The demographic shift is a global phenomenon, but particularly critical in East Asia and Pacific which is aging faster than any other region. In December 2016, Bayer therefore initiated a stakeholder dialogue event in Singapore entitled “Transforming Aging with Health Innovation” with the focus on the Asia Pacific region. Chaired by Dr. Amy Khor, Senior Minister of State from the ministry of health in Singapore, this forum brought together high-level stakeholders from across the region to further shape the discussion about the challenges and opportunities of an aging society.
On this occasion Bayer in collaboration with the National University of Singapore launched the open innovation program Grants4Apps Singapore. This global crowdsourcing initiative helps to foster and support innovative digital health technology by challenging developers, startups and entrepreneurs. Its focus in Singapore is to find innovative solutions to improve medication adherence in elderly people with chronic medical conditions.
Health innovation such as new medicines and healthcare technologies has an important role to play in addressing the challenges in our aging societies. Besides helping people live longer, health innovation can also help people live healthier and more productive lives. The forum’s panel discussion on “Transforming Aging with Health Innovation” has exactly addressed this topic. It was broadcast on Channel News Asia as an episode of their series “Perspectives”, a dedicated TV format focusing on societal themes. Join us in the discussion with the experts:
Voices on Aging from the Experts
We have asked the experts to give us a statement on their view on Healthy Aging. Learn more about the challenges an aging society has to tackle:
Medication adherence in elderly people
One crucial component in the treatment of chronic diseases is medication adherence. It is defined as “the extent to which a person’s behavior agrees with the agreed medication regimen from a health care provider”. Non-adherence has always been a problem among patients – approximately 50 % of patients do not take their medications as prescribed. And this is not only causing treatment failure but also higher costs and thus consequences for health care systems. Health care providers are faced with a unique set of problems working with patients, various and countless and especially critical for people over a certain age.
Get an impression on how far-reaching the topic of medication adherence is for elderly people and learn more about a few important factors:
With a degrading vision it’s even harder for elderly people to read through medical information or to distinguish between similar looking tablets.
With lower cognition elderly people have problems handling and following the medication regimen e.g. remembering what medicine to take, when and how.
Elderly are prone to multiple comorbidities and thus at a higher risk of polypharmacy which results in a higher number of medicines and an even more difficult medication regimen.
Elderly often have to spend a big amount of their retirement for their medicines, even more with multimorbidity.
The lower ability of elderly to open medication packages as well as to break the tablets or other drug handling is often causing non-adherence.
The demographic shift in Asia Pacific
The world’s population is facing a demographic shift. This phenomenon is varying from region to region, depending on respective fertility rates as well as life expectancies. Learn more about this fact in Asia Pacific:
Our commitment to Healthy Aging also takes us to Brazil where the demographic shift will soon become more noticeable as the fertility rates continue to decline and longevity increases. This combination means that the population growth rate is slowing while the number of elderly people in the country is steadily rising.
Right now, the Brazilian population is still relatively young in comparison to other countries – the number of people aged 65 and over is just 8% of the population, or 16.5 million people. However, the trend shows that this is set to change over the coming years. By 2050, the number of people aged 65 and over is predicted to almost triple to 23%, or 53.3 million people.
Our event in Sao Paulo, “Longevidade No Brasil – Envelhecimento Saudável Em Evidência” (Longevity in Brazil – putting healthy aging in the spotlight), brings together prominent members of Brazilian society to share their experience and work on the topic of aging. We also invited a patient to speak about their personal experience with aging while living with a chronic disease, as well as an internal expert who discusses Bayer’s contribution to the issues of an aging population.
Voices on Aging from the streets of Brazil
We went to the streets of Sao Paulo to ask the public how they felt about getting older. Have a look at our videos to see how they responded:
The demographic shift in Brazil
The intensity of the demographic shift varies from region to region. Its impact in Brazil over the upcoming decades will cause an enormous change in society. Read more about the demographic shift in Brazil:
China is currently the largest population in the world with a total population of 1.4 billion in 2017. It also belongs to the top ten largest countries in the world with the lowest fertility rates. In 2015, the percentage of the total population over the age of 65 was 9.7%, this is predicted to reach 26.3% by 2050 – almost a threefold rise.
Our commitment to Healthy Aging raises awareness of healthy aging through Chinese media outlets in support of the Chongyang Festival. This traditional Chinese festival originates from ancient times and focuses on good health and longevity and is designated “Seniors’ Day” in China. It’s used as an opportunity to visit elderly relatives in the harvest season – in 2017 the day falls on October 28th.
