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Simona’s
average rating for
2024
4.4
4.4
First off, I have overdone it with the quotes in this one. I sincerely apologise - there was no way around it.
A factor in my book ratings is, among else, the number of highlights I have made in a book by the time I finish it, and here we stand at a staggering 216 highlights over de facto 221 pages. The book is YELLOW, so here we go.
The book is doing an excellent job at touching on a vast array of aspects around the fact that collectively, we keep First off, I have overdone it with the quotes in this one. I sincerely apologise - there was no way around it.
A factor in my book ratings is, among else, the number of highlights I have made in a book by the time I finish it, and here we stand at a staggering 216 highlights over de facto 221 pages. The book is YELLOW, so here we go.
The book is doing an excellent job at touching on a vast array of aspects around the fact that collectively, we keep getting older (and oftentimes remain in better health along the way). It answers questions such as:
- How did life expectancy increase in the first place, and by what means will we increase it in the future?
- What are the implications of an ageing population on our national pension systems and the generational contracts in place in many countries?
- What are starting points to defuse the demographic time bomb? How do we secure a liveable old age for an increasing number of increasingly old people without compromising the future of the young by bankrupting them?
- What can people do to increase their health span, next to their life span? (Some of those sports facts amazed me! See down below in the quotes)
- What does the latest research around brain plasticity and neurogenesis tell us about maintaining or even advancing our mental capacities as we age?
- What is the current state of gene research and what does it tell us about ageing (chronological vs. biological age)? How does systemic inflammation tie into that last miserable stretch of our lifespan that we hope to shorten, or ideally, avoid entirely?
- How can advances in AI and Machine Learning help us age better rather than just live longer?
- How do current regulations to the pharmaceutical industry hinder bringing effective anti-ageing drugs to market, and how can we better support ongoing research?
- How does our modern social context contribute to ageing, and what novel concepts are introduced to mitigate negative effects? (loved that part!)
Content Highlights:
- The best part has to be the thoroughly encouraging tone of the book: retired people have a world to offer to their communities, we just need to come up with good concepts to scale it; ageing is not a linear process and a lot of how old age plays out can lie in our hands; retirement doesn't have to be bleak, and there are powerful ways to organise to create the spaces needed for communities to flourish. It's a book that doesn't just lament the problem but suggests actual solutions.
- You truly get a 360 degree perspective on every aspect of Extra Time; we touch on health and lifestyle, economics, politics, society, science and technology. I was amazed at how much oomph can fit into just over 200 pages.
- The author does a great job at looking at successfully and less successfully aging populations around the globe; next to the obvious choices of the US and the UK, we get a glimpse into success concepts around handling the problem of ageing societies in Japan, China, Germany, the Netherlands and Italy and Sub-Saharan Africa. Here something interesting picked up along the way:
"Sub-Saharan Africa finds itself in a demographic bind of a different sort. Its population is expected to quadruple to 4 billion people by 2100, with Nigeria overtaking America as the world’s third most populous country. There is much excitement at the prospect of youth burgeoning as the old world shrinks. Tanzanian President John Magufuli has claimed he sees no need for birth control, insisting a high fertility rate will boost his country’s economy. Sadly, he may be mistaken. The great leaps forward made by the Asian Tiger economies came from the so-called ‘demographic dividend�: of rapid growth in working-age populations, enabling those countries to grow fast and invest, followed by sharp subsequent falls in the birth rate which boosted the skills base, because parents with fewer children could invest more in educating each one."
Key Insights:
- Currently most underrated, one of the most important keys to ageing well are maintaining quality relationships and overall social capital.
- Contrary to popular belief, you are never too old to learn (there are strong learners in every age group) - we now know that there are solid things you can do to maintain your brain plasticity well into old age, chiefly by continuously challenging your brain with activities requiring an intense focus; for example, two areas where there has been robust research are learning a foreign language and playing a musical instrument.
- A higher level of education can help maintain brain plasticity and in turn help starve off degenerative cognitive disease for longer: "This doesn’t mean a professor can’t get Alzheimer’s, but it does suggest that brains which are plastic may be able to re-order themselves to resist its ravages for longer. Studies have suggested that people with higher cognitive reserve may be better at staving off Parkinson’s disease and stroke, as well as dementia."
- The main tenets of ageing well on an individual level are: stay active (notably focusing on the four aspects of fitness: strength, stamina, suppleness and skill), retain your sense of purpose and connect with people, next to nutrition (I quote: "A good basic rule is that what’s good for the heart is generally good for the brain. That means eating oodles of vegetables and fruit, plenty of fibre and avoiding processed foods as much as possible.), limiting stress which includes getting enough sleep, and avoiding excessive pollution, from environmental factors as well as consumption-based ones (e.g. smoking, drinking, etc.).
- Two of the most prominent predictors of old age enjoyed in good health on a population scale are, unfortunately, level of education and (unsurprisingly) income level - if you think about it, it ties into all aspects mentioned above.
- Current retirement ages cannot be sustained: "If current trends continue, some of us living in Europe, parts of Asia and North America could spend a quarter of our lives retired. That is crazy. (...) In 1950, average male life expectancy at 65 was 12 years. By the time we were looking at it, in 2003, it was 20 years. Life expectancy at 65 could be another 35 years by the time we reach mid-century. We should have started increasing the pension age years before.�"Longevity economists Andrew Mason and Ronald Lee have calculated that if people in the ‘older countries�, like Germany, Japan and Spain, were to delay retirement by 2.5 years per decade between 2010 and 2050, that would be sufficient to offset the economic effects of demographic changes.
- The housing crisis and a lack of communities for the elderly are two sides of the same coin; many older people would prefer to move out of their larger homes, however we lack affordable and attractive spaces imbued with a sense of community - "If we could build better housing for older people, we could free up much-needed space for younger ones"
- The dire state of long-term care services (not to be confused with healthcare services), I really had no idea just how bad it was; the book looks at social insurance schemes as pioneered in Germany and Japan.
- Interestingly, your chance of dying stops increasing on a year-by-year basis after age 105 (whether you want to get to that age is an entirely different question...).
The book doesn't fail to pose some tough questions:
Do we truly need anti-ageing research for the well-off, in a world still plagued by TB and malaria?
Do we set the wrong incentives by making access to prescription drugs easier, while keeping steep pay-walls in place for prophylactic maintenance like gyms, physiotherapy, and quality nutrition?
If high earners are set to become much older than the average person, and on top of that receive much higher pension payments for longer, should we introduce corrective measures to ease the tax burden on current generations and maintain a level of fairness compared to blue collar workers?
Great Success Stories mentioned that I don't want to spoiler and cannot paste without making this review even more tediously long:
the Geisinger health centre in Shamokin, Pennsylvania and their Fresh Food Farmacy - Southwark Circle in South London - the Village in Boston - retirement villages in Australia and the US - Germany's multi-generation homes (Mehrgenerationenhäuser) with grandparent service - HomeShare in Australia - Humanitas Deventer in the Netherlands (the latter two are thriving co-housing initiatives between pensioners and students) - Buurtzorg in the Netherlands as an improved concept to conventional care services - the Friendship Benches of Zimbabwe
Favourite Quotes:
What if, instead of defining people by how many birthdays they’ve enjoyed, we define them by how many years they have left? Obviously, that’s hypothetical. None of us can know individually when we will meet our end. But we do know the average. And if we apply that average, things look different. If we defined old age as having 15 years or less left to live, we wouldn’t call many baby boomers ‘old� until they hit 74. Up to that point they’d be middle-aged.
People who have climbed every ladder life presented, bravely meeting challenges along the way, suddenly find themselves with no more rungs to climb and no compass. What is supposed to be a pleasant time of life can be quietly traumatic. That is why I feel so strongly that older people should not be made to give up work and that we must challenge the narrative of ‘golden� early retirement.
Extra Time has given us an entirely new stage of life: the stage of the ‘Young-Old�. We need to catch up with this new reality, stop lumping everyone from 60 to 100 together, and accept that it is normal to be vibrant and capable in your seventies.
