VISION: A society in which people are encouraged and enabled to age productively and with dignity.

MISSION: The Washington University Center for Aging (WUCFA) will provide academic and administrative leadership to foster the development and implementation of activities that enhance productive aging. This University-wide Center will promote research, education, policy, and service initiatives that enable older adults to remain healthy, active, empowered, contributing, and independent for as long as possible.

The mission of WUCFA thus is to promote productive aging. Productive aging can be defined in many ways. We use a broad definition of the term in which growing old is characterized by good health, vitality, and engagement. It thus is closely allied with the concept of successful aging as defined by Rowe and Kahn wherein disease and disability are avoided, good mental and physical function are maintained, and active engagement in life is supported.1

BACKGROUND: The 20th century witnessed an unprecedented increase in human life expectancy. Average life expectancy for 99% of the time humans have been on earth was less than 18 years. In the century just completed, however, life expectancy at birth in developed countries rose from 47 years in 1900 to 76 years in 2000. The unimagined numbers of older people in the United States (where more than 70% of people now live to the traditional retirement age of 65) represents a dramatic change in our society. Of all humans who ever lived to age 65, half are living now. The "old old," those over age 75, are the fastest growing segment of the population. Growing old now is the majority experience for Americans.

The consequences of the increasing population of long-lived men and women are immense. Already, older adults control 70% of the nation's wealth. Seniors have major political influence because they vote in disproportionately high numbers and are represented by the American Association of Retired Persons (AARP), the most powerful congressional lobby. There will be 94 million Americans over the age of 55 by 2020 with corresponding further increases in the economic and political power wielded by the old. On the other hand, once-rare diseases that predominantly occur in the elderly are now reaching epidemic proportions. Frailty and illness plague many older adults, underscoring Art Linkletter's admonition that "old age isn't for sissies." These illnesses typically are chronic, debilitating, and costly. Thirty-three percent of health expenditures in the United States go to the 13% of population that is 65 years and older. Perhaps the most feared age-associated disorder, Alzheimer's disease, extracts a terrible personal toll on patients and their families and represents a major public health burden with annual U.S. costs of $100 billion. The impact of disabling age-associated conditions will continue to increase as more and more people live longer and longer.

THE CHALLENGE: Society has little experience with an aging population, as substantial numbers of older adults have not existed previously. It is instructive to recall that the impetus for founding AARP in 1958 was because seniors then were ineligible for health insurance! Even now, "ageism" persists as a bias wherein older people are believed to become inevitably feeble and "senile." For the large majority of elders, this bias simply is wrong. The physical and mental decline experienced by some older individuals often relate to diseases commonly occurring in the elderly, not to age itself. In the absence of disease, the large majority of older adults live independent lives and are capable of contributing to the greater good of society.

Aging itself is being redefined such that 65 no longer marks "old age" for many people. Almost one-third of the life of individuals born now will be spent in pre-retirement and retirement stages. At least among seniors, expectancies about the nature of later life have undergone modification such that over 50% of elderly individuals consider the years after 65 as the "best years of our lives." Many older adults are engaged in productive (if unpaid) services, such as volunteer activities and caregiving. Perhaps as many as 25% even continue paid work (full- or part-time). The effective integration of this new, growing, and vigorous segment of the population into our society is a major challenge for the 21st century.

THE CAPACITY

There already is a base of ongoing, high quality research on aging at Washington University. Over 200 faculty are engaged in aging research and are supported by over 180 grants, federal and nonfederal (See Appendices). These activities are fostered by the rich scientific environment at Washington University and by its strong research infrastructure. A broad array of aging-related topics are being investigated; a few examples include state-of-the-art neuroimaging studies of brain function, environmental adaptations to enhance the independence of elders, caregiving issues, exercise programs to promote well-being, genetic studies of ocular disorders such as cataracts, and the effect of estrogen on bone loss in women. Several research programs have developed into centers of excellence, including the Alzheimer's Disease Research Center (ADRC) in the Department of Neurology (School of Medicine), the Center for Social Development (School of Social Work), and the Aging and Development Program in the Department of Psychology (School of Arts and Sciences). Additionally, the Longer Life Foundation, a collaboration of Washington University and the Reinsurance Group of America, supports research on factors that enhance the length and quality of life.

There also exist important educational and service activities related to aging. For example, 17 graduate and undergraduate courses feature aging (See Appendices). Two highly regarded University-affiliated educational programs for older adults are in place: the community-based Older Adult Service and Information System (OASIS) and the Lifelong Learning Institute of University College. Originated in St. Louis with substantial support from Washington University, OASIS now has 364,179 members over the age of 55 years nationwide and offers a wide range of artistic and educational activities. The Lifelong Learning Institute, now in its sixth year, provides intellectual pursuits for older adults through courses and study groups. Additional examples of community services sponsored by the University include:

1. Memory And Aging Project Satellite (MAPS): This multidisciplinary program is part of the ADRC and provides home-based diagnosis and case management to cognitively impaired low income and African-American elders. MAPS is designed to maximize the independence of impaired elders and also to enhance the skills of family caregivers. MAPS functions in cooperation with the St. Louis Area Agency on Aging.

2. In-Home Services Initiative of the Program on Occupational Therapy (School of Medicine) is an innovative clinical research program that places emphasis on identifying factors that help to maintain the independence of older adults and those with disabilities in their homes. It addresses the complex and difficult challenges that families and clients face as they attempt maintain their daily lives with functional limitations. Most clients have chronic sensory, cognitive or physiological disorders. Project Safe Home is a related program that identifies in-home barriers that limit the ability of older adults to live safely; individualized plans are designed to create a safe living environment.

By virtue of its talented faculty, successful research programs, educational offerings, and service opportunities, Washington University has a remarkable platform on which to establish a premier Center for Aging. To date, however, the elements of this platform generally have operated independently or in isolation because Washington University lacks a central mechanism to integrate, coordinate, and foster aging activities. The Center for Aging will remedy this deficiency. It will work together with existing programs to further mutual goals. It will provide the environment and resources to enhance ongoing research and enable new investigators to acquire research skills and experience. It will generate new ideas about educational, policy, and service activities and will promote new lines of interdisciplinary, collaborative research. It will serve as a local, regional, and national resource. The Center for Aging thus will coalesce currently fragmented individual components and develop new initiatives to serve a purpose than is much greater than the sum of its parts.