The demographic shift in China
As the world faces a demographic shift, take a look at how China’s population is changing due to longer life expectancy and low fertility rates:
Globally, the population aged 60 or over is the fastest growing. Europe has currently the greatest percentage of its population in this sector, over 24 per cent. In June 2016, Member of European Parliament (MEP) Lambert van Nistelrooij hosted a Bayer initiated stakeholder dialogue on “Harnessing new ways to empower healthy aging in Europe” at the European Parliament in Brussels. Together with our stakeholders, Bayer is helping change public perception of healthy aging by acknowledging and tackling the challenges of a demographic shift and aging worldwide.
Ask the Experts
Our Healthy Aging interview series asks experts from Non-Governmental Organizations, Governments, industry and digital landscape on what Healthy Aging means to them.
Q: Can you tell me about the International Federation on Ageing (IFA)?
A: The IFA is a global non-governmental organization and is a global point of connection of experts and expertise that work to influence and shape age-related policy. It is one of only a few organizations in this field with general consultative status at the United Nations and its agencies.
Q: How has aging changed over the last 50 years?
A: Healthy aging is being redefined. It is no longer the presence or absence of diseases, but rather the process of developing and maintaining functional ability that enables well-being in older age. The new narrative that describes aging recognizes two interrelated factors: all of the physical and mental components of a person and the environment in its broadest sense.
At the heart of the new narrative is the process to enable older persons to do what they value through developing strategies and actions that support maximum functional ability. Three key areas are: prevention, access to health and social care services, and timely and appropriate treatment.
Q: How is the IFA helping to raise awareness on healthy aging?
A: IFA together with academia, industry, government and NGOs have a responsibility to not have the discussion about healthy aging and the burden of older people, but to take rather a proactive approach to maximize the social and economic contributions of all – regardless of age.
Being able to do what you value is the call to action for all. The IFA is committed to being a driver of change in helping to raise critical issues with industry, government and other public sectors on multidisciplinary approaches about growing older in a global world.
Q: How does working with industry help?
A: Industry brings to the conversation table a unique cadre of intelligence that together with views and evidence from other stakeholders is critical to the future development of effective policies. This may enable older people to do what they value in life. Maximizing functional ability is vital regardless of age and diagnoses.
Q: Anything else that you’d like to add?
A: Ageism is in the most insidious and invisible ‘ism’ of our time. Without clear concerted action it will undermine the rich fabric of our society and contributions of people of all ages. Older people are particularly vulnerable to societal and generational stereotyping which inhibits their opportunity to contribute in ways not yet realized. It’s time to take ‘age’ out of the conversation of being a valid and legitimate member of society and focus on creating an environment that enables function.
There is need to ‘reset’ our thinking and actions on the demographic shift and determine how to influence and shape future age-related policies.
To learn more on Healthy Aging and what you can do, please visit the International Federation on Ageing website.
Q: Can you tell us about Medlanes?
A: Medlanes is an on-demand healthcare app that enables clients to connect with a wide range of doctors and specialists that are ready to come, diagnose, treat or help you with almost any medical problem no matter where you are.
Q: Do you believe a health app like Medlanes empowers a younger generation to think about healthy aging?
A: Absolutely. Digital in general is helping to connect a younger generation to the idea of maintaining their health, whether this is through apps, smartphones or wearables. And through digital enablement, the younger generation is arguably the most empowered generation: a generation that has a unique opportunity to take more responsibility for their health.
Q: What is your view on how the young view aging and how aging has changed over the last 50 years?
A: I believe that young people, when they think about getting old, they think about what they perceive old to be: getting sick, being house bound and not living the life you once did. However, over the last 50 years, we’re seeing that it’s possible to stay healthy for a much longer period of time due to modern advances in medicine. So I don’t think younger generations dread aging as much as previous generations did because they’re seeing their parents live longer, fuller lives.
Q: What do you think the future of healthcare looks like?
A: I believe the future of healthcare is digitalization combined with novel, advanced treatment options. Through digital, people are becoming more empowered and are able to take more responsibility for their health. In the past, you had to go to the doctor and the doctor told you what was potentially ailing you. But now, through apps and connected devices, patients can take more responsibility for their own health – whether that’s through an app like Medlanes that connects you to doctors or a smart device telling you when to stand up, run or take your medicine.
Q: So you believe digital health can make healthcare more accessible?
A: Yes, digital health has the unique opportunity to make quality healthcare accessible and ultimately better – regardless of age, location or time – by connecting healthcare providers to those in need as soon as they need it.
