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The Longevity Paradox: Health Span vs. Life Span with Paul Irving
What's the purpose of a long life if our brains can't enjoy it? Paul Irving, Senior Advisor at the Milken Institute on the Future of Longevity and Dean of Faculty at USC's Leonard Davis School of Gerontology, challenges conventional thinking about aging and longevity in a conversation with host, Meryl Comer. Together they address the critical distinction between longevity and brain health and explore why maintaining cognitive function matters more than simply extending lifespan. Paul shares insights into intergenerational collaboration and fighting ageism to create healthier, more productive later years.
Join us for this enlightening conversation that will transform how you think about aging, purpose, and creating a life of meaning regardless of your current age.
If you have a story about your caregiving experience, share it with us at [email protected] to help advocate for continued research funding.
BrainStorm wants to hear from you! Send us a text.
TRANSCRIPT
Georg Vradenburg 00:02
You know, we at UsAgainstAlzheimer's care a lot about how long we live and how healthy we live. There is a strong view in Silicon Valley that aging is now just an engineering problem. Perhaps can stop the process of aging and live forever. I think that's a bit naive. I don't care about longevity. I care about duration of good health, and particularly good brain health, Even if I'm in good physical health, but I don't have my brain. I don't have my sense of relationships and romantic love or love of my family or love of friends. What have I got? What's the whole purpose of life, except for our memories and our relationships and our purpose, all of which are products of the brain? So I want a long life where my brain span equals my lifespan.
Introduction 00:52
Welcome to Brainstorm by UsAgainstAlzheimer's, a patient-centered nonprofit organization. Your host, Meryl Comer, is a co-founder, 24-year caregiver, an Emmy Award-winning journalist and the author of the New York Times bestseller Slow Dancing with a Stranger.
Meryl Comer 01:08
This is BrainStorm, and I'm Meryl Comer. You just heard a top-line view on longevity from our founder, George Vradenburg. Now let's meet today's guest, Paul Irving, senior Advisor at the Milken Institute on the Future of Longevity, dean of Faculty of USC's Leonard School of Gerontology and Senior Advisor on the new PBS documentary Caregiving. Welcome, Paul. Many of our generation and, Paul, I assume you and I are contemporaries have different strategies on how to stay productive, relevant and valued. What most of us want is to support our adult kids and not become a burden. What's your position?
Paul Irving 01:51
That is a very interesting question. So I've got my own perspective about this, which I suppose also goes to my politics, and that is that I think it's incredibly important that in our generation we do all we can to support young people. We're going through, I think, an incredibly stressful, difficult time to be growing up. What we know is that loneliness is really at epidemic levels, at least among young people. You know there were interesting studies on the impacts of COVID isolation on a generational basis and what it found, paradoxically, is that older people, who were frankly more at risk of serious disease and death, were actually less emotionally affected by it than young people. Why? Because we've all been bounced around, We've been bumped, We've had sadness in the past We've experienced this, but for young people that isolation was just incredibly difficult.
02:41
I'm a believer in intergenerational solutions, intergenerational living. I'm on the board of a organization called Co-Generate which is focused on older and younger people working together for social change. Yeah, I'm 73 and proud of it. For those of us who remember the civil rights movement and the Vietnam War, the importance of activism and social engagement, you know. I hope that we say to ourselves as we think about the rest of our lives, knowing that we have fewer years ahead than we have behind. That part of our legacy will be doing something not just for ourselves but for the greater good. So I certainly hope that's the case for a number of people in our generation, and I wish it was the case for more.
Meryl Comer 03:23
Paul, too often with ageism we're treated as invisible. You know, when a doctor says to me we don't have any research on someone your age that's insulting.
Paul Irving 03:33
Meryl, the reality is I used to play sports pretty vigorously. I can't run as fast as I used to and I can't play full court basketball anymore as much as I'd like to, but I'm way smarter than I was when I was 30. And that's just a product of experience, wisdom, judgment. There's an emerging body of evidence Laura Carstensen suggests, who runs the Longevity Center at Stanford, has done a lot of work on this.
Introduction 03:55
Young and old people together.
Paul Irving 03:56
They will outperform same age teams of any age.
04:01
So wisdom, experience, understanding how to navigate environments that comes only with age, and experience the energy and creativity and risk-taking characteristics of youth.
