Long live agetech!

October 16, 2023 | Dubai, United Arab Emirates

Digital technology is helping older people live longer, healthier lives

Extending the average lifespan of humankind is among our greatest triumphs. But most people would agree that life is not only about quantity, it is also about quality. And therein lies the challenge. How can we make sure that all those extra years are lived as healthily, enjoyably and rewardingly as possible?

There are eight billion people alive today, according to the United Nations (UN). Around 10% are 65 or over; by 2050, that figure will rise to 16%^[1]. Older people already outnumber the young: in 2020, there were more 60+ year-olds than children under five.^[2] In the next three decades, there will be 426 million people aged 80 and older globally.^[3]

Population aging initially accelerated in high-income countries (30% of Japan’s population is already over 65 years old^{^[4]}) but low- and middle-income countries are experiencing the fastest change—by 2050, they will be home to two-thirds of people over 60 years old.^{^[5]}

Older people can live fulfilling lives while adding significant value to their families and communities. Much depends on health, though. The World Health Organisation (WHO) defines healthy aging as “the process of developing and maintaining the functional ability that enables wellbeing in older age,” stating that “functional ability is about having the capabilities that enable all people to be and do what they have reason to value.”^[6] Research shows that most older adults prefer to live in their existing homes and communities. The US Centers for Disease Control and Prevention (CDC) defines aging in place as “the ability to live in one’s own home and community safely, independently, and comfortably, regardless of age, income, or ability level.” ^[7]

Unfortunately, the longer we live, the more chance of something going wrong with our bodies or minds. Common age-related complaints include hearing and visual impairment, reduced mobility and balance, incontinence, pulmonary disease, diabetes, and cognitive health issues like dementia and depression. And as the list of conditions goes up, so does the bill.

The UK Department of Health estimates the average cost of providing hospital and community health services for a person aged 85 years or older is around three times greater than for a person aged 65 to 74.^[8] This will be exacerbated by the decline of the working population relative to the number of retired people—contributing to a growing care and care funding gap.

“Many countries are experiencing a shortage of paid caregivers, and many families feel the ‘caregiver burden’,” confirms gerontologist Keren Etkins, author of “The AgeTech Revolution”. “In the past, when birth rates were high and life expectancy was low, older adults had many children and grandchildren who could care for them. These days, it is much more common for a family caregiver to be caring for more than one older relative at the same time.”

AgeTech can help

AgeTech, or gerontechnology, has been described as the intersection between technology and the longevity economy.^[9] Put simply, AgeTech is any digital technology designed around the needs and wants of older people, including tech used by both older people and caregivers.

Oxford Economics, in a report for the US-based AARP (formerly the American Association of Retired Persons) defines the longevity economy as the sum of all economic activity serving the needs of older adults. For example, Americans over 50 spent US$ 7.6 trillion on goods and services in 2018, and are expected to spend US$ 27.5 trillion by 2050. By 2030, over 50s in the US are expected to spend over US$ 200 billion annually on tech products^[10].

The Canadian charity Age-Well identifies eight areas where AgeTech can – and in many cases, already is doing – enable older people to live longer, healthier and more fulfilling lives, while also providing caregivers with the support and tools they need to fulfil their roles[11]:

Supportive homes and communities – Enabling older people to live independently in their own home and community through appropriate supports and services. Example technologies include: smart homes, sensors to monitor safety at home, online portals for community groups and programs.
Cognitive health and wellness – Taking a proactive approach to managing the cognitive health issues that often affect older adults and caregivers. Example technologies here include: medication reminders, digital cognitive assessment tools.
Autonomy and independence – Helping older people to maintain their autonomy and independence, even in the face of impairment, disability or illness. Example technologies: assistive technology, stick on hip protectors, rehabilitation technologies, stabilizing gloves.
Financial wellness and employment – Reducing financial vulnerability and workplace exclusion. Example technologies:employment portals tailored for older users and caregivers, financial apps aimed at older users.
Mobility and transport – Providing inclusive transportation systems that make older adults feel comfortable and safe. Example technologies: smart wheelchairs, autonomous vehicles.
Staying connected – Strengthening the social networks of older adults and caregivers. Example technologies: social platforms and apps, social and telepresence robots, hearing aids.
Healthcare and health service delivery – Supporting older adults to overcome challenges like getting to doctor’s appointments, obtaining health records, navigating the system and affording new technologies that improve quality of care. Example technologies: virtual doctor visits, digital health apps, continuous glucose monitors, bed transfer platforms.
Healthy lifestyles and wellness – Encouraging and facilitating a healthy lifestyle by making it easier to make positive choices about nutrition, exercise and self-management of mental and physical health, while also considering social, economic and contextual factors. Example technologies: wearables, virtual access to exercise, fitness apps.

