- I will begin to post a series of writings on the future of gerontology – from my vantage point and metier – as being involved in the field for over 25 years and having served in the academic world with publications and the development of courses related to aging. I have taken the liberty of modifying the title of Immanuel Kant’s work – Prolegomena to Any Future Metaphysics and using it as the template for what I consider to be a major contribution as far as any future writing on the topic of aging is concerned. The work – collectively – has the title: Prolegomena to Any Future Gerontology: That Will Be Able to Present Itself as a Science.
Immanuel KantMy intent is to challenge the status quo of scholarship in the field of aging with a gentle manifesto – a forward-looking and comprehensive perspective (an architectonics of gerontology) highlighting five (5) significant inflection points in the field of aging. I am proposing that we are now entering 5.0 – “POST-AGING.” I challenge the notion that gerontology will ever have a paradigm – much less a dominant theory to lay claim to; rather, we have operated and worked within a series of inter-related curvatures of prevailing themes that guide and direct our activities in research, teaching, and application (applied).
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Part 1. Transcending the muddle of disciplinary and paradigmatic tensions in gerontology: The use of inflection points in the explanation and understanding of scholarship for the aging experience.
We are in the midst of two striking trends: widespread population aging and rapid diffusion of technology. Both phenomena are very new in human history.
Neil Charness (2004) From Gerotechnology: Research and Practice in Technology and Aging.
Edited by David C. Brudick and Sunkyo Kwon. Springer Publishing, New York. (p.xxv).
The contemporary and assumed trajectory of the journey of life has changed dramatically in terms of both life expectancy and life outlook since the time of Sophocles who according to Kitzinger (2005) textually captured the “fundamental impermanence of the natural and constructed world” via the play Oedipus at Colonus. Here is Oedipus in his greatest speech in the play talking to Theseus (Kitzinger, 2005),
Dearest son of Aegeus, none but the gods
Escape old age and death; all else
Time in its relentless flood sweeps away.
The strength of earth and body fades…(p. 14).
The great flux of life as precursor to mortality was also the purview of the Roman Stoics where both Marcus Aurelius and Seneca offered their philosophical perspectives on the seemingly brief span of time that was life. Their viewpoint was that life only appeared to be short as humans were apt to take for granted the time that was given. Here is Seneca with his thoughts in respect to On the Shortness of Life (1997; translation by Costa)
Life is long enough and a sufficiently generous amount has been given to us for the highest achievements it if were all well invested. But when it is wasted in heedless luxury and spent on no good activity, we are forced at last by death’s final constraint to realize that it has passed away before we knew it was passing. So it is: we are not given a short life but we make it short, and we are not ill-supplied but wasteful of it (p. 1-2).
And then Marcus Aurelius, the philosopher-king, from his work Meditations,
Altogether the interval is small between birth and death; and consider how much trouble, and in company with sort of people and in what feeble body this interval is laboriously passed. Do not then consider life is a thing of any value. For look to the immensity of time behind thee, and to the time which is before thee, another boundless space. In this infinity then what is the difference between him who lives three days and him who lives three generations? (p. 268)
Marcus Aurelius was surely emphasizing the quality of life over the quantity of life as he persuasively tried to indicate that to simply have a longer period of time to be alive would not necessarily make for a better life to live.
But that was then, and this is now.
It is obvious that much has changed in our current understanding of the human condition and of the aging experience since Seneca’s time and of the Roman world (Parker, 2003). In hindsight, an observer can posit that we have experienced significant epochal transitional phases in our understanding of the journey of life. Such epochal transitions are not esoteric grist for the philosophical mill; rather they have critical implications for the study of the aging process. One of the primary goals of this paper will be create a new meta-theoretical approach to the macro-level phases of scholarship for the study of aging. But before I elaborate on that proposed matrix, let us examine some traditional understandings of transitional developments in the understanding of the human condition.
One example of such a transitional design would be the supposed perennial division found between the humanities (Geisteswissenschaften) and the natural sciences (Naturwissenschaften) which has produced two modes of knowing: Verstehen (understanding) and Erklären (explanation) (Dilthey, 1883; Schmidt, 2006). This differentiation is similarly related to the perspectives of C.P. Snow (1964) and his influential (albeit controversial) publication addressing the breakdown of communication between the “two cultures” (science and humanities) of modern society. Since Snow’s publication there have attempts to integrate the two domains (Brockman, 1995; Wilson, 1998). Some see this division as counterproductive and have argued persuasively to have the humanities appreciate more of the contributions from the natural sciences (particularly research on human cognition) so that there can be more of an integrated approach to culture and the human condition (Lehrer, 2009; Slingerland, 2008). Another example would the perennial debate and discussions of consciousness that surround the seemingly incommensurability with human subjective experiences and an objective world and the resulting monist (idealism vs. materialism) and dualist theories (i.e., Cartesian dualism) (Blackmore, 2004; Ramachandran, 2004). Another example of an epochal transition would be the distinction (following Arendt, 1958) and emphasis of vita contemplativa (a contemplative life) in contrast to vita activa (an active life). The transition from vita contemplativa to vita activa also heralded the emergence of the modern scientific enterprise, which (contra Arendt) would now be considered the world-immanent epistemological measure of knowledge and understanding (Brient, 2001). It appears that the enterprise of science is how we primarily focus our theories and methods on the aging experience as well.
The historical development of gerontology as a field of study, a discipline, as interdisciplinary, a taxonomy, an approach, a lexicon, an industry and as a profession has a checkered and dendritic course of progression and many have attempted to profile the major events and prevailing streams of philosophy and thought along the way (Achenbaum, 1995; Achenbaum, 2009; Bass & Ferraro, 2000; Cole, 1992; Hendricks & Achenbaum, 1999; Katz, 1996). Although many gerontologists would concede that the “scientific management of aging” (Cole, 1992) is the prevailing paradigm in which most of the research and policy in aging is derived from, there are also several who would contest this hegemony and would seek equal time (if not equitable awareness) to perspectives that lie outside the foundationalistic scientific enterprise such as in the humanities and in critical gerontology (Cole, 1996; Biggs, Lowenstein, & Hendricks, 2009; Bengston, Gans, Putney, & Silverstein, 2009). Here is Katz (1996) who argued for the “undisciplining” of gerontology because of the rich socio-cultural dimensions of the aging experience,
Aging and old age are intrinsic to every form of knowledge and cultural practice: spiritual, ritual, mythical, symbolic, artistic, metaphorical, and architectural. They are the central organizing resources for a multitude of social structures from nomadic pastoralism to complex kinship systems to statelike bureaucracies. Indeed, aging and old age have been so diversely and richly understood that no single knowledge of them is universal. Nor should it be. The meanings of aging and old age are scattered, plural, contradictory, and enigmatic. They are confirmation that the mysteries of age have furnished the human imagination with limitless opportunities to express itself. Age, is everywhere, but the world’s cultures have taught us that age has no fixed locus. (p. 1)
As Bengston, Putney and Johnson (2005) have indicated in their concise chapter, “The Problem of Theory in Gerontology Today” published in The Cambridge Handbook of Age and Ageing (Johnson, 2005), the perspectives from constructivist and critical orientations offer an alternative to the precepts of science (or more specifically – positivism). Yet for the large part, the business of gerontology is in the scientific business, nevertheless, Bengston, Putney & Johnson (2005) lament the lack of theory driven research and practice in gerontology,
“The field of gerontology has accumulated vast amounts of data over the past decades, creating a goldmine of potential theoretical knowledge. Yet explicit theory development has lagged – prompting some to observe that gerontology remains data-rich and theory poor (Bengston et al, 2005, p. 4; see also Bengston & Schaie, 1999).
Bengtson, Putney, and Johnson (2005) acknowledge the role of critical theory and social construction perspectives, but nevertheless acknowledge that, “science remains the reigning paradigm” (p. 17), and then go further by specifically stating that the “biomedicalization of ageing remains a guiding research paradigm” (p. 6). This assessment appears to be a reactionary stance by several others (primarily within the sub-domain of the social sciences) who either fear the hegemony of the biomedical sciences or the slippery slope of scientism and/or reductionism (Bengston, Rice, & Johnson, 1999; Biggs, Hendricks, Lowenstein, 2003; Katz, 2003). Ferraro (2006) has gone on record as a editor of the Journal of Gerontology: Social Sciences that he hoped to make gerontology more inclusive, yet also stated that because “health issues are inextricably related to the aging process…gerontology flirts with being medicalized” (p. S3).
The debate and dialogue continues along in multiple dimensions and directions in terms of gerontological theory, methodology, and practice (Bass & Ferraro, 2000; Bengston, Gans, Putney, & Silverstein, 2009; Ferraro, 2006, Alkema & Alley, 2006; Haber, 2009). Some see the potential for a “unified theory” (the holy grail) and “integrative model” within social gerontology (Bass, 2006; Bass, 2009) while others ponder if the “age-specific” status of gerontology is in post-mortem when placed in the context of “life course” conceptual models (Settersten, 2006). There are also the on-going academic (and paradigmatic) tensions between life course sociology and life-span psychology (Baltes & Nesselroade, 1984) which bring to bear different level of focus and analysis (micro vs. macro) of the human condition and aging experience, although there are recent attempts to see where the different pathways may complement one another by “extending the interrogation” and finding common ground in a potential integrated paradigm or the proposal of new paradigm altogether (Dannefer & Daub, 2009; Diewald & Mayer, 2009; Settersten, 2009). But it appears that there is much to be worked out in this regard, but I do find Settersten’s (2009) comments about how the behavioral and social sciences will need to engage more directly and extensively with the biological and medical sciences to be highly relevant to the goal of this paper. In fact, I agree with Settersten’s call for a deeper integration of the human sciences with those of the natural sciences in investigating the vagaries of human development. As you will soon discover, I am proposing that the domain of digital technologies and bio-technologies will also become a major cross-cutting influence in the explanation and understanding of the aging experience (Culter, 2005; Culter, 2006, Read, Green, & Smyer, 2008).
Second Installment
August 4, 2009
But, I was disappointed with some statements by Settersten about the so-called “reductionistic tendencies” in the domains of such as genomics and neurosciences. Settersten’s (2009) concerns seem to raise the spectre of fear that conducting science at the molecular level would somehow leave out the human spirit and that only molar level analyses can capture the essential nuances of the “aging experience.” This categorization and distinction-setting appears to rebuilding a wall between Geisteswissenschaften and Naturwissenschaften or between Verstehen (understanding) and Erklären and the notion of the “two cultures” when it comes investigating to the aging experience. In other words, raising the flag of “reductionism” for relatively new foci of analyses (i.e., genomics and neurosciences) appears to resurrect a Catersian dualism for approaching the aging experience.
This unfortunate stance would mean that the potential for interdisciplinary theory-building (Bass, 2009; Bengston et al, 2009) and potential vertical integration in all levels of inquiry could be held hostage because of the belief that “meaning” or making “connections” for the aging experience is the proper domain of only the behavioral and social sciences. In other words, “extending the interrogation” would only be allowed to go so far – perhaps between sociology and psychology – but deeper vertical connections with the biomedical sciences or biotechnological aspects appear to be a lost cause or not worthy of further pursuit for fear of creating an academic slippery slope toward consilience (Wilson, 1998) or a level of reductionism that would exclude the study of what makes us “human.”
Biggs, Hendrick, and Lowenstein (2003) have claimed that exchanges with humanities and social sciences “have been met with indifference” by the biomedical sciences (Biggs, Hendricks, Lowenstein, 2003; p. 5) and Katz (2003) believes that “critical gerontology” has been marginalized due to “the predominance of biomedically-driven funding policies” (p. 26). This kind of bickering and academic tension is understood when defending the academic territories and safe-guarding the heterogeneity of perspectives for the aging experience (Bass, 2009) but it may also reinforce the parceling out of the study of aging to a predetermined set of specialties deemed to be appropriately only understood or researched at the social level or cognitive level or biological level or psychological – but not more than one or even with the chance of integrated among many perspectives. In other words, we end right back to where we started with disciplinary territories (or home departments) that are marked by rigid silos of specialists talking to one another in their appointed domains of either macro –or mid-range or micro-level theories and methods. The study of aging is then left to “professionals” and specialists who defend their hallowed space either out of academic loyalty or career building (Bass, 2009; Hendricks & Achenbaum, 1999). This kind of strategic enterprise might make good academic sense, but whether or not it is good for the depth and breadth in the investigation of the full spectrum of the condition of aging. Fortunately, the latest edition of the Handbook of Theories of Aging (Bengston et al, 2009) has made great strides (since 1999) to be more inclusive and integrative with a substantive awareness of the dividends of interdisciplinary theory-building and research (Bass, 2009). Neverthless, the desire to identify an emergent paradigm or latent one or simply to identify one is bound to be problematic within a domain that either claims to be interdisciplinary (i.e., gerontology) or is the subject of many separate disciplines with their own paradigmatic identities.
But instead of debating the nuances of life-span psychology and life course sociology as the best approach to aging phenomena or whether we identify with either with “the study of aging” or with gerontology (Bass, 2009) or the intricacies of whether gerontology is a really a full-fledged discipline, multidisciplinary or interdisciplinary or whether is gerontology is best served by developing fully developed theories or by engaging in dust bowl empiricism or by primarily focusing on application, practice, or policy (Bengston et al, 2006) or whether we have a singular paradigm or multiple paradigms or if the hoped for paradigm is emerging or “latent or embryonic,” I think it is best to proceed to examine the progress of the “gerontological imagination” (Bass & Ferraro, 2000; Ferraro, 1990; Wilmoth & Ferraro, 2007) not as a paradigm per se but by using an alternative metatheoretical (or perhaps pre-theoretical) structure – and more comprehensive in scope – as to what the inclusive activities in our scientific enterprise and business and ideology and industry practice is being driven by or leading towards in the domain of aging. The usage and definition and application of the word “paradigm” in gerontology/aging heretofore have been highly problematic. On one hand it is questionable whether or not there is “one” paradigm that actually exists to identify for gerontology,
Gerontology has dramatically increased its intellectual capital; however, one limitation of its propitious growth is the perceived absence of a paradigm: the fundamental image that a discipline has of its subject matter…Especially in scientific fields, a paradigm establishes a general set of organizing principles that provides coherence or maps the field. A paradigm also defines what should be studies. (p. 99).
Although I agree with the basic assumptions of how a paradigm in general operates according to Bass and Ferraro (2000), I also believe, in contrast, that any metatheoretical shifting with the “gerontological imagination” (Bass & Ferraro, 2000) should to stay clear of the epistemological baggage that is carried along with the discourse on Khunian paradigms. The connection between the notion of a monolithic paradigm that is eminent and over-arching for all the facets of a “discipline” does not seem to be the case for gerontology if we assume it be assumed to be multi or interdisciplinary, however Bass & Ferraro (2000) have indicated that perhaps gerontology is best understood as “being a multiple-paradigm science” (p. 99) or perhaps there may be a paradigm (i.e., “gerontological imagination”) but in a “latent or embryonic form” (p. 100). I submit that this only complicates the matters, especially when placed in context of the Khunian conceptualization of a paradigm in his works (and others) as it relates to the philosophy and history of science.
Thus, following in the tradition of Cole (1992) and others (e.g., Achenbaum, 1995, 2001, 2009; Bass & Ferraro, 2000; Hendricks & Achenbaum, 1999; Katz, 1996), I am taking the “long view” in proposing an over-arching interpretation of (primarily) the 20th century activities in the scientific enterprise associated with the field of aging that had led to the development of an existing Weltanschauungen in the field of aging. But I also will propose that the existing world-view be soon be supplanted by another emergent world-view or conceptual framework in the 21st century. It is proposed that this new world-view will have the capacity to transform the epistemology and ontology of gerontology for decades to come. I further claim that this superseding shift represents what I call and (and heuristically use to examine such meta-theoretical transitions) – an inflection point.
I am proposing that there have been several key inflection points in understanding our modern journey of life as aging individuals. I use the phrase “inflection point” as a more preferred label – and as didactic strategy – to understand and organize the sequential, but inter-related, epistemological and ontological shifts in inquiries and activities that are associated with the study of the aging process. By “inflection points,” I am referring to the mathematical concept that signifies a point on a curve at which the sign of the curvature for a function changes direction (Weisstein, 2009; see Figure 1).
Points of inflection, derivatives, second derivatives (i.e., derivative of the derivative), and curvature are terms used in the modeling of dynamical systems to describe and measure rates of change (i.e., derivative) for biological phenomena (Adler, 2005), but used here deliberatively as a heuristic device, and as a hermeneutic (Schmidt, 2006) in the investigation of scholarship in the field of aging. When used specifically in the domain of modeling the dynamics of life, a function with a positive derivative is one that is increasing and one with a negative derivative is one that is decreasing. Furthermore, the second derivative tells whether the graphical interpretation of the function curves upward (concave up) or downward (concave down) (Alder, 2005).
