0:00:15.650,0:00:19.750
We have worked very hard[br]to achieve living longer

0:00:20.120,0:00:25.310
and yet today we consider[br]aging as a problem.

0:00:26.420,0:00:30.579
I also used to consider[br]population aging as a problem,

0:00:31.219,0:00:33.789
that's why some years ago I packed, [br]left everything behind

0:00:33.930,0:00:37.640
and enroled a top university in the USA,[br]Johns Hopkins University,

0:00:37.640,0:00:41.570
to acquire tools that'd help me[br]to fight the aging challenge.

0:00:43.320,0:00:47.710
What I was not expecting[br]was to realize that my initial vision,

0:00:48.350,0:00:51.650
my perspective on aging, was distorted.

0:00:53.040,0:00:57.390
I had a series of beliefs,[br]stereotypes and prejudices

0:00:57.880,0:00:59.930
that prevented me from seeing clearly.

0:01:00.750,0:01:04.410
We can think of aging either[br]as positive or as negative

0:01:05.349,0:01:07.480
but we all share one thing:

0:01:07.480,0:01:10.150
That idea is conformed[br]very early in our lives.

0:01:10.460,0:01:12.710
Studies in the '70s

0:01:12.710,0:01:15.609
conducted interviews[br]on 4 to 11 year-old children,

0:01:16.029,0:01:19.279
a gerontologist, Seefeldt, and others

0:01:19.569,0:01:23.290
asked children about[br]their perception of the elderly.

0:01:25.229,0:01:28.580
Results are horrifying.

0:01:29.510,0:01:34.270
Two out of three children[br]believed that older people

0:01:34.620,0:01:39.230
were helpess,[br]unable to take care for themselves,

0:01:39.990,0:01:42.160
and generally passive.

0:01:43.780,0:01:46.910
And that negative perception[br]they had about aging

0:01:47.200,0:01:50.810
would also become[br]an expectation of their own aging.

0:01:51.270,0:01:53.579
60 percent of those children

0:01:54.479,0:01:58.949
already predicted that when they'd be old,[br]they were going to feel awful.

0:02:00.729,0:02:05.690
And how can any 4, 5 or 6 year old[br]know how'd they feel when elderly?

0:02:06.730,0:02:09.299
Probably, what goes on there[br]is that we are absorbing

0:02:09.299,0:02:12.130
that stereotype and that belief[br]from our environment.

0:02:13.470,0:02:16.670
Actually, in the Western world,[br]Europe and North America,

0:02:16.670,0:02:19.690
there's generally[br]a very negative perception of old age,

0:02:20.030,0:02:23.410
it's what we call "ageism"[br]or discrimination by age.

0:02:24.320,0:02:26.670
And what happens [br]when those children grow up?

0:02:26.850,0:02:29.280
By then the stereotype is reinforced,

0:02:29.280,0:02:30.950
the belief is replayed

0:02:30.950,0:02:35.400
by the mass media, advertising, movies --

0:02:35.920,0:02:39.240
If you give a closer look,[br]how is aging usually portrayed?

0:02:39.240,0:02:40.930
Generally not positive.

0:02:41.720,0:02:47.160
At most it's warm, [br]but never as an active aging.

0:02:47.650,0:02:51.000
Actually, in the 90s [br]another very interesting experiment

0:02:51.020,0:02:53.750
was conducted by Burke[br]on healthcare professionals.

0:02:54.300,0:02:57.750
He wanted to analyze[br]why some health professionals

0:02:57.750,0:03:00.780
would talk to older people [br]as if they were children,

0:03:01.140,0:03:03.920
we call this the "elder talk",

0:03:03.920,0:03:06.260
probably most of you have done it[br]or at least have seen it:

0:03:06.810,0:03:10.690
"Hi Carmencita, how are you today?

0:03:11.000,0:03:15.480
Here is your little pill for the heart".

0:03:16.760,0:03:22.110
Right? And Carmen is 75 years old,[br]a professor emeritus at university

0:03:22.250,0:03:26.199
and she is in perfect cognitive state.[br](Laughter)

0:03:27.479,0:03:29.760
Burke proved that healthcare professionals

0:03:29.760,0:03:31.730
would speak like this to the elderly

0:03:31.890,0:03:34.990
regardless of their cognitive state,

0:03:35.240,0:03:38.510
based only on their own beliefs [br]about old age.

