We’re aging differently than we used to—but not necessarily better. That’s the central message from Diane Ty, Managing Director of the Center for the Future of Aging at the Milken Institute, who sat down with me during the Milken Global Conference to unpack the changing dynamics of longevity, healthcare, and caregiving in America.
“We’re all about advancing healthy longevity and financial security for all,” Ty told me. “And the ‘for all’ part is critical—because the way we age is deeply inequitable.”
It’s not just that we’re living longer; it’s that we’re living longer in poor health. According to the Institute for Health Metrics and Evaluation, the average American lifespan is now 76.4 years—but only about 64 of those years are lived in good health. “We call that the healthspan-wealthspan gap,” said Ty. “And for women, it’s even worse. They live longer but spend a larger percentage of those years in poor health.”
That mismatch between lifespan and healthspan has real financial implications. “If a couple reaches age 65 in good health, they’re likely to spend $472,000 on out-of-pocket health and long-term care costs,” she noted. “That’s not including housing or food—that’s just staying alive and functional.”
The roots of the problem are structural. Social Security was created in 1935 when the average life expectancy was just 61 years. Pension plans, once a backbone of retirement security, have largely been replaced by defined-contribution plans—if you’re lucky enough to have employer-sponsored retirement benefits at all. “Most people today are relying on Social Security and personal savings, which just isn’t enough,” said Ty.
And then there’s caregiving—the invisible backbone of elder care. “We have 53 million unpaid family caregivers in the U.S., and 40% are caring for older adults,” she said. “Many are also working full-time jobs. It’s a silent crisis.”
Ty pointed to several areas where innovation is starting to break through. One is brain health. “We’ve entered a new era in Alzheimer’s treatment,” she said. “For the first time, we have disease-modifying therapies that can slow progression. It’s not a cure—but it’s real hope.” The FDA has recently approved drugs like Leqembi, and diagnostics are becoming more accessible and affordable thanks to blood-based biomarkers.
Policy is also beginning to shift. Ty cited the GUIDE Model from the Center for Medicare and Medicaid Innovation, which aims to streamline and improve dementia care. The SECURE Act 2.0 is nudging retirement planning forward, while new employer tools are emerging to help caregivers manage their dual roles.
But Ty was especially energized by the cultural shift around aging. “We’re seeing a change in media and marketing. The old stereotypes—feeble, frail, forgotten—don’t reflect today’s older adults,” she said. “They’re resilient, experienced, and they bring incredible value to the workplace.”
Reframing how we view aging, she said, is not just about fairness. It’s about tapping into a powerful resource. “When you have multiple generations in the workforce, mentorship flows both ways. That’s magic.”
Watch my full interview with Ty here:
