir Chris Whitty

People should use “old fashioned” methods to stay healthy because sickness and disability are not an inevitable part of ageing, England’s chief medical officer has said.

Sir Chris Whitty published his latest annual report on Friday, warning that Britain must wake up to the challenges of an ageing society.

Speaking ahead of the release, he said there should be a focus on extending the amount of time spent in good health. Delaying disease and disability can vastly improve older people’s quality of life and ease pressure on the NHS.

Sir Chris urged people to take responsibility for their health, while also calling on the Government to do more to make healthy lives the norm.

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“Lots of exercise, having mental stimulation and a social network, eating a reasonably balanced diet – not too much high fat, sugar, salt, moderate alcohol – stopping smoking if you do. They’re old fashioned, but they still work.”

The chief medic also said people should have more conversations with their family and doctors about their end of life wishes.

In an age where modern medicine can bring people back from death’s door, we should more often stop to ask what the patient wants, particularly when it comes to treatments that have side effects, he suggested.

Sir Chris added: “One of the things geriatricians are often very good at doing is meeting this person who’s on 25 drugs and saying, ‘Actually you just don’t need to have at least half of these. At this point in your life, this is not going to help you, the side effects cumulatively are going to be quite problematic.’

“We should be rethinking whether maximising every single medicine is the right answer, as well as having this discussion with people about what do you want?”

The report also highlighted the problem of ageing populations concentrating in rural areas.

Many people eventually move out of cities and large towns to places where there are fewer young people to care for them.

Houses and communities should be designed with the elderly in mind from the start, to help them maintain their independence for longer, he said.

Art galleries and libraries could have grab rails or ramps to help people move around, while pavements and cycle lanes should be accessible with even surfaces “because the key thing people want is independence”, Sir Chris suggested.

“Homes for older people need to be located in places where they can easily and safely reach the everyday shops and services that they need, preferably by active transport (walking or cycling) to help maintain their physical health.

“Public and green spaces should be designed to meet the needs of older people, including those with sensory and physical impairments.”

He added: “We have really got to get serious about the areas of the country where ageing is happening very fast, and we’ve got to do it now.

“It’s possible to compress the period of time that people spend in ill health if we’re systematic about it. We’ve got to do that because otherwise, we’re going to end up with large numbers of people living much more dependent lives than they otherwise would have.”

Paul Farmer, chief executive at Age UK, welcomed the “powerful and timely” report.

He said: “It clearly demonstrates why we need politicians and policy makers across the board to get a grip and make the task of adapting to the realities of our ageing population a priority.

“We can already see how the failure to invest in delivering the right services and support is leading to worse outcomes for older people and entirely avoidable problems.

“Older people are isolated at home if the design of our communities mean they can’t safely go out. People end up falling and in the back of an ambulance if our built environment is full of trip hazards.”

Mr Farmer said the failure to provide adequate social and community care was pushing people into overcrowded hospitals.

He added: “None of this is inevitable. Getting it right would have immeasurable benefits for individual older people and their families as well as our communities and society as whole.”

Older people should not be unnecessarily barred from research studies, Sir Chris says

Sir Chris also called for drug and treatment research to be more inclusive of older people.

He said they were too often excluded from clinical trials due to their age or having multiple medical conditions.

But this means potential therapies are not being tested in a population that is truly representative of those who need that treatment.

Sir Chris said: “What you’re trying to do with a trial is trial it in the population in whom the drug is going to be used.

“If 80 percent of the people who take it are going to have multiple other conditions, that is the population in which it should be studied, rather than choosing a highly selective and essentially biased population who are unrepresentative.”

The chief medical officer added that he would rather “change the debate than the rules” but ethics committees should challenge researchers who arbitrarily exclude older patients from their studies.

He added: “The default should be that all trials, unless they’ve told us why they’re not doing it, should have the minimum number of exclusion criteria.

“There may be a very good scientific reason why for this particular trial of observational study, that’s not the right answer. But the default should be that.”

Fiona Carragher, Alzheimer’s Society’s director of research and influencing, said: “The chief medical officer’s recommendations around involving more older people in research, and for better health data, will be key to tackling dementia.

“As the report acknowledges, older people are currently underserved in health care. We urgently need to increase diagnosis rates and transform social care by investing in the workforce and a sustainable funding model.”