Living to a happy, full old age may be a matter of personal choice as much as genetic predetermination, say two Harvard researchers who base their conclusions on a 60-year study of a group of men.
The study, published Friday in the American Journal of Psychiatry, reported results of an unprecedented research project that tracked the physical and mental health of 724 men as they went from adolescence to old age.
Drs. George Vaillant and Kenneth Mukamal identified seven factors measured across adulthood that appeared to predict successful aging: moderate alcohol use, no smoking, a stable marriage, exercise, maintaining an appropriate weight, having positive coping mechanisms and no depressive illness.
Depression was the only factor they found that was beyond any individual's control.
"An active and happy old age, Horatio, may lie not so much in our stars and genes as in ourselves," said Vaillant, a professor of psychiatry at Harvard Medical School.
The researchers also noted that higher education was also critical to happy aging.
The researchers say knowing what contributes to a "good" old age is important, since the fastest growing segment of the population is the elderly, who are often living two or three decades beyond retirement.
"Over the last century, the number of years an individual spends in active retirement has increased tenfold," he said, "so we must pay attention not only to the ills of the old-old, but also to the determinants of successful aging."
The scientists used data from the Harvard Study of Adult Development, which began in 1940, contrasting the health of 268 Harvard sophomores with that of 456 disadvantaged inner-city adolescents.
Participants in the study got physical exams every five years, while psychosocial exams were done every two years.
The researchers used six outcome measures to determine who reached their 70s and 80s "happy-well" at one extreme and "sad-sick" or "prematurely dead" at the other end of the scale: physical health; death and disability before age 80; social supports and mental health, and how well the individuals rated their ability to carry out daily activities and their "life enjoyment."
They found that the health of the inner-city men declined more rapidly than did the health of the Harvard students: their health status at 65 matched that of the Harvard men at 75. But the health of 25 inner-city men who obtained a college education declined at the same pace as the Harvard group, demonstrating that education, rather than money or social prestige makes the most difference in healthy aging.
The authors also reviewed results of other long-term studies of health in late life - although all the earlier research started with people in their 50s or 60s. Those studies also showed that having a high level of education was a predictor of successful aging, but so too was active involvement in an extended family.
Vaillant and Mukamal concede that their study of white American men born in the 1920s may not apply to other groups, like women and minorities. "Still," they concluded, "we think the results contain a hopeful message for young adults destined by actuarial tables to live past age 80."
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