October 15, 2017


Peggye Dilworth-Anderson, PhD
Professor of health policy and management
Member, Global Council on Brain Health
Former president, Gerontological Society of America


There are challenges and opportunities related to global aging.

The group of people in the U.S. – and around the world – who are age 60 or above is increasing rapidly. In 2015, almost 13 percent of the global population was 60 years old and older, and that number is expected to double by 2050 – to 2.1 billion people. This demographic shift brings opportunities and challenges to all aspects of older people’s lives.

One of the positive things about living longer is the acquisition of more wisdom and experience. Older adults can provide familial, social, cultural, educational, political and economic contributions to societies. However, one of the major challenges has to do with the changing health status of many older people. Physical and emotional needs may require high levels of health care, especially among those ages 85 and older. Along with more frequent or complex care often comes the need for more familial and economic support.

Globally, low-income to high-income countries are seeking ways to meet the range of demands, especially for health care, of a population growing increasingly older. Although the World Health Organization (WHO) identified ischemic heart disease, stroke and chronic obstructive pulmonary disease as the three leading causes of mortality among older adults, especially in low- and middle-income countries, brain health also has become a concern.

Q: What are we learning about dementias, including Alzheimer’s?

A: For one thing, we are expanding our discussions about multi-morbidity in later life to include brain health.

Several organizations are leading the way in this discussion, including the National Institutes of Health, Alzheimer’s Association, World Health Organization, Pan-American Health Organization, The World Dementia Council (see below), National Alzheimer’s Project Act, National Academies of Sciences, Engineering and Medicine’s Health and Medicine Division (formerly the Institute of Medicine) and the Global Council on Brain Health.

Even closer to home, former U.K. Prime Minister David Cameron appointed Dr. Dennis Gillings, CBE, as World Dementia Envoy in 2014. In that role, Dr. Gillings chaired the World Dementia Council from 2014 to 2016, raising funds toward a cure for Alzheimer’s disease and other dementias.

These organizations have provided us with important leadership and scientific knowledge. In 2015, the Institute of Medicine, now the National Academies’ Health and Medicine Division, published an informative report on cognitive aging (see tinyurl.com/iom-aging), a process described here by the authors:

Like other organs, the human brain changes with age in both its physical structures and its ability to carry out various functions. The brain is responsible for cognition, a term that includes memory, decision-making, processing speed, wisdom and learning.

As a person ages, these functions may change – a process called cognitive aging. Cognitive aging is not a disease; instead, it is a process that occurs in every individual, beginning at birth and continuing throughout the life span.

The report provides recommendations and steps that can be taken by individuals, families, communities, health-care providers and systems, financial organizations, community groups and public health agencies to promote cognitive health among older adults.

Q: What are you doing currently in the field of aging?

A: I’m pleased to have been named to the Global Council on Brain Health (GCBH) in 2015. Convened by AARP (aarp.org), with support from Age UK (ageuk.org.uk), the council’s governance committee includes 13 scientists, health professionals, scholars and policy experts from around the world who are working in areas of brain health related to human cognition. The governance committee also works with other experts to make evidence-based lifestyle recommendations that can have an impact on brain health.

We aim to offer the best possible advice about what older adults can do to maintain and improve their brain health. Members discuss specific lifestyle issues that may have an impact upon people’s brain health as they age, with the goal of providing evidence-based recommendations for people to consider incorporating into their lives.

I encourage people to look at one or more of our four reports. They include Cognitively Stimulating Activities (2017), Social Engagement and Brain Health (2016), Sleep and Brain Health (2016), and Physical Activity and Brain Health (2016). These are available at tinyurl.com/GCBH-aging-reports.

Good health is about both physical and brain health. Life history has a lot to do with all aspects of the aging process and health. In other words, life course matters.

The health care and attention that I had as a child and throughout life has affected my health today. My level of education has facilitated my brain and physical health. Positive relationships with friends and family provide support in times of need, which is good for all aspects of our health. For many, like myself, having a spiritual home helps develop coping skills and resilience.

Like others, I’m sometimes challenged to maintain ongoing physical activity to support brain and physical health. The Gillings School is a great partner in that regard, with its Culture of Health initiatives. I’m among those who take advantage of our health-oriented work environment. My two-or-three-times-per-day “wellness walks” get my blood circulating and stimulate cognition. I talk to people along the way, so I’m engaging socially as I exercise my physical body. I hope that all of this leads to my sleeping enough and sleeping well – which is the best support for brains of all ages.

Many people don’t have the opportunity to take a 15-minute break to walk or use a treadmill. To those, I would say, if your own work environment doesn’t support your being active and healthy, find ways to create that environment for yourself. Work small things into your routine – take the steps instead of the elevator, stand and stretch periodically. Even small changes toward physical activity, decreased stress and good sleep can make aging less difficult.


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Carolina Public Health is a publication of the University of North Carolina at Chapel Hill Gillings School of Global Public Health. To view previous issues, please visit sph.unc.edu/cph.