THE PLANET IS ageing. It has aged substantially in our lifetime, and it will continue to accelerate during our lifetime. This will fundamentally change some of the concepts around health care, because it is not the same diseases, and even when the same diseases affect our older patients, the kind of care they need is different.... Most of the morbidity, hospital admissions occur in the elderly patient population. So think about what is happening globally and what this means for providers, for insurers and payers, what it means for government and health care policy. Even beyond that, think about what it means for education, how we prepare our medical students, how we prepare our allied workforce and nursing workforce....
Something happened in 2018, a year before Covid hit us. For the first time, there were more people above the age of 65 than children under the age of five. That has never happened before. And that trend is going to continue. So by about 2050, about 16 per cent of the planet will be over the age of 65.... This has tremendous implications. It will strain health care. I am sure AI and other tools will be available, but it still may not solve the problem that is in front of us.
So what are the kind of diseases that we should expect to see? This is purely from my personal experience having taken care of patients now on three parts of the globe. Infections and sepsis are going to be a huge burden. We think infections are manageable, but this is going to be an entirely different spectrum. We have to prepare for it now. Antimicrobial stewardship needs to start today. The way we think about vulnerable populations with implants, intravascular devices, pacemakers and their susceptibility for infection has to change. We need more research, awareness and management around infections and sepsis.
I know there were several conversations around degenerative diseases because we don’t understand them well. Non-communicable diseases like strokes, complications of metabolic disease, cardiovascular disease, cancer, they will continue to present, but the way we will have to take care of an elderly patient population is going to be entirely different. The hospital requirements are going to be different. The need for post-acute care is going to be different. And that sets us up to have plans around rehabilitation and long-term care.
And lastly, I think it is health care education and research. Apollo trains a large number of nurses. We have started new programmes just within the past two weeks aimed at fellowships like colorectal surgery, pulmonary, diseases that we believe will have much higher incidence and prevalence in the next two decades. We are preparing tomorrow’s workforce today. And this applies to nursing as well, which, as most of you are aware, is in severe short supply globally.
And when geriatric patients get admitted, we know that the challenges are different. These patients present with frailty. They have underlying malnutrition and impaired ability to sense nutrients. They have cognitive impairment that flares up during hospitalisation, leading to episodes of delirium and confusion that can independently affect their outcome and mortality. So how we take care of patients, even how we design our facilities, needs to take all of this into account.
This is not for providers to solve. This is not for the education sector to solve. It is society’s responsibility to figure out how we are going to take care of an ageing planet for the next 20 years.