A broad look at Egypt’s ageing population

Long-term healthy ageing surveys are essential to monitor the health, social and economic changes that occur with advancing years, as well as track the most influential factors for healthy ageing.

These surveys help form public policies to improve care for older people, but are rarely conducted in Egypt, a country that has the largest population in the Arab and Middle Eastern region. “Research on older adults has been limited in Egypt and the Arab world owing to a lack of population-representative longitudinal data. There are no validated household data that document and monitor the physical, mental and socioeconomic conditions of older Egyptians, their diversity and their pathways over the life course,” a paper published in Nature Ageing reported.

To fill that gap, a new longitudinal study titled AL-SEHA will be launched in 2024. It will be the first nationally representative cohort study on ageing in Egypt, and the first of its kind in an Arab country among low and middle-income countries. Researchers will study 20,000 respondents over the age of 50, from different areas, over two years. The study is done in collaboration with SHARE, which is a multidisciplinary survey launched in Europe in 2004 to monitor the impact of the economic, demographic, psychological, social, and health aspects on the lives of individuals over the age of 50 years, in an effort to provide a healthier life for the older people.

“The study will improve our understanding of the factors that may lead to ageing-related diseases in Egyptians, in addition to evaluating the impact of climate change on the population. This will eventually add to global knowledge of the determinants of well-being and ageing-associated disability,” says Mohamed Salama, an associate professor at the Institute of Global Health and Human Ecology at the American University in Cairo (AUC) and the leading author of a commentary in Nature Aging, about the issue.

The commentary explains that Egypt will be the first Arab country in a network of about a dozen studies on ageing at the international level. This is particularly important for a country like Egypt that has a very diverse population with high level of health, economic, and social inequalities, and a significant burden of infectious and non-communicable diseases.

The march of years

The average life expectancy in Egypt increased from 58 to 69 years for men, and from 62 to 73 years for women between 1980 and 2020, according to the Nature Aging article. Life expectancy is expected to reach 74 years for men and 79 years for women by 2050. The population will reach 160 million by 2050 with an average age of 29.7 years, including 22 million (13.8%) adults aged 60 or older.

The results of the study indicate that the percentage of people living alone in Egypt increased from 9.9% in 1998 to 21.6% in 2018, and the percentage of older individuals living with children or grandchildren decreased from 69.8% to 46.7%. This reflects an increasing preference among the elderly in Egypt for living alone.

Salama points out that Egypt was previously known as a “young country,”  but that its mean age will increase significantly, similar to the trend in Europe. He believes that now is an ideal timing to launch such a study to better prepare for the evolving reality.

“Reaching this age is accompanied by health, social and economic problems that are completely different from those in other age groups. Therefore, we must get prepared with plans and policies to deal with them, but we currently lack this knowledge. The upcoming study will, hopefully, fill this knowledge gap and enable us to be better prepared to meet the challenges of population ageing in Egypt,” Salama tells Nature Middle East.

Environmental factors

At the biological level, ageing is associated with the accumulation of molecular and cellular damage resulting from modifiable environmental, economic, and social factors that vary greatly among individuals in Egypt. Understanding the interplay between health, gender, socioeconomic status, and old-age poverty is crucial for determining health, social, and economic policy priorities.The elderly in Egypt suffer from a large number of diseases, including depression, dementia, and associated cognitive impairment. Many of these diseases are likely caused by modifiable environmental factors such as climate change, according to the study.

Compared to other countries in Africa, Egypt has a steeper increase in the number of hot days; and with air pollution, pesticides, water pollutants and projected water scarcity, older Egyptians are particularly vulnerable to the potential health impacts of climate change.

Recent reports of high death rates during heat waves and the increase in the number of strokes are clear examples of the direct impact of climate change on older people's health. Therefore, the lack of community support for older people will limit their preparedness for future incidents, the study says.

The heterogeneity of the Egyptian population could facilitate the discovery of causal pathways that may help mitigate the impact of climate change and create new knowledge about factors contributing to healthy ageing in the country.

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