AgeTech is clearly a vast market with huge potential. Covering everything from mobility and finance, to exercise and nutrition, it could have a positive impact on almost every aspect of the lifestyle and wellbeing of older adults. That said, given the physical and medical ailments that affect most people as they age, one of the biggest areas of focus for the AgeTech revolution is healthcare itself.

Telemedicine and remote monitoring, in particular, have increased dramatically over the past two years, boosted significantly by the COVID-19 lockdowns, to the extent that the US Department of Health and Human Services agreed to reimburse telemedicine providers for services provided during the pandemic. Similarly, in the UK, the NHS gifted 11,000 iPads to care homes to enable video consultations and keep residents connected with family members during the pandemic.^{^[12]}

Although usage declined somewhat as pandemic restrictions eased, attitides towards telehealth have undegone a signifcant shift. According to an AARP survey, 32% of adults reported a very high interest in using telehealth for themselves or a loved one.^[13]

There is no shortage of technology providers keen to tap into the potentail of AgeTech, from global players to fast-moving start-ups. Amazon’s Alexa Together, for example, is a subscription service designed to help older adults feel more comfortable and confident to live independently. It includes tools to call for help, an emergency helpline, fall detection, a remote assist option to help manage device settings, and an activity feed for family members to see if someone has been less active than usual. Similarly, Google’s Next Hub Max smart home system includes the option of a more accessible interface that’s easier for older adults to use, helping them feel less isolated.

Some of the most exciting innovation is happening in the startup space. Zibrio’s fall prevention technology, for example, helps to determine if users are at risk from falls, while Nobi’s smart lamp automatically illuminates the floor when someone stands up and alerts caregivers to falls or irregular movements.

Going beyond basic sensors, the latest AgeTech innovations can harness Artificial Intelligence (AI) to analyse multiple data points and provide advanced diagnostics and monitoring without human intervention. For example, Donisi has developed an AI-based remote contactless monitoring system that detects changes in heart rate and breathing patterns in real-time, using optical sensors and infrared light to capture micro-movements on the skin without requiring wires or patches.

Care home innovation is another area where technology can alleviate caregiver burnout and give healthcare professionals more time to interact with residents. Homage builds profiles of caregivers and works with nurses to evaluate their performance at various tasks and match them with patients. Another health care developer, Birdie, is creating software to enable more personalized and preventative care by reducing admin costs and enabling real-time carer check-ins and medication-related notifications.

The potential of AgeTech is attracting more investment than ever.^[14] Over the last five years, venture backers have channeled more than US $2.5 billion into eldercare and home health startups in the US alone.^[15]

The faster potential health issues are detected, the better, which is why some of the most effective AgeTech stays in direct contact with users. So-called ‘wearables’ comprise a large proportion of the market and include fitness trackers, smart health watches, ECG monitors, blood pressure monitors, and other biosensors.^[16] These devices help to identify risks, preempt conditions, and aid recovery, particularly in the transition from hospital to home.

“One of the overarching themes is that [wearables] provide people with a better quality of life, especially when moving from hospital to home. Another is preventative measures. A major driver is mimicking hospital technologies and making them appropriate for the home and basing them around recovery, such as ECG or movement monitoring,” says Jacob Skinner, CEO of Thrive Wearables ^[17], a UK-based wearable technology agency.

AgeTech innovation from Abdul Latif Jameel Health

Abdul Latif Jameel Health is proud to be playing a small part in the development of AgeTech solutions that could help older people to leave healthy, fruitful lives. It has partnered with US-based Butterfly Network to democratize medical imaging with Butterfly iQ+—the world’s first single-probe, whole-body, handheld imaging device. Butterfly iQ+ enables healthcare providers to collect advanced imaging, perform rapid assessments, and guide critical procedures no matter where they are, and share those images seamlessly with doctors across the globe to help with reading and interpreting scans as needed. In appropriatey trained hands, this tech is well-suited to assess patients outside the hospital environment, including the elderly.

“One of the key challenges when developing new AgeTech solutions is overcomig the hurdles to accelerate access. Part of that is about ensuring the regulatory issues are managed efficiently. Then, it is about building the infrastructure to support the launch and educating the healthcare community about the new technology. Of course, the context and the specific challenges will vary for different technoligies and different markets, but that’s one of the key strengths of Abdul Latif Jameel Health – the ability to adapt and adjust to local contexts and address the issues as they arise,” explains Akram Bouchenaki, CEO of Abdul Latif Jameel Health.

