GERONTOLOGY

The quest for explanations for why we age is nearly as old as the written record, going back to long before Ponce de Leon's fabled search for the "fountain of youth" in the early 1500s. It was not until the beginning of the twentieth century, however, that the term gerontology emerged. Writing in 1903, the zoologist Élie Metchnikoff noted "it is extremely probable that the scientific study of old age and of death, two branches of science that may be called gerontology and thanatology, will bring about great modifications in the course of the last period of life" (pp. 297–298). Derived from the Greek words geront ("old man") and logia ("the study of"), gerontology is defined as the scientific study of aging and of the older population. This dual focus on processes of aging and on the characteristics, conditions, and circumstances of older people is at the heart of the field of contemporary gerontology.

Although the distinction is not always clear in practice, gerontology's concern with the scientific study of aging and old age differs from a related field—geriatrics. Geriatrics is the branch of medicine concerned with the treatment and management of diseases and illnesses (e.g., hearing loss, osteoporosis, dementia) that are more prevalent in old age than in the early or middle years. Thus, a geriatrician might be concerned with whether surgical procedures will reverse hearing loss or how an assistive device such as a hearing aid can compensate for declines in a person's ability to hear. A gerontologist might be interested in studying the causes of hearing loss, whether it occurs with greater frequency among older men or older women, and understanding the effects that declining auditory acuity have on an individual's mobility, interaction, and enjoyment of life. Put another way, geriatrics focuses on the clinical diagnosis and treatment of medical conditions that typically occur during the later years, while gerontology involves the scientific understanding of the causes, distribution, and consequences of these conditions.

Gerontological perspectives on aging and old age

Gerontology involves gaining a scientific understanding of processes of aging, processes that take place simultaneously on several levels. Aging occurs at the biological and physiological levels, for example, as the ability of cells to replicate themselves decreases with aging or as respiratory and cardiovascular systems typically become less efficient. Aging is also characterized by a series of interrelated psychological processes that may manifest themselves in changes in the speed with which information is processed or in changes in short-term recall. Aging is also a social process reflecting sequences of roles assumed throughout life and transitions from one role to another (e.g., from employee to retiree, from parent to grandparent, from spouse to widow). When we think of someone as "growing old," we are speaking of the outcomes of these and other processes that take place simultaneously, but at different rates for different people. A thirty-five-year-old grandmother or an eighty-year-old "master" athlete whose cardiovascular system is functioning at the level of a forty-year-old illustrate how processes of aging may vary from one individual to another.

Although we most often think of aging as an individual phenomenon—as what happens to persons as they grow older—it is also true that both aging processes and what constitutes old age are socially defined or socially "constructed." They are the product of historical, social, political, and economic forces. For administrative purposes, for example, when someone "becomes" old varies widely. One needs to be at least sixty-five years old to be eligible to receive full Social Security benefits (although this changed in 2002, when the eligibility age began to climb gradually to sixty-seven) and sixty to be eligible for programs and services under the Older Americans Act, but only forty to be covered under the provisions of the Age Discrimination in Employment Act. How we conceive of the capabilities of older persons also varies from one time to another. A sixty-five-year-old might be considered too old to work during a recession when unemployment rates are high, but that same person may be a highly desirable employee when the economy is booming, unemployment rates are low, and labor in short supply. As a stage of the life course, old age during America's colonial period was a far different experience from what it is during the first years of the twenty-first century and from what it probably will be when the entire baby boom generation (born between 1946 and 1964) has reached old age in the year 2030. What it is like to be old also varies from one group to another within a society, just as it varies between societies with different cultural traditions. At any particular time, the financial situation of a typical seventy-five-year-old African American woman will differ dramatically from that of a typical seventy-five-year-old white male. And the intergenerational experience of living in a Japanese family, with its tradition of multigenerational living arrangements, will differ from that of the American family where the norm has been "intimacy at a distance."

Because aging is a multilevel passage and because old age is socially constructed, the study of aging and of old age necessarily relies on the contributions of a number of scientific disciplines. For this reason, gerontology is considered a multidisciplinary and interdisciplinary field of inquiry, and professional organizations such as the Gerontological Society of America count among their members researchers and scholars from a wide variety of disciplines.

