The Oldest Old Are Astonishingly Healthy

People in their late 90s or older are often fitter than those 20 years younger. Traditional views of aging may need rethinking

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HURLING STRONGLY in a photograph taken at age 102, Takashi Shimokawara still holds world records in the men's over-100 class for discus and javelin throwing. He died at age 104, a victim not of old age but of the earthquake and tsunami that struck Japan in 2011. Shimokawara was among the many healthy centenarians who contradict the traditional idea that age always brings with it severe debilitation.

In medical school I was taught that the incidence of chronic, disabling disorders, particularly Alzheimer's disease, increases inexorably with age. I therefore expected that people older than 95 years, often called the oldest old, would be my most debilitated patients. Yet when I became a fellow in geriatrics, I was surprised to find that the oldest old were often the most healthy and agile of the senior people under my care. In fact, the morning I was scheduled to interview a 100-year-old man as part of a research project, he told me we would have to delay the visit. He had seen 19 American presidents take office, and he would be busy that morning voting for the next one.

Such encounters made me wonder if the prevailing view of aging as advancing infirmity was partly wrong. Could it be that many people in their upper 90s enjoy good health and that the oldest old constitute a special—and long-misunderstood—population? Since then, the centenarians I have met have, with few exceptions, reported that their 90s were essentially problem-free. As nonagenarians, many were socially engaged and enjoyed the outdoors and the arts. They basically carried on as if age were not an issue. And accumulating evidence indicates that a significant number of the oldest old are indeed healthier than many people in their 80s or early 90s. The common idea that advancing age inevitably leads to extreme deterioration does, indeed, seem to require revision.

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