04:12
You put those two things together and you have a very, very powerful way to solve problems and to innovate. When I'm talking to people in the Silicon Valley, trust me, I say to them when you have your most complex Skunk Works project, don't put two 25-year-old Stanford PhDs on the project and don't put two 65-year-old Stanford PhDs on the project. Take one of each and you're much more likely to come up with a fantastic result that's practical, can be operationalized, but also involves new and fresh thinking. So Becca Levy, who's a very prominent professor of psychology at Yale, has done this really interesting series of multi-year studies, and what she's found is that people who see their own aging this is response to self-imposed ageism looking in the mirror and seeing and I often do this kind of pointing at my bald head or my sagging neck seeing those things as necessarily indicative of diminishment, decline, lack of efficacy, et cetera. If we see our aging in a positive light, she finds, we might live an average of.
05:12
Are you ready for this? 7.5 years longer as significant a variable as body mass index, smoking or exercise. So the point is how we think about ourselves, not just about how others think about us, has a direct impact on our health span and potentially on our life expectancy, and is something that all of us should be mindful of.
Meryl Comer 05:33
So, Paul, the politics of our time has put the challenge of age and fitness to serve front and center. In fact, the New York Times recently reported that Congress looks like a gerontocracy. So what does that do to your theory of healthy aging?
Paul Irving 05:49
It's not about chronology. It's about individual capability and capacity. Meryl, one of the things that I think all of us have to recognize and I know you've done, over many years, fantastic work around Alzheimer's, but the reality is that about a third of people, 80, 80 plus, have some meaningful cognitive loss about 50% over 85. But that also means 50%, don't? The point is, we're individuals and we age in our own way. Biology, we know, is more important than chronology. So ageism is wrong. That's idea number one. Idea number two is that, despite the fact that we shouldn't be sidelined, we should be thinking about new roles. We need to enable young people, we need to enable new generations to move into positions of leadership. Need to applaud their succession. Positions of leadership need to applaud their succession. Should politicians cling on to their positions after they lose capacity to do those jobs effectively? No, they shouldn't.
06:44
And yet making assumptions that are based on chronology are wrong. So there are 80-year-olds who were vibrant and engaged and capable you know, warren Buffett just stepped down as the CEO of Berkshire in his late 90s who wouldn't have wanted Warren Buffett to run their company when he was in his late 80s, for example? On the one hand, are people like Mike Bloomberg or lots of others, who continue to be very, very effective in later age. Look, there are 40-year-olds who are ineffective too. There are 20-year-olds who are ineffective. So it's not about chronology, it's about individual performance, and this is why I don't believe in term limits. I do believe in terms, and I think what we need to have is honest conversations with people about where they stand.
Meryl Comer 07:27
Paul, as advocates, we're all concerned that cutbacks by the administration of research initiatives across the NIH firings of CDC and FDA will set back disease treatments and potential cures for patients for years. Okay, paul, now that I got that out of my system, it's your turn to sound off.
Paul Irving 07:47
You know, my inclination on the one hand is to say don't get me started, but now that you've gotten me started, I can't help myself.
07:53
The attack on American science is not only unbelievable and unacceptable. The leadership of American science, not just for our own purposes but around the world, has been critically important, continues to be, and the potential loss of that scientific leadership is devastating, I think, to the United States. And let me address it in kind of two ways. First, at the NIH, which, interestingly, merrill has been one of the most intergenerationally successful organizations in America, because the NIH has been terrifically successful in recruiting the most talented young scientists in America and at the same time figuring out ways to keep incredibly talented older people involved, to mentor the younger people and again engage in this very, very productive intergenerational collaboration. So at the NIH itself, we have now significant risk. This is also huge risk for young scientists around the country. They may not have careers in the United States, which is why, by the way, we now see already scientists leaving the United States for Canada. There was a recent announcement about some going to University of Toronto.
Meryl Comer 09:16
There is now a fund in Europe and you certainly can't blame the Europeans to try to attract talented young American scientists launched Us Against Alzheimer's more than a decade ago, when senior scientists were advising young scientists not to even bother entering the field of Alzheimer's research because there wasn't enough funding available. That spurred our early advocacy. And now, 15 years later, we're fighting to save the four billion earmark for Alzheimer's research because the field is on the verge of major breakthroughs. We have blood-based biomarkers for early detection and disease-modifying therapies to slow progression.