In the basic sciences, research on the biological aspects of aging is being conducted in such fields as biochemistry, cellular and molecular biology, endocrinology, genetics, immunology, nutrition, pathology, pharmacology, and physiology. Medical and health scientists from specialties such as cardiology, neurology, oncology, and orthopedics are studying the causes, consequences, and treatment of illness and disease; the epidemiology (distribution) of physical well-being; and factors associated with the use of health services by older persons. Social and behavioral research in gerontology similarly includes contributions from scientists with many different disciplinary backgrounds: anthropology, demography, economics, geography, history, political science, psychology, public health, sociology, and statistics. Our understanding of aging and the experience of being an older person is also enhanced by the work of scholars from humanities disciplines such as art, literature, music, philosophy, and religion. Gerontological knowledge has benefited, too, from research conducted by investigators from a variety of professions, such as architecture, nursing, physical therapy, and social work.

Gerontology, then, is a multidisciplinary and interdisciplinary area of scientific inquiry dedicated to increasing our understanding of aging and old age. But just as gerontology comprises a wide array of disciplines permitting research at the intersections of two or more traditional fields, its boundaries are flexible in another important way. We have learned that the nature of old age is often a product of earlier life experiences and that processes of aging begin long before one is old. This recognition has led gerontologists to begin to take a longer view of factors that affect aging and old age and to attempt to locate and identify influences that occur in earlier stages of life. Such an approach is variously known as a life course, life span, or life cycle perspective, and it has drawn our attention to the ways in which late life characteristics may have their origin in events occurring long before old age. Glen Elder, for example, has shown that the current attitudes and values of older persons were shaped by their experience during the Great Depression. And in a fascinating project known as the Nun Study, autobiographies written by nuns when they first entered a convent, at an average age of twenty-three, were examined for their linguistic ability or idea density. Over sixty years after the autobiographies were written and upon postmortem examination of the brains of deceased nuns, the idea density scores from early life were highly correlated with the presence and severity of Alzheimer's disease in late life (Snowdon, Greiner, and Markesbery). Studies such as these have made gerontologists increasingly aware of the need to examine early antecedents of late-life behaviors, characteristics, and circumstances.

Twentieth-century advances in the gerontological perspective

Foreshadowings of the storyline of twentieth-century gerontology are plentiful. Early Egyptian, Greek, and Roman commentaries on the course of life were known and carefully read by the first of the modern gerontologists. Cicero's De Senectute and Soranus of Ephesus's Gynaecia and his Acute Disease and Chronic Disease were frequently echoed. For example, Jean-Martin Charcot's examination of pathological causes of aging captured in his Diseases of the Elders and Their Chronic Illnesses (1867) (translated into English in 1881) and the early chapters of G. Stanley Hall's Senescence (1922) recounted descriptions from ancient medical tracts.

The decades on either side of the dawn of the twentieth century resounded with innovative efforts to discover first the pattern, then the laws, and finally the causes of aging. Each was seemingly mindful of Adolph Quetelet's 1842 declaration that "Man is born, grows up, and dies, according to certain laws that have never been properly investigated" (quoted in Achenbaum, p. 35). In France, Charcot's search for pathogens associated with aging was particularly influential. In England, Francis Galton sampled nine thousand visitors to the International Health Exposition of the 1880s to identify changes in physical characteristics. In Russia, Botkin surveyed three thousand almshouse residents in an effort to differentiate normal from pathological aging.

In the United States, Charles Minot blended Charcot's focus on cellular changes with those of nineteenth-century cytologist August Weismann and formulated a kind of a proto wear-and-tear theory that saw aging in terms of entropy and fatigue states. The field was given sharper focus with Metchnikoff's 1903 coinage of the word gerontology. Metchnikoff, who was by then director of the Pasteur Institute, focused his own explorations on ways to ward off infectious autotoxicity induced by phagocyte processes (leukocytes that ingest and destroy other cells) carried by intestinal bacteria. He advanced his prescription for hefty helpings of yogurt to quell intestinal disorders thought to engender the debilitations of age in popular and scientific publications and was awarded the Nobel Prize in 1908 for his treatises The Nature of Man (1903) and The Prolongation of Life (1908).

Thus stimulated, basic biological and physiological research proceeded apace, focusing on such disparate topics as environmental and public health issues, physiological changes, lesions, and cellular-level breakdowns. In 1909, Ignatius Nascher broke ranks and proclaimed that however prevalent pathology might be, old age is not defined by pathological change. Nascher was a true interdisciplinary scientist. Stressing the importance of what might now be called social epidemiology, he dispatched teams of investigators in the New York City area to gather data he then analyzed, using statistical averages to define typical conditions and to contrast one social category with another. With G. Stanley Hall's compendium Senescence (1922), the basic parameters of modern gerontology were set as an array of behavior factors and were added to the biological substrate already enunciated. Hall's approach was also significant in that he emphasized positive attributes thought to accompany the aging process (Hendricks and Achenbaum).

