About the episode

We’re living longer, but not all of those years are healthy ones. In Australia, there’s now roughly a 12-year gap between how long we live and how long we live in good health – meaning many of us can expect a decade or more of life with health problems. So, how can we shrink that gap?

UNSW Scientia Professor Kaarin Anstey is one of the world’s leading experts on cognitive ageing and dementia prevention. She explains why brain health is key to ageing well, and how demographic shifts are transforming workplaces and opening new markets in the ‘brain economy’.

This episode is hosted by Dr Juliet Bourke, with insights from Professor Barney Tan.

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Transcript

Dr Juliet Bourke: We're living longer than ever, but a longer life doesn't always mean a better life, and ageing isn't just personal. It's the biggest business opportunity right now. As individuals, it's about living longer and healthier. For employers, ageing workforces are reshaping how we work, and for businesses, longevity is opening up entirely new markets. So, if everyone is racing to meet the demand, who gets to capitalise on this?

Kaarin Anstey: We have a wealthier ageing population. They've got more disposable income, they're doing more, they're more active, they're travelling. So, all of those things are business opportunities.

Dr Juliet Bourke: UNSW Scientia Professor Kaarin Anstey is one of the world's leading experts on cognitive ageing and dementia prevention. She spent decades studying how our brains and behaviours shape the way we age, and what governments, workplaces and industries need to do to keep up in Australia, people are now living around 12 years longer than staying healthy, meaning we may spend more than a decade of our lives in poor health. So, as the gap widens between health and longevity, a new industry has exploded promising to help us hack ageing, optimise our health and extend our lives.

Dr Juliet Bourke: This is The Business Of a podcast from the University of New South Wales Business School. I'm Dr Juliet Bourke, an Adjunct Professor in the School of Management and Governance. Kaarin, we'd better start at the beginning. Can you explain the difference between health span and lifespan?

Kaarin Anstey: Well, health span is the number of years in which you have healthy life, and lifespan is how long you live. And so, for example, you might live to 100, but you become disabled in your mid-80s, in which case your health span might be 85, and you have 15 years with a disability. And so, in ageing, we're trying to compress that time spent in disability and extend that health span.

Dr Juliet Bourke: And we often think about health as something that we worry about later in life, and the timing that you've put around at 85, maybe we think, well, we'll worry about it when we get to 85, but when should we really start caring about it? And is it ever too late to turn things around?

Kaarin Anstey: Well, in fact, we should be caring about it throughout our lives, which is a hard answer to process when you're in your 20s, but we know that, for example, with brain ageing, the things that improve your brain as you age and protect it from cognitive decline and dementia, those exposures accumulate through the life course. So, the better you look after your health and your brain throughout your life, the better you will age. I mean, there's always genetic risk factors which you can't control, but I guess in midlife it is where we see the emergence of particular risk factors that are really bad for brain ageing, such as high blood pressure, type two diabetes, obesity. It's also a time when we have a lot of change with family structures and employment. So around that age, it's particularly important to really look at making decisions around your health to age well.

Dr Juliet Bourke: You use the term midlife, and I'm curious now that we're living these 100-year lives, does that mean 50? What does that mean, midlife?

Kaarin Anstey:  In the academic world, when we do research, we classify midlife as 40 to 65 but it's actually quite interesting, because about 15 years ago, when I was writing papers on this, it was 40 to 60. So, we've already expanded that upper limit to 65, and I can see a time where we almost talk about 40 to 70 is midlife.

Dr Juliet Bourke: All right, let's get down to what it means to age. Well, how does cognitive health fit into the bigger picture of longevity, and can you explain this idea of the brain economy?

Kaarin Anstey: So cognitive health is your ability to process information, solve problems, your memory, and basically, without cognitive health, you can't function, so you can't solve everyday problems, you can't work, you can't participate in society, and it's about the self as well. It's your identity, who you are, your memory. So cognitive health is absolutely essential to ageing well. And yet, often when people think of health, they might think of mental health or physical health, but they're not thinking of cognitive health. And so, when you look at cognitive function, at the whole population level, with population ageing, you can start to see cognitive function as a form of capital. So, we're now thinking about brain health capital, or cognitive capital, because it's a resource, and if we look after it and grow it and nurture that, we can be more productive. We can age better. We'll have people in employment longer, less dependent on health services. So, it's actually an asset that we haven't really recognised and the brain economy. So, I guess the brain economy is a concept that's come out of Europe and the US. There have been philanthropists and big businesses trying to raise funding to invest in brain health, realising that there's an economic impact or benefit to maintaining brain health across the population.

