"Every man desires to live long, but no man would be old.''
Jonathan Swift, author
Though no one knows exactly what day it will be — indeed for each of us, it is different — there comes a point when the mirror is no longer the amiable companion we used to know.
The mirror has turned accusatory: Apparently overnight, we got old.
What the mirror cannot show, even if we lean across the sink to help our somewhat stressed vision, is that hundreds of thousands of cells have been failing to function at maximum efficiency or even have died.
That didn't happen overnight, of course. Nor has it been confined to your face, as you may have noticed when you got out of bed that morning and wondered why your knees seemed stiff, if not exactly sore.
(Or maybe you wondered why you had to get up twice in the night to use the bathroom . . .)
So what does happen to us as the years pass? Do we have to slow down or have decreased function as we age?
Well, no, and yes.
When the lightbulb dies
Physical and mental deterioration are normal as we age. The changes are due to decreased cellular efficiency throughout the human body.
Aging "is a life arc of the inter-related and overlapping processes and changes in the body's 100-trillion or so cells that take you from birth to death,'' says Dr. Robert Palmer, a noted geriatrician.
He adds that it is a one-way arc: "You can slow it but you can't stop it.''
Palmer also likens the eventual failure of our cells to that time when we turn on a lightbulb but the filament has burned out.
We see this as the bulb failing at that moment, but the wear and tear on the filament began with the first surge of electricity we sent through it — or for our cells, essentially it began with birth.
The failure of enough cells can have a cascading effect on the efficiency of other parts of the body. That is, the hip bone really is connected to the knee bone . . .
Reap what you sow
Some of this cell failure is genetic. But researchers think that an unhealthy lifestyle and poor diet can seriously affect our musculature and cardiovascular conditioning, thus stressing the body's complex equilibrium.
What we do to ourselves over the years, scientists now say, may be responsible for more than 50 percent of our "usual'' aging.
"At 55 or 75 or 95,'' suggests Palmer in his book Age Well!, your brain and immune system "are as healthy as your lifestyle habits and the mileage you've put on them . . . Aging itself is not the cause of many age-related conditions: You can get gray hair anytime.''
(For pointers on how to slow or reverse some results of an unhealthy lifestyle, see related story, Page 14.)
Further complicating the physical situation is how our mental and emotional states control our behavior. If we lack social contact through family, friends or close acquaintances, we may retreat to the solace of home — and more of a sedentary life.
For instance, a 20-year study of 17,000 male Harvard University alumni found that exercising the equivalent of a 3-mile daily jog "countered the life-shortening effects of cigarette smoking and excess body weight,'' notes The Mayo Clinic Plan in the section titled "Fitness and Longevity.''
Stages of aging
And we do have reason to be optimistic about our personal longevity. After all, the life expectancy for someone born in the United States in 1900 was 47 years, but by 2004, that had risen to 77.9.
Part of this increase has to do medical advances, but much of it has to do with changes in the way we earn our living. Farm and factory labor from dawn to dusk, six days a week, long ago ceased to be the norm.
"We geriatricians used to talk about hitting the downhill slope at 40; then it was 50. Now we talk about 70. Maybe by the end of this century, that's going to be 80 or 85,'' Palmer, head of geriatric medicine at the acclaimed Cleveland Clinic, writes in Age Well!.
His three stages of aging:
Ages 65-74: The young old. "The focus for this age group is on disease prevention, screening and the detection of diseases in early and treatable stages.''
Ages 75-84: The old old. "Multisystem decline increases due to . . . the cells' inability to repair themselves and the decline of the immune system. (Diseases now) hit in clusters. Diabetes comes along with heart failure and hearing loss or high blood pressure accompanies kidney disease and vision loss.''
Ages 85 and up: The very old. "Due to the aging of organs, tissues and joints as well as the cumulative effects of interacting chronic conditions, there is a tremendous amount of frailty and disability.''
For instance, it is estimated that by age 85, 30 to 50 percent of us will suffer from Alzheimer's, for which there is no pharmaceutical cure. But just this week, there was more confirmation of the importance of regular exercise and a healthy diet even against this disease:
Researchers told the annual Alzheimer's Association International Conference on Sunday that MRI scans showed that people with early Alzheimer's disease who had better cardiorespiratory fitness ratings had less failure in brain areas associated with memory.
Said Dr. William Thies, a vice president of the Alzheimer's Association, "We may not be able to do anything about aging, genetics or family history, but research shows us that there are lifestyle decisions (that) keep our brains healthier as we age, and that also may lower our risk of developing Alzheimer's disease."
What's in your genes?
What does the future hold? Will we really be able to extend our health and years?
Scientists are experimenting with hormone therapy and gene manipulation in the Orwellian field of "age management.''
Among these researchers is Dr. Cynthia Kenyon, who has doubled the brief lifespan of a simple worm by altering one of its genes.
"Scientists have learned in the last few decades,'' Kenyon told interviewers on a PBS special about boomers, "that the basic biological processes that take place in these little worms are very, very similar to processes that take place in humans.
". . . There are actually genes that control lifespan, and if you (change) them then you can (not only) extend lifespan, you can extend a period of youthfulness.''
On the same 2007 PBS special, gerontologist Dr. Ken Dychtwald said, "This developing science of longevity is only in its infancy . . . It's possible that researchers will be able to prescribe for each individual an optimum blend of vitamins and hormones to keep them healthier and younger for longer periods . . .
"And then the farther end of the anti-aging continuum (gets) into the genetic information where the clock of decline is programmed, and changing it . . . It's going to occur in our lifetimes.''
Which would mean that face in the morning mirror will be pleasingly young for extra decades — and that your knees won't be sore when you get up to see how you look.
Robert N. Jenkins can be reached at firstname.lastname@example.org or (727) 893-8496.