The Myth of Aging Gracefully

Ronnie Kaufman / Corbis

Who wants to live to 100? Just about everyone, if old age fulfills the fantasy that we can sail through our 90s with vigorous bodies and minds and die instantly of a heart attack, preferably while making love or running the last of many marathons. As the oldest baby boomers turn 65, it is past time to take a realistic look at old age as it is—not as a minor inconvenience to be remedied by longevity-worshiping hucksters of "anti-aging" supplements or brain-teasing computer games, not as a "disease" that will soon by "cured" by a medical miracle, and not as an experience to be defied and denied, in the spirit of a 2008 World Science Festival panel on aging titled "90 Is the New 50." No, it's not. It's not even the new 70.

The truth is that we are all capable of aging successfully—until we aren't. The media love to uphold examples of "ageless" aging like Betty White, a scintillating comedian at 89, or Warren Buffett, an investment sage at 80. These exceptions are easier to think about than the general rule that physical and financial hardships mount as people move beyond their relatively hardy 60s and 70s, classified by sociologists as the "young old," into the harsher territory of the "old old" in their 80s and 90s. There is a 50–50 chance that anyone who survives to blow out 85 candles will endure years of significant mental or physical disability. The risk of Alzheimer's disease doubles in every five-year period over 65. Furthermore, two thirds of Americans older than 85 are women, who usually become poorer as they age. Many won't die at home, with the best care money can buy, as Sargent Shriver did in January, but in a Medicaid-funded nursing facility after their life savings have been exhausted. There is nothing wrong with hoping for a medical breakthrough to alleviate age-related diseases—especially Alzheimer's—but hope is not a plan of action. Age-defying hope and hype do nothing to address either the overwhelming political issue of how to pay for Medicare and Social Security as the population ages or the many personal decisions about retirement and end-of-life medical care that each of us must make.

This is not to say that anyone should give up on the rewards life can offer the very old, but that, as individuals and as a society, Americans must prepare for the possibility that not the best, but some of the worst years of our lives may lie ahead if we live into our ninth and 10th decades. Geriatrician Muriel R. Gillick, in her book The Denial of Aging, emphasizes the social consequences of faith in an ageless old age: "If we assume that Alzheimer's disease will be cured and disability abolished in the near term," she writes, "we will have no incentive to develop long-term-care facilities that focus on enabling residents to lead satisfying lives despite their disabilities." More important, blind faith in medical solutions prevents discussion about the urgent nonmedical needs of the old. Americans need not only better long-term-care facilities for the sickest old but community-based services to foster independence for the healthier old. When politicians advocate raising the retirement age to bolster Social Security, they also need to consider the dearth of jobs for old people already looking for work. Only when we abandon the fantasy that age can be defied will we be able to begin a conversation, based on reason rather than on yearning for a fountain of youth, about how to make 90 a better 90.