The working assumptions in this heuristic is to determine and assess the rate of growth (and interest) in the scholarship on aging as either increasing or decreasing (as a function of point in time) depending on the prevailing stream of thought for what constitutes the primary goal and raison d’être of the majority of research, teaching, and practice in the field of aging. One major caveat for the use of this heuristic device is that there is no actual mathematical algorithm used to determine or create an actual graphical outcome for the analysis of determining inflection points, rather the graphical image serves to create the heuristic by which we might understand the transitions in focus and primary activities associated with teaching, research, and application in the field of aging.I am careful here to avoid the cavalier poaching of scientific terms (i.e, inflection point) from other disciplines (especially from mathematics), especially given the critiques of Sokal and Bricmont (1998) who have found many abuses of science in the “postmodern context” where there is haphazard and promiscuous use of extrapolation of ideas from the natural to the social sciences. My goal here is to introduce one term that has relative cross-disciplinary relevance, and it is proposed that the use of this “new” terminology can help to advance a different viewpoint and perspective to understand the change,
Thomas Kuhn
growth and transitions of gerontological scholarship without the necessity of falling back to the notion of the Kuhnian paradigm and the attendant assumptions of that historical framework for interpreting scientific activity in our field. Thus one major point of departure (and interpreted as necessary) when using this heuristic rather than the traditional language of paradigm (via Kuhn) is to understand and appreciate the interconnections of interrelated threads between and among various inflection points over time that are not necessarily diminished or dropped even after a new inflection point has emerged.
Third Installment
August 8, 2009
In fact, each proposed inflection point is intimately tied to and connected to the previous one with interconnected threads – instead of acting as through gerontology has or will advance via scientific revolutions and normal science and that an existing era of “normal science” (within a supposed paradigm) are in essence incommensurable and mutually exclusive to the following one after a significant revolution has occurred. In addition, in contrast to the supposed Copernican-like “revolutions” and then puzzle-solving of normal science of Kuhnian paradigms, I propose that there are incremental shifts that are insidious and subtle, although shifts do occur and new direction are forged, they are not like the decisive breaks that Kuhn envisions as though the research traditions in gerontology are like shockwaves of plate tectonic movements. In other words, I would propose that there is not the sense of a “scientific revolution” or “incommensurability” within the field of gerontological scholarship as Kuhn had rendered it with a sense of a “clean break” from previous operating paradigms,
“… discoveries that cannot be accommodated within the concepts in use before they were made. In order to make or to assimilate such a discovery one must alter the way one thinks about and describes some range of natural phenomena.” (Kuhn, 2000; p. 14-15).
Rather it is proposed here to better understand the changes in the prevailing stream of thought and purpose to be representing by inflection points in which there is a shift in direction for the major themes in scholarship over a designated and set period of time. Inflection points do have some similarities with what Sherraden, Morrow-Howell, Hinterlong, and Rozario (2001) refer to as “pretheoretical tensions” in the field of gerontology (especially as it relates to “productive aging”), but inflection points carry a longer and deeper historical perspective for our field not only in retrospect and but prospectively too. To place this point in perspective, I would propose that there have been five major inflection points in the extant history of gerontological scholarship and practice (see Table 1).
Table 1
Inflection Points (Directional Shifts in Prevailing Theme in gerontology/aging)
1.0: Metaphysics of Aging {Aging as “reflection”}
2.0: Bio-medical [acute and chronic] diseases of Aging {Aging as a “problem”}
3.0: Demographics of Aging {Aging as a “challenge”}
4.0: Optimal Aging {Aging as a “reward”}
5.0: Post Aging {Aging as an “artifact”}
Inflection point [1.0] would represent the metaphysics of aging (as a technique for coping with the shortness of life) has been superseded by a new inflection point [5.0] in our current temporal setting which represents post-aging or aging as an artifact due to an array of bio-technological advancements (e.g., nanotechnology) And between these two diametrical and temporal poles, one quite philosophical and one quite technological, there have been three other inflections points [2.0, 3.0, 4.0] in media res (see Table 1).
The inflection point in this case represents change in direction in the flow of purpose and praxis for what constitutes a dominant theme in the enterprise of conducting scientific (in its broadest sense) inquiries relating to aging. Many readers will find the heuristic of inflection points to be closely related to other terms that have been used in the history and philosophy of science such as paradigms, conjectures, exemplars, disciplinary matrix, and the cognitive apparatus of a given scientific community (Conant & Haugeland, 2000; Kuhn, 1970; Kuhn, 1977; Popper, 1963; Suppe, 1977) or the use of research programme (Lakatos, 1970) or research tradition (Laudan, 1984) or representational spaces (Hung, 2001). But my preference for using inflection points in the domain of gerontological scholarship is based on four substantive motivations:
1)
I think that there are the inherent complications that have followed the Kuhnian historiography of science and the attendant terminology of paradigms, normal science, crisis, gestalt switches, conversion experiences, revolutions, and the highly debatable and contentious notion of incommensurability between paradigms (Caneva, 2000; Von Dietze, 2001; Mayo, 1996; Radder, 1997).
2)
that the use of paradigm to describe scientific advancements via normal science and revolutions may not be applicable to all areas of study in science (Mayr, 1994; Carvalho, 2006);
3)
that the concept of paradigm and its operational definition(s) varies across disciplines even when paying homage to the Khunian expression in its origination. For example, Bhopal (1999) argues for a pro-active use of the Kuhnian notion of paradigm to advance common themes in textbooks in the field of epidemiology and public health, Weaver & Olson (2006) discuss four different “paradigms” for use in nursing research, while Ferrario, Freeman, Nellet, and Scheel (2008) see “successful aging” as a requisite paradigm in changing nursing students attitudes about aging. Kaye, Butler, and Webster (2003) suggest an alternative frame of reference, “toward a productive ageing paradigm” for geriatric practice, while Weaver (1999) envisioned “gerontology education” as a “new paradigm for the 21st century” in order to offset ageism and build intergenerational unity by focusing on successful aging and productive aging as opposed to geriatric health and social problems.
Chapin and Cox (2001) argue for a different “paradigm” of practice in social work that is more “strengths-based and empowerment-oriented”, which sounds very much like Haber’s call (2009) for adding an “empowerment paradigm” to the field of gerontology because of the changing demographics associated with aging baby-boomers. Capri et al (2008) appear to use the term “paradigm” to carve out a new domain of “post-reproductive genetics” in relation to human longevity evolutionary biology because of the “peculiar” findings in this specialty. It is obvious from these few examples that the Kuhnian concept of “paradigm” has been used to express preferred and selected curriculum choices, a heuristic tool to differentiate theories and methods, a way of differentiating attitudes and values, a mechanism to build bridges between related specialties, and as a way handling the paradoxes in a specialty area such as experimental gerontology. Yet, such applications and usage indicate little appreciation for the entire scope of what Kuhn presented in 1962 – and has since modified many times over. Although several scholars have expressed a reluctant (or even recalcitrant) observation that gerontology really operates in a (or wishes to) biomedical paradigm (for whatever that means) either due to hierarchical privileges that it bestows at universities and funding agencies or simply due to its hegemonic tendencies which almost sounds as though there is conspiratorial element in gerontological circles.
I do see predominant theoretical models and favored methodological techniques, and privileged applications and practice concepts, but to claim any existing paradigm for gerontology is simply an over-reach or has missed the mark entirely of what “paradigm” has come to connote in the philosophy of science. So, I respectfully disagree with the assumption that gerontology has identified with itself (by default) with a biomedical paradigm and rather more agree with Ferraro’s (2006) assessment that there is a lack of ruling paradigm and in fact, “the field is only beginning to develop a paradigm” (p. S3). But to just default to the assumption that there is one (biomedical) paradigm, and then to use that as an example is despairging way or as the focus of a polemic is wrong – and then to claim that we operate in a paradigm at all – is wrong again as we do not reach the threshold for the Kuhnian concept in his philosophy of science. I would argue that our field of gerontology is simply too broad and too wide to experience normal science and revolutionary science and any notion of incommensurability between paradigms.
We have an academic détente – an uneasy alliance – an understanding that we go about our business of aging respecting the inclusiveness but in our own ways, but yet I will propose that there is something more that we can use to describe and capture as the prevailing theme in our teaching, research, and practice activities. But I do claim that a nascent paradigm is not emerging (sooner or later) and is not happening and will not happen and furthermore, we should not be adding any more paradigms to gerontology (Haber, 2009) when we never had any to begin with. So I am asking for a cease and desist – an appeal to all – that we…step back, way back, and away, from the paradigmatic cliff in gerontology.
A paradigm or paradigms are not possible, as long as we have primarily an atheoretical approach to empirical research in gerontology, as long as we only primarily have the disciplinary “study of aging” (Bass, 2009), as long as we have discussion of modernity and postmodernity as it relates to the use of science, and as long as we have a four-part framework in the Journals of Gerontology (biological science, clinical science, behavioral science, and social science (Bengston, Putney, & Johnson, 2006), and as long as we have a Handbook of Theories of Aging with a plurality of “single-aspect” or micro-theories or mid-range theoretical perspectives highlighted (Bengston, Gans, Putney, and Silverstein, 2009) – and as long as there is the call for an integrative model for social gerontology – but not the “study of aging” (?) (Bass, 2009).
It does not help to advance our over-arching understanding of the scientific structure of gerontology by stating that gerontology (or the study of aging) is represented by a “multiple paradigm science” or latent or embryonic or gerontological imagination, or it is “biomedical” or that it should be empowerment or strengths-based. Case closed: there is no paradigm and there should not the searching for one in gerontology or the study of aging. It would best to proceed by structuring our field as operating in and through inflection points. And it is proposed here in this paper that we are already underway and moving toward a new inflection point – 5.0 – known as “post-aging.”
4th installment
August 14, 2009
4) and finally, that the heuristic term of inflection point has been already used and thus there is the precedent for it when used to describe a fundamental shift in a macro-level understanding of the human condition. I am referring to the work of Joel Garreau (2005) and his monumental book, Radical Evolution: The Promise and Peril of Enhancing Our Minds, Our Bodies – and What it Means to be Human, where he examines these three issues as it relates to technology and bioengineering and its impact on the human condition (p.6)
• We are riding a curve of exponential change.
• This change is unprecedented in human history.
• It is transforming no less than human nature.
Garreau’s (2005) book presents a significant review and prognosis for the role of four intertwining technologies, known as the GRIN technologies (the genetic, robotic, information, and nano processes) and how these will transform the human experience, including the understanding and meaning of the aging experience. Here is Garreau (2005), presenting the dynamic of “the curve” (i.e., derivative) as it relates to GRIN technologies,
We are at an inflection point in our history…we have started a wholesale process of aiming our technologies inward. Now our technologies have started to merge with our minds, our memories, our metabolisms, our personalities, our progeny and perhaps our souls. (p. 6)
And this I believe that this inflection point will also dramatically impact (and to some degree already has) the domain gerontology and the study of aging and thus represents the next major transition point for theory, research and practice in the field of aging for the 21st century.
B. “Optimal Aging” {Inflection Point 4.0}: The Current and Triumphal Positive Derivative in the Field of Aging
The Longevity Dividend doesn’t suggest that we live longer; instead it calls for living better. The idea is that if we use science to increase healthspan, not lifespan. In other words, tomorrow’s 50-year-old would have the health profile of a 43-year-old.
~ Gray is the New Gold: State of the Science in Two Thousand Nine (2009). [Optimism in Aging Research]. Kronos Longevity Research Institute (KLRI) (p. 4).
In a an earlier publication titled, Life in the Long Lane – A Review Essay, the reviewer (Wright, 2008) used the published book by Robert Butler (2008), The Longevity Revolution: The Benefits and Challenges of Living A Long Life, as an exemplar for the latest in the “long grey line” of significant contributions in the literature on the topic of senescence. In that paper, Wright (2008) proposed the long grey line to serve as a heuristic phrase to characterize the extant literature on aging as a essentially a “scatter plot” and with the trend line representing a moderate positive correlation which appeared to culminate with the overarching theme of toward an optimal aging experience.
As typical with any scatter plot (either scientifically or heuristically) not every possible example in the literature was noted (as a theoretical point on the graph) nor was there any necessary alignment with the trend line as representing the “best fit”, instead there will be varying degrees of correlation (strong versus weak) with some candidates fitting a low positive correlation in understanding the pattern of graph points, and a few examples serving as substantial outliers.
As noted by Wright (2008), this “long grey line” has deep historical roots that originate back to the mythology of the Greek and Roman era. While some narrative explorations of the aging experience were measured, stoical, and grounded in embracing the inevitability of senescence, the trend line representing the flow of works has also evolved toward a more generous and rewarding theme of aging. That is, from a rather descriptive activity, the long grey line of literature has become increasingly proscriptive with the presumptive goal of [4.0] optimal aging (which includes the semantically related phrases of “successful aging” (Rowe and Khan, 1999) and “aging well” (Valliant 2002), and “productive aging” (Bass & Caro, 2001; Hinterlong, Morrow-Howell and Sherradan, 2001) and “healthy aging.” (Stanner, Thompson & Buttriss, 2009) and a host of measurable outcomes such as, life satisfaction and happiness, or “subjective well-being” (SWB)). In this paper, I embrace the working definition of optimal aging to represent the perspectives of Aldwin, Gilmer, Birren (2003) such that the optimization of aging recognizes that there may be different ways of aging well, and that people begin with different configurations of aging vulnerabilities and resources that affect how they age, and that it is a process that continually unfolds. But in essence optimal aging is a,
“…multidimensional construct that involves avoiding the accelerating agents that promote premature illness and disability, as well as developing protective factors that delay or decelerate the disease and aging processes to maintain good physical, cognitive, and mental health (p. 8).
Yet, I have since modified and re-conceptualized the “long grey line” into a series of inflection points that are connected through positive (increasing) derivatives that represent the growth in quantity and quality of a particular prevailing trend in gerontological theory, research, and practice (see also Shenk, Rowles, Peacock, Mitchell, Fisher, Moore, 2001). As noted in Section A of this paper, the inflection points do not represent paradigm shifts, rather, it is important to see that the threads of previous inflection points and curvatures are interconnected into subsequent and sequential shifts in prevailing themes.
1.0: Metaphysics of Aging {Aging as “reflection”}
It was proposed by Wright (2008) that the long grey trend line has extended through the works (a selected few are highlighted here) of Sophocles, Oedipus at Colonus, Marcus Aurelius in his Meditations, and then later synthesized in the contemporary book of Tim Parkin, Old Age in the Roman World: A Cultural and Social History and with Moog and Schäfer’s article, “Joannes Stobaios, ‘On Old Age’: An Important Source for the History of Gerontology” which also examines Cicero’s well-known text “On Old Age” (Cato maior de senectute) as well. But as re-conceptualized for this new approach with inflection points, this in effect was the first positive derivative [1.0] for the curvature as represented by the metaphysics of aging. In effect, I propose that Arthur Schopenhauer (1788-1860) represents an exemplar contributor to the curvature and the positive derivative for the metaphysics of aging – and perhaps its zenith as well (Edman, 1928; Hannan, 2009; Magee, 1997). I submit that the chapter, “The Ages of Life” in Schopenhauer’s book (2008) The Wisdom of Life and Counsels and Maxims and the following excerpt as an indicator of how Schopenhauer attempted to answer the “riddle of the world” (Hannan, 2009) in terms of the human condition,
From the point of view we have been taking up until now, life may be compared to a piece of embroidery, of which, during the first half of his time, a man gets a sight of the right side, and during the second half, of the wrong. The wrong side is not so pretty as the right, but it is more instructive; it shows the way in which the threads have been worked together. (p. 123).
This philosophical drive to solve the “riddle of the world” sounds like a continuation of the ancient riddle of the sphinx that confronted Oedipus with a supposed mystery along the life course: What walks on four legs in the morning, two legs at noon, and three legs in the evening? Of course, Oedipus solved the riddle, answering that it was man that crawls on all fours in infancy, walks upright on two legs in adulthood, and uses a cane as a third leg in old age. Hannan, (2009) also offers an interesting insight that relates to my exposition here in this paper,
Schopenhauer was a transitional thinker, bridging the gap between nineteenth-century and twentieth –century paradigms. It is typical of such transitional thinkers that are officially working within a framework that they are also (half-consciously pushing toward a new epistemology in which both science and metaphysics, seamlessly blending into each other, both depend and do not depend on experience (p. 15).
