TY - JOUR
T1 - A research agenda for ageing in China in the 21st century (2nd edition)
T2 - Focusing on basic and translational research, long-term care, policy and social networks
AU - Fang, Evandro F.
AU - Xie, Chenglong
AU - Schenkel, Joseph A.
AU - Wu, Chenkai
AU - Long, Qian
AU - Cui, Honghua
AU - Aman, Yahyah
AU - Frank, Johannes
AU - Liao, Jing
AU - Zou, Huachun
AU - Wang, Ninie Y.
AU - Wu, Jing
AU - Liu, Xiaoting
AU - Li, Tao
AU - Fang, Yuan
AU - Niu, Zhangming
AU - Yang, Guang
AU - Hong, Jiangshui
AU - Wang, Qian
AU - Chen, Guobing
AU - Li, Jun
AU - Chen, Hou Zao
AU - Kang, Lin
AU - Su, Huanxing
AU - Gilmour, Brian C.
AU - Zhu, Xinqiang
AU - Jiang, Hong
AU - He, Na
AU - Tao, Jun
AU - Leng, Sean Xiao
AU - Tong, Tanjun
AU - Woo, Jean
N1 - Funding Information:
In the past five years, central and local governments in China have made enormous efforts in establishing a multi-dimensional geriatric care system to support healthy ageing in Chinese society. More than 30 national policies have been issued to drive the development of this care system, including cross-ministerial policy measures for promoting the growth of elderly services and the integrated development of medical, health and elderly care, through the Guiding Opinions on Advancing the Development of Age-Friendly Livable Environment ( NDRC, 2016 ), and the State Council Opinions on Promoting the Development of Elderly Care Services ( NHCPRC, 2019b , c ). Following the strategies of the national 5-year plan, provincial and municipal governments have all issued local implementation plans. In places such as Shanghai, Shandong, Jiangsu, Zhejiang and Guangdong, political will has been accompanied by strong financial support ( CNCA, 2020 ).
Funding Information:
The authors acknowledge the valuable work of the many investigators whose published articles they were unable to cite owing to space limitations. The authors thank Dr. Vilhelm Bohr at the NIA and University of Copenhagen for reading of the manuscript. E.F.F. is supported by HELSE SØR-ØST (#2017056, #2020001), the Research Council of Norway (#262175 and #277813), the National Natural Science Foundation of China (#81971327), an Akershus University Hospital Strategic grant (#269901), and a Rosa Sløyfe grant (#207819) from the Norwegian Cancer Society. H.C.Z. is supported by the Natural Science Foundation of China Young Scientist Fund ( 81703278 ), Australian National Health and Medical Research Council Early Career Fellowship ( APP1092621 ), National Science and Technology Major Project of China ( 2018ZX10721102 ), Sanming Project of Medicine in Shenzhen [SZSM201811071] and the Open Research Fund of State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics ( SKLVD2019KF001 ). J.L. is supported by the National Natural Science Foundation of China ( 71804201 ), the Natural Science Foundation of Guangdong Province ( #2018A0303130046 , #2017A030310346 ) and SYSU Scientific Research Foundation ( #17ykpy15 ). L.K. is supported by National Key R&D Program of China (No. 2018YFC2002104 ) and the CAMS Innovation Fund for Medical Sciences ( CIFMS #2017-I2M-3-008 ). G.B.C. is supported by the National Natural Science Foundation of China (#U1801285), National Key R&D Program of China (#2018YFC2002000) and the Natural Science Foundation of Guangzhou City ( #201904010111 ). X.T.L is supported by a Major Project of National Social Science Foundation of China ( 13&ZD163 ), and a Major Project of Zhejiang Social Science Foundation ( 19YSXK02ZD ). C.W. is supported by the Suzhou Municipal Science and Technology Bureau ( SS2019069 ). QL is supported by Kunshan Government Research Fund . We thank Bowen Liang (Sun Yat-Sen University), Chuyao Wang (University of California, Davis) for their contribution to the manuscript. Z. Niu is supported by Aladdin Healthcare Technologies .
