We have worked very hard to achieve living longer
and yet today we consider aging as a problem.
I also used to consider population aging as a problem,
that's why some years ago I packed, left everything behind
and enroled a top university in the USA, Johns Hopkins University,
to acquire tools that'd help me to fight the aging challenge.
What I was not expecting was to realize that my initial vision,
my perspective on aging, was distorted.
I had a series of beliefs, stereotypes and prejudices
that prevented me from seeing clearly.
We can think of aging either as positive or as negative
but we all share one thing:
That idea is conformed very early in our lives.
Studies in the '70s
conducted interviews on 4 to 11 year-old children,
a gerontologist, Seefeldt, and others
asked children about their perception of the elderly.
Results are horrifying.
Two out of three children believed that older people
were helpess, unable to take care for themselves,
and generally passive.
And that negative perception they had about aging
would also become an expectation of their own aging.
60 percent of those children
already predicted that when they'd be old, they were going to feel awful.
And how can any 4, 5 or 6 year old know how'd they feel when elderly?
Probably, what goes on there is that we are absorbing
that stereotype and that belief from our environment.
Actually, in the Western world, Europe and North America,
there's generally a very negative perception of old age,
it's what we call "ageism" or discrimination by age.
And what happens when those children grow up?
By then the stereotype is reinforced,
the belief is replayed
by the mass media, advertising, movies --
If you give a closer look, how is aging usually portrayed?
Generally not positive.
At most it's warm, but never as an active aging.
Actually, in the 90s another very interesting experiment
was conducted by Burke on healthcare professionals.
He wanted to analyze why some health professionals
would talk to older people as if they were children,
we call this the "elder talk",
probably most of you have done it or at least have seen it:
"Hi Carmencita, how are you today?
Here is your little pill for the heart".
Right? And Carmen is 75 years old, a professor emeritus at university
and she is in perfect cognitive state. (Laughter)
Burke proved that healthcare professionals
would speak like this to the elderly
regardless of their cognitive state,
based only on their own beliefs about old age.
I invite you to never talk like this to an older person.
(Applause)
In 2008 an article in The New York Times
gathered all the scientific evidence
of why talking like that to older people
is harmful to their health.
In a very simple way we can realize we are reinforcing their idea
that they are useless and incapable.
No, the elderly are not like children.
In another very interesting study also starting in the 70s
a gerontologist, Ashley, went to a town in Ohio
and managed to convince 2/3 of the population over 50
of participating in it.
That's an achievement for any researcher
because nobody wants to take part in scientific studies,
less if they are periodic.
These people were periodically asked
about their mental health status, their physical health status,
their working environment, family, etc.
And they were also asked some questions on their perception of old age:
Do you think you become less happy as you get older?
Do you think that as you get older you are less useful?
Well, this study was very interesting,
and had the most powerful results 15 years later.
A social psychologist, Becca Levy, from Yale University,
has revolutionized the world -- at least for me, my world --
by proving that the negative stereotype of old age
becomes a self-fulfilling prophecy.
Meaning that it affects our health,
if we think we are going to age badly, we most probably will.
Becca Levy with her Ohio study resolved to test an hypothesis:
do people with a positive vision of old age live longer?
She went to Ohio and retrieved all the death certificates
from people participating on the research who had already died
and compared the life expectancy of people with a positive vision
with those who had a negative vision of old age.
And she found that those with a positive vision lived longer.
How much longer do you think they lived?
One year? Two years?
It's 7.6 years!
That is 7.6 years more of life expectancy
in those with a positive vision of old age.
Monitoring all other factors.
Do you know how much it costs as society
to increase life expectancy ... in 3 months?
"With surgery ... got another year of life expectancy ..."
Changing our attitude.
A change in our beliefs about aging.
And how can a belief become a change in your cells,
in your life expectancy?
It's very revolutionary.
Well, they've managed to understand
how the negative stereotype is associated to things like memory,
to our performance in cognitive tests.
In 2013, they managed to associate the negative vision of old age
with the size of our hippocampus.
So, our ideas change the anatomy of our brain.
And to apply it a little in our day to day
there are many hypotheses of how this happens,
what is the biological mechanism, how does this happen?
But there's one thing that we have all said or listened,
that is: "Me, at my age..."
"What am I doing wearing sneakers at my age?"
"What am I doing in the gym at my age?"
"What am I doing, being 40, with those who are 20?"
Suddenly, we stop doing things that are good for our health
because there's some kind of expiration date
from which we throw in the towel.
It seems like the day we turn 65,
"game over", we are done,
we can no longer introduce any positive activity for our health
because it's not worth it, there's no turning back,
aging is negative by definition, it is inexorable.
Actually that number, 65 years,
I tried to find out where it came from,
and the most probable cause is called Otto Von Bismarck,
who was the German Chancellor in the late 1800s.