0:03:39.390,0:03:43.640
I invite you to never talk like this[br]to an older person.

0:03:44.840,0:03:48.570
(Applause)

0:03:53.470,0:03:56.610
In 2008 an article in The New York Times

0:03:57.420,0:04:00.070
gathered all the scientific evidence

0:04:00.070,0:04:02.470
of why talking like that to older people

0:04:02.470,0:04:04.620
is harmful to their health.

0:04:04.990,0:04:08.310
In a very simple way we can realize[br]we are reinforcing their idea

0:04:08.310,0:04:10.840
that they are useless and incapable.

0:04:11.510,0:04:14.090
No, the elderly are not like children.

0:04:15.120,0:04:18.190
In another very interesting study [br]also starting in the 70s

0:04:18.190,0:04:21.829
a gerontologist, Ashley,[br]went to a town in Ohio

0:04:21.829,0:04:25.740
and managed to convince [br]2/3 of the population over 50

0:04:25.750,0:04:27.720
of participating in it.

0:04:28.050,0:04:30.090
That's an achievement for any researcher

0:04:30.090,0:04:32.839
because nobody wants to take part[br]in scientific studies,

0:04:32.839,0:04:34.720
less if they are periodic.

0:04:34.990,0:04:37.560
These people were periodically asked

0:04:37.560,0:04:40.630
about their mental health status, [br]their physical health status,

0:04:40.630,0:04:43.600
their working environment, family, etc.

0:04:44.080,0:04:47.640
And they were also asked some questions[br]on their perception of old age:

0:04:48.490,0:04:51.650
Do you think you become less happy[br]as you get older?

0:04:53.680,0:04:56.420
Do you think that as you get older[br]you are less useful?

0:04:58.180,0:05:00.230
Well, this study was very interesting,

0:05:00.480,0:05:03.300
and had the most powerful results [br]15 years later.

0:05:04.050,0:05:08.130
A social psychologist, Becca Levy,[br]from Yale University,

0:05:08.300,0:05:12.130
has revolutionized the world[br]-- at least for me, my world --

0:05:12.130,0:05:14.970
by proving that[br]the negative stereotype of old age

0:05:14.970,0:05:17.520
becomes a self-fulfilling prophecy.

0:05:18.070,0:05:20.410
Meaning that it affects our health,

0:05:20.410,0:05:23.870
if we think we are going to age badly,[br]we most probably will.

0:05:24.190,0:05:28.090
Becca Levy with her Ohio study[br]resolved to test an hypothesis:

0:05:28.090,0:05:31.870
do people with a positive vision[br]of old age live longer?

0:05:32.550,0:05:35.840
She went to Ohio and retrieved [br]all the death certificates

0:05:35.880,0:05:38.249
from people participating on the research[br]who had already died

0:05:38.249,0:05:41.810
and compared the life expectancy [br]of people with a positive vision

0:05:42.290,0:05:45.039
with those who had[br]a negative vision of old age.

0:05:45.429,0:05:49.410
And she found that those[br]with a positive vision lived longer.

0:05:51.700,0:05:54.520
How much longer do you think they lived?

0:05:55.700,0:05:59.729
One year? Two years?

0:06:01.279,0:06:04.419
It's 7.6 years!

0:06:05.919,0:06:09.130
That is 7.6 years more of life expectancy

0:06:09.130,0:06:12.509
in those with a positive vision of old age.

0:06:12.759,0:06:14.889
Monitoring all other factors.

0:06:15.149,0:06:17.069
Do you know how much it costs as society

0:06:17.069,0:06:20.029
to increase life expectancy ...[br]in 3 months?

0:06:20.349,0:06:23.280
"With surgery ... got another year[br]of life expectancy ..."

0:06:24.390,0:06:26.659
Changing our attitude.

0:06:28.210,0:06:30.930
A change in our beliefs about aging.

0:06:31.530,0:06:35.279
And how can a belief become[br]a change in your cells,

0:06:35.279,0:06:37.169
in your life expectancy?

0:06:37.639,0:06:39.269
It's very revolutionary.

