Lifestyles of Centenarians
Robert W. Griffith, MD
June 18, 2004
Professor Thomas Perls of Harvard Medical School is the founder of the New England Centenarian Study (NECS); this study reports on the heath of some of the United States' oldest citizens. He has distilled the most interesting results in his book "Living to 100". Here are some further extracts. Robert Griffith, Editor.
While we were studying centenarians' cognitive function, we were also looking at their individual characteristics, hoping to find something that would account for their ability to live to 100. Our goal was to find out what made centenarians healthier than the vast majority of people. Some highly visible studies had indicated that environmental and behavioral factors -- like diet, exercise habits, access to health care -- were much more important than inherited abilities in coping with aging.
Most researchers believe that studies of diet, lifestyle, and personality would yield more concrete, usable information about healthy aging. However, one morning we were at a lecture at Beth Israel-Deaconess Medical Center, where we happened to bump into Lester Steinberg, the son of one of our NECS subjects. At 79, Dr. Steinberg shows all the signs of slow aging we've become accustomed to seeing among centenarians' children, and he continues to practice medicine in the Boston area. Lectures such as the one we were attending are frequently accompanied by breakfast buffets; Dr. Steinberg reached out for a particularly sugary Danish.
"Do you really want to do that?" we said, surprised at Dr. Steinberg's choice of breakfast fare.
"Why not?" he replied. "I bet if you really knew what all the centenarians grew up eating, even my mother, you would be astounded. Back at the turn of the century, everyone ate fatty, salty foods. Storing food was the big problem, and people ate salted fish and meat, and pickled meat and vegetables. Everyone ate as much sugar and fat as they could find, because it was scarcer. I'm sure my mother grew up eating Danishes, and for all I know, they're probably good for me!"
We then turned to another important and easily measurable dimension of lifestyle: formal education. But when we looked among our subjects for signs of higher learning, again we found a great variety of backgrounds and histories. Only two of our study subjects had advanced degrees: MIT mathematics professor Dirk Struik and psychology PhD Lucy Boring. Some of our centenarians may have educated themselves extensively. Others may have been great readers but for not followers of any professional discipline. However, the average educational level our subjects attained was the 10th grade, which was completely consistent with the times they grew up in. Centenarians tell us it's not formal education that allows one to live to 100 in good cognitive and physical health.
Another avenue that lay open to us was the study of personality. Why did some people cope so well with aging and remained happy and engaged in life, while others with equal or perhaps even greater financial and health resources became miserable in old age? As we began interviewing our subjects, their stories of survival became more amazing and impressive to us. We had previously suspected that one of the reasons centenarians were able to live cell so long was that, just as they had avoided disease, they had also been lucky enough to skirt dangerous and stressful situations. But we quickly found out how wrong we were.
Personality is one of the most important factors in survival. We see this in war, in treatment of disease, in sports, in academics, and in the type of terrible episodes Mrs. Blunder has lived through.1 And we see it as an important component in the lights of centenarians. Something about centenarians allows them to accept the many losses of loved ones that occur along the road to 100, to live with limitations that come with growing over, and to deal with the feelings of impending mortality that certainly hang more heavily as time goes on. Not only do centenarians endure these upsets, but they frequently flourished despite them -- writing poetry and autobiographies, learning to paint, winning golf tournaments.
To identify lifelong personality traits that might lead to healthy aging, we administered personality testing to 60 centenarians. The NEO Five-Factor Inventory is a personality assessment tool that has been widely used to study neuroticism, extraversion, openness, agreeability, and conscientiousness in older individuals. It was very revealing to find that centenarians, particularly women, are relatively immune to neuroticism. The term "neuroticism", the most important and pervasive domain of the five personality traits, is really a measure for what has been called "negative emotionality" or unhealthy feelings, like anger, fear, guilt, and sadness. It includes such emotional facets as depression, anxiety, hostility, self-consciousness (social unease), impulsiveness, and vulnerability. For example, older people who are high in neuroticism would see advancing age as a crisis, and might begin to worry about an unhappy retirement and poor health.
Centenarians are natural stress-shedders, but what comes easily to them because of their innate personalities may have to be consciously learned by the rest of us. This doesn't mean we can't do it with enough efforts or practice, just as those of us without natural athletic ability have learned to hit a tennis ball or ski down a mountain reasonably well. Myer Saxe, a 100-year-old man who rose from newsboy to owner of a large shoe factory, attributes his abilities to shed stress not to an easy-going personality but to a conscious decision at a certain point in life that he was going to be a "fun guy". "I decided not to worry about anything . . . I saw that worrying didn't do any good."
