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Dementia rates are falling.

I can’t say that often enough, so I’m going to say it again: dementia rates are falling. Previous small studies have found the same trend, and a large national survey recently confirmed it. The total number of cases will rise along with the number of older people in the population, but the likelihood of any given person getting dementia has dropped—significantly. Lead author Dr. Kenneth Langa estimates the decrease at 25 to 30 percent compared with the rate in the early 1990s. And people are being diagnosed at older and older ages.

This comes as a surprise to epidemiologists along with the rest of us, especially give a surge in diabetes among older Americans, which significantly increases the risk of dementia. It’s part of a larger trend that that New York Times has dubbed a “medical mystery of the best kind”: common diseases of aging are in retreat in the United States and some other wealthy countries.

A recent study from the National Bureau of Economic Research confirms it: “the increase in life expectancy in the past two decades has been accompanied by an even greater increase in life years free of disability.” In other words, although longer lives mean spending more years with disease, “disability-free life expectancy” has risen faster than lifespan. Better treatments for heart disease and for vision problems—cataract surgery, that is, which has become a simple outpatient procedure—are responsible for much of the improvement, as are better diagnoses, but they don’t explain the trend. Although Parkinson’s, dementia, and diabetes remain huge concerns, even the rate of “all-cause mortality,” which lumps together chronic diseases, is falling. And every one of those diseases links to aging. Perhaps, all these degenerative diseases share something in common, something inside aging cells themselves, suggests Dr. Steven R. Cummings of the California Pacific Medical Center Research Institute. The cellular process of aging may be changing, in humans’ favor. That seems like a stretch, but more research into the biology of aging is definitely welcome and badly needed.

Why don’t more people know these things—especially the good news about dementia rates? A 2012 Marist poll found that Alzheimer’s had edged out cancer as the disease Americans fear most. Part of the reason is just human: fears loom large because danger affects survival. Part of it is because of media coverage: scary stories pull people in, and dementia is a terrifying prospect. And the alarm garners research dollars. In the words of advocate Christine Bryden, who lives with dementia, “What is the cause of the stigma and fear? It’s the stereotype of dementia: someone who cannot understand, remembers nothing, and is unaware of what is happening around them. This stereotype tugs at the heartstrings and loosens the purse strings, so is used in seeking funds for research, support, and services. It’s a Catch-22, because Alzheimer’s associations promote our image as non-persons, and make the stigma worse.” What age scholar Margaret Gullette calls “our irrational fear of forgetting” has made such deep inroads into our psyches that routine memory lapses provoke terror, and diagnoses invoke thoughts of suicide.

The odds of dementia increase with age, but the illness is not typical of aging. Our fears are way out of proportion to both the scale and the nature of the threat. Falling dementia rates ought to reduce those fears, as should the fact that the world is becoming a better place to be a person living with dementia, thanks to the work of remarkable advocates like Bryden, grassroots movements like Momentia in Seattle, and geriatrician and thought leader Bill Thomas. Thomas proposes an approach based on his Eden Alternative nursing homes, humane communities where people with dementia thrive. Since there’s no cure for the disease, Thomas point out that, “the tool we have is culture.” Few of us are medical researchers, but each of us has the capacity to reduce the stigma and suffering associated with dementia through culture change. What can we learn from people living with dementia, how can we learn to face the disease on an emotional level, and how can we change the culture to become more inclusive?

Thomas is taking this idea on the road with his Disrupt Dementia tour, which advances the idea that a dementia-inclusive world is a human-inclusive world. That world, says tour member and psychotherapist Kyrié Carpenter,  “offers a cure of sorts for what we currently call dementia.”  The tour blends film, music, story-telling, and cutting-edge research into an event that turns conventional thinking on its head in a very welcome wayThe tour kicked off in California this week, and it’s probably coming to a city near you. Check out the itinerary here. And be less afraid.

 

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It’s official—I’ll be speaking at TED2017 in Vancouver in April

That’s big, no-suffix TED mainstage—a thrilling opportunity to introduce ageism as a global human rights issue on the world stage, and it’s damn exciting. It’s also a perfect fit with this year’s theme:

It’s also terrifying, especially the part about not using notes, and I hope the hell words come out of my mouth. Then again, almost all the speakers are terrified, and it’s quite a crew. I’m especially looking forward to meeting Atul Gawande, the author of Being Mortal (and my predecessor as Next Avenue’s Influencer of the Year), and I’m sure Elon Musk is thrilled I’ll be there. Only people who’ve ponied up $8500-$17000 to attend the weeklong conference (no pressure!!!) get to hear talks live (make that competed to pony up—no pressure!!!), and TED decides when (and whether—no pressure!!!) to post each talk online over the course of the year.  Of course I’ll let the world know as soon as it’s available. If words come out—yikes!  And yay!!!