Schopenhauer is the exemplar of the tradition of the metaphysics of aging, yet his influence and those of others before him (e.g., Marcus Aurelius, Seneca) would still resonate as influential threads for scholars (e.g., Freud, Jung, Levinson) into the next inflection point 2.0 – and beyond. It is obvious that it would appear that I have glossed over many centuries of literature and other writings between the works of Sophocles, Seneca, and Marcus Aurelius and then to Schopenhauer, but I am attempting to stay engaged with the primary purpose of this paper in the examination of inflection points and the aging experience from a historical viewpoint. Nevertheless, I will privilege the following works to serve as supplementary texts to those professionals with an interest in educational issues in the study of aging who prefer to think and use the “long view” perspective and thus would be well advised to consider for further reading to cover the significant transitions from the metaphysics of aging [1.0] to 2.0: Bio-medical [acute and chronic] diseases of Aging {Aging as a “problem”}. From Dawn to Decadence: 1500 to present (500 years of Western Cultural Life) by Jacques Barzun (2000); The Dream of Reason; A History of Philosophy from the Greeks to the Renaissance by Anthony Gottlieb (2002); A Secular Age by Charles Taylor (2007); History of the Twentieth Century by Martin Gilbert (2001); The Problem of the Soul by Owen Flanagan (2002); The Crooked Timber of Humanity by Isaiah Berlin (1990), Flesh in the Age of Reason: The Modern Foundations of Body and Soul by Roy Porter (2003), and The Age of Wonder: How the Romantic Generation Discovered the Beauty and Terror of Science by Richard Holmes (2009; also recommended is the review of this book by Freeman Dyson in New York Review of Books, Aug. 19, 2009). I would place the modern publication, The Oxford Book of Aging: Reflections on the Journey of Life, edited by Thomas R. Cole and Mary G. Winkler (1994) and the publication Journal of Aging, Humanities, & the Arts (JAHA) as an example of the continuation of the prevailing theme of 1.0, but as indicated by the editors there is a deliberate effort to sustain dialogue between the humanities and arts and the bio-medical, psychological, behavioral, and social sciences. Yet, the shift or change in curvature toward the sciences would begin for 2.0 at approximately the turn of the century as the “scientific management of aging” would begin its ascent as the prevailing theme and epistemological endeavor (Cole, 1997).
Fifth installment – August 19, 2009
2.0: the Bio-medical [acute and chronic] diseases of aging (or Aging as a “problem”)
The second positive derivative [2.0], the Bio-medical [acute and chronic] diseases of aging (or Aging as a “problem”) is identified with approximately with the beginning of the 20th century with the advent of both specialties {or what Bass & Ferraro, 2000 refer to as the beginning of the “intellectual capital in Gerontology”} investigating the phenomena of aging as a “problem” to be addressed scientifically: gerontology and geriatrics (Achenbaum, 2001).
A few exemplars are represented by Sanford Bennett Dodd and Old Age: Its Cause and Prevention {readers should note the related stories of reversing aging by Mircea Eliade, Youth Without Youth and F. Scott Fitzgerald’s, The Curious Case of Benjamin Button, both of which were recently made into a movies (respectively by Francis Ford Coppola, 2007; David Fincher, 2008). There was G. Stanley Hall’s (1922) Senescence: The Last Half of Life and another book, titled Old Age: The Major Involution: The Physiology and Pathology of the Aging Process (1930) by Alfred Scott Warthin. And in the 1930’s there was Carl Jung’s (1933) insightful chapter, “The Stages of Life” in Modern Man In Search of Soul, which I believe carries on threads from the metaphysics of aging [1.0] curvature.
Moving upward along the positive curvature of 2.0, Ageing, the Biology of Senescence was written by Alex Comfort (1964) and soon after the deeper reflections of Simon de Beauvoir, (1972) in her book, The Coming of Age. We could then move upward to the book, Aging and Mental Health: Positive Psychosocial Approaches (1973) by Robert N. Butler and Myrna I. Lewis. We could explore the textured dimensions of aging captured in The Psychology of Adult Development and Aging (1973) edited by Carl Eisdorfer and M. Powell Lawton and then continue on to yet another hallmark publication (and Pulitzer Prize winning book) by Robert Butler, Why Survive? Being Old in America (1975). In the following year, A Good Age by Alex Comfort (1976).
And it is here, in time frame of the late 1970’s and early 1980’s that I propose that the third inflection point has been initiated 3.0: Demographics of Aging {Aging as a “challenge”}. Yet the active threads of 2.0 curvature (but not as positive compared to the next derivative) are still present and strongly identified in contemporary publications such as Hazzard’s Geriatric Medicine & Gerontology, Sixth Edition (Principles of Geriatric Medicine & Gerontology (Halter, Ouslander, Tinetti, Studenski, High, Asthana & Hazzard, 2009). As Bass (2007) has noted, “Gerontology in the early 1980s was very much focused on the frailty, dependence, and decline in later life (p. 135), and I will further propose while was the prevailing trend, it would soon be dominated by a more macro-level perspective that would take the “aging as problem” theme and transform it into the larger collective level with “aging as a “challenge” due to demographic transitions already underway in developed countries – and with the looming challenge of the aging baby boomers ahead.
[3.0] Demographics of Aging {Aging as a “challenge”}
This change in direction along the curvature is clearly indicated by exemplars of several publications such as the edited book by Alan Pifer and Lydia Bronte (1986), Our Aging Society: Paradox and Promise (see also the Winter 1986 publication of Daedalus: Journal of the American Academy of Arts and Sciences – “The Aging Society”). But again as proposed by my heuristic model, there are also several publications that carry over the threads from previous inflection points such as Thomas R. Cole’s 1992, The Journey of Life: A Cultural History of Aging in America which I consider more of meta-theoretical and historiography of both 1.0 and 2.0 curvatures. The publication, The New Aging: Politics and Change in America (1992) by Fernando Torres-Gil is clearly falls along the 3.0 in direction, while Betty Friedan’s (1993) The Fountain of Age served to break new ground between 3.0 and the next inflection point to follow 4.0 labeled as “optimal aging.”
I consider Leonard Hayflick’s (1994) How and Why We Age as a continuing thread from the 2.0 curvature, while Jean Amery’s (1994) publication, On Aging: Revolt and Resignation carried the philosophical gravity of the 1.0 curvature with strong narrative reflecting the metaphysics of the aging process. Gail Sheehy’s (1995) New Passages: Mapping Your Life Across Time, continues the trend of Betty Freidan’s work to become an influence on the 4.0 curvature toward optimal aging. Then there was Richard Posner’s, Aging and Old Age which strongly influences the 3.0 positive derivative. I then capture Theodore Roszak’s (1998)“America the Wise: the Longevity Revolution and the True Wealth of Nations” and then later expanded and revised to be published again in 2001 under the title of Longevity Revolution: As Boomers Become Elders as a part of the 3.0 curvature along with Peter G. Peterson’s (1999) less than optimistic outlook about aging as “the problem,” Gray Dawn: How the Coming Age Wave Will Transform America and the World, but then the counterweight publication of Age Power: How the 21st Century Will Be Ruled by the New Old (1999) by Ken Dychtwald. The publication The Quest for Immortality: Science at the Frontiers of Aging (2001) by S. Jay Olshansky and Bruce Carnes represents a cross-weaving of threads for 2.0 and 3.0 curvatures and offers a cautious guide into the curvature of 4.0.
But perhaps the exemplar for this inflection point and representation of an ongoing thread for the previous prevailing theme was the publication, International Handbook of Population Aging (Uhlenberg, 2009) which was represented by 34 chapters on various topics ranging from migration patters, economic issues, to the interconnection with health care issues.
Of all those chapters, the one chapter that I believe represents a “bridge” into inflection point [5.0] (or “post- aging”) was authored by S. Jay Olshansky and Bruce A. Carnes (2009), The Future of Human Longevity. Interesting enough, I believe this is a bridge publication not so much for any “pro” post-aging stance they might have taken (which they do not); on the contrary, it is because they represent that rare breed of scholar that will look beyond their silo(s) of research emphasis (and the view of [3.0]) and critically examine the implications and consequences of technologies for human longevity.
In this chapter by Olshansky and Carnes (2009), they present a very convincing and explicit profile for “pathways to longer life” and proposed that there are three camps with differing perspectives and viewpoints about the prospect for human longevity. The three groups are: the futurists, the optimists, and the realists. Olshansky & Carnes (2009) believe it is the first group of researchers and writers, known as “The Futurists,” are invested in and believe that “yet-to-be developed advances in biomedical technology and the anticipated emergence of nanotechnology are going to radically transform the landscape of human aging and longevity”; p. 731).
It should be pointed out that Olshansky & Carnes (2009) do not find any compelling evidence for either the futurists or the optimists to gain traction for dramatically changing the limits of human longevity beyond the 88 years for women and 82 years for men, unless – and this important – unless there is a technological breakthrough “capable of slowing the rate of biological aging” and that it (the breakthrough) can also eventually be “broadly disseminated” (p. 732). Although I am presenting the case for the next inflection point and I have a degree of affinity with the “futurist” camp (although I do find the label a bit awkward and loaded with metaphysical trappings), I also find their “realist” label of (and their preferred stance) to be sobering and a needed counterweight to the over-reach of several futurists involved in “post-aging” speculations.
Nevertheless, it is my assertion that they have underestimated the potential impact for technologies to change the course of direction in the domain of gerontology in terms of scholarship, teaching, and application and to alter the current prevailing viewpoint from optimal aging – to a post-aging curvature. I also submit that they have over-estimated (or over-extrapolated) the lack of successes in historical track record of human endeavors in trying to extend the life span. In other words, I do not think that past is prologue – especially in the case of technological advancements affecting the aging process. Finally, I believe they have narrowly defined the role of futurists (or prolongevists) as succumbing to the allure of immortality as the main motivation (or preoccupation) for who would study – and advance – the intersect of technologies in the domain of aging.
Yet, I do credit Olshansky & Carnes (2009) to at least identify a weakness in the realist’s argument which is, ironically, related to the possible and potential advancement in bio-medical technologies that may emerge in the near future that could (and may) facilitate exceeding the “limits” of human longevity. My point is that Olshansky & Carnes (2009) at least concede that going beyond these limits is possible, but, on the other hand, they do not see any existing or near-term advancements to create this change on the visible horizon. A final point: I am in complete agreement with them that any developments and advancements in extending human longevity due to breakthrough technologies would have to be broadly disseminated to avoid the specter that only a select few – or elite group – would (or could) benefit from such advancements. As of August, 2009, the latest publication that represents the continuation of [3.0] would be the report hosted by the U.S. Census Bureau and National Institute of Aging titled, An Aging World: 2008 (Kinsella & He, 2009). This report indicated that although the world’s population is aging, children still outnumber older people as of 2008. However, projections indicate, that in fewer than 10 years, older people will outnumber children for the first time in history.
4.0: Optimal Aging {Aging as a “reward”}
Sixth installment – August 25, 2009
The next inflection point, and the current prevailing theme in gerontology, is posited to have taken place in the mid to late 1990s with the full positive derivative positive effect expressed with the turn of the century (the year 2000). The following represent exemplars of this change in direction for the curvature: The Creative Age: Awakening Human Potential In The Second Half Of Life (Cohen, 2001); Productive Aging: Concepts and Challenges (Morrow-Howell, Hinterlong, and Sherrden, 2001); Challenges of the Third Age: Meaning and Purpose in Later Life (Weiss & Bass, 2002); Vaillant (2002) and his work, Aging Well: Surprising Guideposts to a Happier Life; and Positive Aging (Hill, 2005). Again, as stated in the proposal of inflection points there are always threads of previous prevailing themes that carry over into the subsequent curvatures and Challenges of an Aging Society: Ethical Dilemmas, Political Issues edited by Rachel A. Pruchno and Michael A. Smyer (2007) would represent such an exemplar. We begin approach the final exemplars of 4.0 with Sherwin B. Nuland’s (2007) The Art of Aging: A Doctor’s Prescription for Well-being and then Robert Butler’s (2008) book, The Longevity Revolution, proposed as the literary capstone work for indicating the incremental works on the experience of aging as essentially an optimistic endeavor and the triumphal and prevailing theme for all of gerontology as of the year 2010: optimal aging.
In other words, according to some, we have reached the point whereby we can begin to reap the benefits of the so-called “longevity dividend” (KLRI, 2009). Butler (2008) admits that there is much work to be done and there are significant threats to sustaining an increase in longevity, especially in geographic areas that are characterized by “shortgevity” (International Longevity Center Global, Alliance, 2009). Nevertheless, Butler is cautiously “optimistic” that the future is now if we are to reap the rewards of increase longevity, there is the attitude of making good use of the tools that we have (and hope to have) in order enjoy “the triumphant prolongation of life.” So, although the longevity revolution has both “benefits and challenges,” the overarching tone is progressive and the faith in the scientific enterprise to address the challenges of increasing longevity is unwavering. For example, Butler (2008) noted in the preface of his book that,
Scientific advancements should and will add vigor and health throughout life, and not just at its end. The aging population increasingly consists of active, vigorous, robust people. We must not take them for granted, but the trend can continue and it should be celebrated. Above all, I hope that this book will convince people that our increased longevity constitutes a supreme achievement. (p. vx)
I do not go so far as to claim a teleological argument or grand narrative to be found within the exemplars already, but I am in agreement with Cole (1992) that the “long-term transition from the existential to scientific tonalities” in our understanding of the aging experience has led us to this point on the trend line – so far. Cole elaborates,
In the last fifty years, the central goal of the modern scientific enterprise – the conquest of premature death from acute disease and the prolongation of healthy, vigorous life – has become a realistic expectation for most people in Western, urbanized countries…Since the mid-nineteenth century, Americans have come to view aging not as a fated aspect of our individual and social existence, but as one of life’s problems to be solved through willpower, aided by science, technology, and expertise. According to this view, the road to a better future has been paved with the methodology of positivist science, which assumes that we know more about all aspects of aging than our predecessors. An accumulation of empirical facts will someday produce total understanding of the natural and social worlds, allowing us to grow old without disease, suffering, conflict, or mystery. (p. xxii – xxiii)
But having said that, Cole (1992) was not so sure that the assumed outcome of all the supposed scientific activity was going to be necessarily a positive gain for humanity. Cole was skeptical about “successful aging” models (and thus under the later rubric of ‘optimal aging’) serving as the end game to such scientific endeavors as they tend too idealistic and deny and negate the harsh realities of decline and death. Cole believed that dominance and hegemony of the scientific management model – “with its drive to maximize health and organic functioning” – had stripped away existential meaning that addresses the paradoxical nature of aging and has instead replaced it with a “relentless hostility to physical decline and its tendency to regard health as a form of secular salvation” (p. 239). In other words, the scientific management of aging has come at high spiritual and ethical price. Cole (1992) believed that the emergence of a duality, a dichotomous treatment of the aging experience, had become the guiding paradigm in the field of aging,
“…middle-class American culture since the 1830s has responded to the anxieties of growing old with a psychological primitive strategy of splitting images of a “good” old age of health, virtue, self-reliance, and salvation from a “bad” old age of sickness, sin, dependency, premature death, and damnation. Rooted in the drive for unlimited individual accumulation of health and wealth, this dualism has hindered our culture’s ability to sustain morally compelling social practices and existentially vital ideals of aging.” (Cole, 1992; p. 230).
And from this duality, it was the positive pole that would facilitate the dominance for the perspective of an optimal aging: “Old people are (or should be) healthy, sexually active, engaged, productive, and self-reliant.” (p. 229). This perspective is also represented in the emergent domain of positive psychology as it intersects with aging (Hill, 2005) and with the call to understand and promote “blue zones” as viable geographic and social areas that encourage health lifestyles leading to a longer life expectancies (Buettner, 2008).
And yet, Cole believed that the postmodern cultural era (see also Butler, 2002) would hold the promise to become a renaissance of balanced perspectives that would reflect a deepening existential awareness of the aging experience and thus much more that a “problem to be solved.” Indeed, Cole believed that the “modern quest for a rational, healthy, and orderly life course has reached a limit – or at least a turning point.” Cole called upon the possibility of the postmodern self to “cultivate the existential nourishment” (perhaps through the arts as example) along the life course, especially as an aging individual. But Cole’s scholarly work was first published in 1992 and it all begs the question to ask – and then determine if his hoped for potential has actually been realized, much less initiated, as we approach the year 2010 – some 18 years later.
And so I offer a synopsis in order to provisionally measure the significant and substantial attainment of the hoped for emergence of “vital postmodern ideals of aging” that perhaps relates to larger rubric of “humanistic gerontology” (Cole, Kastenbaum & Ray, 2000; Cole & Sierpina, 2007). In other words, although I am posing the question to you the reader, I will nevertheless take the tactical move in this paper/presentation and advance my diagnosis – and then I propose an entirely different prognosis of what lies ahead than what Cole and others had hoped for. At this juncture, I want to be clear about my stance on the premise and goals of a humanistic gerontology: I am in full support of this approach for the understanding the aging experience both personally and professionally. As a Director of a Gerontology Program (with a Ph.D. in Human Development) I embrace the significance of interdisciplinary approach for the study of aging and weave that structure and attitude into our curriculum content so that a full spectrum of conceptual models, theories, and methodologies are presented. This spectrum of perspectives ranges from the molecular to the molar – from the study of telomeres to the examination of macro-level policies on aging at the national {federal} level.
