 Excellent. Well welcome. We take our inspiration for this session from the great philosopher Woody Allen who said, I don't want to achieve immortality through my work. I want to achieve it by not dying. I think after three or four days of eating this much, talking this much, sleeping this little, we may all feel like we have lived to be 150 by the end of Davos. But in fact, we are going to talk about the reality in the medium, near medium long term of an exponential increase in life expectancy and the implications for that on just about everything, not just obviously on health and medicine, but on economics, on politics, on how we live and love and play. And so I apologize for the fact that all of us have our backs to some of you, but I do like the fact that we are sitting in a circle because I'm very eager to hear what all of you think, because this is an experience that we are not just studying and we're very lucky to have a great deal of expertise here with us. But this is an experience that we are living and that our children in particular will be living. And so with that, I would like to introduce this group, which I'm very honored when I was asked how I came, what expertise I bring to this topic. The answer is none other than my curiosity. This is a topic, though, at time that we have written about frequently because we find that our audience, both in the U.S. and globally, is aware that really transformational change is upon us. So here to explore that, Nobel Laureate Dr. Lisbeth Blackburn, who is the, heads the Jonas Salk Institute of Biological Studies in La Jolla, and Linda Gratton, an author and advisor and professor at London Business School, Derek Yach, who is the chief health officer at the Vitality Institute and Tom DeRosa, the CEO of Welltower. So between the four of them, we have a mix of experience and expertise in health and in medicine, in the economics and the social and the educational implications of increased longevity. But before we dive in, so take a look and log on at wef.chvote and let us see what you think if you had a common life expectancy of 150 years. What do you expect? You can vote for more than one thing. I'm going to give you a minute to do this, and then I will not only show the results in the room, but we also, we posted a version of this poll on time.com some days ago, so we have a public sampling of how people at large view this question. Okay, can we see the results from the room? Wow. Okay, so marriage, which I think we can confidently say was not designed to last 125 years. I am in favor of marriage, and I am working towards that goal, but retirement would last at least 100 years. Okay, let's see. I'm interested in how this compares with the public response. Very similar, very similar. Okay, that's interesting, which suggests that this group, which I suspect has more occasion to be thinking about these issues, is very much attuned to where the public is on this. So I'd like to start, Dr. Blackburn, if you could walk us through the developments that you are seeing and that you're most excited about and intrigued by on the medical front from Telomere's extension and growing replacement organs and stem cell therapies, and give us the lay of the land medically about what is likely to take us to this great increase in life expectancy. Well, if we look at how long humans have actually lived, I think the longest living is about 120 plus years, and so we talked about 150 years, which is not really that different. So we're not talking about something that's ridiculously ambitious or unrealistic or overly visionary. And I think what's most important is how we get there and the manner in which the human life will be lived out in order to get there. So if we're living there, let's say we, to that point, 150, let's say how did we get there? What will have happened to make us, let's say, commonly live to 150 or 125, not much difference? I think what will have happened medically and scientifically will have been that there's been a real understanding that much of what is both attributed to aging as an inexorable process, the slow decline, the increase in heart disease, cancers, you know, dementias and so on, much of that will be recognized to be something that was avoidable and medical advances will be taking care of a lot of that. And what will be realized is that it's pretty programmed in our species to have a lifespan limitation. We see it all across the spectrum of different animals that there's a real genetic component in it. Sadly for all those researchers who are looking for that magic gene or two or three or four, it's not that. It's a system, it's a complex system. So it's not something that's going to lend itself to some wonderful magic pill that we just counteract certain genes, that'll be it. But we're understanding this complex system and that's the advances in the sciences. But to come back to this point about how we get there to the point where our, you know, shelf life so to speak expires because genetically, for whatever reasons, evolutionarily we happen to be programmed there. I think that we do understand so much of the decline in the health and well-being, in other words, the rise in diseases, often very comorbid, is happening in ways that really are modulatable. And I'll take, you know, the clear examples of cardiovascular diseases, a great example. It was clearly lifespan. Life's were limited. Sorry, it was lifestyle. There was a lot of lifestyle. There was a lot of eating of steaks and smoking and a whole lot of things which were quite modifiable. And now life expectancies are different because cardiovascular disease is being recognized. Now, in addition, I want to say that if you look at the people who do live very long lives and you look at centenarians who are becoming more and more frequent and then people who are living, you know, 110 plus, starting to really come up in numbers, it's very interesting to say, well, what are they dying of? They don't actually frequently die of. The common killers in the elderly population that limit our life expectancies, like cardiovascular disease, cancers, diabetes and so forth, that's not really what they commonly die of. They die of. They mystify their physicians because it's often some crisis that happens and then things go downhill. It looks like a system's failure. So this is quite interesting because it takes away, in some ways, to me, the dread of getting older. If you can live that kind of life and there will be processes of aging, but I think we'll