Our aging societies: ethical, moral, and policy challenges.

The aging of industrialized nations poses grave ethical, moral, and policy challenges for health professionals and our societies. The demand for both acute and long-term health care for the elderly will increasingly strain the economic resources of older persons and our nations. These pressures generate a number of difficult issues for our aging societies. Three of the most important issues are: (1) How aggressive should curative medical treatment be for severely demented patients?; (2) How should the financial burden of long-term care be distributed between the public and private sectors?; (3) Should public policies establish old-age-based limits on acute medical care in order to conserve resources? These issues are complex, of great importance, and require substantial reflection and discussion by health care professionals and the public at-large.

Older voters and the 2004 election.

For several decades, candidates in U.S. presidential election campaigns have articulated policy issues designed to appeal to older Americans. However, exit-poll data have consistently shown that older people have distributed their votes among presidential candidates in roughly the same proportions as the electorate as a whole, favoring the winner of the popular vote. This happened again in 2004. The percentage of older persons voting for George Bush was slightly more than the national average, suggesting that old-age policy issues are not the predominant factors affecting older voters.

Anti-aging medicine and research: a realm of conflict and profound societal implications.

Biogerontologists have recently launched a war of words on anti-aging medicine. They seek to discredit what they judge to be fraudulent and harmful products and therapies, and to distinguish their own research from what they regard as the pseudoscience of anti-aging injections, special mineral waters, and other services and products. Yet, many of these biogerontologists are themselves trying to develop interventions that will actually slow or arrest the fundamental processes of human aging and substantially extend average life expectancy and maximum life span. Achievement of these biogerontological goals would drastically alter the nature of individual and collective life, radically transforming virtually every social institution and norm. Biogerontologists who are engaged in anti-aging research need to undertake more active leadership in helping the public to understand their goals, to deliberately consider the implications of their fulfillment, and to begin thinking about ways to shape those ramifications in constructive fashions.

The war on "anti-aging medicine".

Leading members of the gerontological community have recently launched a war on anti-aging medicine, seeking to discredit what they judge to be fraudulent and harmful products and therapies, and to distinguish their research from what they regard as the pseudoscience of the anti-aging movement. This article interprets the contemporary war on anti-aging medicine as largely an attempt by established gerontological researchers to preserve their hard-won scientific and political legitimacy, as well as to maintain and enhance funding for research on the basic biological mechanisms of aging. First, it recounts the difficult struggle of U.S. biogerontologists to join the scientific mainstream in terms of legitimization and public funding. Second, it examines how elements of a contemporary anti-aging movement seem to threaten the hard-won public legitimacy of established gerontological researchers and practitioners. Third, it looks at the "boundary work" responses of the gerontological community to the anti-aging movement. Finally, it assesses the consequences of the war on anti-aging medicine to date.

Anti-aging medicine: can consumers be better protected?

The use of interventions claiming to prevent, retard, or reverse aging is proliferating. Some of these interventions can seriously harm older persons and aging baby boomers who consume them. Others that are merely ineffective may divert patients from participating in beneficial regimens and also cause them economic harm. "Free market regulation" does not seem to weed out risky, ineffective, and fraudulent anti-aging treatments and products. Public health messages, apparently, are having little effect. What more can be done to achieve better protection for older consumers? An analysis of the potential for federal and state action reveals many barriers to effective governmental regulation of anti-aging interventions. In view of dim prospects for stronger public regulation, physicians and other professionals--especially geriatricians and gerontologists--will need to be more aggressive in protecting older consumers. In particular, The Gerontological Society of America and the American Geriatrics Society should undertake a sustained program of specific educational efforts, directed at health professionals and the general public, in which they sort out as best they can the helpful, the harmful, the fraudulent, and the harmless anti-aging practices and products.

Older voters and the 2010 U.S. election: implications for 2012 and beyond?

PURPOSE: To analyze the extent to which Americans aged 65 and older may have voted as an old age-benefits bloc in the 2010 midterm election in response to threats of Medicare rationing. METHODS: Analysis of age group data from the Edison Research 2010 Election Day exit polls, complemented by data published elsewhere. RESULTS: For the first time in 4 decades, there were signs of an old-age voting bloc in the 2010 election; yet, analysis of the age group data by sex and race/ethnicity reveals notable differences among these subgroups. IMPLICATIONS: This new tendency toward old-age bloc voting may well continue in the 2012 election and beyond. If "reforming" Medicare and Social Security persist as policy issues, the votes of older persons may increasingly be affected to a much greater degree than in past elections.

