Learning to Stay Young
Author : John Stark    -   Subject : Exercise

The idea is as old as humanity: Learn from your elders. There's wisdom born of age. Maybe that's why, when they decided to see if they could crack the code of healthy aging, Thomas T. Perls, M.D., and Margery Silver, Ed.D., went right to the top: some of the oldest people in America. Though they were looking at frail bodies and wrinkled faces, Perls and Silver quickly realized they were seeing something else: the healthiest people in America. After all, why are they centenarians? Because they don't get sick. Now, through a comprehensive study of what has helped America's healthiest people live such long, healthy lives, Perls and Silver believe they can help extend the health of all of us.

As a healthy (so far) boomer, I want to see what the researchers have seen, perhaps to glimpse my own future. At Silver's suggestion, I call Catherine McCaig, one of the research subjects. She tells me that if I want to meet her, I'd better come soon. Seeing as she's 104 years old, born the century before last, I hurry to her apartment in southern Massachusetts, where she lives by herself. As it turns out, McCaig wasn't referring to her time left on Earth, but to her travel plans. She's about to leave on a train trip to San Francisco, where she plans to see the town. "I love to travel," she says. "If I had the money, that's all I'd do."

Though McCaig's Irish eyes are the faded color of distance, her mind is completely in focus. In the course of my visit, she advocates a boycott of gasoline as a protest against rising prices, recounts James Joyce's vision of hell, and scolds TV chef Emeril Lagasse for not properly pre-heating his oven (McCaig should know, having been a hospital cook for many years). Active in volunteer work, McCaig shows me afghan squares that she's knitting as part of a national project to provide blankets for the homeless. When I tell her I hadn't heard about this, she says, "Everybody's doing it. Catch up with the times."

If you think McCaig is some kind of superwoman, you're probably right. Except for some hearing loss, she has bypassed and outlived the diseases that were supposed to have killed her, like Alzheimer's, cancer, diabetes, and coronary disease. But if you think this centenarian's an anomaly, then you're as wrong as the medical world has been up until the last few years. Of the 169 centenarians whom Perls, Silver, and their staff have studied, nearly all of them had bodies up through their early to mid-90s that overwhelmingly defy what science knows about aging. Colds are rare, as are cavities and broken bones.

Based at Beth Israel Deaconess and Harvard Medical School in Boston, the New England Centenarian Study (NECS) has already yielded some surprising results. Like the fact that women who have children past 40 are more likely to live to 100. Or the theory that the gap in longevity between men and women might be explained by women's low levels of iron. Or that family ties are critical to longevity, even among people without families. The idea behind the data is an idea so simple it was revolutionary: study healthy people. "Up until 10 years ago, most medical training was in hospitals, so all the old people that doctors saw were very sick and frail," says the youthful, 39-year-old Perls, chief of the division of gerontology at Beth Israel Deaconess and an assistant professor at Harvard. "Like most other physicians, I had a very jaded view of who the elderly are. This idea that the older you get the sicker you get had been very strongly ingrained in me." All that thinking went out the window after Perls began interning at a rehabilitation center for the aged outside Boston in the early 1990s. There he met people like Celia Bloom, who at 103 was giving piano recitals, and Ed Fisher, who at 102 was still working as a tailor-and dating. "They were never in their rooms," recalls Perls. "I had to make appointments to see them."

As a result, NECS is the most comprehensive study of the extremely old ever undertaken. Every aspect of McCaig's life (and the lives of scores of other participants), both physical and mental, from the time of her birth until now, is being scrutinized. What NECS wants to know is: What do McCaig and her ilk have that most people don't? Where amid the complex stew of our genes, lifestyle, and environment are the keys to keeping us healthy for as long as possible?

Even if the researchers answer that question, it doesn't mean that someday people will live significantly longer. Although he admits he is searching (successfully) for the so-called aging genes, Perls refuses to contribute to all the millennium hype about future generations doubling and tripling their life spans. NECS' mission isn't to turn people into Methuselahs, he says. "I'm not looking for the fountain of youth, but the fountain of aging well." He terms this concept "compression of morbidity."

"The vast majority of centenarians have lived 90% to 95% of their lives in incredible health, compressing the time that they are sick to the very end of their lives," he says. "If we could all live the vast majority of our natural life spans in excellent health and then have this relatively sudden decline and die-that would be Utopia."