Dr Juliet Bourke: Have you seen anything by way of technology that can help us stay cognitively healthy?

Kaarin Anstey: There's two ways of looking at it. One is things that keep you cognitively stimulated. So being cognitively engaged and active and using your brain is very important as you get older, and that also includes social engagement. There's also technology to help compensate, so digital tools help you remember to help compensate in daily life when people start to have sensory or cognitive difficulties. And there's also a lot more in home technology that will help people remain in their homes and age well.

Dr Juliet Bourke: So, I'm curious then, because one of the things we see happening is us outsourcing our brains, so to speak, to AI, and I wonder what's going to happen to our long-term cognitive health.

Kaarin Anstey: Look, it's a really interesting issue, and we don't know yet, but we have examples from other areas, where, when people stop using particular cognitive skills, it's like physical muscles that kind of atrophy. And you know, you'll talk to people now who used to know a list of phone numbers of their friends and family, whereas you don't need to remember phone numbers now, because they're all in your mobile phone. So, you can see that our daily activities and how we use our brain shape our cognition, and I guess we just don't know the long-term impact of that on cognitive decline in ageing. And what we will need to do is make sure that if we outsource aspects of our thinking and problem-solving to AI, we compensate and have other activities to engage our brain and ensure that we keep mentally active and don't lose those cognitive skills.

Dr Juliet Bourke: So, I feel like I've got a clearer picture of what the ageing world looks like, and I know now that it's not just about my physical health and my mental health, but my cognitive health. But I'm curious as well, how is it going to shape the workforce and technology and policy in the years to come? What is it going to do for us at that coal face of work?

Kaarin Anstey: We've got an interesting situation in Australia where we actually have quite a lot of ageism. It's really the one form of discrimination which is socially acceptable, and the more you become aware of it, the more you see, I mean, all the sort of anti-ageing products that are pushed at people, foods and cosmetics, and so much is advertised as though you know ageing is bad and you have to scrub it out, and it's often difficult for older workers to find employment, and there's age discrimination in the workplace, which is gradually being challenged, and some companies are introducing age diversity policies, which is really positive. But we're also seeing in the care sector a shortage of workers, and overall, what's changing is the dependency ratio. So, at the moment we have about five people in the workforce for every older person who's over 65, or child out of the workforce by 2050, we're going to only have about 2.7 people in the workforce. So, the dependency ratio is going to change significantly if we keep the retirement age what it is. Now I expect what's going to happen is people will work longer, and that dependency ratio will change because of change work patterns. And we're already starting to see that. We're seeing more people in their 70s continuing to work different work patterns, more flexible work patterns. And I think to some extent, this will work its way out naturally. As people want to work, they're healthy; they've got lots to contribute. Other people will need to work, and I think employers will need workers. But we really need to look at policies around retirement, around age discrimination, around supporting people to care whilst they're still in employment. We have, you know, a lot of policies around childcare. We have fewer policies to support workers with caring for older relatives. So, there does need to be quite a rethink about how this transition can play out in the way that's beneficial to all and equitable as well.

Dr Juliet Bourke: So, if businesses are operating in this broader context of ageism, how can they sort of move against that tide? What should they be doing to address ageism and the inclusion of age diversity in their workplace?

Kaarin Anstey: So of course, they need to have the right policies and training in place, but there's other things that have been shown to work in the workplace, that one is multi-generational teams. So, creating a workplace. Where people of different ages are working together, that can break down some of the barriers, reduce ageism, and improve the workplace. The other really important area, and this is important for all of us, is lifelong learning, realising that we all constantly need to train and upskill ourselves, particularly with AI and giving people the opportunity to upskill and investing in older workers as you would invest in a younger worker.

Dr Juliet Bourke: Well, all of that sounds very positive. You've convinced me we need to develop diverse and age-literate workforces. But what I'm curious about is whether there's any tradeoffs, you know, any negative unintended consequences if we create an expectation encourage people to work for longer.

Kaarin Anstey: I think there can be, and it very much depends on the profession and the person some people don't want to work, particularly in jobs that are physically demanding, or standing up in front of a classroom may not be something that someone wants to keep doing. So not all jobs are as appropriate or adaptable for an ageing workforce, and also some people are not able to keep working for physical health needs, cognitive health or carer roles. So, I think this expectation can be perceived as quite burdensome from some people. They're really looking forward to retiring, and then the thought that they might have to work another five or 10 years and they can't get the age pension to a certain time, that can be problematic, and we've seen it internationally that's caused a lot of problems. For example, in France, there's a lot of protests around raising their retirement age. So, I do think this has to be thought through.

