GLOBAL HEALTH AGING

Rita Barrock is an 84-year-old Alzheimer’s patient. She lives in a nursing home, where she has to be under constant supervision. One of the daily challenges that the nurses who care for her face, is getting her to take her medication. As an Alzheimer’s patient, Barrock is not always compliant with her medication – she often forgets why she needs to take the several multicolored pills that she is given three times a day and throws a fuss that is both disruptive to the home as well as detrimental to her own well-being. [1]

One in three senior citizens in the USA dies with Alzheimer’s disease or dementia. In sub-Saharan Africa, the current population of older adults is 46 million and is estimated to reach 157 million by 2050. A number of these people have HIV and yet another portion contract a whole host of other diseases on a regular basis. By 2050, India’s aging population is set to be 323 million, 45 percent of whom will carry the entire country’s disease burden, the most prevalent of which is diabetes. There are currently 197 million elderly living in poverty, 40 percent of whom live alone.

Anyone who has spent time with grandparents or other elderly folk have been privy at some point or another to their daily intake of medication. However, research proves that for a number of different reasons, older populations tend to be less regimented than younger ones when it comes to swallowing the pill. In a study of 34,501 coronary heart disease patients aged 65 or older, for example, only 26 percent continued to use their medication five years into their regimen.

Common reasons for abandoning the intake of medication include the number of pills prescribed and the stigma of taking oral or injectable medication. Apart from not wanting to take medication, and medical conditions that prevent older folk from making coherent decisions regarding their health; poverty, lack of access to medication and inadequate health literacy – for instance, the inability to correctly inject oneself with insulin – also deter seniors from following their medical routine.

With so many barriers, it is time to rethink the way people ingest medication. Some progress being made in this field includes extended-release tablets that minimize the daily dosage one needs to take. Over the last few years, there has been another technology that has the potential to revolutionize the way people medicate. Microneedle technology is a new drug delivery system that relies on a transdermal release of medication. Imagine a small patch of biodegradable polymeric protein or silicone with several microscopic needles embedded in it. The needles are coated with medication and are applied in the same way one would apply a nicotine patch. Their small size makes them a minimally invasive, easily applicable, pain-free way to medicate, that is also devoid of the stigma of the pill.

Microneedles are still in the testing stages. They are currently being developed for use in insulin for diabetes, quantum dots for cancer, TB testing, gene delivery and several immunizations, including HIV, tetanus, polio, and influenza (plasmid DNA). In addition, it is primarily universities such as Georgia Tech, UNC-Chapel Hill, MIT, and some international institutes such as the Indian Institute of Technology Kharagpur and Tokai University of Japan, that are developing this technology, with a view to disseminating more effective vaccines in developing countries. There are, however, a handful of private enterprises investing in the technology for mass production such as California-based TheraJect.

Medical technology is a dynamic field that has the potential to significantly change the quality of life for older adults. This population should be recognized as a vital market for technologies like microneedles.

[1] This particular story is fictional. It is based on the experiences of older adults in nursing homes.

Sachi Shah is a recent graduate with a degree in International Development and Economics from Sarah Lawrence College, New York.