The Future of Ageing

At the recent World Economic Forum, one of the tabled papers made the startling claim that people born in the developed world today could reasonably expect to live to be 120, or even 150.

That, probably, is the good news.  Advances in medical technology are opening up the probability of longer life – some futurists see the possibility of immortality in the longer term.  The cracking of genetic codes to predict future susceptibility to illness, effective early diagnosis and the use of biotech and technology to screen for the earliest signs of health problems, and advances in medicines all offer the chance of keeping ill-health at bay.  Replacement of diseased body parts – new hearts and livers grown from stem cells, for example, is now in prospect, and the use of technology to enhance or replace non-functioning body parts offers new hope for tackling sight loss, hearing loss, and even paralysis.

So much for the good news.  Such a major change in life expectancy throws up some major societal and economic challenges.  The International Longevity Centre – ilc.org.uk – describes some of the problems facing today’s aging society: problems that would be magnified in the scenario described to the WEF.  In its document, Tomorrow’s World: the Future of Aging (November 2015), the ILC warns that:

Without action to better support more disadvantaged social groups and communities, the gap in life expectancy between the wealthy and the poor will continue to increase.

Without action to address the current funding and workforce shortages in health and social care, the future needs of our ageing population are unlikely to be met.

Without action to better highlight how long people are likely to live, and the measures that they need to take to ensure financial security later in old age, even wealthier older adults may experience financial difficulties in later life.

Without action to encourage and facilitate longer working lives we will see a future drop in the UK’s employment rate and reductions in overall productivity.

Without action to build more houses, and houses which are adapted to the needs of older people, the housing shortage will continue.

For futurists, it’s natural to try and counter the ILC’s well-articulated list of warnings with opportunities.  People should be healthier, and thus able to work longer, and retire later.  Older people will predominate, even more than they do now, among the electorate.  They will be a powerful, active and empowered lobby, to which democratic governments will need to pay particular attention.  Either the state will need to provide a gateway to health & social care, or facilitate personal provision through the tax and benefits system.  Corporations will see the older generation as an increasingly key market, whether for goods, services, technology or housing, and advertisers will pursue the “silver pound” avidly.  The old people of the future will be technologically savvy, and tech companies will target them.  The aging population will increase the demand for carers and home support – potentially a useful counterweight to the loss of jobs as robotics and AI make their presence felt.  The burgeoning population of Africa – which is set to increase 50% by 2050, and double by the end of the century, will provide a valuable potential source of carers and health workers.

Even if the above is true, there remains one fly in the ointment.  Advances in medical science are slowest in the most complex human organ: the brain.  There is a risk that our ability to prolong life outstrips – at least in the medium term – our ability to prevent and treat the degeneration of the brain.  The prospect of longer life being for many no more than an eternal twilight clouded by dementia would be unacceptable – to people and to governments.  A YouGov poll in January showed that just 1% of people polled would choose to spend their twilight years in a care home.  The costs and the logistics of caring for increasing numbers of people, who were living longer, would be almost impossible, even given the assistance of carer robots.  At that point, demand for the legalisation of euthanasia would become irresistible.

And even if, as seems inevitable, medical science eventually finds ways to prevent, or treat degenerative brain disease, the question of how and when we die, will remain.  Death – a preoccupation of our Victorian forebears, but unmentionable in contemporary society – may make a comeback as a topic of polite conversation.

David Lye, SAMI Fellow

The views expressed are those of the author and not necessarily of SAMI Consulting.

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