0:06:40.529,0:06:42.409
Well, they've managed to understand

0:06:42.409,0:06:46.309
how the negative stereotype[br]is associated to things like memory,

0:06:46.819,0:06:49.439
to our performance in cognitive tests.

0:06:50.229,0:06:54.670
In 2013, they managed to associate[br]the negative vision of old age

0:06:54.670,0:06:57.469
with the size of our hippocampus.

0:06:57.469,0:07:01.389
So, our ideas change[br]the anatomy of our brain.

0:07:03.860,0:07:06.170
And to apply it a little in our day to day

0:07:06.170,0:07:08.240
there are many hypotheses[br]of how this happens,

0:07:08.240,0:07:11.689
what is the biological mechanism,[br]how does this happen?

0:07:11.689,0:07:14.609
But there's one thing that[br]we have all said or listened,

0:07:14.819,0:07:18.359
that is: "Me, at my age..."

0:07:19.899,0:07:23.489
"What am I doing[br]wearing sneakers at my age?"

0:07:24.189,0:07:26.499
"What am I doing in the gym at my age?"

0:07:26.889,0:07:29.350
"What am I doing, being 40,[br]with those who are 20?"

0:07:29.660,0:07:32.960
Suddenly, we stop doing things[br]that are good for our health

0:07:33.250,0:07:35.429
because there's some kind[br]of expiration date

0:07:35.459,0:07:37.799
from which we throw in the towel.

0:07:38.449,0:07:41.479
It seems like the day we turn 65,

0:07:41.929,0:07:44.589
"game over", we are done,

0:07:44.779,0:07:48.109
we can no longer introduce any[br]positive activity for our health

0:07:48.109,0:07:50.039
because it's not worth it,[br]there's no turning back,

0:07:50.039,0:07:53.750
aging is negative by definition,[br]it is inexorable.

0:07:56.800,0:08:00.360
Actually that number, 65 years,

0:08:00.610,0:08:03.679
I tried to find out where it came from,

0:08:04.789,0:08:08.829
and the most probable cause[br]is called Otto Von Bismarck,

0:08:10.379,0:08:13.729
who was the German Chancellor[br]in the late 1800s.

0:08:14.200,0:08:19.000
In 1893 he introduced[br]the world's first retirement policy.

0:08:19.400,0:08:21.360
The right to retirement is very recent,

0:08:21.360,0:08:24.370
the workers were protesting a lot

0:08:24.370,0:08:26.320
and he wanted to calm things down a bit,

0:08:26.320,0:08:29.030
so he stablished[br]the retirement age in 70 years.

0:08:29.650,0:08:32.400
When I researched a little

0:08:32.400,0:08:36.009
about which was the life expectancy[br]in Germany in 1893 --

0:08:36.720,0:08:39.600
(Laughter)

0:08:40.440,0:08:43.938
How long do you think[br]people lived in 1893?

0:08:44.530,0:08:47.930
Life expectancy at birth was 39 years old.[br](Laughter)

0:08:49.160,0:08:53.030
Otto Von Bismarck was a genius --[br](Laughter)

0:08:54.550,0:08:57.590
Those who were lucky[br]and managed to reach 30,

0:08:57.590,0:09:01.440
would live on average[br]another 30 years, that is, 60.

0:09:02.170,0:09:04.880
Otto Von Bismarck lived up to 78,[br]more or less,

0:09:04.880,0:09:07.330
good for him, but not for the rest.[br](Laughter)

0:09:07.550,0:09:11.680
Can you see there's no ground for this?[br]There is no medical basis for 65.

0:09:12.580,0:09:15.730
The other countries acquired[br]that number, 70, 60 --

0:09:15.920,0:09:19.120
actually, in the United States[br]it's said that 65 was adopted

0:09:19.120,0:09:22.150
because someone said "60", [br]another said "70",

0:09:22.150,0:09:26.080
and a third said "let's not argue: 65".

0:09:27.110,0:09:31.830
And now in the collective mind[br]it has become some kind of halfway point

0:09:31.830,0:09:38.680
in which we go deep into[br]not having a solution nor remedy,

0:09:38.780,0:09:40.650
and we do have a remedy.

