In China, fundamental changes in population development have occurred during the past 50 years. The demographic transition in China required only a few years, while in most European countries this process took several decades. The fertility and mortality rates have declined very quickly, like in Japan and South Korea. China is one of the countries that has passed through the transition process the quickest. In the following article, this development is considered in more detail. Even if the fertility and mortality rates should stabilize at a new low level, which today certainly cannot be conclusively stated, the age effects will persist for the next few decades. The demographic aging during recent years will increase enormously in the coming decades. This development leads to far-reaching social and political challenges. The demographic aging in China is associated with a loss of function of the family. Both developments have a strong impact on the old-age insurance and on old-age care. Only a few years ago did politics and society start to respond with comprehensive reforms. For example, a modern pension system was introduced, but only in urban areas of China. Rural populations are still waiting for such reforms even today. Currently, there is a pilot project to gain experience with a pension system for the entire population. In contrast to the old-age insurance, in China there is very little public interest in old-age care because the elderly have until now been only a matter for the family. In the near future, the changing role of family and demographic aging will require a greater discussion about the care of older people in China.