Publications: hallmarks and benchmarks

During the early decades of the twentieth century, interest was piqued then quickened again. In 1905, the Journal of the American Medical Association printed Stockton's "The Delay of Old Age and the Alleviation of Senility," and the next year Marshall Price's "Ancient and Modern Theory of Old Age" appeared in the Maryland Medical Journal. The most influential of these early publications was undoubtedly Nascher's 1909 article in The New York Medical Record titled simply "Geriatrics," followed five years later by his volume Geriatrics: The Diseases of Old Age and Their Treatment, Including Physiological Old Age, Home and Institutional Care, and Medico-Legal Relations (1914). He coined the term geriatrics to describe a clinical focus and single-handedly launched a new medical specialty. During the same period, Lee Squier's Old Age Dependency in the United States (1912) joined Nascher's publications and stands as one of the early efforts in the United States to survey the conditions of old age. These watershed contributions helped lead to the inauguration of a regular geriatrics section in the Medical Review of Reviews in 1917 to promote professionalization of the study of aging. Further impetus came when the Scientific American published Genevieve Grandcourt's "Eternal Youth as Scientific Theory" in 1919. Nascher's eye-catching article "Why Old Age Ends in Death" appeared the same year in the Medical Review of Reviews.

With G. Stanley Hall's publication of Senescence, the behavioral sciences were given clarion voice in the discussion of the causes and implications of aging. Hall was noteworthy because he melded basic research with practical interventions and a critique of societal arrangements. With the publication of Edmund Cowdry's edited handbook, Problems of Aging (1939), the broad parameters of gerontological inquiry were pretty well drawn (Hendricks and Achenbaum). Accompanied by financial support by the Josiah Macy Foundation and endorsements from the National Research Council's medical sciences division, Cowdry assembled the best minds of the era to launch a unified fusillade at the problems of aging. Cowdry's encyclopedic reference, which appeared in a second edition in 1942, provided the first widely heard call for a multidisciplinary approach and helped create the collective consciousness of biomedical and behavioral cross-linkages within contemporary gerontology and geriatrics.

Learned societies and other organizational events

A series of organizational events ran parallel to the many scholarly and scientific publications. Together they helped merge gerontology into the scientific mainstream and contributed to the professionalization of the enterprise. No doubt it was fortuitous that Metchnikoff had become affiliated with the Pasteur Institute in Paris in 1888, for his associates there contributed to his thinking just as he contributed to theirs. The seed was fertile and one of his students, V. Korenchevsky, went on to establish the International Club for Research on Ageing in England, succeeded in 1939 by the British Society for Research on Ageing. The club served as a learned society providing scholarly forums to present and exchange ideas. When Korenchevsky came to the United States in 1939 to create a North American branch, his efforts were virtually anticlimactic. Organizational efforts to promote analysis of aging had appeared on the national agenda as early as 1908 as part of President Theodore Roosevelt's conservation agenda as formulated by the Committee of 100. Members of that group later established the Life Extension Institute in 1914 to promote inquiry into the causes of illness and death. The New York Geriatrics Society was founded in 1915 and other comparable state-based organizations proliferated in short order.

Aging sessions in one guise or another appeared as part of the annual meetings of the American Psychological Association by the turn of the century and other learned societies followed suit. In 1917, the National Conference of Social Work scheduled a plenary session and invited Nascher and a number of speakers to participate in a scholarly exchange on pathological models of aging and to suggest appropriate efforts for social workers.

Attention to the implications of aging grew in the period immediately after World War I. A popular magazine, Voix du Retraite, appeared in Paris in 1919 and the Swiss Foundation for the Aging began publishing its Pro Senectute in 1923. In 1928, a Japanese organization for the aged, Yokufukai, launched initially in 1925 to help older victims of a major earthquake, began disseminating the Yokufukai Geriatric Journal, succeeded in 1930 by Acta Gerontologica Japonica. In Eastern Europe, the magazine Problems of Ageing (printed in five languages) appeared in 1935 under the auspice of the International Institute for the Study of Old Age and the Romanian government. Meanwhile, in the Soviet Union, I. Fisher and P. Yengalvtchev launched a series of empirical investigations and publications on the role of physical condition, mental status, and environmental factors in promoting longevity. Their efforts led to a major conference in 1938 in Kiev that stands as a milestone for bringing together researchers from Eastern Europe. International interest was accelerating and the number of contributors and publications spread around the globe.

