Although universal anti-aging pills have not yet been invented, improving the quality of life for the elderly is quite achievable, believes Gulmira Baitova, head of the Department of Therapy at the International School of Medicine and the Gerontology course at the S. Daniyarov Kyrgyz State Medical Institute for Postgraduate Education and Continuing Education, as well as a Doctor of Medical Sciences and Professor.
“In Kyrgyzstan, it is necessary to develop gerontology and geriatrics to address the health issues of the older generation and to study the mechanisms of aging,” shared Professor Baitova, who was one of the first in the country to raise this topic and has been working on an active longevity program for many years, in an interview for vb.kg.
Why do you emphasize active longevity, despite the fact that, according to official data, life expectancy in Kyrgyzstan is increasing?
— This is indeed the case. Over the past decades, the number of people over 60 has increased worldwide, and Kyrgyzstan is no exception. In 2024, the average life expectancy in our country was 72.1 years. Women live eight years longer than men (76.6 years versus 68.3 years). The republic's permanent population exceeds seven million, of which more than 400 thousand (5.7 percent) are citizens over 65 years old. According to the UN classification, if the share of the elderly is less than 4 percent, the country is considered young; from 4 to 7 percent — on the verge of aging; and more than 7 percent — aging. It is projected that by 2030, the elderly will make up 7 percent of Kyrgyzstan's population. Aging is a problem that affects everyone if they are fortunate enough to reach that age, and it is related to lifestyle, opportunities, and challenges.
The increase in the elderly population is a challenge for social policy and effective development strategies. What role should healthcare play in this process?
— Undoubtedly, healthcare should take center stage in providing medical services, especially in the area of disease prevention. Unfortunately, the gerontological service that existed during the Soviet period ceased to function after the collapse of the Union. This direction can only be restored with the active participation of the healthcare system. Today, it has been proven that biological age can be managed, delaying aging and frailty while maintaining activity and endurance in old age. This is not only a matter of personal well-being but also an important task for society as a whole. By maintaining economic activity for longer, citizens contribute more to the country's GDP and reduce the burden on the state budget.
The term “active longevity” was first introduced by the World Health Organization in 2002 as part of the active aging strategy. WHO defines active longevity as the optimization of opportunities for maintaining health, participating in social life, and protecting human rights, which ultimately improves the quality of life for the elderly. In the same year, the UN General Assembly adopted the Madrid International Plan of Action on Aging, calling on states to develop national programs for active aging. Kyrgyzstan joined this plan, committing to provide elderly citizens with decent living conditions and active participation in public life.
In this process, healthcare truly plays an important role. The medical community responded to the recommendations of the Madrid Plan, and in 2011, courses on gerontology and geriatrics were opened at the S. Daniyarov Kyrgyz State Medical Institute for Postgraduate Education and Continuing Education. We began training family doctors on the peculiarities of diagnosing and treating elderly patients, as diseases in older age have their own characteristics. These courses continue to operate, and we also conduct outreach lectures in remote regions, which provide practical benefits.
In 2019, at an international conference organized by WHO and the UN in Moscow, the “Decade of Healthy Aging 2020–2030” program was discussed. More than 30 countries presented their ideas, confirming the significance of the topic and the need for a comprehensive approach to it in Kyrgyzstan. We need large-scale national programs to support the elderly. Although some projects are currently being implemented, they are local and temporary, improving the lives of elderly citizens only for a short period. The “Resource Center for the Elderly” is actively working in this direction. A gerontological office has been opened in Bishkek based on the Chyngyz Aitmatov Library, where, together with our gerontology and geriatrics course, training sessions for active retirees are held. Our specialists teach them how to maintain health and extend active life, focusing on the prevention of cardiovascular, endocrine diseases, and other chronic conditions.
We have also invited yoga instructors to conduct classes with the elderly. Participants listened with interest, actively participated, and enjoyed the sessions. Importantly, they then share the knowledge gained with other peers from different regions. This is one of the most effective ways to prevent diseases, playing a key role in ensuring active longevity.
