Abstract
We are very grateful for the interest shown in our published article and for highlighting the relevance of this topic in our society. It is true that older adults will represent a large proportion of the global1 and Mexican2 populations; consequently, we share the urgency that older adults should have guaranteed access to the health system and be treated with both quality and compassion.
Although we agree with the general idea of the comment, we regret to point out that we do not agree with certain arguments, such as assuming that all older adults are frail or that the health system’s goal should be to ensure they are “in their right mind.” These assertions reflect an ageist and prejudiced view of this population group. We therefore take this opportunity to emphasize that we must consciously and continuously fight against ageism in the scientific literature. While it is true that there is frailty at this stage of life, it is not exclusive to older adults and can be mitigated with actions such as physical activity and a healthy diet.3,4 Additionally, in Mexico, frailty is estimated to range between 20% and 35%,5-7 depending on how this health issue is measured. Therefore, stating that aging implies frailty is not entirely accurate. Regarding cognitive decline, findings indicate that only a small proportion of older Mexican adults present this condition,8,9 making such assertions imprecise once again.
As for the preference for private over public health care, this may be due to organizational barriers in the health system, such as service saturation, lack of resources, or long waiting times,10 in addition to system fragmentation and affiliation difficulties.11 Therefore, adapting the health system to the demographic transition occurring in our country is vital to ensure adequate healthc are for this population group.12 In this regard, the health system could overcome the vulnerabilities (poverty, marginalization, social isolation, informal employment, etc.) faced by some older adults, fulfilling its role as an intermediate social determinant13 through which health equity and population well-being can be achieved.
We appreciate the shared vision of establishing a health system that meets the needs of older adults. All this evidence contributes to drawing the attention of decision-makers and promoting specific actions to address this situation.