 

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Guest post: Silicon Valley’s unspoken, dirty little secret (hint: it’s not what you think)

This post is  by Jessica Orkin, a President oSYPartners, where she helps people see new possibilities – for themselves, for their organizations, for society – and then create the strategy, experiences and platforms needed to support ongoing transformation and behavior change at scale. For the last four years, she has partnered with AARP and its visionary CEO, Jo Ann Jenkins, to challenge outdated beliefs on aging. This post first appeared on Fox News Opinion.

Recent media coverage has begun to highlight the ageism that is prevalent, but largely unacknowledged in Silicon Valley.  Yes, Silicon Valley is ageist. But the truth is, we all are. Even you. Even me.

Ageism is one of the last “isms” so embedded into our culture that we rarely recognize it in our daily lives. Every day, we draw conclusions about other generations. Boomer employers want to solve the “Millennial problem.” Millennials want the older folks to get with the new program.

My deep desire is to end this generational standoff. It is not doing us any good.  It hurts us personally as we unwittingly limit the things we go after citing our age as a reason.

It hurts us as a society as we limit the ingenuity and innovation that comes from age-diverse workplaces.

It is time to tap into the value brought by bringing generations together, rather than focusing on the differences that divide us.

Consider that a 10-year-old in the U.S. today has a 50 percent chance of living to 104. The implications of this are staggering for how we live, how we learn, and how we work.

Ten thousand people in the United States turn 65 every day — and yet, most of the technology and tools at the frontiers of innovation are designed for and by young people. This gap represents a huge opportunity.

The tech industry has the opportunity to lead the way by taking on two major blind spots:

1. The value of designing for the entire age spectrum: Human-centered design is great, but let’s make sure some of those humans we are designing for are older people. There’s money in it. The annual economic activity generated by people 50+ account for $7.6 trillion in the US alone. And, bringing the best of design and technology to edge cases can drive unexpected innovation.  Consider that Oxo Good Grips created an entire market category – high end, stylish, user friendly kitchen gear designed for people with arthritis but used by everyone.

2. The value of the intergenerational workforce: Scott E. Page’s research has proven that teams of people with diverse backgrounds find better solutions than brilliant individuals working alone.

We often consider gender, race, ethnicity as contributing to diversity. But rarely do we include age.

Yes, we protect against age discrimination, but we don’t yet value age diversity as a thing to strive for.

The companies that figure out how to make the most of intergenerational teams will unlock huge competitive advantage.

There are more older people, living longer than at any other time in human history.

We need more solutions for this new reality. And the first step is to take on our own ageism.

I came to this realization at age 40, through my work with AARP and its visionary and straight-talking CEO, Jo Ann Jenkins. She has invited us all to challenge outdated beliefs about aging and to spark solutions so people can choose how they live as they age.

This work has changed my life. It has changed how I see age and aging.

It has changed how I am parenting my 12-year-old son, as I look ahead to helping him lead a purpose-driven, adaptive, resourceful 100+ year life.

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Ten myths about ageing and health, ranked by the World Health Organization

All around the world, people are living longer—a basic hallmark of human progress, and a triumph of public health. The World Health Organization (WHO) is in the public health business, and no organization has done more to raise awareness of ageism—the biggest obstacle to meeting the challenges of population aging and capitalizing on the “longevity dividend.” Part of the WHO’s global anti-ageism campaign  is a new list of ten common “misconceptions on ageing and health.” The global perspective is instructive, and it’s making me rethink some things—including the burning question of whether to start spelling “ageing” the logical, British-and-Indian way.

  1. There is no typical older person.

That would top my list too. Stereotyping—the assumption that all members of a group are the sameunderlies all prejudice. Of course stereotypes always a mistake, but especially when it comes to age, because we all age in different ways and at different rates. As geriatricians put it, “Heterogeneity is the hallmark of ageing.” Or, less formally, “If you’ve seen one 80-year-old, you’ve seen one 80-year-old.”

  1. Diversity in older age is not random.

Spoken like a tactful epidemiologist! WHO is pointing out that the playing field is far from level: “The physical and social environments in which we live are powerful influences on Healthy Ageing” and are further shaped by “our sex, our ethnicity, and financial resources.” As I write in the manifesto, “The way we grow old is governed by a whole range of variables, including environment, personality, and genes, compounded by class, gender, race, luck, and the churnings of the global economy—over which we have varying degrees of control.” The effects compound each other and add up over time, which is why the poorest of the poor, all around the world, are old women of color.