On the importance of staying active: Lazarus is not just a biking fanatic, he is also emeritus professor at King’s College London, where he has co-authored a study into amateur endurance cyclists like himself. The older cyclists in the study � aged between 55 and 79 � were found to have similar immune systems, strength, muscle mass and cholesterol levels as those who were only in their twenties. The King’s researchers believe that endurance sports, including cycling, swimming and running, may protect the immune system by boosting the number of T-cells in our blood. These protective white blood cells are thought to decline by about 2 per cent a year from our twenties onwards, making us gradually more susceptible to infections and conditions like rheumatoid arthritis. But the older endurance cyclists had almost as many T-cells as 20-year-olds � a protective effect that no medicine yet invented can provide.
and
Stunning results have been seen in an otherwise normal group of American septuagenarians who started running when it became fashionable during the 1970s, and stayed hooked. Over the next 50 years some went on jogging, others took up cycling or swimming or working out, but they did it regularly � and as a hobby, not to compete. To the amazement of the researchers, the muscle strength of these seventy-somethings was almost indistinguishable from 25-year-olds, with as many capillaries and enzymes. Their aerobic capacity was 40 per cent higher than people of their age who were not regular exercisers. The researchers at Ball State University, Indiana, concluded this made both the men and the women biologically 30 years younger than their chronological age.
According to the Harvard Business Review (HBR), older entrepreneurs actually have a much higher success rate than younger ones. The average age of founders of the highest-growth start-ups in the US is now 45, which rises to 47 if you remove social media but keep biotech.
Many ambitious people have their feet clamped so hard on the career accelerator that they have too little time for their families in their thirties, only to get spat out at 60 when they’ve still got plenty of energy and their children don’t need them any more.
When ageing is thought to be immutable, it creates an unusual hurdle for scientists trying to bring anti-ageing drugs to market. Regulators will only license drugs which target defined diseases. Ageing itself is not defined as a disease, because regulators do not think of ageing as something which is treatable, let alone curable. However this makes it difficult to persuade pharmaceutical companies to invest, as they may not get a licence to sell their inventions.
‘We need to shuffle the pack and get younger people into the larger homes, and older people into lovely, purpose-built accommodation without stairs,� says Lord Richard Best, social housing expert and former chair of Hanover Housing Association. ‘In England, 4.2 million pensioners own properties with two bedrooms they don’t use. If just 2 per cent of them moved out, this could free up 85,000 homes for families who need houses with gardens. Do that every year for ten years and we could house 4 million people!�
(...)legendary work done in one nursing home by the psychologists Ellen Langer and Judith Rodin. The residents were each given a houseplant for their room. Half were told a nurse would look after it, the other half were told they were responsible for it. The improvements in mental and physical wellbeing of the second group were so considerable that, 18 months later, they were only half as likely as the first group to have died.
Taken together, this means that many rich countries are now at a point when ‘an unprecedented claim on economic resources by the oldest generation� is said to be ‘threatening the social contract between the generations and prospects for continued economic growth�.
Throughout history, transfers have flowed downwards, from old to young. But population ageing has led to a steady decrease in the strength of this downward pattern. In Japan, Germany, Austria, Slovenia and Hungary, rich nations with some of the oldest populations, Lee and Mason find that the direction of transfers has been reversed, probably for the first time in history. This means that current generations are now claiming the resources of future generations. (...)
Many people who have worked hard and paid taxes believe they are entitled to ‘take out� what they’ve ‘paid in�. Unfortunately, it’s not quite that simple. In pay-as-you-go welfare systems, today’s workers don’t put their taxes into a pot labelled with their name, waiting to be retrieved when they need it. Their taxes are paying the benefits of today’s retirees. UK national insurance contributions and US payroll taxes are invested in government bonds, whose value depends on the ability of future taxpayers to service them. The problem is that baby boomers are set to take out considerably more than they ever paid in, partly by just living longer.
Further reading on the topics of ageing, health span vs. life span and the factors impacting both:
How Not to Age: The Scientific Approach to Getting Healthier as You Get Older
The Village Effect
Why We Sleep: Unlocking the Power of Sleep and Dreams (I'll never not recommend this one)
Extreme Measures: Finding a Better Path to the End of Life
Aging with Grace: What the Nun Study Teaches Us About Leading Longer, Healthier, and More Meaningful Lives
The Obesity Code: Unlocking the Secrets of Weight Loss
Fiber Fueled: The Plant-Based Gut Health Program for Losing Weight, Restoring Your Health, and Optimizing Your Microbiome
[German] Wechselhafte Jahre - Schriftstellerinnen übers Älterwerden ...more
A factor in my book ratings is, among else, the number of highlights I have made in a book by the time I finish it, and here we stand at a staggering 216 highlights over de facto 221 pages. The book is YELLOW, so here we go.
