A Virtual Earth Model of the Dementias in China Presented by Professor Andrew Georgiou Macquarie University AUSTRALIA

Contents Introduction Population Ageing in China The Dementias in China Geographic Analysis Spatial Visualisation Discussion Conclusion

Introduction Population ageing is an increasingly global concern It is affecting countries across the whole development spectrum China has the largest population of any single state That population is ageing rapidly, especially from 2025 onwards The dementias are an important element of this ageing pattern Dementia is closely linked to other chronic, high-care scenarios including overlapping physical and cognitive disability The health and social care requirements/costs of an ageing population will rise dramatically, demographic dynamics and composition matter Interventional possibilities will become increasingly important – medical and non-medical (lifestyle, education etc.) An improved health informatics will be key to managing the impact and societal effects of population ageing at this order of magnitude

Ageing Composition in China - Older and Oldest Old

Epidemiology of the Dementias in China By 2050 nearing 400 million people aged 65+ Major growth in the oldest old, most prone to dementias and other neurodegenerative conditions Growing research base on ageing in China e.g. China Health and Retirement Longitudinal Study (CHARL) http://charls.pku.edu.cn/en Dementia prevalence variations by geography – mainly urban/rural split at present Female versus male life expectancies and social implications for care Changing educational patterns and attainment Rural/urban variations and population movements – tier 1-3 cities, internal migration etc.

PubMed Search: Dementia China (2017)

Age-Cohort Dementia and AD Rates from Chan et al (2013) The Lancet

Major Dementia Sub-Types - Top 10 County Estimates 2010

Population Aged 65+ by County 2010 Census

Dementia Estimation by County 2010 Census

Dementia Data Transferred into Google Earth

3D Visualisation of Dementia Data

Sub-Type Visualisation – Alzheimer's Estimate by County

AD Graphical Data in Combination with County Geography

Discussion Limitations include point-in-time data set, dementia rates by age-cohort only etc. Provides a developmental basis for spatial visualisation of major population-based health conditions across large geographies and populations Scale issue better addressed than in standard cartography (zoom in/out, pan and tilt etc.) Can add other data (demography, health, infrastructure) and geography (village, township, county, prefecture, province) China’s investment in geoscience is already significant, health informatics can parallel those developments – e.g. Digital Earth Society in Beijing Makes complex scenarios accessible to a large audience from differing technical backgrounds (informatics, clinical, administrative, financial etc.)

Conclusion Population ageing is a complex and, we suggest, non-linear process – changes will occur (e.g. dementia rates rise/fall, morbidity/mortality compression) Scale of China’s ageing is and will remain a care and resource challenge Population ageing is a truly spatial phenomenon – see previous slides! Visualisation supports multi-system strategies and interventions Complexity management increasingly important to sustainability China’s spatial science commitment is well-established Health informatics can, we propose, better integrate its agenda through use of spatial data strategies and tools A key step towards better management of population ageing and its inevitable consequences