Europe has not done enough to prepare for a dramatic increase in the proportion of its population who are elderly. The belated effect of the baby boom – the bulge in births experienced after World War II – is that Europe will soon have more pensioners than there are people of working age to pay for their care.

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“This is an economic issue that the governments are ducking. As far as I can see, they’re hoping it’s going to go away,” says Gordon McVie, a senior consultant with the European Institute of Oncology in Milan. “But it’s not going to go away, it’s just going to get worse.”

He says that there are few examples in Europe of governments well prepared for the coming baby boom retirements. The Netherlands, where he worked for several years, is one of those few. “The Dutch have done a typically clever, careful forward planning exercise,” he says. “But I remember being deeply depressed when I came back to the UK and nobody had done anything at all.”

As McVie knows, the quality of healthcare provided to the elderly has improved enormously, but that in turn has amplified the disproportionate presence of the elderly in the population, because people are living with diseases that previously they died from. The average life expectancy of EU citizens born today is expected to be 80.

The improved healthcare is adding to the cost of caring for the elderly, because the frail elderly are being kept in homes or hospitals for longer. The challenge for healthcare – and for other sectors – is to delay the point at which the elderly become economically dependent, by prolonging their years of active and healthy life.

New initiatives

Earlier this year the European Commission launched a European innovation partnership (EIP) on active and healthy ageing. The logic of the EIP is to identify a need or problem that Europe must address and to encourage innovation across both the public and private sectors to come up with solutions, using both national and EU money.

The EIP on active and health ageing has three overarching aims: to improve the health status and quality of life of older peoples, to increase the efficiency of health and social care systems; and to foster innovation. Together, the hope is to increase the average healthy lifespan of the elderly by two years by 2020.

The EIP has begun with two immediate initiatives. The first is to prevent unnecessary hospitalisation, by using eHealth techniques and individualised healthcare (see page 18). The second is to prevent falls by the elderly – a significant cause of hospitalisation and further health complications.

McVie says the innovation partnership has been very much welcomed by those working in geriatrics and oncology. But he says in the future more focus is needed on prevention rather than treatment.

Recent advances in the mapping of the human genome and links with disease mean that at-risk populations can be identified more quickly. A genetic analysis can determine whether a person is likely to live a very long life, and whether they are at risk of such conditions as cancer, dementia or diabetes. “We can now look at where risk lies, discussing with each individual person how to handle that risk,” says McVie.

In the medium to long-term, he suggests, that should reduce bills for healthcare.

Without such improvements, the future of healthcare for the elderly will be an unhappy story of supply falling far short of ever-growing demand.