These six lessons from centenarians can move us closer to that Utopia right now: LESSON 1: GET BUSY

Silver, a neuropsychologist, studies all aspects of the subjects' mental health, particularly looking for the prevalence of dementia. Until recently, psychologists assumed that anyone who reached extreme old age was pretty much out of it. To the contrary, Silver's findings have shown that 25% of centenarians have excellent cognitive functioning, and that, surprisingly, "only a few, but not a large number," are depressed.

Certainly not McCaig, who blew me away with her energy and enthusiasm. "I only need four hours of sleep at night," she says. Despite having a rough go at it-being widowed at a young age, never remarrying, and working to support two children-she does not complain. She tells me she never has. Nor has she been a worrier. When I ask her if times were better now, or long ago, she says now. She keeps active, she says, through her volunteer work for the blind and by cooking for her friends. America's healthiest people, Silver says, "love to vote."

Kathy Newell, M.D., one of the neuropathologists on the NECS team, sees physical evidence of that lifetime involvement when she conducts autopsies. So far, more than 20 centenarians have volunteered to leave their brains to NECS. "The first brain I autopsied belonged to a woman who was 101," Newell tells me from her office at the Harvard Medical Lab. "The brain was amazing in terms of its healthy size and weight. There was little, if any, shrinkage, which usually accompanies dementia. I was in awe, as were all of my colleagues. It was quite a beautiful brain."

Newell offers personal evidence as well. "My grandmother just died at age 94," she says. "Osteoporosis gave her considerable pain and limited her mobility, but her lifelong positive outlook did not allow this to keep her from enjoying life. Although walking was uncomfortable, which kept her from getting out much, she really worked to keep her mind active. She kept in touch with her friends by calling and writing letters. Her memory was incredible. I would like to think how we live does affect brain health."LESSON 2: AVOID TOXIC WAIST

Perls and Silver have encountered only a few centenarians who are overweight. Like McCaig, most have been thin throughout their lives, have never smoked, and rarely drank alcohol. "I've always eaten what I wanted," says McCaig, offering me some of her ginger candies. But then, she says, "Up until age 100, I exercised my arms and legs regularly. I think that really helped me." And, she says, to get to the hospital where she worked, she had to climb steep hills.LESSON 3: REACH OUT & TOUCH SOMEONE

"Centenarians," says Silver, "have very strong social networks and families. That's been the biggest surprise to me." Those without their own families have created families of friends and associates. Again McCaig proves no exception, being very close to her son (who's a mere 78 years old), whom she sees almost every day, and his family.

Silver describes a centenarian charisma: "They attract people. People want to be around them. Centenarians have wonderful senses of humor. They use it for all kinds of things, like joking about death. The thought of dying is no big deal. They've had time to prepare, to resolve the issues of their lives."

Who wouldn't cherish spending time with McCaig? For my visit, she wore a smart blue suit and leopard print scarf. She made brownies, put on a tape of herself being interviewed for CNN, and told me tales of her father's Model T. Even though she's dependent on a walker since breaking her hip four years ago while vacationing in Ireland, she eagerly jumped up to play me show tunes on her grand piano, which occupies half of her cramped studio apartment. Asked if she had any fear of death, she said matter-of-factly, "none whatsoever."LESSON 4: ADEPT AT ADAPTING

"Centenarians exhibit an extraordinary ability to adapt, even to something as traumatic as moving into a nursing home," Silver says. That's not to say they don't experience shocks and stress, it's to say they handle it well. "Many have had very tough lives, but they manage to get on with things. At their age they've had many losses. It's not that they don't grieve, it's that they grieve and move on." When I ask McCaig about outliving her husband, her daughter, and most of her friends, she says it hasn't been so difficult. "You go on." LESSON 5: LUCKY TO BE A WOMAN

Most centenarians are women-an overwhelming 85%. Be it for centenarian women or women destined to live average life spans, both Perls and Silver have hunches as to why women outlive men.

"Many people think women live longer because of estrogen, which is, among other things, a pretty powerful antioxidant," says Perls. But he's about to release a paper proposing an alternative theory.

"I personally think," he says, "women live longer as a result of their menstruating for 30 to 40 years. Because of that they become iron deficient. Seeing as iron attracts cell-damaging free radicals in the body, that iron deficiency anemia may be responsible for helping women age more slowly than men. As soon as women stop menstruating, their iron levels catch up with men's. That could explain why we see the onset of heart disease and stroke developing in women 10 years later than they do in men."