Q: How has aging changed over the last 50 years?
A: In 50 years we’ve improved global life expectancy by roughly 20 years. But, our overall health – that is being healthy later in life – has not really improved. In the future, we envision a patient-centered approach that enables individuals to be more empowered and take more direct control of their health.
Q: How is Bayer helping tackle the demographic shift?
A: With the world population facing a demographic shift, one of the areas we’re seeing an increase in is the number of cancer patients. By exploring treatment approaches that can offer meaningful progress to doctors and patients battling the toughest cancers, Bayer has tripled its oncology pipeline over the past three years by prioritizing treatments that show promise for hard-to-treat cancers.
Q: What else is Bayer doing?
A: We have a responsibility to work on prevention as well as researching and developing new treatments – but this needs to be a joint effort. We believe that solving healthcare problems requires partnerships, collaborations and a broad approach in terms of education. This is why we’re helping to stimulate the debate around healthy aging with governments, NGOs and industry.
For example, we’re partnering with the International Federation on Ageing and the International Agency for the Prevention of Blindness to ensure more patients get access to proper eye care, especially the most vulnerable and most in in need.
Q: How do you involve young people in the discussion on aging?
A: We’re taking a broad approach that involves everyone including today’s young people. We need to help young people understand a bit earlier that they can take action today to improve their health later on in life. The choices that we make when young will determine how healthy we will be in our old age.
Q: What is your view on prevention?
A: Prevention is an indispensable part of the value chain that helps contribute to a new healthcare paradigm. Healthy lifestyles, timely diagnosis and intervention are critical for delaying the onset of chronic diseases. And it will be the responsibility of all concerned stakeholders, including patients old and young, to actively take part in this endeavor.
Q: Can you tell us about the Social Progress Imperative?
A: The Social Progress Imperative works with partners to help increase awareness on social progress being as important as economic growth or gross domestic product (GDP). Our network consists of partner organizations in business, government and civil society that use our so-called Social Progress Index to improve human wellbeing and guide social investments.
Q: What is the Social Progress Index (SPI)?
A: The Social Progress Index complements the measure of national performance using traditional economic measures such as GDP with data on social and environmental performance. The Index measures the extent to which countries provide for the social and environmental needs of their citizens and defines social progress as the capacity of a society to meet the basic human needs of its citizens, establish the building blocks that allow citizens and communities to enhance and sustain the quality of their lives and create the conditions for all individuals to reach their full potential.
Q: How does the social progress index measure health?
A: There are two components in the index that we use to measure health. One of the components is around nutrition and basic medical care, which deals with some of the issues around child mortality, maternal mortality and nutrition. The second component is on health and wellness. That is, how are countries dealing with health issues. One of the toughest challenges for social progress is on the health and wellness component, which does not tend to improve as countries get richer.
Q: How has aging changed over the last 50 years?
A: We have seen that life expectancy has increased over the last 50 years and represents one of the crowning achievements of the last century, but also presents significant challenges. Societal aging may affect economic growth and many other areas, including the ability of states and communities to provide infrastructure, resources and healthcare services for older citizens.
Q: How do we begin the discussion on aging?
A: We need to partner with industry players like Bayer; NGOs like the International Federation on Aging; and governments at all levels and confront this urgent global challenge so we can define how we’re going to measure, track, improve, innovate and lead the discussion on health and aging.
Q: What can governments do to help raise awareness on healthy aging?
A: Governments can help raise awareness on aging issues by having a targeted policy dialogue that will help address the multi-faceted needs of an aging population.
Q: Aging has changed over the last 50 years. Are you now seeing aging impact communities?
A:Yes, health costs are rising and we have to deal with a demographic shift in our society. The current ratio of working population to old is four to one. By 2050, it will be two to one. This demographic shift will challenge us, but it also represents an opportunity to introduce structural changes to healthcare systems.
Q: How do you see the role of partnerships?
A: I believe partnerships are very important. Healthy aging requires all of us to work together, from government and NGOs to industry and digital. We all have to put our heads together to solve this ever complex topic.
Q: Can you tell us a little bit about the European Innovation Partnership on Active and Healthy Aging?
A: The European Commission has identified active and healthy aging as a major societal challenge common to all European countries, and an area which presents considerable potential for Europe to lead the world in providing innovative responses to this challenge. The European Innovation Partnership on Active and Healthy Aging ties in to the European Commission’s challenge and aims to help promote European competitiveness that addresses societal challenges through research and innovation.
