The Oldest Old; January 1995; Scientific American Magazine; by Perls; 6 Page(s)

In medical school I was taught that the incidence of chronic, disabling disorders, particularly Alzheimer's disease, increases inexorably with age. I therefore expected that people older than 95 years, often called the oldest old, would be my most debilitated patients. Yet when I became a fellow in geriatrics, I was surprised to find that the oldest old were often the most healthy and agile of the senior people under my care. In fact, the morning I was scheduled to interview a 100-yearold man as part of a research project, he told me I would have to delay my visit. He had seen 19 American presidents take office, and he would be busy that morning voting for the next one.

Such encounters made me wonder if the prevailing view of aging as advancing infirmity was partly wrong. Could it be that many people in their upper nineties enjoy good health and that the oldest old constitute a special--and longmisunderstood--population? Since then, the centenarians I have met have, with few exceptions, reported that their nineties were essentially problem free. As nonagenarians, many were employed, sexually active and enjoyed the outdoors and the arts. They basically carried on As If age were not an issue. And accumulating evidence indicates that a signi ficant portion of the oldest old are indeed healthier than many people in their eighties or early nineties. The common idea that advancing age inevitably leads to extreme deterioration does, indeed, seem to require revision.