Taxes and the greying population

It’s the annual e-mail I dread as my accountant requests an appointment.

It’s time to discuss tax and nothing good can ever come from this meeting.

At the same time, I need to revise my retirement or annuity contributions and make the appropriate adjustments.

One day you may regret not going on that cruise or buying that Mini.

But then the wise men and their asset managers will warn you about retiring and dying in poverty or being dependent on your children.

We all have an idea when we want to retire, but when will we die?

The greying population is a recent term that describes the steady worldwide increase in the percentage and number of older people in populations.

The number of people above the age of 60 will double in the next 30 years and those above 80 will triple in that same time.

This is due to a combination of factors, including a decrease in fertility rates and a significant rise in life expectancy.

Though this trend began in the developed world, the developing world is following the same pattern and today more than 60% of the aged are living in the developing world.

If you are born in Africa today your life expectancy would be 23 years longer than in if you were born in 1950. For Asia, the figure is 30 years.

Another pattern is an increase in the aged living independently. On average, only 20% of the European and North American aged population co-reside with the rest of the family whereas the figure is about 50% for the developing world.

Many countries have started to address the socioeconomic problems that are presenting due to this process.

Housing, health care and social protection need to be managed. Changes are being made to the age of retirement and flexible employment options are being created.

Pension systems also need a rethink. Migration has been seen as a possible way to resolve dwindling numbers of young labourers and immigration legislation is being adapted.

Japan has the world’s most aged population — 33% of its citizens are above the age of 60. The average couple has only 1.4 children, well below the 2.1 needed to replace the next generation.

The Japanese have turned to mechanisation and robotics to replace their workforce. It is not strange to find a robot in an old age home in the role of the caregiver.

Age-related diseases are on the rise as a direct consequence of our increasing life expectancy and osteoporosis is gradually becoming a more important and relevant disease.

Osteoporosis means “porous bones” and it increases one’s fracture risk from minimal trauma.

This is called a fragility fracture.

Humans achieve maximal bone strength in about their mid-twenties and then there is a slow decline with increasing age.

But there are a number of factors that increase one’s risk of developing it earlier or to a worse degree.

It is also a silent disease because it is usually an incidental finding during the evaluation of a patient presenting with a hip, wrist or spinal fracture after a fall.

It is advised to screen for osteoporosis or osteopenia (its precursor) by doing a DXA bone density assessment test.

This is a radiological assessment that compares your bone density to that of a race and gender-matched person of your age and also to that of a young adult at peak bone density.

For the average low-risk female, screening would start at 65 and at 70 for males.

The National Osteoporosis Foundation of South Africa has a wonderful tool on its website (osteoporosis.org.za) where you can assess your own risk.

Some risk factors are inherent such as genetical susceptibility, age, race, sex and menopausal status.

Others are lifestyle-related like smoking and alcohol use, lack of exercise, low weight and poor diet.

Deficiency in Vitamin D and calcium intake, often related to a poor diet, is a big factor.

Medical conditions such as rheumatoid arthritis and drugs like corticosteroids also increase risk.

Lifestyle changes are clearly the best way to prevent, or delay, osteoporosis in our ageing population.

Regular weight-bearing exercise, limited alcohol and smoking and a diet full of calcium and Vitamin D is essential.

Consider asking for a DXA if your risk is high, and if diagnosed discuss all your treatment options with your doctor.

Also, assess if some of your risk factors are modifiable as well as ways to modify them.

They say that there are two inevitable things in life — death and taxes.

It seems to me that only one of these has a deadline. So pay Caesar what he is due and live each day to the fullest.

• Dr T is a registered medical practitioner working in Nelson Mandela Bay