A Virtual Earth Model of the Dementias in China

Presented by

Professor Andrew Georgiou

Macquarie University

AUSTRALIA

Contents

• Introduction

• Population Ageing in China

• The Dementias in China

• Geographic Analysis

• Spatial Visualisation

• Discussion

• Conclusion

Introduction

• Population ageing is an increasingly global concern

• It is affecting countries across the whole development spectrum

• China has the largest population of any single state

• That population is ageing rapidly, especially from 2025 onwards

• The dementias are an important element of this ageing pattern

• Dementia is closely linked to other chronic, high-care scenarios including overlapping physical and cognitive disability

• The health and social care requirements/costs of an ageing population will rise dramatically, demographic dynamics and composition matter

• Interventional possibilities will become increasingly important – medical and non-medical (lifestyle, education etc.)

• An improved health informatics will be key to managing the impact and societal effects of population ageing at this order of magnitude

169 606

200 604

243 171

299 293

342 919

357 831371 391

407 924420 078

406 376

0

50 000

100 000

150 000

200 000

250 000

300 000

350 000

400 000

450 000

2020 2025 2030 2035 2040 2045 2050 2055 2060 2065

China Population Projection 65+ (000s) Medium Scenario

Source: UN 2015 Revised Projections

Ageing Composition in China - Older and Oldest Old

22,359,38326,915,231 31,521,608

41,405,874

59,972,043

72,703,899

92,269,905

120,571,815

0

50,000,000

100,000,000

150,000,000

200,000,000

250,000,000

300,000,000

350,000,000

400,000,000

2015 2020 2025 2030 2035 2040 2045 2050

65+ 80+

Epidemiology of the Dementias in China

• By 2050 nearing 400 million people aged 65+

• Major growth in the oldest old, most prone to dementias and other neurodegenerative conditions

• Growing research base on ageing in China e.g. China Health and Retirement Longitudinal Study (CHARL) http://charls.pku.edu.cn/en

• Dementia prevalence variations by geography – mainly urban/rural split at present

• Female versus male life expectancies and social implications for care

• Changing educational patterns and attainment

• Rural/urban variations and population movements – tier 1-3 cities, internal migration etc.

PubMed Search: Dementia China (2017)

0

100

200

300

400

500

600

700

800

900

1000

Age-Cohort Dementia and AD Rates from Chan et al (2013) The Lancet

Major Dementia Sub-Types - Top 10 County Estimates 2010

0

5000

10000

15000

20000

25000

30000

35000

40000

45000

50000

Pudongxin Chaoyang Haidian Tongzhou Rugao Yangpu Dongguan Minxing Rudong Putuo

Total 55+ w/AD Total 55+ w/Other Total 55+ w/ Dementia

Population Aged 65+ by County 2010 Census

Dementia Estimation by County2010 Census

Dementia Data Transferred into Google Earth

3D Visualisation of Dementia Data

Sub-Type Visualisation – Alzheimer's Estimate by County

AD Graphical Data in Combination with County Geography

Discussion

• Limitations include point-in-time data set, dementia rates by age-cohort only etc.

• Provides a developmental basis for spatial visualisation of major population-based health conditions across large geographies and populations

• Scale issue better addressed than in standard cartography (zoom in/out, pan and tilt etc.)

• Can add other data (demography, health, infrastructure) and geography (village, township, county, prefecture, province)

• China’s investment in geoscience is already significant, health informatics can parallel those developments – e.g. Digital Earth Society in Beijing

• Makes complex scenarios accessible to a large audience from differing technical backgrounds (informatics, clinical, administrative, financial etc.)

Conclusion

• Population ageing is a complex and, we suggest, non-linear process –changes will occur (e.g. dementia rates rise/fall, morbidity/mortality compression)

• Scale of China’s ageing is and will remain a care and resource challenge

• Population ageing is a truly spatial phenomenon – see previous slides!

• Visualisation supports multi-system strategies and interventions

• Complexity management increasingly important to sustainability

• China’s spatial science commitment is well-established

• Health informatics can, we propose, better integrate its agenda through use of spatial data strategies and tools

• A key step towards better management of population ageing and its inevitable consequences