In a world built by and for the young, we need technologies to engage the booming population of elders
By Laura L. Carstensen
Throughout history humans have sought eternal life. In Greek mythology, Iolaus prayed to the goddess Hebe, who could restore youth. Spanish explorer Ponce de Leon claimed to have found the Fountain of Youth on a 1513 expedition to Florida. Today human life expectancy is nearly double that of our great grandparents, thanks to science and technology, but we’re missing the mark, says Laura L. Carstensen, founding director of Stanford’s Center on Longevity. Instead of finding ways to enjoy our old age, we worry about the illnesses and handicaps that will plague us when we get there. Rather than resign ourselves to bedpans and dentures, we should use technology to make our increasingly old age the best time of our lives.
In everyday parlance, “technology for aging” has come to be synonymous with health technology; and to most, “longevity technology” is simply a euphemism for aging technology. Older societies demand innovations in health care, to be sure, but longevity requires the development of a far broader technology agenda, one that addresses nearly all aspects of life and spans generations.
Given that advances in science and technology are the very reason for the stunning increase in length of life, it is particularly curious that the technology world has participated in the widespread societal resignation about its potential. Nobel Prize–winning economist Robert Fogel and his colleague Dora Costa describe the near doubling of life expectancy in the 20th century as the product of “technophysio evolution” — namely, biological changes due to technological advances. Agricultural technologies became so effective that, for the first time in human history, a steady food supply was ensured throughout the year. Electricity was harnessed and made widely available in American households. Refrigeration greatly improved the safety of the food supply in the entire population. Pasteurization and water purification contributed further to the health and longevity of entire populations. The systematic disposal of waste reduced the spread of contagious disease.
And the direct consequence was that, for the first time the vast majority of babies born in the developed world began to have the opportunity to grow old. Although we were (and remain) no different genetically from our ancestors ten thousand years ago, the working capacity of our vital organs greatly improved. Average body size increased by 50 percent. We are taller and our brains process information faster. And we came to live a lot longer.
I am amused when I hear young people today remark that they are more technologically sophisticated than generations past. The technological proficiencies of our great- and great-great grandparents nearly doubled life expectancy!
Fixing aging’s image problem
You’d think that we’d start investing heavily in science and technology to ensure happiness, health and prosperity during these extraordinarily long lives. But currently the technology space surrounding aging includes a range of products from video surveillance of older relatives, pill boxes that remind users to take medications, and necklaces with buttons that call for help when an old person has fallen and can’t get up. If you google “technology aging,” almost all of the links access stories, businesses and government agencies that provide health care services to elderly people; the texts on these links refer to “patients” as often as “people.” In most minds, aging translates into illness.
Aging is associated with a desire to find emotional meaning, make a difference and leave a legacy.
Don’t get me wrong. The over-85 age group is the fastest growing segment of the population. Ensuring that elderly people can live on their own terms (for most this means living independently in their own homes) has ignited a fast-growing industry of elder technologies aimed at helping elders stay safe. Although there has been a tendency in this industry toward “over-monitoring” guided more by capability than perceived need on the part of older people, very thoughtful new products like “My Lively,” are coming on the market. These sensor-based systems improve safety by sharing information about activities among loved ones, strengthening social connections across the miles while simultaneously respecting privacy.
The Lively approach recognizes that although aging is associated with a range of increased risks, by and large, older people are going about their lives as younger people do. The majority of Americans over 65 years old are not functionally impaired. The more we learn about aging, the more nuanced the story becomes. The last two decades of research have shown clearly that aging is not a slow and steady downhill slide. Most people are happy and healthy until a few years before they die. Alzheimer’s disease is a pernicious disorder that steals the minds of victims. But equating old age with dementia is wrong. If there is any good news about the disease, it’s that the majority of us will not suffer from it. And although most people are limited in their abilities the last few years of their lives, for most of the decades beyond 65, most older people live independently and contribute to families, workplaces and communities.
Emotionally, older people are doing better than younger and middle-aged people. Aging is associated with a desire to find emotional meaning, make a difference and leave a legacy. As people grow older, they grow more selective. They care less about meeting new people and more about maintaining connections with close friends and relatives. Aging is associated with the desire to savor life. As much as we need to develop technologies that make accommodations for older people who need help, an exclusive focus on frailty misses the mark. It’s no wonder that grandma isn’t crazy about a system that will videotape her every move and send messages to her children. She’d probably prefer Readeo, an application that allows grandparents and grandchildren, no matter the distance between them, to see one other as they turn pages of storybooks together.
Optimistic — not resigned — technologies for aging
Some of the most exciting technologies for aging address emotional aspects of life. Some, like Good Night Lamp, which to my knowledge was not developed for old people, is a network of physical lamps. When one lamp is touched the others light up wherever they are in the world; with a simply touch you can tell someone you are thinking of them — perfect for people who care far less about sending global “tweets” than maintaining contact with a select group of family and friends. Music Memory Box, developed by the granddaughter of a woman suffering from Alzheimer’s disease, is another product that elicits memories by activating emotion centers of the brain (which remain reasonably intact even into late stages of dementia).
The greatest gap in longevity technologies concerns an unfilled need to help young people age well. For the first time in history, young people can anticipate with considerable certainty that they will be old people (for a very long time). Yet the human brain is ill-suited to plan decades ahead. The distant future, for most of us, is hazy at best. It’s no wonder that we don’t save enough money or exercise like we should. Rather than resign ourselves to doom, we need to recognize these human foibles and develop technologies that help us address them.
For the first time in history, young people can anticipate with considerable certainty that they will be old people (for a very long time).
Once again it comes down to emotion. Projections into the long-term future are devoid of that visceral connection that motivates action. If you tell me there won’t be dessert tonight, I begin to plan ways to get to the bakery. If you tell me there’ll be no dessert after the New Year, I gladly accept the resolution. Absent strong emotional connections, we tend to plan for our futures in cold and calculating ways, the way we would plan for strangers. At Stanford, we’ve introduced young people to their future selves by representing their aged selves through age-morphed digital avatars and using immersive virtual reality to provide them with a lifelike experience with the avatars. After they complete the exercise, we ask them how much of a hypothetical $1,000 they want to allocate to their retirement savings. Compared to a group who interacted with an avatar of the same age, participants contribute twice as much money to retirement.
Virtual reality is but one technology that could help people age well. Technologies can help people monitor spending habits and make wise investments. Technologies can make lifelong education possible and rather than exacerbate class disparities, technologies can be designed to reduce them. The greatest obstacle may be lack of imagination. As much as we may fancy ourselves free-thinking, humans are creatures of culture; and the crux of the longevity challenge is, quite frankly, that we live in a culture that evolved around lives half as long.
At the Stanford Center on Longevity, which I direct, we maintain that to the extent that we build a world in which the majority of people arrive at old age mentally sharp, physically fit and financially secure, the problems of individual aging and aging societies will recede and we can change the ongoing conversation from one about a crisis on the horizon to one about long life and new opportunities.
The angst that so many feel about their own aging and aging societies is predicated on the belief that aging people are needy, sick and unproductive. I asked a large class of Stanford students how many of them looked forward to being 80. One hand went up. I said, what if I told you that you’d be fit, sharp and financially secure at 80? More than half of the students then raised their hands. I could see a couple of students chuckling and I added, what if I could assure you’d be good looking too? I had the rest of them.
Let’s start aiming higher.