The press is constantly reminding us that the dramatic increase in the age of our population over the next 30 or so years will cause national healthcare systems to collapse, economies to crumple under the strain of pension demands and disintegrating families to buckle under increasing care commitments. Yet research at Oxford is beginning to expose some of the widespread myths that underlie this rhetoric. 

Demographic ageing is undoubtedly a reality. Life expectancy in developed countries has risen continuously over the past century, increasing the percentage of those over the age of 60 relative to those under the age of 15. By 2030 half the population of Western Europe will be over the age of 50, with a predicted average life expectancy of a further 40 years. By then, a quarter of the population will be over 65 and by 2050 the UK's current number of 10,000 centenarians are predicted to have reached a quarter of a million. Some demographers have even suggested that half of all baby girls born in the West today will live to see the next century. 

Rather than fearing such a future, however, we should see this trend as a great success. It must undoubtedly be a major achievement of civilisation that most individuals within a society can expect to enjoy a long and healthy lifespan. Indeed, if this could be achieved throughout the world, it would surely count as the success of civilisation, for then we would also have conquered the killers of poverty, disease, famine and war. 

Decreasing mortality rates, increasing longevity and declining fertility mean smaller percentages of young people within populations. Over the past 20 years life expectancy at birth in the UK has risen by four years for men (to 75) and three years for women (to 80). Meanwhile fertility rates across Europe have declined more or less continuously over the past 40 years and remain well below the levels required for European populations to be able to replace themselves without substantive immigration. But again, rather than seeing this as a doom and gloom scenario, we need to explore the positive aspects of these demographics. The next 50 years should provide us with an opportunity to enjoy the many advantages of a society with a mature population structure. 

In 2001, in recognition of the significance of these demographic changes and the global challenges and opportunities that will accompany them, the Oxford Institute of Ageing was established at the University. It is made up of researchers in demography, sociology, economics, social anthropology, philosophy and psychology, with links to other specialists in medicine, biology, law and policy in research units across the University. This cross-disciplinary approach has made it possible to challenge some of the most pervasive myths about ageing societies. 

The first of these is the current political rhetoric, which claims that health services across the Western world are collapsing under the strain of demographic ageing. George Leeson, a demographer at the Institute, points out that while a number of cross-national studies have considered the determinants of spiralling healthcare costs, only one has found the explanatory factor to be the proportion of the population aged 65 and over. Rather, it is growth in income, lifestyle characteristics and environmental factors such as technology and drugs that are driving up healthcare costs. In addition, the costs are shifting between population groups. 'Most healthcare expenditure occurs at the very beginning and the very end of our lives', explains Leeson. 'As populations age, the proportion of young people decreases while the proportion of older people increases.' The key here, he adds, is to develop sufficiently flexible health service structures to shift not only economic resources but also personnel. 'We cannot expect midwives, for example, to become geriatric nurses overnight, nor pediatric wards to turn into nursing homes.' 

The second myth is the view that the ratio of workers to non-workers will become so acute that Western economies will collapse, compounded by a massive growth in pension debt. While there are undoubted concerns over current pension shortfalls, it is also clear that working lives will themselves change over the next few decades, with a predicted increase in flexible and part-time work and the probable extension of working life until the age of 70. Indeed, we have to recognise that we cannot expect to retire at the age of 50 and then be able to support ourselves for another 40 or so years. Neither a solid pension scheme nor savings can carry people that long. 

Since it is likely that a longer active working life will coincide with a predicted labour shortage resulting from a lack of younger workers, we need to provide the opportunities and training to encourage older men and women to remain economically productive. Our studies show that there are benefits from having an age-integrated workforce. It is another myth that older workers are less productive than younger ones. In fact, the combined energy of younger workers with the experience of older ones can lead to increased productivity - something from which young and old alike will benefit. 