Although we may not be able to change our basic personalities, we can change how we respond to situations. For example, people with hard-driving, achievement-oriented personalities are probably not going to change their basic tendencies, mellow out, and avoid stressful situations. However, they can learn from centenarians that managing stress is important. They can learn the advantages of being adaptable and changing those aspects of their lifestyle that do not contribute to health. They can make conscious decisions to spend more health-enhancing time with family and friends. And they can gain a new perspective on their strivings by taking a humorous look at themselves.
With their stress-resistant personalities and low risk for neuroticism and depression, centenarians are natural stress-shedders who shrug off life's slings and arrows with relative ease. If people can emulate centenarians, either through stress reduction programs, alternative approaches like yoga, or a regular physical exercise program, we believe they stand a much better chance of coping with the mental and physical problems of old age.
Some survival strategies of the centenarian lifestyle are unexpected. One of our centenarians' most effective self-protective devices comes from their ability to lighten their emotional load with humor. Many older people become sensitive about discussing illness, sex, and the prospect of death, or become preoccupied with troubles. In contrast, a visible and consistent component of the centenarian repertoire is humor.
Humor not only helps us cope emotionally, it also helps us to think creatively and solve problems. It encourages and enables our minds to keep active, which is one of the most important defenses we have against aging. In a kind of cognitive reframing, it allows us to approach situations in a new way. As in the saying "If life gives you lemons, make lemonade," humor can turn an embarrassing situation, like accidentally stepping off a dock and getting soaked, into a hilarious and memorable story. Humor often helps people put physical or psychological pain aside so they can get on with their work and lives. Doctors and nurses working with terminally ill patients can use humor as a way to "package and send off" the emotions they themselves feel while watching people die. In the same way, centenarians use humor to gain perspective on their own imminent deaths.
Despite the unavoidable fact that they have outlived numerous family members and friends, nearly all centenarians have many meaningful relationships. They are almost never "loners". William Cohen, 101, who viewed independence as important to his longevity, realized that a close family was just as important. "The goal when you're older is to keep family close," he said, "to be independent, but to have them to help. As you get older, you need people, not dollars and cents."
One of the most interesting paradoxes we found in the study was that a relatively high proportion of female centenarians -- about 14% -- lacked the most important social connection in our culture: marriage. A surprisingly large proportion of our centenarian women never married, even though marriage was an important goal for young women of this generation. However, these lifelong single women were surrounded by loving people of all ages. Marion McDonald, a former Harvard Medical School chemistry instructor who never married, sent out nearly 150 greeting cards each year that she had painted and lettered herself. She received visits and telephone calls from former students across the country, who sought her advice and conversation.
National polls show that religious behavior and attitudes are more prevalent in people over 65. Half of these people go to church each week and three-quarters of them agree with such statements as, "I constantly seek God's will through prayer," and "I believe God loves me even though I might not always pleased Him." Among persons 65 and older, 82% say their religious beliefs are a very important influence in their lives.
One of the key reasons for centenarians' longevity, we believe, is their adaptive capacity. Adaptation is not exclusively passive, nor is it limited to responses to environmental stimuli. The full repertoire of adaptation includes the ability to control the environment and to take charge of situations.
However, when centenarians see that they cannot continue an activity to which they have become accustomed, they quickly either find a workable new way to do the activity or substitute a more manageable one. Several of our centenarians took the unusual step of arranging their own admissions to nursing homes and assisted living environments. Most older people fight fiercely against this loss of independence, and then deteriorate noticeably. When the best solution is a nursing home, centenarians jump in and get comfortable.
The next extracts from Professor Perls' deal with the differences between men and women in their marathon race to centenarian status. You can buy his book "Living to 100" at Amazon; click here
* Living to 100: Lessons in Living To Your Maximum Potential at Any Age. TT. Perls, MH. Silver, 1st edition, Basic Books, New York, NY, 1999
1. Mrs. Blunder is one of the centenarians who survived the Nazi invasion of Austria and the loss of many of her relatives.
* * *
Professor Boring?! Is she ever in the wrong profession!
103 year old appointed to the Order of Canada
10 years ago