0:09:41.140,0:09:47.930
There are changes in our lifestyle[br]that'd benefit us no matter when,

0:09:48.580,0:09:54.630
for example, if after this talk [br]you resolve to quit smoking,

0:09:57.800,0:10:01.280
tomorrow, in 24 hours,[br]your cardiovascular risk

0:10:01.280,0:10:05.260
would have decreased,[br]regardless of your age:

0:10:05.550,0:10:08.170
20, 40, 60, 80...

0:10:09.680,0:10:12.510
In two days, you'd recover[br]your senses of smell and taste.

0:10:13.600,0:10:17.490
Reducing our overweight, [br]that constant struggle,

0:10:18.000,0:10:19.980
at any time of our life,

0:10:19.980,0:10:22.410
even if we are 80 years old,

0:10:22.410,0:10:26.180
reducing overweight is positive,[br]especially abdominal fat,

0:10:26.180,0:10:31.499
the belly, which is a very important[br]predictor of cardiovascular events,

0:10:31.709,0:10:34.370
I'm sorry to break it to you.[br](Laughter)

0:10:35.910,0:10:39.029
And let's point out not only[br]the most physical things

0:10:39.029,0:10:42.059
but also the cognitive and social,

0:10:42.319,0:10:44.629
how about signing up to do something new,

0:10:44.629,0:10:48.509
enroll a course, meet new people.

0:10:49.179,0:10:51.469
The social environment, the people we meet

0:10:51.469,0:10:55.089
is also essential in our aging,[br]in our life in general.

0:10:55.569,0:10:57.589
When I started researching,

0:10:57.589,0:11:01.859
my goal was to find[br]preventive medicine interventions

0:11:02.099,0:11:07.799
that could improve the quality of life[br]and life expectancy of older people,

0:11:07.999,0:11:10.249
not only consider prevention in children,

0:11:10.249,0:11:11.879
but also in older people.

0:11:12.109,0:11:14.760
And I, as a doctor,[br]thought about the classic issues:

0:11:14.760,0:11:19.109
overweight, tobacco,[br]excessive alcohol, sedentary lifestyle --

0:11:19.889,0:11:22.230
However, as I was researching,

0:11:22.230,0:11:26.900
I had a US database which is[br]representative of the whole country,

0:11:26.939,0:11:29.889
its results are very solid,

0:11:30.149,0:11:32.519
and people over 65

0:11:32.529,0:11:34.689
were asked three questions[br]about their neighborhood:

0:11:35.199,0:11:38.960
Do you think that your neighbors[br]know each other well?

0:11:40.250,0:11:43.830
Do you think that those neighbors[br]are willing to help each other?

0:11:44.149,0:11:46.979
Can you trust your neighbors?

0:11:47.299,0:11:49.409
It's a measure of social cohesion

0:11:49.409,0:11:51.669
that sociologists used for other areas,

0:11:51.669,0:11:53.339
not for preventive medicine.

0:11:53.539,0:11:56.469
But it caught my attention[br]and I included it in my models.

0:11:57.139,0:12:00.259
And it turns out that people[br]who had a high social cohesion,

0:12:00.549,0:12:04.869
feeling that in their neighborhood people[br]knew, helped and trusted each other,

0:12:04.869,0:12:09.198
they have a 40 percent lower risk[br]of suffering a cardiovascular event.

0:12:11.039,0:12:13.129
Besides the classic risk factors,

0:12:13.129,0:12:15.309
there's also the social risk factors,

0:12:15.309,0:12:18.780
and our neighborhood, our environment,[br]is very important for our health.

0:12:19.539,0:12:23.720
Your neighbors affect your health. [br](Laughter)

0:12:26.400,0:12:28.689
And you, are you good neighbors?

0:12:29.014,0:12:31.474
Do you greet?

0:12:32.509,0:12:35.989
There's a lot of scientific evidence[br]being published and accumulating

0:12:35.989,0:12:39.359
on how neighborhoods affect health,[br]not just the social environment,

0:12:39.359,0:12:43.350
but also the physical,[br]sidewalks that are walkable.

0:12:43.350,0:12:45.450
Actually here in Spain[br]there is a leading group

0:12:45.450,0:12:47.320
at the University of Alcalá de Henares,

0:12:47.329,0:12:51.189
I recommend checking their results[br]because they are fascinating.