The book is doing an excellent job at touching on a vast array of aspects around the fact that collectively, we keep First off, I have overdone it with the quotes in this one. I sincerely apologise - there was no way around it.
A factor in my book ratings is, among else, the number of highlights I have made in a book by the time I finish it, and here we stand at a staggering 216 highlights over de facto 221 pages. The book is YELLOW, so here we go.
The book is doing an excellent job at touching on a vast array of aspects around the fact that collectively, we keep getting older (and oftentimes remain in better health along the way). It answers questions such as:
- How did life expectancy increase in the first place, and by what means will we increase it in the future?
- What are the implications of an ageing population on our national pension systems and the generational contracts in place in many countries?
- What are starting points to defuse the demographic time bomb? How do we secure a liveable old age for an increasing number of increasingly old people without compromising the future of the young by bankrupting them?
- What can people do to increase their health span, next to their life span? (Some of those sports facts amazed me! See down below in the quotes)
- What does the latest research around brain plasticity and neurogenesis tell us about maintaining or even advancing our mental capacities as we age?
- What is the current state of gene research and what does it tell us about ageing (chronological vs. biological age)? How does systemic inflammation tie into that last miserable stretch of our lifespan that we hope to shorten, or ideally, avoid entirely?
- How can advances in AI and Machine Learning help us age better rather than just live longer?
- How do current regulations to the pharmaceutical industry hinder bringing effective anti-ageing drugs to market, and how can we better support ongoing research?
- How does our modern social context contribute to ageing, and what novel concepts are introduced to mitigate negative effects? (loved that part!)
Content Highlights:
- The best part has to be the thoroughly encouraging tone of the book: retired people have a world to offer to their communities, we just need to come up with good concepts to scale it; ageing is not a linear process and a lot of how old age plays out can lie in our hands; retirement doesn't have to be bleak, and there are powerful ways to organise to create the spaces needed for communities to flourish. It's a book that doesn't just lament the problem but suggests actual solutions.
- You truly get a 360 degree perspective on every aspect of Extra Time; we touch on health and lifestyle, economics, politics, society, science and technology. I was amazed at how much oomph can fit into just over 200 pages.
- The author does a great job at looking at successfully and less successfully aging populations around the globe; next to the obvious choices of the US and the UK, we get a glimpse into success concepts around handling the problem of ageing societies in Japan, China, Germany, the Netherlands and Italy and Sub-Saharan Africa. Here something interesting picked up along the way:
"Sub-Saharan Africa finds itself in a demographic bind of a different sort. Its population is expected to quadruple to 4 billion people by 2100, with Nigeria overtaking America as the world’s third most populous country. There is much excitement at the prospect of youth burgeoning as the old world shrinks. Tanzanian President John Magufuli has claimed he sees no need for birth control, insisting a high fertility rate will boost his country’s economy. Sadly, he may be mistaken. The great leaps forward made by the Asian Tiger economies came from the so-called ‘demographic dividend�: of rapid growth in working-age populations, enabling those countries to grow fast and invest, followed by sharp subsequent falls in the birth rate which boosted the skills base, because parents with fewer children could invest more in educating each one."
Key Insights:
- Currently most underrated, one of the most important keys to ageing well are maintaining quality relationships and overall social capital.
- Contrary to popular belief, you are never too old to learn (there are strong learners in every age group) - we now know that there are solid things you can do to maintain your brain plasticity well into old age, chiefly by continuously challenging your brain with activities requiring an intense focus; for example, two areas where there has been robust research are learning a foreign language and playing a musical instrument.
- A higher level of education can help maintain brain plasticity and in turn help starve off degenerative cognitive disease for longer: "This doesn’t mean a professor can’t get Alzheimer’s, but it does suggest that brains which are plastic may be able to re-order themselves to resist its ravages for longer. Studies have suggested that people with higher cognitive reserve may be better at staving off Parkinson’s disease and stroke, as well as dementia."