Paul Irving 09:43
All of us, I think, have to speak up about this and push back. And you know, I'm hoping that the administration reimagines the importance of American science, the importance of American leadership, what's distinguished us for a generation, and I hope that that will continue. But obviously we're in very challenging times. I think if there's sadness about policy today, you and I both know there was a time when a significant additional slug research money was approved for AD and that was a product of not only advocacy by outside groups, people like us against Alzheimer's, but also very much bipartisan activity on the Hill. This is Democrats and Republicans working together in a collaborative way to try to tackle a really important challenge for America.
10:31
And since you know Alzheimer's is your thing, just for purposes of consideration for your audience, direct care costs for Alzheimer's last year were something what approaching $300 billion-ish. Right At the Milken Institute we did an analysis a few years ago that suggests if you think beyond care costs, you think about the economic losses of both disease sufferers and caregivers. The numbers were closer to a trillion bucks a year. So if we can tackle this disease successfully, if we can cure it or, frankly, if we can even defer it, we can defer it a couple years. Eventually, by the way, we're all going to die and maybe we'll die of something else.
11:12
But if we could save some portion of that money? Imagine the investment in public education and public health and infrastructure in the United States. So people don't really fully appreciate because oftentimes, I think, the economic costs are not included in the calculus. They don't understand the stakes. So these investments, while they seem significant, frankly pale in comparison to the risk and the cost. So it's crazy that we don't continue to invest and invest aggressively, and it's crazy that we're doing anything that would chase scientific talent out of the United States.
Meryl Comer 11:45
Especially at this moment in time when we do have disease-modifying therapies that begin to slow disease progression. So to cut that prospect off is very disheartening. Paul, you advise companies and investors on the longevity economy. What are the biggest myths and misconceptions about the economic potential of our generation?
Paul Irving 12:08
Well, it's not just our generation but the generations to come, because, as you know, we have historically low, remarkably low birth rates and at least the prospect of longer lives. I'm understanding the. We have historically low, remarkably low birth rates and at least the prospect of longer lives. I'm just saying the challenges we have and we don't do as well in the US as many of our peer countries. But the point is that a demographic picture that looked like a pyramid in the past has now gone in unprecedented ways to kind of a rectangle where we have now a distribution of age. It's basically equal across life force, across the age spectrum, to what we face in the future, which is very likely a reverse triangle where we have relatively few young people and a huge number of old people.
12:46
So, if you think about it, this is products, services, innovations to serve this aging population, and it's reimagining workforces, employment and health, rest that engages old people in longer work lives and new work lives. It just couldn't be more important. The longevity economy is actually we've talked a lot about sad news. This is actually, in many ways, happy news, because what you realize is that this is a really dramatically underserved market.
13:13
I remember years ago my mom was on a walker. We were outside her building and we saw walking by us this young couple with a baby with the most gorgeous baby carriage you've ever seen. It was titanium and it had swooping lines and it was absolutely gorgeous. And here was my mom on one of those aluminum, metal walkers we all know and I thought to myself, knowing what the numbers are, knowing what the economics are, the person who designed that baby carriage was crazy. What they should have done is designed the world's most beautiful, sexy, interesting walker, because that's the opportunity and, by the way, we've seen evolution on this front. It is beginning to happen.
13:49
People are beginning to understand the fact that we are old doesn't mean that we don't want beautiful design. The fact that we're old doesn't mean that we don't want beautiful design. The fact that we're old doesn't mean that we don't want products and services that are responsive to our needs. It's health innovations, it's new approaches to care, but it's also travel and fashion, and food and education, lifelong learning, social engagement and all the rest. And all of it, I think, presents opportunity, by the way, not just for old people, but for young people. One of the most fun things I do every now and then is give a talk at school, and you know we have young, not just gerontology students and medical students, but engineers, computer science types and others show up and we talk about the fact that this is an opportunity for them to think about designing, not just for their parents and grandparents, but for their future selves, for the things that they're going to need as they have potentially 100-year lives.
Meryl Comer 14:43
Well, Paul, you were obviously a visionary. The Wall Street Journal recently cited that the number of US workers providing care to older adults has just surpassed the number providing care to preschool children. So that is the future. Yep, what emerging technologies and innovations do you think will be most transformative in the silver economy?
