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Americans over the age of 75 are expected to account for more than 50% of an anticipated population increase of 19 million during the coming decade. This is according to a March 2024 report by Wells Fargo that also warns, “Assuming the share of the population that has difficulty with self-care remains constant … an additional 1.7 million seniors will require care a decade from now.” This comes with not just health care costs but societal and economic ones, particularly for women, who represent 59% of unpaid caregivers.
Other nations are also struggling to find solutions. Japan now has the highest life expectancy in the world, but it comes at a cost. It’s now commonplace to find people 80 years old or older taking care of their parents, who are 100 years or older. With Japan expected to soon have more than 100,000 people over the age of 100, a care solution is needed.
In the U.K., with its public-funded National Health Service (NHS), there are 8.7 million care contacts provided by community care services every month. With 70% of these services face-to-face, they are highly resource-intensive.
How wearables can help
What is universal among the elderly demographic is a desire to live independently, either in their own home or in an assisted-living situation. Wearables, although not a cure for this crisis, have the potential to contribute to a solution by allowing the elderly to be health-monitored remotely, using sensors to check heart rate, temperature, respiration and other signs.
Technological advances and better integration, coupled with a firm grasp of the importance of human-centered design, are propelling innovation in the sector. Concerns about privacy and data ownership are also significant issues the industry must tackle.
The very early stages in the development of wearables focused on performance, or more accurately, just getting the technology to work reliably. Largely funded by the military, human-centered design was not a priority. As the technology has come to the consumer, it has become apparent that to gain acceptance and to ensure that it is worn—and worn correctly—designers of these wearables need to put the human at the forefront of the design process.
Comfort, flexibility, haptics and aesthetics are important considerations, but when thinking about elderly users, additional factors such as reduced mobility, visual limitations and cognitive impairment must be considered. The impetus is moving toward wearables that are indistinguishable from regular clothing, are no more difficult to put on or take off, and are comfortable and flexible.
Advances are being made with technology integration as a first step, but this is not a simple task and requires several partners. Funded by the German government, researchers at the Technical University of Dresden—with partners including WarmX, a German company specializing in heated knit garments, and custom electronics specialists Dresden Elektronik—are developing wearables to monitor and analyze human movement.
Specially designed applications include gloves that track finger movement and pressure as well as leggings that monitor the angle of the user’s knee and leg movement—both for continuous medical assessment and rehabilitation such as analyzing gait. The intended application determines what the sensor design and positioning will be, and the end-product goal is a fully fashioned and integrated manufacturing process.
Problems with lymphatic drainage can be debilitating. Most commonly affecting the arms, hands and legs, it can become exacerbated with age, causing pain and poor body movement. Currently available compression sleeves used to treat this condition are designed to be tight and can be difficult to put on and take off, leaving patients with mobility issues seeking a new design.
Researchers in Portugal at the Centre for Nanotechnology and Smart Materials and their partners (CeNTI) are developing a smart sleeve under the country’s Health from Portugal agenda. Their approach is to combine sensors, actuators and an inflatable sleeve that can apply pressure to different parts of the sleeve as needed. Comfort is considered with moisture management properties and breathability, as the inflatable cells mimic manual lymphatic drainage—usually achieved by hand massage—with an app that’s also used to monitor the limb.
Managing digital data
The digital health market is projected to be worth $171.9 billion in 2024 and is predicted to rise at an annual CAGR of 8.49% to $258.3 billion by 2029, with the aging population being one of the key drivers, according to a report by German data management firm Statista. The U.S. is expected to hold its position as the lead region, followed by China, Japan and the U.K.
The British government already has an “aging society” challenge policy in place, with the NHS having a long-term plan for a “digital first” treatment within the next 10 years that aims for 90% of NHS trusts to adopt electronic records. This gives the issue of privacy and data ownership a new urgency. As wearables are used in a patient’s everyday life as opposed to confined to a health care facility, attention to security in shared data is no small matter and could be complicated by growth in sensing-garments’ use and availability.
Alex “Sandy” Pentland has served as a professor at the Massachusetts Institute of Technology and a fellow at the Digital Economy Lab at Stanford HAI. He is concerned with data use and misuse, ownership, and protection over many years. One of his many achievements is the launch of openPDS/SafeAnswers (PDS being a personal data store) with the research and development of legal and software code made available for public access and reuse. A platform is offered where people can securely store, manage and choose to share their data, with data ownership defined as the right of possession, use and disposal as opposed to a literal ownership. The platform is designed to be a reference point for national and international policies and legal frameworks such as the National Strategy for Trust Identities in Cyberspace in the U.S.; in Europe, it is aligned with the European Commission’s 2012 reform of data protection rules. Pentland’s group, with the Bill & Melinda Gates Foundation’s support, has developed
a digital health system for rural health workers in developing countries that guides health services for approximately 400 million people.
The Advanced Research Projects Agency for Health has identified specific need areas involving real-world health care data and related services, such as data curation and linking, individual data protection, and real-world data as a “public utility.” Real-world health care data includes electronic health records and diagnostic testing alongside social determinants of health and environmental factors.
Real-world data as a “public utility” is aimed at making data available to the research community seeking ways to reconcile “a public utility model, enabling research by lowering barriers to data access while fairly compensating vendors for their investments.”
These are all big asks, but it is crucial for society and industry that they be addressed.
Marie O’Mahony, Ph.D., is a writer, industry consultant, author and academic based in London.