Robert P. Friedland is a neurologist and professor of neurology and neurobiology at the University of Louisville School of Medicine at Kentucky. Unaging is a self-help book which Friedland claims in the Preface reflects his mission ‘to proclaim the truth that aging is not inevitable – that what we do makes a difference’ (p. xii). The overall message of the book is that ‘even though we cannot stop all age-related declines in function, we can delay their onset and reduce their impact on our lives (p. xvii). To this end, Friedland uses the book to explain the importance of sustaining and improving what he calls the four ‘reserve factors’ (cognitive, physical, psychological and social) that maintain the balance of our body systems. He argues that by building up these reserves we arm ourselves against the effects of ageing.
The book is divided into three parts. Part I, ‘Foundations: What Do We Need to Know About Optimal Aging’, comprises 11 chapters in which Friedland explains what he sees as the three goals of ageing. These are: ‘not dying’, ‘not being ill’ and ‘being fit’ (p. 7). In Part I, Friedland expounds his ideas about what factors either contribute to or help mitigate ageing. As well as expanding on the ‘theory of multiple reserve factors’, in these chapters Friedland discusses the brain and its functions at length, describing it as the ‘master’ of all other bodily systems. Another prominent theme is the importance of microbiota (gut bacteria) to our overall health as we grow older.
Part II, ‘Applications: What Can We Do About the Opportunity of Aging’, comprises 14 chapters and contains suggestions for improving each of the four reserve factors. These include the importance of keeping physically and mentally fit and active; getting good quality sleep; attending to the microbiome through choosing the right diet; maintaining good oral health; understanding the impact of drugs and medication on our bodies; and improving both the quality and quantity of our social interactions.
Part III, ‘Conclusions’, consists of two chapters: ‘Considerations for Society and the Future of Aging’ and ‘Our Attitude and the Opportunity of Aging’. Here Friedland argues that public policy makers should facilitate the development of the four reserves by, for example, using the tax system to promote healthier eating. He also discusses the potential impact of developments such as metagenomics and artificial intelligence on ageing. Part III concludes with underlining the value of mindfulness and a positive attitude in contributing towards successful ageing. This is followed by a glossary which defines many of the bio-medical terms used in the book.
This is a book which primarily stresses the importance of individuals taking responsibility for their own ageing and of the centrality of individual lifestyle choices. There is no obvious sociological dimension to the book, so there is scarcely any discussion given over to structural/societal factors, social inequalities or cultural factors that might impact on ageing. Whilst Friedland's argument is that we need to understand ageing in a holistic manner, of the four reserve factors discussed, the social reserve factor is given noticeably less coverage. The fact that a large proportion of the book discusses the functioning of the brain and the neurogenerative diseases of ageing clearly reflects Friedland's expertise as a neurologist and medical doctor, and these sections are the most obviously academic parts of the book. The bio-medical bias is illustrated by the fact that most of the academic references provided are from medical and neurological journals. Friedland is not a social gerontologist and there is little engagement to be found in the book's chapters with gerontological theories or current debates within gerontology. A good example of Friedland's, at times, overly narrow bio-medical focus is the chapter on ‘Dealing with Stress’ which is far too short at just over two pages and fails to discuss any of the socio-economic or lifecourse factors that can cause stress.
In the Preface, Friedland claims he wants his writing to be ‘down-to-earth’ and ‘readable’ (p. xii) and he largely succeeds in this respect. As such, this is a book more designed to be found in the popular ‘self-help’ sections of bookshops than in the gerontology sections of academic libraries. For the more academically minded reader, it is frustratingly unbalanced in terms of the lack of consideration given to socio-economic factors, cultural issues and gerontological theory generally. However, if one accepts the book on its own terms as a self-help book aimed at the lay reader, it does have several points of potential interest. As Friedland himself admits, whether all of his suggestions for positive ageing work for everyone is impossible to know, but it was interesting to read his various ideas on how attending to the health of our brains can contribute towards this goal.
