Problem domain analysis

Population ageing 1950 – 2050 report [118] provides detailed summary of world ageing population process. Report considers elder increase for more and less developed countries, for major areas and regions, covering 1950 – 2050 period. From the demographic perspective world fertility and mortality decline (Fig 2.1); in the future more and more elder people survive. At the present days around 3 of 4 new borns in the world will survive to age 60 and about 1 of 3 to age 80. Projected at the period (2045-2050) approximately 7 of 8 new borns survive to age 60 and more than half to age 80. Significant elder population increases in developed regions determined by improved chances to survive to old ages (Grundy 1999).

Total fertility rate and life expectancy at birth: World 1950-2050 [118]

In present days Europe has the highest proportion of elders in the world; EUROSTAT indicates that at 2060 elder population in the Europe be almost twice bigger – from 17.1% at 2008 to 30% at 2060 year. According to [118] more and more people live longer, thus, varying proportion in different age groups tends to make pressures in society and tend to change its resource distribution patterns. For example, additional burdens to the labour force are pensions, elder hospitalization, medical costs, costs including elder surveillance and health care.

Therefore, most high-income (developed) regions already expanded or expanding their social security systems to improve old as well as young quality of life, while population is aging [118]. However, strains will remain since elder population grows faster than young population; because demands for the rest of population grow. Over the period of 1950 – 2000 – 2050 world elder population aged 60 and over will grow from 200 million (at 1950) to 600 million (at 2000) and 2000 million (at 2050). In proportion 8% (at 1950) to 10% (at 2000) and to 22% (at 2050) of elders will be in the world.

Magnitude and speed of World population aged 60 and over [118] Less and more developed countries

Life expectancy in the developed and less developed regions can be concluded with figure above. If the same trend remains next half of the century, then the most world elders live in the less developed regions. As projected that population aged 60 and over will increase from 231 million in 2000 to 395 million (+164 million) in 2050 in developed regions. In contrast, at the less developed regions, total increase from 374 million to 1.6 billion (+1.23 billion).

In the world health risks are classified into traditional and modern risks, which may take different trajectories in different countries. Risks are leading by potential loss or undesired outcome, here – health diseases. Poor sanitation, hygiene are traditional risks, leading by communicable diseases, which are common to low income countries. However, tobacco smoking, overweight and obesity, physical inactivity, are modern risks, which are common to advanced economic (high-income) countries. As the consequence of previously mentioned risks are cardiovascular diseases, which is the one of the largest worldwide killer (see figure), among men, women and do not depend on the race [117].

Cause of deaths in the world at 2008 [117]
Age is the primary cause to increase risk to have a cardiovascular disease, which is main consequence of death. Figure concludes the world deaths at 2008. A high death rate in the Western Pacific region clarifies the high density of population comparing to Europe. According to European Union official page, cardiovascular diseases also are the largest cause of deaths in the EU, which surround 40% total deaths or about 2 million people annually. Similarly, all Europe regions surround 4.58 million deaths (total 44 countries, including 27 European countries).

Deaths around the world, in 2008, cause by cardiovascular diseases
Hypertension (high blood pressure), coronary artery disease, arrhythmias are consequences, which will later can evolve to serious health injuries such as heart attack, stroke or sudden death. At the early stages sometimes it is difficult to measure and diagnose health status, because it is not easy observable. For instance hypertension sometimes called “silent killer”, symptoms are not appreciable in early stages until it develops to serious health risk. Likewise arrhythmias sometimes are difficult to measure, if they occur in short time of periods during the day. Therefore, leading causes of chronic diseases often bring enormous harm to state of health, as well as economically it is disadvantageous.

According to [120] cardiovascular diseases in Australia are the most expensive diseases in terms of health expenditure. During 2004-2005 costs in Australia was around $ 5.94 billion (Australian dollars) including hospitalization, out-of hospital medical services, prescriptions, and researches. Overall increase of CVD in Australia is projected to increase by $ 8.5 billion, between three decades from 2002-03 to 2032-33. Expenditure of CVD sharply increased over 45 years, and the most money spent on people aged 85 years and over. As an example 45-54 year person expenditure is about $ 300, 65-74 year person $ 1000, and 85 and over is about $ 1900 [120].

Financial burden for health care systems across EU in 2006 was over € 110 billion, which represents 10% total health care expenditures. Apart from that loss in labour market due to long term sickness brings even more financial deformation. According to [121] expenses in the USA from CVD, projected to be more than $ 475 billion in 2009, which includes health care expenditures and productivity lost.

Despite the risk, still 30% of hypertensive patients unaware about their condition [102]. It was shown that approximately 70% of people are not diagnosed until their deaths [113]. Patients with cardiac diseases or high cardiac risk would benefit by being monitored for early abnormal pattern detection. Therefore, it would be economically and socially advantageous by enhancing treatment and prevention until disease development. It was shown that correct and timely diagnosis of cardiovascular disease is the key feature to reduce increased health care costs [ ,124].

Estimated, that 80% of CVD in EU can be prevented if right means will be taken. Presently operate new project named EuroHeart II (2011 – 2014) [122] – “Building action on heart diseases and stroke”, which was lead by Euro Heart (2003 - 2008) project. EuroHeart II main objectives are CVD prevention, future predictions, and trends.

Future innovative software technologies like telemedicine can serve to compensate raised inequalities between age groups, as well as minimize increasing future health care demands. For continuous vascular system estimation would be beneficial to include photoplethysmography approach, and electrocardiography 11 approach for the abnormal electrical heart activity detection. Combination of PPG and ECG technologies opens more heart risk assessment methods which are important elements for the heart risk assessment.

© 2015 Heart Risk Warner