In 1893 he introduced the world's first retirement policy.
The right to retirement is very recent,
the workers were protesting a lot
and he wanted to calm things down a bit,
so he stablished the retirement age in 70 years.
When I researched a little
about which was the life expectancy in Germany in 1893 --
(Laughter)
How long do you think people lived in 1893?
Life expectancy at birth was 39 years old. (Laughter)
Otto Von Bismarck was a genius -- (Laughter)
Those who were lucky and managed to reach 30,
would live on average another 30 years, that is, 60.
Otto Von Bismarck lived up to 78, more or less,
good for him, but not for the rest. (Laughter)
Can you see there's no ground for this? There is no medical basis for 65.
The other countries acquired that number, 70, 60 --
actually, in the United States it's said that 65 was adopted
because someone said "60", another said "70",
and a third said "let's not argue: 65".
And now in the collective mind it has become some kind of halfway point
in which we go deep into not having a solution nor remedy,
and we do have a remedy.
There are changes in our lifestyle that'd benefit us no matter when,
for example, if after this talk you resolve to quit smoking,
tomorrow, in 24 hours, your cardiovascular risk
would have decreased, regardless of your age:
20, 40, 60, 80...
In two days, you'd recover your senses of smell and taste.
Reducing our overweight, that constant struggle,
at any time of our life,
even if we are 80 years old,
reducing overweight is positive, especially abdominal fat,
the belly, which is a very important predictor of cardiovascular events,
I'm sorry to break it to you. (Laughter)
And let's point out not only the most physical things
but also the cognitive and social,
how about signing up to do something new,
enroll a course, meet new people.
The social environment, the people we meet
is also essential in our aging, in our life in general.
When I started researching,
my goal was to find preventive medicine interventions
that could improve the quality of life and life expectancy of older people,
not only consider prevention in children,
but also in older people.
And I, as a doctor, thought about the classic issues:
overweight, tobacco, excessive alcohol, sedentary lifestyle --
However, as I was researching,
I had a US database which is representative of the whole country,
its results are very solid,
and people over 65
were asked three questions about their neighborhood:
Do you think that your neighbors know each other well?
Do you think that those neighbors are willing to help each other?
Can you trust your neighbors?
It's a measure of social cohesion
that sociologists used for other areas,
not for preventive medicine.
But it caught my attention and I included it in my models.
And it turns out that people who had a high social cohesion,
feeling that in their neighborhood people knew, helped and trusted each other,
they have a 40 percent lower risk of suffering a cardiovascular event.
Besides the classic risk factors,
there's also the social risk factors,
and our neighborhood, our environment, is very important for our health.
Your neighbors affect your health. (Laughter)
And you, are you good neighbors?
Do you greet?
There's a lot of scientific evidence being published and accumulating
on how neighborhoods affect health, not just the social environment,
but also the physical, sidewalks that are walkable.
Actually here in Spain there is a leading group
at the University of Alcalá de Henares,
I recommend checking their results because they are fascinating.
I believe that in the future the real state ads will say:
two bathrooms, one bedroom, and social cohesion.
(Applause)
And how should your neighbors be, how a neighbor affects you,
-- besides you liking them more or less --
how does a neighbor affect your cardiovascular risk,
it's a leap.
There are many mechanisms of action and also different hypotheses,
but I believe that a very simple one is walking,
specially if we are considering people over 65,
to whom walking is perhaps the easiest physical exercise
and the most recommended.
Do you think people not feeling safe or sheltered in their neighborhood
will practice physical exercise in it, or go for a walk?
How important it is to go for a walk accompanied.
I was fascinated by a paper published in 2016,
also in Madrid, at Universidad Autónoma,
at the Department of Preventive Medicine,
leading in cardiovascular research,
they are doing a research relating hypertension or blood pressure
with social support.
A very intelligent researcher had the idea of introducing this question:
Do you walk alone or accompanied?
People who walked accompanied had less nocturnal blood pressure.
It was hugely beneficial for their health
because it is not just walking and moving the muscles, legs or heart.
It's also the company, talking.
Aging is not a problem,
aging is a privilege
and a fact.
In little more than ten years
we will be one of the oldest countries in the world.
Of every three persons, one will be over 60 years old.
Where do we want to grow old?
Where do we want our parents to age, or our grandparents?
In what society?
We have to get rid of that negative vision of old age,
first because it affects our health,
and second because it affects the health of others.
I invite you to question these stereotypes
that are sometimes unconscious,
about what a person can or cannot do based on their appearance.
And I also invite you to build a society
in which we all fit,
a person of 20, a person of 80,
a person pushing a cart and a person carrying a cane
or in a wheelchair.
A society in which we can age with quality,
in which we can age with health,
in which we can grow old walking together.
Thank you very much.
(Applause)