And so to put it most diplomatically, I for one am not convinced that such a movement {or any actuality} for any “postmodern ideal of aging” has taken hold and gained traction in our culture. While I concede that optimal aging is our prevailing theme (notice I did not say “paradigm”) in gerontology, and that there are a few exceptions to be found with the intersect of aging baby boomers and civic engagement (e.g., the work carried out by the Civic Ventures organization and Encore) I would submit that the return to “meaning” (see Krause, 2009) and a balanced return to the grand humanistic tradition of the aging experience has been left to fend for itself with well-intentioned advocates and devotees (to which Cole & Sierpina, 2007 seem to agree as they identify this group as an “important minority” p. 252) in the few remaining and somewhat secluded islands of publications such as the emergence of the Handbook of Humanities and Aging (Cole, Kastenbaum, & Ray, 2000) and the journal, Journal of Aging, Humanities, and the Arts (JAHA). I entirely support these publications and outlets, but at the same time I am confident that this perspective “humanistic gerontology” will not be able to withstand the emergence and forthcoming predominance of new and more powerful force in scientific endeavors (which is the proposed 5.0 inflection point underway) which will result from the convergence of bioengineering and technology in the domain of gerontology.
August 30, 2009 – Seventh Installment
Towards a Post-Aging [5.0]
And so I postulate that the call to reinstate the themes of “fate and mutability, mortality and finitude, suffering and wisdom” (see Cole, 1992; p. 243) are certainly noble ideals, nevertheless, they have been swept aside by the rising tide of a postmodern culture that has not only embraced the ever-expanding domain of the “aging industry” (Estes, 1979; 1993) but has taken the scientific management of aging and morphed it into many macro-level extensions of a “scientific-industrial” complex emerging out of the 1950’s. There may be a “new aging enterprise” (Moody, 2004/5; 2008) on the rise, but I argue that there has not been any relinquishment of the hegemony found with the “positive” pole of the duality (i.e., the striving toward an optimal aging) influence and instead, ironically, there is the emerging value-laden zeitgeist in gerontology that seems to embrace only the way forward – exponentially – without much regard for premodern, modern or postmodern values of aging – at all.
If anything the postmodern era has splintered itself into a myriad of conditions with the prefix “post” to be found almost connected to everything traditionally studied and practiced (e.g., post-colonial, post-structuralism, postdigital, postbiology, postAmerican, and posthuman). This grammatical and “paradigmatic” shift in tone and temporal development signals that some kind of conceptual train (i.e., epistemological, theoretical, methodological, ontological) has already left the academic station. Although, some may wish for us to consider “gerontology’s future” by the privileging of three main disciplines: biology, psychology, and sociology into a an ‘integrative model” and perhaps even embrace gerontology’s entry into the disciplinary status due to identified accomplishments thus far (Alkema & Alley, 2006) – others such as Ferraro (2006) are not so sure that the critical mass – the tipping point – is there yet. In either case, whether one is “pro-discipline” and advocate as though “it” has arrived, or if rather you believe like Ferraro (2006) that such a tipping point is still “several cohorts” away from achieving the laurel wreath of representing a bona fide academic discipline, or perhaps if you believe (and hope) that the disciplinary evolution never happens, my argument is this (in any case) and it is inherently controversial and provocative:
the absence of recognizing the bio-technological in the tenets of a gerontological imagination or any other integrated model for disciplinary advancement is and will be a major limitation in addressing the aging experience from this point forward as we begin to experience (and already underway) the next inflection point [5.0] of “post-aging.”
And so despite the call(s) for a new focus in the field of aging to balance the hegemony of the natural sciences (Cole & Sierpins, 2007) such as Haber’s (2009) suggestion of an “Empowerment Paradigm” for (and about) aging boomers, I would contend that this simply represents a continuation, an extension of the prevailing optimal aging curvature of 4.0 (the positive derivative thereof) – (or the positive pole in Cole’s duality) that has already had its moment in sun (see also interesting parallel development of “positive psychology” with the article in Chronicle of Higher Education by Jennifer Ruark, 2009)
In other words, the optimal aging theme has been the predominant pathway and compass within the gerontological literature, but for better or for worse, I would suggest that a new direction has already taken place in our contemporary era (and it does not matter to me which label you find more affinity with – modernistic or postmodernistic), and this new direction (a change on the curve – the 5.0 inflection point) does not simply an overturn or replace the scientific management of aging, but rather has changed via a metamorphosis in perspective and outcome into a “scientific-technological” weltanschauung that seeks to move beyond aging as a necessary phase or stage in the life course; rather aging (biologically, socially, and psychologically) is something to be overcome and transcended – incrementally – and then completely.
And so I have also reconsidered my analysis of the linear grey line for gerontological exemplars in the literature and thus for any future heuristic (and for the purposes of this paper and presentation), I now envision the change in direction effects of an emergent – and then prevailing theme (thus inflection points) in the flow of the literature on the aging experience advancing (heretofore) toward the primary goal and efforts of the modernistic era: the striving toward and achievement of optimal aging.
I further propose that another related, but vastly different trajectory of epistemological, ontological, and experiential approaches to aging will soon eclipse the supposed penultimate goal (in our limited temporal horizon) of optimal aging in gerontology. In other words, the momentum has shifted and the scientific activity within the domain of aging is undergoing a transformation, and the driving force in gerontology will no longer be a descriptive analysis of the “longevity revolution” to come (Bulter, 2008), but rather a proscriptive call to action in implementation and practice of making longevity no longer revolutionary, but normative and customary. And along with “normative” longevity will then come the expected 5.0 change – toward a “post-aging” [5.0]
Therefore, I am proposing a significant change in the present curvature of optimal aging and that there will be a another significant shift (change in direction) in the literature ahead. Will Optimal Aging [4.0] and Aging as “challenge” [3.0] and aging as “problem” [2.0] and aging as “reflection” [1.0] still continue on and have influence in the literature? – Yes…of course. But I propose that these previous tracks of prevailing themes have already reached their zenith in the weighted impact in terms of the cumulative effect of research momentum and activity, curriculum content and delivery in higher education, and with public interest. Of course, there will always be enough rooms in the large house that is “gerontology” for the metaphysics of aging [1.0] and for the understanding of the social construction of aging – and for a humanistic gerontology. But the soon-to-be largest room in the “house” where the greatest proportion of interest and activity and exponential growth will be in the room where bioengineering and technology takes place and subsequently transforms the significance and understanding of the aging experience.
September 5, 2009 – Eighth Installment
This proposed inflection point – this new tip of the spear in research, teaching, and application – is already underway and although such a claim may appear to be grandiloquent to those fully invested in their own research specialties and thematic tracks and service sectors that represent previous inflection points, I submit that the new transformation will be tectonic in scope and that the “ripple-effect” will affect the very nature of our understanding of the aging experience.
Robert Butler’s book, The Longevity Revolution (see also review of book by Finch, 2009) in my estimation, represents not only the culmination of the positive derivative (for inflection [4.0]) that has described and analyzed the deepening human condition that has been influenced by the radical transitions associated with the exceptional and “unprecedented demographic transformation” (Butler, 2008; p. xi) in the 20th century, but I also propose that it is also a part of an hermeneutical “inflection point” (a point on a curve at which the changes sign) which may (theoretically speaking) be representative of a new direction in the aging experience that is (and will be) increasingly influenced and directed by the monumental force and actions of advancements in bioengineering and in bio-technology. This inflection point is summarized in the statement from the International Longevity Center (ILC) taken from their annual report “Embracing Longevity” (2008),
“We recognize longevity as a great human and social achievement that can only advance if we embrace it fully in all of its dimensions through knowledge, action and creative solutions.”
And so while the scientific management of aging and the drive towards an optimal aging continues to generate energy for the wheels of normative science, I am propose that we are already moving into a post-aging era [5.0] that is inspired and being directed by a force, which is the realm of bio-techno-engineering, which will overtake and proceed beyond domain of optimal aging [4.0]. This post-aging weltanschauung has the capacity to transform all aspects of existential and humanistic meaning of the aging experience into the future. If anything, I am convinced that Cole’s concerns about the hegemony of “scientific management of aging” will pale in comparison to what is at stake in the 21st century.
Before I present the evidence and the case for the next inflection point [5.0] of “post-aging” {Aging as “artifact”}, let us briefly review the current proposed positive derivative and the curvature that represents “optimal aging” [4.0]. Thus, it is proposed that in our current line of theoretical and conceptual understanding of aging (some may refer to this as our “the received view”), we have witnessed both an increased longevity and increased expectation that will all live longer – and better.
We have quickly moved from contemplating a demographic revolution of “squaring the pyramid” (Pifer & Bronte, 1986) to the promotion of a “longevity revolution” (Butler, 2008; Rosak, 2001) in the short span of about 30 years. In other words, it appears that the Stoic tradition of embracing the shortness of life is but a quaint form of wisdom of yesteryear, and the concerns of population aging (Siegel & Taeber, 1986) have been transformed in our current setting and emergent (and soon-to-be prevailing view) into a philosophical outlook (and attitude) that we can have “one’s cake and eat it too.”
It used to be said the life is short and art is long; but in our high point for the era of the “scientific management of aging” (Cole, 1992) our goal is now – the art of living longer and optimally. Our current landscape for understanding the experience of aging is representing by the following indicators of the “received view” which illustrate but do not exhaust the examples in the literature: age wave (Dychtwald, 1990); fountain of age (Friedan, 1993); from age-ing to sage-ing (Schachter-Shalomi, 1997) and that we have entered into phase of “age power” (Dychtwald, 2000), and the power years, (Dychtwald, 2005); “the creative age” (Cohen, 2001); third age (Sadler, 2001); successful aging (Rowe and Khan, 1999); “prime time and encore” (Freedman, 2000; 2007); “aging well” (Valliant, 2002); positive aging (Hill, 2006); healthy aging (Weil, 2007); the art of aging (Nuland, 2007); productive aging (Morrow-Howell et al, 2001); transcendence in later life (Tornstam, 1999-2000); vital aging (Achenbaum, 2005); and self-empowerment (Maples & Abnet, 2006).
These indicators represent a collective theme (not a paradigm) that captures the essence of optimal aging [4.0] as our triumphal and prevailing theme in gerontology. It is the resulting effect of previous inflection points that has guided the scholarship of aging and thus I am in agreement with Bass & Ferraro (2000) – that we are in transition (yet again) in gerontology education, but instead of a paradigm (or paradigms) evolving or the possibility of a “discipline” emerging for gerontology education, I beg to differ. Our field will sustain itself as “interdisciplinary” and by letting go of the need for identifying a paradigm (per se) for the field. The evolution that is taking place in our field is a highly complex set of inter-related threads of scholarship that represent previous prevailing themes that increase (along a curvature – with time passing) as a positive derivative, but then there is a change in direction along the curve. The change is due to intersecting forces within – and from outside the permeable boundary for gerontology. This is the {quite natural} effect of an interdisciplinary foundation and operation that is: “gerontology.”
Our science and our inquiries into the aging experience are influenced by the operations and activities of other fields, specialties, programs, disciplines, and organizations. They too are investigating the domain of “aging” – and many of their activities represent “sentinel” operations that the “mainstream” (normative science – “puzzle-solving” as Khun had called it) of gerontology simply are not aware of or ignore because it does not fit their assumptions of what is the “prevailing theme” or what should be examined due to the influence of previous themes. Although Khun had described the process of “revolutionary science” as the break-point set against “normal science”, it appears to me that in gerontology, there is more of the ascent and then gradual flattening one of one prevailing and dominant theme, while other themes emerge and enter the landscape of potential inflection points, but a select one will gather momentum and critical mass, and ascend as a different (but positive increase) against the previous curvature that represented then dominant “goal.” There does not appear to be any revolutionary “flip” or “break point” or paradigmatic shift in gerontology.
I will submit that it is fruitless to pursue or promote a “paradigm” (from the Khunian perspective) in gerontology and that any discussion of paradigms (emergent or evolutionary) has only muddied the waters due to the improper usage of paradigm in our field anyway. Our field is simply too broad and too interconnected with other disciplinary ventures and professions to have one pristine “gerontological paradigm” emerge and dominate the field. Although there is the distinct possibility and probability that there may be a bona fide monolithic paradigm to refer to in other connected fields or disciplines, it is proposed that gerontology will be driven less by shifts dependent on revolutionary science than it will be by shifts due to inflection points that do not replace the pre-exiting order, rather build upon it, and then change in direction from the previous arc in curvature to another one.
What we have had and do have are prevailing themes (closer to a meta-theoretical position) that is over-arching in the field that serves as an implied and expressed “lodestar” that governs and serves as our raison d’être. In the current manifestation of the curvature, we have reached the zenith of optimal aging [4.0] which (and let me be clear here) will continue to be research track, a publication category, a curriculum offering, a service mission, and “quasi-paradigm” for some in the field and whether the goal be the compression of morbidity as in [2.0] “aging as a problem” (Fries, 1980) or the navigation of “new passages” [4.0] “aging as reward” (Sheehy, 1995) or in visualizing the human condition as a “human odyssey” with metaphysical overtones [1.0], the culminating curvature we now find ourselves in is the operations and supreme goal of optimal aging.
In effect, this also means that we have taken to be the “meaning” of later life to be more – or more of the same – but only better. That is, we want to be productive, vital, successful, positive, engaged as before (that is before aging “took place”)– and as never before – and better. There is no stoic acceptance or resignation or revolt, rather only the conquering of all that represents senescence. There is senescence, but we have elected to have it reframed, re-packaged and re-tooled to become an anti-senescence. We don’t retire, we re-career. We don’t age, we transcend. We don’t decline, we transform. We are seeking to overcome entropy and gravity within the optimal aging. The way forward – is onward and upward. We pay homage to Longevity as the prince, but the ultimate loyalty and obedience is toward Immortality – as the king.
September 12, 2009 – Ninth installment
So, perhaps we have not quite reached the final stage or destination of human progression in relation to the aging experience. Some are proposing that there is something more to be gained and achieved beyond optimal aging which could completely transcend the aging experience altogether. Thus, the next inflection point is labeled – post-aging – [5.0], which reflects an array of technologies and bioengineering that could forever alter the landscape of the journey of life. I will propose that we have begun to cross the threshold for the change in direction into the next positive derivative.
The metaphysical traditions and reflections of Seneca and Marcus Aurelius have been turned on their head so that we now assume life can never be long enough and that the only time we are wasting in our modern/postmodern condition is by not allowing or supporting the scientific and technological movement to be fast enough in the quest for a “post-aging” condition – and perhaps the possibility of removing the “final constraint” of existence, that is death itself. We may think of death as inevitable, but it is has also become more of nuisance than as a fulcrum for existential significance.
What is wanted and what will be desired in the 21st century is not the reflection upon the “shortness of life” but rather the active investigation and implementation of strategies and tactics that will create a longer interval between birth and death – with the ultimate goal of post-aging. I believe we will come to see this inflection point and resulting curvature become not only the prevailing and dominant theme within gerontology but was also emerge as a socio-cultural expectation that science and technology should and shall continue to serve as the catalyst for optimal aging to transform into “post-aging.” Many will see this as an entitlement for simply being alive – so that having a life can be extended for as long as possible – with minimal aging – or ultimately with no manifestations of “aging” (as we know it to be and understand it as senescence – now) at all. So, in contrast to Seneca and Marcus Aurelius – it does and it will make a difference to live not only across the span of “ three generations” but perhaps with the goal of an existing a thousand years (de Grey, 2008).
But before many of you may think this is all irrational exuberance on my part (and others who share my perspective) and that any notion of a “post-aging” therefore represents ageism, or a titanic denial (see Gillick, 2006), or discounts any possibilities of “shortgevity” (Butler, 2008) or ignores the realities of an aging society or “ageing world” that sees demographic aging and its attendant “problems and challenges” (representative of 2.0 & 3.0 themes) as a “slow burning fuse” (see special report from The Economist, June 27th, 2009), I want the reader to realize that I am aware of many daunting issues that would counter any post-aging [5.0] scenario.
I too can appreciate and understand the contra-scenarios suggested by others (see Peterson, 1999) who see living in a world of increasing Methuselahs who are beyond aging and thus (theoretically) contribute to some hellish context, which would result in diminishing the quality of life for almost everyone else – both economically and environmentally. And yet, as Schulz and Binstock (2006) have shown that while there is cause for considerable concern as many issues, they argue that with a variety of sound policies and programs in place, and smart individual choices, the elderly can prosper and a demographic tsunami is not inevitable. Nevertheless, I will cite just a few that illustrate, but do not exhaust, the concerns and significant fissures that indicate substantial threats to sustaining optimal aging as our current prevailing theme in gerontology and possible barriers to the realization of post-aging as the prevailing theme in our future.
