I have reason to think my chances for survival are good: Experts say that 25 to 35 percent of life expectancy is genetic (the rest is lifestyle and environment), and my four grandparents, who range in age from 86 to 97, show no intention of leaving us, or each other, anytime soon. They cling so stubbornly to their independence—often against the advice of doctors and loved ones—that my mother jokingly calls them “elderly delinquents.” When one grandfather recently injured his shoulder and his doctor suggested moving my grandmother into a nursing home until he’d recovered enough to resume the cooking and driving he does for the two of them, my grandfather insisted we find another solution. “We’ve been together for over 60 years,” he told me. “I couldn’t sleep at night without her.” After all that time together, he still leaves notes at her bedside, telling her he loves her and that she’s beautiful, in case she wakes in the middle of the night and is disoriented or lonely.While their enduring love is my ideal, in the past I imagined I’d spend my dotage alone—most women do. Eight out of 10 centenarians (people who live to 100 or older) are women, and only 13 percent of women over age 85 are married (78 percent are widows; the remaining 9 percent are either divorced, separated, or never married). The best-case scenario I could come up with was a sort of Golden Girls thing, where my girlfriends and I would move in with each other. However, they’ve been irritatingly unwilling to get on board my “live forever” bandwagon. When I tried to persuade one friend to quit smoking so we could retire to Boca together, she rolled her eyes and lit up. “I’m not like you. I don’t want to live until I’m a vegetable,” she said. “If I stub my toe, I want them to pull the plug.”
Then I met my husband. In addition to his many other alluring attributes, he revealed one tantalizing fact over the course of our courtship: Several of his grandparents and great-grandparents survived well into their 90s, and his great-aunt was, at the time of her death at 119, the oldest woman in the world. Now here was a gene pool I could work with!
While it’s still a long shot for us both to make it to those rockers on the front porch, recent research shows it’s not as unlikely as it once was. The over-85 age group is currently the fastest growing segment of the population. Life expectancy has increased radically over the past century due to improvements in public health, such as vaccination and antibiotics, and promises to continue its upward climb, thanks to better medical care for top killers like heart disease and cancer.
Men still lag behind women in longevity—as of 2000, they had about five fewer years of life expectancy—but the age gap is narrowing. According to a 2005 report from the U.S. Census Bureau, this is not only because men respond better to treatments for heart disease than women do, but also because women have taken up smoking in increased numbers and more are dying of lung cancer. The government also points to evidence that, while men’s health doesn’t seem to be affected by the increasing pace of American life, women may be more likely to suffer negative consequences from the “stresses related to multiple roles such as housework, occupational activities, caregiving roles including child care and elder care, social activities, etc.” So even though my husband is five years older than I am, with his genes and my stress level, perhaps we can time it so that we’ll dwindle synchronically.
Of course, the only drawback to loving someone so much you never want them to die is that it means spending a lot of time worrying about keeping them alive. The pressure of another 60-odd years of lying awake at night fretting about everything from my husband’s red meat consumption to his exposure to PCBs has been daunting, especially added to my workload of worry about my own health and that of our children. So I was relieved to see research in February’s "Archives of Internal Medicine" on the “modifiable factors” associated with exceptional longevity in men. Finally, some guidance about where to focus my anxiety.
The paper looked at 2,357 men in the Physicians’ Health Study, starting in their early seventies and following them for 25 years (if they survived) into their nineties. The group was pretty homogenous (mostly white, healthy for their age, and all doctors), but the author, Laurel B. Yates, MD, MPH, associate physician at Brigham and Women’s Hospital in Boston and instructor in medicine at Harvard Medical School, points out that this is actually something of an advantage because there’s less chance that socioeconomic, educational, or racial disparities will confound her data. Yates and her team found that the men who abided by five simple Dos and Don’ts had a 54 percent chance of surviving to age 90.
1. Don’t smoke. Current smoking—even in the absence of any other risk factor—doubled men’s risk of dying before age 90. It also reduced their mental and physical competence. “Smoking is just bad for everything,” Yates says. “Bad for the blood vessels, bad for the brain, bad for the lungs, and certainly it’s carcinogenic. Smoking has so many ramifications that it’s number one.” And she emphasizes that it’s never too late to quit; smokers who did stop before the study began erased most of their tobacco-associated risk of death. To encourage a partner to give up cigarettes, she says, the best you can do is provide them with information in a supportive way and hope they make the right decision: “They have to be ready and willing to do it on their own.”