be able to separate them out much better from the avoidable ones which make aging much more miserable. My 101-year-old mother-in-law was a very happy, lively individual until very recently. But the point is that you can have a high quality of life and there seems to be a real genetic component in there. So people who lived to 100 when they were asked by the physicians, large surveys, two reasons. Why did you live to be 100? They say people in my family also lived to be a very long time. That's genetics. And then they'll give every reason under the sun. So in other words, I'm eating bacon every day. I'm eating bacon every day. I'm smoking every day. I do exercise. I do no exercise. The point is that there's real genetic components to this, but unfortunately they're very, very complex to sort out. And I think the science is getting there. And then it'll be a matter of what can you tweak in this very complex system genetically to push the lifespan out longer. You can do it in worms, you can do it in flies, you can do it in little creatures that live for incredibly short times. We have a life expectancy of 80, maximum about 120 plus. We don't yet know what are the rate-limiting things that might let us push that out. And we shouldn't delude ourselves that we do, but I also think it's a solvable problem. And so really what we want to do is avoid the avoidable declines in health that make us miserable and often will kill us, such as the ones that need to cancer, diabetes, and so on. So you put your finger, I think, on the key that I don't think a lot of people are looking to extend old age. We're looking to extend youth and extend middle age and extend our productive years. And so I wonder if each of you would just touch on what you think the major implications of this prospect of extending not our elderly years, but our productive years across many more decades than we at least have assumed. Lynn, I'll start with you. Well, oddly enough, I and an economist called Andrew Scott asked the question three years ago of ourselves, what happens when everybody lives to 100? And that's been our main research actually for the last three years. And it's just absolutely fascinating. And I think you're right that the real question, Nancy, is how do you live a productive life? And what would a productive life look like? Well, here's we focus, we focus primarily on the working part of it, although actually relationships turn out to be really important as well. So here's the sort of top line on work. First thing, and we looked at 100. You see, we didn't look at 150 because we felt that was implausible. Maybe you feel it's not implausible. I think you probably think it is as well. But we stuck with 100. What happens if you live to 100? If you live to 100 and want to retire on 50% of your income, which most of us do, you're working until you're 79 until 82. Full stop. So that's the first thing to know. There's no way out of that. So, okay, well, let's imagine you're now working till you're 79. Well, what do you actually do? Well, the most obvious thing is you've got to work to make money. And that's about tangible assets. But it turns out that intangible assets come into play in a long life in a way that they really don't do in a short life. And we actually also looked at the scenarios around shorter lives, you know, what happens if you live to 60, 70, 80 and so on. And by intangible assets, we think primarily about the assets that help you to be productive and the assets that help you to have vitality. Now, productive assets are the skills that help you to carry on working because of clearly one of the marvelous things about the next 100 years is it's not just you are going to be working the whole world changes. And Davos is very much about this this year, you know, jobs disappear, new jobs appear. So it's obvious that if you're going to work until you're 80, then you're going to have to keep on learning. And we see a real shift from the notion of leisure and recreation into recreation. We also think that there's a whole set of new stages emerge. Last time, you know, life elongated, we saw the beginnings of teenagers and we saw the beginnings of old age pensioners. We think new stages will emerge. I mean, for example, the explorer. I mean, why would you want to start making all your big career decisions at 20 when you could explore and create more choices? We see individual producers becoming more important as a stage. I mean, why wouldn't you use all the technology we've described at Davos this year to build your own company? We think portfolios are going to be much more important. And that really then brings in a third asset intangible asset that we think is crucial. And that's about the capacity to change and to make transitions. And if you live for 60 years, you the three stage life education work retirement doesn't really have any major transitions because everybody's transitioning at the same time as you are. You're all in lockstep. But once you take lockstep away, then people are having to change in an individual path on their own. And suddenly the capacity to transform yourself becomes crucial. And that's to do with the sort of people you hang out with. It's to do with your social capital. It's to do with the people that you want to spend time with. And then, of course, the final point that I wanted to make is about relationships. I mean, would a marriage last that long? I have no idea. We've been talking to our MBA students at London Business School. We run a class now on living to 100. And we asked them to build their own scenarios. And by the way, they build all sorts of scenarios around relationships. Some people say, I will find the right person and I will live with them for the rest of my life. Some of them actually say I will divorce at 28 and I'll marry this sort of person and then at 35. It will be somewhere between that. But what's really clear is that in terms of the major restructuring of life that we believe is going to happen with regard to longevity, corporations are not prepared for this. Governments are not prepared for this and it will rest with the individual, both working on their own and collectively who will be the agents of change. So I expect to see, and we're certainly monitoring, some amazing experiments occurring over the next decade as people come to terms with what it really means to live 100 years. Yes? You know, I think if you try and project 50 to 100 years, we would make a terrible error if we only projected the question of our