As previously mentioned, the “aging as challenge” [3.0] theme has generated important research findings that has and continues to investigate the demographic transitions from various levels – from the city block and census track level – and to the other end of the scale at the global level (see Uhlenberg, 2009). This has led to some innovative re-conceptualizations (“a rethinking”) of both the meaning (and definition) of age and ageing to better understand and compare people who live in periods and places where life expectancies differ by using the concept of “prospective age” (Sanderson & Scherbov, 2008). The differences – or disparities in health – as evidenced from the data generated from various parts of the world comparing and contrasting the various countries is of great concern because it does indicate that increased longevity is not necessarily a given universal expectation and that “shortgevity” may indeed be the case for many geographic areas across the globe and in some areas within the United States due to a myriad of conditions that affect health status and the quality of life.
For example, in a recent study by the Robert Wood Johnson Foundation “Reaching America’s Health Potential Among Adults: A State-by-State Look at Adult Health” (2009), it was found that almost half of all adults 25 to 74 in the United States reported being in less than very good health, and that the rate differed depending on level of education. Adults who have not graduated from high school are more than two and half times as likely to be in less than very good health as college graduates. Those who graduated from high school but not gone to college are nearly twice as likely to be in less than very good health as college graduates. In other words, America’s adults are not as healthy as they could be and this study revealed “substantial shortfalls in the health of American adults at the national level and in every state…shortfalls in health are greatest among the most-disadvantaged adults, but even those considered middle class are less healthy than adults with greater social and economic advantages” (p. 3).
These findings obviously highlight a major concern that optimal aging – and for that matter any “post-aging” experience – may be limited to a select group of people who have “greater social and economic advantages.” There are geographic patterns of disparities in mental health across the U.S., which has indicated significant variation in unmet mental health care needs (Moriarity, Zack, Holt, Chapman & Safran, 2009) and in the spatial patterns of natural hazards mortality in the United States (Borden & Cutter, 2008), both of which points to greater need for prevention measures in emergency planning and in strengthening the public health sector and through educational awareness in this country for all socio-economic groups – particularly for those most vulnerable, including older adults without social capital.
We have learned that a concentrated effort in this country to reduce fine-particulate air pollution has resulted in increased life expectancy (Pope, Ezzati, & Dockery, 2009), which is an “across-the-board” dividend for all age groups from the enforcement of environmental protections (air quality), yet as Ezzati, Friedman, Kulkarni & Murray (2008) have reported in their study on trends in county mortality and cross-county mortality disparities, including the contributions of specific diseases to county level mortality trends, there was a steady increase in mortality inequality across the US counties between 1983 and 1999, resulting from stagnation or increase in mortality among the worst-off segment of the population. Female mortality increased in a large number of counties, primarily because of chronic diseases related to smoking, overweight and obesity, and high blood pressure.
Again, these reports have highlighted disparities in health status by geographic location and have indicated important correlations with a “reversal of fortunes” in subsets of our population that will most certainly affect the aging experience in a negative way. In other words, optimal aging [4.0] may be the current prevailing theme and predominant goal in gerontology, but there are many social, cultural, public health, and environmental conditions that create and sustain disparities across the human life course (see also Frey, Berube, Singer, & Wilson, 2009). The investigation and prevention and intervention of these disparities not only represents a continuation of the 3.0 and 2.0 curvatures of research, teaching, and practice as it relates to the aging experience (see Institute of Medicine, 2009, report, “Retooling for An Aging America: Building the Health Care Workforce”), it is imperative that these issues inequalities by race, ethnicity, class, and geographic region are adequately addressed before we claim that optimal aging is the normative experience for older adults.
It is one thing to state that optimal aging is the prevailing theme and predominant goal, but it is another to then state that it is the prevailing and expected experience for all – or even the majority of older adults – in the course of aging process in this country. Thus, while the optimization of aging is the prevailing theme in gerontology and serves as the current lodestar for the longevity revolution that is underway, there is also the need to see it as the expected experience toward the latter part of the journey of life – for all citizens.
Another concern is that with increased attention on centenarians – and super-centenarians – (Adams, Nolan, Andersen, Perls, & Terry, 2008; Perls, Kohler, Andersen, Schoenhofen, Pennington, Young, Terry, & Elo, 2007) and the expectation from the public that to experience a triple-digit chronological age experience is assumed to be almost an entitlement, we need to heed the wisdom of William J. Hall (2008) in an editorial in the Archives of Internal Medicine, who offered that,
“Of course longevity is a Pyrrhic victory if those additional years are characterized by inexorable morbidity from chronic illness, frailty-associated disability, and increasingly lowered quality of life.” (p. 262).
In other words, the continued momentum for the optimization of aging [4.0] and the emergence of the “post-aging” curvature is very much dependent on the continuation of biological and medical research (see Michel, Newton, & Kirkwood, 2008; Norris, High, Gill, Hennessy, Kutner, Reuben, Unutzer & Landefeld, 2008; Reuben, 2007) into the issues of senescence and for policy issues regarding health care for older Americans with multiple chronic conditions (MCCs) so that morbidity and disability can continue to be compressed “into a smaller time frame near the end of life as predicted by Fries in the “compression of morbidity’ hypothesis.” (Hall, 2008; p. 263).
Yet, despite these potential fissures in the sustained momentum of optimal aging [4.0] and the emergence of a post-aging [5.0] curvature, there is also evidence that overall experience of “growing old in America” is summarized in this statement: the older people get, the younger they feel (Pew Research Center, 2009). Interesting enough, this same landmark study found significant generational differences in the expectations and realities of the aging experience. In other words, the share of younger and middle-aged adults who report expecting to encounter potential problems related to old age is much higher than the share of older adults who report actually experiencing them. My point here is to show how the actual experiences of older adults is better than what most people realize and that not only is there a compression of morbidity, there also appears to be a compression of the “feeling” of senescence (of what it means and what age is determined to be “old”) into the later years of life which runs parallel to the notion that – in general – aging can be optimized – up until a point, which appears to be (according to this survey) associated with approximately the age of 90. After that point, it appears that the expectations for any significant quality of life (optimal aging) are significantly lowered.
But this issue of “living a good old age” – whether that be 85 years, 90 years, or 115 years – represents a cogent segue into the next dimension of this paper. That is, is there a realistic possibility that not only can age be optimized into the ninth decade, but is there also a possibility for life to be extended – and optimized – beyond that? Can we, given the expansion and growth of bioengineering and technology, contemplate an aggressive life extension beyond the centenarian mark – and into the decades that follow? Can we expect that there will be dramatic successes in optimizing aging with anti-aging medicine? Or with nanotechnology? Or with biotechnology? Is it even possible that we should contemplate – and pursue – the possibility of immortality in our lifetimes? Will we move beyond aging itself and into the realm of a post-aging curvature [5.0]?
This is the subject of the next section of this paper. I am suggesting that this change in direction, this new positive derivative (see Alder, 2005) for the investigation and understanding and experiencing of aging will be driven and guided and fueled by the intersect of theoretical and research activities associated with biotechnology, computer technology, and molecular biology. One could argue that these intersecting influences on the study of aging may simply represent an extension of optimal aging [thus, a 4.1 version], but I will argue that the over-arching goal in this new theme is not to optimize aging, but rather to surpass it, to transcend it, and to end it. In other words, the prevailing theme that will emerge is seeking to move beyond it (aging) so that the cultural history, the existential landscape, and the humanistic interpretation thereof – will all be dramatically transformed by what Nicholas Carr (2009) refers to as the “the big switch” and Joel Garreau (2006) refers to as a “radical evolution” in the human condition. Garreau (2006) proposes that these new technologies will offer both promise and peril in the enhancement of our minds, bodies – “and what it means to be human.” I am further proposing that the future of gerontology will be embracing this new inflection point [5.0] – and that the study of aging will undergo a change in direction for its prevailing theme in guiding research, teaching, and practice.
As I have stated before in this paper, previous themes from other inflection points continue onward in gerontology as focal points for some scholars in the field, but each subsequent inflection point is understood as emerging as “prevailing” and dominant in terms of becoming the primary lodestar for the field in terms of its raison d’être. Thus, optimal aging will continue as a theme, but I propose that it will be yield to the next inflection point (and resulting curvature) that is now emerging – and underway. I will end this section with a few excerpts to set the stage for what I propose as the next inflection point [5.0] in the domain of gerontology (and the study of aging) – 5.0: Post Aging {Aging as an “artifact”}. I am proposing that the initial signs and the sentinel activities are already in place – and underway – to give us a preliminary look into the new direction.
There will soon be as many artificial neurons on earth, in all of our ‘intelligent’ machines, as in all our ‘natural brains (120 billion neurons each). Are we not running the risk, after the elimination of dark matter, of an exhaustion of all grey matter, from the point when the stock of Artificial Intelligence exceeds the symbolic capital of the species, this latter ceasing to exist once its much more efficient artificial counterpart comes into being? Is there room on the earth for as many artificial as natural species, for as much computer-generated substance as organic matter, dead or alive, for as much Artificial Intelligence as natural intelligence? Is there room for the world and its double?
~ Jean Baudrillard (2005). The Intelligence of Evil or the Lucidity Pact. Berg: New York. p. 193-194
Two revolutions will affect the well-being of older Americans in the twenty-first century: the demographic revolution of an aging society and the scientific revolution of molecular biology.
~ Catherine Read, Robert C. Green, Michael Smyer (Eds.) (2008). Aging, Technology, and the Future, The Johns Hopkins University Press. Baltimore, MD. p. xi.
It is possible that we are now entering a new Romantic Age, extending over the first half of the twenty-first century, with the technological billionaires of today playing roles similar to the enlightened aristocrats of the 18th century?…If this new Romantic Age is real, it will be centered on biology and computers, as the old one was centered on chemistry and poetry.”
~ Freeman Dyson (2009). When Science and Poetry Were Friends. New York Review of Books. August 13, 2009 (#13) {a review of the book: The Age of Wonder: How the Romantic Generation Discovered the Beauty and Terror of Science by Richard Holmes. Pantheon}
To the reader of 2009, some of these changes {biotechnology} may sound freaky or unsettling. But a century from now, they’ll seem as normal as pacemakers, hip replacements and in vitro fertilization have become today. Our descendents, like us, won’t just be technology’s judges. They’ll be its products too.
~ William Saletan (2009). You: The updated owner’s manual. New York Times Book Review. “Crossroads – A Series of Essays. August 2, 2009; p. 23.
September 19, 2009 – 10th installment
C. Towards a Post-Aging: A Critical Examination and Provisional Typology for Understanding the Varied Roles of Technology in an Aging Society
5.0: Post Aging {Aging as an “artifact”}
And so the price of our immortality is our humanity.
~ Nick Lane (2009). Life Ascending: The Ten Great Inventions of Evolution, W.W. Norton & Co. p. 285.
I have proposed that we consider inflection points as the more appropriate structure to understand changes in prevailing themes in gerontology as opposed to the Khunian notion of “paradigm” or “paradigm shifts.” I do not take exception to the Khunian stance to a (the) philosophy of science, it is just that I do not see “paradigm” as having any functional use in describing major shifts in gerontology – as gerontology does not fit conveniently into any single disciplinary mold nor can we apply the conditions of Khunian revolutionary science and paradigmatic shifts to the study of aging. As previously mentioned, the inflection point as heuristic is proposed to the better pedagogical mechanism to understand and explain the shifts in prevailing themes in gerontology over the course of many centuries (if we assume the metaphysical “reflections” [1.0] to be a part of the foundation for gerontology, but prior to the formal founding of gerontology itself) – and into the 21st century.
I understand that it is a matter of debate to consider the use of paradigm vs. inflection points, and it is the subject of further debate to consider five inflection points over a span of time (see Table 2), but I believe it will be even more contentious for some readers to consider that a new inflection point [5.0] will become the new prevailing theme in gerontology beyond the proposed and current one labeled as: optimal aging [4.0]).
Table 2: Inflection Points
(Directional Shifts in Prevailing Theme in gerontology/aging)
1.0: Metaphysics of Aging {Aging as “reflection”}
2.0: Bio-medical [acute and chronic] diseases of Aging {Aging as a “problem”}
3.0: Demographics of Aging {Aging as a “challenge”}
Proposed current theme:
4.0: Optimal Aging {Aging as a “reward”}
Proposed emergent theme:
5.0: Post Aging {Aging as an “artifact”}
In other words, to reinterpret the developments and shifts in gerontology from an historical perspective (in hindsight) by using inflection points is one thing, but then to offer a prospective (and emergent) prevailing theme (such as [5.0]) before any critical mass has taken place to verify and corroborate the theme actually exists is bound to be a risky venture (and adventure).
But such is the purpose of this paper (and my goal), which is: to tread carefully, but with courage and integrity so as to look ahead and create the profile for what I think is – and will be – the next inflection point in gerontological research, teaching, and application. But having said that, I want to remind the reader that the inflection point model and structure does not imply that each new and emerging “prevailing theme-to-be” does not simply replace the contributions and perspectives of the previous prevailing theme in gerontology (contra the Khunian notion of “paradigms”) – nor do I claim any sort of incommensurability between inflection points. As I have stated before, it is assumed that the subsequent themes are very much still active (to one degree or another) in gerontology and have their functional place in the literature, but the dynamics in the study of aging are such that some themes (and sub-themes) emerge and prevail and then reach of point of stasis (and in some cases stagnation) in research, and in the pedagogical currency of the classroom, and in the field as “practice.” More often than not, the stasis profile (which is characterized by little or no change in the direction or momentum of the scholarship) is very close to what Thomas Khun did come to recognize as “normal science” (or “puzzle-solving”), such that “the field” drifts along – quite content to follow the prevailing lodestar that is the over-arching raison d’être for where it is headed – and being led to. And currently, it is proposed that the prevailing theme and majority of “action” in gerontology is now supporting and promoting and advocating for optimal aging.
In this case, it matters little – at the meta-theoretical level of the field (or from the aerial viewpoint or bird’s-eye view) that we in gerontology ponder the nuances of modernism or post-modernism, or the use of quantitative or qualitative methodologies, or whether or not we actually use explicit theory or not (most likely we do not); rather, the guiding weltanschauung for most of us (when asked – or when we self-identify with it) is still associated with the prevailing theme (i.e., “optimal aging” and the attending research which focuses on life satisfaction and happiness, or “subjective well-being” (SWB)) which cross-cuts, and weaves, and intersects into almost all that we do: both didactically and clinically. This what we preach within the field and it serves as an encompassing vision for the entire field of study and practice – regardless of academic debates about molecular or molar theories, cross-sectional or longitudinal methods, or whether the project is funded by corporate entities or community-based grants.
But here we are at the cusp of new inflection point that is identified as: 5.0: Post Aging {Aging as an “artifact”}, and this change in direction as a prevailing theme in gerontology is very much influenced by the rapid developments and advancements by what Nicholas Carr (2009) refers to as the “the big switch” and what Joel Garreau (2006) refers to as a “radical evolution” in the human condition, and to some degree what researchers such as Aubrey de Grey believe is “the end of aging.” Garreau (2006) proposes that these varied new technologies will offer both promise and peril in the enhancement of our minds, bodies – “and what it means to be human.”
And I believe (along with Garreau, 2006) that the convergence of four inter-related, intertwining technologies: genetic, robotic, information, and nano processes (hereafter known as GRIN technologies; see Garreau, 2006) represents the new inflection point for gerontology [5.0] into the first half of this century. However, as the reader shall soon discover, some of the scholarship in the field of gerontology related to the use of technologies is theoretically being grouped into a several categories (i.e., gerotechnology, assistive technology) which some still have connections with previous inflection points [2.0] and [4.0] as strategies to prevent, delay, or compensate or the perceptual, cognitive, and physical declines of aging {Aging as “problem”} and the use of technology to support or enhance the opportunities associated with aging related to communication, leisure, learning, service, and artistic expression {Aging as “reward”}(see Fozard, Rietsema, Bouma, & Graafmans, 2000).
But because the intersect of technology and bio-engineering with aging are see as a critical feature to distinguish [4.0] from [5.0], I will also acknowledge that inflection point as a change in direction is not overtly dramatic and not like the assumed “switch” that would take place in some Khunian “paradigm shift.” As the reader will discover, there are incremental developments within the inflection point change in direction –and as the curvature suggests – it is a gradual process. Nevertheless, a change does take place in the prevailing view. Thus, one of my goals is to differentiate the various uses of technologies by using the inflection point heuristic in the domain of aging so that we can better understand the purposes, function, goals, and stated outcomes of the categories of technologies as they relate to the study of the aging process and aging condition of the individual. As a brief example of my intent and goal with the heuristic, one can imagine that technologies used to address “aging as a problem” will be different is purpose, function, and application as opposed to “aging as reward” – and then again different from the uses of technologies to transcend – overcome – and the move beyond the aging process entirely (post-aging – or “aging as artifact”).