Paul Irving 15:07
Well, I mean a lot of things will change and enable, for example, back to kind of the care economy, will change care, the emergence of robots, which, by the way, already exist in some places in the world People call them care bots in Japan and the use of AI for monitoring and for evaluation and all the rest. But I have to say that care provision, whether it's family care or direct care workers, I think it's one of the hardest things to replace by technology. So technology can enhance the care experience, can connect us with others who are going through it, can help us monitor those who are caring, can improve environments, the care environments in which we operate.
Meryl Comer 15:49
Paul, may we get personal? You've spoken about purpose and lifelong learning. How would you define a meaningful life in the context of a 100-year lifespan?
Paul Irving 15:59
To an extent it's individual.
16:01
I'll revert back to Vivek Murthy, who was smarter than me at this point, our certain general in the Biden administration.
16:08
At the very end of his term and this is a guy who's a serious physician, but at the end of his term I think it was a press release he had a statement that he recognized the three most important things that one can do for health.
16:22
And those three most important things didn't have anything to do with diet or exercise or some of the other things that we would have kind of thought it might. It was relationships, service and purpose, and I think all three of those things just couldn't be more important the importance of social connections throughout life, staying engaged, staying active, family, friends, colleagues, volunteering for those of us who don't want to work, continuing to work ways we can for those who do. That relationship connection is so important. My friend Mark Friedman and I both use a slide which is a famous proverb, and the Greek proverb is wise men plant trees under whose shade they shall never sit. I think all of us recognize that the important thing that we can do in our lives is to leave a legacy for our kids, for our grandkids, for our friends, to do something that's important in life and that's about serving to other people.
Meryl Comer 17:17
What do you make of those who are determined to push the boundaries of longevity?
Paul Irving 17:22
There are kind of two worlds in my space and I very much fall into one of those two worlds. The two worlds are kind of longer life and better life. I'm a better life guy as much as I admire and appreciate and understand the inclinations of people to want to live forever and to focus on particularly scientific innovations that will dramatically increase life. It's kind of a rich person's problem, a rich person's opportunity. It's a neat aspiration, but we have so much work to do to improve lives.
17:53
We have in the United States extraordinary longevity inequality, Meryl.
17:58
If you know about the zip codes analysis in cities across the United States, from the richest zip code to the poorest zip code, people live on average 20 to 30 years difference.
18:08
That's just unacceptable. People in rural communities in the United States, who not only can't get good care or good attention, they're isolated and live alone, don't have access to the kinds of benefits and health resources that we do in major cities. So you know, I think what's important is that we focus on health span, that is, the amount of time that we remain healthy, obviously for those with some form of dementia, alzheimer's disease being maybe the most important and most prominent of those trying to figure out ways to not only ultimately cure the disease but to shorten the experience, to compress mortality and morbidity. I think is a really, really important objective, and my strong bias is that our investment should be in prevention, in wellness, in keeping people healthier longer not necessarily living longer, although living longer lovely notion, I'm not criticizing it which is that I think better should be our priority and we have a lot of work to do in the United States on that front.
Meryl Comer 19:10
Paul, knowing what you now know, what advice might you have given to your younger self about preparing for your long, healthy life?
Paul Irving 19:19
Good question. Eat healthier, get more exercise. And I've had successes and failures, like everyone else in life, and I've made mistakes and something's right. But I would say if I have pride about anything beyond family and friends, it's the fact that I wasn't afraid of changing my life for all of us. And as we think about the education of our kids, we think about the messages that we convey to younger people, particularly because there are such advances in science, even with the setbacks that I think we've seen over the last couple of months, the need for flexibility, adaptability, never settling, never saying that we are done, regardless of our circumstances. And I guess I would reinforce that to my younger self to say you're going to go through a lot in your life, enjoy it and change and adapt as you do it. Don't stop at 73, keep it going as long as you can.
Meryl Comer 20:30
Our guest Paul Irving, senior Advisor at the Milken Institute on the Future of Longevity, dean on the Faculty at USC's Leonard School of Gerontology and Senior Advisor on the new PBS documentary Caregiving. Before we wrap up, I'd like to speak directly to our listeners, many of whom are caregivers, past and present. We want to hear your personal stories. It doesn't have to be polished or perfect, it just has to be real, or audio clip 60 seconds in length, or send us an email about your experiences, your frustrations, and send them to usagainstalzheimersorg. Every single story matters. Your voice helps us show Congress what families are going through and the need for continued research funding. That's it for this edition. I'm Meryl Comer. Thank you for brainstorming with us.
