Tuesday, November 4, 2014

Dementia Crisis Roils Japan as 10,000 Seniors Go Missing

From Bloomberg:
Asayo Sakai banged on the front door, demanding to be let out. She was at her daughter’s apartment, where Asayo has lived for the past six years. She has no memory of how she got there or what she’s doing there.

As her daughter, Akiko, blocked the way, Asayo, 87 and suffering from dementia, lashed out, hitting and biting. The scene repeated itself with agonizing predictability for a solid year until one day Akiko, exhausted, gave in and opened the door, letting Asayo wander the streets of Osaka’s busy financial center in western Japan....

... Elderly Care Crisis
That dynamic has given rise to a growing elderly care crisis in Japan, where more than 10,000 seniors with dementia went missing last year, according to the National Police Agency. Some disappear for years, others never return or are eventually found dead. Caretakers have snapped, injuring or even killing their loved ones. In 2012, 27 seniors in Japan were murdered or died from neglect, although it’s unclear how many suffered from dementia.

The number of seniors abused by family members jumped 21 percent to more than 15,000 in 2012 from 2006, half of whom suffered from the condition, according to a Japan Health Ministry survey.
 
While other countries are aging, none have done so as rapidly as Japan, where an estimated 8 million people suffer from dementia or show early signs of developing the disease. That’s about 6 percent of Japan’s population. By 2060, 40 percent of Japanese will be over 65, up from 24 percent today, according to National Institute of Population and Social Security Research. And as the population ages, the proportion of tax-paying workers will decrease relative to the swelling ranks of dependent seniors....MORE
And from VoxEU:

Demography and economics: Look past the past 
Most of the world is now at the point where the support ratio is becoming adverse, and the growth of the global workforce is slowing. This column argues that these changes will have profound and negative effects on economic growth. This implies that negative real interest rates are not the new normal, but rather an extreme artefact of a series of trends, several of which are coming to an end. By 2025, real interest rates should have returned to their historical equilibrium value of around 2.5–3%.

Introduction
Our history is our database. When seeking to peer dimly into the future, our normal response is to examine what happened in (similar) past episodes and then to extrapolate those outcomes into the future. This assumption, that the future will mimic the past, is hard-wired into almost all our forecasting exercises, from the most simple to the econometrically and technically most complex.
Yet this assumption, that the future will be like the past, is perhaps more questionable now than for decades, at least in the economic sphere. All around the world we stand on the cusp of a dramatic shift in the structure of our populations, the ageing of our people. Only Japan has yet decisively entered into this difficult new world, and its experience has been affected by some special factors; it coincided with a financial crisis and occurred while its neighbours in Asia were still benefitting from a population ‘sweet spot’, with their ratio of workers to dependents (otherwise known as the ‘support ratio’) rising. So its experience is not necessarily a reliable guide to the future either.

Future demographic changes
In the standard demographic transition process, outlined by Ronald Lee in his paper at this year’s Jackson Hole Conference (Lee 2014), with improving living and medical conditions,
“mortality begins to decline from its initially high level, followed typically some decades later by the beginning of fertility decline from its initially high level. During this early phase the population growth rate first rises and then declines, and the share of the population in the working ages first declines and then rises. Inevitably low fertility and mortality lead eventually to population aging as a final outcome. But population aging is substantially delayed, starting decades after fertility begins to fall. Even in Japan, which is currently farthest along in the aging process, aging is still at an early stage. The old age dependency ratio (ratio of population 65 and over to population 20 to 64, or OADR) will be twice as great in 2050 as in 2010, rising from .39 to .78 according to United Nation projections.”
Most of the world – excluding Africa and, perhaps, parts of Latin America, but including Asia, Australia, Europe, and North America – is now at the point where the support ratio, defined as the ratio of producers to effective consumers, shifts sharply from being beneficial to being adverse, as shown in Tables 1 and 2, taken from Lee’s same talk. Not only is the support ratio falling, but also the absolute number of those of working age (taken to be 20–65) will decline in many countries, and be much lower in the next 35 years (2015–2050) than in the past 35 years (1980–2015).
Table 1. Support ratios have peaked and will fall in emerging markets
 1950197019902010203020502100
China1.130.991.141.341.241.111.05
India0.760.720.750.820.880.870.78
Brazil0.540.520.580.670.670.600.50
Indonesia0.640.630.660.770.810.820.77
Thailand0.640.630.750.900.830.710.65
Mexico0.520.470.520.610.640.620.54
Chile0.660.600.700.750.730.670.59
South Africa0.660.610.630.710.760.780.73
Turkey0.700.680.720.810.850.820.74
Source: National Transfer Accounts

...MUCH MORE