  1. Only a small proportion of older people are care dependent.

“Care-dependent” is a great way to put it. I tend to frame this in terms of the high percentage of Americans over 85 who live in nursing homes (10 percent) and who can go about their everyday activities without any personal assistance (over half).  The WHO frames this in economic terms as well, drawing on recent research showing that the contributions of olders in the UK “were worth nearly GBP 40 billion more than expenditure on them through pensions, welfare and health care combined”—a figure set to nearly double by 2030.

  1. Population ageing will increase health-care costs but not by as much as expected.

The notion that older North Americans are an inevitable sink for healthcare dollars is incorrect, and the WHO makes the international case. “In high-income countries, there is growing evidence that at around age 70, health-care expenditure per person falls significantly, with long-term care filling the gap,”the WHO observes, so it makes sense to invest in long-term care. Aging influences health care expenditures far less than other factors, especially expensive medical technologies. Related predictions that “too many old people” will tank the economy—debunked here—are biased, outdated, and just plain wrong.

  1. 70 is not yet the new 60.

I take issue with claims like “60 is the new 40!” because they’re based in denial—60, no matter how active, is still 60—but I’ve been assuming that we’re generally healthier and more vigorous than the generations that preceded us. Not so, says the WHO. Although severe disabilities may be less common, “no significant change in less severe disability has been observed during the past 30 years.”

  1. Good health in older age is not just the absence of disease.

“The combination of a person’s physical and mental capacities (known as intrinsic capacity) is a better predictor of their health and wellbeing than the presence or absence of disease,” notes the WHO, suggesting that we focus on improving intrinsic capacity rather than on specific ailments.  As I write in the book, “While physical decline is inevitable, poor health is not.” People get chronic conditions but we learn to live with them. We find ways to keep doing the things wel love—versions of them, at least. No single age-related condition affects most older people. Some of the oldest of the old live well not by avoiding illness, but despite it.

  1. Families are important but alone cannot provide the care many older people need.

“While families will always play a central role in long-term care, changing demography and social norms mean it is impossible for families alone to meet the needs of care dependent older people,” the WHO points out, calling for training and supporting caregivers and for the government and other sectors to share responsibility. It’s the absence of publicly funded support that turns caregiving into a burden—one that falls largely on women. How about paid family leave and subsidizing care for people of all ages? How about a guaranteed, collective, universal right to long-term care that gives women the same options that men—white men with good jobs, at least— have always enjoyed? How about providing decent wages, health and unemployment insurance, and a path to citizenship to those we pay to do this intimate and important work? Which would allow families to do what they do best: be family instead of nurses and administrators.

  1. Expenditure on older populations is an investment, not a cost.

Programs that help olders stay mobile and functional require funding, but what’s often omitted from the accounting is the cost of not making these investments. “These investments can yield significant dividends, both in the health and well-being of older people and for society as a whole through increased participation, consumption and social cohesion,” says the WHO. Some of the return on investment is direct. For example, better healthcare leads to better health, which saves money, improves lives, and allows people to contribute to what AARP calls the “longevity economy.”  Some is indirect, helping societies protect the human rights of their older members and enabling them to live with dignity.

  1. It’s not all about genes.

“While Healthy Ageing starts at birth with our genetic inheritance, only approximately 25% of the diversity in longevity is explained by genetic factors.” I remember how surprised I was to learn that, from none other than geriatrician Robert Butler, who coined the term “ageism” and founded the National Institute on Aging. “It’s really never too late to reinvent yourself and to invent different health habits. Only about 25 percent of our health appears to be due to genes. Seventy-five percent is environmental or behavior,” Butler told me. That why WHO recommends that policies “address these person-environment interactions across the life course.”

  1. Mandatory retirement ages do not help create jobs for youth.

“Policies enforcing mandatory retirement ages do not help create jobs for youth, but they reduce older workers’ ability to contribute. They also reduce an organization’s opportunities to benefit from the capabilities of older workers,” write the WHO. Indeed: the exchange of skills across generations is the natural order of things, but in much of the developed world age discrimination in the workplace has subverted it. Another false dichotomy is that older workers take jobs away from younger ones. Economists call this the fallacy of the “lump of labor.”When jobs are scarce, this is true in the narrowest sense, but that’s a labor market problem, not a too-many-old-people problem. A 2012 Pew Charitable Trusts study of employment rates over the last 40 years found rates for younger and older workers to be positively correlated. In other words, as more older workers stayed on the job, the employment rate and number of hours worked also improved for younger people.