Yet, all of the exemplars to be noted for [5.0] have technology and/or bioengineering as the center focus for aging research, teaching precepts, and application.My goal with the typology will be examine more closely the various developments within post-aging and then to assign the incremental “versions” of development a number (e.g., [5.1; [5.2]; [5.3] and so on) to correspond with the movement and progress toward a positive curvature in the inflection point [5.0} derivative.
September 26th, 2009 - 11th installment
Despite the incremental developments, it would be easy to understand why there would be substantial resistance and skepticism by some readers to embrace the notion of any kind of new inflection point [5.0] for gerontology (thus a major shift in direction in terms of a prevailing theme) based on various emergent technologies that have seemingly inundated every facet of the human condition. One reason would be that that such a focus would be interpreted as a direct assault on the existential and humanistic traditions with the study of the aging process. In other words, the proposed 5.0 inflection point (could) would strip away the essence of what makes as human, especially the significance as an aging individual with spiritual and philosophical characteristics that transcend the reductionism and consilience found in the scientific domains of biology and technology.
Another reason for incredulity of considering a new inflection point for the domain of gerontology would be the substantive lack of inclusion and coverage of the real and potential impact of these intertwining GRIN technologies (genetic, robotic, information, and nano processes, see Garreau, 2006) in the majority of handbooks and encyclopedias that offer a comprehensive review of theory, research, and application in the field of aging. For example, in the second edition of the Handbook of Theories of Aging (Bengston, Gans, Putney & Silverstein, 2009) there is little presentation or discussion on the GRIN technologies, although it is understood that the handbook is primarily presenting the overview of theories and models; nevertheless the coverage is minimal, and ironically the one time it is somewhat addressed in the handbook, it is presented in an “integrative model” for gerontology (Bass, 2009).
This model not only includes “technology” in the integration matrix (see “A.”), but the author (Bass, 2009) also uses a metaphor and graphical model that is inherently “technological” – a “radio tower structure” – (see Figure 19.1; p. 362) in order to indicate the need for greater integration between various micro- and macro-level forces and influences on the aging individual. Although I like the integrative model and the metaphor (the conceptual model that is evolving) that Bass (2009) has proposed, I believe it will need to be much more inclusive to capture the dramatic developments in the GRIN technologies (genetic, robotic, information, and nano processes, see Garreau, 2006) in order to be a relevant and an integrative model for gerontology in this century. But then again, part of the rationale for doing including the nuances of the “post-aging” inflection point – is my responsibility – to which I intend to do, as I further elaborate on inflection point 5.0 and the developments associated with this curvature (5.x).
But we need to continue our examination of how these technologies have been addressed thus far – starting with the larger and comprehensive handbooks and encyclopedias. In The Cambridge Handbook of Age and Ageing, the editors Johnson, Bengtson, Coleman, & Kirkwood (2005) have included 7 parts, 72 chapters, 110 contributors and 744 pages worth of materials and in addition to an entire section devoted to “The Aging Body” (Part Two), there is a chapter (see pp. 662-669) on “Adaptation to New Technologies” by Neil Charness and Sara J. Czaja (2005) and they focus their attention on “contexts in which older adults will use technology and how technology, when well designed, can promote quality of life and independence for older people” (p. 662). There is also an entry for “technology” in The Encyclopedia of Aging edited by Shulz, Noelker, Rockwood, & Sprott (2006), but again the discussion is brief and limited per the structure of the book in terms of space limitations per entry.
So is the domain of gerontology completely bereft of the discussion of technologies as it intersects the aging process? Of course not. But before I examine the specific works in the literature (since the year 2000) it is important to review the typology proposed by Garreau (2006), which I prefer to use in order to frame the emergent inflection point [5.0] dynamic which is associated with the GRIN technologies (genetic, robotic, information, and nano processes). The reason I believe it is important to review this at this point is so we can assess the developments and applications of technologies in the domain of aging so far – and what we in the field will need to consider in the near future – if not the immediate present.
As I have stated before, I will use the year 2000 as a benchmark, both as a matter of convenience and as a preference to indicate the “turn of the century” (from a historical perspective) so that I can review and assess the literature thus far as it relates to aging and technologies and the proposed heuristic of inflection points.
Next installment – October 2, 2009
5.0: Post Aging {Aging as an “artifact”}
5.1 to 5.2 – Moderate versions of the inflection point and positive derivative
The best place to start in the literature (while recognizing that were previous publications throughout the 1990’s on this topic) is with the publication, Gerotechnology: Creating enabling environments for the challenges and opportunities of aging, by Fozard, Reitsema, Bouma, & Graafmans (2000). I use this article as the starting position because it offers a nice review of the literature up until that date (previous to the year 2000) but then I hope that the reader does not infer that the topic of technology and the intersect with the human condition necessarily begins there (in the year 2000). For example, we should marvel at the “early” philosophical scholarship reflections of Martin Heidegger on this topic with his publication, The Question Concerning Technology (which tangentially corresponds to the [1.0] curvature in my heuristic), which was written in 1954 (see also Hanks, May 2009). Or consider the prescient works of Alvin Toffler with his publications Future Shock (1970) and The Third Wave (1987) (which tangentially corresponds to the [3.0] curvature in my heuristic). In an article in the New Scientist (1994) titled, “Alvin Toffler: still shocking after all these years: New Scientist meets the controversial futurologist,” Toffler shared what inspired him to write Future Shock,
Our ideas came together in 1965 in an article called ‘The future as a way of life’, which argued that change was going to accelerate and that the speed of change could induce disorientation in lots of people. We coined the phrase ‘future shock’ as an analogy to the concept of culture shock. With future shock you stay in one place but your own culture changes so rapidly that it has the same disorienting effect as going to another culture.
In effect, Toffler’s assessment of “future shock” as a barometer of social transformation in large part due to technology advancements is an important thread that weaves into the unfolding of the 5.0 inflection point for the study of aging and the for understanding the aging process into the 21st century. And my decision to use the year 2000 as a breakpoint to examine the shift in direction should be qualified by the appreciation of many examples in the literature that serve as precursors to the proposed 5.0 inflection point in gerontology. And now back to the exemplars for the discussion of the shift from 4.0 to 5.x inflection points – and the developments (or versions 5.x) along the positive derivative. I will introduce at this point, a secondary degree typology to categorize the developments along the change in direction (and along the positive derivative) that has the labels of: moderate and radical versions regarding the intersection of technology and aging issues. The demarcation between the two will be determined by the direct relevance to and association with the GRIN technologies (Garreau, 2006), (genetic, robotic, information, and nano processes). The moderate versions of the 5.x inflection point has ample connections and references to technology and aging in the publications and still represents the emergent prevailing view, but the topics have focused on assistive technology, the human factor, applied psychology and cognitive science. The moderate versions have focused on the use of the Internet by older adults, computer-mediated and computer-based communication, household and safety monitoring, and tele-health applications. In order to reach the radical version of the emergent inflection point – and thus merit a greater inflection point “score” (5.x) – the publication(s) would have to explicitly indicate the intersection of technologies and bio-engineering issues with the aging process that Garreau (2005) has eluded to (i.e., GRIN technologies).
Now, back to the publication, Gerotechnology: Creating enabling environments for the challenges and opportunities of aging, where the authors (Fozard et al., 2000) offered an overview of the emergent “new discipline” of gerotechnology and describe the special needs and interests of older persons with respect to technology that included six areas: (a) housing; (b) communication {see other publication – Communication, Technology and Aging, Opportunities and Challenges for the Future by Charness, Park, & Sabel, 2000 on this topic), (c) personal mobility and transportation; (d) health; (e) work; and (f) recreation and self-fulfillment. What is interesting to note is how the authors defined gerotechnology: “means engineering and technology for the benefit of aging and aged people” (p. 332) and that they indicated that the term gerotechnology was actually coined by Graafsman and Brouwers in 1989. Based on my analysis using the heuristic previously discussed, this article certainly has the connections with two previous inflection points [2.0] and [4.0]; that is, Fozard et al (2000) indicated how engineering and technologies (as of the year 2000) can assist (thus, assistive technology) in compensating for losses with aging process – or prevent or delay them (see [2.0]). Furthermore, Fozard et al (2000) indicated how these same engineering changes could facilitate opportunities for older adults “by enhancing technical application for daily living, communication, transportation, safe workplaces, learning and artistic endeavors” (p. 332; and see [4.0]). But when using the GRIN technologies typology (genetic, robotic, information, and nano processes, see Garreau, 2006), this publication does not quite capture the essence of the latter developments (“radical version”) that Garreau (2006) addresses and so this publication merits a [5.1] inflection point “moderate” version, but is acknowledged as a change in direction of a prevailing view under the aegis of “post-aging.”
The next publication to highlight is, Impact of Technology on Successful Aging, edited by Neil Charness & K. Warner Schaie (2003), which provided a detailed examination of changes in technology that impact individuals as they age with an emphasis upon cultural contexts and person-environment fit from human factors, psychological, and sociological perspectives. Charness & Schaie (2003) take into consideration the role of macro-influences in shaping technological changes in industrialized societies that effect successful aging in terms of quality of life. Of several topics discussed, there is an emphasis on human factors and aging; the impact of the internet; and assistive technology. From my viewpoint and given the array of chapters and topics addressed, the publication edited by Charness & Schaie (2003) has connections to at least three previous inflection points (in relation technology and aging) based on my proposed heuristic: [2.0] – aging as “problem”; [3.0] – aging as “challenge”; [4.0] – aging as “reward” (especially given the title of the book with “successful aging), but again I do not think that this publication necessarily meets the radical version of technology (again when using the GRIN technologies {genetic, robotic, information, and nano processes}see Garreau, 2006), but it does represents a change in direction associated with the emergent inflection point [5.0] and toward “post-aging” and so this publication merits a [5.1] inflection point “moderate” version.
Next installment : Is Aging Superannuated? – October 12, 2009
The same analysis and interpretation, and thus meriting a [5.1] inflection point version, can be applied for the next publication, Technology for Adaptive Aging (Pew & Hemmel, 2003), which is the product of a workshop that was designed to identify high-payoff areas in the technological devices that assist people who are aging normally, as well as those with disabilities and impairments. There were six areas examined in this publication: communication, employment, health, learning, living environments, and transportation. But again, while there is ample discussion of the intersect with technology and the aging process, the level of inflection point focus is on aging as “problem”, “challenge” or “reward” which reflect the previous inflection points [2.0], [3.0, and [4.0] and it represents the [5.1] “moderate” version along the curvature.
The next publication to be discussed, Gerontechnology: Research and Practice in Technology and Aging (Burdick & Kwon, 2004), is interpreted as a slightly stronger version [5.2] of the “post-aging” exemplar (but yet – still moderate version) associated with the positive derivative. This book repeats and extends to a large extent the agenda of previous inflection points where technology (or gerotechnology) is promoted as having as its main purpose and function as building connections to the previous prevailing viewpoints of aging as “problem”, as “challenge”, and as “reward.” Such an interpretation is validated by the review of books and the resulting interpretation that was published in The Gerontologist (Vol.45, No.5, 2005; pp. 704-710) by Russell Morgan with the eye-catching title of “Technology Greets the Age Wave.” The three books that Morgan (2005) reviewed as group have been previously mentioned in this paper (Impact of Technology on Successful Aging, Charness & Schaie, 2003; Gerontechnology: Research and Practice in Technology and Aging, Burdick & Kwon, 2004; Technology for Adaptive Aging, Pew & Hemmel, 2003).
Gerontechnology: Research and Practice in Technology and Aging (Burdick & Kwon, 2004) is an edited book and so the topics are varied and comprehensive with the following sections: Section B (Computers, Older Adults, and Caregivers), Section C (Assistive technology in the Home and Environment), and Section D (Models, Prototypes and Specific Applications) offering, for the most part, the traditional perspectives (i.e., “moderate version”) on the intersect of aging and technology. I want to highlight three specific chapters in this book that represent both the various levels (or versions of the 5.x inflection point) as far as extending the scientific conversation as it relates to the 5.0 inflection point. First, is a chapter (which is actually the epilogue) by Fozard (2004), titled “Applications to Aging Are Helping Human Factors and Ergonomics To Grow Up Right” that I found to be disappointing. I say, “disappointing” in the sense that the edited book had no feel or sense of “looking forward” to what possible developments could (or should) occur in this domain. Instead, the epilogue (last chapter) focused on the specific domain of gerotechnology (or perhaps it is what gerotechnology actually is {?}) that related to human factors and ergonomics, which granted, is an important aspect of the domain, but it has the limited perspective of “what has happened” in the field as sort of a historical reflection. I found this to be disappointing because it promoted and then highlighted a specific dimension of what gerotechnology could embrace and include but did not by neglecting to entertain any discussions or applications of the radical versions of the inflection point [5.0] as it related to the emergence of GRIN technologies. Next, is chapter, which was titled, “Aging and Technology – Social Science Approaches” by Heidrun Mollenkopf (2004) that I found to be one-dimensional. I say “one-dimensional” in the sense that, while it was the prerogative of the author to emphasize a “social science perspective” over – let’s say a bio-technological one – it is nevertheless concerning that the author claimed to be interested in the balance of “micro-levels approaches” (p. 56) (i.e., previous research related to human factors and ergonomics) which is assumed to be the prevailing approach with gerotechnology – with the so-called “macro-conditions” of socio-cultural contexts of symbolism and “cultural and action theory” (p. 64). The author also seems to believe that the “socio-constructivist” approach could have had more to say on the intersection of technology and aging, but evidently has failed to deliver on that promise – and potential. The irony of all this retrospection and review by Mollenkopf (2004) on the macro-conditions for technology and aging is that while the author proceeded to then call for “integrating technology into a holistic, integrated approach” (p. 56), I found that the author missed the mark because Mollenkopf announced that,
“…social science technology perspectives seem to offer the most suitable framework for linking and integrating the most important micro and macro aspects of human aging and social and technological change in a larger societal and historical view.” (p. 64).
I must respond to this over-reach by the author, such that while the social science perspectives may have the most to say (which is their prerogative) about larger societal and historical perspectives, I do not think that it is then necessarily “the most suitable framework for linking micro and macro aspects.” Based on this chapter in the book, I failed to find any solid evidence that these specific social perspectives were “holistic” or “integrated” or even representative of a micro-macro linkages. In my opinion, they simply represent more of the same macro level (theoretical) perspectives that have dominated the (heretofore) moderate versions of this inflection point. The focus (with the moderate version) has been on environmental and contextual factors that interact with the human activities, but there is little to be found in these perspectives that address the burgeoning domain of the GRIN technologies that often reflect more of the biological, cognitive, genetic, and the neurosciences. My point is this: in order to truly grasp the “micro” levels that are – and will be – a part of the technology and aging intersect, Mollenkopf (2004) and others will have to extend their “holistic” vision beyond the human factors and ergonomic dimensions as the supposed end-point of the micro-level approach. With the advent of GRIN technologies and the intersect of these with the aging condition, a truly “holistic” and “integrated” approach will have to (from this point forward) include the “radical versions” of this domain of technology and aging. While it is perfectly acceptable have to have macro level theories and perspectives in the integrated and holistic models, it would be extremely limited and short-sighted to not incorporate the emergent “radical versions” that are more micro – than what Mollenkopf (2004) has associated with the human-machine interactions of human factors and ergonomics. I will discuss the more micro issues later in this paper, but to illustrate my point here, I think it is imperative for gerontology to understand technology not just as “something as out there” that interacts with aging individuals to assist in their activities of daily living (ADLS or IADLS), technology itself has a “nature” that can evolve and transform itself over time (Arthur, 2009). Furthermore, to solely rely upon the social sciences as the most suitable framework to understand the complete range – the full scale of technologies – that affect and influence the aging process will potentially overlook the emergent perspectives in psychology, biotechnology, brain plasticity, linguistics, neuroscience, nanotechnology, artificial intelligence, robotics, and human-computer systems that reflect the “embodied mind” and “cognitive extension” perspectives (Chodzko-Zajko, Kramer, Poon, 2009; Clark, 2008; Gazzaniga, 2008; Hanna & Maiese, 2009; Jones, 2004; Lakoff & Johnson, 1999; Read, Green, & Smyer, 2008) that should complement the macro-level perspectives in any “gerotechnology” (or “gerontechnology”).
The last chapter to discuss in the edited book Gerotechnology: Research and Practice in Technology and Aging by Burdick & Kwon (2004) is authored by Gari Lesnoff-Caravaglia (2004) – and I think it is the strongest (perhaps more of a “radical version” than the other moderate chapters in my opinion) and most forward thinking – and reflective – of all the chapters in the book. This chapter, “Ethical Realities: The Old, the New, and the Virtual” is wide-ranging and it anchors the examination of gerotechnology in both a historical perspective (Lesnoff-Caravaglia makes connections to previous inflection point themes such as discussing the role of technology in the philosophical works of Heidegger which was previously mentioned in this section) and with a prospective vision – especially in the context of ethical issues. For example, Lesnoff-Caravaglia (2004) stated that reciprocal relationship between technology and aging in this fashion:
The societal effects of technological change and the aging of the population are likely to be felt in various ways: health status, living environments, and work. The creation, dissemination and use of technology involves not only mastery of sciences and engineering tools and concepts, but the ability to cope with a difficult set of ethical and economic issues and choices (p. 245).
