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Fit in the future: Staying healthy in an aging world

May 25, 2018

Globally, aging populations are posing big challenges for healthcare systems; together, new technology and old techniques offer the opportunity to manage them.

Thanks largely to scientific advances, today there are more people aged 60 or older than ever before. Over 900 million1 people, or 12%, of the earth’s inhabitants are in their golden years, and a combination of greater life expectancy and lower fertility rates means by 2050, 2.1 billion people2, or nearly 22% of the population, will be 60 or older.

Increasing life expectancies also mean that the global population of people 80 and older, sometimes referred to as the oldest old, will more than triple by 2050, growing to almost 450 million3. In some Asian and Latin American countries, the number of the oldest old is predicted to quadruple by 20504.

The new challenge for the 21st century

The booming population of older adults is a testament to the incredible developments5 in science and technology over the last century. Vaccines, antibiotics, and improved hygiene have helped keep many infectious diseases in check. Safer conditions both at home and in the workplace also contribute to longer life spans, while new agricultural technologies and a better understanding of nutrition means people can eat better than their ancestors.

However, the increasing life spans made possible by these advances are creating new challenges for science. While the advances of the 20th century had the greatest effect on infectious diseases6, the advances of the 21st century will need to address the problems associated with chronic conditions that are increasingly prevalent among older adults.

Studies conducted in the United States show that about 80% of people over 65 have at least one chronic condition, and 68% have two or more. Among the most common of these conditions are heart disease, lung disease, stroke, cancer and diabetes.7

The trends being seen in the areas of diabetes and hypertension particularly illustrate the increased disease burden we face. Globally the number of people suffering from diabetes has risen from 108 million in 19808 to 425 million nowadays9, with experts warning that 1 in 3 adults10 could have diabetes by 2050. The number of people suffering from hypertension, one of the main risk factors for heart disease and stroke, has almost tripled to nearly 1 billion since 198011, with 41%12 of adults in the United States predicted to have high blood pressure by 2030.

The unseen impact of chronic conditions

While chronic conditions like diabetes and hypertension increase the chance of death in older adults, many people overlook the effect these increasingly common conditions also have on the quality of life of older people. For example, both can have profound effects on an older person’s eyesight.

Diabetic retinopathy, a condition that occurs when high blood sugar levels cause damage to blood vessels in the retina, affects one in three13 people living with diabetes, and one in 10 diabetics14 develop a vision-threatening form of the disease.

Another common cause of blindness among older adults – age related macular degeneration (AMD) – slowly destroys a person’s central vision, the type of vision necessary for tasks like reading and driving. While the causes of AMD are complex, it is also linked to diabetes and hypertension.

Preserving health for a happy old age

Preventing or controlling the types of chronic diseases that afflict an aging population is key to preserving quality of life. In the case of eye problems, WHO estimates 80% of all visual impairment15 can be prevented or cured, and a large part of prevention involves properly managing conditions like diabetes and hypertension through a combination of diet, exercise and currently available prescription medications.

However, advances and new classes of pharmaceuticals are proving more effective at managing or even eliminating some of the most common chronic conditions associated with aging, and breakthroughs in manufacturing mean that existing treatments are becoming more widely available.

For instance, researchers are already exploring genetic sequencing techniques to combat diabetes. However, the gene therapy is not used directly on diabetics. Instead it is used on the bacteria that naturally create acarbose, a substance used in pharmaceuticals that diabetics take to regulate blood sugar. By altering the genes of bacteria to make them more efficient producers of acarbose, scientists can help meet the increasing demand for antidiabetic medications.16

Potential help for older adults goes well beyond pills or injections. In Japan, where more than 25%17 of the population is already over 65, specialized robots called carebots are increasingly being used to assist the older people with everything from turning off lights to moving from a bed to a wheel chair. Carebots are even assisting the growing numbers of visually impaired seniors by reading barcodes on medicine labels, helping to ensure that vision loss doesn’t prevent older people from taking their medications properly.

80 is the new 60

Robotics and medications are only two of an abundance of new developments that will help meet the challenges associated with an aging population. As new innovations aimed at improving the health of older adults become more widely available, it’s possible that subsequent gains in life expectancy may mean that in the future you’ll have to be much older than 80 to be a member of the oldest old.

As comedian George Burns once said, “You can’t help getting older, but you don’t have to get old.

Footnotes

  1. World Population Prospects The 2015 Revision, United Nations, https://esa.un.org/unpd/wpp/publications/files/key_findings_wpp_2015.pdf
  2. World Population Prospects The 2015 Revision, United Nations, https://esa.un.org/unpd/wpp/publications/files/key_findings_wpp_2015.pdf
  3. He, W. et al. An Aging World: 2015, U.S. Census Bureau, https://www.census.gov/content/dam/Census/library/publications/2016/dem…
  4. He, W. et al. An Aging World: 2015, U.S. Census Bureau, https://www.census.gov/content/dam/Census/library/publications/2016/dem…
  5. Who wants to live forever?, Royal Geographical Society, http://www.rgs.org/OurWork/Schools/Teaching+resources/Key+Stage+3+resou…
  6. De Flora, S. et al. The epidemiological revolution of the 20th century, University of Genoa, https://www.ncbi.nlm.nih.gov/pubmed/15923399
  7. Chronic Disease Management, National Council on Aging, https://www.ncoa.org/healthy-aging/chronic-disease/
  8. Diabetes Fact Sheet, World Health Organization, http://www.who.int/mediacentre/factsheets/fs312/en/
  9. http://www.diabetesatlas.org/key-messages.html
  10. Number of Americans with Diabetes Projected to Double or Triple by 2050, U.S. Centers for Disease Control and Prevention, https://www.cdc.gov/media/pressrel/2010/r101022.html
  11. Global Health Observatory data – Raised Blood Pressure, World Health Organization, http://www.who.int/gho/ncd/risk_factors/blood_pressure_prevalence_text/…
  12. Heart Disease and Stroke Statistics 2017 At-a-Glance, American Heart Association, https://healthmetrics.heart.org/wp-content/uploads/2017/06/Heart-Diseas…
  13. Lee, R. Et al., Epidemiology of diabetic retinopathy, diabetic macular edema and related vision loss, Singapore Eye Research Institute, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4657234/
  14. Diabetic Retinopathy, The International Agency for the Prevention of Blindness, https://www.iapb.org/knowledge/what-is-avoidable-blindness/diabetic-ret…
  15. Vision impairment and blindness Fact Sheet, World Health Organization, http://www.who.int/mediacentre/factsheets/fs282/en/
  16. https://www.research.bayer.com/en/treating-diabetes-with-acarbose.aspx
  17. World Population Prospects, United Nations, https://esa.un.org/unpd/wpp/DataQuery/

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