2. Don’t become diabetic. Being a diabetic was nearly as detrimental to men’s longevity as smoking. In other studies, metabolic syndrome—a precursor to diabetes marked by high blood pressure, cholesterol, and blood sugar—is significantly associated with senility. The best way to ward off diabetes is to avoid becoming overweight, Yates says, which is an area in which spouses can have an “enormous” impact. “In any relationship, particularly the longer ones, you know what buttons not to push, and you know that you get less distance out of nagging than honey,” she says. “This is a wonderful opportunity to do things together. Use a little psychology and say, ‘You know, I want to start walking, will you go with me?’” She also notes, “In this country, women still do most of the cooking, so there is certainly room to control diet and portions.”
3. Don’t be obese. Have you ever noticed that when you see a really old person walking down the street, they’re usually on the svelte side? As the nation has gotten heavier, obesity is one of the biggest threats to the gains we have made in public health and life expectancy, Yates says. It reduced men’s chances of surviving until age 90 to just 32 percent. Obesity is medically defined as having a BMI of more than 30 (for the average 5'9" American male, this would mean weighing about 203 pounds). If the love of your life is pushing this kind of weight around, it’s time to use Yates’ tactics to manipulate, I mean encourage, him to lose at least 10 percent of his body weight.
4. Don’t have high blood pressure. In this study, hypertension reduced the chances of men’s survival to extreme old age to 42 percent. Maintaining a healthy weight, exercising, not smoking, limiting sodium, and consuming moderate amounts of alcohol are all proven ways to keep blood pressure in check. Also, a study this past spring of people aged 20 to 68 found that those who reported they were in satisfying marriages had lower blood pressure than singles or those in unhappy marriages. So if things are rocky with your partner, think of couples counseling this way: It may save not only your relationship, but your lives.
5. Do exercise. Men in the study who got regular, vigorous (meaning they worked up a sweat) exercise two to four times a week reduced their risk of mortality by up to 30 percent. They were also less frail and more able to carry out the physical functions of daily life independently. Interestingly, the research found no connection between cholesterol levels or alcohol consumption and men’s mortality, although other research has found moderate drinking to add longevity. And because the study was not originally designed to assess longevity (it began as an evaluation of whether low doses of aspirin and beta carotene supplements reduce cancer and heart disease), there was no data to look at some of the social factors that have been found to influence risk of death in the elderly. So to the list of medical Dos and Don’ts, I’ll add two social ones:
6. Do keep up your sex life. While all those ads for drugs that treat erectile dysfunction (ED) do a good job of making a flaccid penis look like an aphrodisiac, the truth is that ED in middle-aged men can be a sign of heart trouble. Several studies have linked the two, and one late last year found that a flagging erection can predict cardiovascular troubles such as angina, stroke, and heart attacks by about five years. Research published this spring on Viagra users found a high incidence of underlying cardiovascular disease. Sexy! Simply telling your partner how his health habits might effect his virility is often all you need to get a guy off the couch, says cardiologist Mehmet Oz, MD, author of "You: Staying Young: The Owner’s Manual for Extending Your Warranty." Men don’t respond to emotional appeals about future death in the same way a woman would, he says. “Tell them it’s going to affect their performance today—their athletic ability, their mental acuity, impotence,” he says. “Men don’t care about being thin. They want to be masculine and physical.”
7. Take care of yourself. There is ample evidence that marriage is especially important to men’s health, both because wives tend to provide care for their husbands in old age and because men seem to find being widowed more depressing than women do. Single older men have one of the highest suicide rates of any age group, says William Hall, MD, director at the Highland Hospital Center for Healthy Aging at the University of Rochester Medical Center, and studies have shown that widowed men have a high risk of dying in the year after their wives pass on. “Those men aren’t committing suicide,” he says. “They tend to just lose interest in life, as mystical as that sounds.” So one of the best things you can do for his health is make sure you stick around for the long haul too.
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