Living to a century with a few major problems

February 12, 2008 by  
Filed under ALZHEIMER'S

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Can you reach 100 if you’re not in perfect health? According to an article in the Archives of Internal Medicine Disentangling the Roles of Disability and Morbidity in Survival to Exceptional Old Age, the answer is Yes. People commonly marvel at how healthy a certain centenarian seems. But for some 100-year-olds, “seems” is the operative word. For up to a third of the people in the study, they did have diseases (heart disease, dementia, diabetes, etc.), sometimes for 15 years. The difference is that their diseases didn’t disable them.

One reason that these very elderly people were not disabled by disease is that their diseases weren’t taken for granted, as an untreatable but natural part of growing old. Sometimes elderly people get worse because the elderly don’t receive the same treatment a younger person would have. Why bother, the doctors tell themselves. How much longer can they live anyway?

A long time, it turns out, at least for the elderly people in the study. But aggressive treatment was not the only factor. In fact, some of the centenarians prided themselves on not taking any medications. When a doctor asked my grandmother to what she attributed her long life, she replied, “I eat right, get exercise and I stay away from doctors.” The doctor was caught off guard, of course, but he admitted that she might have a point.

Many of the elderly people in the study were not brought down by their diseases until the very end. The researchers called it “compression of disability.” Instead of dragging along for many years, they dragged along for only a few years. Of course, the more problems they had, the less likely they were able to do that. A person can reach 100 with a major problem such as Alzheimer’s or heart disease or hypertension or Parkinson’s disease. But few people can reach 100 with five major problems.

Public health officials warn against a coming epidemic of Alzheimer’s disease. And it’s true that the more people who live to 85, or 90, or 100, the more there will be with Alzheimer’s disease. But with compassionate, understanding caregivers, their lives need not be hopeless.

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