In 2019, the government of the Kyrgyz Republic approved an Action Plan to Improve the Quality of Life for Elderly Citizens for 2019–2025, which includes measures to create conditions for the active participation of elderly people in societal life and to improve their economic situation.
Professor, the deadline for the plan has expired. How do you assess its impact on the older population of the country, and what will happen next?
— During the time of the previous plan, much was done in the field of health improvement. In particular, studies were planned on medical and social assistance for patients with cardiovascular diseases among citizens aged 60-74, 75-89, and 90 years and older. We studied the healthcare needs of the elderly and issues related to the prevention of strokes and heart attacks. This is an important study, as Kyrgyzstan ranks among the highest in the world for mortality from cardiovascular diseases: first for strokes and sixth for heart attacks.
Of course, it is impossible to solve the problem of active longevity in a short time, and a multifaceted, indefinite state program is required, which will be constantly updated in accordance with new challenges. Currently, a program titled “Active Longevity of Kyrgyz Citizens for 2025-2030” is being developed in Kyrgyzstan, but it will not be the last, as the number of elderly people is growing, and their needs are changing. I believe that a gerontology institute should be established in Kyrgyzstan, which will be the main body dealing with issues of gerontology and geriatrics. For example, in Russia, branches of the main institute have been opened, and the solution to the problem of active longevity involves almost all ministries, businesses, sports and social organizations, as well as the retirees themselves.
However, aging is not only a medical but also a social problem. We need to engage the older generation. Elderly people often sit on benches not out of choice; they need communication. Therefore, it is worth creating communities for the elderly, united by common goals and values. A person should not isolate themselves within four walls. Notably, Swedes, who are considered leaders in supporting the elderly, actively unite in associations where events are held for them.
Moreover, communication helps maintain tone. This is an important factor for longevity. Studies show that social activity and psycho-emotional state improve health for many years.
Currently, my assistants regularly meet with elderly patients at the Centralized Medical Center No. 8, conducting discussions on disease prevention. These meetings are becoming increasingly popular, and the number of those wishing to hear doctors' advice is growing. We are convinced that many elderly people maintain high intelligence and activity, willingly participate in initiatives, and need trusting communication.
In my opinion, such meetings should be held in all Centralized Medical Centers, and it is necessary to resume the work of schools for hypertensives and diabetics. For these classes to become regular, appropriate human resources are needed. Family doctors often lack time for prevention, but in such schools, patients can be trained, who can then pass on knowledge to others.
Do you believe that it is possible to change the population's attitude towards their health, including the younger generation? What would you advise all of us to maintain health and prolong life?
— Attitudes are already changing! After the pandemic, people became interested in prevention, asking many questions about health. Even our simple recommendations are helping more and more people. Prevention should begin not only among the elderly but also in kindergartens and schools, so that young people can live to active longevity. The recipes for health are known to all: proper nutrition, quitting bad habits, physical activity, and regular check-ups.
Unfortunately, there is also the opposite trend: adults continue to eat fast food and feed their children burgers. I have encountered cases where small children do not develop properly because they spend most of their time on their phones.
At an international conference in London, I noted that 60 percent of the adult population of Kyrgyzstan suffers from hypertension, and 50 percent are unaware of it. These figures surprised my foreign colleagues. The main cause of strokes is the late diagnosis and treatment of arterial hypertension. People come to doctors already in a pre-stroke state. There are many cases where even pregnant women accidentally find out about their hypertension or diabetes during screening.
Sixty percent of health is the responsibility of the individual. Negative habits such as smoking, alcoholism, and poor nutrition worsen health, even if a person has good genetics. Only 40 percent of health is influenced by ecology and the healthcare system.
Therefore, it is so important to motivate everyone to take care of their health and the health of their loved ones. This is not an easy task, but it brings remarkable results. For example, in the 1980s in the USA, preventive programs managed to reduce mortality from strokes by 53 percent and from heart attacks by 46 percent. This saved many lives and shows how important it is to engage in prevention and self-education.
In this important endeavor — not only in increasing life expectancy but also in improving the quality of life — a state program for active longevity in Kyrgyzstan for 2025-2030 can help. Caring for the quality of life of the elderly is a task for any government with the active support of society as a whole.
