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Needed: Federal leadership on R&D for our aging society

Adults age 65 and over will outnumber children by 2034. By 2060, they will account for nearly a quarter of Americans.

Globe staff illustration; Miriam Doerr & Martin Frommherz/Adobe
Adobe/Globe Staff

The US population is in the midst of a once-in-history transformation. Adults age 65 and over will outnumber children by 2034. By 2060, they will account for nearly a quarter of Americans. This new demographic reality will change life in ways both sweeping and mundane. It is imperative that we as a society do everything we can to make sure these changes are good ones, befitting the gift of longer life.

Even if the meaning of “old” changes for the better, however, the possibilities of later life will still be constrained by technological and medical reality. Happily, when it comes to science and technology, the realm of the possible can be stretched. This work, in the form of research and development, has the potential to explode limitations on what we can achieve, and even imagine, in the decades ahead. But disorganized half-measures will no longer suffice. Federal leadership elevating R&D for our aging society needs to be a top priority.

Eldercare, for instance, is in dire need of a technological breakthrough. Demand for professional care is already outstripping the existing home care workforce. The size of the population requiring assistance is growing so rapidly that, barring changes to the national workforce (which might be achieved by welcoming in more immigrants, already responsible for a disproportionate share of care work), it will become harder to fill these positions over time. Costs will go up, and many older adults may be forced to go without the support they deserve — and require.


Technological and research breakthroughs could change this equation. More research is needed in the field of robotics, for instance, before machines can safely help families and eldercare professionals with crucial, backbreaking jobs, such as helping someone out of bed. Further work is also required to better explore how older adults and their families actually use technologies — knowledge critical to making sure new devices genuinely improve lives.


The economic case for pouring support into aging-related research grows clearer when it comes to health care. The United States spends more than its peers on health care (about 17 to 18 percent of GDP, compared to an average of 11 percent in other wealthy nations). Population aging stands to magnify those costs substantially, since individual health care expenditures generally increase with age. Based on projections made by the Centers for Medicare and Medicaid Services Office of the Actuary, the $3.8 trillion the United States spent on health care in 2019 may grow to $6.2 trillion by 2028 and $11.8 trillion by 2040.

The good news is that remedies for the older population’s health problems may also heal some of its cost problems. Deloitte predicts that current rates of progress toward curing disease, combined with other cost-saving steps including placing a higher priority on preventative care, may help reduce 2040 health care spending from CMS’s estimate by as much as $3.5 trillion.

Any strides we make against the “big four” age-related diseases — Alzheimer’s, cancer, cardiovascular disease, and diabetes — will have major implications. Alzheimer’s (and other forms of dementia) remains an especially important economic target. Alzheimer’s has not yielded to recent medical research breakthroughs in the same way that cancer and cardiovascular disease have. To make matters more economically dire, because the prevalence of dementia increases exponentially with age, any strides we make in extending the human lifespan bring along the cruel side effect of higher incidences of dementia — and with it, increased demand for high-intensity care.


This reality is sobering, but it underscores the need for ramping up age-related disease research across the board: not just in health care and robotics, but also in smart-home tech, user design, transportation, workplace technologies, education and training, and nutrition. R&D in these fields won’t just improve lives; it will also strengthen tomorrow’s economy.

The federal government must step up and provide not only funding but something even harder to come by: leadership. A new federal agency could serve as an agenda-setting and convening force, connecting business innovators with researchers on topics ranging from molecules to marketing, policies to financial products. Such an agency could launch a nationwide education initiative arming service professionals, from geriatricians to geriatric care managers, with technologies and strategies designed to make their lives easier and their work more effective. Leveraging the procurement power of public agencies, it could prioritize equitable tech access and affordability. And as older adults begin to rely on new technologies in unforeseen ways, it could help develop a legal framework around emerging issues of privacy, data ownership, and consent.

Innovation is always an act of optimism. Federal leadership on age-ready R&D would stand as a continuous reminder that living longer can, and must, be about living better.

Joseph Coughlin is director of the AgeLab at the Center for Transportation & Logistics at MIT and author of “The Longevity Economy: Unlocking the World’s Fastest-Growing, Most Misunderstood Market.” Luke Yoquinto is a research associate at the MIT AgeLab and coauthor of “Grasp: The Science Transforming How We Learn.”