Answers on Aging
Boomers have plenty of issues to wade through in the years ahead. We asked five experts to help.
(Photograph by Josh Campbell)
Joseph Coughlin and the MIT Agelab are studying experimental systems, such as touchscreens, that personalize cars and are using cameras to examine how older drivers use new technology.
AS BOOMERS GET older, their questions build: How can I fight aging? Am I really ready for the next stage in life? Is my 401(k) growing fast enough to help me retire when I want to? Do I need a Facebook page? We asked some local experts in business and technology, dermatology, finance, pathology, and mental health to help out this generation with some of their most pressing questions. Their suggestions range from the small (use sunscreen!) to the superhuman (here's an idea: let's overhaul the nation's healthcare system).
WHERE MACHINE MEETS CONSUMER
Joseph Coughlin is the director of MIT's AgeLab, a research program aimed at understanding consumers over 45.
What are boomers looking for in gadgets and technology?
Ease, accessibility, and fun.
But if anything, technology seems to be getting less simple.
Whether it's a product, a service, or a technology, we have feature creep. If you need directions for how to use something, that's just bad technology.
What manufacturers are doing it right today?
Well, this is why Apple has really started to take off. Their strategy around design is clean, fun, and easy to use. GM and
Is the focus on ease and accessibility mainly to accommodate aging eyes and brains?
People think we need to develop gadgets for older folks, and nothing could be further from truth. Baby boomers may not be young, but they don't think they're old. So another lasting feature that they're going to demand is personalization.
For example?
At the AgeLab we're working on the Aware Car, or Miss Daisy. It has dashboards and interfaces that can be customized for more than one driver, so you can select the gauges you want, their font, the backlighting. We're working on interfaces like this in many areas, from kitchen appliances to medical devices. Cars will also help people drive longer. They'll have greater sensitivity to the driver's health. They'll detect fatigue and distraction.
But will these cars be on the road in time for boomers to use them?
There is a call to urgency here and we need to work quickly. Cars take several decades to show innovations. The technology in today's cars is already five to 10 years old, though some businesses are trying to respond faster.
And what about the fun part you mentioned earlier?
We're working on devices that use emotion and social networks to improve home healthcare. Imagine you and your grandchild have linked Tamagotchi-like toys. If your grandchild is doing her homework and doing everything a good kid should be doing, your pet will be healthy and happy. And if you're taking your meds and taking care of yourself, her pet will be healthy and happy. If either one of you breaks the social contract, the bunny dies.
REFINING THE SCIENCE OF LOOKING GOOD
Ranella Hirsch is a Cambridge dermatologist and coauthor of the Concise Manual of Cosmetic Dermatologic Surgery.
How is technology changing people's attitudes toward aging?
On a lot of levels, baby boomers have taken ownership of the definition of aging. People really believe that 50 is the new 30. There is some adaptation necessary, but people understand that in many ways their best years are still in front of them, and they're thinking, "Why shouldn't I look my best?"
Are most of your patients women?
Yes, but I'd say probably 30 percent now in this age group are men, which is a significant upswing. And they don't necessarily fit the stereotype of metrosexuals.
What are the most common procedures?
Aside from laser hair removal, there are three major areas. First is the use of injectables: dermal fillers, which function almost like spackle, filling in the spaces that used to be filled by a patient's own collagen, and Botox. Second is lasers for removing sun damage - dark spots, red marks, and fine wrinkling. Third, and most often overlooked, is skin care. In between appointments with someone like me you can go home and use great, inexpensive products that can help you maintain - foremost, of course, being sunscreen, but also over-the-counter retinols, alpha hydroxy acids, and antioxidants like Co-Q10.
What about so-called nonsurgical face lifts?
They apply some form of energy to the skin, either heat or light, to create controlled injury so that when the skin heals it produces new collagen. The results have been mixed, but these procedures are getting better every day.
Will there come a time when we never have to go under the knife?
That's the intention. A lot of my plastic surgery colleagues are moving away from radical face lifts and making more subtle changes rather than dramatic shifts. There will probably always be a role for surgery, but a lot of people go to the plastic surgeon and in many cases don't need to.
What great thing is out there that people are not taking advantage of?
You can spend a lot of money on me, or you can start buying, at age 20, a simple bottle of sunscreen. And we now know that SPF-30 is the bare minimum.
RETHINKING THE DEFINITION OF AGING
David Sinclair is an associate professor of pathology and director of the Sinclair Lab at Harvard Medical School.
Is aging a disease?
As I define it, disease is a process that prevents you from functioning in an optimal way. And that's what aging is. I think of aging as a collection of diseases.
So we need to change our paradigm?
Absolutely. The medical establishment regards aging as something we really can't do much about. The new science of aging says that's wrong and that we can intervene in the process.
How long before we know whether the drugs now in development delay or reverse aging?
Well, there's no way to speed up the process of learning whether people are living longer. But it's routine to extend the lifespan of most lab organisms. We've known for 70 years that rats live longer on calorie-restricted diets.
Calorie restriction is pretty difficult for most people. Is a pharmaceutical alternative coming?
