Greater Ageism Correlates with Greater Ability to Treat the Consequences of Aging

All societies have a complex relationship with aging and the old, but in the English-language Western cultures that I'm most familiar with it seems especially convoluted and strange. Individualism and a high value placed on future potential and raw talent do not have to go hand in hand with a lack of respect for older folk who have found their way to positions of authority on their own merits, but it certainly seems that way at times. Any number of fields in which older people can do well, such as hands-on software engineering, shut their doors to anyone with more than three decades of active experience. Media outlets relentlessly display youth and only youth: the state of being old is hidden away. The comparatively small number of young entrepreneurs are idolized, while the vast majority of successful captains of industry, largely older folk, fade into the backdrop.

There is simultaneously a fear of being old, an unwillingness to talk about the realities of being old, and a knee-jerk rejection of serious attempts to extend healthy life through medical science. Yet at the same time, the marketing of obviously fake "anti-aging" potions is a multi-billion dollar industry. The drawn-out details of the late stages of aging to death are hidden away to be rediscovered by every family, one small group at a time, and never to be shared in public or polite society. Everyone looks away.

Conflicted doesn't even begin to describe this morass. I think it is ancient at root, and what we have today is the modern iteration of fears and apprehensions that are as old as human society. No-one wants to look their own mortality in the face. Consider the old fable of The Three Living and the Three Dead, often presented in the form of three nobles meeting with three corpses while out riding in the woods, who tell them: "What you are, we were. And what we are, you will be." Ageism has an impact on medicine because it has an impact on every aspect of life:

Ageism and its clinical impact in oncogeriatry: state of knowledge and therapeutic leads

Cancer is a major health problem that is widespread in elderly people. Paradoxically, older people suffering from cancer are often excluded from clinical trials and are undertreated when compared to younger patients. One explanation for these observations is age stigma (ie, stereotypes linked to age, and thus ageism). These stigmas can result in deleterious consequences for elderly people's mental and physical health in "normal" aging. This discrimination against elderly patients is not limited to research; it is observed in the clinic too. Older patients are undertreated when compared to younger patients. Yet it should be remembered that "advanced" age alone should not be a contraindication for treatments that can increase a patient's quality of life or significantly extend a patient's survival.

A recent paper, quoted below, marshals evidence to suggest that ageism in its present form is not in fact an ancient thing at all, but rather a modern phenomenon. The authors argue that correlations between the rise of modern medicine, lengthening life expectancy, and ageism suggest that there is something in the growing ability of medical science to treat the consequences of aging that encourages ageist views. Ironic if so, as ageism is one of the hurdles we face when trying to direct more resources to help eliminate suffering and pain in aging. Most people would rather devote resources to any of the presently popular charitable causes instead, and you often hear arguments along the lines of "the old have had their fair innings at life." But are the old not people too?

Increasing Negativity of Age Stereotypes across 200 Years: Evidence from a Database of 400 Million Words

Scholars argue about whether age stereotypes (beliefs about old people) are becoming more negative or positive over time. No previous study has systematically tested the trend of age stereotypes over more than 20 years, due to lack of suitable data. Our aim was to fill this gap by investigating whether age stereotypes have changed over the last two centuries and, if so, what may be associated with this change. We hypothesized that age stereotypes have increased in negativity due, in part, to the increasing medicalization of aging.

This study applied computational linguistics to the recently compiled Corpus of Historical American English (COHA), a database of 400 million words that includes a range of printed sources from 1810 to 2009. After generating a comprehensive list of synonyms for the term elderly for these years from two historical thesauri, we identified 100 collocates (words that co-occurred most frequently with these synonyms) for each of the 20 decades. Inclusion criteria for the collocates were: (1) appeared within four words of the elderly synonym, (2) referred to an old person, and (3) had a stronger association with the elderly synonym than other words appearing in the database for that decade. This yielded 13,100 collocates that were rated for negativity and medicalization.

We found that age stereotypes have become more negative in a linear way over 200 years. In 1880, age stereotypes switched from being positive to being negative. In addition, support was found for two potential explanations. Medicalization of aging and the growing proportion of the population over the age of 65 were both significantly associated with the increase in negative age stereotypes.

Comments

I would argue that ageing politics, debate, and its consequent controversy is largely moot in the sense of it being able to influence public policy, technological advancement and roll-out, and financial resource availability. The idea that ageing technology can be given a type of 'pandemic response' priority in our culture is to completely misunderstand those drivers of all things technological - in that technology, in all its forms, is a consumer item, almost always subject to release by trickle-down economics. If we cannot provide cheap drugs and food to the hungry 60%+ as we watch them suffer on our CNN, movies, and blogs, what realistic chance is there to mobilize a ground swell of response - no matter how allegedly noble. The most effective technological development environments are those that embrace high risk, low transparency, and sustained non-political/ideological vision - that is R&D labs sponsored by small groups of investors. How do you influence such a group - make a marketable product that will appeal to a certain audience that will promise a desirable return - all else is hippy-economics based on volunteering, save-the-world visioneering, and propagandizing - gaining an audience likely with little access to money or resource networks - the lowest form of activism: the semi-informed, ideological activist. If there is any grass-roots influence that can be made to facilitate demand, it is the burgeoning space of health apps and medical/ therapeutic daily monitoring devices which serve to track factors and provide interactive lifestyle content. Perhaps a few universities and bare-bones labs may provide the 'rock-star' researcher that will be swept up into that private Geneva lab where the real breakthroughs are being made, likely funded by Russian oligarchs. So, increasing the visible talent pool may provide a few key players. The point is: Once reliable healthy-age-extending therapies become available, they will be only available to the top 1% for the first 20 years, when drama and controversy are likely to increase. As costs fall and clinics start to pop up in lightly-regulated modern economies, the upper 10% may find regular access for 20 years. At this point controversy will reduce as people make life decisions to sell houses, etc., to gain access. 50 years after reliable treatments have become somewhat available, costs and the regulatory environment will allow the middle class the opportunity to extend healthy life in the 20 year increments to facilitate regular improvements. Controversy will shift to class-warfare over public support and distribution. The end consequence, over the next 100 years, is that 60% will choose to never take part, approximately the same percentage who live high-risk-health lives today. Those that want the treatment will pay and those that are not willing to sacrifice for its high cost will not. This is the best-case scenario: trickle down economics in high-risk environments, supported by a culture of informed people who virtually-plan their longer lives (but will likely fail) via their smartphones. Noble intentions will never equal profit motive for research productivity and accomplishment. Mobilize consumer demand not citizen entitlement to get break-through technology.