own personal aging without looking at what is going to happen in the broader environment. So there's some harsh realities. Massive demographic change continues. We're not just talking about aging. The population 50 to 100 years from now will be between 10 and 11 billion, of which an additional 3 billion will be African. Rising very fast or for low base with a relatively low level of wealth, a large proportion of older people will be concentrated in the three largest countries in the world at that time, India first, China and Nigeria. That's where we'll have the highest proportion of people aging. And they will have aged when the countries would not have yet achieved wealth, as happened in the OECD countries. That's one reality. Second, climate change, which this conference is also emphasizing, is not going to go away for the next 100 years. It's going to get steadily worse, even under the best scenario of everybody committing to the commitments that are being made, which means that the cities at the coast are going to be deluged and pretty miserable. Large parts of the world are going to be denuded of agricultural potential. And I could continue. So the older people and as we get older, we're going to be living in a very climate challenged world. That's a reality. The first thing we will see is continued epidemics of the kind of heat strokes we saw in Paris not so long ago. That'll become common, where the vulnerability of older people will be subject to large white parts as temperature extremes continue to happen. I've got some good news. I'm this close to saying it. So I think on the positive side, and I think Elizabeth is probably sitting with the tools in the technology side, where we're putting a lot of hope on technology, not just solving our ability to live full, complete and happy lives, but environments that will actually start tackling the consequences of climate change, that will have food systems that will feed the 10 billion people, so we won't have mass starvation. And I think the question is going to be what likelihood is it that the technology potential actually outrun some of the negative realities we've seen on population growth and the underlying political strife that that will begin to lead us to, which raises the fact that the decisions we make in the next 10 years or 15 years may be the most important, particularly the political and the ethical and the social decisions we make to actually protect the ability for older people to age into a society. We're actually going to be able to take full potential of the technologies. And I think when we continue the discussion we can see what is the balance likely of evidence that we starting to see a more broad-based approach to the global commons, values around the importance of addressing the inequalities that are deeply starting to schism our society. And I think that's going to really determine what it's going to be like to live 100 years from now. So Welltower is literally about living how we live and what it's like to live in in our advancing years right now. What have you learned and what are you watching most closely for Tom? Well I'm going to use a word that is often used here at endavas, which is sustainability. And I think that we need to be focused on the sustainability of the aging population and the aging body. And what is the key to sustainability of that population? It's wellness. And that's a word that's thrown around a lot. We really focus on making wellness the priority for the over 150,085 and up seniors that live in our communities. And when I talk about wellness I talk about first nutrition. It's very hard as you age and as we know most adults would say I want to age in place. And which means I want to age in the home that I raised my family in. And we challenge that because it's very difficult as you age to age in place. The first thing is nutrition is often compromised. One of the key issues that we were discussing earlier is safety. The traditional home. Our cities are not safe for an aging population. If you live in New York, think about how an 87-year-old navigates the public transportation system. It's impossible. There's no place to sit if you're waiting for a New York City bus. So the environment today is not safe for this aging population. We also need to keep people moving. This is something that we do. We're very focused on mobility. The body cannot go from a bed to the kitchen to a chair in front of a television and be able to maintain a state of vitality and health and wellbeing. We need to keep our bodies moving. And the last piece of this is cognition. We need to stay socially connected. And so as we age, if we become isolated, we have a huge problem. And this is something when I talk to the leaders of some of the major health systems in the U.S., for example, one of their most profitable activities are orthopedic procedures for an aging population. We all know that we may be living longer, but our bones age and as well as our minds and cognitive skills start to deteriorate. Most major hospitals are very good at replacing a hip for an 88-year-old widow. But when that 88-year-old widow arrives at that hospital without Alzheimer's disease, it becomes an unmanageable situation. So what we're trying to do is keep that population healthy so when they do have to go to the hospital, they arrive in a state in as productive a state as they possibly can. So that's what we're trying to do as a company is focus on maintaining this population well. That is the key, I think, at least in the near term, the medium term. Because with respect to cognitive disease, I think as we heard from Elizabeth, there's no magic bullet today. There's no drug therapy around the corner that's going to reverse dementias and Alzheimer's disease. So I'm grateful that you between you have touched on so many themes and there's so many different places we could go, but the obvious one when it comes especially to issues of inequality is already a huge one is in the near and medium term before new technologies become both more available and affordable. How are we going to pay for this period that we're in of greater life extension without necessarily extending productive years and so needing for a smaller younger population, working population to be supporting this growing aging population. I know there are already experiments I think in Singapore you're automatically signed up at 40 for long term care insurance unless you opt out. I'm wondering both what you think the government's role is