Throughout most of human history, a society’s
population formed a sort of pyramid: young children
represented the largest portion—the base—and each
successively older cohort represented a smaller and
smaller group.In 1950,children under theageoffive
were 11 percent of the US population, adults aged
forty-five toforty-nine were 6 percent, and those over
eighty were 1 percent. Today, we have as many
fifty-year-oldsasfive-year-olds.Inthirtyyears,therewill
beasmanypeopleovereightyasthereareunderfive.
The same pattern is emerging throughout the
industrialized world.
Few societies have come to grips with the new
demography. We cling to the notion of retirement at
sixty-five—a reasonable notion when those over
sixty-fivewere a tinypercentageofthepopulation but
increasingly untenable as they approach 20 percent.
Peopleareputtingasidelessinsavingsforoldagenow
thantheyhaveatanytimesincetheGreatDepression.
Morethanhalfoftheveryoldnowlivewithoutaspouse
andwehavefewerchildrenthaneverbefore,yetwegive
virtuallyno thoughtto how wewill liveout our later
years alone.
Equallyworrying,andfarlessrecognized,medicinehas
beenslowtoconfronttheverychangesthatithasbeen
responsible for—or to apply the knowledge we have
abouthowtomakeoldagebetter.Althoughtheelderly
population is growing rapidly, the numberof certified
geriatricians themedicalprofession hasput in practice
has actually fallen in the UnitedStates by 25 percent
between 1996 and 2010. Applications to training