We aim to do this in three ways:
- Enable EU citizens to lead healthy, active and independent lives while aging.
- Improve the sustainability and efficiency of social and healthcare systems.
- Boost and improve the competitiveness of the markets for innovative products and services, responding to the aging challenge at both an EU and global level, thus creating new opportunities for businesses.
Q: You recently wrote a booklet called, “Road to the Valley.” Could you elaborate a bit on this concept?
A: The “Road to the Valley” is about how our European cities should create knowledge and innovation clusters in every community that brings likeminded people together, whether it’s in health, digital or other innovations. I believe by focusing on “the Valley” we can bring people together to help solve tomorrow’s problems today.
One example of using the “Road to the Valley” approach is the program “Lifelines” in Groningen, Netherlands. This program is using three to five generations of family health data to detect which diseases occur among the participating families. This research will help predict the quality of life and preventive measures that may need to be taken to address possible genetic predispositions, whether that’s through prevention or therapeutic means.
Voices on Aging
Through research and development, Bayer is aiming to help an aging population live a life that is as active as possible. And through targeted awareness activities, younger generations can take steps to help prevent diseases, so they remain healthy later in life.
When it comes to aging, you’re not alone. Learn more about aging from people just like you in our video series Voices on Aging:
The demographic shift in Europe
The world’s population is facing a demographic shift. This phenomenon is varying from region to region, depending on respective fertility rates as well as life expectancies. Learn more about this in Europe:
The intersection of digital and aging
The next stop of our Healthy Aging journey lands us in Finland where we join the Digital Silver Forum which discusses the combination of two global megatrends: digitalization and aging societies. Attendees range from public policy experts to corporate leaders and entrepreneurs, all connecting to explore opportunities in the digital world to help with the needs of aging populations.
Digitalization of our healthcare systems
Digitalization has a huge impact on the way our healthcare systems are run. We are seeing the introduction of apps and wearables, giving consumers the chance to closely monitor their health. The ability to harness technology creates opportunities to provide services and solutions for the aging population. Accompanying us to Finland are two companies that are doing just that – Sky Labs and GlycoLeap are both winners of Bayer’s Grants4Apps program from the APAC region.
Digital solutions save money
Accenture estimates that that FDA-approved digital health solutions managed to save the United States USD 6 billion in 2014. Savings were primarily driven by medication adherence, changes in behavior and fewer visits to the emergency room. Lack of medication adherence is an issue that is common in older patients who often find it hard to juggle multiple medicines and prescriptions. This cost saving is expect to rise significantly to USD 18 billion for 2016 and USD 50 billion in 2018 as digital health solutions offer more ways to manage everyday healthcare and lifestyle.
Voices on Aging from Finland
We asked older people from Finland on what they value in their old age. See what they said here:
The demographic shift is already at a very advanced stage in Germany. Therefore it is not surprising that Germany is currently the second oldest country in the world, after Japan. Life expectancy continues to rise while the birth rate remains low, with the result that the proportion of elderly people in the population has been growing consistently for a long time. This has enormous consequences for our societal coexistence.
For this reason, Bayer is also continuing its global initiative on the topic of Healthy Aging in Germany. At the annual press conference of Bayer Vital in August 2017, the discussion continued on healthy aging as it relates to the demographic developments in Germany and the effects on society. Among the speakers was guest of honor Prof. Dr. Bertram Häussler from the IGES Institute in Berlin, who spoke about the development of life expectancy and quality of life in Germany in the past century.
Voices on Aging from the Experts
Learn here more about the topic of Healthy Aging from our German experts:
The effects of the demographic shift on society
The demographic shift affects many different areas of society. Our present conception of coexistence is going to change, and we need to find new paths and approaches. Learn more about the wide-ranging effects of demographic change.
The demographic shift is effecting a great transformation of both the health and care systems. Because the expenditure per head rises sharply with increasing age, statutory health insurance bodies, together with care insurance, are faced with higher expenditures at the same time as revenues are dropping due to the reduced number of paying contributors. In Germany, the statutory pension scheme provides the basis for caring for elderly people in retirement. As a result of the demographic shift, there are fewer workers paying into the system but more people who are entitled to a pension.
The demographic shift leads to a decrease in the proportion of the population that is working. Thus, in order to maintain the gross domestic product, productivity must be increased. There will be less work in the production sector, with the result that consumer goods will have to be imported from younger foreign countries. This in turn increases the demand for capital. The financial and tax systems are also affected, because working and consuming behaviors altered by the demographic shift will be accompanied by changes in tax revenues.
