A P DDITIONALL RAISE FOR TTT UUU A HEE PSIDE OFF GING “Paul Irving has gathered some of the smartest, most thoughtful minds for a wide ranging discussion of the challenging, the good , and the hopeful parts of the aging phenomenon.” Donna Shalala, president, University of Miami; former U. S. Secretary of Health and Human Services “This extraordinary book is profoundly optimistic, enlightening, and empowering. Our aging population presents unprecedented opportuni- ties for enhancing health, transformation, and success across virtually all disciplines. If you read only one book this year on aging, this is it.” Dean Ornish, M.D., founder and president, Preventive Medicine Research Institute; clinical professor of Medicine, UC, San Francisco; author, The Spectrum “It’s time that all of us, young and old, talk about aging in the 21st century and how we can tap into the wisdom and experience we gain to create stronger communities. This compelling book redefi nes aging: Getting older isn’t about declining abilities; it’s about increasing oppor- tunities. It’s recognition that aging doesn’t limit the possibilities in front of us; it grows them.” Kathy Calvin, president and CEO, United Nations Foundation “Paul Irving brings together extraordinary thinkers who explain why we must transform our approach to aging from one that assumes depend- ency and disability to one of engagement, productivity and potential. They make a compelling case that we cannot aff ord to do otherwise.” Dr. John Beard, director, Department of Ageing and Life Course, World Health Organization “This is the moment for creating the opportunities of our now-longer lives. This book off ers the optimistic and innovative lens and path forward we need, for society, for leaders and for our communities. Brought to us by energized, expert and thoughtful voices, it is a critical conversation changer for our future.” Linda P. Fried, MD, MPH, dean, Mailman School of Public Health, Columbia University The Upside of Aging The Upside of Aging How Long Life Is Changing the World of Health, Work, Innovation, Policy, and Purpose Edited by Paul H. Irving with Rita Beamish Cover Design: Wiley Cover Illustration: © iStockphoto.com / Kotkoa Copyright © 2014 by the Milken Institute. All rights reserved. Published by John Wiley & Sons, Inc., Hoboken, New Jersey. Published simultaneously in Canada. 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For general information on our other products and services or for technical support, please contact our Customer Care Department within the United States at (800) 762-2974, outside the United States at (317) 572-3993 or fax (317) 572-4002. Wiley publishes in a variety of print and electronic formats and by print-on-demand. Some material included with standard print versions of this book may not be included in e-books or in print-on-demand. If this book refers to media such as a CD or DVD that is not included in the version you purchased, you may download this material at http:// booksupport.wiley.com. For more information about Wiley products, visit www.wiley.com. ISBN 978-1-118-69203-5 (Hardcover) ISBN 978-1-118-69190-8 (ePDF) ISBN 978-1-118-69191-5 (Mobi) Printed in the United States of America 10 9 8 7 6 5 4 3 2 1 Contents Foreword xi Michael Milken Preface: Aging and Change—A New Day Is Coming xix Paul H. Irving Acknowledgments xxiii Introduction: The Rise of a Mature World: By the Numbers xxv Paul H. Irving and Anusuya Chatterjee Part One: Opportunities and Innovations 1 Chapter 1: Our Aging Population—It May Just Save Us All 3 Laura L. Carstensen Longevity Is Here to Stay 5 The Future of Aging Societies 7 Senior Moments 8 The Power of the Aging Brain 11 Motivation, the Aging Brain’s Secret Weapon 14 v vi contents Tapping a Rich Resource 16 Notes 16 Chapter 2: Personalized Aging: One Size Doesn’t Fit All 19 Pinchas Cohen Personalizing Medicine 23 Genomics: Sci-Fi No Longer 24 Nutrition and Genes 25 To Diet or Not? 26 A Field in Its Infancy 27 Let’s Prove It 28 To Run or Walk? 29 Supplemental Jury Out 30 Looking Good, Feeling Good 30 Conclusion 31 Notes 32 Chapter 3: The Bold New World of Healthy Aging 35 Freda Lewis-Hall The Mother of All Confl uences 36 A Data and Diagnosis Revolution 37 Our New Guardian Angels 39 A Golden Age of Medicines 42 The New World of Vaccines 43 Never Too Old—For Surgery 44 Is That My Liver on the Printer? 45 The Wild Card: Tackling Alzheimer’s 46 We Have Met the Solution, and It Is Us 47 Eight Days a Week—Only the Start 48 Notes 48 Chapter 4: Disruptive Demography: The New Business of Old Age 51 Joseph F. Coughlin Demographic Transition and the New Face of Old Age 52 Mapping New Markets in an Aging Society 53 Supporting People as They Age 56