**13.8 Aging and space gerontology**

Another issue is less theoretical and actually inevitable. Space medicine will be difficult enough without the added complications of advanced aging. Many settlers will necessarily be older based on the need for them to put their expertise and training into effect. In any case, they will age. Therefore, gerontology, defined as the scientific study of old age, the process of aging, and the particular problems of old people, will become important as everyone ages under a never-before set of medical conditions exacerbated by the Martian environment. It will involve medical astrosociology in terms of how individuals handle growing old on Mars in addition to the biomedical changes that will challenge them.

*Space gerontology* has been recognized by NASA and others for quite some time, in fact since 1978 or earlier. The advent of the Space Shuttle program with its first flight of Columbia in 1981 and the recognition that older astronauts would be traveling into near Earth orbit in microgravity, it became worrisome that little was known about the long-term effects of space travel as people age [69]. Nearing the end of the human life cycle in space ecosystems will produce changes, many of which will have never been experienced on Earth. Will ageism be a problem if, for example, not enough medical supplies exist for the younger members of society.

How will settlers handle death? What will cemeteries on Mars look like and what types of religious ceremonies will be held? What meanings will be attached to the deaths of the new Martians? It is quite possible that the ways that deaths are treated will evolve into one or more uniquely Martian versions of Earth observances. This type of sociocultural change is important for astrosociologists to study and understand.

Very importantly, the added complications affecting human beings in a harsh Martian environment that will inevitably impact significantly on the internal ecosystem will make implementing healthcare extraordinarily unique and difficult. What was learned regarding living in microgravity will not apply exactly the same way in a one-third gravity field. Gerontologists who also possess social science training will prove to be invaluable members of the Martian society, just as will geriatric physicians.
