Enhancing Aging and Ending Ageism
Authors: Sharon K. Inouye, Ishani Ganguli, Elizabeth A. Jacobs
Journal: JAMA Network Open (2021)

1 and the World Health Organization 2 have identified aging and ending ageism as urgent issues for our era.In the past century, human life expectancy increased nearly 2-fold, a profound increase exceeding the number of years added in all prior millennia combined.Globally, more than 600 million people are aged 65 years or older, and this number is expected to exceed 1.6 billion by 2050, representing nearly 20% of the world's population.The population of individuals aged 80 years or older will increase more than 3-fold, reaching nearly half a billion globally. 3This gain in life expectancy has been driven by advances in public health, sanitation, socioeconomic development, public education, and health care.It is an unparalleled human achievement that presents both extraordinary challenges and opportunities.Gains in life expectancy coupled with declines in fertility have substantially shifted population demographics, particularly in industrialized countries, where the proportion of older individuals may outnumber the young, producing critical economic, social, and health care challenges.Societies are increasingly forced to grapple with the rising health care expenditures and long-term care needs of multimorbidity and disability that are associated with aging.Age is the strongest risk factor for many chronic diseases, including heart disease, stroke, cancer, and dementia 4 -all of which may require extensive health care and long-term care services.The COVID-19 pandemic placed additional stress on societal and health care delivery systems worldwide, exposing deeply entrenched structural ageism and leading to high rates of morbidity and mortality among older populations. 5Age-associated inequities in health care access, delivery, and outcomes revealed how unprepared health care systems are to meet the needs of a rapidly aging society.These circumstances have prompted the United Nations, World Health Organization, World Economic Forum, and Global Age-Watch to call for prioritizing medical, scientific, social, and financial preparedness for population aging as a global imperative. 6st aging research to date has focused on risk factors, diseases, impairments, and health care outcomes that increase with age, as well as the challenges that arise with aging.Moreover, medical research has often reflected the disease-and cure-focused nature of our health systems, rather than the whole-human, person-centered approach that is essential for optimal care of older adults.Importantly, the current emphasis distorts the reality of aging, largely ignoring many of the potential benefits for individuals and communities.The present generation is aging with better health and functioning than any generation before.Most older adults retain the ability to work well into their 80s. 7,8While some cognitive functions decline with age, some functions, such as complex decisionmaking (which requires expertise and experience), do not peak until age 70 years or older. 9,10Some studies, such as a 2010 study by Charles and Carstensen, 11 have found that older persons report significantly less stress and worry and significantly more happiness and life satisfaction than younger adults.Acceptance, adaptability, and resilience are common traits seen with aging.Leading economists have identified the growing older population as an untapped resource of wealth and potential societal contribution, providing a "new demographic dividend." 12JAMA Network Open is issuing a call for papers to contribute to the evidence base to build the health and social care system needed to provide better health and health care for older adults and to eliminate ageism.We seek rigorous, high-quality scientific evidence to address critical gaps in knowledge that will advance our understanding in priority areas.These priority areas include 1 : ageism