Closing 21:37
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About This Episode
What's the purpose of a long life if our brains can't enjoy it? Paul Irving, Senior Advisor at the Milken Institute on the Future of Longevity and Dean of Faculty at USC's Leonard Davis School of Gerontology, challenges conventional thinking about aging and longevity in a conversation with host, Meryl Comer. Together they address the critical distinction between longevity and brain health and explore why maintaining cognitive function matters more than simply extending lifespan. Paul shares insights into intergenerational collaboration and fighting ageism to create healthier, more productive later years.
Join us for this enlightening conversation that will transform how you think about aging, purpose, and creating a life of meaning regardless of your current age.
If you have a story about your caregiving experience, share it with us at [email protected] to help advocate for continued research funding.
BrainStorm wants to hear from you! Send us a text.
TRANSCRIPT
Georg Vradenburg 00:02
You know, we at UsAgainstAlzheimer's care a lot about how long we live and how healthy we live. There is a strong view in Silicon Valley that aging is now just an engineering problem. Perhaps can stop the process of aging and live forever. I think that's a bit naive. I don't care about longevity. I care about duration of good health, and particularly good brain health, Even if I'm in good physical health, but I don't have my brain. I don't have my sense of relationships and romantic love or love of my family or love of friends. What have I got? What's the whole purpose of life, except for our memories and our relationships and our purpose, all of which are products of the brain? So I want a long life where my brain span equals my lifespan.
Introduction 00:52
Welcome to Brainstorm by UsAgainstAlzheimer's, a patient-centered nonprofit organization. Your host, Meryl Comer, is a co-founder, 24-year caregiver, an Emmy Award-winning journalist and the author of the New York Times bestseller Slow Dancing with a Stranger.
Meryl Comer 01:08
This is BrainStorm, and I'm Meryl Comer. You just heard a top-line view on longevity from our founder, George Vradenburg. Now let's meet today's guest, Paul Irving, senior Advisor at the Milken Institute on the Future of Longevity, dean of Faculty of USC's Leonard School of Gerontology and Senior Advisor on the new PBS documentary Caregiving. Welcome, Paul. Many of our generation and, Paul, I assume you and I are contemporaries have different strategies on how to stay productive, relevant and valued. What most of us want is to support our adult kids and not become a burden. What's your position?
Paul Irving 01:51
That is a very interesting question. So I've got my own perspective about this, which I suppose also goes to my politics, and that is that I think it's incredibly important that in our generation we do all we can to support young people. We're going through, I think, an incredibly stressful, difficult time to be growing up. What we know is that loneliness is really at epidemic levels, at least among young people. You know there were interesting studies on the impacts of COVID isolation on a generational basis and what it found, paradoxically, is that older people, who were frankly more at risk of serious disease and death, were actually less emotionally affected by it than young people. Why? Because we've all been bounced around, We've been bumped, We've had sadness in the past We've experienced this, but for young people that isolation was just incredibly difficult.
02:41
I'm a believer in intergenerational solutions, intergenerational living. I'm on the board of a organization called Co-Generate which is focused on older and younger people working together for social change. Yeah, I'm 73 and proud of it. For those of us who remember the civil rights movement and the Vietnam War, the importance of activism and social engagement, you know. I hope that we say to ourselves as we think about the rest of our lives, knowing that we have fewer years ahead than we have behind. That part of our legacy will be doing something not just for ourselves but for the greater good. So I certainly hope that's the case for a number of people in our generation, and I wish it was the case for more.
Meryl Comer 03:23
Paul, too often with ageism we're treated as invisible. You know, when a doctor says to me we don't have any research on someone your age that's insulting.
Paul Irving 03:33
Meryl, the reality is I used to play sports pretty vigorously. I can't run as fast as I used to and I can't play full court basketball anymore as much as I'd like to, but I'm way smarter than I was when I was 30. And that's just a product of experience, wisdom, judgment. There's an emerging body of evidence Laura Carstensen suggests, who runs the Longevity Center at Stanford, has done a lot of work on this.
Introduction 03:55
Young and old people together.
Paul Irving 03:56
They will outperform same age teams of any age.
04:01
So wisdom, experience, understanding how to navigate environments that comes only with age, and experience the energy and creativity and risk-taking characteristics of youth.
