Older Americans are dominating like never before, but what comes next?

Virginia Boothe, a palliative care physician, retired at 69. She loved her work helping people navigate the final chapter of life, but it was relentlessly trying, one emotionally fraught day blending into the next.

She was ready to cast off the burdens of medical bureaucracy, the endless battles with insurance companies to get her patients the treatment they needed. "I wanted to take a step back from human suffering," she said.

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At home in Richmond, she had her hardwood floors refinished. She went hiking in Utah and volunteered at the SPCA, working to become a dog trainer. Still, she struggled to fill her days. Starved for mental stimulation, she missed her colleagues and patients. And with no strong pipeline of palliative specialists pumping new doctors into clinics, she felt needed.

"It's driving me nuts," she said. "I have way too much free time. And I feel the most competent and proficient that I've ever felt in my life. I really feel I'm at my peak, really able to help people."

At 70, Boothe was ready to unretire.

As the nation heads into an election year, American politics can look much like a gerontocracy, with the most likely presidential nominees being two men who would be octogenarians in the White House (President Biden is 80 already; former president and leading Republican candidate Donald Trump is 77). Senate Minority Leader Mitch McConnell (R-Ky.) is 81; Sen. Charles E. Grassley (R-Iowa) is 90; and Sen. Bernie Sanders (I-Vt.) is 82. Sen. Dianne Feinstein (D-Calif.) died at 90 last month, following a visibly diminished capacity that prompted widespread discussion of the role that the oldest politicians are playing at the highest levels of government.

Yet even beyond Washington, a geriatric elite also controls many other aspects of an aging society, to such an extent that in some professions there are deep concerns about how those roles will be filled in decades to come. In medicine, big business, farming, construction trades, and across much of the American economy, the workforce is getting older and older. In the leadership ranks, the elderly are increasingly staying in command, well past traditional retirement age, which can sometimes limit the positions available to younger workers from a wider variety of backgrounds.

In Tinseltown, this fall's top movies feature actors who predate the boomers: Robert DeNiro, 80, in a film by Martin Scorsese, also 80; and Harrison Ford, 81, in his fifth Indiana Jones flick. When the National Research Group asked moviegoers which actors would draw them to a theater, the top 20 performers included two octogenarians and no one under 35. The average age of those actors is now 58.2. Tom Cruise is still leaping off towers and surviving explosions on an impossible mission that has carried him into his 60s. Only three women made the top 20, and all three were Hollywood's warped version of old for women - Julia Roberts, 55; Sandra Bullock, 59; and Angelina Jolie, 48.

In big business, companies are asking their top dogs to stay longer. Disney rehired CEO Bob Iger at age 71, replacing a 63-year-old, signing him to a two-year deal, then re-upping him for another two years beyond that. The longtime head of Fox, Rupert Murdoch, only recently relinquished control of the media empire at 92. The average age of chief executives of U.S. corporations when they were hired into that position was 45.9 in 2005. By 2018, that average had shot up to 54.1, according to Statista Research, a business data firm.

Some lines of work do skew young - Silicon Valley, obviously: TikTok CEO Shou Zi Chew is 40, as is Reddit co-founder Alexis Ohanian - but most industries with the lowest average ages involve low-pay, often physically-demanding work: restaurants, fast-food outlets, animal care, parking lots. An increasing number of fields are dominated by older workers, such as farmers (median age: 56.2), school bus drivers (55.9) and building inspectors (53.2), according to Bureau of Labor Statistics data.

The increased dependence on the oldest Americans was in some ways inevitable - the baby boom generation has dominated society in every phase of its life span and many people, especially more affluent workers, are staying healthy longer.

But the graying of American leadership is also the unpredictable result of a deadly pandemic: In a time of high anxiety, economic turmoil and political division, voters, corporate boards and people of all ages put a premium on stability and attitudes toward work and career paths were redefined virtually overnight.

The aging leadership phenomenon is not exclusively American. King Charles III, who is 74, was the oldest person to be crowned a British monarch. At 73, Benjamin Netanyahu has ruled Israel for more than 15 of the past 27 years. At 69, Recep Tayyip Erdogan has been in charge in Turkey for 20 years. China's president, Xi Jinping, is 70 and Russian President Vladimir Putin is 71; both are in their second decade of leading their countries.

In politics and beyond, the United States seems more wedded to leadership from its older generations than many other societies are, with little prospect of a shift back to the pre-pandemic normal.

"This change affects all aspects of society," said Jonathan Evans, a geriatrician in Charlottesville whose research focuses on demographics and retirement. "Why should people at the top of their game retire? This is their life."

Yet after half a century in which American culture revolved around young people - from the teeny boppers and the Pepsi Generation through the MTV generation and the powerful influencers of the social media era - the dominance of the nation's oldest generation can seem alienating, even troubling, to many.

"Age diversity is super important to a healthy society," said Brian Spisak, a Harvard public health researcher and business consultant. His research on voters' attitudes toward the age of political candidates found that "people prefer the look of older leaders to assure stability and younger leaders to explore alternatives."