In the same period a number of philanthropic foundations with interests in public welfare and scholarly advancement sponsored various conferences and workshops that led to some of the publications noted above. Among them the W. K. Kellogg Foundation, the Russell Sage Foundation, the Carnegie Corporation, the Josiah Macy Foundation, and the Rockefeller Foundation stand out. None of the efforts were more luminous that the Woods Hole conference that led to Cowdry's Problems of Aging. The inter-disciplinary message Cowdry and his coauthors promulgated did not gain sweeping acceptance but by 1940, Edward Stieglitz, a newly appointed clinician with the Public Health Service, suggested that the proper study of aging should incorporate no less than geriatrics, the biology of senescence, and sociological perspectives on aging populations. Nathan Shock took over from Stieglitz and continued the same mission for the next thirty years. The same year that Stieglitz began promoting a truly interdisciplinary focus, the National Institutes of Health, founded in 1930, also incorporated a Unit on Gerontology with an edict to enhance knowledge of aging processes.

Although the American Geriatrics Society was founded in midst of World War II (1942), the war years slowed many further developments. However, within a year of war's end, what is now called the Gerontological Society of America was established, with the initial issue of the Journal of Gerontology appearing in 1946. Under the auspices of the International Association of Gerontology, which was founded in 1950, international scientific congresses are held to bring together researchers from around the world in an open exchange of ideas.

Despite the publication in 1945 of two important books—Leo Simmons's The Role of the Aged in Primitive Societies and Oscar Kaplan's Mental Disorders in Later Life —Otto Pollack declared in Social Adjustment in Old Age (1948) that insights into aging from the social and behavioral sciences lagged behind those of medicine and biology. Soon a breakthrough contribution began to change that picture. Together with her colleagues from the University of Chicago, Ruth Cavan surveyed three thousand older persons and published the results in Personal Adjustment in Old Age (1949). It was only the first of the many contributions made by the Committee of Human Development at the University of Chicago. Perhaps not as well remembered as the famous Kansas City Studies of Adult Aging, or many of the early, seminal contributions of Bernice Neugarten, Ethel Shanas, Robert J. Havighurst, Robert Burgess, Elaine Cumming, William Henry, and others, it nonetheless paved the way for the shape of social gerontology. By the time Elaine Cumming and William Henry published their disengagement interpretation of the results of the Kansas City Studies in their Growing Old (1961), gerontology had come of age and advances were occurring along many fronts.

From that point on, the relatively narrow flow of information spread out across the landscape. Programs and certificate training sprang up in California, Michigan, North Carolina and around the country. By the 1960s the Gerontological Society transformed a newsletter into its second journal, The Gerontologist, and the first of the White House Conferences on Aging was held. Out of that conference came the establishment of an Office on Aging (under the leadership of Donald P. Kent), later the Administration on Aging, and the momentum that led to both the passage of Medicare and Medicaid (1965) and support via the Older Americans Act for the development of education and training programs in gerontology in the late 1960s and 1970s. The last of the building blocks came in 1975 with the inauguration of the National Institute on Aging to oversee basic research in a wide array of disciplines and to train future researchers. Significant publications continued to emerge, including Clarke Tibbitts's Handbook of Social Gerontology (1959), the three-volume Aging and Society series under the leadership of Matilda White Riley, and the five editions of the Handbook of the Biology of Aging, Psychology of Aging, and Aging and the Social Sciences under the general editorship of James E. Birren.

Teaching and training

The steadily increasing recognition of the importance of gerontology is reflected in its growing presence in the curricula of institutions of higher education in the United States. In the 1950s, coursework on aging was offered on only a small number of campuses. Data collected in 1957 showed that only fifty-seven colleges and universities offered credit courses in gerontology. The number of campuses with courses on aging increased to 159 in 1967, 607 in 1976, and 1,335 in 1985. By 1992, when the last major survey was conducted, it was estimated that gerontology instruction was offered on 1,639 campuses, or at 55 percent of American institutions of higher education. Of these campuses with credit instruction in 1992, the average number of courses in gerontology was 9.4 and over 40 percent offered a structured program of course-work in gerontology, geriatrics, or aging leading to the awarding of a degree, certificate, specialization, concentration, minor, or some other form of credential (Peterson, Wendt, and Douglass.

An important development in graduate education was the establishment of the first Ph.D. programs in gerontology in the late 1980s and early 1990s. A long and continuing debate has centered on the question of whether gerontology is better viewed as a field of specialization or as an emerging academic discipline. Those taking the position that gerontology is a field of specialization contend that doctoral work should take place in one of the more traditional disciplines (e.g., biology, psychology, sociology), but with an emphasis on aging in coursework and research. Those holding the view that gerontology has reached a stage of maturity in its theories, methods, and content argue that doctoral-level work leading to a Ph.D. in gerontology is justified. The merits of each of these positions aside, academic programs leading to a Ph.D. in gerontology existed at a handful of American universities at the outset of the twenty-first century. The debate about whether gerontology is a specialty or a full-fledged academic discipline will doubtless continue, but the emergence of Ph.D. programs attests to the increasing recognition of its importance.

