50 is the new 60
- Beth Amato
Africa’s population is living longer but not necessarily healthier. Research on brain health, gut health and robust policy can change this phenomenon.
In the Vhembe District Municipality in Limpopo, there are 2 000 centenarians, according to a 2022 Census SA report. Vhembe is not an official Blue Zone (where there are high rates of people living to 100) but many of its 100-year-olds live in ways that echo the world’s oldest populations: eating traditional foods, staying active into old age, maintaining close social bonds and living with strong spiritual and cultural convictions.
When 101-year-old Muyahavho Maria Muedi, who lives in the Vhembe region, was interviewed by The Citizen, she also attributed her ripened years to listening to elders and to avoiding alcohol, drugs, sugar and fatty foods.
Okinawa, Japan, has one of the highest rates of people living to 100 in the world. Here, people not only live longer but also live well, with fewer chronic diseases or later onset of illnesses. Vhembe’s centenarians, however, are outliers in a region where people are living longer but not always healthier.
Rapid transitions and NCDS
Elsewhere in the country and across southern Africa, people live, on average, to 65 years old. However, about nine of those years are spent in ill health, according to the World Health Organization’s universal health coverage tracking. Notably, women live longer than men but those years are still spent in poor health. While a longer lifespan in the region is mainly attributed to preventing and treating infectious diseases, non-communicable diseases (NCDs) such as hypertension, diabetes, cardiovascular diseases and others have increased rapidly.
“We are seeing that about 60% of those over 60 years old in our study area are hypertensive. This is much higher than the global average,” says Professor Xavier Gomez-Olive, Associate Director of the South African Medical Research Council’s Wits Rural Public Health and Health Transition Research Unit (Agincourt).
Agincourt’s longitudinal ageing data confirm that people are living longer but that they are acquiring non-communicable diseases younger than the global average. “This seems to coincide with what we term a ‘rapidly transitioning society’ where profound, fast-paced economic, social, lifestyle and behavioural changes interact with complex health and life-course dynamics,” explains Gomez-Olive.
Not forgetting dementias
As sub-Saharan Africa’s population ages, dementia cases are set to rise sharply by 2050. In South Africa, estimates point to more than a million people living with the condition in the near future. “This deepens the social, economic and community pressures already felt in the rural areas,” says Professor Stephen Tollman, Agincourt’s Director.
He notes that brain health runs through every stage of life and every sector of society. “If countries integrate brain health into what Africa is already doing well, the continent can protect ageing citizens and sustain our economies,” he says.
Elevating the aged
Although older populations are traditionally viewed as frail and unable to work at full capacity, in low- and middle-income countries like South Africa, older people take on central and productive roles in their communities.
The impact of NCDs and dementia presents a challenge for the older population in Agincourt and indeed for the wider community of which they are a critical part. Older people are often the chief caregivers in extended families owing to labour migration and the remnants of the HIV crisis, where many younger people died. The old-age pension is also heavily relied on as a source of income in some communities.
Research on what makes older adults strong and resilient while others experience early and rapid decline is therefore necessary and has become one of the most urgent public health issues of our time, according to Tollman.
Gut feelings
Alongside social and clinical determinants, Africa’s scientists are uncovering biological pathways that help explain why some people age better than others.
Researchers at the Sydney Brenner Institute for Molecular Bioscience (SBIMB) are investigating the gut microbiome.
The gut is home to trillions of microbes and as much genetic diversity as the human genome itself.
These microbes produce metabolites that regulate inflammation, metabolic health, immunity and even aspects of cognition.
Ageing healthily from conception
Drawing on the Africa Wits-INDEPTH Partnership for Genomic Research longitudinal data from Soweto and Agincourt, scientists are mapping how lifestyle, environment and genetics shape these microbial communities and in turn how they influence frailty, diabetes risk, cardiovascular disease and cognitive ageing.
“The microbiome gives us a biological lens to see how lifelong exposures accumulate and how ageing can be made healthier, not just longer,” says Dr Luicer Olubayo, a researcher at the Institute.
What is evident is that diseases like HIV, diabetes or dementia are no isolated events of older age. Many of the pathways that drive risk are already set in motion decades earlier. “Healthy ageing begins at conception, essentially,” says Gomez-Olive, taking us right back to the beginning of our life cycle.
- Beth Amato is a freelance writer.
- This article first appeared in?CURIOS.TY,?a research magazine produced by?Wits Communications?and the?Research Office.
- Read more in the 20thissue, themed #Thrive, which explores what it truly means to flourish — across a lifespan, within communities, and on and with our planet.
- This feature is part of a series on what is required for us to thrive at each stage throughout our lives. Also read: