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A global roadmap to seize the opportunities of healthy longevity
Abstract
The US National Academy of Medicine (NAM)’s first global grand challenge is dedicated to healthy longevity. We summarize the NAM’s Global Roadmap for Healthy Longevity, highlighting evidence that societies can benefit from untapped human, social and economic capital through investments throughout the life course.
... The healthy aging initiatives face significant challenges in fostering collaboration among diverse stakeholders, including health insurers, government agencies, healthcare providers, and local communities (WHO, 2020). These stakeholders often operate with distinct and sometimes conflicting goals, leading to fragmented efforts that undermine the scalability and effectiveness of long-term initiatives Fried et al., 2022). For instance, health insurers' focus on short-term cost containment often conflicts with healthcare providers' long-term goal of improving population health outcomes. ...
... Promoting healthy aging relies on multi-stakeholder collaboration, as highlighted by frameworks such as the World Health Organization's Decade of Healthy Ageing, which prioritizes fostering age-positive attitudes, empowering older adults in supportive communities, delivering person-centered care, and ensuring access to long-term care (WHO, 2020). The Global Roadmap for Healthy Longevity advocates for inclusive social infrastructure to combat ageism, improve digital access, and integrate health and lifelong learning to support equitable care and active participation for older adults (Dzau & Jenkins, 2019;Fried et al., 2022;National Academy of Medicine, 2022;Wong et al., 2023). Similarly, Cox and Faragher emphasize prioritizing aging biology, fostering interdisciplinary research networks, and scaling aging initiatives through targeted funding and awareness campaigns (Cox & Faragher, 2022). ...
... This study uses a comparative analysis to assess the effectiveness of EDEN in generating actionable recommendations within the healthy aging ecosystem (Sharma & Kaur, 2017;Verma et al., 2016). Using value propositions from user input and from previous longevity landscape study , our comparative analysis compares (A) qualitative content analysis conducted by an author W.M. based on existing guidelines to code organization segment, target customers, and products and services (Fried et al., 2022;Hsieh & Shannon, 2005; WHO, 2020), (B) standalone LLM using GPT-4o model (OpenAI et al., 2024), and (C) proposed EDEN's CRISP-DM methodology, which integrates LLMs GPT-3.5-turbo with NLP techniques such as topic modeling and similarity computation, see Figure 2. The study examines the contextual relevance, granularity, and actionability of the insights generated, providing an initial requirement of EDEN's capability in addressing incentive misalignments. ...
Incentive misalignment among healthcare stakeholders poses significant barriers to promoting healthy aging, hindering efforts to mitigate the burden of long-term care. Despite extensive research in public health, incentive gaps persist, as static implementation guidelines often fail to accommodate dynamic and conflicting incentives. This study introduces and evaluates EDEN (eden.ethz.ch), a computational framework designed to dynamically map stakeholder incentives using a Retrieval-Augmented Generation pipeline. A comparative study using a health insurer use case evaluates alternative incentive analyses; qualitative content analysis, large language models, and EDEN. The evaluation assesses their ability to identify and address incentive gaps. Preliminary findings demonstrate the EDEN's ability to map incentives and highlight misalignment compared to alternative approaches. These findings demonstrate how EDEN can offer evidence-based strategies for key healthcare stakeholders, such as health insurers, based on retrieval features to align incentives in healthy aging.
... The global population is aging rapidly, and by the year 2050, the number of people aged 60 years and older will drastically increase to over 2 billion [1]. Concurrent with this increase in the number of older individuals, life expectancy is projected to increase in the coming decades [2]. However, as is often the case with advanced aging, this increased life expectancy will almost certainly be associated with accompanying morbidities and their associated costs to individuals and health systems [3,4]. ...
... Therefore, the purpose of this retrospective study was to demonstrate the validity of the TrueLooto (1) record and identify toileting sessions with regard to stool and urine events; (2) compare the results with the person-reported, standard-of-care methods; and (3) establish metrics of user acceptability and ease of use in a assisted living facility population. We hypothesized that the TrueLoowould demonstrate significant improvements in the event capture of toileting sessions compared with the current reporting systems, while being well accepted in the target population. ...
Background
Because of the relationship between independent living and activities of daily living, care teams spend significant time managing assisted living residents’ toileting problems. Recently, the TrueLoo was developed as a connected toilet seat to automatically log and monitor toileting sessions.
Objective
This study aimed to demonstrate the validity of the TrueLoo to (1) record and identify toileting sessions with regard to stool and urine events; (2) compare the results with the person-reported, standard-of-care methods; and (3) establish metrics of user acceptability and ease of use in a assisted living facility population.
Methods
We used two phases: (1) initial development of the TrueLoo algorithms to accurately identify urine and stool events and (2) evaluation of the algorithms against person-reported, standard-of-care methods commonly used in assisted living facilities. Phase 2 analyzed data over a 3-day period from 52 devices. Participants’ age ranged from 63 to 101 (mean 84, SD 9.35) years. Acceptability and ease-of-use data were also collected.
Results
Regarding the development of the TrueLoo algorithm for urine assessment, sensitivity and specificity of 96% and 85% were observed when evaluating a gold-standard labeled data set, respectively (F1-score=0.95). For stool, sensitivity and specificity of 90% and 79% were observed, respectively (F1-score=0.85). Regarding the TrueLoo algorithm in assisted living settings, classification performance statistics for urine assessment revealed sensitivity and specificity of 84% and 94%, respectively (F1-score=0.90), and for stool, 92% and 98%, respectively (F1-score=0.91). Throughout the study, 46 person-reported instances of urine were documented, compared with 630 recorded by the TrueLoo. For stool events, 116 person-reported events were reported, compared with 153 by the TrueLoo. This indicates that person-reported events were captured 7% (46/630) of the time for urine and 76% (116/153) of the time for stool. Overall, 45% (32/71) of participants said that the new toilet seat was better than their previous one, 84% (60/71) reported that using the TrueLoo was easy, and 99% (69/71) said that they believed the system could help aging adults. Over 98% (69/71) of participants reported that they would find alerts related to their health valuable and would be willing to share this information with their doctor. When asked about sharing information with caregivers, 66% (46/71) reported that they would prefer the TrueLoo to send information and alerts to their caregiver, as opposed to the participant having to personally communicate those details.
Conclusions
The TrueLoo accurately recorded toileting sessions compared with standard-of-care methods, successfully establishing metrics of user acceptability and ease of use in assisted living populations. While additional validation studies are warranted, data presented in this paper support the use of the TrueLoo in assisted living settings as a model of event monitoring during toileting.
... The global population is aging rapidly, and by the year 2050, the number of people aged 60 years and older will drastically increase to over 2 billion [1]. Concurrent with this increase in the number of older individuals, life expectancy is projected to increase in the coming decades [2]. However, as is often the case with advanced aging, this increased life expectancy will almost certainly be associated with accompanying morbidities and their associated costs to individuals and health systems [3,4]. ...
... Therefore, the purpose of this retrospective study was to demonstrate the validity of the TrueLooto (1) record and identify toileting sessions with regard to stool and urine events; (2) compare the results with the person-reported, standard-of-care methods; and (3) establish metrics of user acceptability and ease of use in a assisted living facility population. We hypothesized that the TrueLoowould demonstrate significant improvements in the event capture of toileting sessions compared with the current reporting systems, while being well accepted in the target population. ...
BACKGROUND
Due to the relationship between independent living and activities of daily living, care teams spend significant time managing senior living residents’ toileting problems. Recently, the TrueLoo (TL) was developed as a connected toilet seat to automatically log and monitor toileting sessions.
OBJECTIVE
The purpose of this retrospective study was to demonstrate the validity of the TL to (a) accurately record and identify toileting sessions with regard to stool and urine events, (b) compare results to the person-reported standard of care methods, and (c) establish metrics of user acceptability and ease of use in a senior living facility population.
METHODS
We utilized two phases: (1) initial development of the TL algorithms to accurately identify urine and stool events; (2) evaluation of the algorithms against person-reported standard of care methods, commonly employed in senior living facilities. Phase 2 analyzed data over a 3-day period from 52 devices. Participants ranged from 63 and 101 years old (average age = 84 ± 9.35 years). Acceptability and ease of use data were also collected.
RESULTS
Regarding development of the TL algorithm for urine assessment, sensitivity and specificity of 96% and 85% were observed when evaluating a gold-standard labeled dataset, respectively (F1 score = .95). For stool, sensitivity and specificity of 90% and 79% were observed, respectively (F1 score = .85). Regarding the evaluation of the TL algorithm in senior-living settings, classification performance statistics for urine assessment revealed a sensitivity and specificity of 84% and 94%, respectively (F1 score = .90). For stool, a sensitivity and specificity of 92% and 98% were observed, respectively (F1 score = .91). Throughout the study, 46 person-reported instances of urine were documented, compared to 630 recorded by the TL. For stool events, 116 person-reported events were reported, compared to 153 events reported by the TL. This indicates person-reported events were captured 7% of the time for urine and 76% of the time for stool. Overall, 45.1% of participants said the new toilet seat was better than their previous seat, 84.5% participants reported using TL was easy, requiring no effort, and 97.6% said they believed the monitoring system had the potential to help aging adults. Over 98% of participants reported they would find alerts related to their health valuable and would be willing to share this information with their doctor. When asked about sharing information with caregivers, 65.7% reported they would rather the TL send information and alerts to their caregiver, as opposed to the participant having to personally communicate those details.
CONCLUSIONS
The TL demonstrated the feasibility to accurately record toileting sessions compared to standard of care methods, while successfully establishing metrics of user acceptability and ease of use in senior living populations. While additional validation studies are warranted, the data presented in this paper support the utilization of the TL in senior living settings as a model of event monitoring during toileting.
... These life-saving sessions are not only time-consuming, but are also draining the body of energy and vitality. Despite this, they are placed on an organ transplant waiting list that is years long; and even when a match is found, this is not a guarantee of a perfect transplant, with the body likely to reject the organs after a few years [3,4]. Advancements in healthcare are rapidly changing the future of transplantation. ...
The shortage of donor organs remains a critical challenge in modern medicine, with thousands of patients worldwide on transplant waiting lists. 3D bioprinting has emerged as a groundbreaking technology that has the potential to revolutionize organ transplantation by enabling the fabrication of patient-specific tissues and organs. This paper examines the current state of organ transplantation, the challenges associated with donor dependency, and how 3D bioprinting is transforming the field. We discuss the technological advancements in bioprinting, including the development of biomaterials, vascularization techniques, and artificial organ fabrication. Additionally, we analyze ethical and regulatory considerations surrounding bioprinting and its potential societal impact. Looking beyond bioprinting, we examine emerging technologies in regenerative medicine, such as stem cell therapy and gene editing, which may further enhance the future of organ transplants. As bioprinting continues to evolve, it holds the promise of improving transplant success rates, reducing dependency on donors, and ultimately saving countless lives.
... However, societies as a whole remain dismally unprepared for this demographic transition. The Global Roadmap for Healthy Longevity calls for a multidisciplinary effort to shift the focus from merely coping with aging populations to enabling successful and sustainable aging for all (1,2). Artificial intelligence and other digital technologies (AIDTs) stand out as pivotal forces with the potential to drive a paradigm shift in healthcare by improving medical care, addressing social isolation, enhancing mental wellness for seniors and augmenting the healthcare workforce. ...
... Longevity medicine aims to extend the healthy lifespan of humans by preventing and treating age-related diseases and has many potential benefits for society. First is improving the quality of life and well-being of older adults and families by reducing the burden of chronic diseases, disability, and dependency (Fried et al. 2022). Second is enhancing the productivity and contribution of older adults to the economy, society, and innovation, by enabling people to work longer, volunteer, mentor, and participate in civic activities (Accius et al. 2022). ...
Health Agents are introduced as the concept of a personalized AI health advisor overlay for continuous health monitoring (e.g. 1000x/minute) medical-grade smartwatches and wearables for "healthcare by app" instead of "sickcare by appointment." Individuals can customize the level of detail in the information they view. Health Agents "speak" natural language to humans and formal language to the computational infrastructure, possibly outputting the mathematics of personalized homeostatic health as part of their reinforcement learning agent behavior. As an AI health interface, the agent facilitates the management of precision medicine as a service. Healthy longevity is a high-profile area characterized by the increasing acceptance of medical intervention, longevity biotech venture capital investment, and global priority as 2 billion people will be over 65 in 2050. Aging hallmarks, biomarkers, and clocks provide a quantitative measure for intervention. Some of the leading interventions include metformin, rapamycin, spermidine, NAD+/sirtuins, alpha-ketoglutarate, and taurine. AI-driven digital biology, longevity medicine, and Web3 personalized healthcare come together in the idea of Health Agents. This Web3 genAI tool for automated health management, specifically via digital-biological twins and pathway2vec approaches, demonstrates human-AI intelligence amplification and works towards healthy longevity for global well-being. The AI Longevity Mindset The AI Mindset The AI Stack. The AI infrastructure is evolving rapidly, particularly with genAI (generative AI which creates new data based on what it has learned from a training dataset). Activity can be ordered in the four tiers of human-interface AI assistants, reinforcement learning (RL) agents (self-driving, robotics), knowledge graphs, and artificial neural network architectures (ANNs). AI assistants and RL agents (embodied through prompting) are an intelligence amplification tool for human-AI collaborative access to the other tiers of the vast range of knowledge and computational power now available. ANNs. The first neural network architecture to deliver genAI at scale is transformers (GPTs, generative pretrained transformer neural networks), Large Language Models (LLMs) which use attention as the mechanism to process all connections in a dataset simultaneously to perform next word (any token) prediction (OpenAI 2023). LLMs treat a data corpus as a language, with syntax, semantics, and grammar, whether natural language, mathematics, computer code, or proteins. These kinds of Foundation Models are trained on broad internet-scale data for application to a wide range of use cases. Transformers are so-called because they "transform" vector-based data representations during the learning phase (using linear algebra methods). Transformer architectures are being extended with state-of-the-art LLMs released for multimodal VLMs (vision-language models) (Gemini 2023), larger context windows (e.g. genome-scale training, 1 million base pair size context window (HyenaDNA, Nguyen et al. 2023)), and longer sequential data processing with various convolutional and other methods such as SSMs (structured state space models (Mamba, Gu and Dao, 2023)) and model grafting (hybrid network architectures evolving during training, StripedHyena-7b (7 billion parameters (learned weights between data elements), Poli et al. 2023). GPTs to GNNs: 2D to 3D+. An advance in digital biology is GNNs (graph neural networks, technically a form of transformer) to process 3D data such as molecules (Bronstein et al. 2021) with attention or message-passing. The early success of GPTs is credited to the "traditional" machine learning recipe (Halevy et al. 2009) of a small set of algorithms operating on a very large dataset, with substantial computational power. GNNs require a more extensive implementation of physics to treat 3D environments. The transformations of data representations in GNNs are more closely tied to the three main symmetry transformations in physics: translation (displacement), rotation, and reflection.
... Our positive results of a webinar-based educational initiative specifically tailored for DOHaD education not only holds promise for enhancing MCH practices but also serves as a blueprint for future DOHaD education initiatives and similar interventions, including broader public health initiatives targeting a life-course approach, such as promoting healthy longevity [39]. ...
Objectives
The Developmental Origins of Health and Disease (DOHaD) concept has gained prominence in maternal and child health (MCH), emphasizing how early-life factors impact later-life non-communicable diseases. However, a knowledge–practice gap exists in applying DOHaD principles among healthcare professionals. Healthy Early Life Moments in Singapore (HELMS) introduced webinars to bridge this gap and empower healthcare professionals. We aimed to conduct a preliminary assessment to gain early insights into the outreach and effectiveness of the educational initiative offered with the HELMS webinars.
Methods
We employed a pragmatic serial cross-sectional study approach and targeted healthcare professionals involved in MCH care. We also collected and analyzed data on webinar registration and attendance, participants’ profession and organizational affiliations, and post-webinar survey responses.
Results
The median webinar attendance rate was 59.6 % (25th–75th percentile: 58.4–60.8 %). Nurses represented 68.6 % of attendees (n=2,589 out of 3,774). Post-webinar surveys revealed over 75 % of the participants providing positive responses to 14 out of 15 survey questions concerning content, delivery, applicability to work, and organization.
Conclusions
Assessment of the HELMS webinars provided insight into the outreach and early effectiveness in enhancing healthcare professionals’ knowledge and confidence in delivering DOHaD education. Bridging the knowledge–practice gap remains a crucial goal.