The most comprehensive list of college and university programs in gerontology, geriatrics, and aging has been compiled by the Association for Gerontology in Higher Education (AGHE, now an Educational Unit of the Gerontological Society of America). In its seventh edition, the Directory of Educational Programs in Gerontology and Geriatrics (Stepp) provides detailed information on the content, focus, and type and level of credential offered in close to eight hundred programs in the United States, Canada, and other countries.

Applied gerontology

Knowledge accumulated from scientific research on the biological, physiological, psychological, and social processes associated with aging adds to our basic understanding of the human condition. But gerontological research serves another essential purpose. By learning about the nature of aging and old age, we are in a position to use the knowledge to improve the quality of the later-life experience. Applied gerontology emphasizes the translation of basic research into the development of services, programs, and interventions for the betterment of the older population. Basic biological research not only illuminates the mechanisms underlying this aspect of the aging process, but also offers clues that have the potential to slow down or reverse deleterious outcomes. Knowing how physiological and sensory processes change with aging provides valuable information that can be used to design environmental modifications to enhance the functional ability of older persons. Gaining a scientifically sound appreciation of the extent and nature of family caregiving can counter the myth of abandonment and allow for the development of an appropriate blend of supportive services to help families cope with the stresses of caring for a frail relative. Studies on the barriers and obstacles people encounter in accessing services and programs enable us to consider ways to restructure their delivery and enable health and human service providers to better meet the needs of target populations.

Gerontology makes a distinction between life expectancy—how many more years one can expect to live at a given age—and "active" life expectancy—or how long one can expect to function well prior to the onset of debilitating conditions. This distinction serves to focus attention on the quality of late life and not simply its quantity. In this sense, the fundamental and complementary objectives of basic and applied gerontology might best be summarized as the pursuit of scientific knowledge to promote and extend the active life expectancy of older persons or, as in the motto of the Gerontological Society of America, "to add life to years, not just years to life."

Stephen J. Cutler Jon Hendricks

See also Aging; Geriatric Medicine; Careers in Aging; National Institute on Aging; Prolongevity.

BIBLIOGRAPHY

Achenbaum, W. A. Crossing Frontiers: Gerontology Emerges as a Science. Cambridge, U.K.: Cambridge University Press, 1995.

Elder, G. H. Children of the Great Depression, 25th Anniversary ed. New York: HarperCollins, 1998.

Hendricks, J., and Achenbaum, W. A. "Historical Development of Theories of Aging." In Handbook of Theories of Aging. Edited by Vern L. Bengtson and K. Warner Schaie. New York: Springer Publishing Co., 1999. Pages 21–39.

Metchnikoff, É. The Nature of Man. New York: Putnam and Sons, 1908. (First published in France, 1903).

Peterson, D. A.; Wendt, P. F.; and Douglass, E. B. Development of Gerontology, Geriatrics, and Aging Studies Programs in Institutions of Higher Education. Washington, D.C.: Association for Gerontology in Higher Education, 1994.

Pollack, O. Social Adjustment in Old Age. New York: Social Science Research Council, 1948.

Snowdon, D. A.; Greiner, L. H.; and Markesbery, W. R. "Linguistic Ability in Early Life and the Neuropathology of Alzheimer's Disease and Cerebrovascular Disease: Findings from the Nun Study." In Vascular Findings in Alzheimer's Disease. Edited by Raj N. Kalaria and Paul Ince. New York: New York Academy of Sciences, 2000. Pages 34–38.

Stepp, Derek D., ed. Directory of Educational Programs in Gerontology and Geriatrics, 7th ed. Washington, D.C.: Association for Gerontology in Higher Education, 2000.

