The ageing male: demographics and challenges

In the year 2000, there were more than 400 million people aged 65 and over in the world--projected to increase to almost 1.5 billion by the year 2050--a close to fourfold increase compared to the 50% increase for the global population as a whole. More than 25% of these 1.5 billion elderly people are projected to be "oldest-old" (aged 80 and over). Global ageing is a triumph and a challenge. As we enter the 21st century, it will put increased economic and social demands in all countries. But if more and more individuals reach older age in good health--and remain healthy for longer--the benefits will be shared by all. Therefore, the promotion of healthy ageing and the prevention of disability in all older people must assume a central role in medical care and research as well as in the formulation of national health and social policies. Effective programs promoting healthy ageing will ensure a more efficient use of health and social services and improve the quality of life in older persons by enabling them to remain independent and productive. With prolonged life expectancy, men and women can expect to live one-third of their lives with some form of hormone deficiency. Life expectancy differences between men and women exist in various regions of the world with a mean of 4.2 years, and is projected to increase to 4.8 years by the year 2050. The ageing male, in particular, has the risk of developing gender-specific urological diseases, such as prostate cancer, benign prostate hyperplasia continence disorders (generally ignored by men) and erectile dysfunction. Hormonal changes in the ageing male are associated with changes in the body mass index, osteoporosis, and sleep and mood disorders. A significant relationship between body fat mass and both cardiovascular and overall mortality in men has been demonstrated. In some populations, at least, men may run a higher risk for cardiovascular complications than women. It is our sincere hope that the next few years will enrich us with facts and clarify the state of our present knowledge, permit us to recognize some of the missing links, give us the tools and methodology to design and plan ways to understand ageing in men, allow us to help to improve the quality of life, prevent the preventable, and postpone and decrease the pain and suffering of the inevitable.