Dr Juliet Bourke: But it sounds like the way that you're speaking about it is that they would be exceptions, and potentially the general rule is that you might work for longer.

Kaarin Anstey: What we're hearing is that people want flexibility. They don't necessarily want to work in the same job. They maybe choose and do something that they'd always wanted to try. They want to have time to do other things, whether it's hobbies, travel, carer roles. The idea that you just stay in these 9-5 jobs for another 10 years can be quite soul-destructive for some people and feel quite disempowering. I think that needs to be flipped, where this is seen as a time for opportunity and choice, where we have much more flexibility for older workers.

Dr Juliet Bourke: As we live and work for longer, businesses are adapting fast. Professor Barney Tan breaks down some of the benefits for companies who are jumping on board.

Professor Barney Tan: What are the benefits of organisations that embrace an ageing workforce rather than treating it as a problem to be managed, one of the obvious benefits is access to experience and pattern recognition. Older workers often carry deep institutional memory, customer knowledge, tacit to know how to get things done. Studies on multi-generational workforces show that organisations that retain and integrate older employees tend to have better continuity, stronger knowledge transfer, and a more robust pipeline of talent. There's also a productivity angle. When you keep experienced people, you're not constantly paying the learning tax of high turnover; mixed-age teams have been linked with better problem solving and decision making, because you're combining fresh perspectives with seasoned judgement. When we talk about preparing for an ageing workforce, there's a concrete example of a company that's often cited at being at the forefront of this BMW in one of its German plants, BMW realised the average age of workers on the production line was rising and would continue to rise as the population aged. Instead of quietly pushing older workers out, they created a pilot assembly line staffed mainly by older employees, then asked those workers to help redesign the line so that it would be sustainable for them. The result was not a single grand gesture, but around 70 small changes, better flooring to reduce joint stream, adjustable chairs and workstations so people could sit or stand, improved lighting, larger and clearer screens, job rotation to vary the physical load, simple tools and jigs to reduce awkward reaching and build in micro brakes. The total cost was relatively modest, yet the outcome was powerful productivity on that older line matched or exceeded other lines; error rates dropped and absenteeism went down. Younger workers also benefited from ergonomics and design improvements. In other words, by designing older workers, BMW ended up designing a better workplace for everyone. But why did they do it? Because they could see the demographic riding on the wall. Germany, like many countries, faced labour shortages and an ageing population. BMW understood that if they did nothing, they would lose experienced workers faster than they could replace them, along with the skills and tacit knowledge of those workers had by investing in Age Friendly work. Design, they aim to retain skilled employees for longer, preserve quality and safety through experience and know-how and position themselves as an employer of choice for older workers in a tight labour market, the benefits they anticipate and are already seeing include higher productivity, lower turnover, better safety and a more resilient workforce that can bridge between generations of technology and processes. So, when you bring it all together, the picture around longevity is actually quite hopeful. If we get this right, an ageing workforce isn't a burden; it's an asset that can boost productivity, innovation, and social connection for everyone.

Dr Juliet Bourke: I'm going to flip it now to a broader economy. And of course, there are links between what individual businesses do and the broader economy. But thinking about healthy lifespan, what is the primary long-term impact of this longevity and health span on the economy?

Kaarin Anstey: Well, there's been some modelling done by some economists in the US that have shown that it can potentially flip it to be an economic benefit. So it's called the longevity dividend, because as people are healthy and they're out spending and perhaps working longer, they're paying more taxes, they're contributing, there's also a lot of unpaid work contributed by older adults, whether it's care or contributing to community organisations, and that all has an economic value. So having a healthy older population that's active and contributing has a lot of economic and social benefits.

Dr Juliet Bourke: Oh, you've really got to get that balance right then in terms of keeping people in the workforce for longer, because those people might be doing that unpaid care in our community, volunteering, for example.

Kaarin Anstey: 100% and also minding grandchildren, participating in clubs, you know, running in local sports clubs; they do an enormous amount sitting on boards. There's lots of not-for-profit boards, where you have a lot of really, really experienced older people, investing a lot of time. It has a huge economic value, which we shouldn't underestimate.

Dr Juliet Bourke: So, I can see how health-span is transforming our society. I'm wondering, just diving a little bit into particular industries, how is it changing what health providers do?