Want older people to be healthy?  End ageism

A growing body of evidence shows that attitudes towards aging have an actual, measurable, physical effect on how we age. People with more positive feelings about aging behave differently from those convinced that growing old means becoming irrelevant or pathetic. They do better on memory tests and are less likely to develop the symptoms of Alzheimer’s disease. They can walk faster and are more likely to recover fully from severe disability. And they actually live longer—an average of seven and a half years. Everyone agrees that health has the biggest effect on how we age—and how much it costs. Think what a global anti-ageism campaign would do to extend not just lifespan but “healthspan.”

 

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Envisioning Elderhood—This-Chair-Rocks style

This email came in a few days ago from gerontology professor Elizabeth Bergman, and it made very happy—almost as happy as the video beneath it, which was created by her student, Anne Qu. It’s smart and funny all the way through, but I especially loved the part where Qu rearranges photographs of all the people she’s already been—a perfect representation of the book’s epigraph: “We contain all the ages we have ever been”—and anticipates the wrinklier incarnations to come. Also, I admit, the scene with the two guys on the sofa talking about the “old guy in the club,” which made me laugh out loud.

Hello, Ashton,

I’m writing to tell you how much I appreciate your book. As a gerontology educator at Ithaca College, my primary endeavor is to teach “traditional age” college undergrads about age and the aging process. Most of my students will only ever take one such course in their entire educational career, so I strive to make as much impact as I can in the course of one short semester! I am using This Chair Rocks for the second time this semester in a course I teach called “Age Matters: Discovering the Possibilities beyond Midlife.” Your book is so accessible and my students really connect with your message.

Students conclude the semester with an “Envisioning Elderhood” presentation, in which they reflect on the development of their thinking about age and aging and imagine their own experience of aging. They are given several prompts to which they must respond in the presentation, including how they plan to “Push Back” and how they are an “Old Person in Training.” Here is a link to the presentation created by Annie Qu last semester (she was happy for me to share with you). You’ll see the influence of This Chair Rocks all over it!

AQu Envisioning Elderhood Pres.1 from Ashton Applewhite on Vimeo.

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AARP’s new video: Aging Stereotypes Aren’t a Punchline

I like! It’s provocative, witty, and a huge improvement on one that preceded it, “What Does ‘Old’ Look Like to Millennials?” I do take issue with the video’s first punchline, Aging is a state of mind. Ageism is indeed a state of mind, but aging is also a physical reality; it’s the same problem I have with the saying that “age is just a number.”  The punchline improves when more two words are added: “Own it.” I’m down with that.

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It’s so great—and I’m so grateful—when readers get it.

This week the 93rd and 94th reviews of my book came in on Amazon, and the combination made me wildly happy.

Jaclyn Geller is the first reader to articulate the hidden-in-plain-sight, why-don’t-we-know-these-things theme that connects my two serious books. She wrote, “In Cutting Loose: Why Women Who End Their Marriages Do So Well, Ashton Applewhite said what many knew but wouldn’t admit: divorce is not the shattering tragedy it’s often made out to be. In fact, many women exit marriages and begin to blossom. For those of us who’ve watched friends leave matrimony behind, start looking and feeling better, and begin to take off professionally, Applewhite’s book was a reality check. One had to wonder, why did it take so long for someone to say this in simple, straightforward terms? This Chair Rocks accomplishes a similar feat of stating the obvious/not-so-obvious in clear, witty prose. Remember being a teenager, hearing that these were the best years of your life, and wincing in horror? Applewhite shows the benefits of getting older: wisdom, sensuality, the pleasure of time-tested, meaningful relationships… Her account is personal but not overly-confessional. Real-life lessons and unique insights emerge from the people she interviews. She debunks myth after myth about getting older, putting everything into a meaningful political context. Buy this book, and buy a copy for someone you love who’s just turned 70!”

Jane Bertrand is working on a book about climbing the highest peak in all 50 states. (Someone’s gotta do it!) She wrote, “I read your book This Chair Rocks: A Manifesto Against Ageism during the fifth annual cross country ski trip in northern Maine with my best friend from kindergarten, her older sister, and a college roommate (ranging in age from 67-69). As we relaxed around the fire each evening, I would regale my friends with key passages from your book, which resonated deeply with this group. Prior to this trip, we had asked ourselves: how many more years can we keep making this three-day trip? After reading the book, we simply vowed “As long as we can.” Bertrand went on to appreciate my “captivating writing style” and “strategies for defying stereotypes,” but that’s not the part that brought a giant smile to my face.  How long will I keep being an activist? As long as I can.

When I hit 100 reviews, I’m having a party.