Posted by: Jer at February 21st, 2015 10:10 AM

There's quite a lot of things wrong with this worldview, Jer, and I'm not sure if I can unpack all of it.

"Perhaps a few universities and bare-bones labs may provide the 'rock-star' researcher that will be swept up into that private Geneva lab where the real breakthroughs are being made, likely funded by Russian oligarchs."

Don't you even read this site? This place shows you where the real breakthroughs come from. Unless you're suggesting that there's a secret cabal of longevity experts that are far more advanced than anything being discussed in public, which is just plain unsupported conspiracy hogwash.

"If we cannot provide cheap drugs and food to the hungry 60%+ as we watch them suffer on our CNN, movies, and blogs, what realistic chance is there to mobilize a ground swell of response - no matter how allegedly noble."

The groundswell has nothing to do with nobility and everything to do with people not wanting to die and being in a position to do something about it. Even Reason makes this mistake a few times when talking about advocacy. Old age is not something that happens to people you don't care about on the TV. It's something that happens to your family and will happen to you.

"Once reliable healthy-age-extending therapies become available, they will be only available to the top 1% for the first 20 years,"

This is total nonsense, and de Grey himself warns against this kind of thinking, stating that "mayhem" is a likely result of inadequate access. Think the millions of underemployed Gen Xers in Western countries are going to accept rich people getting younger while they, themselves, don't? What do you think sufficiently motivated (by the threat of slow, painful death) people might do to ensure their own access? If my choices are "get it or die", what do you think I might see as reasonable options towards getting it?

Healthcare access (or lack thereof) is already causing a gigantic stink in the United States. The kind of backlash to limited access would be extreme. It's much more likely that the federal government will simply step in and take away Social Security benefits in exchange for not needing to retire, ever. And in Western semi-socialist countries with national healthcare, they'll just add longevity to an approved treatment list once it's proven that it works, both to save lives and the tremendous, ludicrous amounts of money lost to long-term palliative care of the dying.

Posted by: Slicer at February 21st, 2015 11:04 AM

In the study cited from 1970 to now negative stereotypes are tending down. That would be in correlation with modern medicine?

I would counter argue that age is starting to become accepted to point of passiveness because of exercise, skin treatments, and plastic surgery.

Additionally, I bet reverse ageism exists and is increasing. I am in my 20's and hear and read negative things about my generation all the time (mostly deserved btw). In fact, just by declaring myself as being in my 20's people reading this comment and future comments will give my opinion less weight.

@Jer and @Slicer

To build on on what Slicer said:

The 1% in developed nations do not have access to superior treatments than the rest (excluding uninsured Americans). Steve Jobs had the same options as everyone else.

There is no indication the future will be any different. With that said, on a global level, I think Jer is right about class access.

Posted by: johnathan at February 21st, 2015 12:08 PM

"Steve Jobs had the same options as everyone else."

Steve Jobs was simply stupid, refusing to use modern medicine until it was too late. And surely he had more options than me or you. Here in Spain middle-class people with hepatitis C are dying because current drugs are too expensive and the public health system doesn't want to pay for them, preferring transplantation. We have currently many demonstrations and it seems that the government will change that (this year we have elections).

What the S.J. case shows is that rich people can be as stupid as poor people. Indeed, we have lots of examples in this web of whealth people that are in the "pro-aging trance" or funding the same old, inneficient anti-aging research of CR mimetics and the like.

Posted by: Antonio at February 21st, 2015 4:48 PM

Steve Jobs really is a bad example; there's a plausible argument that his own fruitarian diet killed him.

Antonio shows what I'm talking about. A few demonstrations and the government of Spain rightly goes "Woah! We're about to get thrown out of office!" and takes steps towards making the cure available despite the expense. That's for a disease that affects about 2% of the population. Now imagine the demonstrations for access to the cure for a condition that affects 100% of the population.

Posted by: Slicer at February 21st, 2015 6:04 PM

I know what happened to Steve Jobs. His decision does not affect the validity of my statement. Despite his wealth he had the same options as everyone else. American healthcare is insanely expensive and just an overall mess, but for the most part access to treatment is not unequal.

If Mr. X billionaire developed a heart issue he is going to get the same treatment as everyone else. Maybe, if anything, he could afford the travel/stay costs for the "best" hospitals and the "best" doctors? However, I'm not even sure it matters except in the most remote areas because every region in the U.S. has there own "go to" facilities with specialists.

I don't know anything about the healthcare in Spain and I empathize with those people. Spain is certainly in a vulnerable spot economically. I hope it gets fixed.

Posted by: johnathan at February 21st, 2015 8:27 PM

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