Rudi Westendorp on a trade mission to Japan

Professor Rudi Westendorp was part of the trade delegation that accompanied the Dutch Royal couple from 27 to 31 October on their State visit to Japan. On Thursday 30 October he gave to King Willem Alexander and Queen Maxima and other invited guests a short presentation about vitality and Aging (see below).

Dear majesties, excellences, guests,

We appreciate an explosion of life.
Over the last hundred years, developing countries appreciate an ongoing increase of life expectancy.
Every decade citizens in our nations live 2-3 years longer.
Every week we get a weekend extra.
Few generations ago only one out of three reached age 65.
Nowadays retirement has become a certainty for almost all.
Only one out of ten dies before that age.
Longevity is not a disaster, it is un unprecedented success of mankind but poses our societies with unforeseen challenges.
It is an obligation to find solutions for this demographic revolution.
And that appears not to be impossible.

My home country has a tradition of studying families of which the members have the tendency to become long-lived.
They can ‘tell us’, ‘show us’ how to age successfully.
One of the lessons is that health is appreciated differently by medical professionals and elders themselves.
Professionals emphasize the physical functioning of brain and body.
As if it was a biological machine.
In the end we all become frail, but increasingly we are able to successfully delay that ageing process.
The nowadays 75 year olds are as healthy as our 65 year old grand parents.
However, older people emphasize that it is even more important what you do with your body, healthy or frail.
They tell us that we should follow our dreams and use our talents.
People do not feel good when being bored or lethargic and this is age independent.
For example, quite some healthy youngsters suffer apathy, ‘do nothing’.
Vitality is the inverse quality, it is a mental function.
People who are energetic and resilient can cope with the losses that life will bring.
They feel healthy.

This broad definition of health has major consequences for all.
We often take care of frail older people who have lost the lust to live.
It is important but not sufficient to take a medical emphasis.
In the Netherlands we have developed a routine to include elders in decisions what to do and when to refrain from intervention.
We have learned to take older people seriously.
The same holds when developing new innovative products and services.
Elders warn us to give too much attention to just treating the diseases of old age.
We should prevent overtreatment and hospitalization.
Older people would rather stay at home to maintain independent and feel well even at the cost of a shorter life span.

I summarize the following key messages to address the ongoing demographic revolution:
1. Keep a broad perspective on life balancing the biological and the mental aspects of our functioning: finally we prioritize the quality above the quantity of life.
2. We should avoid institutionalization and in stead make it possible for people to live at their home as long as possible: this necessitates the development of a complete new suit of services and products.
3. In contrast to general opinion, growing older is a normal and valuable part of our lifespan: we should avoid age discrimination at all costs an enable elders to live and act in the middle of our societies.
4. Professionals as well as volunteers should help and interfere only when people appreciate barriers that they cannot overtake themselves in stead of us overtaking their lives: freedom in old age means that people are enabled to organize their own life.

Ageing of our societies is a multifaceted challenge that not only necessitates input of the medical disciplines but also the humanities, law and economics.
It should unite various regional stakeholders to come up with innovations that address the people’s needs and at the same time serve the society as a whole.
For example, in the south west of the Netherlands universities, hospitals, municipalities and private companies of Leiden, Delft and Rotterdam have joined forces to make that chance.
Here at Tokyo University the ‘Platinum’ network has been build, a similar collaborative action and impressive initiative to transform the out of date settlements in Kashiwa into vital communities.
This initiative showcases the ambition and the thought leadership that will successfully deal with the demographic change of our societies.
Before long we will all see that ageing of our societies is a virtue, not a disaster.

Let me finish by thanking you for listening and by wishing you a very successful old age.

Professor Rudi Westendorp