Associate Professor of Gerontology and Sociology Jennifer Ailshire joins Professor George Shannon to discuss the impacts of air pollution, global aging and how factors like location and education can influence the way we age.

On the importance of place, or location, on aging

Well, I think of place as one of the greatest supports and constraints on the way that we want to live our lives. So we envision a life for ourselves, our daily decisions, but it's really dependent on where we live. So for instance, I have a goal to be a very physically fit person and to engage in physical activity every day because I know that's one of the best ways to support my own health and aging. But if I live in a place where there aren't a lot of opportunities for me to exercise outdoors, maybe because I don't have access to good park space or other recreational spaces, maybe because of weather problems, it's going to have a constraining power on my individual choices. So a lot of people really want to eat healthy and exercise. And some people live in places that provide a lot of opportunity for that. And other people live in places where actualizing those wishes, those goals is really quite difficult. And then of course there are other factors about environments that really matter in terms of social stressors like crime or feeling safe in your neighborhood, and also more physical characteristics like, air pollution, which is one of the things that I've spent a lot of time studying while at the school of gerontology here at USC.

On air pollution and aging

We think of air as a physical characteristic. It's something that exists in the physical environment, but actually, maybe it's because I've been trained as a sociologist. I think of the air pollution as a social phenomenon because after all it's produced by humans for the most part. And so air pollution is located in places where we have a lot of industrial activity and where there's a lot of car traffic. So some people live in areas where they're closer to those sources of air pollution, and it usually is the case that those are lower income communities because throughout much of our kind of industrialized history in this country, people who could afford to live in a nicer area that was further away from sources of pollution would move and they would end up in a cleaner air environment.

Now here in Los Angeles, we have poor air quality in a lot of places. On average, LA has worse air quality than a lot of cities in the rest of the United States, but there's also pockets of poor air quality here as well. So by the ports of Los Angeles and the ports of Long Beach, for instance, they have much worse air quality because a lot of that shipping and trucking activity, moving goods around. But living in California these days, particularly during fire season means that a lot of us are going to be exposed to poor air quality at some point during the year. And it doesn't at that point, it doesn't really matter what our own socioeconomic resources are. It's really just ways which way the wind blows and where the fires pop up around us.

Most of the research had been conducted in younger populations in children and adolescents and in younger adults, but just in the past 10 years, it's become really clear that older adults are a vulnerable population and that they're more likely to suffer adverse consequences from chronic exposure to air pollution, and also from these acute episodes. So we've done a lot of work trying to grow that area of research in public health air pollution topics. And I think that it has really caught on, and there are a lot more people who will have been working in this area, trying to understand the negative impacts of air pollution on older adults. Our group was most interested in the aging brain. And so most of my research has been in trying to understand how air pollution might impact cognitive aging, increasing risk of cognitive decline or risk of cognitive impairment or the onset of dementia, for instance.

I would say that until recently, although people understood that older adults were a vulnerable population, there wasn't necessarily a lot of direct attention on older adults themselves. So, those of us who work in this area of air pollution and its impact on health among older adults have been saying for a number of years that the federal regulatory standards that are used to regulate air quality, which had been really successful actually at improving our air quality over the past few decades since these regulations were codified and put into action at state and local levels, they tend to be driven by empirical evidence over the entire life course. They don't necessarily focus on the evidence for older adults specifically. And the problem that we've seen with that is that we tend to find that there are adverse health impacts at lower levels of pollution for older adults than there are for younger adults.

So I think that we need to have a louder voice as gerontologists, geriatricians, people who are focused on the other end of the life course, that we need to have more of a voice at the table when these conversations are occurring about how we should be improving air quality. And I think that the EPA and state and local organizations are really receptive to this idea because they also see the need for it and the importance of it. I've already noted in federal documents that they have been highlighting the need to focus more on older adults. But of course we need that expertise kind of among their ranks. So I'd like to see more partnerships between the environmental sciences side and the policymaker and programming side with gerontologists who are focused on this population.

On the protective role of education

The importance of education for healthy lives cannot be overstated. It is simply the most important factor in all of the research that we've conducted and the aging brain is certainly no exception. But actually we think education is particularly important for the brain because we think what happens is that in early life people develop a cognitive reserve or some people call it resilience, but essentially we're building capacity in the brain to be able to deal with insults that might occur later in life. So for instance, something like building up brain volume or neural connections and early life, which can happen in part through education is really important when an individual gets older and they have exposure to toxic chemicals, for instance, that might cross the blood-brain barrier or enter the brain through other means that having that underlying reserve or that ability to deal with these external threats to brain health is really important.

And people with higher levels of education seem to have a little bit more of that capacity. The other important thing about education though, is that it really sets people up for a lifetime of cognitive engagement. So people who have higher levels of education tend to engage in daily activities that are more likely to operate almost like a brain exercise, but it could be something as simple as playing instruments, speaking other languages and learning new things, taking classes later in life and, socializing with people, but anything that kind of keeps you sharp and keeps you on your feet is another good way to cope with the realities of some of the things that we're exposed to that might otherwise weaken the health of our brain.

On global aging and Colombia

I think if you ask most people, if you think of a place where there's aging happening, or there's a large population of older adults, where are those places? And they would say, think of countries like Japan, the United States, the United Kingdom, some of the countries in Western Europe, but aging is happening everywhere, everywhere, even in lower and middle income countries like Colombia that we didn't previously think of in terms of being an aging country. But Colombia, like a lot of countries in Latin America and other countries around the world, is experiencing a couple of key demographic changes like falling fertility rates and increased lifespan. And it's all happening very quickly. So Colombia will experience the same amount of aging in their population in about 20 years that the United States went through and, you know, in 50 plus years and some countries in Europe did and over a hundred year period. So this is a really opportune time to look at these countries that are undergoing this rapid transition to help us better understand aging.

I also think that there is a potential to use the unique context of Colombia to help us gain insights, to help us understand aging in the United States population. So some of my colleagues in Colombia are working on a very famous study of genetics and Alzheimer's disease that are currently the home of one of the world's most important clinical trials of drugs and interventions for Alzheimer's disease at the moment. And it's because they have a cluster of people who are genetically predispositioned to get Alzheimer's disease at a very young age, in their forties and fifties. And so it's created this real world laboratory to understand a disease that we've just really been struggling to get a handle on. The discoveries made in Colombia will have far reaching impacts outside of that country, into the United States and other countries around the world, because we're all sort of dealing with this impending challenge of an increased number of people in the population who will have some form of dementia in their lifetime.

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