Demographics is certainly a factor, but I think there are two other major factors. Small business is always risky, and the extra regulations and costs under Obama are killing businesses that would have otherwise barely made it. Also, Amazon is a big factor. Almost all many products are cheaper with no storefront, and people window shop in start-up businesses and then buy from Amazon.
Dental and doctors offices are considered small businesses. They are falling the wayside.
Amazon isn't as sure-fire savings as it used to be. For one thing, even when you pay for prime shipping (supposedly free) the items are priced at what non-amazon sellers are selling at including their shipping. I've seen plenty of items in the last year or so cheaper in stores than on Amazon. What Amazon is doing for some of us is making goods available that no longer are in the rural areas.
The big problem with all businesses is lack of demand, because people don't have disposable income. All those companies reporting great earnings quarter after quarter? If you look closely, you'll see most are reporting 'ex-items' - excluding items that are costs, supposedly non-recurring. It used to be illegal to report earnings 'ex-items' without also reporting actual earnings (often negative). Now, no one cares about the law - the news media just wants to report happy news, to keep those Keynesian Animal Spirits up. Very few businesses are doing well at any level, unless they get government to force their competitors out of business through regulation...