e are bombarded with images of physical and mental deterioration that portray aging as the tragic loss of ability and independence. What if, instead of a story of decline, exclusion, and dread, we reframed the experience of aging as a time of opportunity where we concentrate on maintaining the functional ability and the valued contributions of older people.

Aging is a process that starts at the moment of birth. At each stage of life, we have a range of functional abilities that incorporate both the mental and physical capacity to understand and perform various tasks and activities. Our level of functional ability changes over time, and it is the perceived change and loss of this capacity that may leave us anxious and even resigned to the inevitable downward march of our health and quality of life as we age.

The process of aging is often experienced as the loss of individual identity, our me-ness so to speak, dissolved into a web of medical diagnoses and conditions. At the International Federation on Ageing (IFA), we believe this experience is wholly unacceptable.

We believe that we have a responsibility to help develop a new narrative on aging. We need to insist governments and health systems invest the time, expertise, and resources necessary to develop age-related policies and programs that aim to optimize the functional ability and contributions of older Canadians. This action is not a luxury agenda item. The issues and costs associated with a rapidly aging population will inevitably lead to a crippling global crisis.

What can be done?

If we look at global burden of disease, we know the greatest impact on functional ability comes from sensory impairments such as vision loss and hearing, back and neck pain, chronic obstructive pulmonary disease, depressive disorders, falls, diabetes, dementia (particularly in high-income countries), and osteoarthritis.

Looking specifically at the issue of vision loss in Canada, we know every year more than 50,000 Canadians will lose their sight, and more than 5.5 million Canadians live today with a significant eye disease that could cause vision loss. Estimates also suggest the prevalence of vision loss in Canada is expected to increase nearly 30 percent over the next decade, largely due to an aging population.

The personal, social, and economic costs of vision loss can be profound. Higher rates of unemployment, divorce, and clinical depression are all associated with vision loss, as are billions of dollars in direct and indirect costs to the Canadian health care system.

But, we have a choice. We can choose to close our eyes and brace ourselves for this threat to our quality of life, or we can find creative and powerful ways to tackle the problem.

The crisis is looming, but it is largely preventable

Many of the retinal conditions that cause vision loss and blindness — age-related macular degeneration (AMD), diabetic retinopathy, glaucoma, cataracts, and refractive error — are treatable if the appropriate and available treatments are started in a timely manner; this accessibility is not always the case.

Cost inevitably influences access to medication. If as a society we are committed to maintaining the functional independence of our citizens, especially as they age, we need to make sure decisions that may prevent or limit their access to appropriate therapy are based on scientific evidence and in consultation with stakeholders including patients, physicians, and patient organizations, and not strictly on the basis of cost savings.

Specifically, Canadian policy makers need to stand together with older and aging Canadians by protecting their access to approved retinal treatments as prescribed by their physicians. By safeguarding access, policy makers have the unique opportunity to help improve the quality of life not only of the individual but also of the patient’s family and the broader community.

Vision is a cornerstone of the aging discussion. We need to be bold in the face of threats to our vision health and united in our call for better solutions.

The International Federation on Ageing is proud to stand shoulder-to-shoulder with the physicians, patients, and organizations featured in these pages. As advocates for health and vision, we have the opportunity to join together as a powerful voice of innovative thinking and real change, moving us from a society chased by fear and ruled by loss to one that celebrates, enables, and protects ability.