Consistently low birth rates mean that our population will shrink in the long term. This will also affect the number of households and thus the housing market. Additionally, due to the higher proportion of older people, in future the housing market will have to cater more specifically to their particular needs. Assisted living, barrier-free access and elevators in multi-story houses are examples of aspects of age-appropriate living that have to be considered when building or converting residential spaces.
Over the long term, the demand for facilities, personnel and finances in the education system will be altered by the demographic shift. Additionally, the population decrease entails a drop in the number of highly qualified workers.
The demographic shift in Germany
The world’s population is facing a demographic shift that varies in intensity from region to region. Learn here more about this phenomenon in Germany.
Japan is the oldest country in the world. The median age is steadily increasing and shows no sign of slowing over the next 30 years – by 2050 it is expected to reach 53.2 years1.
According to the World Health Organization (WHO), the average life expectancy in Japan is 84.2 years, ranking 1st in the world, while healthy life span is 74.8 years, ranking just second in the world after Singapore2. In 2007, Japan was the first country to be named a super-aged society with more than 20% of the population aged 65 and older. Today this percentage has climbed to over 27%3.
It is therefore fitting that we take our activities to Japan where we are keen to promote a new angle to complete our holistic approach to Healthy Aging. We have seen the benefits of increasing awareness for healthy aging through diet, exercise, brain training and mindfulness, and this time we look at how communication is vital to healthy and happy aging.
From a psychological perspective, the isolation and loneliness that some older people experience can negatively impact their quality of life. Similarly, for younger generations who may be unsure about how to care for their aging parents, a lack of dialogue and information here can be a source of worry.
We conducted a survey on “aging, health and communication” to understand the importance of conversation to help combat loneliness and anxieties in older persons and promote healthy aging. We found that almost 70% of adults aged 65 and over felt anxious about getting older, with the top three worries being: the loss of physical strength, requiring nursing, and losing independence in day-to-day life. Despite these concerns, less than 50% of the people we spoke to talked openly about aging or age-related health concerns with their family, friends or doctor.
We asked two families to share their stories and chat openly about their concerns related to aging; here are the videos we made of them on the occasion of our event in Japan:
The aim of our activity in Japan was to motivate older persons to communicate openly with their friends, families and healthcare professionals. We found that seniors who talked openly about aging were happier as they tended to be more informed about the importance of age-related disease prevention and treatment, as well as having higher emotional support from friends and family.
1 United Nations, World Population Prospects: https://esa.un.org/unpd/wpp/ Last accessed September 2018
2 World Health Organization, http://apps.who.int/iris/bitstream/handle/10665/272596/9789241565585-eng.pdf?ua=1
3 The World Bank, https://data.worldbank.org/indicator/SP.POP.65UP.TO.ZS?end=2017&start=1960&view=chart Last accessed September 2018
Portugal is already a relatively old country with 20.7% of the population aged 65 or over in 2015. This is expected to rise, alongside the worldwide trend, to 35.6% by 2050. The UN estimates that Portugal will be the European country with the smallest proportion of children with just 11.7% under the age of 15 in 2050.
Taking action to promote Healthy Aging is important to us and in Portugal we hosted a range of events to support awareness for the topic. Starting in October and November, we conducted 2 roundtables with a range of diverse stakeholders in different areas of the country to dive deeper into the topic. Following this, we held a working meeting made up of a number of different industry sectors in order to brainstorm disruptive ideas to foster Healthy Aging. This culminated in a hackathon in January 2018 to discover innovative ways to promote Healthy Aging.
The demographic shift in Portugal
See how the demographics of Portugal are changing:
Vietnam is a young country, but projected to undergo a demographic transition marked by slowing population growth and aging. As the percentage of people aged 65 and above in Vietnam is set to be almost triple from 6.7% of the population in 2015 to 21.5% in 2050. As in China, Vietnam also belongs to the list of the ten largest low-fertility countries, explaining the growing proportion of older people in comparison to the younger generation.
Bayer partnered with Ho Chi Minh City Public Health Association and VTV9 to organize the dialogue “Is stroke preventable or not?” to mark World Stroke Day on October 29th. The topic is crucial in aging populations and was discussed by Professor Nguyen Huy Thang, Chairman of Ho Chi Minh City Stroke Association, and Tran Thi Lan Huong, Medical Director, Pharmaceuticals Division of Bayer in Vietnam.
The demographic shift in Vietnam
Vietnam also faces the challenges of the changing demographic shift. Learn more about the predicted changes to society over the coming years and how this might affect the ratio of the working to the retired population: