Age defying or denying? Real life among the old old.

Studies or ideas about human aging are frequently the subjects of posts in this blog (given that I have a vested interest in the aging of yours truly...), and I thought this perspective offered by Susan Jacoby, author of the forthcoming “Never Say Die: The Myth and Marketing of the New Old Age,” as she turns 65, was a very sane one:

..people my age and younger still pretend that old age will yield to what has long been our generational credo — that we can transform ourselves endlessly, even undo reality, if only we live right. “Age-defying” is a modifier that figures prominently in advertisements for everything from vitamins and beauty products to services for the most frail among the “old old,” as demographers classify those over 85. You haven’t experienced cognitive dissonance until you receive a brochure encouraging you to spend thousands of dollars a year for long-term care insurance as you prepare to “defy” old age....“Deny” is the word the hucksters of longevity should be using. Nearly half of the old old — the fastest-growing segment of the over-65 population — will spend some time in a nursing home before they die, as a result of mental or physical disability.

Researchers who were part of a panel discussion titled “90 Is the New 50,” presented at the World Science Festival in 2008, spoke to a middle-aged, standing-room-only audience about imminent medical miracles...The trouble with expecting 90 to become the new 50 is it can stop rational discussion — on a societal as well as individual level — about how to make 90 a better 90. This fantasy is a lot like waiting for Prince Charming, in that it doesn’t distinguish between hope and reasonable expectation.

The risk of dementia, of which Alzheimer’s is the leading cause, doubles every five years after 65...Contrary to what the baby boom generation prefers to believe, there is almost no scientifically reliable evidence that “living right” — whether that means exercising, eating a nutritious diet or continuing to work hard — significantly delays or prevents Alzheimer’s. This was the undeniable and undefiable conclusion in April of a major scientific review sponsored by the National Institutes of Health...Good health habits and strenuous intellectual effort are beneficial in themselves, but they will not protect us from a silent, genetically influenced disaster that might already be unfolding in our brains. I do not have the slightest interest in those new brain scans or spinal fluid tests that can identify early-stage Alzheimer’s. What is the point of knowing that you’re doomed if there is no effective treatment or cure? As for imminent medical miracles, the most realistic hope is that any breakthrough will benefit the children or grandchildren of my generation, not me.

Jacoby on her own situation:

I would rather share the fate of my maternal forebears — old old age with an intact mind in a ravaged body — than the fate of my other grandmother. But the cosmos is indifferent to my preferences, and it is chilling to think about becoming helpless in a society that affords only the most minimal support for those who can no longer care for themselves. So I must plan, as best I can, for the unthinkable.

..I must find someone I trust to make medical decisions for me if I cannot make them myself. This is a difficult emotional task, and it does not surprise me, for all of the public debate about end-of-life care in recent years, that only 30 percent of Americans have living wills. Even fewer have actually appointed a legal representative, known as a health care proxy, to make life-and-death decisions...I can see that the “90 is the new 50” crowd might object to my thinking more about worst-case scenarios than best-case ones. But if the best-case scenario emerges and I become one of those exceptional “ageless” old people so lauded by the media, I won’t have a problem. I can also take it if fate hands me a passionate late-in-life love affair, a financial bonanza or the energy to write more books in the next 25 years than I have in the past 25.