No Telling How Old Is Old

Old age is an incurable disease.

--Seneca For all of medicine's skills, one thing has not changed since Seneca's day. Old age is as inevitable now as it was 2,000 years ago. Despite jogging's obvious benefits (for some people), it can do no more than slow the decline of the heart and lungs. The most conscientious exercises, careful diet and cautious life-style cannot halt the gradual hardening of the arteries, or prevent the reduced output of critical hormones, or bring a cessation to the wholesale death of brain cells. Such holding actions as face-lifts and skin treatments are ultimately futile. They do not stop the stiffening of tissue that causes wrinkling; they only disguise it.

But as relentless as the toll of the years may be, doctors still find it extremely difficult to generalize about when old age begins. By popular reckoning in the U.S., the watershed year is 65. Yet there is such variability in the human condition that it is scientifically impossible to select a single year as the turning point, even for small groups of people. As Author-Physician Leopold Bellak points out: "Some people who are chronologically 80 are biologically only 60. Their bones, eyes, ears, skin--even reflexes and blood pressure --may be those one expects in a 60-year-old." Complicating matters is the fact that physiological aging varies not only from person to person but within the individual as well. Eyesight may fail while hearing remains acute. Says Psychiatrist Robert N. Butler, director of the National Institute on Aging: "One may be at different 'ages' at one and the same time in terms of mental capacity, physical health, endurance, creativity and emotions."

No one knows yet why human decline takes such a helter-skelter course, or even what causes aging itself. But it is not for lack of trying. In recent years, the new science of gerontology (the study of aging) has expended prodigious efforts to locate life's master clock and perhaps use that precious knowledge to slow it or even stop it. One locale for the clock (if there is indeed only one) may be within the smallest unit of life, the cell. Growing normal embryonic cells of various species in a test tube, Biologist Leonard Hayflick has made an astonishing finding: they are not immortal, as scientists believed from early experiments, in which a single cell line had been cultivated for years, but have definite life spans.

Mouse cells divide only about twelve times before dying, chicken cells 25 times, human cells 50 times. That discovery could explain one important characteristic of aging: the inevitable deterioration of the body's immune system. As the years pass, the system's lymphoid cells, no longer able to proliferate in adequate numbers, lose their power to fight off invaders and sometimes even mistake the body's own tissue for foreign bugs. Thus the aged become increasingly vulnerable to diseases--from cold viruses to cancer.

The aged are also vulnerable in other ways. With the passage of years, tolerance of alcohol declines. Arthritis and other degenerative diseases stiffen the joints. Blood pressure rises, along with risk of strokes and heart attacks, while the functions of such vital organs as the kidneys and the liver decline. One of the greatest differences between old and young is the body's ability to respond to physical stress. A healthy person in his 20s or 30s will be unaffected by a sudden chill because his internal heat-regulatory mechanism keeps his body temperature close to the normal 98.6DEG F. The elderly, on the other hand, are often unable to maintain such temperature stability. When they are exposed to cold, their body temperature may drop sharply, sometimes fatally.

Even so, many effects of aging have been highly exaggerated--largely because past studies of the aged have been based almost entirely on the sick and institutionalized. Gone, for example, is the myth of a lack of sexuality in old age. New studies show that many men and women remain sexually active well past 65--sometimes with embarrassing zeal. Another misconception is that the elderly are dullards.

While they may not be able to come up with the answers as quickly as youngsters, their IQ tests have repeatedly shown that the healthy elderly score as high if given a little extra time. More remarkable, doctors are increasingly finding that symptoms dismissed in the past as incurable senility--forgetfulness, disorientation, inability to do simple chores--can be reversed with drugs and psychotherapy.

As models of fitness in old age, researchers like to point to the inhabitants of the Abkhazia region of Soviet Georgia.

Many of these mountain people are still active, working their gardens, riding horseback, bathing in icy streams, well into their 80s--and not because they like yogurt. Boston's Dr. Alexander Leaf, who spent time with them, attributes their vigor to diet (low fat, high protein, fewer calories), exercise and the right genes. But psychological factors--the sense of being needed, the respect of the community--may also be important. Soviet scientists tell of an elderly man forced to move from his village. Though he had never before been sick, he began to wither rapidly--until brought back to family and friends. The same influences undoubtedly work among people everywhere as they cope with their final years.

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