GLAUCOMA

See Eye, aging-related diseases

Gerontology

BIBLIOGRAPHY

The scientific study of the biological, psychological, and sociological phenomena associated with age and aging, gerontology had its origins in the study of longevity from Francis Bacon (1561–1626) onward. While Jean-Martin Charcot (1825–1893) had explored the relationship between old age and illness, the term gerontology was introduced by Élie Metchnikoff (1845–1916), who developed theories of aging based on his work in medicine and biology. Social science perspectives on aging did not emerge until later, when the economic consequences of aging were recognized. Professional associations were created to support research on aging, such as the Gerontological Society of America (1945) and the International Association of Gerontology (1948). In the 1930s the Josiah Macey Jr. Foundation in New York, under the directorship of Ludwig Kast, ran a series of conferences on aging exploring the relationship between degenerative disease and aging. The Foundation encouraged E. V. Cowdry, professor of cytology at Washington University, to organize a book that would explore not only the biomedical aspects of aging but also the psychological, sociological, and environmental aspects. These activities resulted in the Club for Research on Aging, which promoted the study of aging as an aspect of public health. Major figures in the development of the social and psychological study of aging included, in the United States, Matilda White Riley (1911–2004), and in the United Kingdom, Peter Laslett (1915–2001). Riley and her colleagues developed the “aging and society paradigm” in her Aging and Society (1968–1972), which examines the interaction between a cohort flow of population and social change, and explains age as an aspect of the social structure. Laslett, the author of The World We Have Lost (1965), challenged many conventional, but dubious assumptions in demography and gerontology, such as the idea that the nuclear family is a modern development. He was a founder of the influential Cambridge Group for the History of Population and Social Structure, which pioneered the methodology of using local records in the historical study of population.

Gerontology has become an increasingly important discipline as the governments of the developed world face up to the problem of aging populations. The causes of population aging are either a rising life expectancy or declining fertility, or both. Increasing longevity raises the average age of the population; a decline in fertility increases the average age of the population by changing the balance between the young and old. In the modern world, declining fertility—in precise terms the actual number of live births per thousand women of reproductive age—is the most significant cause of population aging. In terms of the world population, in the year 2000 approximately 30 percent were under the age of fourteen years, but this is expected to fall to around 20 percent by 2050. In the developed world, the median age of the population rose from 29 in 1950 to 37.3 in 2000, and it is predicted to rise to 45.5 by 2050. For the world as a whole, the figure was 23.9 in 1950, 26.8 in 2000, and is predicted to be 37.8 for 2050. One of the fastest-aging populations is modern Japan; in 1950 there were 9.3 people under the age of 20 for every person over 65 in Japan, but by 2002 this ratio was anticipated to be 0.59 people under 20 for every person over 65 years. Worldwide, there are important regional variations. If we define an aging population as one in which at least 10 percent are over 60, then most of sub-Saharan Africa will only see the development of aging populations after 2040, but North Africa will have them before 2030. Most of the Latin American and Caribbean countries will have aging populations after 2010. Many Asian countries, such as China, Singapore, and South Korea, already do.

The United States and Northern Europe face an acute problem of rapid aging. In the United States, the proportion of the population over sixty-five years of age is expected to increase from 12.4 percent in 2000 to 19.6 percent in 2030. In absolute terms, this means an increase from 35 million over sixty-five in 2000 to 71 million in 2030. In Europe the number of people over sixty-five years will increase from 15.5 percent in 2000 to 24.3 percent in 2030.

The aging of the world population is an aspect of an ongoing demographic transition—a switch from high fertility and high mortality rates to low fertility and delayed mortality. This transition also produces an epidemiological transition—a switch from infectious diseases in childhood and acute illness, to chronic disease and degenerative illness. The principal causes of death in the developed world are cardiovascular disease, cancer, respiratory disease, and injuries.

These demographic changes have major implications for health care, the labor force, welfare, insurance, and pensions. In the United States 80 percent of people over sixty-five years have at least one chronic disease and 50 percent have two. Diabetes now affects one in five Americans. The incidence of Alzheimer’s disease in the United States doubles every five years after the age of sixty-five. The economic consequences of an aging population are various and significant. There will be major increases in health care, nursing care, and retirement home costs. As the ratio of working to retired persons increases, there will be a decline in taxation and an erosion of funds for public expenditure. There is already a significant pension crisis in the United States and the United Kingdom, where the combination of compulsory retirement and increasing life expectancy means that people do not have sufficient savings for old age. The problem is a major policy issue because labor force participation of people over sixty-five years has declined by more than 40 percent worldwide. In the United States, the growth rate of the working-age population is projected to decline from its current level of 1 percent per year to half a percent by 2030.

Life expectancy has increased significantly in the developed world. More people are surviving into old age, and once they achieve old age, they tend to live longer. Over the next half century, global life expectancy at age 60 will increase from 18.8 years in 2000–2005 to 22.2 years in 2045–2050, from 15.3 to 18.2 years at age 65, and from 7.2 to 8.8 years at age 80. In over thirty countries female life expectancy at birth already exceeds 80 years. Can life expectancy increase indefinitely?

