Successful aging: THE SECOND 50

The 16th century Spanish explorer, Ponce de Leon, marched off in search of the fountain of youth, only to discover death. Intruding into hostile Indian territory in Florida, de Leon was killed by an arrow at age 47.

But today millions of Americans are experiencing the longer life that eluded de Leon. In fact, the percentage of Americans age 65 and older has more than tripled in the last 100 years, and now represents 13 percent of the population.

Not only are more people living into the second 50 years of life, 70,000 centenarians have entered their third 50 years. And by 2050, the U.S. Census Bureau estimates the number of centenarians at 834,000--although the bureau's "high-end" calculation predicts that figure could climb as high as 4.2 million.

The urgency, now, has begun to shift from that of medically prolonging life to ensuring that a prolonged life is worth living.

Psychological researchers are attacking the problem along several fronts, and some of the most practically applicable work has come from the field of memory and cognition.

"It is cognitive capacity, more than any physical disability," says Margery Silver, EdD, a neuropsychologist at Harvard, "that most often determines whether people can attain extreme old age while remaining active."

Thus, studies in this area range from better understanding mental functioning, to the importance of social support in keeping memories sharp, to the basic review of everyday activities, such as the way we use ATM machines or solve crossword puzzles.

Psychologists are proving almost daily that humans in their later years have far more physical and mental strength than imagined. They are showing that memory loss can be reversed by personal strategies such as daily memory checks and regular mental exercises. And they're designing methods to help people change their behavior to take advantage of increased longevity.

"There are innumerable important questions about health and aging that psychologists are poised to answer," says researcher, Denise Park, PhD, of the University of Michigan.

Decline not inevitable

In fact, a new paradigm, centering on the idea that memory and cognitive power don't necessarily decline with age as traditionally thought, is taking hold within the psychology community.

That concept gained momentum with study results released last fall by a team of Princeton University psychologists. They found that adults continue to grow new brain cells throughout life. Those late-generated cells, they found, may allow older people to bolster their learning and memory capabilities, or even to stave off declines. Such capabilities were never envisioned under the old theory that cells stopped forming--and actually started dying--by age 40.

The byproduct of that report--by Elizabeth Gould, PhD, Alison J. Reeves, Michael S.A. Graziano, PhD, and Charles G. Gross, PhD, in the Oct. 15 issue of Science (Vol. 286, No. l, p. 548-552)--has been hope among researchers.

Why? John Cavanaugh, PhD, a researcher on aging issues at the University of North Carolina at Wilmington, believes the answer lies buried in memory, and filed under "Beliefs."

"With memory, it does appear that people's belief systems are important," says Cavanaugh. "There are hints that the kinds of things people tell themselves [about their ability to remember] matter."

Older people, for instance, might believe their memory and intellectual power is insufficient, and therefore may avoid learning how to use a computer, or may shy away from a training course in strategies for learning and retaining new information.

"The stereotype is that memory is supposed to decline," adds Cavanaugh, "but that's still an open question."

Peter Martin, PhD, a professor of human development at Iowa State puts it even more bluntly: "No matter what your age, the memory is still trainable. You can teach an old dog new tricks."

Pursuing that theory, researchers are studying the value of having older adults develop memory strategies, perform a daily self-monitoring of their memory and carry out regular mental exercises--for example using associations with one or more of the senses, to encode information into memory.

"But people have to make a conscious decision to do this," says researcher Robin West, PhD, at the University of Florida. "It's not going to occur automatically."

In the meantime, other researchers are approaching the memory puzzle by looking beyond the strategic to the very tactical issues faced in everyday life. A group of Georgia Tech researchers, for example, used the daily crossword puzzle as a model for studying differences between young and old in "novel problem-solving" and in memory recall.

Timothy Salthouse, PhD, and David Hambrick, PhD, of Georgia Tech, whose report appeared in the Journal of Experimental Psychology (Vol. 128, No. 21, p. 131-164), were surprised to find no evidence that crossword puzzle-solving reduced, in older adults, the known age-related decline in problem solving ability--nor did it increase the known age-related gains in stored memory.

They also found, to their surprise, that skill at abstract reasoning played no role at all in a person's proficiency at solving a crossword puzzle--whether young or old. Simple knowledge--experience--made the difference.

"In other words," says Salthouse, "some jobs require rapid problem solving, where people are always performing to the limits--professional athletes and air traffic controllers, for example. But many jobs are like crossword puzzles. Novel problem solving is less important than experience."

Thus, says Salthouse, the study suggests that even though older people may not perform as well in spontaneous activities, they can do the job just as well if they have experience in that field.

