“Grow old along with me! The best is yet to be, the last of life, for which the first was made. Our times are in his hand who saith, 'A whole I planned, youth shows but half; Trust God: See all, nor be afraid!”
― Robert Browning
“It's paradoxical that the idea of living a long life appeals to everyone, but the idea of getting old doesn't appeal to anyone.”
― Andy Rooney
Besides the fact that we will likely grow very old and therefore need to plan for it, there is another compelling reason for us to confront our aging and probable old age. Demographic changes have occurred so rapidly that many of us are still living in the past, with negative attitudes and outmoded beliefs and stereotypes about aging. The way we usually view aging is terribly wrong. Let’s examine some of the more destructive myths to uncover our misconceptions around old age.
Myth 1: All older people are basically the same and they are falling apart.
As we age we actually become more unique and differentiated, more individualized and less like one another. None of us ages in exactly the same way and each of us ages at a different rate. Anyone who has attended a class reunion can verify that there are some classmates who seem to have aged very little since they last saw them, while others seem to have aged considerably. So we may see an elderly person with bright eyes and sagging muscles or creaking joints and an active mind.
The organ system changes with age depending on a cluster of interrelated biological circumstances rather than a single dominant factor. Aging represents the interaction between our unique genetic endowment, environmental factors and the rate of its expression through the choices we make. These choices may accelerate or retard the progression of physical change. For example, cigarette smoking appears to speed up aging of the lungs, heart, and blood vessels in addition to substantially increasing the risk of cancer.
We are not only aging longer, we are aging better. We are not falling apart. Longitudinal studies from the U.S., Gotherburg, Sweden and other countries show continued improvements in health status in 65 year-olds enrolled and studied at five-year intervals. The results show that a 75-year-old person in 1990 was roughly the biological equivalent of a 65-year-old in 1960! The findings also confirm the remarkable biological diversity and heterogeneity that occurs with aging.
Myth 2: We become more forgetful and senile as we age
Sir Thomas Beecham (1879-1961), British conductor and founder of both the London Philharmonic Orchestra and the Royal Philharmonic Orchestra, once saw a stately lady in the lobby of a Manchester hotel. He could not quite remember where he had seen her but did remember she had a famous brother. He tried to finesse the situation by asking her how her brother was doing and if he was still employed. The woman replied, “He is doing well and is still King.” We have spent some time in past blogs dealing with forgetfulness and on the need to stimulate our intellect.
Each of us has concerns about our memory and these concerns seem to increase as we get older. We buy into the classical (and modern) stereotype of an old person as someone who becomes progressively more forgetful and childish. What makes things worse is that our contemporary society is not very forgiving of mistakes. We internalize those social values and if we forget where we placed our car keys a process of self-doubt begins. “Is this the beginning of Alzheimer’s disease?” To me, a law of the universe is that we attract what we fear and our preoccupations can distract us to the point that we forget something else. “Now what did I come in here to get?” A vicious cycle can develop.
Most minor forgetfulness is completely normal and inconsequential. Moreover, a significant loss of memory represents a disease and is not normal aging. Well over half of individuals over 85 have completely normal cognitive function. None of this is to trivialize the devastating effects of dementing illnesses such as Alzheimer’s disease, but the key point is that those conditions are diseases that affect memory and other cognitive domains. They do not represent normal aging.
Myth 3: Learning and creativity decline as we age (you can’t teach an old dog new tricks)
This destructive myth is related to the previous myth of inevitable cognitive decline. One of my patients is a 103-year-old former Foreign Service worker who is writing a book on international diplomacy. For the last five years, he has worked on it every morning for a couple of hours pecking away on his portable Smith Corona manual typewriter. Has aging negatively affected his learning and creativity? If it has I cannot see it. Except for his advanced age and his perseverance as a writer, he really is not atypical.
Assuming that learning and creativity inevitably decline with aging is not only inaccurate and pessimistic but it is potentially dangerous. Creative and active projects are crucial to aging well and experiencing a vital longevity. Creativity is the working side of our imagination. It has elements of action, participation and the use of talent. None of this is limited by normal aging. To be sure, elements of our creativity change over our lives but the changes are enriching and are not eroding. To quote Aristotle, “Learning is an ornament in prosperity, a refuge in adversity, and a provision in old age.”
Early measures of mental life appear to be correlated with later mental health. A remarkable scientific study called the Nun Study was a 15-year longitudinal study of 678 Catholic sisters 75 to 107 years of age who were members of the School Sisters of Notre Dame congregation (1). Each nun had annual cognitive, physical and functional evaluations during old age and postmortem examinations were performed on the participants' brains. Each nun had written an autobiographical essay in her 20s when taking her vows. These essays provided researchers at the University of Kentucky with linguistic and stylistic information to compare with later cognitive outcomes. Interestingly, the nuns who filled their sentences with more ideas had much lower rates of Alzheimer’s disease than those with very simple sentence construction. The study was unique because many typical lifestyle factors, such as nutrition, environment, and access to health care, were virtually identical for the nuns.
Leonardo da Vinci remarked, “Learning acquired in youth arrests the evil of old age; and if you understand that old age has wisdom for its food, you will so conduct yourself in youth that your old age will not lack for nourishment.” The continuation of learning capacity throughout life is strongly influenced by interest, activity, motivation, and health. It is important to begin to cultivate some interests when we are young, then keep active and productive with projects and other enriching interests. Sometimes this outcome is not so easy for those deprived of adequate education or other resources.
Riley KP, Snowdon DA, Desrosiers MF, Markesbery WR: Early life linguistic ability, late life cognitive function, and neuropathology: Findings from the Nun Study Neurobiology of Aging 26(3):341347, 2005.