When They’re 64

Interview by William Sweet

A longitudinal study has been following 26,000 Americans as they grow old.

[Aging] What is it like to grow old? As associate director of a longitudinal study on aging, Dr. Kenneth Langa ’85—who majored in sociology at Amherst—is working to answer that question.

Launched in 1992, the University of Michigan Health and Retirement Study is following 26,000 Americans older than 50, surveying them every two years. The research—supported by the National Institute on Aging and the Social Security Administration—has led to, among other things, a widely publicized New England Journal of Medicine article about the heavy economic burden of dementia.

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Illustration of faces of 2 men with numbers overlaid showing ages
Illustration by Anthony Russo

How do you keep up with 26,000 people for 20 years?
For about half of them, we go to their homes. We have 250 interviewers across the United States. About 12,000 interviews are done with an interviewer in the home, and the rest are done by telephone.

What is your role in the study?
I am one of two physicians on the research group and the number-two person administratively. We have economists, psychologists, sociologists and epidemiologists also collaborating. We view ourselves as doing a scientific public service: Upwards of 10,000 researchers have used our data.

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Kenneth Langa ’85

“Hyptertension and high cholesterol make it more likely that you will become demented.”

The Journal article argued that dementia puts a financial burden on society comparable to those of heart disease and cancer.
The key policy issue is long-term care. The number of children per older adult is going down over the next 20 years. Who will be around to take care of the baby boomers? We don’t have an established financing system for long-term care in the United States.

How effective are the treatments for dementia?
There are very weak treatments right now. The medications for Alzheimer’s disease [the most common cause of dementia, especially in Western countries] may provide symptomatic relief. Right now there’s no treatment that changes the course. There is progress being made on the science, but because of the complexity of the brain and the complexity of the interaction between the Alzheimer’s process and vascular process, there is more to be learned.

Are adequate resources being put into dementia research?
There’s about $7 billion a year that NIH invests in cancer research, about $3.5 billion for cardiac research and about $600,000 for dementia. We live longer, which in general is a good thing, but it also makes it more likely that you will live to an age where Alzheimer’s becomes a bigger risk. I wouldn’t say we want to take money away from cancer and heart disease, but we think that more investment in [dementia] research would have important payoffs.

Are there preventative measures against dementia?
Hypertension and uncontrolled or high cholesterol make it more likely that you will become demented. Better control of blood pressure and of high cholesterol can decrease the incidence of dementia upwards of 20 percent. Also, there is a clear link between using your brain—both early and later into life—and the prevention of cognitive decline.

Use it or lose it.
Absolutely. People who have had more education and more mental stimulation, from birth through 18, have different brains, brains that can resist the insults that everyone is going to have as they age.