Tikkun Magazine, September/October 2010
Seventy-Five as the New Forty-Fiveby George Vradenburg
The people of the world are living longer. Baby boomers are feeling younger and healthier than their parents did at the same age. At the beginning of the twentieth century, life expectancy was fifty. Now it's close to eighty. Thirty years added to life expectancy in just one century. Science and lifestyle changes have permitted the greatest extension of life in human history.
Is this all good news? What if, as expected, regenerative science and lifestyle improvements lead to another twenty-plus-year extension of life expectancy in the twenty-first century?
Even as people are living longer, women are having fewer babies, in many countries below the replacement rate (about two children per woman). For the first time in human history, there will be more people over the age of sixty than under the age of fifteen. What are the consequences of this historically unique "age shift" of human populations?
Culturally, those in the developed nations have been accustomed to "retiring" by age sixty (France) or sixty-five (United States). The dictionary tells us that "retirement" means "withdrawal" from work or "taking out of circulation." If life expectancy extends to one hundred, should society want those in their sixties to withdraw and be "out of circulation"?
Public and private pension and health systems are built on the assumption that people retire in their sixties and are given income support and health insurance. What if most people live into their nineties?
Alzheimer's now afflicts one out of two people over the age of eighty-five. If that doesn't change, people may live to one hundred, but half of that population above eighty-five will have Alzheimer's and the other half will be taking care of them. While life expectancy may be extended to one hundred years, will people's brains be there?
In developing nations, longer life expectancies coupled with greater-than-replacement fertility rates mean larger populations and potentially greater poverty. Will the income inequality between richer and poorer nations grow, with implications for poverty reduction, migration, and global security?
Imagine if present demographic trends continue. The population of Japan will decline from 120 million today to 90 million in forty years. The population of Russia may fall at even a faster rate. The populations of Germany, Italy, and other European nations are falling today. Iran's fertility has already dropped below replacement rate. China's population will peak in 2030 and fall as the consequences of the One Child Policy take hold. The populations in high-fertility, Catholic Latin America will continue to grow, and those of sub-Saharan Africa will grow as the scourges of malaria, smallpox, and HIV/AIDS are arrested.
Alzheimer's is an emerging pandemic, with an estimated 36 million victims today, doubling every ten years (by comparison, an estimated 33 million are infected with HIV/AIDS). For every Alzheimer's victim, there are conservatively two to three caregivers providing support, composing a population of over 100 million today personally and directly affected by the disease. But, amazingly, over two-thirds of the cases of Alzheimer's in the next forty years will occur in developing, not developed, nations as life expectancies grow in those countries.
These trends are requiring nations around the globe to think and act differently about aging in three ways:
First, older populations are being viewed not simply as an expense and burden on society, but as potentially experienced workers able to contribute to national prosperity and competitiveness. This shift in thinking will require different approaches to lifelong education and training programs, staggered retirement ages based on physical and cognitive health, and blended public-private pension and health care schemes for part-time work and workers. For developed nations with declining populations, urgent attention to these issues is a national imperative.
Second, as older populations continue to work full- or part-time, attention to healthy aging, including cognitive health, becomes increasingly important to national competitiveness. Many nations, including France, Germany, the United Kingdom, Canada, and Australia, have developed explicit national strategies to deal with Alzheimer's and other dementias. India, Japan, South Korea and others are following. Investment in cures for dementias and other diseases of older populations is shifting national medical research priorities. Next year, the United Nations will host the first-ever conference on noncommunicable diseases, reflecting the reality that, for the first time in history, more people will be dying of noncommunicable than communicable diseases.
Third, important new attention is being paid to increasing private savings rates to build the reserves needed to support individuals and families as fiscally constrained national pension and health care systems are forced to reduce benefits for older populations.
As seventy-five becomes the new forty-five, the ability of nations to stay prosperous, competitive, and safe will demand dramatic new ways of thinking about global aging.
George Vradenburg is the co-publisher of Tikkun.
Source Citation: Vradenburg, George. 2010. Seventy-Five as the New Forty-Five. Tikkun 25(5): 6