Getting regulation right

In countries with universal healthcare, the expansion of the AgeTech sector will depend to a large extent on how governments regulate care delivery. Currently, care providers are largely free to choose where they invest their money. However, given the shortage of healthcare workers in many key markets, regulators may decide that funding wage increases should take precedence over tech investment.^[18]

As Avnish Goyal, founder of Hallmark Care Homes and chair of Care England, explains: “Government initiatives around funding social care are fraught with challenges. What we have at the moment is choice, but it’s how the Government decides to regulate care delivery that could really stifle innovation should they invite regulations that reduce the level of choice.”^[19]

There are also several regulatory hoops for manufacturers to jump through. For example, companies selling into the EU market must adhere to new medical device regulations (MDR), and in vitro diagnostic medical device regulations (IVDR). In February 2022, The Association of British HealthTech Industries announced a £7 million funding programme to help SMEs navigate the health-tech regulatory process.^[20]

Data privacy is another concern. AgeTech, like most digital technology, is improved by collecting and analysing ever more data, often at the expense of privacy; a tricky tradeoff to grasp for many people, young and old. Some AgeTech users with cognitive decline or mental health conditions may not be able to provide meaningful consent to share their data. Likewise, “overreliance or misuse of technology may lead to dehumanizing care practice or create new forms of segregation and neglect. We need to ensure that technologies are designed and deployed safely, which requires active participation of older persons in their development”^[21], says Peggy Hicks, Director of Thematic Engagement, Special Procedures, and Right to Development Division, Office of the High Commissioner for Human Rights (OHCHR).

The World Economic Forum advocates an approach called Authorized Public Purpose Access, which provides a framework for evaluating technology like contact-tracing apps to balance the interests of individuals, technology developers, and society at large.^[22]

Is there such a thing as too much tech? Many older people, especially those with declining cognitive function, need help to navigate commonplace digital technology such as smartphones. However intuitive these products become, it’s likely that caregivers and family members must remain on hand to help older users get to grips with their gadgets.

When focusing on innovative AgeTech, it’s also easy to forget the underlying technology which makes it all possible: connectivity. Most AgeTech, particularly remote monitoring, relies on consistent, high-speed internet. The US government’s Federal Communications Commission (FCC) considers 25 Mbps download and 3 Mbps upload to be minimum broadband speeds. However, nearly half of the countries in the world have a lower-than-average speed.^[23] This could lead to digital exclusion. Even in America, there are 22 million adults who are not online at all.^[24]

Another sticking point is getting AgeTech to actually work. Currently, most digital tech requires multiple devices, including a smartphone, app, email address, etc., which makes it harder for some older people to set up. The Matter Protocol, launched in October 2022, is a smart home interoperability protocol backed by Apple, Amazon, Google, Samsung, and other hardware makers, which seeks to make devices work seamlessly across different providers, operating systems and types of tech.^[25] However, the number of products using the standard is still limited.

AgeTech is growing up

What does the future hold for AgeTech? Many products and services, such as telehealth, apply existing technology to age-related use cases. Others, like the latest biosensors, are hyper-sophisticated and truly novel. In either case, innovation and proliferation will continue as long as the funding keeps coming. And data, as ever, will enable the development of increasingly effective, hyper-personalized services. AI-assisted early detection and discreet monitoring alone will do much to alleviate caregiver burden and support the wellbeing and longevity of vulnerable older people.

AgeTech will never replace the personal touch. It can, however, enable deeper connections, better diagnoses, and more effective treatments that lead to longer, healthier lives.“At its heart, AgeTech is about finding new ways to care for our ageing population; creating sustainable impact by empowering people to live in their own homes, stay healthy, keep connected and maintain their roles as purposeful members of our society. In many cases, the technology is already there to enable us to achieve these aspirations – it’s up to us to apply it,” says Bouchenaki

[1] https://www.un.org/en/desa/world-population-reach-8-billion-15-november-2022

[2] https://www.who.int/news-room/fact-sheets/detail/ageing-and-health

[3] https://www.who.int/news-room/fact-sheets/detail/ageing-and-health

[4] https://www.sciencedaily.com/releases/2022/04/220427115813.htm

[5] https://www.who.int/news-room/fact-sheets/detail/ageing-and-health

[6] https://www.who.int/philippines/news/q-a-detail/healthy-ageing-and-functional-ability

[7] https://www.cdc.gov/healthyplaces/terminology.htm

[8] https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/ageing/articles/livinglongerhowourpopulationischangingandwhyitmatters/2018-08-13

[9] https://www.forbes.com/sites/tinawoods/2019/02/01/age-tech-the-next-frontier-market-for-technology-disruption/

[10] https://longevityeconomy.aarp.org/?CMP=RDRCT-PRI-OTHER-LONGECON-111319

[11] https://agewell-nce.ca/wp-content/uploads/2021/05/AGE-WELL-Challenge-Area-one-pager_EN_05-20-21-1.pdf

[12] https://transform.england.nhs.uk/covid-19-response/social-care/ipad-offer-care-homes/