Kaarin Anstey: I think it's changing expectations about what sort of treatments might be acceptable at a certain age. And you know, would you replace someone's hip if they were 90? So maybe 10 years ago, people were thought to be too old for particular operations, whereas now they're not. So, you see a different attitude towards ageing, well, quality of life, and this is also addressing discrimination, because why shouldn't an older person be entitled to the same health care that a younger person is entitled to?

Dr Juliet Bourke: Zooming out a little bit from a policy perspective, are there other things that you can think of that the government could do to support this move towards cognitive health?

Kaarin Anstey: One is awareness raising and integrating brain health checks into Medicare. From say, the midlife check one is addressing some of the broader social determinants of health. You know, having a healthy brain requires a good start to life, good nutrition, early education, so addressing childhood poverty, preschool education, and access to healthy food. Having a serious look at the commercial determinants of health, particularly the food industry and people eating more ultra-processed food, less fresh food, all of these things, they're affecting our brain. You may not see a short-term effect, but over 2030, 40, 50 years, these things are affecting our health and our cognitive health.

Dr Juliet Bourke: Now that we're living longer and seeing that reflected in the workforce and the economy, it's opening up a whole new world of business opportunities, from new services to innovative products. The rise in longevity is reshaping markets and creating space for companies to rethink what they offer. Kaarin, how are the shifting longevity trends opening up these new business opportunities?

Kaarin Anstey: There's huge opportunities in all of the you know, travel and lifestyle products. You know, we have a wealthier ageing population. They're still employed. We've got compulsory superannuation. They've got more disposable income. They're doing more, they're more active. They're participating in fitness organisations. They're travelling. So, all of those things are business opportunities. Look, one thing we know is that people become more different from each other as they age. So, diversity actually increases. You know, older people are just so fascinating. They've had so many rich life experiences, and they're changing and growing in all different ways. And once that's seen as a real rich resource and treasured, we'll start to change our views.

Dr Juliet Bourke: And for business, what opportunities might that open up if there's greater diversity in this cohort?

Kaarin Anstey: I think you know, there are more options a business has probably been, in a sense, swallowing a very two-dimensional stereotype of what older people want, what they look like, what sort of music they listen to, what they want to do with their leisure time. And once you sort of throw that out and see that this is just a diverse group of really interesting people with a whole range of interests as any group of people, you can start thinking differently about what's offered to them, what you know, you go into some residential villages, and the colour schemes will be very bland, you know, you sort of think, well, who made that decision and assume that everybody over a certain age only likes coral or pale pink, you know? So, I hope we'll have a revolution, and it will start to just not make those assumptions about older people.

Dr Juliet Bourke: Let's zoom out to a global perspective. How are the countries approaching longevity and ageing populations, and are there lessons we can take from nations with older populations, like Japan?

Kaarin Anstey: There are lessons that we can learn in the way older people are respected in Japan, so much more highly respected than in general in Australia. But obviously that's a massive generalisation, because we have some cultures where older people are very highly respected as elders. Also, the use of technology. Japan is at the forefront in using robotics and AI to support older people, as is China, so a lot more use of technology in those countries. So all the tasks that can be feasibly outsourced to a robot, or where we can reduce the need to have a person go and physically visit someone, where they could interact with a care worker on a monitor or screen where they can monitor things like whether you take a medication or falls, all of those health related things, they're being integrated in aged care settings.

Dr Juliet Bourke: And looking 20 years ahead, what changes do you think will define the next era of ageing? Well, I'm thinking about science, I'm thinking about policy, I'm thinking about business.

Kaarin Anstey: I think we're going to really come to grips with the need for cognitive health. It hasn't fully recognised the importance of the brain and cognition for ageing. Well, you could talk about falls prevention all you like, but you know, most people want to have their memory of who they are and have good cognition. So, I think that's going to become central to how we think about an ageing society as a whole, and the need to invest in whatever it takes to grow and maintain that brain economy.

Dr Juliet Bourke: Thanks to Kaarin Anstey for joining us. If you liked this episode, you'll want to hear our conversation with Katrina McPhee from Aware Super on how one of Australia's biggest super funds is closing the gender retirement gap and shaking up what financial well-being really means.

Katrina McPhee: You can actually have a really profound impact on what you're delivering for your members by implementing things that feel not overly modern elsewhere, but are revolutionary to an industry like ours.

Dr Juliet Bourke: This is The Business Of, a podcast brought to you by the University of New South Wales Business School, produced with Deadset studios. If you're enjoying listening, we'd love it if you left us a rating or review in whichever app you're listening to us on right now, or you can share this episode with a friend or colleague who might also find it useful.

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