The mission of the Mind Division is to harness the human capital represented in a growing number of mature and talented older citizens. Absent significant disease, aging is associated with an increase in knowledge and expertise, emotional stability and heightened motivation to engage in meaningful work. At the same time, the speed and efficiency of new learning typically declines with age, as does sensory functioning affecting hearing and vision. Such changes can hamper the effectiveness with which people engage with work, families and communities.

The Center aims to develop and evaluate infrastructures that channel the strengths of older people into families, workplaces, and communities. This includes improving cutting-edge technologies that compensate for deficits in hearing, vision and balance. We work to understand and improve how older people make important decisions about health care and financial matters. We also pursue efforts to distinguish normal from disease-related aging in cognition, so that interventions and policies are targeted appropriately.

RESEARCH TOPICS

ENGAGEMENT

PERCEPTION

DECISION-MAKING

COGNITIVE HEALTH

Key Faculty: Laura L. Carstensen, PhD; John W. (Jack) Rowe, MD; William Damon, PhD

A growing body of research indicates the benefits to cognitive functioning that come from stimulating environments and new learning. Yet current norms and social institutions often reduce opportunities for active engagement as people grow older. Longer working lives and volunteer activities, in particular, benefit both individuals and communities. The Center’s research on engagement focuses on ways to scale interventions that promote volunteerism and longer working lives. We consider what types of work people find most satisfying and consider age-related changes in motivation. With support from the MacArthur Foundation Research Network on an Aging Society, the Center has established a partnership with the leadership of the Santa Clara County, California, that enables research with a large and diverse workforce.

The Center’s work on engagement has linkages with the Financial Security Division, on the subject of working longer and the benefits of work to older individuals.

PROJECTS

• The Cognition and Retirement Study: “Is working longer good for you?”
• 2014-2015 Design Challenge: Maximizing Independence for Those with Cognitive Impairment
• Study of Cognitive Benefits of Volunteering – Santa Clara County Project
• “Pass it On: Mobilizing Encore Talent to Transform the Prospects of Vulnerable Children and Youth”

Key Faculty: Jonathan Berger, PhD; Gerald Popelka, PhD

A very large percentage of Americans over the age of 65 experience sensory deficits that affect many aspects of life, including work, balance, interpersonal relationships and community engagement. Hearing and vision problems contribute to cognitive impairment by placing greater demands on working memory. Sensory losses are associated with social withdrawal.

The Center will bring together interdisciplinary groups of experts from areas as diverse as medicine, law, psychology, and public policy to examine perception. Our research will be directed toward understanding the challenges facing an aging population experiencing sensory changes. This work will include studying and improving assistive devices, as well as identifying environments that enhance sensory functioning. Individual devices such as hearing aids, environment modifications such as public space hearing loop technologies, policy recommendations, insurance coverage guidelines, and better distribution and adjustment of technology will be part of our discussion and research.

PROJECTS

• Longevity, Music and Memory

Key Faculty: Laura L. Carstensen, PhD; Mary Goldstein, MD, MS

The decisions people make throughout their lives about finances, work, health and social relationships have a tremendous influence on aging trajectories. And as the numbers of older citizens grow, the decisions they make will have tremendous economic and social impact.

This impact will increase because there is a growing emphasis on individual choice and responsibility in our society. Consumer directed healthcare, for example, is increasingly advocated. Employers have largely moved from defined benefit plans to defined contribution plans in retirement planning, which require active participation of workers. Because of the evidence that older and younger people use different decision strategies and that the quality of their decisions may vary, it is important to characterize these differences and, when needed, provide decision supports.

The Center’s research focuses on how decision making changes with aging, and how high quality decisions can be supported and fostered in long-lived individuals. The Center’s Scientific Research Network on Decision Neuroscience and Aging grant awarded by the National Institute on Aging (NIA) is leading an emerging field that aims to integrate economics, finance, marketing, psychology, neuroscience, computer science, and public policy (among other fields) to study decision making through team-based, multidisciplinary research. Although this field has only recently developed, the combination of methods and expertise has already produced high-impact basic research with translational implications. The Center has made two research seed grants in this area.

