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The road to longevity

Photo Elliott Burr/Town Crier Les Spring, left, a volunteer with RoadRunners, drives Los Altos resident Barbara Schulke, 79, home from a doctor's appointment.

Imagine that it’s the early 1900s and you have only 50 years to live – a half century to grow and learn, establish a career, find a spouse, start a family and raise children. There isn’t time to do much else after that. Time travel forward to today, 100 years later, and a man who lives to 65 can expect to live to 82 – a woman who reaches 65, 84. By 2050, life expectancy will increase an additional two years for both.

It’s the phenomenon of longevity – and that phenomenon is growing in the United States and globally. And the number of senior citizens is increasing. By 2050, the 65-and-over club will outnumber children, expanding its population 120 percent over the next 40 years. The 15-and-unders – 35 percent (aforementioned figures from U.S. government agencies).

Consider it a mixed bag of blessings and blight. On the one hand, U.S. citizens are leading longer, healthier lives. On the other, an aging population that lives longer places stress on entitlement programs such as Social Security and Medicare.

That mixed bag was the impetus in establishing the Stanford Center on Longevity, a research facility affiliated with Stanford University that studies the nature of the entire human life span, seeking ways to use science and technology to solve the problems an older generation will experience and improve the well-being of people of all ages, according to center director and Los Altos resident Laura Carstensen, Ph.D.

“We have supersized our lives. We have doubled life expectancy in the 20th century – we added 30 years,” she said. “The issue is: What do we do to the world we live in? This has created challenges – planning for the human species that has an opportunity to grow old.”

 

The three ‘Ms’

The center may well be the first of its kind in the country. While many clinics and studies collect data on “aging,” Carstensen and 20 Stanford faculty co-founders of the center focus on “longevity.” What do people need to learn to live healthy lives into their 80s? And if you’re a toddler today, you’ll very likely hit the centenarian mark.

“Mobility, mind and (money),” Carstensen said. “Stanford has real expertise in all these fields.”

Mobility is an issue for Los Altos resident Barbara Schulke, 79, a widow who forfeited her driver’s license in 2003 because of vision problems and Type II diabetes affects her circulation and walking gait. El Camino Hospital Auxiliary’s RoadRunners get her where she needs to be.

Family members help Schulke with grocery shopping and other weekend errands, but RoadRunners volunteer drivers deliver her to weekly doctors appointments.

“I just can’t drive. Your independence really takes a hit – to depend on others to take you there,” Schulke said. “(RoadRunners has) been a goodsend ever since.”

For Carstensen, it’s getting the mobility thing ingrained in children that will keep them mobile in the future. Along with longevity, the growing incidence of diabetes not only threatens seniors’ health, but it’s also a health concern for younger generations. Carstensen cites alarming numbers for poor children. By age 5, too many exhibit preconditions for diabetes, including obesity.

“We’ve got to stop that,” she said. “In an age of longevity, we can’t afford that.”

The not-so-old-or-young ones are vulnerable, too.

“Being physically sedentary at work for long periods of time is just as bad as sitting at home in front of a TV,” Carstensen said. “Revamp your workplace. We can change our environment as much as it can change us.”

Ultimately, it’s the behavior and lifestyle changes that people make that get them into the most trouble healthwise, but some aging processes aren’t necessarily preventable.

Los Altos resident and Stanford engineer Thomas Andriacchi, Ph.D., has designed a shoe that slows progression of osteoarthritis, Carstensen said, and other researchers are studying stem cells for repairing muscle – the science and technology thing again.

But new shoes won’t help Schulke, who reminisced about the small, village community Los Altos was when she arrived in 1958.

“It was perfectly safe walking,” she said. “I don’t take long walks in the neighborhood, but I do OK. I fix my own meals and do my own laundry. And right now, I can still get in and out of the doors.”

 

Mindful matters

It won’t matter how physically fit, healthy or mobile people are if their faculties are on an extended vacation. Remaining cognitively alert is instrumental to a happy life lived long.

“With mental fitness, the problems associated with longevity fade,” Carstensen said. “You can live healthy for decades.”

Advanced age is an attributed major risk factor for Alzheimer’s disease and other dementias. Interestingly, though, fewer years of education is also associated with increased risk for dementia, as is a genetic factor called Apo-E allele, according to information from B.L. Plassman et al., “Prevalence of Dementia in the United States: The Aging, Demographics, and Memory Study,” in Neuroepidemiology’s October 2007 issue.

