Malaysia is an ageing nation, and is expected to transition into an aged nation in 2030.
What is an ageing and aged country?
Globally, many countries including Malaysia, define ‘elderly’ as a person aged 65 and above. Ageing population is a phenomenon where older individuals makes up a larger part of the total population.
The United Nations (UN) has defined 3 categories fo ageing, based on the percentages of population aged 65 years and above.
- Ageing society: 7% of the population are aged 65 years and above
- Aged society: 14% of the population are aged 65 years and above
- Super-aged society: 20% of the population are aged 65 years and above
UN studies indicate that the global population aged 65 and over is growing faster than all other age groups. From 2021 to 2050, the worldwide proportion of older individuals is anticipated to rise from under 10% to approximately 17%.
What about Malaysia’s ageing population?
According to Department of Statistics Malaysia (DOSM), Malaysia’s ageing population is growing at a faster rate compared to 30 years ago.
In 2023, the percentage of population aged 65 years and over increased to 7.4% from 7.2% the previous year. This incerasing trend has been consistent in the preceding years. Conversely, the composition of population aged 0-14 years has steadily decreased from 23.2% in 2022 to 22.6% in 2023. Average age of Malaysian population is expected to reach 34.1 years in 2030, up from 28.2 years in 2015. This indicates that Malaysia is experiencing population ageing.
According to the UN, the pace of population ageing in many developing countries especially in Asia today is substantially faster than what had been experienced by some developed countries in the past. To put things into perspective, the UN has mapped out the time it took for the proportion of the population aged 60 years and above to double up from 7% to 14%:
| Country | Doubling time of population (60 years and above) from 7% to 14% |
|---|---|
| France | 115 years |
| Sweden | 85 years |
| Australia | 73 years |
| United States | 69 years |
| United Kingdom | 45 years |
| Spain | 45 years |
| China | 34 years |
| Thailand | 23 years |
| Malaysia | 20 years |
In 2030, it is postulated that 15.3% of Malaysia’s population will be aged 60 and above, doubling from 7.9% in 2010, making Malaysia one of the fastest nation to achieve aged country status (within 20 years).
The crossroad between population ageing and declining fertility rate
*source: EMIR Research
At one end of the spectrum, partly due to improved socioeconomic conditions and advances in health care, we are seeing longer life expectancy of our population. This in turn contributes to the ageing population in most countries across the globe.
At the other end, there is rapid decline in total fertility rate with parents having fewer children, and increased female participation in higher education and workforce. According to World Bank data, the latest reported data on fertility rate for Malaysia in 2021 is 1.8 births per woman. This rate puts us below the replacement level fertility.
Replacement level fertility is a level of fertility at which a population exactly replaces itself from one generation to the next. Simply put, the children born into a family would replace their parents in the population. Malaysia’s fertility rate had for the first time dipped below replacement level in 2016.
The dangers of population ageing
Population ageing poses the dangers of deteriorating health condition and increased risk of falling into poverty. Based on findings from the Laboratory of Social Gerontology at Malaysian Research Institute on Ageing (MyAgeing) at Universiti Putra Malaysia (UPM), Malaysia has yet to be ready to enter the ageing nation phase. We are still lagging behind in terms of infrastructure facilities to cater to the need of people in various age groups including senior citizens.
More and more Malaysians are pessimistic about ageing and the prospects of life in retirement. On a personal level, many can’t afford to retire. Soon, retireees will outnumber working-age population. To the economy, the reduction in working-age population reduces labour force productivity and this in turn slows down economic growth. The already existing problems such as lack of professional caregivers, burdens on public healthcare and social protection for senior citizens are yet to be addressed comprehensively.
According to a survey on aging conducted by Ipsos in Malaysia in 2018, 76% of respondents agreed that the responsibility to take care of the elderly falls on the younger people. Elderly care is an intricate issue that is deep seated into our culture and the mindset around it could contribute to the underdevelopment of social services for the elderly. The inverse demographic pyramid, sometimes dubbed as “the silver tsunami”, where the younger age group is smaller than the elderly would surely put a burden on the latter.
Menopause & midlife healthcare: a key to support the elderly to strive and sustain livelihood
As Malaysians age, the risk of non communicable diseases (NCD) increase. Addressing menopause-related health issues is essential in mitigating the impact of NCDs in aging women. Many women worry about dying from cancer especially breast cancer. However, the biggest killer and cause of disability in Malaysia for both men and women is cardiovascular disease i.e. heart attacks, strokes and other heart related issues.
*source: Department of Statistics Malaysia (DOSM)
*source: Department of Statistics Malaysia (DOSM)
The alarming risk of high blood pressure, diabetes, high cholesterol and obesity are on a dramatic rise. It is estimated that 1 in 5 adult Malaysians are living with diabetes, 1 in 3 are living with hypertension, and nearly half are overweight or obese (National Health and Morbidity Survey, 2019). The growing prevalence of NCDs is placing an increased strain on the country’s health system.
Women spend at least a third, if not half of their lives in the menopause. Menopause is closely linked to an increased risk of NCDs, such as cardiovascular diseases, osteoporosis, and type 2 diabetes. The hormonal changes that occur during menopause, particularly the decline in estrogen levels, can lead to adverse effects on a woman’s health.
*Hypothetical graph of changes in cardiovascular risk factors related to chronological aging versus ovarian aging over the menopause transitionWith chronological aging, changes in CVD risk factors over the menopause transition are linear. On the other hand, with ovarian aging, inflection points can be identified around the perimenopausal stage, where the worsening of CVD is steepest during this period.
Estrogen plays a critical role in maintaining cardiovascular health by regulating cholesterol levels and promoting the elasticity of blood vessels. Its decline can result in higher cholesterol levels and increased arterial stiffness, elevating the risk of heart disease. Additionally, reduced estrogen levels contribute to decreased bone density, making postmenopausal women more susceptible to osteoporosis and fractures. Insulin resistance, which can develop or worsen during menopause, also heightens the risk of type 2 diabetes.
In summary, Malaysia is rapidly transitioning into an aged nation, with significant implications for its population’s health and socioeconomic structure. This demographic shift, characterized by a growing proportion of elderly individuals and a declining fertility rate, presents unique challenges, particularly in healthcare and economic productivity. Addressing menopause and midlife health issues, especially the management of non-communicable diseases, is crucial for supporting aging women and mitigating the broader impacts on the healthcare system. As Malaysia approaches this demographic milestone, proactive measures are needed to ensure the well-being and sustainable livelihood of its aging population.