... As aging leads to NCDs, the obvious solution is to proactively minimize those risks by living a healthier lifestyle. This movement to extend the health span rather than merely living longer refers to healthy longevity (Fried et al., 2022). ...
Amidst non-communicable diseases' substantial health and economic burdens, health insurance companies and digital health technologies (DHTs) are increasingly crucial in enabling preventive care and minimizing global health expenditure. This position paper explores the perspective of an innovation manager of a Swiss health insurer. The interview transcript was analyzed using thematic analysis. The results highlight the importance of current regulations, the future role of health insurance companies, and the potential of DHTs to promote preventive care and business model innovation.
Background: The global aging population underscores a critical need to tackle accompanying health and economic challenges, at all levels of society. This All-of-Society approach emphasizes the involvement of various stakeholders - governments, NGOs, researcher centers, private companies, local communities, and opinion leaders - to collectively promote healthy aging. However, how stakeholders enable healthy longevity remains unclear.
Objective: This study examines how global stakeholders (governments, NGOs, researcher centers, private companies, local communities, and opinion leaders) create value towards healthy longevity. We identify the healthy longevity dimension of stakeholders' value propositions and examine alignment between their propositions as an indicator of shared goals.
Methods: Following the All-of-Society approach, we analyzed the healthy longevity aspects of value propositions among the six classes of stakeholders (N=128). We (1) employed semantic topic modeling to identify the primary value proposition topics as related to healthy longevity and (2) computed proposition alignment using similarity networks.
Results: Our analysis revealed varying degrees of alignment between stakeholders' healthy longevity propositions, with the lowest alignment observed for local communities and researcher centers.
Conclusions: Findings underscore a key need to strengthen synergies between academic and community-based initiatives to promote translational science and highlight opportunities for strategic partnerships in the evolving healthy longevity field.
Countries are advancing retirement age as life expectancy advances. But increases in healthy life expectancy are not keeping pace with total life expectancy, lengthening the portion of life spent with disability and threatening the capacity of individuals to work longer. Now, a study forecasts healthy life expectancy for people in England in 2035.
Population aging in the United States poses challenges to societal institutions while simultaneously creating opportunities to build a more resilient, successful, and cohesive society. Work organization and labor-force participation are central to both the opportunities and challenges posed by our aging society. We argue that expectations about old age have not sufficiently adapted to the reality of aging today. Our institutions need more adaptation in order to successfully face the consequences of demographic change. Although this adaptation needs to focus especially on work patterns among the “younger elderly,” our society has to change its general attitudes toward work organization and labor-force participation, which will have implications for education and health care. We also show that work’s beneficial effects on well-being in older ages are often neglected, while the idea that older workers displace younger workers is a misconception emerging from the “lump-of-labor” fallacy. We conclude, therefore, that working at older ages can lead to better quality of life for older people and to a more productive and resilient society overall.
Projected distribution of the world’s population from 2020 to 2100
- Statista Research Department
Statista Research Department. Projected distribution of the world's population from 2020
to 2100, by age group. Statista, https://www.statista.com/statistics/672546/projectedworld-population-distribution-by-age-group/ (2022).
Life expectancy at birth for both sexes combined (years). data.un.org
- Un Data
UN Data. Life expectancy at birth for both sexes combined (years). data.un.org,
https://data.un.org/Data.aspx?d=PopDiv&f=variableID%3A68 (2019).
Getting more from a longer life
- L P Fried
Fried, L. P. Getting more from a longer life. Trend Magazine, https://www.pewtrusts.org/
en/trend/archive/winter-2018/getting-more-from-a-longer-life (2018).
Making aging positive. The Atlantic
- L P Fried
Fried, L. P. Making aging positive. The Atlantic, https://www.theatlantic.com/health/
archive/2014/06/valuing-the-elderly-improving-public-health/371245/ (2014).
It’s time we stopped undervaluing older adults
- D E Bloom
- A Khoury
- E Algur
- J P Sevilla
Bloom, D. E., Khoury, A., Algur, E. & Sevilla, J. P. It's time we stopped undervaluing older
adults. World Economic Forum, https://www.weforum.org/agenda/2020/12/it-s-high-timewe-stopped-undervaluing-older-adults/ (2020).
- J Rowe
- L F Berkman
Rowe, J. & Berkman, L. F. Nat. Aging 2, 3-4 (2022).