When one generation seems to be in charge, he said, the results can be unsettling. In politics and business alike, "when leadership stays too long, they can be stiff and unchanging," Spisak said. "Older employees bring a ton of practical knowledge . . . But if you're staying on and status-hoarding, maybe you're not really a leader, you're just somebody in a hierarchy trying to maintain power."

The leading role played by older folks is something the country may have to get accustomed to: A decade from now, according to federal population projections, the United States will be home to more people over 65 than those under 18 - a complete reversal of the current picture.

William Tate, the 81-year-old mayor of Grapevine, Tex., has held that position for 48 years and he's convinced his work is keeping him alive. "If you retire, what do you do?" he said. "Your mind and body start shutting down. I would be so bored, I don't think I'd live very long."

Tate attributes his longevity in office to a shift in how Americans live. "People are living longer and staying functional," he said. "This idea of retirement at 65 was based on life expectancy back when Social Security started. My father died at 58. People got to be 60 back then and they looked old."

The mayor says voters in Grapevine keep him around because they're afraid someone else might raise taxes and because the next generation doesn't seem to share his work ethic or commitment to local affairs. (Tate won his last election, in 2021, with 81 percent of the vote against a 39-year-old opponent.)

"People don't have the same passion for the community anymore, especially since covid - it's made people more selfish, more self-centered," Tate said. "I grew up on Main Street, I've practiced law here for 55 years. I get tired, I get frustrated, but what keeps me going is people stopping me on the street saying, 'Don't leave, we don't want change.'"

Tate owns a ranch in the Hill Country of Texas but when he thinks about retiring there, he gets gloomy. He's trimmed back his law practice and doesn't take on heavy trial work these days, but he plans to run for one more term as mayor; he's got a proposal to cut taxes that he'd like to push through before retiring when he's 89.

Tate is no anomaly. In an increasingly geriatric America, many political leaders long past traditional retirement age defend keeping hold on their offices by saying they are as effective as ever.

But when Mitt Romney, who is 76, announced in September that he would not seek another term as a senator from Utah, the 2012 Republican presidential nominee told The Washington Post that it was time for a new generation to "step up" and "shape the world they're going to live in."

Some younger politicians are making that argument in their campaigns. "America is not past our prime - it's just that our politicians are past theirs," former South Carolina Gov. Nikki Haley, who is 51, said at the launch of her drive for the Republican presidential nomination. She called for a "new generation" of leaders and a "mandatory mental competency test for politicians over 75 years old." (She is trailing far behind the 77-year-old Trump).

Biden often jokes about his age, trying to deflect widespread concern that he's not up to another four years in the White House. "Try being 110," he'll tell audiences, or he'll note that he served in the Senate "for 270 years." Then he touts his experience as the key to his accomplishments as president. Still, in an Associated Press-NORC poll last month, 77 percent of Americans overall and 69 percent of Democrats said Biden is "too old to effectively serve" a second term.

The current Congress contains the oldest Senate ever (median: 65) and the third oldest House (median: almost 58). Thirty-three senators are 70 or older; only 9 are under 50. The median age of Americans is 38.

In the federal judiciary, where there are neither mandatory retirement ages nor term limits, the median age of judges is now 68, the oldest ever. When the Founders decided to appoint judges for life, they did not foresee life lasting quite this long. Alexander Hamilton argued for lifetime tenure, noting "how few there are who outlive the season of intellectual vigor." (Most states never went along with that approach; in 31 state court systems, judges face a mandatory retirement age, in most cases at 70.)

Beyond the leadership, the federal government's rank and file, 2.2. million strong, is lopsided by age: More than 30 percent of federal workers are 55 or older, and only 8 percent are under 30 (by comparison, in the private sector, 20-somethings make up 23 percent of the workforce). Leaders have long worried about their ability to fill crucial roles when the older workers do finally retire.

In U.S. politics, it hasn't always been this way. Bill Clinton was president almost three decades before Biden took office - and Clinton is just shy of four years younger than Biden. Presidents Clinton, George W. Bush and Barack Obama each completed their eight years in the White House well before turning 65. All are younger than the two leading candidates in 2024.

Just as Trump and Biden began their presidencies as senior citizens, so too have many major American businesses turned to silver-haired leaders in a period of economic and social insecurity and rapid structural change. The covid-19 pandemic threw many prominent companies into existential crises by playing havoc with workers' roles and attitudes toward their jobs. A striking number of those companies retained or turned to older bosses for guidance.

At Target, the mandatory retirement age of 65 was scrapped to allow CEO Brian Cornell, then 63, to sign a three-year extension. Caterpillar similarly waived its retirement requirement for CEO Jim Umpleby, then 64.

At 88, Jack Fitzgerald no longer runs for exercise - "my knees went bad," he says - but he still runs his 16 car dealerships in Maryland, Pennsylvania and Florida, and he's not retiring anytime soon.

That's an attitude shared by many U.S. car dealers, whose average age is now 72, the oldest it's ever been.

"Experience matters," Fitzgerald said. But he's the first to admit that his continued leadership represents a significant change in how American business operates. "We stay longer in leadership because we're selfish. I'm sitting here talking to you and there's no way I should be alive. We're benefiting from the wonderful private medical system: I had my aortic valve replaced with a bull's valve. I just had a pacemaker installed this spring. I have two bad knees and I had one repaired. We're all living longer, 20 years longer than our fathers lived."

