Over the years I’ve attended a number of Age Boom Academies—seminars for journalists co-hosted by Columbia University’s Mailman School of Public Health, the Journalism School, and the International Longevity Center. The speakers are always impressive and it’s provided an invaluable overview of the evolving economics, logistics, and science of the longevity boom. As my own focus has sharpened I’ve enjoyed them more, and this year’s seminar, which wrapped up on Tuesday, September 10 at the office of the Atlantic Philanthropies, was the best yet. My colleagues were sharp, it was great to meet Dr. Ursula Staudinger, Founding Director of Columbia’s new Aging Center, and I wasn’t the only speaker to highlight ageism.
I talked about the need to reframe “age beat” stories to include people of all ages, reject “anti-aging” and ageist language, and avoid the temptation to focus on the exceptional stories, whether awe- or dread-inspiring. Age Boom founder Jack Rosenthal named two obstacles to seeing increased longevity as a greater advance than the Pill or decoding the genome: stereotyping and ageism. (Two sides of the same coin, if you ask me.) Wendy Lustbader’s discussion of caregiving opened with, “As we age life gets better on every level of what it is to be a human being except the physical. But nobody knows this, including elders, because the ageism is so intense in our society.
Some other interesting take-aways from the Age Boom 2013 sessions that I was able to attend:
Geriatrician Linda Fried, dean of the Mailman School of Public Health:
• Population aging is not the primary driver for rising healthcare expenditures. “It’s controversial,” said Fried, “but it would appear that more significant drivers are the overtechnologized and highly fragmented nature of the healthcare system.”
Demographer S. Jay Olshansky, of University of Illinois at Chicago’s School of Public Health:
•“When it comes to lowering death rates, there isn’t much room for improvement. [The death rate is the population of given age cohort divided by number within it that die in a given year.] You’ll see some people saying we’ll live to 100 or 150, but the death rate would have to go down to near zero for that to happen. . . . Even if we you cure heart disease and stroke, only get about 15 more years.”
• “Each cohort has its own unique conditions and qualifiers. Everything experienced by people farther out was affected by the generations who went before them. We should forecast the future on the basis of the health status of subgroups—the ones young now—because they’re the ones who are going to be old in the future.”
• The longest-lived subgroup population in the US is Hispanics.
• “We have consistently underestimated the effect of obesity on longevity. It’s worse than we thought.
• Olshansky noted that life expectancy was just one demographic metric, and not a very sensitive one. “Jay’s specialty is mortality, which is just one biological indicator,” Staudinger observed in a follow-up comment. “There’s no one definition of aging. You can look a cognitive aging, social aging, personality aging and see different trajectories in these different domains…. Cognition is closest to biology, with a pinnacle at 25, and then steady decline, but the decline does not accelerate. It seems to be case that depending on the domain, ‘aging” tends to remain steady until a rapid increase within a couple of months to up to a year before death.”
Epidemiologist Lisa Berkman of the Harvard School of Public Health Center for Population and Development Studies:
• Family caregivers provide $450 billion worth of unpaid support—more than more than Wal-Mart earns and substantially more than we pay out in Medicaid. Caregivers carry out highly medicalized tasks, and In the future there will be fewer of them
• Along with a number of other speakers, Berkman spoke of the need to retool archaic workforce policies. “Just as public health interventions focused on the physical environment [e.g. refrigeration, clean water, antibiotics] brought major advantages in longevity, we need to look at the same interventions but focused on the social environment.” She used an example of pension plans in South Africa as an example of an intergenerational win-win-solution. “Pensions were first awarded to whites, then to blacks; first to men, to then women, so we could study the effects. It turns out that when older women got pensions, their children, especially their daughters, had higher heights and weights. We often don’t look at this kind of spillover, which in the US reduces burdens on middle-aged people.”
Psychologist Toni Antonucci of the University of Michigan:
• “It’s not a child’s responsibility to caregive alone. We have to think about how a lot of healthy people can be taking care of the fewer people who are not healthy… I suggest we redefine lifespan plan, starting with all the healthy 60-year-olds who are making contribution to other 60-, 70-, and 80-year-olds.”
Economist Debra Whitman of AARP:
Whitman pointed out that life expectancy women is lower in the US than in all other rich industrialized countries, and that it’s the only country with no social protection for working families. She talked about how innovative policy could help families out, noting that “FMLA [the Family Medical Leave Act] does not work if you have to take care of a grandparent, only for child or parent,” and that in Finland both parents need to take care of children in order to qualify for public assistance.
Writer, teacher and social worker Wendy Lustbader:
• “As who we are gets more and more intense, we are all the ages we’ve ever been.”
• The exceptions to life getting better with age are a) “if you’re on a detour of alcohol and/or drugs,” and b) “the more self-centered you are, because all the things that burnish us don’t reach you.” Lustbader noted that “Life is completely different when we go through illness and come out the other side,” and that “if someone gets a massive shock, even the extremely self-centered, they suddenly become aware of their needs for kindness and of others’ needs for it as well.”
• Octogenarians are much slower at learning a random task and perform far less well than 20-year-olds. “But take the same groups, give new information that happens to be connected to an interest or expertise of the 80-year-old, and the elder remembers every word and even connects it to new insight. She leaves the 20-year-old in the dust.”
• Lustbader’s wise answer to “How do you define an elder?” “The best thing is to self-define it.”
Lawyer and policy expert Michael Sparer of Columbia’s Mailman School of Public Health:
Sperer reviewed the history of Medicare and Medicaid and pointed out that Medicaid was originally focused on moms and kids and needs to be redesigned to meet the needs of the elderly, disabled, and chronically ill. In order to offset the costs to employers of higher salaries and healthcare costs for older workers, his colleague Jack Rowe proposed a return to “the original setup where Medicare-eligible people had Medicare as their primary insurer and the employer would be supplementary. That would make these workers less expensive.”
Lifespan psychologist Ursula M. Staudinger of the Columbia Aging Center:
•We should speak of societies of longer lives [instead of aging societies].
•Because of declining fertility, global population will stabilize and eventually even shrink.
•As societies industrialized and people lived longer, “we chose to work less” and “early retirement became the hallmark of an accomplished society.” How should the discourse change now that workers are growing older and fewer?
•“It’s very hard to estimate the value of work before we lose it.”
•Studies indicate a “pretty intense positive association” between employment after age 60 and cognitive performance.
•It’s foolish to base estimates of worker productivity–like the old age dependency ratio–on chronological age, which is not highly informative. But other metrics are far more complex.
•Workforce productivity does not decline with age.
•“As we look across generations, the cognitive capability of each generation has increased. Cognitive capacity is trending older.” In 2042, for example, the UK (which has the best data) will be chronologically older but cognitively younger than it is now. The key is regular exposure to new challenges. Training interventions can slow physical decline as well. We need to develop institutions and lifestyle habits to support these goals.
•Staudinger described the last myth on her list—What others/you think about aging affects aging—as “very true. Beware of negative plasticity,” she warned. “Images of aging, both negative and positive, are powerful,” as are self-fulfilling prophecies.
Staudinger’s handout was a booklet titled “More Years, More Life: Recommendations of the Joint Academy Initiative on Aging, an endeavor led by the Leopoldina Academy, Germany’s National Academy of Sciences. A sentence in the introduction jumped out at me: “While preparing this volume, it became clear that one central precondition for unfolding the potential of demographic aging is: changing attitudes and overcoming prevalent negative stereotypes about aging and old age.” Bingo.