Contemporary gerontology as a field of research is changing rapidly under the impact of advances in the biological sciences. In conventional gerontology, living a long life had meant in practical terms living a full life, according to some agreed upon set of cultural and social criteria, and achieving the average expectation of longevity according to gender and social class. More recently however, there has been considerable speculation as to whether medical science can reverse the aging process. Between the 1960s and 1980s, biologists such as Leonard Hayflick (1982) argued that normal cells had what was known as a replicative senescence, that is, normal tissues can only divide a finite number of times before entering a stage of inevitable quiescence. Cells were observed in vitro in a process of natural senescence, but eventually experiments in vivo established an important and far-reaching distinction between normal and pathological cells in terms of their cellular division. It was paradoxical that pathological cells appeared to have no such necessary limitation on replication, and therefore a process of immortalization was the defining feature of a pathological cell line. Biologists concluded that finite division at the cellular level meant that the aging of whole organisms was an inevitable process. These scientific findings supported the view, shared by most religious traditions, that human life had a predetermined limit, and that it was only through pathological developments that some cells might outsurvive the otherwise inescapable senescence of cellular life. Aging was regarded as both natural and normal.

This traditional conception of aging was eventually overthrown by the discovery that human embryonic cells were capable of continuous division in laboratory conditions, where they showed no sign of any inevitable “replicative crisis” or natural limitation. Certain non-pathological cells (or stem cells) were capable of indefinite division, and these new developments in the conceptualization of cellular life have consequently challenged existing scientific assumptions about the distinctions between the normal and the pathological. Stem-cell research is beginning to redefine the human body in terms of renewable tissue, and suggests that the limits of biological growth are not immutable or inflexible. The human body has a surplus of stem cells capable of survival beyond the death of the organism. With these developments in micro-bio-gerontology, the capacity of regenerative medicine to expand the limits of life becomes a plausible prospect of medicine, creating new economic opportunities in the application of life sciences.

The controversies that surround modern gerontology are primarily to do with population aging, resource allocation, and equality. First, can prolongevity be increased almost indefinitely? Secondly, will significant increases in life expectancy severely increase the inequality in the distribution of resources worldwide? Finally, can intergenerational justice be maintained?

In contemporary debates about the legitimacy of the life-extension project, faith-oriented beliefs and moral justifications are prominent. It is clearly the aspiration of furthering biomedical science that is the most common supporting argument in the literature. In general, scientific curiosity and potential health-enhancing discoveries are cited as justifications for life-extension research. The ethical principle of beneficence is also included, because the research, it is argued, can help to decelerate the aging process and diminish the onset of chronic illness. Such a view emerges from a conception of aging as a condition to be cured (that is, as a disease), and it assumes that health and life extension will necessarily evolve together. In these debates on life extension, Gregory Stock, director of the program on Medicine, Technology, and Society at University of California, Los Angeles (UCLA) School of Public Health, argues that we should not accept the natural life span as a fixed state of affairs, because prolonged health is a general good. Because the technological advancements in anti-aging intend to provide more youthfulness to aging people, he contends that life extension is valuable both to individuals and for societies. Similar sentiments are reflected in the posthumanist perspective, which strongly advocates the overcoming of biological limitations through technological progress. One public figure promoting life extension in England is the editor in chief of Rejuvenation Research, Aubrey de Grey at the University of Cambridge, who has vigorously supported the life-extension project.

The arguments against life extension are that, given a scarcity of resources, it will greatly contribute to the depletion of natural resources and significantly increase environmental degradation. It will increase inequality between the Southern Hemisphere and the affluent Northern Hemisphere. It will have an adverse effect on intergenerational justice by further concentrating wealth in the hands of the elderly rich. Finally, it raises important issues about the psychological and spiritual distress that the elderly but disabled cohort of survivors would confront. The prospect of “living forever” would only be tolerable if medical science could guarantee a reasonable level of mobility and well-being (such as freedom from chronic disease). There would also be the prospect of intergenerational conflict, for example in the form of ageism.

The term ageism was first employed by Robert N. Butler, then director of the American Institute of Aging, in 1968. Referring to negative stereotypes of elderly individuals that classify them as senile, dependent, or conservative in their attitudes, ageism has become an important political issue. Against the background of the rapid aging of populations, new ageism refers to intergenerational conflicts of interests where the elderly are criticized for being parasitic on society, that is for being “takers” rather than “givers.” Some aspects of ageism can be overcome by making more accurate information about aging available, especially to young people. Another change would be to remove a fixed or compulsory retirement age, thereby allowing fit and able elderly to continue in employment. These strategies will come up against the fact that, given high unemployment, housing shortages, and other scarcities, there will be an inevitable conflict of interests between age groups. There are few convincing social policies to resolve the pension crisis, the impact on health care, and the erosion of the tax base that are outcomes of population aging.

