If you visit Japan in 2017, you will be startled to see so many people across society who recognize themselves as the first “super-aged” society. And it’s not just leaders in government, business, and academia, but the general population. “Super-aged” has shot from esoteric theory to common sense in Japan, capturing the notion of aging of Japanese society defined not only by longer lives, but by the remarkably low birthrates: over 40% of the population already over 50, the fastest growing demographic over 80.
In the matter of aging, Japan is the future.
Take technological innovation – the robotics, artificial intelligence, computerization of most everything, including their toilets. These “autonomous” technologies are filling in for the cohort of younger workers that simply were never born. And, fueling a “silver economy”, from caregiving to exercise. For any visitor to Japan, there’s something fascinating and even exciting about seeing a nation prepare for an aging society.
But then there’s the darker side, the one that recognizes for the foreseeable future that dementia (which includes Alzheimer’s ) has already become their health, social and fiscal nightmare. By 2020, Japan will sell more adult than baby diapers, and this isn’t only because of the scarcity of infants.
It was therefore not surprising that, on his 10th anniversary celebration of becoming CEO of Alzheimer’s Disease International (ADI), Marc Wortmann would pick Kyoto, Japan to hold this year’s annual conference. And, while the conference attracted thousands of attendees from over 100 countries – including the U.S., across Europe, Australia, China and Nigeria – over 95% were Japanese. The local population swarmed in from Japan’s multitude of local Alzheimer’s chapters, coming with elderly parents, many “living with Dementia,” and often from the growing phenomenon of “Dementia-friendly Communities.”
From ADI, a few critical takeaways emerged:
• People “living with dementia” all around. This is a truly new development, and it begins to give one a sense that we have entered a transformative phase in the politics of Alzheimer’s. Like HIV/AIDS, which is the model disease for how to use political attention to gain money, research, and cures – Alzheimer’s has reached this turning point. Also like HIV/AIDS, which got Dr. Peter Piot heading up UNAIDS to become the catalyst for that disease’s political and funding support trajectory, we met in Kyoto Yves Joanette, Chair of the recently formed World Dementia Council (WDC), itself an output of the G7 political commitment to curing Alzheimer’s during Prime Minister Cameron’s leadership in 2014. If Joanette is Alzheimer’s Piot, the genius of the WDC is that it has representatives not only from government, research, the academy and NGOs, but also someone living with dementia.
• Global momentum continues to accelerate. In Kyoto, there were leaders from the World Health Organization in attendance to foreshadow a forthcoming inflection point this month, when the WHO’s Assembly will convene in Geneva to pass “The WHO Global Action Plan on The Public Health Response to Dementia.” This will be only the second time ever, joining HIV/AIDS, for the WHO to take such a step for a particular disease. Then there were the five new members brought into the ADI network – Bolivia, Gibraltar, Kenya, Namibia and the United Arab Emirates -- which is the reaction to the unfortunate truth that Alzheimer’s Disease is a global burden, reaching 135 million, costing over a trillion dollars in a few years. By mid-century, 19 million people will be living with Alzheimer’s in Latin America, surpassing the 16 million in Europe. And the 63 million people with dementia in low- and middle-income Asian countries, including of course China, will outpace every other region. Even in Africa/Middle East, their 12 million with dementia will be more than the 11 million here in the U.S. and Canada combined. No wonder, then, there was also the launch at this year’s ADI of the G7 Dementia Innovation Readiness Index, which measures G7 countries’ innovation environment for prevention, cure, treatment, and care of Alzheimer’s that G7 leaders know will be needed globally. Jeff Huber, President of Home Instead Senior Care, the leading global private home care provider said it well, "The Index is a valuable tool for policy makers, scientists, academics and businesses alike because...it creates a platform for...collaboration to advance innovation.” The Dementia Innovation Readiness Index will track progress among the G7 societies on many, but including critical factors of “earlier detection and diagnosis,” progress on “national plans” and even the “basic science” itself.
• Elder caregiving is at the heart of progress. It would have been impossible to walk around the Kyoto Convention Hall and not be impressed by the powerful role elder caregiving plays in dementia, which only increases as prevention and cure continues to elude us. But the innovation in this space is as profound as any in prevention and treatment. One such session was “Skin Health: A New Frontier to Improve Quality, Costs and Care for Older Adults with Dementia.” Led by Dr. Akihiko Ikoma, Medical Director, Nestle Skin Health SHIELD Tokyo, Dr. Toshiya Ebata, Chitofuna Dermatology Clinic, Tokyo, and Hao Luo, Assistant Professor at China’s Tsinghua University and of the Pine Tree Elder Care Company in China. New research was unveiled connecting dry and skin itch, pruritis and xerosis to Alzheimer’s Care where it had previously been misdiagnosed as agitation. And then we saw the new “Itch Tracker” for Apple Watch. Of course, there was also the discussion in another session that connected that Dementia-Friendly Communities movement to outcomes around independence and quality of life.
As I left Kyoto, returning to New York City, I was struck that this year’s ADI will be seen as a tipping point, from the vantage of 2025 – the declared date by the WHO, the World Dementia Council and even tracked through the new Global Coalition on Aging/Alzheimer’s Disease International Index. Stay tuned!