going to have to be in creating an actual safety net and what you think what actions you think have to be taken in the private sector to to account for what we're going to be seeing. We we we hosting a series of meetings through the World Economic Forum through our Council on Aging looking at some of these issues. So not surprisingly the first meeting was held in Tokyo. We're interesting the the chief economist of the Prime Minister was very much engaged in this meeting because this is about the long term national survival. This is about how we're going to address national debt over the long term. How we're going to support entitlement programs. And I wish I could say that I've heard high levels of innovation beyond what is the obvious. The the step in the short term and the medium term for all developed countries must be to strengthen the entitlement programs and to ensure that they are financed over the next seventy five years. Something that a bipartisan group I'm pleased in the U.S. has actually risen up to challenge people in the upcoming elections to commit to regardless of their party. That is a must do. In some parts of the world where the current entitlement programs don't exist are rudimentary investing now before you start seeing the numbers of aging rising in starting to build that social security and government apparatus is an absolute must. And while doing it starting to talk about raising the retirement age is again going to be essential in every part of the world. In the private sector we're engaged in a big experiment in starting to develop life insurance. You may have heard of what many call life insurance but most of what's out there is death insurance. Life insurance should be encouraging longevity actively through the way it's programmed. And so we look at how do you incentivize people to live long healthy lives. Something that is we think is innovative but actually was thought about a hundred years ago when some of the innovators started saying what happens if we try and extend life expectancy of Americans from 45 to 60 as it was a century ago. We've got modern science on our hands smallpox vaccine and hand washing. We could do it. And so the life companies at the time started looking at no space care at programs to incentivize people to live longer to try and get to that period. The biggest problem that rolled back at that point was the my own medical profession who saw that as a threat to their long term livelihoods and challenged that in a Supreme Court in a court decision and that was the end of the program. I'm thrilled to say a hundred years from now life insurers around the world are getting together to say surely it's good for the life insurance business if we promote longevity and quality of life. We are going to both promote allow people to live those lives ideally in good health and do it in a profitable way in which there will be a make financial mechanism to show its long term benefit. I would see that kind of experiment going further and starting to link to financial in financial support as well. At the moment as you know we've got life insurance policies. We've got long term insurance. We've got financial insurance. All of these things I can see the need to coalesce to say how do we assure long term health, life and financial security over time and that's going to take very different type of programs which is going to require a big shake up in the regulatory structures that we currently have in place. But it's coming. Yes and I think beyond the obvious rise in taxation which certainly when we've looked at the scenarios where everybody lives to a hundred it's pretty obvious to us that there will be no decrease in taxation. We just can't imagine any country being able to do that. But more importantly we also see that retirement rates should rise a lot quicker than they are doing and we think that governments have made a mistake to say to their population we expect you to live even a child now if you look at the UK government predictions they predict a child now born today will live to 85 years old. Well that's obviously ridiculous and there's a whole set of reasons why they're sticking to that prediction. But many governments are now one of the reasons they're doing that is to actually look at the reality of the length of life of a child born today means that all of our pension schemes are underwater and it's it will look more and more like a Ponzi scheme. And I think we have to actually face up to that and encourage corporations and individual individuals to realize two things firstly they will need to work into their seventies and probably mid seventies and secondly they will have to save and that says that's just a fact and I think one of the most things about being a professor rather than a politician is I think it's actually for people like us to say that because you won't get any politicians standing here saying that it is not an electable fact. But it also sounds as though counting on private employers to take on a greater burden of people's retirement financial stability when all the movement is in the opposite direction of both putting the onus on the employee or not having the employee in the first place because everything is now you know we all are self employed in the new economy. So so where does the support come from. It's a challenge. We are right now undertaking a study with Johns Hopkins University to look at outcome data based on the population of those who live with us who have dementias and Alzheimer's and we know that we are reducing Medicare spend. We know we're reducing trips to the ER again because we're keeping this population healthier. There is no recognized data in Washington that supports this but we are undertaking that now. And I think that gets us closer to some of the things that Derek was saying at a certain point governments are going to have to reimburse a percentage of the population for residential dementia Alzheimer's care when they can no longer live at home but a sobering fact is that the average cost for someone with dementia and Alzheimer's living with us is about $8,000 per month and that can rise to $15,000 per month and that is totally paid for out of pocket. There is no in the U.S. we really do not have a well functioning long term care insurance product. So this is being paid for out of pocket. And when the pocket is empty then when the pocket is empty there's a problem and it generally falls on the adult children and because if you have a parent without Alzheimer's