3 And the third?
Socialisation. Loneliness is one of the biggest causes of depression and early death. In the United Kingdom about two million people over 65 live by themselves — one million of them would not speak to anybody in the course of a month.
4 How are we going to cope with the financial burden of ageing populations?
In the 1930s in the United States there were 130 workers to support each retired person; now the ratio's about 10 to one in America and two to one in Japan. Japan is leading the way in finding creative ways to utilise its older workforce. BMW in Stuttgart has set up specific work lines for previously retired workers to better cater for their needs with things like flexible hours, lifting machines and non-slip floors. They're now producing just as well as the young workers because they're more reliable.
5 But what about people with dementia?
Dementia is the world's greatest medical problem. One in three people start to get dementia past the age of 80; past 85 it's about one in two people. In New Zealand it's estimated we'll have 170,000 cases by 2050 at a staggering cost to the state. There is no cure for Alzheimer's disease. There's been 200 clinical studies on Alzheimer's disease in the past 10 years and none has worked. You can slow the risk of vascular dementia, or mini strokes, through a healthy lifestyle. As a population we have to do everything we can to delay the onset of dementia and chronic diseases through lifestyle changes.
6 Is it really possible to ward off dementia by doing puzzles like Sudoku?
Conservative analysis of formal brain training interventions has found they're only suggestive of making a difference with dementia. However most people working in the area of cognitive function would say there's enough powerful evidence to show the more you use your brain, the better. I get up every day and read the latest research from the United States National Institute of Health and Centre for Communicable Diseases.
7 Growing up in Remuera, did you always want to work in medicine?
I'm dyslexic, which I didn't realise until I was about 50. My parents were told I was an idiot kid but I knew I was smart enough because I could compete at most things except spelling. After med school I did research in London and Melbourne. Here in Auckland, I did some of the first bone marrow transplants with a mate of mine. But getting funding was a constant struggle so I took a job at Boehringer Ingelheim, the world's 15th biggest pharmaceutical company, and became worldwide head of clinical drug development. These days I consult for biotech companies and advise investment banks on what healthcare projects to invest in.
8 What's the most exciting biotechnology advance you've been part of here in New Zealand?
One of the simplest ones; I'm on the board of AFT Pharmaceuticals where Hartley Atkinson had the great idea of combining two pain relief drugs — paracetamol and ibuprofen. We found investment for a large clinical trial and got Maxigesic licensed in 120 countries. It could be a game changer in places like the United States where paracetamol overdoses are the biggest cause of liver failure and there's an opioid epidemic.
9 How does New Zealand compare internationally on drug research?
New Zealand is great at innovation but, like most of the world, struggles when it comes to drug development, which is tough, expensive, slow, boring, precise, detail obsessed and high risk. During my time in the United States, we got 16 drugs to market but with that we had about 70 fail — even more in the earlier phase of research and development.
10 Why does Big Pharma have such a bad reputation and is it deserved?
At times they clearly push the envelope by promising too much, but ignoring bad outcomes is potentially disastrous for everyone. All the information you collect, good bad or indifferent, has to be shared with conservative regulatory authorities Iike the FDA and the European Medicines Agency who might notice an adverse effect across several programmes that you'd thought minimal in one study.
11 Are generic drugs undermining the ability of Big Pharma to come up with new cures?
They are, but that's the reality of doing business. Without generic drugs the cost of medicine would be a major penalty. Increasingly the cures are biological drugs. It's harder to make generic versions of these. For example Herceptin is made in a lab by persuading bacteria to produce an antibody and then providing cultures from that. They're much more complex to produce than chemical drugs.
12 Since semi-retiring to Taupo, you've written 10 children's books with heroes like the environmental warrior Tom Hassler. Why is storytelling important to you?
Sometimes my stories are more real to me than the rest of the world. The genre of storytelling goes back thousands of years and can be a great motivator. All of my children's books use storytelling to get a message across.
• Aging for Beginners by Dr Doug Wilson is sold exclusively in Paper Plus stores. RRP $39.99