0:12:51.399,0:12:54.119
I believe that in the future[br]the real state ads will say:

0:12:54.119,0:12:58.479
two bathrooms, one bedroom,[br]and social cohesion.

0:13:00.319,0:13:03.589
(Applause)

0:13:08.480,0:13:11.960
And how should your neighbors be,[br]how a neighbor affects you,

0:13:12.320,0:13:14.790
-- besides you liking them more or less --

0:13:14.790,0:13:17.230
how does a neighbor affect[br]your cardiovascular risk,

0:13:17.230,0:13:18.720
it's a leap.

0:13:20.050,0:13:23.340
There are many mechanisms of action [br]and also different hypotheses,

0:13:23.360,0:13:26.080
but I believe that[br]a very simple one is walking,

0:13:26.660,0:13:30.630
specially if we are considering[br]people over 65,

0:13:30.830,0:13:33.540
to whom walking is perhaps[br]the easiest physical exercise

0:13:33.540,0:13:35.330
and the most recommended.

0:13:35.560,0:13:39.370
Do you think people not feeling safe[br]or sheltered in their neighborhood

0:13:39.370,0:13:43.380
will practice physical exercise in it,[br]or go for a walk?

0:13:44.670,0:13:47.630
How important it is[br]to go for a walk accompanied.

0:13:48.320,0:13:50.910
I was fascinated by a paper[br]published in 2016,

0:13:50.910,0:13:53.190
also in Madrid, at Universidad Autónoma,

0:13:53.190,0:13:55.420
at the Department of Preventive Medicine,

0:13:55.420,0:13:58.410
leading in cardiovascular research,

0:13:58.700,0:14:02.290
they are doing a research relating[br]hypertension or blood pressure

0:14:02.930,0:14:04.650
with social support.

0:14:04.970,0:14:08.540
A very intelligent researcher[br]had the idea of introducing this question:

0:14:08.540,0:14:11.170
Do you walk alone or accompanied?

0:14:11.790,0:14:16.660
People who walked accompanied[br]had less nocturnal blood pressure.

0:14:17.380,0:14:19.430
It was hugely beneficial for their health

0:14:19.430,0:14:25.810
because it is not just walking[br]and moving the muscles, legs or heart.

0:14:26.090,0:14:28.170
It's also the company, talking.

0:14:28.990,0:14:31.440
Aging is not a problem,

0:14:32.240,0:14:34.320
aging is a privilege

0:14:36.400,0:14:38.200
and a fact.

0:14:38.930,0:14:40.740
In little more than ten years

0:14:40.740,0:14:43.780
we will be one of the oldest countries[br]in the world.

0:14:44.950,0:14:47.900
Of every three persons,[br]one will be over 60 years old.

0:14:50.830,0:14:52.790
Where do we want to grow old?

0:14:52.790,0:14:55.860
Where do we want our parents to age,[br]or our grandparents?

0:14:55.870,0:14:57.820
In what society?

0:14:58.630,0:15:01.150
We have to get rid[br]of that negative vision of old age,

0:15:01.150,0:15:03.040
first because it affects our health,

0:15:03.040,0:15:05.540
and second because[br]it affects the health of others.

0:15:06.140,0:15:09.440
I invite you to question these stereotypes

0:15:09.440,0:15:11.740
that are sometimes unconscious,

0:15:11.740,0:15:15.000
about what a person can or cannot do[br]based on their appearance.

0:15:15.640,0:15:18.480
And I also invite you to build a society

0:15:18.480,0:15:20.220
in which we all fit,

0:15:20.590,0:15:23.889
a person of 20, a person of 80,

0:15:23.889,0:15:27.230
a person pushing a cart[br]and a person carrying a cane

0:15:27.230,0:15:29.050
or in a wheelchair.

0:15:30.200,0:15:33.889
A society in which[br]we can age with quality,

0:15:34.239,0:15:37.409
in which we can age with health,

0:15:39.219,0:15:42.139
in which we can grow old[br]walking together.

0:15:42.429,0:15:43.600
Thank you very much.

0:15:43.600,0:15:45.600
(Applause)