No matter how you slice it, the U.S. population is aging. But we’re not getting old the way we used to. Thanks to remarkable breakthroughs in medicine, public health and technology, the bodies we bring to the last third of our lives are dramatically different from those of the generations that have gone before.
Unlike our ancestors, our grandparents and even, in some cases, our parents, people growing older today can reasonably expect to go to their graves with their eyesight and their teeth. They will retain their mobility longer and will likely even look younger.
Here’s a closer look at five ways in which we’re becoming a nation of younger feeling (and looking) oldsters.
Before surgical interventions, there was little relief for people aging with the crippling pain of joint diseases such as osteoarthritis. They were often advised to seek temperate climates and were sold oils, tinctures, rubs and liniments, which may have somewhat eased the symptoms.
“It hurt to move, so they didn’t move,” said Dr. James Pacala, a geriatrician who heads the Department of Family Medicine and Community Health at the University of Minnesota.
“They needed wheelchairs and crutches and were at a high fall risk. They couldn’t drive and had to rely on caregivers. You had a whole family involved with this one problem.”
That’s why Pacala considers it a “game changer” to “simultaneously be able to eliminate someone’s pain and improve their mobility almost immediately.”
First performed in the 1960s, total knee and hip replacements are now among the most common elective surgeries. A 2014 Mayo Clinic study found that 4.7 million Americans have had knee implants and 2.5 million had undergone hip arthroplasty.
According to the American Academy of Orthopedic Surgeons, these replacement surgeries are projected to grow by 189% by 2030.
“These operations have been perfected and are now being done in surgical centers or on an outpatient basis rather than with a hospital stay,” Pacala said.
“The rehab techniques for recovery have also improved.”
Those improvements help restore the quality of life and independence for the patient as well as caregivers.
Throughout history, those lucky enough to live a long life often did so with some loss of vision.
While cataracts, a natural part of the aging process, are still the leading cause of blindness among older adults, cataract removal preserves the sight of millions. In fact, it’s become the most frequently performed surgical procedure in the Western world.
Early indications of cataracts arrive in middle age, when the eye’s clear lens begins to thicken and cloud. Bifocals and reading glasses help initially, but for some, blurry vision and difficulty seeing in low light causes problems with driving and reading. That can be followed by decreased visual acuity, when colors dim.
“By age 65 to 70, everyone has some degree of this. There’s no way to avoid it,” said ophthalmologist Dr. Joshua Hou, assistant professor in the Department of Ophthalmology and Visual Neurosciences at the U’s Medical School.
The first documented case of cataract removal was in India in the fifth century, a brutal business that used needles to push the cloudy lens off the pupil. The modern version of the surgery didn’t begin until 1949, when a British doctor implanted the first corrective plastic lens after removing the cataract. Recovery was taxing, though.
“When I was a medical student in the late ’70s, patients were still hospitalized and laid on their backs for two to three weeks after cataract surgery,” said Dr. Erik Van Kuijk, professor and chairman of the Department of Ophthalmology and Visual Neurosciences at the U.
“Now we do surgeries in five to 10 minutes and the success rate is 99 percent. Patients go back to work the next day seeing better than they have in years. Their most frequent comment is, ‘I wish I would have done this sooner.’ ”
Added Hou: “When the surgery was more invasive and the risk was higher, we waited until the patient was debilitated. Now we offer it as soon as they feel their vision is impaired.”
When Dr. Stephen Shuman graduated from dental school in 1982, it was not unusual to see older patients with extensive tooth loss. Not now.
“In my teaching clinic we routinely care for patients in their 80s and 90s with a mouthful of teeth — their own — and with crowns, bridgework, implants,” said Shuman, associate professor at the U’s School of Dentistry and director of the Oral Health Services for Older Adults program.
These days, Shuman’s patients — even his older ones — have benefited from a revolution in dentistry that occurred in their lifetime: fluoridation of public drinking water, which became the official policy of the U.S. Public Health Service in 1951, and was widespread by the 1960s. It’s credited with reducing decay, a major cause of tooth loss.
There’s also been a significant shift in how we care for our teeth.
“Social norms evolved with advances in oral hygiene. Previous generations did not brush a couple of times a day or see the dentist for routine checkups and preventative care,” he said. “They went to the dentist when they were suffering and there wasn’t much to do but extraction.”
New techniques and technologies have improved crowns and implants. Innovations in pain management have made a trip to the dentist easier to endure.
“Anesthetics got better and safer,” Shuman said. “When the discomfort was not well managed and people were holding onto the sides of the dental chair, they wouldn’t come in and use the services.”
Into the 1960s and ’70s, smoking and “laying out in the sun” (often wearing only a bathing suit and baby oil) were popular activities. At the time, there was little persuasive evidence that sun exposure and smoking accelerated aging of the skin.
But as research accumulated, public policies changed, as did the conventional wisdom about protecting our skin.
Early sunscreens (including those developed during World War II to block ultraviolet radiation for U.S. servicemen in the Pacific) evolved. By the 1970s, commercial sunscreens hit the market. They’ve been improving ever since.
There are now water-resistant sunscreens and longer-lasting, broader-spectrum lotions, gels, foams, creams and sprays. Many over-the-counter moisturizers and makeup products regularly include sunscreens. And sun-protective clothing is growing in popularity.
Meanwhile, the dramatic drop in the rate of smoking has benefited our skin as well as hearts and lungs. When the surgeon general concluded that smoking causes cancer and heart disease in 1964, 45% of Americans smoked. By 2017 that number had fallen to 14%. One side effect of quitting (or never taking up the habit) is fewer accumulated wrinkles.
“Chronic exposure to nicotine shrinks blood vessels — and blood vessels nourish the body, including skin — which accelerates sagging,” said Dr. Ed Szachowicz, an Edina facial plastic surgeon. “The act of smoking, the repeated pursing of the lips, accelerates those lines around the mouth. Smoke has a toxic effect on the skin, as you exhale and it surrounds the face.”
Now that rigid rules about who could wear what and when have largely disappeared, our clothing choices no longer signify our age.
“House dresses are a thing of the past,” said Kelly Gage, who taught the history of fashion at St. Catherine University in St. Paul.
Instead, yoga pants have become the go-to “leisure wear for hanging out at home.”
The change has been gradual but dramatic.
“Historically, there were even cultural norms about how women of certain ages could wear their hair, what was appropriate for maidens or matrons,” Gage said.
That’s long gone, as fashion has become more casual and “there’s more individuality for men and women and how they style themselves,” she said.
That includes footwear, as well.
Foot pain — bunions and hammertoes, fallen arches and tendinitis — affects one in four adults over 45. But that doesn’t mean aging adults have to strap on the boxy orthopedic shoes of yore.
“There’s so much knowledge about how shoe construction supports the foot, with heel placement and control of the pressure on the ball of the foot,” Gage said. “Shoes are designed in a way that considers the longevity of feet. They are comfortable and sturdy, but still attractive.”
Kevyn Burger is a Minneapolis-based freelance broadcaster and writer.