A further myth is that we will all live in loose, multigenerational families, experiencing increased emotional distancing from our kin. Evidence from a variety of studies across the developed world suggests that, if anything, the modern family is actually becoming more close-knit. Work carried out by the Oxford Institute in Scandinavia and in a Pan-European Family Care Study, for example, shows that despite the influence of the welfare state, over the past 10 years, people have come to value family relationships more than previously. 
As Institute healthcare ethicist Kenneth Howse points out, family obligations towards older relatives may change over the next 20 years, but current indications are that families are retaining a strong responsibility to care. Furthermore, as societies age, the contributory role of older people as grandparents becomes more important. Work by Institute researchers on another European Union study on multi-generational families has highlighted the role that grandparents play by freeing up the responsibilities of the younger reproductive population. 

In the developed world, therefore, we can see actual benefits from population ageing: a better balance between age groups, mature and less volatile societies, with an emphasis on age integration. The issues will be very different in other parts of the world. Herein lies another myth: that the less developed world will escape from demographic ageing. Instead, the massive increase in the age of populations facing these countries - predicted to be up to one billion older people within 30 years - is potentially devastating. The problem is not only that demographic ageing is occurring at a far greater pace than we have seen in Western nations, but also that few if any developing countries have the economic development and infrastructure necessary to provide widespread public pensions and healthcare to these growing elderly populations. As a result, older people are among the poorest in every developing country. They have the lowest levels of income, education and literacy, they lack savings and assets, have only limited access to work, and even in times of crisis are usually the last to be cared for under emergency aid programs. Perhaps of most concern is healthcare, for as we conquer acute diseases, we are going to see a rapid increase in levels of chronic illness and disability, but no long-term care programs or facilities to tackle this. 

Against this backdrop, the Oxford Institute of Ageing is developing a program to address the devastating impact of HIV/AIDS on older people. We do not tend to think of HIV/AIDS as an old-age issue, wrongly assuming that older people are no longer sexually active. In addition, in parts of Africa a belief exists that sex with an older person can cure AIDS, which leaves many older women, in particular, vulnerable to traumatic abuse. In addition, older adults now frequently end up being the primary caregivers and economic supporters for their infected children and orphaned grandchildren. George Leeson has recently completed a study of old age in HIV/AIDS-ravaged Zimbabwe. The case of Sophie, an 82-year-old widow and lone caregiver of her granddaughter Thoko, whose parents have both died from AIDS, exemplifies the personal crisis facing many African older women. 'Thoko has chronic learning disabilities and suffers from epilepsy', says Leeson. 'When I visited the two-room concrete shack in which she lives with her grandmother, she was tied to an iron bedframe with a lead, two metres long, attached to her left ankle. Sophie told me that this was to stop Thoko from wandering off, since she herself is too slow to stop her.' Without Sophie, Thoko would be abandoned and die herself. For this woman, old age is just a constant responsibility of care combined with the endless worry about what will happen to her granddaughter when she herself dies or becomes too frail to care for her. 

However, even in those countries not ravaged by HIV/AIDS, the responsibilities of caregiving in old age can still be acute. Research funded by the Wellcome Trust on family care in Indonesia by Institute team members Philip Kreagar and Elizabeth Schroeder-Butterfill exemplifies this. As Schroeder-Butterfill points out, far from merely assisting with childcare and domestic tasks, elderly people are often the central pillars of multigenerational families. 

Juminah, a 70-year-old widow, receives a modest pension and should be winding down her responsibilities. However, she not only cares for her three grandchildren, she is also largely financially responsible for them. 'To generate a little extra income she was trying to grow mushrooms in her damp kitchen', explained Schroeder-Butterfill. 'Without her dependants, she would be comfortably off. As it is, she is struggling to make ends meet.' This research has now received additional funding from the British Academy, and Kreagar and Schroeder-Butterfill plan to expand it into Nepal, India and Malaysia.
 
It is clear that the changing demographic landscape poses challenges for the future. The necessity now is to develop appropriate economic, social and political structures to take advantage of the opportunities that mature societies will bring, while ensuring that there are appropriate safety nets for those left vulnerable within these populations - which will include both young and old alike.