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STANFORD -- If people wore tags with their ages printed on them, Americans would be shocked by the youth of the over-60 set, suggests Clifford Barnett, a Stanford University medical anthropologist who teaches a course on aging.
"As long as people are functioning, they don't fit the image we have of old people and therefore, they are not counted as belonging to that population," said Barnett, who, at 65, surprises his students when he tells them his age. Because he still works full time and rides his bicycle, he said, he doesn't fit their stereotype of someone eligible for Social Security.
Americans will have to change their stereotypes of the old, Barnett believes, because the population is getting older, and society will need to make more use of older people's skills.
Right now, the courts are seeing a growing caseload of age discrimination suits, he said, a sign that we are having some difficulty adjusting to the end of mandatory retirement at age 65.
"Employers, like everyone else, discriminate against older people because their stereotype of them is based on this misperception of the condition of older people," Barnett said.
In his course, Barnett finds students almost always overestimate the proportion of people 65 and older who are institutionalized in nursing homes.
"The proportion is 5 percent - and just 1 percent of those between 65 and 74 are institutionalized," he said, "but just about everybody in my classes thinks at least 20 percent of those over 65 are institutionalized."
Older people also hold negative stereotypes of aging, Barnett said.
"We don't lose our stereotypes just because we become older. To the extent an individual has absorbed those stereotypes, we know from studies that this makes aging especially difficult for him or her," he said.
"There is a very interesting difference between negative stereotypes about the aged and negative stereotypes about other groups. If you are white and have stereotypes about Chicanos, for example, you are never going to become part of the group you stereotype. In the case of aging, if you are lucky, you are going to become part of the group."
Another reason for confusion about what getting older means, he said, comes from a misinterpretation of cross-sectional studies that assign certain attributes to specific age groups.
"The aging process is hard to study, because it is a moving target. That is, people who are 65 now are, very likely, different from what 45-year-olds will be when they are 65."
This is because "each age cohort goes through different life events," he said, including wars, depressions, and different eating, work and exercise habits.
Longitudinal studies that track the same people over time give a more realistic view of aging, he said, but are seldom done because of their cost.
"In the few longitudinal studies we have, when you look at the health of the same people over time, you see that in terms of physical abilities - such things as how much air they take in, their heart rates and cognitive abilities - each cohort gets better," Barnett said. "In fact, people who are age 75 today are like people in the past who were 65."
"It's no mystery" why people are functioning better at older ages, he said.
"As I tell the students, I bicycle to work every day, and I privately cuss the people who are jogging in my bike lane, because they are in my way," Barnett said. "But if those younger people keep jogging, keep not smoking and keep worrying about saturated fat, by the time they reach 65, they will be different from me."
Barnett's course on aging is increasingly popular with young adults, who are beginning to recognize the industrialized world's population is aging, he said. By the year 2030, for example, the United States will have about 66 million people over age 65, more than twice their number in 1990 and about 22 percent of the population.
It is not so much that people are living longer, Barnett said, as that the birth rate has declined so that a greater proportion of people are older.
Young adults come to his introductory course with little previous exposure to people over 60.
"Many of them remember negatively the sights and smells and sounds of a nursing home they visited on a school trip as a child," he said. "They may have had some experience with a grandparent, but over all, our society is very age segregated compared to many others."
Most of Barnett's students choose to work with older people off campus for part of their course credit, and this generally changes their view of the old, Barnett said.
"In nearly every class," he said, "I get students who say, 'You know, these older people are having a hell of a lot better time than I'm having.' "
Not all are pleased to discover the vitality of those who are older, he said.
"It can be very disorienting for a young adult to learn that there isn't a big line you cross over where, suddenly, things are totally different. Rather, you are already pretty much socially what you are going to be."
Students who take his course include many who plan careers in medicine, he said.
"Unless they specialize in pediatrics or obstetrics, those who are planning to go into medicine will find somewhere around 60 to 65 percent of their patients will be over the age of 65 when they finish medical school," Barnett said. "That's the way the demography is going."
Modern medicine is often criticized for keeping people alive on respirators and through treatments that destroy the quality of life. Barnett points out, however, that medical technology also has added to the quality of life.
"One thing that has gotten little public attention but has been really important are hip replacements. They make it possible for older people - particularly women, who are more likely to suffer from osteoporosis - to function longer. In the past, when any person 65 or older fell and became immobilized with a broken hip, it was really a death sentence," he said.
Medical training, Barnett believes, is gradually shifting its focus from "saving lives" to "keeping people able to function longer."
Partly that may be the result of new theories that seem to question past conceptions of aging as a singular process distinct from disease. Hardening of the arteries, for example, is now thought of as a disease that sometimes can even be reversed.
On the other hand, Barnett said, there is some laboratory evidence for the theory that "free radicals" are created within body systems and that they keep accumulating until a particular body system breaks down.
"This has led to the question, Is aging distinct from disease processes or not?" he said. "We will need more research results to know the answer."
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