F 121 AgeTech Series Part 1: Healthcare and technology in the oldest population in the world - Japan

Japan is the nation with the largest elderly population in the world. Over 28% of people in Japan are older than 65. For comparison, in Germany, 21% of the population is older than 65, and in the US “only” 16% of the population.

Over 2.3 million people died due to COVID by February 2021. These were mostly older people. Many of them died alone in the hospital, without the option to say goodbye to their families. Without even someone from the medical staff at their bedside. COVID opened up space for us to start reconsidering on a broader level how we wish to die, lead quality last years of life, and fear death less. In the upcoming episodes that’s what we will talk about: improving old age, dying, and geriatric care.

Tradition in an app

What makes the Japanese generally healthy even at older ages is to a large extent attributed to the nation’s diet and lifestyle. As mention by Yasuro Koizumi Director & CFO of FiNC Technologies, the Japanese walk more than people in the West, their diet includes a lot of fish and vegetables. More often than not, the households are big, enabling the transfer of knowledge and habits about healthy living among generations. Where that’s missing, technology is jumping in.

Yasuro Koizumi: “Japan has roughly 120 million people. We used to have only 25 million households, meaning on average there were five or six people in the same household. The grandparents or parents teach their kids how to eat and how to lead a healthy lifestyle. Currently, we have about 60 million households for the same populations, meaning there are only 1.6 people in the household. We strongly believe that smartphones through AI can teach younger people how to stay healthy, instead of on behalf of the parents or grandparents.”

If WeChat enables consumers to do almost everything on the platform - from chat, banking, taxi booking, etc. FiNC almost looks like a WeChat platform for health - apart from quantifying oneself through sleep, steps, weight, the period for women, you offer meal tracking and advice, health and fitness content, and an eCommerce mall.

The healthcare and society constraints of aging

Dr. Kenji Suzuki is the CEO of Plimes - a company working on solving Aspirational pneumonia. Dr. Suzuki warns about another aspect of the aging population. When people live longer, the elderly start taking care of the elderly: “Many people reach the age of 100. Now imagine: the age of retirement is 60 or 65. You become an adult when you are 20 years old. When you retire you are almost in the middle in your journey of life. We need seriously to think about that to design the system. All developing countries face this issue.”

Japanese are known about their longevity, but their healthcare system is quite malnourished with staff. The number of healthcare professionals per 1000 people is already very low - 2.5 doctors per 1000 people according to the OECD. The only OECD countries with lower numbers in 2018 were India, South Africa, Turkey, China, Korea, Poland, Colombia and Mexico. There is however quite a high number of nurses in Japan - 11.5 per 1000 people. Only USA, Australia, Ireland, Germny, Iceland, Switzerland and Norway have higher numbers among the OECD countries. But these numbers, says dr. Suzuki are very black and white: “We have a national that Medicare system. In the last one year of your life, you spend all of your insurance. While the official number of nurses is high, hospitals are always looking for nurses, more than doctors. We need some new doctors, but as they are a more expensive workforce, the increase would also increase costs of healthcare. From my viewpoint, a more serious issue is that current medicine is designed for the acute phase. If you for example get a stroke, care is excellent. We have a high number of MRI and CT machines, and access to diagnostics is not a problem. The problem is centenarians. After a stroke, you need to think about post-care so this does not become a chronic condition. We are not well prepared for that.”

The machines and the lack of expertise

Japanese healthcare is famous for is high number of MRI machines. But according to the paper published in 2015 titled - The Japan Radiological Society/Japanese College of Radiology Imaging Guideline - expert management of the MRI examinations tends to be insufficient. The numbers of CT and MR systems per person are markedly higher than in foreign countries, and 60–70 % of them are in operation in the absence of a radiologist. Adrian Sossna is the VP of global sales at Hacarus. This is a platform for Medical & Life Sciences AI solutions. Hacarus works with Medical imaging data such as CT & MRI scans, time-series data, such as ECG data, and medical records to create precise, complex tools, that aid caregivers and researchers to provide better, faster, and safer treatment, based on data-driven insights. Sossna emphasized two things: first, AI is still often very narrow, and second, it needs to be introduced well to clinicians. Clinicians need to be educated about AI. This is why Hacarus launched a training program for the medical industry. “Hacarus Academy is a full course program, where we train doctors, medical professionals, researchers, pharmaceutical companies, the basics of how to work with AI.”

AgeTech and solving aspiration pneumonia

One would think Japan would be at the forefront of AgeTech. However, as mentioned by dr. Kenji Suzuki, the CEO of the company called PLIMES, the trend of technology used for the elderly is hardly emerging with the approaching generation of the elderly that are already familiar with the technology.

Let’s take a closer look at how PLIMES is solving issues related to aspiration pneumonia. Aspiration pneumonia is pneumonia developed due to a bacterial infection in the lungs caused by inhaling food, stomach acid or saliva into the lungs. The way dr. Suzuki approached the problem was by designing an audio recording technology that with the help of AI detects when swallowing is problematic.

The algorithm is based on a database of over 20.000 sounds. To make the device as easy to use as possible it has a necklace-like design to bring comfort to the users.

Tech and the fight for the visually impaired

One of the things that decline with age is sight. Visual impairment however is far from only an issue of the elderly. Worldwide, the number of people with visual impairment and blindness is around 300 million people. The American Foundation for the blind estimates that the unemployment rate for people with vision difficulty is around 70%. Solutions to help improve their quality of life have advanced with technology. While the population of the younger visually impaired and the elderly is not the same, they can both use the same solutions for improved quality of life.

Several solutions are on the market that help the visually impaired with orientation in the environment. Technological solutions include smart glasses or solutions with head-mounted cameras that feed the software with visuals in the environment and voice assistants tell the person what surrounds them. A Japanese company called Digital Attendant took a different approach. Instead of making a solution that would fit onto the head, they created a solution where a camera looks like a necklace. As explained by the CEO Kazuo Kaneko this makes it easier for the users to blend in the society:

Solutions for the blind are of significant importance as they increase the independence of people with visual impairment and also impact bring job opportunities. There are a few products on the market helping visually impaired individuals with camera-like solutions that are attached to the head or glasses. Digital Attendant provides users with a solution that recognizes scenes, texts, traffic lights, and location and provides audio notification. - Scene recognition, GPS, Direction Finding, Texts Recognition, Trafic Lights Recognition.

All this increases the quality of life and independence. However, as mentioned by Mr. Kazuo Kaneko this will still serve a percentage of visually impaired since the system runs on cloud-based servers and is not applicable to less developed areas without digital infrastructures.

The future of prevention in a healthy lifestyle

The future of better and nicer aging lies in technology adoption. Finc technologies aims to be a one-stop-shop smartphone app for health. To make sure people are continuously engaged, Finc uses a points reward system where users can use earned points in the eCommerce shop. The platform also engages users with gaming techniques.

Aging is a significant societal and healthcare-related issues. We need to rethink how we enable healthy aging, improve the last years of our lives and reduce the fear of death. These are some of the issues we will address in the upcoming episodes. We will tune into how an Austrian startup matches caregivers and the elderly based on their psycho-social profile, we will talk about innovation in geriatric care and the need to rethink end-of-life planning.

This topic was supported by CROSSBIE and JETRO Berlin. Crossbie is a Berlin based company with a focus on bringing together Japan and the global startup ecosystem. CROSSBIE creates a tech marketplace for both companies and startups, promotes development of new innovations, and drives business and societal impact. JETRO is the Japan External Trade Organisation promoting mutual trade and investment between Japan and the rest of the world.