Delaying disability, not disease

It’s been chastening and illuminating to see certain preconceived notions fall by the wayside as my research progresses. An early one was the assumption that good health was a precondition for an active old age. Although I expected to encounter the occasional, extraordinary geriatric Stephen Hawking, it seemed intuitively obvious. And certainly most of the people I’ve spoken with are exceptionally healthy, remaining physically mobile as well as mentally agile. Good luck, good genes.

But many also suffer from chronic or degenerative disease — and it doesn’t keep them from their work.

Macular degeneration has rendered industrial designer Eva Zeisel nearly blind; now she designs with her hands. Chronic bronchitis ended Marcia Muth’s teaching career and tethered her to an oxygen tank; “It doesn’t interfere with the painting, that’s the important thing,” she says. Helen Gressett, a community activist, had her pacemaker battery replaced the week before we met in Santa Fe. Piano player Irving Fields had just gotten a hip replacement. Cornelius Reid taught through cancer. None let illness prevent him or her from engaging with the world.

A newly-released, 25-year study reported in the New York Times confirms my intuition. Of the 2,300 subjects (healthy men an average of 72 years old in 1981), 970 had survived into their 90s. This group suffered just as much chronic illness. The difference — in quality of life as well as its duration — correlated with five behaviors: not smoking, controlling weight and blood pressure, avoiding diabetes, and regular exercise. Predictable, yes; more importantly, completely modifiable. As the lead author of the study put it, ““The take-home message is that an individual . . . can improve the probability that not only might he live a long time, but also have good health and good function in those older years.”

A second study in the same issue (Feb 11) of The Archives of Internal Medicine suggests that some of the oldest of the old survive not because they avoid illness, but because they live well despite disease.