PY - 2020/12
Y1 - 2020/12
N2 - One of the key issues facing public healthcare is the global trend of an increasingly ageing society which continues to present policy makers and caregivers with formidable healthcare and socio-economic challenges. Ageing is the primary contributor to a broad spectrum of chronic disorders all associated with a lower quality of life in the elderly. In 2019, the Chinese population constituted 18 % of the world population, with 164.5 million Chinese citizens aged 65 and above (65+), and 26 million aged 80 or above (80+). China has become an ageing society, and as it continues to age it will continue to exacerbate the burden borne by current family and public healthcare systems. Major healthcare challenges involved with caring for the elderly in China include the management of chronic non-communicable diseases (CNCDs), physical frailty, neurodegenerative diseases, cardiovascular diseases, with emerging challenges such as providing sufficient dental care, combating the rising prevalence of sexually transmitted diseases among nursing home communities, providing support for increased incidences of immune diseases, and the growing necessity to provide palliative care for the elderly. At the governmental level, it is necessary to make long-term strategic plans to respond to the pressures of an ageing society, especially to establish a nationwide, affordable, annual health check system to facilitate early diagnosis and provide access to affordable treatments. China has begun work on several activities to address these issues including the recent completion of the of the Ten-year Health-Care Reform project, the implementation of the Healthy China 2030 Action Plan, and the opening of the National Clinical Research Center for Geriatric Disorders. There are also societal challenges, namely the shift from an extended family system in which the younger provide home care for their elderly family members, to the current trend in which young people are increasingly migrating towards major cities for work, increasing reliance on nursing homes to compensate, especially following the outcomes of the ‘one child policy’ and the ‘empty-nest elderly’ phenomenon. At the individual level, it is important to provide avenues for people to seek and improve their own knowledge of health and disease, to encourage them to seek medical check-ups to prevent/manage illness, and to find ways to promote modifiable health-related behaviors (social activity, exercise, healthy diets, reasonable diet supplements) to enable healthier, happier, longer, and more productive lives in the elderly. Finally, at the technological or treatment level, there is a focus on modern technologies to counteract the negative effects of ageing. Researchers are striving to produce drugs that can mimic the effects of ‘exercising more, eating less’, while other anti-ageing molecules from molecular gerontologists could help to improve ‘healthspan’ in the elderly. Machine learning, ‘Big Data’, and other novel technologies can also be used to monitor disease patterns at the population level and may be used to inform policy design in the future. Collectively, synergies across disciplines on policies, geriatric care, drug development, personal awareness, the use of big data, machine learning and personalized medicine will transform China into a country that enables the most for its elderly, maximizing and celebrating their longevity in the coming decades. This is the 2nd edition of the review paper (Fang EF et al., Ageing Re. Rev. 2015).
AB - One of the key issues facing public healthcare is the global trend of an increasingly ageing society which continues to present policy makers and caregivers with formidable healthcare and socio-economic challenges. Ageing is the primary contributor to a broad spectrum of chronic disorders all associated with a lower quality of life in the elderly. In 2019, the Chinese population constituted 18 % of the world population, with 164.5 million Chinese citizens aged 65 and above (65+), and 26 million aged 80 or above (80+). China has become an ageing society, and as it continues to age it will continue to exacerbate the burden borne by current family and public healthcare systems. Major healthcare challenges involved with caring for the elderly in China include the management of chronic non-communicable diseases (CNCDs), physical frailty, neurodegenerative diseases, cardiovascular diseases, with emerging challenges such as providing sufficient dental care, combating the rising prevalence of sexually transmitted diseases among nursing home communities, providing support for increased incidences of immune diseases, and the growing necessity to provide palliative care for the elderly. At the governmental level, it is necessary to make long-term strategic plans to respond to the pressures of an ageing society, especially to establish a nationwide, affordable, annual health check system to facilitate early diagnosis and provide access to affordable treatments. China has begun work on several activities to address these issues including the recent completion of the of the Ten-year Health-Care Reform project, the implementation of the Healthy China 2030 Action Plan, and the opening of the National Clinical Research Center for Geriatric Disorders. There are also societal challenges, namely the shift from an extended family system in which the younger provide home care for their elderly family members, to the current trend in which young people are increasingly migrating towards major cities for work, increasing reliance on nursing homes to compensate, especially following the outcomes of the ‘one child policy’ and the ‘empty-nest elderly’ phenomenon. At the individual level, it is important to provide avenues for people to seek and improve their own knowledge of health and disease, to encourage them to seek medical check-ups to prevent/manage illness, and to find ways to promote modifiable health-related behaviors (social activity, exercise, healthy diets, reasonable diet supplements) to enable healthier, happier, longer, and more productive lives in the elderly. Finally, at the technological or treatment level, there is a focus on modern technologies to counteract the negative effects of ageing. Researchers are striving to produce drugs that can mimic the effects of ‘exercising more, eating less’, while other anti-ageing molecules from molecular gerontologists could help to improve ‘healthspan’ in the elderly. Machine learning, ‘Big Data’, and other novel technologies can also be used to monitor disease patterns at the population level and may be used to inform policy design in the future. Collectively, synergies across disciplines on policies, geriatric care, drug development, personal awareness, the use of big data, machine learning and personalized medicine will transform China into a country that enables the most for its elderly, maximizing and celebrating their longevity in the coming decades. This is the 2nd edition of the review paper (Fang EF et al., Ageing Re. Rev. 2015).
KW - Ageing policy
KW - Dementia
KW - Inflammageing
KW - Oral ageing
KW - Sexually transmitted diseases
KW - Square dancing
UR - http://www.scopus.com/inward/record.url?scp=85091870837&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85091870837&partnerID=8YFLogxK
U2 - 10.1016/j.arr.2020.101174
DO - 10.1016/j.arr.2020.101174
M3 - Review article
C2 - 32971255
AN - SCOPUS:85091870837
VL - 64
JO - Ageing Research Reviews
JF - Ageing Research Reviews
SN - 1568-1637
M1 - 101174
ER -