The Center has close ties to the Center for Advanced Decision Making in Aging (CADMA), one of 13 Edward R. Roybal Centers for Research on Applied Gerontology, funded by the National Institute on Aging. Mary K. Goldstein is the Principal Investigator at CADMA, and Laura L. Carstensen is the Co-Principal Investigator.

PROJECTS

• Family Decision-Making Surrounding Life-Threatening Illness
• Scientific Research Network on Decision Neuroscience and Aging

Key Faculty: Hank Greely, PhD; Michael Greicius, MD

Cognitive health is a key determinant of satisfaction, engagement and independence throughout life. Cognition refers to functions of the brain including attention, learning, memory, language and executive function along with higher order functions, like decision-making, goal-setting, planning and judgment. In addition to normal changes in cognition that occur in most people, brain diseases grow more common with age and threaten the well-being of older people and their families. Very significant health, social and economic burdens are associated with dementia.

Healthy aging is notably distinct from disease-related aging, however. Although speed of processing declines even in normal aging, verbal ability, procedural and semantic memory are well preserved, and knowledge trajectories and emotion regulation abilities increase. Cognitive performance is also improving over historical time, and gains are observed in late life as well.

We pursue research that explore lifestyles and practices that maintain cognitive health, early detection of brain diseases and the implications of age-based policies and interventions that may support and sustain optimal cognitive functioning throughout life.

PROJECTS

• Expert Consensus Statement on Brain Health
• 2014-2015 Design Challenge: Maximizing Independence for Those with Cognitive Impairment

Mobility is strongly associated with quality of life – the ability to move about independently at home and at work, to move about our community, to travel to distant places. Embedded in the concept of mobility is physical fitness across the life course, which is central to the notion of healthy aging.  Maintaining physical fitness is a major focus of the division, including projects on exercise, reducing sedentary behavior, optimal nutrition, and measurement of fitness through wearable devices.  Beyond  lifestyle choices, research in the biology of aging holds promise that therapeutics may emerge that may be able to extend the period of physical fitness and delay the onset of functional decline. Technological advances also may be able to enhance functionality even in the face of physical decline associated with chronic disease.

The Mobility Division looks to improve the lives of people in all of these ways by leveraging Stanford research, bringing individual disciplines together to create larger solutions, and working with industry and government to translate academic research into products to benefit individuals and society.

In addition to encouraging and supporting research, the Mobility Division strives to be a source of unbiased, scientifically-based information amid a proliferation of confusing, and often conflicting, messages related to changes that occur during aging and how to delay, arrest, or even reverse such changes.

RESEARCH TOPICS

SEDENTARY BEHAVIOR/EXERCISE

STRENGTH & FRAILTY

AGING IN PLACE

Key Faculty: William Haskell, PhD; Cathy Heaney, PhD

Sedentary behavior and exercise represent two ways of viewing the question of how much physical activity an individual gets, or should get, in a day. Modern lifestyles have become increasingly sedentary as we spend more time sitting in front of our computers and television sets, driving our cars, and playing video games. According to the U.S. Centers for Disease Control (the CDC), “Less than 5% of adults participate in 30 minutes of physical activity each day; only one in three adults receive the recommended amount of physical activity each week.” In the meantime, the evidence that physical activity can ward off chronic disease and restricted mobility continues to grow.

We believe the issue should be addressed in two parallel ways. First, research should continue into understanding how physical activity – or lack of it – affects our bodies. As we understand these mechanisms more fully, we will be able to target our activities in the ways that most positively affect health and quality of life. Second, we need to act on the large body of research that already exists. Both the scientific community and the public at large recognize the health benefits of more physical activity – but activity levels are not rising significantly. This disconnect creates a challenge beyond the confines of biological and biomedical research and places questions about how to increase the general physical activity of the population in the realms of psychology (especially motivation), public policy, and education. The breadth and quality of expertise represented by the Stanford faculty position us well to make a significant and lasting impact in this area.