If that sounds controversial, it won't be a first for Perls. A media storm hit two years ago when he released a paper demonstrating that women who gave birth after the age of 40 had four to five times more likely a chance to live to 100. His findings showed that 20% of the centenarians he studied had given birth past age 40, compared to only 5% of women with average life spans. That shouldn't, however, imply that middle-aged women should be buying Pampers along with their vitamin E and selenium.

"It's not the actual act of having a child," explains Perls. "It's that having a child later in life is a good marker of a reproduction system aging very slowly."

According to Silver, women have it over men on the mental-health front, too. "I think women seem to handle stress better," she says.

But don't take all of this to mean that women truly are the stronger sex. "If a man can reach the age of 100, a phenomenal thing happens," says Perls. "He is less likely to suffer dementia than a woman, and more likely to live longer."
LESSON 6: ALL IN THE FAMILY

The Centenarian Sibling Study Program that Perls launched in 1997 found that living to 100 and beyond often ran in families. The odds of it being a pure coincidence that so many people from the same bloodlines live to 100, Perls says, are "10 to the 18th zero." In other words, one has the right genes, or one doesn't. In McCaig's case, her parents lived into their 80s in an era of poor nutrition and no antibiotics. McCaig's sister, Winnie, is 95 and going strong.

But Perls is hoping that some of that genetic magic can have applications for the rest of us. That's why the team is examining the centenarians' DNA, searching for regions of DNA or chromosomes that the centenarians have in common. He says the team is narrowing down which genes in particular are responsible for survival traits. "We are very close to defining that region," he says, "and when we do, it's going to turn the field of aging on its head. There's going to be valuable information for developing drugs that will allow people to become more centenarian-like. These drugs may not let you live to 100, but they will help you markedly delay or escape the diseases usually associated with aging."

Think "compression of morbidity." And, Perls warns, don't wait for the miracle drugs.
HAPPY ENDINGS

"For the majority of us who carry an average set of genes," Perls says, "those average genes should allow us to get well into our 80s in excellent health. In order to do that, we need to markedly improve upon what we're doing with our environment, because we're currently living about 10 years less than that. That means giving up smoking, not being overweight, eating a proper diet, getting appropriate exercise, and taking antioxidant vitamins."

Even though Perls says that anti-aging drugs are on the horizon, he says they're not going to be the answer to staying young. "Are the drugs more important than lifestyle?" he asks. "Absolutely not. That's my point. We don't need to wait 10 years for such drugs to come down the pike. And in fact, we shouldn't. As far as I'm concerned, changing behaviors will have as dramatic an effect as any medication. Although changing your diet requires willpower and effort, it's my hope that people will realize it's worth it, because what they're doing is adding 20 to 25 years of good health to their lives beyond the age of 65.

"If your ancestors are dying in their 60s or 70s, an alarm bell should be going off," Perls says. "You should establish a very good regimen of prevention and screening with your physician. You need to be doing things right, otherwise you'll follow suit with the rest of your family."

Take McCaig's word for it. After all, she's 104 years old. On her wall is a bronze plaque in recognition of her volunteer work. On her couch is a stack of books to be read. On her end table is a pair of castanets that she has somehow just acquired, and is trying to figure out how to play. Before heading out, I can't help but ask McCaig the question she's doubtlessly heard a million times: What is your secret for staying young? "I have no secret," she tells me simply and directly.

But she does, and any day now Perls will be telling us.
COUNT TO 100


Although centenarians were almost nonexistent before the 19th century, today they're the fastest-growing group of Americans. A just-released U.S. Census Bureau report estimated that there are almost 61,000 in the country, almost double the 1990 census figure of 37,000.
By 2050, centenarians are estimated to be anywhere from 800,000 to 4 million in number.
The largest percentage of U.S. centenarians live in the so-called "Longevity Belt," which encompasses Wisconsin, Minnesota, and the Dakotas-areas that were largely settled by Scandinavians.
Hallmark Cards expects to sell 70,000 centenarian birthday cards this year.
In laymen's terms, most centenarians die because everything wears out. "It's often an incredible shock when they do die," says Margery Silver, Ed.D. "Because they're doing so well, you almost begin to think they're immortal."
About 9% of people over 100 live independently.
Because most centenarians didn't spend a lot of time in the sun, they often look younger than their children who enjoy outdoor activities (this should tell you to wear sunscreen).
The oldest human being in recorded history was France's Madame Jeanne Calment, who died in 1997 at age 122. (She quit smoking at age 117.)
Living to 100 won't create a national health crisis. The Health Care Financing Administration recently reported that medical expenditures for people in their 70s for the last two years of their lives averages $22,600. For centenarians, it's a mere $8,300.

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