Looking at the Future of Geriatric Care in Developing Countries

During the next 20 years, many less developed countries (LDC) will have age structures approaching those of the present time in more developed countries (MDC). This is occurring more rapidly in the LDC of Asia and Latin America. The future of aging populations in LDC is dependent on the degree of poverty in these countries. Poverty is a major determinant of disability and mortality in older persons. With the march of globalization, dis-eases in LDC are changing from infectious to noncommunicable diseases, such as diabetes. Nevertheless, infec-tions such as tuberculosis still take a major toll on the elderly. The epidemiological transition in LDC has created a need for health care transitions from systems based on cure to ones that highlight prevention and long-term care. LDC have the opportunity to develop systems that differ from those in MDC by capitalizing on the lack of infrastructure to produce more home-based rather than institution-based long-term care systems. Involvement of the elderly in the planning of their own futures is of paramount importance. Appropriate planning now will decide the future of the elderly in LDC during the next 20 to 40 years. The growth of the elderly population presents a new challenge to health systems and social support networks in many less developed countries where populations are becoming old before they become wealthy. —A. Kalache (1) ALKING about the future is no easy task. In the past