And in this edited book, I was surprised (but pleased) to see – at long last - commentary about the future in terms of expanded and more elaborate uses of technology,
In the near future there may well be an increased fusion of the biological and the technological. It is already predicted that the majority of surgical procedures in the future will be on the order of organ transplants and the implanting of a variety of prostheses. The goal of such prostheses may include the enhancement or ameliorization of sensory functions such as vision and hearing beyond what are currently considered normal capabilities. Night vision, distance hearing, and specialized gloves for tactile discrimination are increasingly part of the technological armamentarium” (p. 248; emphasis mine)
As you can read in the excerpt above, Lesnoff-Caravaglia (2004) has touched upon the very nature of the newer and emergent “radical versions” of technology that is exactly part of the landscape addressed by Garreau with the GRIN technologies (see also Lesnoff-Caravaglia, 2007). I found the chapter by Lesnoff-Caravaglia to be deeply philosophical in the sense that accurate and relevant questions were posed concerning the ethical issues surrounding the use of technologies in relation to the implications of potential scientific breakthroughs that focus on the “problem” of aging (see also, Bramstedt, 2001; Hackler, 2001). And yet, the reader could sense that Lesnoff-Caravaglia had one foot well-grounded in the traditions of the past, but also felt comfortable recognizing and embracing the inevitable changes that were to lie ahead in the near future associated with the evolution of technology. Interesting enough, Lesnoff-Caravaglia (2004) was able to make the conceptual connection of how both technology and the study of aging have much in common in terms of structure and content; thus, I found the following statement (in the excerpt below) to be the quintessential description of the [5.0] inflection point – and capturing the developments along the curvature of the positive derivative from a moderate version [5.1, 5.2] to a more radical version [5.3, 5.4, 5.5…5.x],
Technology and aging are very similar in one respect – they both have an onward or forward movement. There is no going back. Once a technology is invented and improves to be useful, it is changed only to become even more complex and does not disappear. Aging also moves forward in an inexorable fashion. In this sense, technology and aging are both structured by time. (p. 254)
Next installment: Toward Post-Aging: The Role of Technology
October 23, 2009
Before I indicate the three publications that best represents the transition from the moderate [5.1, 5.2] to the radical version of the inflection point/curvature [5.3, 5.4] it is important to conduct a partial inventory the burgeoning amount of literature that has emerged to represent the moderate version of the [5.x] inflection point.
5.1 to 5.2 – Moderate versions of the inflection point and positive derivative –
other examples to indicate the curvature ~
My goal here is to illustrate but not to exhaust the examples along the 5.1 and 5.2 curvature, which represent the traditional gerotechnology and assistive technology domains. The issue of Science Studies (Volume 17, No. 2, 2004) with the guest editor Britt Ostlund examined the intersection of ageing and technology using (primarily) a social constructivist (socio-technical) perspective. Along the same line and approach were the publications by Agree, Freedman & Sengupta (2004) who examined the factors that influenced the use of mobility technology in community-based long-term care and Lansley, McCreadie, Tinker (2004) who examined the adaptations and use of assistive technology in enabling older people to remain in their homes. Mann (2005) edited the book, Smart Technology for Aging, Disability, and Independence – The State of the Science, which presented a very comprehensive look at “smart technology” for home and community including the various uses of assistive technology and robotics. Stephen Cutler (2005) provided a nice overview of the connection between ageism and technology (noting a reciprocal influence) and then there was the special issue of Generations (Summer 2006, with Sara Czaja and Richard Schulz as guest editors), which offered a nice cross-section of articles relating to the moderate version of the inflection point and curvature. Sara Czaja continues her scholarship in this track with a significant co-authored publication (Czaja, Charness, Fisk, Hetzog, Rogers, Nari, & Sharit, 2006) titled, “Factors Predicting the Use of Technology: Findings from the Center for Research and Education on Aging and Technology Enhancement (CREATE)” in the journal – Psychology & Aging. This article by Czaja et al (2006) is definitively categorized and placed in the moderate version with its focus on the successful adoption of technology (e.g., primarily the use of computers and the internet) as an important factor to increase functional independence in community-dwelling adults (see also Hammel, 2000). In the Journal of Housing For the Elderly, Mahmood, Yamamoto, Lee, & Stegell, (2008) discussed a pilot project that was conducted to explore attitudes, opinions, and preferences of older adults concerning the use of technology to support and extend their ability to “aging in place” and readers of this paper should also refer to the web site publication of the American Association of Homes and Services for the Aging (http://www.aahsa.org) for a complete report on the “State of Technology in Aging Services.”
In other examples of the moderate version of post-aging [5.1, 5.2], Skubic, Popescu, Rantz, & Keller (2009) discussed the role of passive sensor networks have been used for monitoring older adults in their homes and Steel & Gray (2009) reviewed the published studies to describe issues and quality of evidence surrounding assistive technology (AT) use by the baby boomer generation (see also Lindenberger, Lovden, Schellenbach, Li & Kruger 2008). Clarke, Chan, Santaguida and Colantonio (2009) examined the demographic, and social characteristics of mobility device users (assistive technology) in long-term settings, whereas Kitchner, Ng, Lee, and Harrington (2008) analyzed data related to assistive technology in Medicaid Home-and Community-Based Waiver Programs (see also Resnik & Allen 2006). In a track related to the use of technological devices by older adults, Slegers, Boxtel, and Jolles (2009) examined the role of cognitive functional decline, whereas Wright and Hill (2009) stated concerns about the over-reliance of internet access for older adults to a obtain information about Medicare part D and they worry that both issues of increased disability and decrease in income (among older adults) may affect computer/internet access for many older adults thereby increasing the stratification of access to health care. But Godfrey and Johnson (2009) offer potential solutions to these challenges in stratification by describing the role of informal networks (“digital circles of support” – (many of them as older adults who are “technology literate mediators”) that can help assist other older adults thereby facilitating both groups as engaged active citizens in their own care. Lai (2008) examined the use of information and communication technologies (ICT) and its affects on inter-generational dynamics in the country of Japan, while Hernandez-Encuentra, Pousada, Gomez-Zuniga, 2009) examined the similar topic in the the country of Spain. (Finally, it should be noted that the International Society for Gerontechnology (ISG) (http://www.gerontechnology.info/Journal/) represents a professional organization capturing the spirit of the moderate version of the curvature – which has as its mission:
ISG encourages and promotes technological innovations in products and services that address older peoples’ ambitions and needs on the basis of scientific knowledge about ageing processes including cultural and individual differences.
And aim the journal publication is:
to provide a forum for reporting original research, review papers, and personal perspectives on the broad area of fitting technological environments to support changing life goals and lifestyle preferences into advanced age. Research outcomes reported in the Journal form the basis – for designers, architects, standards developers, builders, engineers, marketeers, manufacturers, medical doctors, pharmacists, decision makers, and related professionals in the health, social, business and technology professions – to provide the proper environment for the greatest number of people in society.
5.3 to 5.4 – Transition publications from the Moderate version of the inflection point (and positive derivative) and to the Radical version (for the inflection point)
As I mentioned earlier, I believe there are three significant publications that represent “bridge” publications – or transition publications – from the moderate version to the radical version of the positive curvature of literature representing the inflection point [5.0]. The first publication I have designated as [5.3] to indicate a continuation of the moderate version but also an example of scholarship that is forward-looking to the radical version in terms of discussion and concrete examples. The first exemplar is associated with the journal article, “Intelligent Technology for an Aging Population: The Use of AI to Assist Elders with Cognitive Impairment” by Martha Pollack (2005) published in AI Magazine which is official publication of the Association for the Advancement of Artificial Intelligence (www.aaai.org). Pollack (2005) surveyed new technologies that incorporate artificial intelligence (AI) techniques to support older adults and help them cope with the changes of aging, in particular with cognitive decline and also discussed the use of robotics (thus touching the GRIN technology threshold of Garreau, 2005) in the lives of older adults.
The second exemplar [also as 5.3] is represented by the book, Gerontechnology: Growing Old in a Technological Society, edited by Gari Lesnoff-Caravaglia (2007), which offers six sections, and I believe the two chapters in Part I both represent an outstanding overview of the multi-faceted convergence of technology and aging. It is in Chapter 2 (of Part 1) “Gerontechnology: The Challenge” where Lesnoff-Caravaglia (2007) proposes an interesting and viable distinction of the uses of technology (“high and low technology”) that would intersect with aging issues and that complements my use of the heuristic for the 5.0 inflection point and the differentiation of “moderate” (or low technology) and “radical” (or high technology) versions of the curvature for “post-aging.” Lesnoff-Caravaglia (2007) marks the distinction in this manner,
The practical application of science can be either at the level of high technology or low technology. On occasion, simple solutions on the level of low technology, such as redesigning tools or altering home environments, have more practical outcomes. Some high technology streams such as genetics, robotics, informatics, and in particular, communication technology provide the potential for very powerful and controversial applications. For example, the science of genetics is leading to the possibility of predicting such conditions as heart disease and Alzheimer’s Disease (p. 23).
For the most part, the remainder chapters to address some artificial intelligence and robotics issues, but there is less discussion on genomics and nanotechnology (using the GRIN technology template of Garreau, 2005). The last chapter (“Gerontechnological Ontology: Human Experience within Extraordinary Frameworks”) is especially intriguing as Lesnoff-Caravaglia (2007) analyzes the human experience from the perspective of the extraordinary framework for living in an aging society, and again reminiscent, of her earlier work (Lesnoff-Caravaglia, 2004) in the edited book by Burdick & Kwon (2004). I found this chapter to a much needed philosophical reflection regarding the ethical and existential issues that permeate the intersection of technology and the study of aging. It also should remind you (the reader) of the cross-threads with other inflection points (i.e., aging as “reflection”) that still are relevant in our current prevailing theme [4.0] “optimal aging” and the new emergent curvature of [5.x] – “post-aging.” Nevertheless, the recent work of Lesnoff-Caravaglia (2007) is indicative of the transition literature [5.3] that is developing along the post-aging curvature and her summary statements in the last chapter are insightful and prescient,
“In the near future there will be an increased fusion of the biological and the technological” (p. 302).
The next publication, Aging, Biotechnology and the Future, edited by Read, Green, and Smyer (2008), represents a further and extended transition from moderate [5.3, 5.4] to the radical version [5.5 and >] because of the heavy emphasis on biotechnology which is more “radical” (or “high technology” according to Lesnoff-Caravaglia, 2007) that the prevailing emphasis within the moderate version that has reflected primarily ergonomics and assistive technology (or “low technology” according to Lesnoff-Caravaglia, 2007) and so I have classified this publication by Read, Green, & Smyer (2008) as [5.4] on the curvature. I also found this publication to be far more advanced along the curvature (than other exemplars with 5.x… so far) by providing coverage and discussion of the GRIN technologies (Garreau, 2005) with wide-ranging multidisciplinary perspectives that offered both arguments for advancing the development of biotechnologies, and in addition, constructive criticisms that need further dialogue and resolution. For example, in the Preface the editors (Read, Green, & Smyer) review the ethical issues that arise at the intersection of collective aging, personal aging, and biotechnological advances,
Recent advances in biotechnology and our newfound understanding of the human genome have opened a door to exciting new possibilities for improving the quality and duration of life, albeit with many caveats. The idea of replacing ailing organs or tissues with healthy ones created from stem cells is gaining widespread acceptance, yet the use of related technology to reproduce an entire human being generally evokes condemnation. Using a genetic test to determine whether a person is at increased risk for colon cancer seems prudent because early colonoscopy can target a malignancy for removal before it becomes lethal, but genetic testing for incurable diseases such as Huntington or Alzheimer disease may have psychosocial consequences that outweigh any potential benefit. Antiaging technologies have a tremendous marketing appeal, but there are significant limitations to their benefits and lack of regulatory control on their use. (p. xi).
And what followed from the Preface were the contrasting perspectives by a commendable list of scholars throughout, and some who extol the positive elements of extended longevity and the potential for greater quality of life, while other contributors examine such ethical quandaries as presymptomatic genetic testing, therapeutic cloning, antiaging technologies, and the transhumanist (and posthumanist) movement. Many of these issues (i.e., transhumanism, antiaging technologies) will be examined in more detail as we encounter the transition of post-aging into the “radical version” of the curvature and review the exemplars for 5.5 and beyond. But I think the most important issue that emerges from this publication related to theme of “ensuring the equitable distribution of life-extending products and services in a diverse aging society” (Read, Green, & Smyer, 2008; p. xiii). I also think that this represents the greatest challenge and barrier to a full societal understanding and acceptance of the emergent radical version as a part of nascent prevailing view in the study of aging. In other words, once these issues are addressed in a comprehensive manner (both ethically and equitably), then I foresee the curvature moving beyond [5.4] and into the radical version of 5.5 and > of the inflection point (and beyond). Thus, I am in agreement with Sprott’s (2008) assessment in his chapter titled, “Reality Check: What is Genetic Research on Aging Likely to Produce, and What are the Ethical and Clinical Implications of Those Advances?” where he succinctly states the issue – and the challenge,
This question of resource allocation is the central ethical question we face in this discussion. At bottom, the issue is not age. Age is just one of the markers we use to discriminate when we allocate resources of any type, including the benefits of scientific advances and expensive medical treatments. Ultimately, the question is how we will allocate the great opportunities we will see as a result of a better understanding of our biology, not whether we can stop that progress. (p. 
Aside from the critical issue of “resource allocation,” the other ethical conundrums in the “post-aging” inflection point are related to both the experience of the aging process as 1) a natural and inevitable outcome of human development (or should it be?) and 2) to the prospect of mortality as a part of the human condition (or should it be?).
These two dimensions of the post-aging inflection point are –and will become – hugely controversial and highly provocative and thus reflect the emotionally-charged, and ethically-challenged, and technologically-possible landscape of the radical version [5.5 and >] of this positive curvature. I think the last chapter in the book by Rosemarie Tong (2008), “A Lonely New World- Or Me, Myself, and I” sets the tone for the purported need of establishing some boundaries in how fast and how far we (as a society) and those in the health care professions should be (or are willing) to go in developing biotechnological “therapies.” Tong (2008) was hoping to establish and elucidate both the nuances of science and the moral practice of medicine in this regard. In other words, Tong (2008) wondered if biotechnology is supposed to make people happy – or healthy (?). And supposedly there is the world of difference between the two motivations for conducting science and engaging in the development of technological advancements. Tong (2008) placed the same structure of that moral compass against the backdrop of the aging process – not so much in regards to happiness or health – but mortality or immortality,
It is one thing to “compress morbidity” (Fries, 1980) so that chronic diseases and disabilities that currently strike people around 50 do not occur until age 90 or so, shortly before one is schedules to die (Miller, 2002). However, it is quite another for medicine and science to wage war against death, working feverishly to find ways to indefinitely postpone aging and/or to create posthumans (De Grey et al., 2002). Reading Faust (Goethe, 1998, translation) explains the difference. Human beings were meant to die. (p. 255).
Tong (2008) (and like Read, Green, & Smyer, 2008) was seeking a boundary, some sort of firewall, a demarcation to what is needed versus wanted, between what is possible versus what is pragmatic, between what is assistive or what is enhanced (or even overcome) in the domain of biotechnology – but the same concerns and issues are at stake with the entire landscape of the advancing technologies similar to what Garreau (2005) proposed his “Heaven,” “Hell,” and “Prevail” scenarios associated with the GRIN categories – and several regards, the “Prevail” scenario representing the “middle ground” of the debate and activity where humans will seek some limits and control and guidelines to what is based on “good’ principles and ethical bearings versus being misguided or dangerous to human welfare. The issues of ethics, morality, limits, purpose, meaning, significance, the process of science, then bring us to the crossroads to where the moderate version [5.1 to 5.4] of the inflection point will “cross-over” to the radical version [5.5 and >] of the curvature and towards the activities and literature that will propel the movement onward to “post-aging” {Aging as ‘artifact”}. But the crossing-over is not a simple bridge or necessarily a smooth transition. Furthermore, I do not want to leave the reader with the impression that there is necessarily a demarcation between the moderate and radical versions of the curvature, rather the incremental 5.1, 5.2, 5.3, 5.4 points noted in the literature represent significant precursors or “portals” toward the radical version and not just a separate category of technology and aging issues. But it appears that the transition toward the radical version [5.5 and >] has sparked and energized the debate and dialogue about the goals and values of science and technology. For example, in the year 2002, there were two publications that heralded the onset of the varied perspectives (some might say polemics) associated with the developments of biotechnology. On one hand, Fukuyama (2002) pondered the negative consequences that may emerge from the biotechnology revolution, especially as it relates to the political structures associated with liberal democracy. On the other hand, there were the proclamations of Stock (2002) who argued that the biotechnology revolution is inevitable and that by the end of this millennium, “we would change ourselves enough to become much more than simply human” (p. 5). Stock (2002) further argued that extended lifespans (based on a germline procedure) would be of benefit to both the individual and society,
Longer and more vital lifespans would not only have personal consequences, they would also enrich society. The family cycle of pain and disruption from old age and death is clear to every one, but economists try to be more specific. William Nordhaus, an economist at Yale University, estimates that half the increase in the standard of living in the United States during the past century is due to the rise in longevity that has lengthened our active lives. The benefits to society of extending our vital years are as a clear as the burdens of prolonging our decrepitude. We require decades of education and experience to learn to handle ourselves effectively in the world, but we tire and fade all too quickly. Added years of health would lessen the drain. If youth is wasted on the young, then why not see what the old can do with it? (p. 95-96).