04:12
You put those two things together and you have a very, very powerful way to solve problems and to innovate. When I'm talking to people in the Silicon Valley, trust me, I say to them when you have your most complex Skunk Works project, don't put two 25-year-old Stanford PhDs on the project and don't put two 65-year-old Stanford PhDs on the project. Take one of each and you're much more likely to come up with a fantastic result that's practical, can be operationalized, but also involves new and fresh thinking. So Becca Levy, who's a very prominent professor of psychology at Yale, has done this really interesting series of multi-year studies, and what she's found is that people who see their own aging this is response to self-imposed ageism looking in the mirror and seeing and I often do this kind of pointing at my bald head or my sagging neck seeing those things as necessarily indicative of diminishment, decline, lack of efficacy, et cetera. If we see our aging in a positive light, she finds, we might live an average of.
05:12
Are you ready for this? 7.5 years longer as significant a variable as body mass index, smoking or exercise. So the point is how we think about ourselves, not just about how others think about us, has a direct impact on our health span and potentially on our life expectancy, and is something that all of us should be mindful of.
Meryl Comer 05:33
So, Paul, the politics of our time has put the challenge of age and fitness to serve front and center. In fact, the New York Times recently reported that Congress looks like a gerontocracy. So what does that do to your theory of healthy aging?
Paul Irving 05:49
It's not about chronology. It's about individual capability and capacity. Meryl, one of the things that I think all of us have to recognize and I know you've done, over many years, fantastic work around Alzheimer's, but the reality is that about a third of people, 80, 80 plus, have some meaningful cognitive loss about 50% over 85. But that also means 50%, don't? The point is, we're individuals and we age in our own way. Biology, we know, is more important than chronology. So ageism is wrong. That's idea number one. Idea number two is that, despite the fact that we shouldn't be sidelined, we should be thinking about new roles. We need to enable young people, we need to enable new generations to move into positions of leadership. Need to applaud their succession. Positions of leadership need to applaud their succession. Should politicians cling on to their positions after they lose capacity to do those jobs effectively? No, they shouldn't.
06:44
And yet making assumptions that are based on chronology are wrong. So there are 80-year-olds who were vibrant and engaged and capable you know, warren Buffett just stepped down as the CEO of Berkshire in his late 90s who wouldn't have wanted Warren Buffett to run their company when he was in his late 80s, for example? On the one hand, are people like Mike Bloomberg or lots of others, who continue to be very, very effective in later age. Look, there are 40-year-olds who are ineffective too. There are 20-year-olds who are ineffective. So it's not about chronology, it's about individual performance, and this is why I don't believe in term limits. I do believe in terms, and I think what we need to have is honest conversations with people about where they stand.
Meryl Comer 07:27
Paul, as advocates, we're all concerned that cutbacks by the administration of research initiatives across the NIH firings of CDC and FDA will set back disease treatments and potential cures for patients for years. Okay, paul, now that I got that out of my system, it's your turn to sound off.
Paul Irving 07:47
You know, my inclination on the one hand is to say don't get me started, but now that you've gotten me started, I can't help myself.
07:53
The attack on American science is not only unbelievable and unacceptable. The leadership of American science, not just for our own purposes but around the world, has been critically important, continues to be, and the potential loss of that scientific leadership is devastating, I think, to the United States. And let me address it in kind of two ways. First, at the NIH, which, interestingly, merrill has been one of the most intergenerationally successful organizations in America, because the NIH has been terrifically successful in recruiting the most talented young scientists in America and at the same time figuring out ways to keep incredibly talented older people involved, to mentor the younger people and again engage in this very, very productive intergenerational collaboration. So at the NIH itself, we have now significant risk. This is also huge risk for young scientists around the country. They may not have careers in the United States, which is why, by the way, we now see already scientists leaving the United States for Canada. There was a recent announcement about some going to University of Toronto.
Meryl Comer 09:16
There is now a fund in Europe and you certainly can't blame the Europeans to try to attract talented young American scientists launched Us Against Alzheimer's more than a decade ago, when senior scientists were advising young scientists not to even bother entering the field of Alzheimer's research because there wasn't enough funding available. That spurred our early advocacy. And now, 15 years later, we're fighting to save the four billion earmark for Alzheimer's research because the field is on the verge of major breakthroughs. We have blood-based biomarkers for early detection and disease-modifying therapies to slow progression.