Banking on success

But what if they have no experience in a field?

That was an issue raised by Wendy Rogers, PhD, at Georgia Tech, with her study of automatic teller machine (ATM) usage--conducted with Elizabeth Cabrera, PhD, and Neff Walker, PhD, and published in Human Factors (Vol. 38, p.156-166).

Not surprisingly, they found younger adults more likely to use ATMs than older adults are. But in all age groups, ATM users took advantage of more technologies and had more experience with computers. Nonusers avoided ATMs because they felt unsafe or uncomfortable dealing with machines.

The point, says Rogers: Older adults who don't use ATMs are penalizing themselves. "They are falling behind in everyday living," she says.

But older people certainly can lead independent lives--with training, she adds. For instance, home health-care technology has begun to produce devices that would allow older patients to care for themselves. So researchers are now working on ways to make blood pressure and blood glucose devices easy for older adults to operate, says Rogers.

Similarly, she'd like to see psychologists design training programs for these types of new technologies.

"The best predictor of who will use the [home health] machines is someone who used technology previously," says Rogers. "Those people are more quick to adapt."

There are even training methods to make it more fun for people to adapt. Lawrence C. Katz, PhD, a professor of neurobiology at Duke University says his easy-to-perform "neurobic exercises" help the brain to not only maintain connections between nerve cells--and thus preserve memory recall--but aid in developing new connections.

Those exercises are at the heart of his book "Keep Your Brain Alive," (Workman, 1999) co-authored by Manning Rubin.

"The mental decline most people experience is not due to the steady death of nerve cells," says Katz. Rather, it is the atrophy of connections between nerve cells in the brain. Contributing to such atrophy, he says, are routine behaviors, many of them almost subconscious, that require little brainpower.

"It's startling to realize just how predictable and free from surprises our everyday lives really are," he says.

Neurobics is based on two principles, he says: "Experience the unexpected and enlist the aid of all of your senses during the course of the day."

For instance, he suggests listening to a piece of music while smelling a particular aroma. Or turning the photographs on your desk or the clock on your wall upside down to completely engage your attention. Or take a completely new route to work to break your routine.

In developing his exercises, Katz says it was important not to set a single standard for everyone, "Because some people would give up after repeated failure," he explains. "The important thing is not to force people to do things that they can't do, or to provide exercises that bore them."

Thus, he stresses the offbeat and the element of fun.

"Do something that challenges and engages your mind," he says, "not because it's difficult, but because it's different from what you normally do."

Meanwhile, memory loss isn't the only age-related decline that can be reversed. So, too, can the frailty of old age, says Robert Kahn, PhD, 81, of the University of Michigan. Kahn, co-author of "Successful Aging" (Pantheon, 1998) says that most older people, even the very old and weak, "have the capacity to increase their muscle strength, balance, walking ability and overall aerobic power."

Many older people tout the value of a daily exercise regimen in maintaining their positive outlook on life and physical health. But, in fact, says Kahn, a major benefit of pursuing a physical exercise program is for its influence on memory.

"Physically active people are most likely to maintain sharp mental ability," he says.

Memory enhancement also appears to be a potential benefit of a balanced diet, says new research. While it's been widely proven that good nutrition enhances overall health, research recently conducted at Tufts University, for example, found that men aged 50 and older who had low levels of the B vitamins folate and B12 were not as good at performing memory tests as those with higher levels of vitamin B.

Other research in the past several years has linked mental dexterity to vitamins C, E and beta carotene: These antioxidants may prevent damage to the brain's neurons.

Social support vital

Another key research finding that promotes successful aging is the need to stay connected with other people. Yet even as research has shown for years the value of promoting and developing social support programs, it is often overlooked.

"Psychology can get the word out that certain kinds of behaviors, like diet and exercise, are important," notes Kahn. "But a less appreciated area is specifically psychological. People do better if they continue to engage with life and maintain close relationships."

Those relationships can enhance both physical and mental health. For instance, a study of 695 older men and women--mean age 79--by Namkee Choi, PhD, and John Wodarski, PhD, of the State University of New York-Buffalo, published in 1996, examined the relationship between social support and the health status of elderly people. They found that "social support for the elderly tends to slow down further deterioration of their health, proving that a higher level of social support may result in better health outcomes."

And in another 1996 study, Maria Mireault, PhD, and Anton de Man, PhD, of Concordia University in Montreal, found that thoughts of suicide in aging adults were connected to "high social isolation," and "dissatisfaction with health and social support."

"There is a definite link between social support and health," adds psychologist David Myers, PhD, author of "Pursuit of Happiness" (Avon, 1993). "Those who enjoy close relationships eat better, exercise more and smoke and drink less. Perhaps, a supportive network helps us evaluate and overcome stressful events."

And just perhaps, Irene Deitch, PhD, a veteran New York therapist, embodies not only what Ponce deLeon never found--the secret of healthy long life--but the ideal model that the rest of her psychology colleagues are homing in on.

"I am a woman of a certain age," she says, politely sidestepping the "number issue" during a recent conversation.

"I'm still running first place in my age group, still holding up beautifully. I start the day running three miles. I play tennis, keep office hours, I teach full time. I am trying new things, taking piano lessons, learning how to hike. I don't feel I'm supposed to look a certain way or dress a certain way. The moment I do that I'm segregating myself. As soon as people segregate themselves, they see themselves in a certain way, buying into stereotypes about themselves, buying into what others say about them, which leads to depression and withdrawal. I don't think I'll live to be 100, but I'll live until I check out. I'm enjoying my life because there's just so much to do."

C. KERMIT PHELPS, 91, was out raking leaves when the Monitor called to ask about the secrets to his successful aging.

"Exercise is essential," says Phelps of Kansas City, Mo. "It can take five or six minutes, but do it every day to keep the muscles supple."

Eating right and intellectual stimulation are also critical, he says. His cerebral outlet is lecturing at the Shepherds Center, a senior citizens organization that he spearheaded in Kansas City that has expanded to 160 locations across the United States. These centers offer classes in creative arts and language, as well as his own creation, "Life Enrichment," a lecture aimed at helping older people grow emotionally.

"From age 55 on," he says, "you have to focus on what is on the inside, not just what is on the outside. People need to do an internal audit to see what they can improve and what they can throw away."

Passion keeps JERRY CLARK, 87, young in mind and body. Passion for promoting psychology, for exercise and especially for his three grandchildren--Austin, Sarah and Nate.

Clark, of Carpenteria, Calif., the oldest member of APA's Council of Representatives, is a former military psychologist who still serves on the Board of Sansum Medical Research Institute in Santa Barbara.

Originally from Texas, Clark grew up on chicken-fried steak, "but I found out about salads 40 or 50 years ago, so I've been eating better ever since." His stay-young hobbies include regular bridge games and cooking for his family and friends--in fact, for his birthday, he baked 20 cakes and gave them to the Sansum clinic staff.

The most exhilarating part of his week? Swims at the local pool. "Sometimes, I walk out of there and I say to the pool attendant, 'That was great! I feel like I'm 70 again!'"

For SATORU IZUTSU, 71, every day is "fun-filled with interesting, active people," and that's been key to his successful aging.

Connecting with people is why this psychologist is wired to three voice mail systems, a cellular telephone and two e-mail systems. "I'm accessible throughout the world."

His professional life includes consulting three-and-a-half days for the Queen Emma Foundation, which focuses on collaborative research activities between the University of Hawaii School of Medicine and the Queen's Medical Center. For two days, he's at the University of Hawaii School of Medicine serving as associate dean, chair of the Admissions Committee and liaison for International Medicine Programs.

"An important factor for me is that I genuinely believe that, hopefully, I am making a difference in other people's lives," he says.

He attributes his physical and mental fitness to regular aerobics, jogging, swimming and weight-training, tempered with a weekly tea ceremony to "practice the precepts of harmony, respect, purity and tranquility."

MARY STARKE HARPER, 80, is a midnight gardener.

"Often I can't go out in my yard 'til evening because I'm so busy," says the psychologist of Tuscaloosa, Ala. "It's not uncommon for me to be pulling grass at 2 a.m."

And keeping busy, she says, keeps her young. "I always have more to do that I can accomplish."

As an expert in aging issues, Harper is a member of two national aging committees: the Advisory Council of the National Institute for Aging and the Surgeon General's Task Force for Mental Health and Aging. She's also chair of two aging conferences this year, one exploring aging research, another on older citizens in rural areas. And she's active with the Mary Starke Harper Geriatric Psychiatric Center in Tuscaloosa, named in honor of her work in the area of mental health and aging.

Her advice to others?

"Stay current with your profession and your community, and you don't have a chance to know you're getting old."

Serving as APA president might not hurt either...

It appears serving as APA president could also contribute to successful aging. Ten of the association's 109 presidents have lived into their 90s. Ernest Hilgard, who became APA's 58th president in 1949 is now APA's longest living past president at age 95. He still goes to his office at Stanford University two mornings a week.

William Bryan (1860 - 1955), APA's 12th president also lived to be 95, but died 20 days after his birthday.