Only 12 percent of adults 65 and older have some type of cognitive impairment - not much higher than the 10.8 percent of those aged 45 to 64 who are impaired, according to the American Society of Aging. The American Academy of Neurology reports that mild cognitive impairment affects only 15 percent of people ages 75 to 79.

Fitzgerald, who employs more than 1,800 workers, has long been the face of his operation, starring in the company's TV ads, a drab narrator who has won a cult following for his no-nonsense style. He stays not only because he's built the brand around his own image, but because he says "older people make better decisions; you know what decisions not to make."

Fitzgerald launched his business when he was 32, buying a Dodge dealership after the previous dealer died.

For those in the executive suites, the decision to retire is a matter of preference. For the middle and working classes, it's often a question of ability to afford not working. Only 36 percent of Americans aged 55 or older say they expect to be able to retire when they had hoped to, according to an Axios-Ipsos poll.

And increasingly, some older workers also feel pressure to stay on the job because the supply of younger workers is thin.

Electricians are already weathering what industry leaders call a "silver tsunami" - a severe shortage of younger specialists to take the places of the oldest contingent of workers, who can only toil so long in a physically demanding job.

"It's an issue that frankly we're facing across all construction trades," said Thayer Long, executive director of Independent Electrical Contractors, an industry group that trains apprentices. "We can talk about doing a better job recruiting, but there's just a fundamental math problem. There are just not enough people to replace retiring workers."

The problem isn't entirely new. Construction trades have "always had a poor retention rate," said Scott Duckett, a general superintendent for Dvorak Electric, a contractor in the Baltimore suburbs. But now, "the workforce is diminishing and young people are job-hopping," he said.

To get them to stay, Duckett has been seeking advice from companies in other fields - Hilton, CarMax, Sysco - about how best to retain young people through improved pay, health benefits and longevity bonuses.

Young workers "all have options now," said Long, who is 48. "There's a lot of jobs out there and the old tough-it-out culture of the construction industry isn't resonating with the workers of today and tomorrow. It's hard to hire people, and I don't see any end in sight."

In farming, too, the next generation is not rushing to follow their elders' paths.

Rob Rettig is luckier than many. At 62, he's wrapping up his time as chief executive of New Vision Farms in Napoleon, Ohio, where he spent 36 years building a 60-cow dairy with 700 acres of crops into a three-farm company focused on corn, green beans, seeds and other vegetables. He's taking an earlier out than he'd anticipated because his son, who is 32, "is ready and I've got to get out of the way."

Rettig, whose family started his farm in 1860, always encouraged his kids to find their purpose in life by moving somewhere else for at least a while before deciding whether to make a life on the farm. Now his son, after working at a big grain manufacturer for a time, is back and eager to carry on the family tradition.

For Rettig, leaving the work he loved - he's cut his hours from 60 to 30 each week - is turning out to be hard, so hard that he sees why many of his peers hang on into their 70s.

"I'm quite lost from not working," Rettig said. "We're new grandparents, and that helps me with finding purpose, but I'm addicted to accomplishment."

Rettig sees the generational gap in everything he does, from consulting with fellow farmers ("There's just not that many kids willing to put in this amount of work") to serving on the local school board, to taking part in Rotary ("Few people in their 30s and 40s are willing to commit the time.")

Carl Zulauf, an agribusiness professor at Ohio State University who grew up in a farming family, said many kids grow up on farms with the expectation that they will go away to college and probably not return.

"The young people don't know that euphoric high you get the first day of planting," he said. "And the old farmers love that high, so you see them now still at it into their 80s."

Boothe, the palliative care doctor, was energized to discover that at age 70, she has more passion to serve than many people her age had in previous generations. She's still deciding whether to dive back into her work, but she feels a pull from the shortage of doctors, as well as the push from her own quest for fulfillment.

Similar feelings are behind the aging of the nation's physician corps. The trend is particularly marked in certain specialties: According to American Medical Association data, 71 percent of pathologists are 55 or older, as are 65 percent of cardiovascular specialists, 62 percent of psychiatrists and 61 percent of orthopedic surgeons. (By contrast, only 9 percent of sports medicine specialists and 17 percent of pediatric internists have reached 55.)

Evans, the Charlottesville geriatrician, who turns 60 this fall, said some specialties are not attracting nearly enough young doctors because the nature of the work has shifted in a less interesting direction. The most urgent gap is among surgeons, who are far less likely to extend their careers into their senior years because of the work's emphasis on fine motor skills.

"We're going to run out of orthopedic and thoracic surgeons," said Atul Grover, an internist who is executive director of the Association of American Medical Colleges' research wing. "We need to train some more doctors."

Fitzgerald, the car dealer, is bullish about the people who will guarantee the future of his business. He's already chosen his next chief executive, and he's arranged to transfer ownership of the firm to his employees through a trust.

But even then, the old boss expects to maintain some control: "I get to pick the majority of the board members."

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