This pessimistic conclusion can be challenged by arguing that technological improvements will continue to increase the productivity of those who remain at work, and that flexible retirement regulations will allow people to remain employed on a voluntary basis past sixty-five. We cannot assume that the values and attitudes of old people in the past will be characteristic of future generations. The postwar Baby Boomers who are now close to retirement are socially and culturally very different from their parents and grandparents. The social character of aging and the cultures of the elderly will continue to change and evolve over time, thereby making pessimistic extrapolations from past generations unreliable, and often prejudicial.

SEE ALSO Baby Boomers; Demographic Transition; Demography; Maturation; Welfare State

BIBLIOGRAPHY

Cowdry, E. V., ed. 1939. Problems of Ageing: Biological and Medical Aspects. Baltimore, MD: Williams and Wilkins.

De Grey, Aubrey. 2003. The Foreseeability of Real Anti-Aging Medicine: Focusing the Debate. Experimental Gerontology 38 (9): 927–934.

De Grey, Aubrey. 2004. Welcome to Rejuvenation Research. Rejuvenation Research 7 (1): 1–2.

Hayflick, Leonard. 1982. Biological Aspects of Aging. In Biological and Social Aspects of Mortality and the Length of Life, ed. Samuel H. Preston, 223–258. Liege, Belgium: Ordina.

Laslett, Peter. 2005. The World We Have Lost. 4th rev. ed. London: Routledge. (Orig. pub. in 1965.)

Riley, Matilda White, Marilyn E. Johnson, and Anne Foner, eds. 1968–1972. Aging and Society: A Sociology of Age Stratification. 3 vols. New York: Russell Sage Foundation.

Shostak, Stanley. 2002. Becoming Immortal: Combining Cloning and Stem-Cell Therapy. Albany: State University of New York Press.

Bryan S. Turner

gerontology The study of the processes of ageing, old age, and the elderly. Frequently viewed as a branch of biology, with a focus on the role of genetic factors (the extent to which ageing is pre-programmed), the study of the social aspects of ageing, sometimes termed social gerontology, is now well established. Interest in ageing has grown enormously with twentieth-century demographic changes. Increases in life expectancy and reduction in childbearing have transformed the age-structures of the population of advanced industrial societies, increasing significantly the proportions of the elderly (usually defined as persons aged 65 or over). Since the use of many forms of welfare provision (especially health care, personal social services, and state benefits) rises markedly amongst those over 65, increases in the numbers of the elderly (especially in the growing numbers of those aged 75 or over) are of major concern to policy-makers and policy analysts.

However, although policy issues are of great importance, the sociological contribution to gerontology comes from the study and analysis of age as a social category, and of the way in which the structures of society shape the ageing process, including the way it is experienced by individuals. The status of the elderly varies significantly across time, place, and social arrangements, including the extent to which retirement policies, pension provisions, and housing can foster independence or generate dependence, with important implications for physical and psychological health. There is growing awareness of the salience both of stratification by age and of ageism in society.

Gerontology

Gerontology is a branch of sociology that studies aging and the problems—psychological, economic, and social—that arise in old age. Gerontology includes the field of geriatrics, the medical study of the biological process of aging and the treatment of illnesses of old age.

Since the days of the ancient Greeks, speculation about aging has gone hand in hand with the development of medicine as a science. During the 1800s, researchers began to study populations and social patterns of aging in a systematic fashion. During the 1930s, the International Association of Gerontology was organized. Over the next decade, governmental bodies sponsored conferences on aging, and by 1945 the Gerontological Society of America, Inc., was established in Washington, D.C.

In the United States in the late twentieth century, the median age of the total population has increased. On average there are more and more older people than younger ones in the country. Because of this increase, research in the field of gerontology has broadened.

The health and economic status among the elderly vary widely. Gerontologists have been researching the increased costs of health care paid by communities and the federal government for the elderly. Gerontologists also have studied how the aging of a particular member of a family affects the entire family, focusing on issues such as the interrelationships of different generations within a family or the impact of death on those different generations.

[See also Aging and death ]

ger·on·tol·o·gy / ˌjerənˈtäləjē/ • n. the scientific study of old age, the process of aging, and the particular problems of old people. DERIVATIVES: ge·ron·to·log·i·cal / jəˌräntlˈäjikəl/ adj. ger·on·tol·o·gist / -jist/ n.

gerontology (je-ron-tol-ŏji) n. the study of the changes in the mind and body that accompany ageing and the problems associated with them.

gerontology see geriatrics .