Healthnotes Newswire (June 14, 2001)—Men may have greater personal control over their physical and mental health as they age than previously thought, according to a landmark review published in the June edition of the American Journal of Psychiatry.¹

The Study of Adult Development at Harvard University, which began around 1940, is the first published study to examine physical and mental health from adolescence to old age.

The researchers followed two groups of adolescent boys (237 college students and 332 inner-city youth) for 60 years or until death. Complete physical examinations were performed every five years and psychosocial data was obtained every two years. The authors tracked lifestyle factors that were out of the participants’ control (i.e., social class of their parents, family togetherness, major depression, ancestral longevity, childhood temperament, and physical health at age 50) as well as lifestyle factors that reflected some measure of personal control (i.e., alcohol abuse, smoking, marital stability, exercise, overweight, coping mechanisms, and education).

At 70 to 80 years of age, the participants’ quality of life was evaluated. Well-being in old age was defined along a continuum ranging from the happy-well to the sad-sick. Between the two poles were individuals with a mixed evaluation of their well-being. The relative “success” with which an individual aged was expressed as a composite of physical health, death and disability before age 80, social support, mental health, key activities of daily living, and life enjoyment.

The authors found they were able to accurately predict “good” and “bad” aging from age 70 by evaluating lifestyle factors before age 50, and sometimes as far back as adolescence.

Protection From the Ravages of Time

For both the college and the inner city groups, absence of alcohol and cigarette abuse before age 50 were arguably the most important protective factors for successful aging. Physical health, death and disability before age 80, social support, mental health, and key activities of daily living were all adversely affected by heavy use of alcohol and cigarettes.

Other important predictors of healthful and happy aging included a “warm” marriage, absence of major depressive disorder, and good physical health at age 50.

Education, Longevity, and Quality of Life

One key finding of the new study is that a higher degree of education is associated with a slower rate of health decline. The proportions of men in the happy-well, intermediate, sad-sick, and prematurely dead categories did not differ between the college group and the inner city group, except that the college group reached every stage of disability and death about 10 years later than did the inner city group. Despite large differences between the two groups in terms of social class, prestige of college, intelligence test scores, current income, and job status, the men in the inner city group who completed 16 or more years of education declined no more rapidly than did men in the college group. In other words, education appears to have been a more significant determinant of successful aging than other differences in socioeconomic status.

Adding Life to Years; Not Just More Years to Life

In 1990, there were 4 million people age 85 and older in the United States. There will be ten times that many in 2040. The octogenarian of today, thanks to changes in lifestyle and medical advances, is more active and less disabled than the octogenarian of 20 years ago. Nevertheless, aging is associated with inevitable decline. Senses slowly fail after the age of 20: vision in dim light declines steadily; by age 70, adults can perceive only 50% of the smells they could recognize at 40.² The ability to move about declines until, by age 90, most people can no longer use public transportation.³ In addition, we become increasingly dependent on medications. However, the extent to which the decline of aging debilitates an individual varies considerably. And some things do not diminish with age, such as our ability to love and experience joy.

A previous study on aging recently concluded, “Old age is not foremost a negative and problem-ridden phase of life.”⁴ The new findings concur and paint a hopeful picture for young adults who will live into old age. The protective factors that distinguish the happy-well from the sad-sick (i.e., weight, exercise, abuse of cigarettes and alcohol) are largely within our power to control. With hard work and possibly therapy, strategies for coping with stress and difficulties in relationships with spouses can be improved. The authors conclude, “A successful old age, Horatio, may lie not so much in our stars and genes as in ourselves.”

Jeremy Appleton, ND, is a licensed naturopathic physician, writer, and educator in the field of evidence-based complementary and alternative medicine. Dr. Appleton is Chair of Nutrition at the National College of Naturopathic Medicine and Senior Science Editor at Healthnotes.
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