In Genesis 6:3, after creating people and watching them multiply, God promptly put a limit on man’s lifespan, setting the maximum number of years a person could live at 120.
Moses is said to have reached his 120th year. Antisa Khvichava, a Georgian woman who laid claim to the title world’s oldest, died last month at 132 (or so she said; her birth certificate was lost), and Besse Cooper of the state of Georgia turned 116 over the summer.
If those are the types of numbers we’re shooting for as a species, we haven’t quite reached our full potential yet. But would we want to?
“Depressive disorders are much more common” in people who have had strokes, heart attacks or other ailments associated with aging, says Marc Zisselman, director of geriatric psychiatry at Einstein Medical Center in Philadelphia.
“Functional impairment, cognitive impairment, uncontrolled pain, insomnia, isolation — they’re all strongly associated with depression. Individuals in nursing homes have a very high prevalence.”
Depression affects more than 6 million Americans over age 65, according to the Geriatric Mental Health Foundation, and the American Psychological Association says there is evidence to suggest some of the natural physical changes associated with aging may in fact increase the risk. (Zisselman does point out that depression, however common, is not considered a “normal” part of aging. Grief and sadness in response to life events, on the other hand, are.)
A hundred years ago, there were fewer than 4 million Americans 65 and older. In 2010, there were over 40 million, according to the U.S. Census Bureau, which predicts that by 2050 that figure will have more than doubled.
The fastest-growing subgroup in that population is the 85- to 94-year-olds.
Living longer means, of course, being healthier for longer, at least relatively — but there’s a huge discrepancy among the older set, Zisselman says: “If you take a bunch of 25- or 30-year-olds, they’re much more alike than dissimilar. If you take a bunch of 75-year-olds, they run the gamut from people who are CEOs of Fortune 500 companies to people in a vegetative state or suffering from Alzheimer’s disease.
“Most baby boomers, in the scheme of things, are interested in living longer — but more interested in maintaining a high quality of life,” he adds.
Medical research is working on maintaining that high quality of life by trying to prevent the diseases of aging before they occur. Scientists are identifying the biomarkers — the biological molecules found in the body that indicate risk for certain ailments — and coming up with treatments that can be started well in advance of a disease appearing.
Low bone mineral density, for example, can be a biomarker of osteoporosis. High blood pressure might be another biomarker, and “an argument to intervene,” says Jason Karlawish, a professor of medicine, medical ethics, and health policy and a fellow of the Institute on Aging at the University of Pennsylvania. His research focuses on dementia.
“There’s no question a variety of common events seen as people age are, more and more, being regarded as discrete diseases that are amenable to diagnosis and intervention,” Karlawish says.
In other words, rather than looking at osteoporosis or heart disease or stroke as something that just happens when you get old, they’re now seen as avoidable — or at least delay-able.
Like Zisselman, Karlawish points out the “tremendous variability amongst older adults,” but adds that some diseases are common enough that “packaging the phenomena of aging as discrete diseases” and focusing research on preventing each one individually makes sense.
Many times prevention comes in pill form, but there are other ways to stay healthy longer. Karlawish compares seniors in the U.S. to those in Italy, who are generally more functional, he says, because “for much of their lives, Italians were walking around, climbing hills, carrying groceries — they have a regular chronic exercise habit. Habits and physical activity absolutely influence what we call aging.”
On a public health level, Karlawish suggests revamping cities and towns as a way to encourage habitual exercise and a healthier, more independent old age. He also thinks it’s time to change the conversation about aging entirely.
“We need to explore new opportunities for thinking about what it means to grow old in America. Instead of seeing the end as retirement for many, many years, people should go through different phases of working,” he says.
Rachel Vigoda is an award-winning writer and editor represented in a number of area publications and online sites. This article appeared originally in "The Good Life," a special section.