PROJECTS

• The Science of Sedentary Behavior”

Key Faculty: Thomas A. Rando, MD, PhD; Thomas Andriacchi, PhD; Marcia Stefanick, PhD

Personal functional independence is in large part determined by physical health. The strength (or weakness) of muscles, bones, joints, and the cardiovascular system define our capacity to move through our days and accomplish the normal daily activities of living. We view strength and frailty as opposite ends of the same spectrum and strive to find solutions to move individuals in the direction of strength. While exercise can help in this regard, it may at times be necessary to intervene in other ways ranging from pharmaceuticals to devices to other types of treatments.

In this area, the Center will initially focus on sarcopenia as a primary indicator of strength. Translated literally from Greek as “poverty of the flesh,” sarcopenia refers to age-related loss of muscle mass. While such loss is common in humans, the exact point at which it can be diagnosed as sarcopenia remains a topic for discussion. Regardless of this threshold, sarcopenia is a critical component, along with osteoporosis, of frailty syndrome. A 1991 study at the Palo Alto VA estimated that 27% of patients over age 65 were judged to be frail.¹ It has been estimated that the direct cost of sarcopenia to the U.S. in the year 2000 was $18.5 billion.²

The Center will also continue its work on osteoarthritis, which is estimated to affect nearly 27 million people in the United States alone.

PROJECTS

• Stanford Arthritis Shoe Hits Shelves
• Youthful Healing, Old Bodies: A Surprising Journey into Biotechnology

Key Faculty: Pamela Matson, PhD

The challenges and opportunities of an aging population already are beginning to transform our homes and neighborhoods.

Today, we do not have enough affordable, appropriate housing and services to meet the needs of a population that includes significant numbers of very old Americans. Challenges will be particularly pressing for the vulnerable “oldest old,” those who can no longer work, whose savings are depleted, who are in poor health, and who need services that are unavailable. Among the oldest old, the percentage of the population residing in skilled nursing facilities is declining. The desire to age in the home of one’s choice actually increases with age.

Action is needed through research and culture change in four priority areas:

• housing
• neighborhoods
• amenities
• services

Important questions include:

• What factors are important in the decision to stay in one’s current home, remodel, and/or to move elsewhere?
• What are the community indicators that measure the well being of older people?
• Which incentives would encourage builders and remodelers to construct smaller, age-appropriate, lifelong homes?
• Which affordable, replicable technologies and systems can effectively deliver services to old people?
• How can individuals working in a wide array of fields be linked to share information and priorities for action?

PROJECTS

• How Housing and Services Matter in Aging: The Practice Agenda
• Spatial Mapping of an Aging Population
• March 2014 Conference: The Road to Autonomous Vehicles and the Aging Population
• December 2012 Conference: “Homes for an Aging America: Priorities for Research and Federal Action”
• Independent for Life: Homes and Neighborhoods for an Aging America
• Indicators for Successful and Sustainable Aging in Place

In an age of unprecedented longevity, a focus on lifelong individual financial security has never been more crucial. The mission of the Financial Security Division is to bring a unique interdisciplinary perspective to financial security issues facing our society by rethinking the perceived problems around an aging population, especially retirement planning and the need to work longer. By understanding the role that research, education and policy can play in solving these issues and by looking at the problems from multiple perspectives, we will drive the dialogue forward in order to facilitate a healthier state of long-term financial security for the individual and society.

We bring together the best thinkers, policymakers, and business leaders to drive innovation and change around financial security issues. We focus our efforts on three topic areas: financial capability; the new career lifecycles; and common financial pitfalls such as fraud. For each of these areas, we identify key research and policy issues, catalyze research around practical solutions, disseminate information to key stakeholders and thought leaders, and discuss ways to encourage evidence-based policy decision. More specifically, for financial capability, we will explore how to help individuals become wise consumers of financial information and prepare for financial milestones such as retirement. For the new career lifecycle, we will redefine the concepts of “work” and “retirement” in order to reflect the reality of increased longevity. Finally, our work on common financial pitfalls such as fraud will consolidate research from a range of disciplines to form a unified understanding of fraud and effective fraud prevention.

