Aging in the New Millennium

WHAT IS AHEAD FOR US?

by Fred Warshofsky

As we enter the new millennium we are also crossing a watershed in human history. For the first time the likelihood exists that a child born in America today will live to see his one-hundredth birthday. There is also a better than even chance that at least one of his or her parents will achieve the Biblical three score and ten, and perhaps four million of that group will become centenarians.

Many social policy analysts consider the coming explosion of the elderly in America the equivalent of a new tidal wave of immigrants, with the power to forever change the social and cultural landscape. Consider that each day three thousand people turn sixty-five, and only two thousand over that age die. The net is a thousand new members of the elderly generation. In the next twenty years the sixty-five-plus population in America will grow by 71 percent, more than twice the growth rate of the general population. By the year 2020, one out of every six Americans will be over sixty-five.

Genetics will play a large role in determining just who will enter that select group. After all, if grandma lived to a ripe old age, so might you. That at least has been the prevailing wisdom. But in point of fact, lifestyle and location may play an even greater role than genealogy in determining longevity. A recent study in The New England Journal of Medicine states flat out that the United States may be the healthiest place on earth for old people. The report found that Americans who reach age eighty could expect to live about a year longer than the elderly in four other industrialized countries. The results were totally unexpected, since the United States trails many other countries in life expectancy measured from birth.

But those Americans who do make it to old age, do as well as or better than elderly people anywhere. "It's a surprise to us, and I think it will be a big surprise to the Europeans, who always argued that they are doing so much better than the U.S.,'' says Dr. Richard M. Suzman, head of the Office of the Demography of Aging at the National Institute on Aging.

One probable explanation for older Americans' longevity is the quality and availability of their health care.

"When people turn sixty-five, we become a country with universal health care,'' notes Kenneth G. Manton of Duke University, the study's principal author. "Other countries have it from birth, but they cap expenses, and that translates into delays.''

Americans on Medicare get virtually any care they need-new knees, coronary bypass surgery, transplants, whatever-without long waits. Other countries hold down costs by limiting the availability of expensive services and requiring patients to queue up, sometimes for many months.

"Older people can tolerate waits less well,'' Manton said. "Being incapacitated while waiting for joint replacement surgery can have a disastrous effect on someone who is eighty.''

Manton and fellow demographer James W. Vaupel of Odense University in Denmark looked at death records of people born between 1880 and 1894 in the United States, Sweden, France, England, and Japan. The data offers the first reliable comparisons between countries.

The study found that American women who turned eighty in 1987 were expected to live 9.1 more years, while men were expected to live 7 more years. Life expectancies for eighty-year-old women and men in Japan were 8.5 and 6.9 more years, respectively; France, 8.6 and 6.7; Sweden, 8.3 and 6.5; and England, 8.1 and 6.2.

The researchers also calculated the odds of surviving five more years at ages eighty, eighty-five, ninety, and ninety-five. Americans consistently did best. For instance, an eighty-five-year-old American woman has a 58 percent chance of living five more years, compared with 53 percent in France, 52 percent in Japan, 51 percent in England and 50 percent in Sweden.

When life expectancy is measured from birth, the United States trails Japan, France and Sweden and is locked in a virtual tie with England. Japanese women have the world's highest life expectancy at 83. An American woman's life expectancy is 79.8.56

The other major factor is that a generation that has devoted itself to eating right and keeping fit has a far better chance of becoming centenarians than those who by circumstance or decision eat poorly and get little or no exercise. Thus, longevity may well be determined as much by our own desires as by our genealogy.

Given the fact that we are all inevitably going to age, the question becomes less one of quantity than of quality. How good will life be for those of us who hit the century mark and beyond? Will we roller-blade along on our replacement hips and knees, our bones and muscles strengthened by hormone and vitamin cocktails, our minds and memories enlivened by Urdu lessons and games of virtual three-dimensional chess?

The idea is appealing, but still, 100 or 120 years is a long time to live. Even setting aside the enormous social and economic problems facing a nation with one-third of its citizens on social security and Medicare, will those who successfully meet the physical challenges of old age enjoy their longer lives?

Getting older usually signifies more aches, pains, memory problems, and other age-related discomforts. And these problems will not go away despite our lengthening life spans. But that does not necessarily signify a decline in the ability to enjoy life. Individual happiness according to a study reported in the Journal of Personality and Social Psychology found that as people get older, they become happier, not sadder. Psychologist Daniel K. Mroczek, Ph.D., of Fordham University, and Fulbright Scholar Christian M. Kolarz, B.S., of the University of Warsaw in Poland examined the responses of 2,727 men and women age twenty-five to seventy-four years old to a survey to find out how much a person's age, gender, marital status, education, stress, health, and personality (levels of extroversion, introversion, and neuroticism) affected their well-being.

"The older the person was, the more he or she reported positive emotions like cheerfulness, life satisfaction, and overall happiness within the past thirty days," wrote Mroczek and Kolarz. "And surprisingly, the younger participants reported more negative emotions, like feeling sad, nervous, hopeless, or worthless. We found that age still had an affect even when the other factors (gender, marital status, education, stress, health, or personality) were taken into account as possible influences."

Another surprise turned up among older men, especially the married ones, who reported being the happiest and having the least amount of negative emotions. Older women also reported more positive emotions than their younger counterparts. But age played no role among the women in their reporting of negative emotions.

Those that were measured as the happiest were not only older and male, but were also married and more extroverted," said Dr. Mroczek. "We have seen this before in other research on age and well-being which found that relationships played a major role in determining the extent to which people gain greater regulation over their emotions as they age. It is possible that men are able to learn how to minimize negative emotions in their marriages.

"From our research," said the authors, "we have seen that older adults regulate their emotions more effectively than younger or middle-aged adults. We can propose that older individuals seem to be able to know, through their years of experience, what kinds of external events increase or decrease their positive and negative emotions.Therefore, they achieve a better 'emotional balance' by selecting people and situations that will minimize negative and maximize positive emotions."57

Amidst the flurry of studies and testing the elderly have been subjected to over the last decade or so, one single characteristic seems to typify those who are successful agers. Mental toughness is the trait shared by virtually all centenarians. "Strong personalities distinguish centenarians," says Leonard Poon, director of the Centenarian Project at the University of Georgia, the longest ongoing study of people one hundred and older in the nation. "They tend to be domineering. They tend to be what we call suspicious. Essentially they would not easily believe what you say. They want to verify what you say."

A deep and abiding spiritual belief is another distinguishing characteristic. "Religiosity was found to be an important factor in the lives of all centenarians," notes Poon. These older adults, regardless of whether they are black or white, are all very religious and it serves as a support system. We found this related to mental health. We did not find much depression among our centenarians."

The future, like the past, will be pretty much what we make it. But never before have we had the awesome, almost God-like ability to virtually double the human life span. For the first time in history control of the aging process lies in our own hands. Everything from complicated genetic technology to simple exercise, constant intellectual challenge, and a good diet can mean longer, healthier years. The only remaining question is how many of us will take advantage of the miracle that is being offered. For it will happen, and sooner rather than later.  

From Stealing Time, The New Science of Aging, by Fred Warshofsky. Copyright 1999 by Fred Warshofsky. Excerpted by arrangement with TV Books. $26. Available in local bookstores or call 800-242-7737 or click here.