- The main tenets of ageing well on an individual level are: stay active (notably focusing on the four aspects of fitness: strength, stamina, suppleness and skill), retain your sense of purpose and connect with people, next to nutrition (I quote: "A good basic rule is that what’s good for the heart is generally good for the brain. That means eating oodles of vegetables and fruit, plenty of fibre and avoiding processed foods as much as possible.), limiting stress which includes getting enough sleep, and avoiding excessive pollution, from environmental factors as well as consumption-based ones (e.g. smoking, drinking, etc.).
- Two of the most prominent predictors of old age enjoyed in good health on a population scale are, unfortunately, level of education and (unsurprisingly) income level - if you think about it, it ties into all aspects mentioned above.
- Current retirement ages cannot be sustained: "If current trends continue, some of us living in Europe, parts of Asia and North America could spend a quarter of our lives retired. That is crazy. (...) In 1950, average male life expectancy at 65 was 12 years. By the time we were looking at it, in 2003, it was 20 years. Life expectancy at 65 could be another 35 years by the time we reach mid-century. We should have started increasing the pension age years before.�"Longevity economists Andrew Mason and Ronald Lee have calculated that if people in the ‘older countries�, like Germany, Japan and Spain, were to delay retirement by 2.5 years per decade between 2010 and 2050, that would be sufficient to offset the economic effects of demographic changes.
- The housing crisis and a lack of communities for the elderly are two sides of the same coin; many older people would prefer to move out of their larger homes, however we lack affordable and attractive spaces imbued with a sense of community - "If we could build better housing for older people, we could free up much-needed space for younger ones"
- The dire state of long-term care services (not to be confused with healthcare services), I really had no idea just how bad it was; the book looks at social insurance schemes as pioneered in Germany and Japan.
- Interestingly, your chance of dying stops increasing on a year-by-year basis after age 105 (whether you want to get to that age is an entirely different question...).
The book doesn't fail to pose some tough questions:
Do we truly need anti-ageing research for the well-off, in a world still plagued by TB and malaria?
Do we set the wrong incentives by making access to prescription drugs easier, while keeping steep pay-walls in place for prophylactic maintenance like gyms, physiotherapy, and quality nutrition?
If high earners are set to become much older than the average person, and on top of that receive much higher pension payments for longer, should we introduce corrective measures to ease the tax burden on current generations and maintain a level of fairness compared to blue collar workers?
Great Success Stories mentioned that I don't want to spoiler and cannot paste without making this review even more tediously long:
the Geisinger health centre in Shamokin, Pennsylvania and their Fresh Food Farmacy - Southwark Circle in South London - the Village in Boston - retirement villages in Australia and the US - Germany's multi-generation homes (Mehrgenerationenhäuser) with grandparent service - HomeShare in Australia - Humanitas Deventer in the Netherlands (the latter two are thriving co-housing initiatives between pensioners and students) - Buurtzorg in the Netherlands as an improved concept to conventional care services - the Friendship Benches of Zimbabwe
Favourite Quotes:
What if, instead of defining people by how many birthdays they’ve enjoyed, we define them by how many years they have left? Obviously, that’s hypothetical. None of us can know individually when we will meet our end. But we do know the average. And if we apply that average, things look different. If we defined old age as having 15 years or less left to live, we wouldn’t call many baby boomers ‘old� until they hit 74. Up to that point they’d be middle-aged.
People who have climbed every ladder life presented, bravely meeting challenges along the way, suddenly find themselves with no more rungs to climb and no compass. What is supposed to be a pleasant time of life can be quietly traumatic. That is why I feel so strongly that older people should not be made to give up work and that we must challenge the narrative of ‘golden� early retirement.
Extra Time has given us an entirely new stage of life: the stage of the ‘Young-Old�. We need to catch up with this new reality, stop lumping everyone from 60 to 100 together, and accept that it is normal to be vibrant and capable in your seventies.