RESEARCH TOPICS

FINANCIAL CAPABILITY

CAREER LIFECYCLE

FRAUD

Key Faculty: John Shoven, PhD; Gopi Shah Goda, PhD

In line with the mission to “redesign long life,” we think it is time to redefine traditional notions about financial capability. Our cultural norms and our standards for financial education need to change as individuals are living longer and need to be increasingly responsible for their own financial well-being.

Financial capability refers to possessing a level of understanding of financial matters to take effective action toward achieving individual and family financial goals. Whereas financial literacy only focuses on building knowledge, financial capability expands the definition and puts additional emphasis on attitudes and behaviors needed to successfully achieve financial goals.

Topics within this realm include understanding financial concepts (from numeracy to wealth transfer), using that knowledge to create and execute financial plans (understanding the roles of individuals and financial professionals), and the underlying financial education and standards that support building such knowledge and behavior. Typical conceptions of retirement, for example, must change in order to reflect the current reality of increased responsibility and longevity. Changes in pension and retirement plans, confidence in the stability of government entitlement programs, the lingering effects of the recent recession on investments and housing, continued low interest rates and returns, rising healthcare expenses, and longer life spans have made retirement planning an incredibly complex equation.

Current studies show that individuals’ confidence in the ability to retire comfortably, or to retire at all, are at new lows. According to the Employee Benefit Research Institute’s 2012 Retirement Confidence Survey, 47% of all workers were either “not too confident” or “not confident at all” about their ability to retire. Not only do individuals lack confidence about their ability to retire, they also have very little confidence in their ability to develop and execute a plan through retirement. This is because retirees and pre-retirees often fall prey to several “pitfalls” surrounding retirement planning.

• • • Failing to Plan
    • Underestimating Expenses
    • Underestimating Years in Retirement
    • Retiring Too Early
    • Failing to Save Enough

Important first steps in changing retirement planning behavior include identifying which resources individuals are likely to use, and what education or financial advice will stimulate appropriate action.

• • • Education and Advice – How Pre-Retirees/Retirees Access Information
    • The Curriculum – What Pre-Retirees/ Retirees Need to Know

PROJECTS

• • • The Science of Sedentary Behavior”

CAREER
LIFECYCLE Our work on the new career lifecycle follows from the understanding that we must redefine the concepts of “work” and “retirement” in order to reflect the reality of increased longevity. Although life expectancy has continued to increase, the average retirement age has remained flat at about 63 years of age since 1980, according to the Center for Retirement Research at Boston College. As a result, the number of years spent in retirement has increased greatly; for men, the number of years spent in retirement rose from eight years in 1950 to 19 years in 2000. Given this increase, people must now save more in order to maintain their standard of living through retirement. This new reality necessitates a change in the meaning and nature of work across the entire lifespan, particularly among older people.

We will begin by exploring how employees, employers, and policymakers can work together to rethink the traditional career lifecycle and encourage individuals to work longer, save more, and embrace alternative career trajectories. Some initial topics for consideration include: affordable employee benefits for an aging workforce, especially the impact of healthcare costs; extended and non-traditional career paths; and social and cultural changes in the workforce. We will also identify the barriers and disincentives that affect labor force participation rates among older people and investigate what incentive structures would encourage older people to work longer. We are particularly interested in identifying potential legislative policies that would provide incentives for both employees and employers to promote working longer, such as payroll tax changes that incent keeping older workers in the workforce.

FINANCIAL
FRAUD Financial fraud, as a crime of deceit for money, relates to a range of disciplines: behavioral economics, psychology, marketing, law, finance, and criminology, among others. The Financial Fraud Research Center, launched by the Stanford Center on Longevity and the Financial Industry Regulatory Authority (FINRA) Investor Education Foundation, consolidates research from this range of disciplines to form a unified understanding of financial fraud targeting individual consumers. Through this understanding, we can identify the most effective detection and prevention strategies. The Center has two urgent initiatives: consolidate research and connect research to policy.

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