Differences in life expectancy due to race and educational differences are widening, and many may not catch up.

It has long been known that despite well-documented improvements in longevity for most Americans, alarming disparities persist among racial groups and between the well-educated and those with less education. In this article we update estimates of the impact of race and education on past and present life expectancy, examine trends in disparities from 1990 through 2008, and place observed disparities in the context of a rapidly aging society that is emerging at a time of optimism about the next revolution in longevity. We found that in 2008 US adult men and women with fewer than twelve years of education had life expectancies not much better than those of all adults in the 1950s and 1960s. When race and education are combined, the disparity is even more striking. In 2008 white US men and women with 16 years or more of schooling had life expectancies far greater than black Americans with fewer than 12 years of education-14.2 years more for white men than black men, and 10.3 years more for white women than black women. These gaps have widened over time and have led to at least two "Americas," if not multiple others, in terms of life expectancy, demarcated by level of education and racial-group membership. The message for policy makers is clear: implement educational enhancements at young, middle, and older ages for people of all races, to reduce the large gap in health and longevity that persists today.

From compassionate ageism to intergenerational conflict?

During the 50 years in which The Gerontologist has been publishing, the politics of aging in the United States has undergone distinct changes. The political behavior of older individuals has remained largely the same even though different birth cohorts have succeeded each other in populating the ranks of older people. But the politics of policies on aging-the organized interest and advocacy groups active in this arena, the tenor of public discourse about older people as beneficiaries of policies on aging, the national political agendas regarding public old-age benefits, and the broader U.S. political economy-have changed substantially over these five decades. Now, in the contexts of the aging of the baby boom and concerns about reducing large federal fiscal deficits (annual and cumulative), the politics of U.S. policies on aging may change considerably from those of yesterday and today. Is there a possibility of future intergenerational political conflict over taxes and expenditures for the major old-age benefit programs? If so, what might prevent or mitigate it?

Older voters and the 2008 election.

PURPOSE: In the 2008 presidential election, a majority of older persons voted for John McCain, the loser. The purposes of this report are to help illuminate why older voters were the only age-group that gave a majority to McCain and to delineate some ongoing issues in the analysis of older persons' voting behavior. METHODS: Analysis was undertaken by mining raw data from the 2008 Edison-Mitofsky national Election Day exit poll, as well as compilations from that poll that were published by various media that finance it. RESULTS: Republican leanings of the Eisenhower birth cohort that is presently among those aged 65 years and older were a factor, whereas the immediately succeeding younger cohorts did not manifest the same partisan predilection. Positive self-identification with the 72-year -old McCain by voters aged 65-74 years seems to have been another factor, although there was no indication of such age identification among those aged 60-64 years and 75 years and older. Race may have been a factor, although all groups of White voters aged 30 years and older gave McCain a substantial majority, whereas the youngest cohort of Whites, aged 18-29 years, favored Obama. IMPLICATIONS: In the study of age-group voting behavior, ongoing attention is needed to cohort and period effects, as well as candidates' contrasting individual characteristics-in addition to possible effects of campaign issues.

Anti-aging science: The emergence, maintenance, and enhancement of a discipline.

Through archival analysis this article traces the emergence, maintenance, and enhancement of biogerontology as a scientific discipline in the United States. At first, biogerontologists' attempts to control human aging were regarded as a questionable pursuit due to: perceptions that their efforts were associated with the long history of charlatanic, anti-aging medical practices; the idea that anti-aging is a "forbidden science" ethically and scientifically; and the perception that the field was scientifically bereft of rigor and scientific innovation. The hard-fought establishment of the National Institute on Aging, scientific advancements in genetics and biotechnology, and consistent "boundary work" by scientists, have allowed biogerontology to flourish and gain substantial legitimacy with other scientists and funding agencies, and in the public imagination. In particular, research on genetics and aging has enhanced the stature and promise of the discipline by setting it on a research trajectory in which explanations of the aging process, rather than mere descriptions, have become a central focus. Moreover, if biogerontologists' efforts to control the processes of human aging are successful, this trajectory has profound implications for how we conceive of aging, and for the future of many of our social institutions.