This is, overall, splendid news. Commendable this was funded by the Bill and Melinda Gates Foundation.
The economy should adapt not the other way around
Some degree of distribution of wealth and multi generational households would render it tenable again.
The care issue is real, not so much because we need people to look after them, which potentially could be automated, but rather the new generations are the ones paying into the system and funding their pensions.
For instance if you have an asset that appreciates over time and represents true value (say because it generates more income over time) then you can't realize that appreciation if there is no-one to buy that asset from you. That is the marginal effect of having less people.