disease and you're told now your father's run out of money he needs to move in with you how do you manage that? You know I think we spoke earlier about how this 60 age cut off was a Bismarckian idea in an era when that was pretty good to make it to 60. I think that we need to have that kind of leadership now to say let's plan at least for 100 today and do the kind of work that you're saying and put it out realistically. How is the how the book is going to balance if we're going to live to 100 and realize that these other threats I spoke about are coming at us fast plus the one that we've hinted at but haven't spoken about enough which class Schwab I think has put on the table very strongly the jobless implications of the massive advances in technology and what that means for having some kind of global minimal wage and how we are going to pay for it. Today that would never pass muster anywhere in the world we're struggling to get minimum wages up even from really very low levels but if you're going to have large unemployment induced by the technologies that are going to give us or particularly the top 15 percent the potential to live well beyond 100 we're going to have to think about changing our economy. It reminds me of some of the discussions way back when the human genome project started. I think one of the greatest foresight that the NIH had at the time was to recognize that they had to have the ethics get ahead of the science not follow the science. Now with the technological options whether it's on robotics or many of these other areas we've allowed our ethical social and legal thinking to actually slip behind some of the advances and we need to catch up quickly. Well it's partly because those advances are coming so fast and that's exactly where I'm curious Elizabeth to hear where you think in the face of so much technological and scientific opportunity where do you think the pain points are going to be in making ethical decisions of what we're comfortable with where and when we intervene in the human genome or in how some of these new technologies are going to be used. Well we're going a little bit into I think what you're getting at is when you're talking about the human genome and ethical ideas are about what to do if anything about manipulating the human genome if that's where you're going I don't think we're anywhere near something where you could say okay we understand enough about the genetics of aging of humans who age very successfully notably the centenarians and onwards we don't understand nearly enough to sort of manipulate that to make that a reality. Because there's no magic gene to begin with. It seems like a very right. So that can be put down the line. There are interesting questions about certain very specific diseases that might be you know taken care of if you will a gene mistake fixed that might give a child you know a good life instead of a terrible life of immune deficiency or something. There are possibilities there but we're not talking about that. I think well to me it comes back to all of these economic issues partly we're assuming that the people who are living long lives would not be productive and the technology advances which are making people seem redundant which relates to how do we retrain people to constantly reinvent themselves or become their own business owners. I think that's really crucial but what we have to understand is if we can make situations where people are healthier for longer they can be productive in these new ways and that means really thinking about what is I'm going to take this little bit further and say well what is it we sort of think of aging well something that happens when we're old. Actually the likelihood that you're going to get these sorts of diseases of aging that make aging debilitating start happening very early and there's really excellent studies looking prenatally and then you look the least later in the offspring of people who have been born of deprived pregnancies of various kinds and you find they're much more likely to have hypertension, diabetes and so on. So the aging process starts right away. So investing in things like prenatal health and parental education mother education and early development that's a terrific investment against having aging related problems develop decades down the line because that's what has been seen. It's not just when you get old and your dreams begin they've started building up and the seeds of them have started building up very much dependent on early development things. And this is now starting to emerge. So I think we can think of a very good investment in early life and early development. It won't pay off for decades but we're thinking in those sorts of time frames. We haven't really talked about fertility but that too wasn't even thinking about fertility. I was thinking about producing a child whose chances of getting diabetes, hypertension and so on are lessened because of what we luckily do know is good conditions prenatally and in early development. But again if we're talking about now an age in which 150 becomes a natural lifespan then one assumes that we will also have to improve fertility technology to expand the period. Would our fertility still be the relatively narrow range? Why? Or not? What's wrong? We're worried about a population why do we want more fertility? I'll just throw the question out. People have voted with their feet and generally said when they have a chance they do not choose to have large numbers of children which often in more economically challenged situations are seen as more of an insurance and I'm not speaking about expertise but when people have a chance we see people do not choose to have large families by and large. And actually interestingly just on Linisworth's point and the point on fertility a colleague of mine has been studying the Wharton MBA students for over 20 years now obviously they're a very specific group and I'm not suggesting that they're in any way the rest of the population but actually a simple question like are you planning to have children? 