Despite the fact that technology and aging have become interconnected – irrevocably – the threads from previous prevailing views [1.0, 2.0, 3.0, 4.0] are still present and guiding our interpretations of the emergent inflection point of “post-aging” [5.0]. Thus, as the radical version of the inflection point gains momentum, we are increasingly seeing the evidence of the shock waves and turbulence of where science and metaphysics collide (see Tauber, 2009) in scholarly journals (e.g., Journal of Medicine and Philosophy, Rejuvenation Research) in popular fiction (see Houllebecq, 2005), in books (e.g., {and here listed by publication date} The Shattered Self: The End of Natural Selection, Baldi, 2001; Wondergenes: Genetic Enhancement and the Future of Society, Mehlman, 2003; Beyond Therapy: Biotechnology and the Pursuit of Happiness, Kass, 2004; Is Human Nature Obsolete? Genetics, Bioengineering, and the Future of the Human Condition, Baillie & Casey, 2005; Genesis Redux: Essays in the History and Philosophy of Artificial Life, Riskin, 2007; Enhancing Evolution: The Ethical Case for Making Better People, Harris, 2007; The Case Against Perfection: Ethics in the Age of Genetic Engineering, Sandel, 2007; Just Genes: The Ethics of Genetics Technologies, Barash, 2008); in film (see Blade Runner, Gattaca, Twelve Monkeys, Terminator series, Minority Report), trade magazines, and on the internet via a plethora of web sites and blogs (e.g., Institute for Emerging Ethics & Technologies, IEET).
In the study of the aging process, I am convinced that there will be the need for more panel groups, conferences, special issues of journal publications, and edited books to address the science and the morality and the ethics of the intersection of aging and technology in a balanced and interdisciplinary fashion. But the discourse and consensus, and intervention, needs to occur now as the radical version [5.5 and >] already has significant momentum – worldwide.
The entire enterprise of biotechnology, artificial intelligence, robotics, and nanotechnology is a sleeping giant that has awaken and the speed of its delivery and implementation in both research and development laboratories – and then for individual and societal application is staggering and overwhelming. But my call for dialogical intervention and policy guidelines now does not mean that there has been a vacuum of literature on the subject matter, rather the call is targeted to those in the field of gerontology and those who identify themselves as scholars and investigators in the field of aging to appreciate and understand both the momentum and the implications of the inflection point of “post-aging” that are intimately connected to both the moderate and radical versions. Although not every previous publication associated with the radical version has necessarily addressed “aging issues” per se, it is hoped that this paper will indicate the need for gerontologists to stay abreast of the burgeoning and emergent literature on the GRIN technologies. It is also proposed that every gerontology program in higher education (and ideally {and hopefully} endorsed by the Association for Gerontology in Higher Education – AGHE) should begin to integrate these issues into their existing gerontology courses or offer a special topics course that relates to technology and aging issues. I believe every gerontologist should know the differences in values, attitudes, and perspectives among bioconservatives (left and right wing), the transhumanists, and the technoprogressives – as much as one might expect a gerontologist to know the difference between Medicare, Medicaid, and Medigap.
Next installment: Nov. 7, 2009
5.0: Post Aging {Aging as an “artifact”}
5.5 and > – Radical versions of the inflection point and positive derivative
To set the stage for the radical version of the 5.0 inflection point and to indicate the continuation of the positive derivative (and curvature), I will directly state the exemplar for 5.5 and then expound on the historical context for the emergence of this exemplar (and others) and then examine the philosophical and scientific foundations that surround the exemplar and then foray into one rapid developing angle that captures the emergent view (and soon to be prevailing) of “post-aging.”
And the exemplar for 5.5 is, Ending Aging: The Rejuvenation Breakthroughs That Could Reverse Human Aging in Our Lifetime by Aubrey de Grey and Michael Rae (2007). Before I examine some of the contextual issues that led up to this exemplar, I want to also directly state the rationale for selecting this controversial and provocative title as the key representative to serve as the tipping point away from the moderate version and critical momentum toward (and as the portal into) the radical version of the 5.0 inflection point. The primary reason for choosing the book by de Grey and Rae (2007) is that clearly represents a mainstreaming of the radical version of “post-aging” into the hands of the both the professional and the layman in terms of articulating the role of rejuvenation therapies targeted at the molecular and cellular level of human organism. While there has been many other publications prior to this one (that is indicated as the exemplar by de Grey and Rae, 2007) which present and advocate for “anti-aging” strategies, none yet have defined and expressed the nuances of biotechnology as effective and as provocatively as Aubrey de Grey. The book Ending Aging: The Rejuvenation Breakthroughs That Could Reverse Human Aging in Our Lifetime is therefore recognized as the exemplar and the gateway publication that captures the radical version of the inflection point. I also propose that the benchmark publication of de Grey builds and creates the interconnections with an array of other dimensions of the GRIN technologies (Garreau, 2005), which will be discussed, in greater detail in the next several sections. But first, I will present some historical, contextual and philosophical factors that help to set the foundation for the emergence of the 5.5 exemplar and for what is possible in the near future for the GRIN technologies, especially as it relates to the study of aging.
5.5 and > From Biogerontology to Post Aging: Historical, Philosophical and Technological Dimensions
I have presented earlier in this paper some historical exemplars that related to the 1.0 inflection point {Aging as ‘reflection’} as it related to the metaphysical issues and aging by noting the “long grey line” of deep historical roots that originate back to the mythology of the Greek and Roman era (see Wright, 2008). The interest in the physiological dimensions of the aging process has a fascinating history as well, but perhaps not as historically deep as the metaphysical dimension. For example, there was the curious 1921 publication by Sanford Bennett Dodd, Old Age: Its Cause and Prevention which appears to be a provocative precursor to the Jack LaLanne school for living well into the later years. Dodd, who at the age of fifty, claimed to have physically completely broken down but then “reversed” his aging process through a regimen of exercise and diet, which matched the fabled miracle of Faust by changing an old body into a new one. There was also G. Stanley Hall’s (1922) Senescence: The Last Half of Life and another book, titled Old Age: The Major Involution: The Physiology and Pathology of the Aging Process (1930) by Alfred Scott Warthin who proclaimed that the involution associated with the later years was a “tragicomedy” and would only create a greater number of individuals who would reach their eighties and nineties, “more or less useless” because they enter into a second childhood. Moving forward along the path, we could also seek guidance in Ageing, the Biology of Senescence by Alex Comfort (1964) and but one certainly has to acknowledge the benchmark publication for biogerontology, Leonard Hayflick’s (1994) How and Why We Age. Hayflick’s book is considered a classic mainstream publication of – and for – biogerontology. It also included a forward by Robert Butler who then suggested that many ethical dilemmas would have to be addressed before engaging in lofty scientific goals and tampering with the clocks that govern aging. But that was then – and this is now and the game (and the literature) has changed dramatically since 1994 such that there appears to be much more interest in How Not to Age and Why Not (meaning: Do We have to Age at All?). Hayflick has come a long way from being one of the few voices addressing the issues of biogerontology (with his 1994 publication) to where he is presently not only (and still) one of the leading spokespersons for biogerontology (see Hayflick’s 2009 leadership with symposium presentation “Ageing Is No Longer an Unsolved Biological Problem” at the World Congress of Gerontology and Geriatrics in Paris, France), but he is also actively engaged in the defensive posture of defining biogerontology against (or versus) anti-aging medicine or prolongevity or the disease model orientation of many scientists or the burgeoning activity (both scientific and market-based) that seeks to extend the human life span. For example, in an interview with the publication Technology Review (7/1/2009; and see article at http://www.technologyreview.com/biomedicine/22954), Leonard Hayflick (2009) made it very clear that understanding the cause of aging does not necessarily mean that there is necessarily a “cure” to the aging process,
TR: So it doesn’t imply that there is a solution to aging?
LH: Why would you want to do that?
TR: Some people would like to slow or halt the aging process.
LH: They haven’t thought about the consequences. We relate to each other by perceptions of differences in age, which would be destroyed if some chose to increase their longevity and some did not. The social, political, and economic discontinuities that would occur would be enormous. People who say they want extended longevity say they want it to be so when life satisfaction is greatest. Yet they won’t know [when that is] until late in life. If you’re in your eighties and you decide you want life extended when you were happier, at fifty, it’s no longer possible.
In essence, Hayflick (1994; 2004; 2009) was perfectly comfortable in drawing a line with knowing the underlying issues with aging (the how and the why) and embracing the natural order and limits that are essentially built in the human organism (i.e., “the Hayflick Limit”) rather than entertaining any efforts that are “highly improbable” in terms of extending life beyond the biologically determined life span. Furthermore, Hayflick (2009) was very specific about where the focus of research and large funding opportunities should go in aging,
TR: Why is it so important to distinguish between aging and the diseases of aging?
LH: You cannot learn about the fundamental biology of aging by studying disease processes. Resolving age-associated diseases tells us nothing about the fundamental biology of aging, just as the resolution of childhood diseases, such as polio and childhood anemia, did not tell us one iota about childhood development.
TR: Why, then, is it important to do research on the fundamental processes of aging?
LH: Because the fundamental processes of aging increase vulnerability to all age-associated diseases. That is why cancer, cardiovascular disease, and stroke, the three leading causes of death in developed countries, occur in older age. The root cause of age-associated diseases implies–demands, even–that for anyone to understand the causes of age-associated diseases, they should know something about the fundamental processes of aging. Learning something about why old cells are more vulnerable to pathology is a key question for which we have little research being conducted.
(Source: http://www.technologyreview.com/biomedicine/22954/page2/)
And yet, this perspective of Hayflick’s drew a response from Ray Kurzweil (whom you shall learn more about in this section) about a week later in the same publication (Technology Review via their blog site) who replied with a rebuttal titled, “How to Combat Aging” (7/6/2009). Kurzweil’s (2009) viewpoint runs counter to Hayflick’s perspectives in that Kurzweil is a complete and unabashed devotee of the promise of the bioegineering potential in the near future and believes that Hayflick’s “science” focuses on “limits” (“the Hayflick limit”) and that he is hampered and hamstrung by a conventional linear thinking that expects, “…that the slow pace of the past will characterize the future.” And so Kurzweil (2009) argued that, “…the reality of progress in information technology is exponential, not linear… We do not yet have all of the knowledge and tools to do this with the human body, but that knowledge is growing exponentially.”
I think the best way to frame the debate between Hayflick and Kurzweil is to review once again my heuristic of inflection points as a tool to understand how scholars can operate in vastly different prevailing viewpoints – and yet have an interest in the same dimension of aging – biogerontology. As you recall, the proposed inflection points were designated as,
1.0: Metaphysics of Aging {Aging as “reflection”}
2.0: Bio-medical [acute and chronic] diseases of Aging {Aging as a “problem”}
3.0: Demographics of Aging {Aging as a “challenge”}
Proposed current theme:
4.0: Optimal Aging {Aging as a “reward”}
Proposed emergent theme:
5.0: Post Aging {Aging as an “artifact”}
and Hayflick’s scholarship record is very much connected to inflection point [2.0] and [4.0] with his emphasis on biological determinants of aging (although it should be noted that Hayflick has clearly stated the need to separate the biological process of aging from disease processes) and that aging is a “problem” that can overcome by focusing scientific research on the underlying process of aging – and not exclusively on disease(s) per se. Hayflick would like to see advances in science lead to a better quality of life so humans can live out the natural order of life until the point of maximum life span. In other words, life expectancy should be optimized [4.0] up until the point of the natural “limit” endowed within Homo sapiens such that anything that would focus beyond that “limit” is simply not scientifically feasible nor is it desirable for our species. And this is a critical demarcation point – the inflection point that Hayflick operates within, whereas Kurzweil (2009) is clearly operating in the [5.0] inflection point and curvature that has a different prevailing viewpoint about so-called “limits” and the inevitability of the aging process and maximum life span. Most importantly, the prevailing viewpoint associated with [5.x], especially with 5.4 and greater (the radical versions) carries forward the scholarship and application to lead us (in theory) toward the full realization of “post-aging.” Kurzweil (like Aubrey de Grey and many others) is deeply embedded in the promotion and use of radical versions of the GRIN technologies (Garreau, 2005) which also serve as the mechanism to realize, to bring to fruition, the time in the future in which “aging” will be an seen as artifact. In other words, “aging” will have become associated with an experience that was “in the past” and that humans will have moved beyond the process of aging – and into a vastly different living experience permeated by enhancement and bioengineering. With “post aging” as the prevailing view, there is the expectation of longevity that will surpass what we now associate with the “maximum life span” of our species. Here is Kurzweil (2009) indicating (from the blog posting in Technology Review http://www.technologyreview.com/blog/guest/23802/) the promise of technology as it relates to interventions in sustaining the quality of life,
The most important perspective in my view is that health, medicine, and biology is now an information technology, whereas it used to be hit or miss. We not only have the (outdated) software that biology runs on (our genome), but we have the means of changing that software (our genes) in a mature individual with such technologies as RNA interference and new forms of gene therapy that do not trigger the immune system…We can design interventions on computers and test them out on increasingly sophisticated biological simulators. One of my primary themes is that information technology grows exponentially, in sharp contrast to the linear growth of hit or miss approaches that have characterized medicine up until recently. As such, these technologies will be a million times more powerful in 20 years (by doubling in power and price performance each year). The genome project, incidentally, followed exactly this trajectory.
This perspective of Kurzweil is further elaborated in his book (and co-authored, see Kurzweil & Grossman, 2009), Transcend: Nine Steps to Living Well Forever, where the authors “promise to reverse aging, extend your life span, and maintain vitality forever.” The working premise in the book (and Kurzweil’s strategy for the near future) is that if people would follow the guidelines (“the nine steps”) then they would remain healthy enough, and live long enough, to then “take full advantage of the biotech and nanotech miracles of tomorrow.” Kurzweil (2009) has gone on record to state that he believes that “immortality” is only twenty years away according to his theory, “The Law of Accelerating Returns”, which presumes that our understanding of genes and computer technology is increasing and thus nanotechnologies will be able to replace vital organs in human body systems.
Needless to say, not everyone is in agreement with such prognostications about the future and the promise of reversing aging (the complete realization of “post-aging”) for both scientific and ethical reasons. Thus, before we move forward into the radical versions [5.5 >] of the inflection point of “post-aging,” (e.g., Ending Aging: The Rejuvenation Breakthroughs That Could Reverse Human Aging in Our Lifetime, Aubrey de Grey, 2007), it will be necessary to briefly review the literature that has critically examined the merits of anti-aging medicine, life extension, the quest for immortality. This will help to provide an important counterweight (and alternative perspective) to burgeoning line of literature that is leading (and promoting) a more optimistic perspective at the intersection of biotechnology and aging. And perhaps this is what serves as the keystone feature for the prevailing view of inflection point [5.x] versus that of the [4.0] inflection point: the supposed benefits using of GRIN technologies to not only optimize aging {thus, [4.0]} and fulfill a complete and qualitative life span existence (“natural order of human life to maximum life span”) but to also use GRIN technologies to (in a optimistic fashion) surpass and exceed the maximum life span for Homo sapiens and embrace the possibility that humans (or human existence) may be transcended by some other entity with far greater intelligence and survival potential that what exists for the organic “limits” of the human body. This is what makes the 5.x inflection point and the curvature representing 5.5 > so vastly different in its prevailing view than that of [4.0] – optimal aging. But again, it is important to state that not all scholars who are in support of using the GRIN technologies are in agreement about the so-called “optimistic” end result for either humans or the planet from both an economic and ecological perspective (see Garreau, 2005 with the Heaven, Hell, and Prevail scenarios). Therefore, the following material in the next section will help to address some of the “Historical, Philosophical and Technological Dimensions” of the [5.x] curvature as it relates the activities from biogerontology to post aging.
To be continued……………
The full set of references will be available with the last section of this work.
Marcus Aurelius
