Karela Fry

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Developing while aging

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Science reports on an important and interesting survey which has started in China:

China is getting old before it gets rich—a massive shift that could strain the economy, health care system, and labor market. The introduction of the one-child policy in 1980 coincided with rapid economic development that extended lifespans, creating a generation of only children who are burdened with caring for their aging parents. The number of people aged 60 and over is on course to increase from 12% of China’s population in 2010 to 34% in 2050, according to U.N. Population Division projections.

Overseen by Peking University’s China Center for Economic Research (CCER), with $5.25 million in funding from the U.S. National Institute on Aging (NIA) and additional support from sources including the Natural Science Foundation of China, CHARLS [China Health and Retirement Longitudinal Study] is designed to gauge the health, wealth, and emotional well-being of older Chinese as they transition into retirement.

So far, CHARLS has painted a largely bleak picture for China’s 185 million residents ages 60 and over, nearly a quarter of them living in poverty. Fully 40% show obvious symptoms of depression, and more than half have hypertension, a worrisome finding for China as it vastly expands its health care coverage (Science, 1 February, p. 505).

On many health measures, from body pain to depression, women fare worse than men. … The women surveyed so far also do worse on tests of cognitive skills and memory. The cognitive gap is more pronounced in older age groups, where women typically received less education than men. But nutritional and other factors may play a role as well, Smith notes: For older generations, discrimination “permeates the entire society.”

With follow-up rounds every 2 years, the most critical research findings are yet to come. Longitudinal data will offer “the real payoff” for researchers, Treiman says, and it could help flesh out some of the early findings. The gender difference in cognition, for example, could be exaggerated by the fact that women live longer than men. CHARLS’s investigators also hope to analyze subjects’ DNA, using blood samples collected in the baseline survey. By pooling that data with results from other aging surveys, researchers can search for genetic markers linked to cognition, personality, and behavior.

In the meantime, the survey could help inform policy discussions. Proposals for raising the retirement age—the age for collecting pensions ranges from 50 for low-level women workers to 60 for men—have so far proven unpopular in China, with upcoming retirees alleging that they’re being treated unfairly. CHARLS showed that urban Chinese retire early, supported in part by millions of rural migrants, while “in the country side they work until they drop,” Zhao says. Postponing retirement would reduce inequity, not create it, she says. And knowing underdiagnosis rates for diseases such as hypertension, Smith says, could help the government plan for health care spending, an urgent task. “China cannot be spending the kind of money that they are in the United States,” he says.

One wonders how different such a study would reveal India to be.

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