Paul Irving 09:43
All of us, I think, have to speak up about this and push back. And you know, I'm hoping that the administration reimagines the importance of American science, the importance of American leadership, what's distinguished us for a generation, and I hope that that will continue. But obviously we're in very challenging times. I think if there's sadness about policy today, you and I both know there was a time when a significant additional slug research money was approved for AD and that was a product of not only advocacy by outside groups, people like us against Alzheimer's, but also very much bipartisan activity on the Hill. This is Democrats and Republicans working together in a collaborative way to try to tackle a really important challenge for America.
10:31
And since you know Alzheimer's is your thing, just for purposes of consideration for your audience, direct care costs for Alzheimer's last year were something what approaching $300 billion-ish. Right At the Milken Institute we did an analysis a few years ago that suggests if you think beyond care costs, you think about the economic losses of both disease sufferers and caregivers. The numbers were closer to a trillion bucks a year. So if we can tackle this disease successfully, if we can cure it or, frankly, if we can even defer it, we can defer it a couple years. Eventually, by the way, we're all going to die and maybe we'll die of something else.
11:12
But if we could save some portion of that money? Imagine the investment in public education and public health and infrastructure in the United States. So people don't really fully appreciate because oftentimes, I think, the economic costs are not included in the calculus. They don't understand the stakes. So these investments, while they seem significant, frankly pale in comparison to the risk and the cost. So it's crazy that we don't continue to invest and invest aggressively, and it's crazy that we're doing anything that would chase scientific talent out of the United States.
Meryl Comer 11:45
Especially at this moment in time when we do have disease-modifying therapies that begin to slow disease progression. So to cut that prospect off is very disheartening. Paul, you advise companies and investors on the longevity economy. What are the biggest myths and misconceptions about the economic potential of our generation?
Paul Irving 12:08
Well, it's not just our generation but the generations to come, because, as you know, we have historically low, remarkably low birth rates and at least the prospect of longer lives. I'm understanding the. We have historically low, remarkably low birth rates and at least the prospect of longer lives. I'm just saying the challenges we have and we don't do as well in the US as many of our peer countries. But the point is that a demographic picture that looked like a pyramid in the past has now gone in unprecedented ways to kind of a rectangle where we have now a distribution of age. It's basically equal across life force, across the age spectrum, to what we face in the future, which is very likely a reverse triangle where we have relatively few young people and a huge number of old people.
12:46
So, if you think about it, this is products, services, innovations to serve this aging population, and it's reimagining workforces, employment and health, rest that engages old people in longer work lives and new work lives. It just couldn't be more important. The longevity economy is actually we've talked a lot about sad news. This is actually, in many ways, happy news, because what you realize is that this is a really dramatically underserved market.
13:13
I remember years ago my mom was on a walker. We were outside her building and we saw walking by us this young couple with a baby with the most gorgeous baby carriage you've ever seen. It was titanium and it had swooping lines and it was absolutely gorgeous. And here was my mom on one of those aluminum, metal walkers we all know and I thought to myself, knowing what the numbers are, knowing what the economics are, the person who designed that baby carriage was crazy. What they should have done is designed the world's most beautiful, sexy, interesting walker, because that's the opportunity and, by the way, we've seen evolution on this front. It is beginning to happen.
13:49
People are beginning to understand the fact that we are old doesn't mean that we don't want beautiful design. The fact that we're old doesn't mean that we don't want beautiful design. The fact that we're old doesn't mean that we don't want products and services that are responsive to our needs. It's health innovations, it's new approaches to care, but it's also travel and fashion, and food and education, lifelong learning, social engagement and all the rest. And all of it, I think, presents opportunity, by the way, not just for old people, but for young people. One of the most fun things I do every now and then is give a talk at school, and you know we have young, not just gerontology students and medical students, but engineers, computer science types and others show up and we talk about the fact that this is an opportunity for them to think about designing, not just for their parents and grandparents, but for their future selves, for the things that they're going to need as they have potentially 100-year lives.
Meryl Comer 14:43
Well, Paul, you were obviously a visionary. The Wall Street Journal recently cited that the number of US workers providing care to older adults has just surpassed the number providing care to preschool children. So that is the future. Yep, what emerging technologies and innovations do you think will be most transformative in the silver economy?
