Ageing is a triumph and a new research paradigm is needed
By Patricia Edgar and
Don Edgar
Posted Monday, 13 October 2014
We have a problem with social attitudes towards ageing and it's not just with politicians and policy bureaucrats. It's with the media, journalists and misguided advertising where older people are rarely presented in any way but negative. And it's with the wider public who are obsessed with trying to stay and look young, and who view with dread the negative stereotyping applied to what will be the largest cohort of people over 60 ever seen in the history of mankind.
It is claimed a pending tsunami of the aged will create a social and economic crisis. The validity of such claims is questionable so we need evidenced based studies to understand this demographic revolution. The aged are no longer the halt, the sick and the lame. They are a new breed and we need to move beyond last century models of gerontology. We need new research because we can't develop sensible policies and programs for people when we don't know who we are talking about.
Treasury and age researchers need to be reminded that people do not just become dependent when we become old. How useful is the measure of GDP in understanding this assertion when caring, voluntary and creative work which contributes $200 billion to the economy is not counted in GDP? And to what extent is ageing really the cause of escalation in health care costs? Much of the increase is due to new technologies, new pharmaceuticals and treatments, not ageing.
We need to think of ageing not as a disease, but as a process of living. It's not even a 'stage', as we begin to age from the moment of birth - with no clear cut-off point defining when we become 'old'. It is the ageing process and its variations that should be the focus of research and the development of ageing policy.
Clearly our bodies do not stand alone - they operate within diverse and changing physical and social conditions that explain as much, if not more, about how we age differentially than genetic makeup and inherent weaknesses. The really interesting questions will be what differences in lifestyle explain why and how genes operate and mutate differentially as we gradually age? How do we help people understand that they can modify their lifestyle to alleviate the effects of physical ageing, rather than waiting for a new miracle drug or passively accept the inevitability of decline?
Research by the American National Institute of Ageing suggests negative stereotypes influence how elders view themselves: they even adversely affect health and longevity becoming self fulfilling prophesies. The New York Times reports studies that show seeing or hearing gloomy nostrums about what it is like to be old can make people walk more slowly, hear and remember less well, and even affect their cardio-vascular system.
We need to shift the research paradigm from a medical, disease-prevention model, which starts from a 'problem' to be solved, with 'cures' or 'treatments' to be found and prescribed to a model based on well being - using concepts like 'healthy ageing', 'optimal ageing', 'positive outcomes from health intervention'. The terms we use will make all the difference. But people (including professionals) are slow to grasp this concept and seem to persist with their old habits.
The new ageing research paradigm should identify the factors that distinguish those who age healthily and optimally from those who do not, applying in control group experiments interventions which are likely to have a positive effect on the ageing experience; and measure the outcomes in individual, social and economic terms. We should study the very old who are not having medical or 'ageing' problems and we should ask why. Research has to measure outcomes and measure 'success', not by how many drugs are administered, but by whether, and by how much, health and wellbeing are actually advanced.
Ageing research funds would be more likely to flow if we could demonstrate to Treasury more positive outcomes for society and the economy as well as the individual.
Such a paradigm shift requires researchers to be active disseminators of their work, to get the evidence-based message out into the community. Publishing a paper, or presenting at a conference is not enough. Universities are notoriously slow to turn their research and peer-reviewed articles into papers and positions that can influence public policy. But that is an essential part of the job. That engagement is what research in this field now requires.
Other research questions need to examine how education and social engagement can enliven the brain, prolong a healthy life and stall dementia; how lack of social contacts and support can be a person's undoing. Changed patterns of marriage, separation, divorce and remarriage obviously alter the experience of ageing, yet where is the research on support for the aged when divorce has disrupted contact between grandparents and grandchildren? Or where a new partner does not get on with their in-laws? Or where perhaps the existence of multiple parents and grandparents transforms the nuclear couple family into an extended 'lattice family' with multiple support networks?
Who will do the research on how the trend for young people to live at home into their thirties, delay marriage, bring sexual partners into the parental home, plus the rising cost of housing and extended 'earn or learn' policies for unemployed youth, combine to alter the patterns of inter-generational relationships and, in particular, the way family support systems cope with an ageing population? Such changed patterns will generate new challenges for future public policy decisions. But we need new research to convince the policy makers that a whole new approach to ageing is worthwhile and necessary.
Unless researchers start to document such issues, we will continue to stereotype the aged as a dependent burden on society which is far from the case.
Patricia Edgar is an author, television producer and educator. She was the founding director of the Australian Children's Television Foundation.