The 21st century is maturing and bringing with it miracles of the age: 5-G, Artificial Intelligence (AI), and an Internet of Things(IOT) network to name a few. Readers, as you may know, this is not a science blog. This is the world we will live in and we will soon be asked to adapt. How will 2018 changes impact us? What do these changes have to do with aging? What 2018 improvements will assist us in the years ahead? How do we make sense of it all and where will it lead? Some of these questions will be answered by time but let's look back at 2018 and see what we know right now.

We know that 2018 was marked by unprecedented change. We witnessed change in everything from tax law to President Trump's cabinet. Ongoing suspicions of Russian influence lurked constantly backstage and the stock market strained to adjust to leadership by tweet. Major world alliances were shaken and environmental protections rolled back. Blockchain became the disruptor of the year in tech, #metoo was the hot topic in boardrooms, and the first cannibis drug, Epidiolex, was approved for use by the FDA.  It was a year of tragic fires and another year of mass shootings986 people were shot by police in 2018. 52 officers died on duty. It was the worst year yet for school shootings. It was a rocky year that opened with a government shutdown and closed with a government shutdown. In other words, much of 2018 was volatile and full of uncertainty.

One way to make sense of volatility and uncertainty, such as we experienced last year, is to turn to the past for reference. Despite all in 2018 that wasn't the same as it once was history still repeats itself and Americans found themselves in a similar situation roughly 100 years ago--- nearly 2 decades into the 20th century. Read the Wikipedia summary of social issues and changes that people faced in 1920, below, and ask yourself...does this sound familiar?

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My summary from Wikipedia:

A variety of social issues rose amidst a rapidly changing world. People differed on what was acceptable or respectable and debated what ought to be made illegal. Differences boiled down to demographics: urbanites and rural communities diverged in the way they perceived life and values. People in the 1920's witnessed the miracle of automobiles, made possible by the adoption of assembly lines, and facilitating public movement across this great country. They marveled at radio, refrigeration, and all matter of household devices made possible by electric energy. The dawn of airlines began to connect the world in contrast to isolationism, xenophobia, and nativism that rose in the US. The National Origins Act of 1924 set quotas on immigration and limited the countries of origin an immigrant could be from.  

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Does that ring a bell? In 2018 we could clearly see the coming of similar struggle and major transformation. Replace 'automobiles' with 'self driving cars' and 'airlines' with 'commercial space flight' or substitute 'quantum computing,' '5-G' or 'wireless advancements' for 'electric energy' and you've got text written about today.  It was hard to see where the world was going in 1918 because people were blinded by WW1, which had just ended, and staggered by the Spanish flu pandemic that followed. In addition to that tragedy however, history shows us that Americans experienced growth, discovery, and new freedoms in the years that followed. Cole Porter captures that mood in the song, "Anything Goes."  We too are preoccupied with the present and not fully aware of the amazing potential immediately ahead. Like Americans of 1918 we too will have the choice of how to adapt to the coming years and whether to embrace the changes but we cannot turn back the technology that will shape our future nor shirk from the democratic debates that will determine our humanity.

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You may be surprised that our lifespan in 2018 was just 78 years of age. We talk so much about living longer and the commonplace of turning 100. In fact, our lifespans today are nearly double what they were in 1918 in part because the Great Influenza of 1918. It sickened 25% of America creating hysteria, confounding medicine, and rapidly killing millions of people in the US and worldwide. Today flu and other viruses continue to remain aggressive and elusive warranting all the caution and medical sophistication we employ. That concern fueled millions of dollars spent in 2018 seeking new antibiotics and the fast tracked FDA approval for Xofluza, a pill that can reduce the duration of flu in healthy patients. Xofluza, the first flu medicine in 20 years, is just one of today's medical advances and, amazing as they are, they present new questions: How will we use genetic discoveries? Will we continue to improve care for advancing age? Will we have choice over chips, sensors, and injectables? Can we make the miracle of new medicine available to all?  How long we live will be decided in part by how well we manage our health and health care systems. That debate raged in 2018.

Many people believe longer lives are a benefit only if we maintain acceptable health and a sense of meaning. New technology can support that or aggravate our loneliness. 5G, the fastest connectivity speed yet and much more, was widely developed in 2018 and will move more Internet of Things (IOT) applications and Artificial Intelligence (AI) processes from the lab to mainstream. Among those applications are faster video and facetime/skype connections to improve our ability to talk with family and smart home advances to facilitate Aging in PlaceRemote sensoring and wearable medical devices will help our family and physicians monitor vital signs and may eventually enable widespread remote surgery. One hope is to use robotic caregiving to support the wave of boomers in later years. The hurdle, as you can imagine, is acceptance and whether or not it improves a sense of meaning and wellness.  Though we're far away from the technology in the clip, below, from Blade Runner 2049, it demonstrates the alluring hope we place on replacing human companions with AI/Robotics and the distance between an artificial companion and reality where loneliness resides. In the scene, Officer K has just given his AI companion an enhancement that allows her to be mobile and experience sensation.

 

2018 advances will give us even greater freedom than the dawn of cars and planes a century ago. They will facilitate travel and action irrespective of our skill level or mobility through the use of smart technology, voice activated devices, and self driving cars. No longer will we need to be able to drive or call for a car to reach family and friends and we can ask our smart devices to turn on things that we can't reach perhaps even things we can't remember. But how costly will this ease become? Can we make it work for those of us that lost our pensions, that went bankrupt trying to afford medicine or long term care, or that worked a life of service and have only modest means? The decisions are ours. We're the leaders. 72 year old Donald Trump is our president, 78 year old Nancy Pelosi is our house leader and 76 year old Mitch McConnell heads the Senate. Much has been said about the young, diverse (and more female than ever) congressional freshmen/women we elected at midterms but 50% of congress is still over 65 years of age! What will our leaders decide? Will you and I step forward with ideas or activism to lead the nation into providing more innovative and compassionate eldercare? 

Henry David Thoreau said in Walden, " Turn the old; return to them. Things do not change; we change." In 2018, we struggled with the volatility and uncertainty inherent in that tension between old and new. How will we resolve those tensions? Here, on the threshold of profound social and technical transformation how will we change? We can see already that medical advances will likely lengthen our life span and offer new cures. We hope technology can free us from many of the limitations of aging. History tells us that new ease from technology will outweigh the conflicts we're experiencing as we approach 21st century transformations. In Anything Goes, above, Ethel Merman, sings, "The world is topsy turvy, non-conventional, technicolor, high potentional but love love love is here to stay." This year, let's resolve to love one another better and to talk respectfully face to face as we debate the pressing questions of our day. Let's turn to our friends as we deliberate how change impacts us as individuals and how we'll shape change in our nation. Happy New Year, dear reader!