Okay, I realize that to some readers, this title may seem like an oxymoron; but I will try to make this post as painless as possible.
Mark Twain famously wrote in 1906 that “There are three kinds of lies: lies, damned lies, and statistics.” One would think that math is the absolute factual science—numbers don’t lie, do they? But having survived another electoral cycle (and from watching TV ads and Facebook posts at any time of year), we can see that numbers are often bent and stretched to fit any particular agenda.
With that in mind, let’s look at two common examples around aging and dementia; in this case, the numbers are absolutely correct, but part of the equation has been left out. Both of these relate to the well-known figure of age distribution as it changes over the next several decades.
As we all know, the huge cohort of Baby Boomers is aging. As a result, the “pyramid” shape of age distribution that we used to have is becoming distorted, moving toward becoming a rectangle or even a somewhat inverted pyramid over time. With advancing age, the “Boomer bulge” is moving upward through the figure, year after year, like an oversized antelope being slowly regurgitated by an unhappy python.
One result of this changing demographic is that my generation has been labeled “Generation Alzheimer’s,” based on the fact that the Boomers will produce more people living with dementia than ever before. While this is true, it is only part of the picture. It is purely a function of math after all: Alzheimer’s is primarily an age-related condition, and my generation will produce the highest number of old people over the next few decades; ergo, more people living with Alzheimer’s. In addition to the above label, the coming wave of older people in general has been commonly described as a “silver tsunami,” portending potential fiscal disaster for our society.
But what’s the unspoken part of the equation? As I wrote in Dementia Beyond Disease:
. . . let us consider what these numbers also tell us: there will also be more cognitively normal older people than ever before in our history. So why are we not being called “Generation Cognitively Able”? My generation will also produce more 80-year-old CEOs and more 90-year-old marathon runners. There will be more elder volunteers in a variety of societal roles. There will be an unprecedented accumulation of life wisdom and experience—millions upon millions of new “historians.” And the rising number of people with cognitive disorders also means there will be more people who can teach us the precepts of humanized care.
Showing only half the picture is certainly a way to advance one’s agenda, but it also serves to feed stigma and fear, which ultimately defeats our very efforts to move forward with useful and meaningful initiatives. Like our societal views of both aging and dementia, it’s a deficit-based analysis that does not open our minds to new insights.
Here is a second offshoot of the above demographics that I find interesting. We have been graphing this age distribution figure for decades, and yet none of our projections have ever extended beyond the year 2050. Is that because the majority of people leading these discussions are Baby Boomers or those slightly younger, so that this is our horizon? This brings up another fascinating math fact.
What happens after 2050?? Well, in that year, the Boomers will range in age from 86 to 104. In other words, most of us will be dead or near the end of our lives. We are mortal, after all (sorry, Aubrey de Grey, but our industrialized society, increasing use of processed diets, lifestyle choices, use of planes, trains, and automobiles, trashing of the planet, and propensity for violence all combine with our innate cell biology to render significantly longer lifespans virtually impossible).
But getting back to the math, since no other generation has been nearly as large as the Boomers, this means that in the years after 2050, the antelope will be regurgitated, the tsunami will recede back into the ocean, and the pyramid will quickly de-invert. The proportion of older people will decrease, and the number of people with Alzheimer’s will drop sharply, even with no new treatments available. Of course, elder wisdom will also decrease proportionately.
And when the strain of aging demographics is finally eased, what will we have learned? Will we have created a more inclusive society? Will we be more accepting of frailty? Will we respect our elders for more than how much they can produce?
So for all you Millennials and your future progeny, here is a gift from my generation to yours: We are gifting you with a challenge to help you develop a stronger sense of humanity and community. And in the latter half of the century, you will take the wisdom you have gained and the society you have created to help you be more resilient in responding to the other challenges (climate change, overpopulation, pollution, man-made and natural disasters) that will surely occupy much of your attention.