We'll probably find that one of the drugs we're working on to increase lifespan will also treat a specific disease - probably a disease of aging. The scenario I hope to see is that a doctor prescribes a medication for diabetes, and then says to the patient, "I have to tell you that as a side effect that you'll be protected against cancer, osteoporosis, and heart disease. Are you willing to live with that?"
How do the new drugs work?
They're targeting the body's natural pathways against aging. We've learned in the past 15 years that there are key genes that control the pace of aging; when one of them, SIRT1, is activated, in yeast or worms or flies or mice, it improves health. SIRT1-activating drugs are now in clinical trials for specific diseases. One of the nice side effects of these molecules is that they increase endurance.
Are these drugs basically a way to make the body heal itself?
That's exactly it. We've known the body is capable of healing, but haven't really known how to turn those mechanisms on with a drug.
So these drugs might represent actual cures?
The misconception is that because we study aging, the only drug we'd come up with is one that would prevent disease. But clinical trials have found that they can also treat disease. That's important because making drugs that prevent disease is extremely difficult and takes a long time to prove, but for something like diabetes, you can see results in three months.
What commitment do we as a nation need to make to research?
I think it comes to the fact that scientists, politicians, and the general public think that aging is something that's natural. There's almost a subconscious feeling that we shouldn't be attacking it directly. But death during childbirth used to be natural, too.
A MORE SOLID FOOTING IN RETIREMENT
Alicia Munnell is a professor of management sciences at the Carroll School of Management and director of the Center for Retirement Research at Boston College.
What should we be aiming for in retirement?
The goal when you retire is to maintain approximately the same lifestyle you had before you retired. For the bulk of the population, Social Security is the backbone. Even for those with incomes over $100,000, it accounts for almost 40 percent of their income. The concern is that the balances in people's 401(k)s are modest. For households approaching retirement - age 55 to 64 - in 2004, the typical balance was $60,000, and it should've been probably $300,000.
The current market aside, can owning real estate help?
In the past, people never had to touch their houses. But that may be a luxury people can't afford in the future. The house is an extremely important asset for most people - after Social Security, it's probably the major one, and I think people will be forced to take on loans such as a reverse mortgage. Right now reverse mortgages have a bad rap. They have been missold and they have upfront high fees and caps, and many companies that do them have taken advantage of people. But in the future they'll become more important.
How will waiting a few more years affect your Social Security?
If you retire at 66 instead of 62, which is when you can first get benefits, your monthly benefit will be one-third higher. If you can hold on until 70, your monthly benefit will be 75 percent higher than if you retire at 62. The good news is that in surveys, boomers say they'll work past 65.
So, problem solved?
The problem is this prescription can be hard to implement. People often make the important decision of when to retire on a whim. They come home from a horrible business trip and say, "I can't take it anymore." And in a split second they've made a decision that will condemn them to a lifetime of low benefits.
CARING FOR THE MIND
Gary Moak is director of the Moak Center for Healthy Aging in Westborough and a clinical associate professor of psychiatry at the University of Massachusetts Medical School.
What do you make of the recent studies suggesting that baby boomers are more depressed and more suicidal than other generations?
Emerging data suggest that boomers may be less healthy in general as they age than their parents, which is startling considering the advances in health care and health consciousness that have occurred. We don't know why yet.
What other kinds of mental-health problems are most common among older adults?
About a third of my patients have Alzheimer's disease. Another third have mental-health problems due to other brain diseases like stroke or Parkinson's or other medical conditions such as chronic respiratory illness or heart disease, which can be associated with severe anxiety, depression, and cognitive impairment. The final third are people who develop problems like depression and anxiety while adjusting to the changes of late life. Geriatric psychiatry largely treats people who've had good mental health their entire lives.
What can boomers expect as they grow older?
The children of my current patients are boomers, and they ask me all the time, What can I do now so I don't get Alzheimer's disease? It's a good question.
Are you saying there's nothing one can do?
We're probably not going to eradicate Alzheimer's anytime soon. But some of the things involved are the same as the basic principles for healthy living. Exercise, not eating too much, getting enough sleep, not smoking, drinking alcohol in moderation. An important one is managing your stress. We've learned that chronic stress can be harmful not only to the body generally, but also, more specifically, to the brain.
What else do boomers need to watch for?
Mental-health problems represent the single greatest threat to quality of life in old age, and we don't have enough subspecialists to deal with these issues. Our healthcare system is not set up for the elderly, even though they're the largest consumers of it. We're not training enough geriatric psychiatrists, nurses, social workers, and doctors now. It's a real global-warming story: We have to start doing something about it now if we're going to make an impact.
How can we make an impact?
We need a massive restructuring of the healthcare system. The current public debate has to do with coverage. The bigger problem for baby boomers and their parents is that the coverage they have doesn't support the kind of infrastructure to treat the kind of medical problems they face. The Medicare system was put into place in the 1960s, and it's designed to provide 1960s mental-health services. We need 21st-century models of mental-health delivery for older Americans.
Elizabeth Gehrman is a frequent contributor to the Globe Magazine. Send comments to magazine@globe.com.
