Counting the twilight years in the hundreds
Advances in medicine mean it’s time to stop fearing old age, a leading professor in longevity tells Helen Rumbelow.
WE don’t want to die. I don’t want to die. That’s the fear running through every fitness plan us mortals ever attempted. I think it’s also why I find Rudi Westendorp so fantastically rude.
‘‘Madam,’’ he says, peering at my tired face popping up to begin our Skype video link. ‘‘You don’t look like your photograph. Oh dear, not at all. Older. Ah well, OK.’’
I laugh politely, because this is what British people do in the face of death and Dutch professors of old-age medicine. However, as the interview proceeds, I start to suspect that Westendorp is playing with my head. I think he wants me to examine why I find his verdict on my – yes, wrinkling – face so painful when he is the bearer of such good news.
For while Westendorp may be one of the world’s leading experts in ageing, architect of many of the most interesting studies in the field, he doesn’t come across like that. He has the evangelical zeal of a quack or a messiah, for these are his tidings: we will live longer than we have dreamt.
Life expectancy, he says, is going up in the West faster than we can adjust for it. Every week, we get an extra weekend of life expectancy; every day, we gain six hours. Longevity records are being smashed, he states – ‘‘the first person to live until 135 has already been born’’.
Later in our conversation, he talks of a human celebrating their 400th birthday with a casual ‘‘why not?’’.
‘‘We must get away from the idea of a maximum possible length for human life.’’
It is hard to take in that this view is from an eminent scholar, not a crazed science-fiction fan. The title of his book, Growing Older Without Feeling Old, sounds like an advertisement for elasticated trousers, with their whiff of the coffin. It is nothing like that.
Westendorp has a shock of white hair – melanin has already given up the ghost, as befits his 55 years – a dapper bow tie and a puckish air. He says we hate ageing because we fear death. In the past, the latter followed the former like night following day.
However, we need no longer associate the two, he says. We are ageing slower than ever, and probably have half a century or more from first grey hair to copping it. We just haven’t realised it.
Westendorp says we need a revolution – educating children for a century of work; becoming aggressive about old people reaching a high level of physical and mental fitness; reorganising the world as a low-birthrate, longlife one; and embracing how much happier and more efficient that will be.
‘‘It is our fear of growing old that makes it grim for older people. It makes me angry. Why are we so grim about old age? We dislike old age so much because it is death we are afraid of.’’
We still think of our lives as predicted in the time of the King James Bible: ‘‘Threescore years and ten; and if by reason of strength they be fourscore years, yet is their strength labour and sorrow; for it is soon cut off, and we fly away.’’
We may have seen our grandparents die in their 70s and think that is coming to us, unaware that advances in medicine and living standards in the past few decades have changed the rules.
One controversial figure in the field of geriatric medicine, Aubrey de Grey, has even predicted that if medical technology can keep up its present success at repairing or replacing cells, tissues and organs, the first person living to 1000 could have been born. I ask Westendorp if he goes so far.
‘‘I know that De Grey is quite often seen as a maniac, a futurist or not a real scholar, but what I like is that he makes it explicit that there is no barrier that we know of in the human lifespan. People who have tried to estimate how high the ceiling is have always turned out to be wrong. Their estimates are far too conservative.
‘‘Think about cars,’’ Westendorp tells me. ‘‘Cars are meant to last six to nine years. But some cars are running around 100 years later. It’s the same with our human body. We are meant to last 40 years. Can we last 400 years? Why not?
‘‘Of course, you do need some spare parts to keep them running that long. There will be faults, some parts break down, and if we cannot repair it, our body dies.
‘‘But what we can repair now we couldn’t 20 years ago, and now what we can’t repair we will be able to in 20 years. Think about your lenses – easy-peasy to fix now. Think about your hips, your knees. Replacements were unthinkable 30 years ago, now routine.’’
Part of the trouble, he says, is that we are bombarded with bad news about ageing that is not evidence-based. Our modern cultural horror story is a society burdened by wrinkly wraiths who are ill with a variety of horrific diseases but kept alive beyond any value. This prospect is terrifying for young and old – but not true, Westendorp says.
In the second half of the 20th century, half of the population died of cardiovascular disease. Now the proportion has dropped to a third, and the incidence of heart disease continues to fall. This may be because people are giving up smoking, but it is also something of a mystery. The rate of strokes is following suit.
Even dementia, the bogeyman of the present, is in significant decline. A large-scale population study in Britain reported a 30 per cent drop in the risk of getting dementia over the past 20 years.
A study of the mental functions of those in their 90s today showed they were better than nonagenarians born 10 years earlier. This may be because they had a better education earlier in life. It may also be because of the reduced smoking and increased living standards that have meant heart disease and strokes have dwindled, but ‘‘an end to the dementia epidemic is in sight’’, Westendorp writes.
Cancer has now moved into the top spot, possibly swelled by the last generation of smokers.
Westendorp is full of surprises. At his age, with his daughters grown up, he could have thought of early retirement. But he thinks an official retirement age is ‘‘stupid, ageist nonsense’’.
If people are underperforming, they should be sacked, he says.
‘‘If you’re happy, keep them in service; that is ageless. There’s a 20-year-old in my department I want to get rid of. The more you think about a retirement age, the more it is a form of discrimination. It is always too late or too soon.’’
Since his work proved to him that he probably has many decades ahead, he decided it was ‘‘time for a new adventure’’. So he and his wife moved countries this year; he is now professor of oldage medicine at the University of Copenhagen in Denmark.
He is always baiting old people by asking them what career they want in 10 years’ time. He says the ‘‘boring ones’’ look at him as if he is mad.
‘‘That’s the point. I tell everyone, ‘You’ll live longer than you think’. Even 85-year-olds, I say, ‘What are you going to do for the next five years?’.’’
Despite all this, Westendorp doesn’t buy into the old saying that quality of life is better than quantity.
He says a lot of old people put up with niggling chronic illnesses but still rate their lives as very happy.
In fact, in most surveys older people come out as the most contented.
‘‘We consider a life of good health more important than quantity, which I tend to disagree with more and more. We put old people away and discriminate against them, don’t want to see them. But old people generally rate their lives as a seven out of 10, depending on which country they live in.
‘‘It is the country in which you live that affects your quality of life, no relation to health. Diseased people can give 10 out of 10 for quality of life, healthy people two out of 10. And in general, older people in most studies rate their lives higher than young people.
‘‘It is you youngsters who don’t want to see that there is a second part of our life that is valued as much as youngsters value it. We only see the dark clouds of death on the horizon, and we don’t want to be there.’’
Westendorp doesn’t have any secret formulas for ageing well. Like everyone in his field, he has studied the areas of the world where people live extraordinarily long lives, and he says there are only a few rules to be drawn.
Stay active in mind and body is the first rule – and by this he means properly fit, more than is expected of the elderly at present. Second, stay slim and eat a ‘‘colourful’’ diet. And finally, be social. All the rest is just hype, he says.
‘‘Diet is such a complex thing. Within the western world, the advice to stick at the right weight is far more important than the specifics of what you eat.’’ Does he feel his age? ‘‘Since I’ve moved to Denmark, I feel younger, like a teenager. At the beginning of May, my wife and I were cycling back home from having dinner with friends. I said to her, ‘Do you feel it, too?’. It felt like the days after we finished our exams, the three weeks we spent partying in the dark evenings with the same smell of flowers. That same feeling of freedom was still there.’’