20 years ago the majority of students at the age of 24 would say I am planning to have children. Now 30% say they're not. 30% 30% I think just the notion of even asking the question I think it's a very important question you've asked actually I think it's a question that's going to be regarded as quite quaint for 30 years from now. Well the notion of even asking are you having children? Are you having children in the old biological way as opposed to designing a child that is perfect using the best knowledge Elizabeth can get us on current form that is going to be we're a long way away from that. We're not screening already. Maybe this thing to snake oil salesman salesman. That's very frightening. No. We're really screening for certain genes we're already screening for that's what I'm saying. specific genes that's right but the designer child who will be a tall basketball sorry not going to happen for a long time. But the child where we're actually starting to see the complexity defining traditional parents is going to change very fast. Family structures that's a very evolving process. So the very question we're asking about how are you going to have children is probably going to be not that simple to answer in the future. No, aunts can have very fulfilling interactions with with children I mean aunts and uncles you know I mean one doesn't always have to have it be one's own biological child. I understand. So one of the great things that happens to Davos is the is the collision of public and private of the academic and the on the ground expertise. And so I'm curious given the real challenges and we have focused more on the challenges. I mean arguably if we were greatly extending our productive years one could imagine an unleashing of creativity of innovation a way of addressing some of the demographic challenges that of not you don't have to replace your your young population if people's productive years are extended but I'm curious about conversations what debates do you think need to happen and where and how in real practical terms we know the politicians are not going to be racing to make raising the retirement age the centerpiece of their platforms on the other hand we also know that older voters vote in greater numbers and can exercise disproportionate political influence compared obviously to children and so in the waiting of political power one might expect that the needs of older people are paramount how do you see and then I'd like for the rest of the audience to dive in but how do you see this conversation unfolding and needing to unfold what are the discussions that we need to be having as societies and how is that going to come about well there needs to be a movement around this and there's a very well known product design firm called IDO which has started a movement which is taking concepts of product design to how do we create a world for an older population and how do we think about work as we've been talking a lot today how do we think about how we invest how we live how do we how do we think about community and I think this has to become a front burner conversation something we were talking about earlier today is I was it was rudely announced on January 6 I'm 58 years old in the New York Times when they they wrote an article about me I thought I was 57 but that was my birthday and one of the things that it made me think about is those of us in our late 50s and early 60s are really the first generation that are dealing with parents that are now living into their 90s and 100s because my grandparents died in the 1970s in their 70s and no one before their time we expected people would die in their 70s so we're really the first people that are considering this and dealing with the realities of the older population because many of our parents are not able to afford a life that takes them into their late 90s and 100s so the burden is falling on us so this really needs to be a conversation that is I think is elevated and I appreciate that Time magazine has taken this on particularly in the cover story you did this past year on this baby could live to be 142 years old well it's interesting the reason and one of the reasons we did this and it's a conversation that at time we think is a very important one and that we want to encourage but it's also because there's almost a taboo around it and you know if people are their children they will not talk about their parents or it is the private secret conversation that you will have where you discover that a colleague or a neighbor is also struggling with what to do with mom what to do with dad and again we're talking about the near term challenge before we have figured out how to extend the productive and non-medically problematic lifespan and we all are living in this transitional and I do believe that we maybe we're the last generation who will live in this kind of transitional period where there is such a thing as old age which people both want to have and yet dread and there's a very complex emotional and psychological and financial and social dimension around it and I'm thrilled that you spoke about how we talk about our agenda council that step one must be deeper work on destigmatizing issues related to aging step two we would see that in the private sector seeing that they are age friendly principles that we could apply at work in terms of flexibility retirement age but they go much further to start saying what are the real opportunities for business in the future given that we have people living three decades longer today than just and how this can create enormous wealth and talent and excitement and we see products and services that never existed from robotics to advanced pharmaceuticals to leisure opportunities to a range of things and the companies are stretching all the way from Silicon Valley to Japan, Korea and around the world the third I'd say is in the public sector that the public spaces designing for longevity is very advanced in many countries like Japan, I walk around Tokyo or Singapore you'll get a feeling of how they're thinking about how you prevent and anticipate falls how you adjust for the time to cross the road with traffic lights New York has started advancing a lot of this in its housing in its access to public services in private spaces that needs to be expanded through the World Health we're thinking about these dreadfully complicated issues of refining the pension structures and financial systems that are happening fast but we need to have them happen even faster I think that and I work you know as a professor in a business school my major focus really is on corporations and I would say I would ask corporations to think about three things right now which is actually part of because I don't think that longevity is just about the last 20 years of life it's actually about the fundamental redesign of life from the very beginning so if you think about how would somebody actually live to a hundred and be