In 2005, the programs expanded to include five new Indian states. Whereas primary prevention programs target populations before a disease develops, secondary prevention involves identifying (through screening) and treating those who are at high risk or already have a disease.
Secondary prevention is also necessary to prevent recurrence of the disease.
However, WHO reports that adherence to long-term therapy for chronic illnesses is only 50 percent in developed countries, and is likely even lower in developing countries.
Such poor treatment compliance could be bolstered by cultivating better health awareness through education and outreach programs.
In addition to being consequences of the normal aging process, disabilities are also often caused by chronic diseases.
And population aging also increases the prevalence of mental health problems—especially dementia, which results in disability by limiting the ability to live independently.
Types of disability frequently considered among the elderly include limitations in general functioning (such as walking or climbing stairs); managing a home; and personal care.
However, despite the increasing demand for home-based care due to population aging, decreasing fertility rates means that future cohorts of elderly will have smaller networks of potential family caregivers.
The need for public policies to address the demand for caregivers is one of the priority issues for long-term care and a guiding principle for WHO's 2000 publication Towards and International Consensus on Policy for Long-Term Care of the Ageing.
Policymakers must take two steps: Shift health-sector priorities to include a chronic-disease prevention approach; and invest in formal systems of old-age support (see A Critical Window for Policymaking on Population Aging in Developing Countries for more discussion on population aging and the options for old-age support).
More specifically, these countries should institute prevention planning and programming to delay the onset of chronic diseases, enhance care for the chronic diseases that plague elderly populations, and improve the functioning and daily life for the expanding elderly population.