'Will you still need me when I'm . . . 94?'

Institute on Aging addresses impact of increasingly older population

Beatle Paul McCartney took a youthful perspective when, at age 16, he wrote about his prospects "When I'm 64." It likely seemed to him that 64 would be quite old.

Now 66, McCartney is part of a demographic cohort that, around the world, is growing rapidly in size. In the United States, an estimated 28.7 million people in 2008 were over the age of 65, representing almost one of every eight Americans. In terms of median age, America is the oldest it's ever been.

James Lubben, Louise McMahon Ahearn University Professor and director of the University's new Institute on Aging (IOA), knows the increase in the number of older Americans is like the appearance of those first gray hairs—it portends a pattern that will have exponential effects. Further, it will be symptomatic of fundamental changes in our society. The results will be felt by individual older Americans and their families, of course, and also by all members of a society transformed demographically.

"The 'aging' of our society is a recent phenomenon," said Lubben. "Throughout history, people have lived long lives. But only a few. Now masses of people will. We want to celebrate that fact, but we need to help people make the most of those years."

Lubben said IOA draws on the strengths of the centers' research in specific aspects of aging but that IOA has a more holistic approach to the subject and would seek to expand the scope of aging-related activities throughout the University. It also has a broader range of functions than the centers, including fundraising, research, teaching, and knowledge dissemination.

A 'community of scholars'
"The institute is to be a community of scholars looking at the various aspects of the issue," Lubben said. It will, among its projected tasks, seek to accomplish several objectives:

• develop a research grant program for faculty members and doctoral students 
• create a coherent curriculum in "aging studies," including an undergraduate minor in the field ("Younger people are going to live in this aging world, and it presents them opportunities as well as challenges.")
•  implement joint appointments of faculty in academic departments and the Institute (a new member of the sociology faculty has a joint appointment with IOA and there is a search underway for an economist with a joint appointment)
• contribute to the broader community with conferences and special lectures open to alumni and friends of the University ("We look for alumni to be able to tap into a wealth of information.")

"Longevity is a blessing. We have to make sure it doesn't come with a curse," Lubben said. "Our overall goal is to enhance the quality of life, quality of care, and vitality among America's growing aging population and their families."

The major social changes that will result from demographic shifts will be as extensive and as strong as those resulting from the Industrial Revolution, according to Lubben. (In the Industrial Revolution of the late 18th and early 19th centuries, new knowledge and inventions such as the cotton gin and steam engine brought about widespread replacement of manual labor by machines. Factories replaced home-based workplaces, people moved closer to the factories in cities, etc.)

"The American family has not gotten smaller—it's gotten 'longer,'" said Lubben. "More families have more generations of members alive together, and that will increase."

Many consequences for families extended in "length" will be positive. Lubben noted that he had hardly known his grandparents, as most had died when he was very young. His granddaughter, on the other hand, has had the opportunity to meet her great-grandmother and enjoys the regular company of all four grandparents. There are other potential repercussions from 'longer' families, such as perceived obligations of one age group to care for another, however, that may be less beneficial.

Increased longevity does mean greater need for medical care. The older people get, for example, more of them will become afflicted with Alzheimer's Disease. In 2008, according to the Alzheimer's Association, five million people over the age of 65 had Alzheimer's, and family members cared for many of them. By 2030, the number of Alzheimer's sufferers is projected to increase by over 50 percent to 7.7 million. Twenty years after that, unless there is a way to prevent or effectively treat the disease, the number of older Americans with Alzheimer's will be 11-16 million.

And Alzheimer's is but one of the many physical conditions or illnesses to which older persons are more susceptible and that would diminish health or quality of life.

'Healthy aging'
Lubben said IOA is considering adding another center that would address health issues more directly. A prospective "center for healthy aging," in conjunction with the Connell School of Nursing, "would conduct research and operate programs to help people cope with the limitations of old age as well as enjoy those years," he said.

Medical advances may well diminish the impact of Alzheimer's and other diseases, but there remain many other aspects of aging in addition to disease and beyond physical.

"How do you maintain meaning in life at the age of 90?" Lubben asked rhetorically. "It is so much more than physical—it's social and spiritual as well."

Lubben maintains American society will need to provide as many programs for adults approaching the end of their lives as it does for children at the beginning of theirs.

"Consider the very diverse and complex collection of needs within the population of young people from birth to age 20," he said. "And then consider a similar range and complexity of needs for adults age 60-100. We provide public school systems and programs and institutions such as Head Start and Boys and Girls Clubs for youth. We will need programs of similar scale for older adults."
 

James Lubben, PHD
Louise McMahon Ahearn Professor of Social Work; Director, Institute on Aging
Professor emeritus, University of California, Los Angeles; national director, Hartford Doctoral Fellows Program in Geriatric Social Work; former member, U.S. National Advisory Committee on Gerontology and Geriatrics