Approximately 130 Stanford faculty participants at the longevity center pose queries to develop lab research that identifies the actual causes of dementia. Which current research might uncover ways to reduce the progression of dementia? Which levels of education, obesity or other lifestyle factors increase or decrease the prevalence of dementia? Are there estimates of costs savings for even the smallest medical breakthrough?

A study published by the Stanford Center on Longevity projected that dementia cases will exceed 11 million in the U.S. by 2050, more than doubling from the 4.3 million diagnosed in 2010. Moreover, health services for demenia patients cost Medicare and Medicaid a combined $112 billion in 2005, according to 2009 Alz-heimer’s Association data. The assumption that the amount will more than double by 2050 boggles the mind.

Alzheimer’s costs also include a $94 billion value in unpaid caregiving and $36.5 billion in indirect costs to businesses that same year.

And caregiving comes in many forms. When Los Altos resident Les Spring retired in October 1989 – “I remember because it was the year of the Loma Prieta quake” – daily plans were flexible.

“I had a vision of doing whatever I wanted to do, whenever I wanted to do it,” he said.

That lasted about four to six months.

He began a new career as a volunteer with El Camino Hospital’s Auxiliary, working at the front desk, wheeling patients to the exit and serving a stint as treasurer. But when he heard about the growing need to transport seniors to and from medical appointments, Spring dove into driving.

“I like to help people,” he said. “And public transportation is not that hot.”

For more than 20 years, Spring has volunteered his services as a RoadRunners driver, chatting up his passengers as he delivers them to their destinations. And for what he gives, he just may get. Studies increasingly suggest that seniors who socialize are at lower risk for dementias – and the contribution he gives to his community helps plug budget gaps in a troubled economy.

And, when he fell from a ladder while pruning a fruit tree and crushed his leg bone in multiple places, it was a cinch for the RoadRunners driver to hand over the keys and become a passenger while he recuperated.

 

Looking forward

One of the longer-term focuses the Center on Longevity hopes to address is preparing young children to think about their futures – but not in terms of what they want to be when they get older.

“What you are going to be doing when you’re 80?” Carstensen said. “You must envision old age in order to plan for old age.”

She’s got the stats to back her. Stanford colleague and Carstensen’s once-graduate student Hal Ersner-Hershfield surveyed two groups of students. One group viewed screened images of themselves, progressively aged, before answering a questionnaire. Ersner-Hershfield reported that individuals in the group that saw their aging images responded that they would aggressively set aside funds for retirement. The other group wasn’t urgently motivated to set aside money.

“(Ersner-Hershfield) concluded that when people connect to themselves in the future, they plan better,” Carstensen said.

She also uses her book, “A Long Bright Future” (Crown Publishing Group, 2009), to inculcate lessons of social responsibility and reason to her Stanford students. Although she wrote the book with all ages in mind, Carstensen said this up-and-coming generation of students knows that the burdens of Social Security and Medicare will fall to its shoulders.

Carstensen’s premise that with longevity comes a mandate to contribute as much as you can to society for as long as possible – adopting those behaviors that help you live a long, healthy and happy life – strikes a chord with young adults.

“Students really relate to this,” Carstensen said. “If you’re 20 today, you’re going to reap the rewards or bear the burdens of longevity.”

 

For now
Services that the RoadRunners and other agencies offer seniors fill the needs of a generation that has watched computers replace typewriters, cell phones forgo landlines and cars hook up to electrical outlets. But the added years we gain take a toll on entitlements. Carstensen said the Center on Longevity is working to advise policymakers on developing new and flexible plans that, yes, ask able citizens to work beyond the established retirement age.

Perhaps measuring our age to our value as workers is wrong. “We say 65 is when you are old,” she said. “What if we say 75 is when someone is old? Tap the resources that 65- to 75-year-olds have to offer?”

Without creating blanket policies, Carstensen suggested that financial incentives could be awarded to seniors who continue working, while those with health problems could retire at 65.

Spring can’t envision retiring as a volunteer driver, but he admits that day will come. And he’ll probably find another way to contribute his talents.

“To me, volunteering is just a way of helping people out,” Spring said. “I just like to work with people – I’m a people person.”

And RoadRunners always needs volunteers. For more information, call 940-7016.

For more information, visit longevity.stanford.edu.

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