On the importance of staying active: Lazarus is not just a biking fanatic, he is also emeritus professor at King’s College London, where he has co-authored a study into amateur endurance cyclists like himself. The older cyclists in the study � aged between 55 and 79 � were found to have similar immune systems, strength, muscle mass and cholesterol levels as those who were only in their twenties. The King’s researchers believe that endurance sports, including cycling, swimming and running, may protect the immune system by boosting the number of T-cells in our blood. These protective white blood cells are thought to decline by about 2 per cent a year from our twenties onwards, making us gradually more susceptible to infections and conditions like rheumatoid arthritis. But the older endurance cyclists had almost as many T-cells as 20-year-olds � a protective effect that no medicine yet invented can provide.
and
Stunning results have been seen in an otherwise normal group of American septuagenarians who started running when it became fashionable during the 1970s, and stayed hooked. Over the next 50 years some went on jogging, others took up cycling or swimming or working out, but they did it regularly � and as a hobby, not to compete. To the amazement of the researchers, the muscle strength of these seventy-somethings was almost indistinguishable from 25-year-olds, with as many capillaries and enzymes. Their aerobic capacity was 40 per cent higher than people of their age who were not regular exercisers. The researchers at Ball State University, Indiana, concluded this made both the men and the women biologically 30 years younger than their chronological age.
According to the Harvard Business Review (HBR), older entrepreneurs actually have a much higher success rate than younger ones. The average age of founders of the highest-growth start-ups in the US is now 45, which rises to 47 if you remove social media but keep biotech.
Many ambitious people have their feet clamped so hard on the career accelerator that they have too little time for their families in their thirties, only to get spat out at 60 when they’ve still got plenty of energy and their children don’t need them any more.
When ageing is thought to be immutable, it creates an unusual hurdle for scientists trying to bring anti-ageing drugs to market. Regulators will only license drugs which target defined diseases. Ageing itself is not defined as a disease, because regulators do not think of ageing as something which is treatable, let alone curable. However this makes it difficult to persuade pharmaceutical companies to invest, as they may not get a licence to sell their inventions.
‘We need to shuffle the pack and get younger people into the larger homes, and older people into lovely, purpose-built accommodation without stairs,� says Lord Richard Best, social housing expert and former chair of Hanover Housing Association. ‘In England, 4.2 million pensioners own properties with two bedrooms they don’t use. If just 2 per cent of them moved out, this could free up 85,000 homes for families who need houses with gardens. Do that every year for ten years and we could house 4 million people!�
(...)legendary work done in one nursing home by the psychologists Ellen Langer and Judith Rodin. The residents were each given a houseplant for their room. Half were told a nurse would look after it, the other half were told they were responsible for it. The improvements in mental and physical wellbeing of the second group were so considerable that, 18 months later, they were only half as likely as the first group to have died.
Taken together, this means that many rich countries are now at a point when ‘an unprecedented claim on economic resources by the oldest generation� is said to be ‘threatening the social contract between the generations and prospects for continued economic growth�.
Throughout history, transfers have flowed downwards, from old to young. But population ageing has led to a steady decrease in the strength of this downward pattern. In Japan, Germany, Austria, Slovenia and Hungary, rich nations with some of the oldest populations, Lee and Mason find that the direction of transfers has been reversed, probably for the first time in history. This means that current generations are now claiming the resources of future generations. (...)
Many people who have worked hard and paid taxes believe they are entitled to ‘take out� what they’ve ‘paid in�. Unfortunately, it’s not quite that simple. In pay-as-you-go welfare systems, today’s workers don’t put their taxes into a pot labelled with their name, waiting to be retrieved when they need it. Their taxes are paying the benefits of today’s retirees. UK national insurance contributions and US payroll taxes are invested in government bonds, whose value depends on the ability of future taxpayers to service them. The problem is that baby boomers are set to take out considerably more than they ever paid in, partly by just living longer.
Further reading on the topics of ageing, health span vs. life span and the factors impacting both:
How Not to Age: The Scientific Approach to Getting Healthier as You Get Older
The Village Effect
Why We Sleep: Unlocking the Power of Sleep and Dreams (I'll never not recommend this one)
Extreme Measures: Finding a Better Path to the End of Life
Aging with Grace: What the Nun Study Teaches Us About Leading Longer, Healthier, and More Meaningful Lives
The Obesity Code: Unlocking the Secrets of Weight Loss
Fiber Fueled: The Plant-Based Gut Health Program for Losing Weight, Restoring Your Health, and Optimizing Your Microbiome
[German] Wechselhafte Jahre - Schriftstellerinnen übers Älterwerden ...more