Aging is a natural, irreversible physiological process, which manifests itself differently in each individual.

Healthy aging by definition is a process of developing and maintaining functional abilities that enables well-being in old age.

The World Health Organization defines active aging as “the process of optimizing the opportunities for health, participation and safety in order to improve the quality of life as people age”

The 20th century has been marked by a revolution in longevity. People around the world live longer. The average life expectancy has increased by 20 years from 1950 to 66 years and is expected to continue for another 10 years until 2050. In 2017, almost one-fifth (19%) of the EU’s population was aged 65 and over. By 2050, the global population is expected to reach 2 billion by the age of 60, up from 900 million in 2015. The decline in birth rates and prolonged life is changing the demographic picture in countries around the world.

In the Republic of North Macedonia, the phenomenon of regional aging of the population in rural areas is typical due to intensive migration of young productive population in the direction of village-town. This leads to a very large representation of the elderly in the overall age structure of the rural population versus the urban population.

In general, in the age structure, the Macedonian population is getting older. In the Republic of North Macedonia of the total population, the number of elderly people in 2015 was 264,964, while the number of elderly people in 2018 increased to 287,590. In the period from 2008 to 2018, the share of the elderly population aged 65 and over increased from 11.5% to 14.1%.

In January 2020, the World Health Organization (WHO) announced the outbreak of a new corona virus, COVID-19, to alert health authorities to urgent public health and international care.

Corona virus infection, or COVID-19, is a contagious disease caused by newly discovered corona virus. Most people infected with COVID-19 will have a mild to moderate respiratory illness and will recover without requiring special treatment. But older people and those with chronic problems such as cardiovascular disease, diabetes, chronic respiratory disease and cancer are more likely to develop serious illnesses. More than 95% of COVID-19 deaths in Europe are over 60 years old. The U.S. Centers for Disease Control and Prevention reported that from February 12 to March 16, 2020, the fatality of COVID-19 in the United States was highest in people over 85, followed by people aged 65 to 84.

The Republic of North Macedonia has so far successfully dealt with the COVID-19 pandemic, the linear growth of patients in the last 15 days is encouraging, we have a number of patients approximately equal every day. By continuing this trend or reducing it, the healthcare system will be able to serve the citizens and deal well with the corona virus.

According to the statistical analysis of the Institute of Public Health as of May 9 in RNM there are 1645 confirmed cases of COVID-19, the age of the patients ranges from 0 to 94 years, and the average is 45.2 years. The highest number of patients is over 60 years of age (357 people) or 21.7% with an incidence of 93.1 / 100,000, and the highest specific incidence of 124.4 / 100,000 is registered in the age group of 50-59 years (346 patients).

Distribution of COVID-19 patients by age groups, (n = 1.642)

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91 deaths were registered (Lt = 5.5%). Of the registered deaths, most are over the age of 60 (n = 59) where the highest specific mortality was registered – 15.4 / 100,000 inhabitants. 61 deaths were reported in males and 30 in females. Of the deceased, 67 (73.6%) had co morbidities

The WHO’s assessment globally and at the European Region level for further expansion of COVID-19 suggests that the risk is still very high.

Older people and people with previous medical conditions, such as asthma, diabetes, and heart disease, are more likely to have serious complications from the virus. Older people do not have a strong immune system, so they are more vulnerable and more susceptible to infectious diseases. They are also more likely to have: diabetes, heart disease, lung disease that weakens their body’s ability to fight COVID-19. Elderly people are more likely to be placed in institutions such as nursing homes or to live in large families where there is a higher frequency of people. They can also have challenges with isolation, inability to get information, food and thus make their daily lives more difficult.

The Ministry of Health and the Commission on Infectious Diseases advises people of all ages to take measures to protect themselves from the virus by practicing constant and good hand and respiratory hygiene as well as using protective masks or scarves when leaving the home.

Older people want to have reliable modern and accurate information, especially about the COVID-19 pandemic. The Ministry of Health of North Macedonia daily tracks the statistics of the Institute of Public Health of RNM on the condition of the pandemic on the national channel and local channels as well as social media, in order to provide accurate and timely information to the elderly and all citizens of RNM.

To protect against COVID-19 and maintain good mental health, the elderly need to use the telephone line to help and support those with cognitive decline, dementia, stress, anxiety or just need to talk and support in moments of isolation or quarantine. . Both the family and the neighbors are motivated to provide practical and emotional support to their older neighbors or relatives.


It is necessary for the elderly during the isolation to reduce the stress by paying attention to their own needs and feelings, to be engaged in healthy activities in which they enjoy and relax.


There is a direct link between diet, physical activity and health. Nutrition is a key factor when it comes to physical and mental well-being. It is also important for disease prevention.

Older people need to be fed healthy restlessness especially during a pandemic where they are the most at risk group, what to eat and drink can greatly affect the body’s ability to fight, prevent and recover from infections.



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Healthy food tips include:

  • A variety of foods, including fruits and vegetables.
  • Daily intake of foods rich in whole grains, wheat, corn, rice, legumes such as lentils and beans in combination with (fish, meat, milk or eggs).
  • For snacks – fresh fruit, raw vegetables and appetizing without salt.
  • Limit salt intake to 5 grams (equivalent to one teaspoon of salt per day)
  • Consumption of moderate and limited amounts of fats and oils.
  • Avoid processed fried foods that contain industrially produced trans fats.
  • Limited and reduced sugar intake: sweet, carbonated drinks, fruit drinks in powder form, flavored water, etc.

A passive lifestyle is usually associated with an increased risk of chronic motion sickness and reduced immune health. For these reasons, physical activity and movement are especially important during a COVID-19 pandemic. Given the meager time for outdoor activities, it is necessary to adjust the conditions in the home for physical activity.

Adults 65 and older

  • You should be physically active for at least 150 minutes with moderate intensity throughout the week, or at least 75 minutes of intense physical activity throughout the week, or an equivalent combination of moderate to vigorous activity.


  • For additional health benefits, they should increase physical activity to moderate intensity to 300 minutes per week, or equivalent.
  • Those with low mobility should do exercises to improve balance and prevent injuries, 3 or more days a week.
  • Muscle and bone strengthening activities, including larger muscle groups, are recommended at least 2 days a week.

The situation with the COVID-19 pandemic affects all people globally, so it is necessary to respect the recommendations of the World Health Organization and the recommendations of the Ministry of Health in order to more easily and quickly reduce the number of patients and victims.

For active and healthy aging, the elderly need to adhere to the recommendations if they have a problem with loneliness to look for their loved ones over the phone or social networks, not to lose touch with family and friends, not to forget about physical activity, healthy diet as well as to be regularly informed about the recommendations and protection against COVID-19.

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Department of Health Promotion and Disease Monitoring