Biological secrets of exceptional old age: centenarian study seeks insight into aging well.

Abstract

BOSTON—A mania for staving off the signs of aging permeates culture in the United States. Time robs people of health, independence, and perspicacity—or so advertisements warn—so everyone should cling to youth as long as possible. But is this an accurate picture of aging? Researchers who study those who reach exceptional old age are finding that the inexorable march toward the end of life need not be a steady decline. In the last decade, investigators have been studying the growing number of people who celebrate their 100th birthday and have found that many centenarians remain hale and hearty well into their 90s, delaying the onset of agerelated diseases and compressing the time they are ill into a short period at the end of their lives. As a geriatrics fellow at Harvard Medical School in the early 1990s, Thomas Perls, MD, MPH, was struck by this phenomenon. Working with patients at a rehabilitation center for the aged, he found two centenarian patients who stood out—not because of severe illness, but because they were busy members of their community. One often played the piano for her friends, while the other, a tailor all his life, mended clothes for others in the center—that is, when he was not courting his 85-year-old girlfriend. Perls’ observations of these centenarians contradicted the conventional wisdom in medicine at the time that the sickest patients were the oldest. Although not every 100-year-old patient at the facility was doing as well as these two, many had been healthy into their 90s. To better understand the health and functional status of centenarians, Perls began recruiting 100-year-olds from eight towns in the Boston area for the New England Centenarian Study (NECS). He and his colleagues discovered that this group is much healthier cognitively and physically than had been thought. Perls, who is now director of the NECS at Boston Medical Center and associate professor of medicine at Boston University (BU) School of Medicine, and colleagues continue to enroll centenarians from around the world, as well as their siblings and children, into the NECS as they seek to tease out the genetic and environmental factors that help people reach exceptional old age.