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my new talk—Aging While Female, Reimagined—debuts on February 2

I’ve been working for a long time on a big new talk about the gendered nature of aging—and procrastinating, because it’s a fiendishly fraught topic. There’s nothing like a deadline to force the hand, and I’m delighted to announce that you’ll be able to hear it on February 2nd at the Senior Planet Exploration Center, in New York. Doors open at 5:30pm; no charge but an RSVP is required. Register here.  

Here’s a description to whet your appetite:

What makes aging different for women — and so much harder than it has to be? How does the double whammy of ageism and sexism affect women’s health, income and well-being? And how does competing to “stay young” dig the hole deeper? In her rousing new talk, Ashton Applewhite proposes that we throw away the damn shovel, forge cross-generational compacts, and collaborate on different ways of thinking and behaving. The women’s movement taught us to claim our power. A pro-aging movement will teach us to hold onto it. 

 

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Gird your loins for 2017 with a holiday special from This Chair Rocks

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Last-minute Christmas shopping? Order a copy of This Chair Rocks: A Manifesto Against Ageism for $15 here.  We’ll ship them within 24 hours and pay the postage. Here’s a review from someone who got the book for her mom and realized that it’s not just for olders.

I bought this book as a gift for my mother who sometimes feels overwhelmed at the prospect of growing older. This year’s milestones for her included: going 100% gray (no more dye) and becoming a grandmother. Although she shows no signs of slowing down, she feels the general invisibility of becoming an older woman in society and the workplace. Needless to say, she LOVED this book and the timing was perfect. She laughed out loud while reading it!

I quickly realized that this book is suited for me just as much as her. The author writes “The sooner growing older is stripped of reflexive dread, the better equipped we are to benefit from the countless ways in which it can enrich us.” This is really a handbook on how to live side by side with people of all ages respectfully so that we can avoid the prejudices our grandparents face(d). There are so many child rearing books (trust me, I am in the thick of reading them) but until now nothing guiding us and helping us navigate the last quarter or more of our life cycle.

This book accomplishes just that. And it is full of punchy one-liners and staggering statistics. I highly recommend this book to anyone, of any age.

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The current moment: what’s ageism got to do with it?

I wake these days remembering that something awful has happened. Reality assembles itself, and I feel worse. The multicultural, egalitarian, globalized society I hope to inhabit is under assault. Bigotry is ascendant. Racism, sexism, homophobia, religious intolerance—pick your prejudice!—are sanctioned, even celebrated. How do we respond to attacks on those most vulnerable? How does the mission to build a movement against ageism fit into this historical moment?

Until I thought hard about it, just posing that last question felt self-indulgent. Why insist on adding another “ism” to the list when so many higher-profile forms of discrimination, racism in particular, rightfully demand bandwidth? Should ageism move to the back of the line, at least until Medicare is in the crosshairs? Here’s the thing: we don’t have to choose. It’s not a competition. And it’s not zero sum. All forms of discrimination intersect with and compound one another. The flip side is that when we make a community a better place in which to be from somewhere else, to worship a different god, to have a disability or be non-white or non-rich, we also make it a better place in which to grow old.

Ageism is the perfect target for collective advocacy because it affects everyone. That very attribute, its universal nature, means that we undermine ageism when people of all ages show up for stuff. It’s that basic. The vital task for each of us—youngers and olders alike—is to join whatever struggle matters most to us in the days ahead. Stand up and step out—into the community, the classroom, the courts, the town squares.

Age-integrating the struggles ahead means coming to grips with our own internalized ageism, the voices that whisper “too old” or “too young,” that make us complicit in our own marginalization. At times there may be good reasons to sit tight, but age alone is not one of them. Only when each of us rejects this culture’s ageist script can we play the roles for which we were born—and we were all born for this time. Every stage of life has its strengths, from physical resilience to historical perspective, and we are strongest when we collaborate. If everyone in a group is the same age, whether 17 or 70 and whether it’s focused on carbon emissions or hate speech, it will be less creative and less effective. We are stronger together in the streets as well. Many olders are more vulnerable physically, but less likely to be victims of violence or seen as threats. Let’s change that. Let’s share the risk.

Standing together—whether in front of a mosque or a clinic or an encampment or a bank—undermines age stereotypes and builds solidarity. We are all old or future old, and Joining forces across our years offers a unifying cause in these divided times. We add ageism to the list of “isms” that we will not tolerate—implicitly, because all ages show up, and explicitly, because we insist upon it. Dismantling ageism changes from aspirational goal to certain outcome. We move organically towards a society where young and old, gay and straight, black and white, rich and poor all have a voice and a path. We have no other option, because we’re going to need all hands on deck—and because the possibility for radical social change has never been greater.