productive here's three ideas that I think corporations should be working on right now first of all ditch retirement I mean don't push people out at 60 it's absolutely ridiculous and yet many corporations are still doing that that's number we could do something about that right now number two the relationship that an individual has with their organization is often about money how much are you going to pay me i.e. the tangible assets actually when you look at scenarios of living a hundred years the intangible assets how much are you going to train me is just as important so we need to switch the conversation much more to a conversation about intangible assets and thirdly we really struggled to make a hundred year life work from an economic perspective and the only way that we made it work unless you lived until you worked until you were 90 is if two of you worked now assuming that two of you can't work you know really hard all the time you have to switch between you and that's switching let's assume the two people are a man and a woman of course it may not be that but let's assume it is the switching between them has to take place on equal terms and therefore we have to see women working to be exactly the same as men working and we have to see the bringing up of children to be part of a staged life which many men also want to get engaged with so we do think there is a big gender discussion that needs to take place in terms of how do you productively and economically support living a hundred years do you think that yes okay go ahead could I just expand a little bit on this and think about you know what we think about is work is something which you know let's say there are certain things that young people will be very good at you know requiring certain kinds of reflexes and so forth but I think we haven't really defined maximally what are older people really good at to say you know we're wiser and stuff like that but you know I'd like to see some real examination by corporations is what are the skill sets that older people really have that younger people don't have and maximize their use and the second thing I heard and this is not original but I thought that was fascinating was we're so used to the idea of a work week it just sort of has this rhythm Monday to Friday and then Sunday off in many parts of the world and people are starting to look and say for older people is it better to have two days on we just you know this whole premise of a week might be completely outmoded and completely irrelevant and then often often it is already in our you know working lives but we should rethink what that expectation could be and would that shift as people get older and feel that you know first the type of work that they would then productively engage in for their corporation and their employer and the rhythm in which they do it that just might be very different from what we do for no especially good reason I'm not sure there's a great productivity reason why it's a week you know a cycle of seven days I have no idea why that's not at all Well would you extend that analogy to say you know we talk a lot about work life balance and the challenge of juggling rearing young children while working full time if we're talking about a hundred and fifty year life expectancy why on earth would we try to do both things and I've long thought work life balance should be actually balanced over long periods in other words you know I'm a scientist I'm a family young you know what you find is there are periods when you want to be very intensively perhaps involved in one or the other but not necessarily both at once you know sort of half half baked for both at the same time but really spread it out over decades and I think that's a balanced life for sure because there will be intense times for family there will be intense work it doesn't make you less productive in the long run well here's an idea from the corporate corner here many women were able to come back into the workforce whether they wanted to or were forced into the workforce in the 1970s because they were able to bring their children to work many companies set up nurseries and that actually allowed many women to come back today Google allows you to bring your pets to work and they actually have caregivers for the pets at home I think it is very plausible that major corporations will allow you to bring your elderly parent to work and we will set up day care for people with cognitive and or other physical frailties that who cannot be left at home who cannot afford a four to eight thousand dollars a month so that's kind of my big idea that's for the day so I invite all of you to interrogate our guests to elicit their big ideas or share yours yes sir I'm interested thank you I'm interested in your comments on mental health and how society will evolve as a result of longevity we live in a world where I think more and more people including in OSCD countries are being diagnosed at a young age with some sort of mental disorder even depression Mr. Jarosa spoke about Alzheimer's and other diseases my understanding is that we're making less progress on mental diseases as we are making on physical ones so what happens when people start living to a hundred and we have these mental issues do we end up with a society where every next second person is a problem that's a fear and I think that what's evolving is an understanding that some of the things that we think had thought were just getting chronologically old like you know what used to be called senility or dementias right that that was somehow inevitable go back to my 101 year old mother-in-law sharp as a tack there's no reason biologically that people have to be now it doesn't mean she will be able to do something you know to you know code in Python very rapidly although she's loved computers for a long time you know but the point is there are ways of staving off a lot of what was thought to be inevitable now we have the current situation where of course there are a great many people who do indeed have dementias and Alzheimer's and so that medical progress has been slow but there are some you know quite hopeful interesting beginning pilot therapies which are looking more promising but I don't want to you know pretend that that's not a big challenging problem but moving ahead again and thinking how would we think of you know looking into the future and do we think that dementia is absolutely inevitable and it's clearly not the question is how do we stave it off and social and cognitive