The age-old question of old age

Explaining in a 2014 article in The Atlantic why he didn’t want to live beyond the age of 75, Dr. Ezekiel Emanuel, one of the architects of the Affordable Care Act, said that by the time he reaches that age, he’ll have done enough, seen enough, loved enough, and been loved enough to call it quits. No more prostate tests, heart bypass operations or cholesterol-blasting drugs.

‘You are old, father William,’ the young man said,‘And your hair has become very white;And yet you incessantly stand on your head –Do you think, at your age, it is right?’

– Lewis Carroll

Explaining in a 2014 article in The Atlantic why he didn’t want to live beyond the age of 75, Dr. Ezekiel Emanuel, one of the architects of the Affordable Care Act, said that by the time he reaches that age, he’ll have done enough, seen enough, loved enough, and been loved enough to call it quits. No more prostate tests, heart bypass operations or cholesterol-blasting drugs.

One wonders whether at 74, Emanuel might have a change of heart. After all, the U.S. now has 10 million people age 75 or older; and that figure is projected to rise to 17 million by 2050.

But as medical science is increasingly able to prolong life, physicians must cope with growing numbers of old people and their problems. They must also learn to live with what amounts to an affront to their profession––being largely powerless to stem the aging process.

But we can change attitudes to the elderly. Who says, for example, that we should still have an arbitrary retirement age of 65––an invention of German Chancellor Otto von Bismarck in the 1880s, when life expectancy was 48? Or why we should shuffle grandpa off to pasture in some ghastly twilight or sunset home? Or indeed, how about regarding old people as entire human beings rather than as a collection of variously declining organs and faculties?

There are, of course, ways to stop––or at least slow down––any decline. Obviously a good diet, sensible eating and sleeping patterns, and regular exercise, to which might be added mental stimulation such as chess or crosswords, and social stimulation.

For those who don’t follow Emanuel’s formula, there are plenty of good reasons to soldier on to a century or even more. Right now, the U.S. has four million people over the age of 85. Today, among those who reached 100 or more before departing this world in 2012 were 21 sports figures, 29 actors, 16 musicians, eight writers and authors, and three medical professionals. So much for ‘Physician, heal thyself.’

Having varied interests and a sense of curiosity will also go a long way towards making one’s final decades happy ones. A stellar example of this is my uncle Edgar who left school at age 14 to work in an advertising agency; in his 30s he was its managing director, cutting a dashing figure in his opera cloak as he visited La Scala or London’s Covent Garden. In his 80s, he would greet me at the front door of his house, wearing an impeccable handmade suit and jaunty bow tie. A self-made polymath, he seemed to me to have an encyclopedic knowledge about almost everything. On our walks together he would stop a workman digging something or mending something and earnestly ask ‘ have you considered doing it this way?’ This didn’t always endear him to those workers; but he persisted in this missionary work before departing the world just shy of his 100th birthday.

Perhaps the greatest benefit of reaching a truly old-age––aside from the attention and respect it commands––is that one will have lived through a large swath of history: today’s centenarians may have witnessed the Great Depression, World War II, the invention of penicillin, Jet engines, television and computers. Giving one’s grandchildren an eyewitness account of history in the form of a memoir is not only great therapy for the donor, but a huge bonus for the recipient.

A panel of experts at a World Economic Forum in Davos asked the question: What is old? They concluded that a healthy 70 year old is pretty much indistinguishable from a healthy 50-year-old. They also noted that while 48 percent of people over age 60 have one or more chronic health conditions, that also means that 52 percent do not.

So take heart, Dr. Emanuel. Living a healthy and fulfilled life beyond 75 is well worthwhile … not only for you; but also for those around you.

And anyway, it’s certainly better than the alternative.

__

David Woods, Ph.D., is a Philadelphia-based medical writer and editor. A former editor in chief of the Canadian Medical Association Journal, he is the author of four books and more than 200 articles, editorials, and reviews in peer-reviewed health care publications.