Can You Live to 100?
People who've had long lives presumably hold keys to good health, and the rest of us might do well to learn from them. That's why Thomas Perls, a geriatrician at the Boston University Medical School, studies centenarians—people who've been kicking for a century or more. As head of the New England Centenarian Study, the world's largest study of such people, Perls has researched the habits, genes, and medical histories of about 900 centenarians. Perls thinks centenarians offer an unparalleled look into how we can all age gracefully, healthfully, and happily.
What's most striking about long-lived people?
About 90 percent of centenarians live independently into their early 90s. A good chunk of centenarians have had some pretty significant age-related diseases, including heart attack and stroke. But they deal with them much better than other people, who might die of those diseases. When centenarians do develop disabilities, they tend to do so only during a compressed period near the very end of their long lives.
Is it good to have long-lived relatives?
Exceptional longevity runs strongly in families. [These families] may have longevity-enabling genes that slow down aging, or they may lack what we call "disease genes" that make other people develop, for example, heart disease, stroke, or Alzheimer's disease. We also study the siblings and children of centenarians. The kids very much follow in the footsteps of their parents. They have rates of heart disease, stroke, high blood pressure, and diabetes that are 60 percent lower than others born around the same time. They have a mortality rate that's 20 percent lower.
Can all of us live to 100?
I think that most of us are built for about 88 years, a little bit less for men, a little bit more for women. Much of getting to that age depends on your health behavior. To add an additional 10 to 12 years beyond that, you may need to either lack disease genes or have some of those longevity-enabling genes.
So 88 years is a typical maximum lifespan?
Seventh-Day Adventists have the highest average life expectancy in the country—88 years, according to one study. This group is quite diverse in terms of race and geographic location, but they have homogenous health habits, which are dictated by their religion. They're vegetarian, they don't smoke or drink alcohol, they regularly exercise, they eat in moderation, and they really set aside some time for family and religion. All that may help them manage stress well. And, lo and behold, they have life expectancies about 10 years greater than those of average Americans. And I would venture to say that that's largely because of these health habits.
What factors are most important to achieving maximum lifespan and better health in old age?
I have an acronym: AGEING, spelled the British way. "A" is for attitude. Centenarians are optimistic, and they tend to be funny. I think that those personality characteristics translate into being able to manage stress well. They don't internalize stress; they seem to be able to let go. The "G" is for genetics. If people in your family have passed away in their 60s and 70s, alarm bells should be going off: You, more than other people, need to pay attention to prevention and screening. The "E" is for exercise. I say people should exercise five times a week, 30 minutes a day. "I" stands for interest, and that has to do with exercising your brain. "N," nutrition: The goal should be a healthy weight. "G" is for, Get rid of smoking, and get rid of antiaging quackery. I'm a very outspoken critic of the antiaging industry, especially growth hormone, which I think is really quite dangerous.
Do you have a favorite story about a centenarian?
Anna Morgan was one of the centenarians who really woke [my team] up to how amazing some of them can be. She was living on the third floor—the top floor—of a three-generation house, so she was walking those stairs every day. In her mid-90s she had started writing an autobiography, initially around 950 pages. Her editor pared it down to 650 pages, and I'm told she fought over every page. She was completely cognitively intact when we met her, scoring basically perfectly on every test we gave her. We had to ask her if she would be interested in donating her brain for study, and she said, "Well, I'm still using it!" When she did eventually pass away, of a heart attack, her brain showed absolutely no [sign of] disease. Her story became, for us, a gold standard of disease-free aging.
The calculator takes into account the things people are doing right and wrong in terms of maximizing their healthy years. Your smoking habits, your body mass index, whether you're a man or a woman [and whether you have] high blood pressure, heart disease, or diabetes—there's really good evidence to estimate the impact each has on your life expectancy. For other things, like flossing your teeth, I had to estimate the effect. But it's a fact that a person with gingivitis [gum disease] has an increased risk of heart disease.
Do you think people fudge details to get the calculator to overestimate their life expectancy?
I do think that people go back and change their answers to see what the impact will be. But they don't really have to because we provide tailor-made feedback based upon the person's answers. Really, the estimate of the person's life expectancy is an educational tool to get people to realize what they could do differently to not only live longer but to live a larger chunk of time in good health. We've come up with a saying: "The older you get, the healthier you've been." It's an optimistic and positive view of aging, one that I hope is very enabling.