Date: October 1st, 2002
One hundred years ago, when life expectancy for a newborn in the United States was less than 50 years, there wasn't a lot of worry over how to care for massive numbers of older Americans. Back when only one of every 25 Americans reached the age of 65 - and 65 was considered old! - U.S. politics didn't give much attention to something called the "Graying of America." Words like "geriatrics" and "Alzheimer's Disease" hadn't even entered our vocabulary.
To appreciate why population aging had so little hold on our grandparents and great-grandparents, consider this: In the year 1902, if it had been somehow possible to gather together everyone in America who had reached the age of 85 or older, that population would have scarcely made up a single Zip Code in today's Sun Belt. And if 1902 seems too distant to be relevant, you should remember that is the birth year of a currently serving United States Senator - Strom Thurmond of South Carolina.
What happened between then and now was the tempestuous 20th Century. One of the most profound changes wrought by the last hundred years has been a nearly 50% increase in average life expectancy, driven in large measure by the advent of new medical technologies and scientific breakthroughs. We have transformed the duration and quality of human life for people in the industrialized world because of what we have learned from scientific research and what we've been able to apply in better health and care for people as they age.
A century ago the leading causes of death in the U.S. were tuberculosis, diphtheria and influenza. Thanks to discoveries of antibiotics, vaccines and improved public health measures those top three killers are no longer major threats to Americans. More recent developments in IV therapy, clot-buster drugs, angioplasty, along with new understanding of the importance of diet and exercise, have made significant inroads against today's top killer diseases: heart attacks, cancer and stroke.
Chronic age-related diseases that gradually disable over long periods of time are emerging as the leading health challenge of the 21st Century. This is quite a new event in human history. Literature from the Bible onward does not record, until fairly recently, instances of older people dying after long, lingering illnesses. No medieval scribe ever wrote something called "Tuesdays with Theodoric." But in the new century, Alzheimer's and Parkinson's diseases, type II diabetes, vision and hearing loss, bone and joint diseases, incontinence, depression and other maladies of the old could approach epidemic proportions. These diseases deprive older people of their cherished independence, rob the quality of longer lives, and threaten all of us with mounting bills for national health care.
Of course, in the continuing debate over health costs, some will always argue that new applications of science and technology will make matters worse. The bio-ethicist Daniel Callahan, for instance, has written extensively that the quest for longevity and health makes for an explosive combination when merged with still newer medical technologies. Callahan believes this so strongly that he has urged government to explicitly ration health care based upon the patients' age. Others have argued persuasively that only by tapping a deeper understanding of aging and health through further research will be achieve for most people the quality of life we would all wish for ourselves and our loved ones. This point of view was perhaps best summarized a few years ago in a study by the prestigious Institute of Medicine, which said:
"Science offers the best hope to improve the older person's quality of life. Research that is directed and supported properly can provide the means to reduce disability and dependence in old age, and can decrease the burdens on a health care system strained to its limits."
Keep in mind that only with a national commitment to basic biomedical, clinical and behavioral research will we meet humane goals of longer, healthier and more independent lives. The objective of longevity science is not to engineer people who live 200 years or more. It is to add to the good years of life, to strengthen our physical and mental capacities for full functioning, and to allow us to age with health, vitality, and to contribute to our families, our communities, and our unique life goals.