Paul Irving 15:07
Well, I mean a lot of things will change and enable, for example, back to kind of the care economy, will change care, the emergence of robots, which, by the way, already exist in some places in the world People call them care bots in Japan and the use of AI for monitoring and for evaluation and all the rest. But I have to say that care provision, whether it's family care or direct care workers, I think it's one of the hardest things to replace by technology. So technology can enhance the care experience, can connect us with others who are going through it, can help us monitor those who are caring, can improve environments, the care environments in which we operate.
Meryl Comer 15:49
Paul, may we get personal? You've spoken about purpose and lifelong learning. How would you define a meaningful life in the context of a 100-year lifespan?
Paul Irving 15:59
To an extent it's individual.
16:01
I'll revert back to Vivek Murthy, who was smarter than me at this point, our certain general in the Biden administration.
16:08
At the very end of his term and this is a guy who's a serious physician, but at the end of his term I think it was a press release he had a statement that he recognized the three most important things that one can do for health.
16:22
And those three most important things didn't have anything to do with diet or exercise or some of the other things that we would have kind of thought it might. It was relationships, service and purpose, and I think all three of those things just couldn't be more important the importance of social connections throughout life, staying engaged, staying active, family, friends, colleagues, volunteering for those of us who don't want to work, continuing to work ways we can for those who do. That relationship connection is so important. My friend Mark Friedman and I both use a slide which is a famous proverb, and the Greek proverb is wise men plant trees under whose shade they shall never sit. I think all of us recognize that the important thing that we can do in our lives is to leave a legacy for our kids, for our grandkids, for our friends, to do something that's important in life and that's about serving to other people.
Meryl Comer 17:17
What do you make of those who are determined to push the boundaries of longevity?
Paul Irving 17:22
There are kind of two worlds in my space and I very much fall into one of those two worlds. The two worlds are kind of longer life and better life. I'm a better life guy as much as I admire and appreciate and understand the inclinations of people to want to live forever and to focus on particularly scientific innovations that will dramatically increase life. It's kind of a rich person's problem, a rich person's opportunity. It's a neat aspiration, but we have so much work to do to improve lives.
17:53
We have in the United States extraordinary longevity inequality, Meryl.
17:58
If you know about the zip codes analysis in cities across the United States, from the richest zip code to the poorest zip code, people live on average 20 to 30 years difference.
18:08
That's just unacceptable. People in rural communities in the United States, who not only can't get good care or good attention, they're isolated and live alone, don't have access to the kinds of benefits and health resources that we do in major cities. So you know, I think what's important is that we focus on health span, that is, the amount of time that we remain healthy, obviously for those with some form of dementia, alzheimer's disease being maybe the most important and most prominent of those trying to figure out ways to not only ultimately cure the disease but to shorten the experience, to compress mortality and morbidity. I think is a really, really important objective, and my strong bias is that our investment should be in prevention, in wellness, in keeping people healthier longer not necessarily living longer, although living longer lovely notion, I'm not criticizing it which is that I think better should be our priority and we have a lot of work to do in the United States on that front.
Meryl Comer 19:10
Paul, knowing what you now know, what advice might you have given to your younger self about preparing for your long, healthy life?
Paul Irving 19:19
Good question. Eat healthier, get more exercise. And I've had successes and failures, like everyone else in life, and I've made mistakes and something's right. But I would say if I have pride about anything beyond family and friends, it's the fact that I wasn't afraid of changing my life for all of us. And as we think about the education of our kids, we think about the messages that we convey to younger people, particularly because there are such advances in science, even with the setbacks that I think we've seen over the last couple of months, the need for flexibility, adaptability, never settling, never saying that we are done, regardless of our circumstances. And I guess I would reinforce that to my younger self to say you're going to go through a lot in your life, enjoy it and change and adapt as you do it. Don't stop at 73, keep it going as long as you can.
Meryl Comer 20:30
Our guest Paul Irving, senior Advisor at the Milken Institute on the Future of Longevity, dean on the Faculty at USC's Leonard School of Gerontology and Senior Advisor on the new PBS documentary Caregiving. Before we wrap up, I'd like to speak directly to our listeners, many of whom are caregivers, past and present. We want to hear your personal stories. It doesn't have to be polished or perfect, it just has to be real, or audio clip 60 seconds in length, or send us an email about your experiences, your frustrations, and send them to usagainstalzheimersorg. Every single story matters. Your voice helps us show Congress what families are going through and the need for continued research funding. That's it for this edition. I'm Meryl Comer. Thank you for brainstorming with us.
Closing 21:37
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