engagements it's clearly statistically related to staving off the probability of getting Alzheimer's barring unfortunate genetic rare cases where dementias are you know single gene cause but those are very rare while informative they're rare so I think that you know the fear was oh well you know I'll avoid cancer but I'm just going to get dementia you know if I live long enough and that probably is not really the way it's unfolding now certainly it was true that life expectancy changed when hygiene and you know public sanitation got better and now people didn't die of typhoid so they lived long enough to get heart disease right but I don't think the logic of it extends you know these conditions of aging and mental illness and physical illness you know exercise staves off Alzheimer's so this separation of mental and physical illness is becoming less and less tenable where all an integrated system in the brain is a great command system of all our physiology and so I think more and more medical understanding is realizing this is a highly integrated system but isn't there part of that also having good social support structure exactly that's another one of the things not being lonely not being isolated so they all play in in this very interesting you know complex system which is us and so 46 million people today in the world have dementia of which Alzheimer's is a form of dementia that's expected by 2050 to grow to over 130 million people but the good news is the rate per population there's a study James Vopold published the rate is actually going down the absolute numbers are going up but the rate is going down now you can break the numbers down in different ways I understand I'm not minimizing the magnitude of the problem at all right but if there's a silver lining here to the question on mental illness I think that dementia is coming out of the shadows because it will affect every family mental illness has always been kept in the shadows so I think as we make advances in how we handle both from an economic standpoint from a medical standpoint from a social standpoint how we handle dementia and Alzheimer's I think will hopefully benefit other mental and cognitive issues and they're interlinked depression Alzheimer's there's interrelationships there so you know they're not sort of separate silos so we've put them into things we call it dementia we call it blindness but really you know there's a lot of biological interactiveness going on among all these I think we also going back to some of the technology insights we had a very interesting stage when the head of the National Institute of Mental Health in the US took a job at Google one has to ask what are they up to on the technology side Google is not a pharmaceutical company it's betting big time on alternative technological solutions to both better detect manage and address particularly dementia and related issues and we've started seeing that emerging in the areas of robotics and artificial intelligence today not tomorrow one of the things which we're doing as part of our council in a meeting in London is starting to ask the question where we're seeing the most rapid advances for dementia are they coming from pharmaceutical progress from technology progress software type of the side are they coming through nutritional advancements or through social support and the answer is going to be all but the leading edge I think is the technology not the pharmaceutical I think the pharmaceutical solutions will probably be in the next quarter century whereas the near end ones are going to be technology as Elizabeth said already don't wipe out what we already know there's only one major birth cohort that I'm aware of in Scotland where they followed people from the 30s till now and they're now in their 70s and 80s looking at the determinants of cognitive decline the first result they got was very interesting it showed that a large proportion of these people held up pretty damn well into their 70s and 80s and that the proportion who showed a substantial decline may have been about a quarter and the determinants of successful cognition were the ones you mentioned early prenatal care quality of nutrition getting on top of your blood pressure at every age not smoking and then the more interesting one start emerging evidence suggesting that a second language musical instrument social networks basically using it and not losing it actually matter and I suspect that evidence will just become stronger over time so we don't have to just look to the future for the Google X solution we actually can start our children suggesting that the reason we're talking to you about tobacco and blood pressure and activity and healthy diet isn't any more about cardiovascular disease that's in decline precipit it's about your brain health and it's going to protect your brain well into your 90s and 100s this perfectly tees up because we're almost out of time so I have one more poll question for all of you which this is the ideal introduction for so take out your phones again and we put that question up if you thought that actual decisions that you were making would make it more likely that you would live and live well to be 150 which of the following you would exercise more develop a better diet visit the doctor regularly reduce stress or of course you're already perfect so you wouldn't do anything differently or you just the prospect has no appeal yes we asked so I will have public results to this as well okay can we see the results wow I don't know if that is an encouraging reflection of everyone's needs resolution or reflection of the fact that no one feels like they are currently exercising enough and what was the public answer interesting so similar well this is a topic that I would particularly urge all of you to take from this room it is clear because it's a very synthetic challenge it is not any one thing any one decision that we can make as individuals about our own lifestyle it also has to do with how we are operating as families how we are operating as employers and employees how we are operating as neighbors and as societies and so I do think that among the really high level and ground level challenges that we are facing this is a very significant one and so I would urge you to take ideas you've heard today we've talked about socialize them bounce your own ideas off of other people because this is something that we are all going to be clearly living with for a very long time thank you very much for joining us and thank you all