A final surprise. Happiness, it seems, peaks at the age of 74—or so Austrian and German scientists have concluded after asking 21,000 people how happy they were on a scale of 1 to 7. Teenagers registered around 5.5; in their 40s people reckoned they had less happiness, and those who were 74 rated themselves 5.9, the highest of the lot. This change in happiness was apparently most pronounced amongst British respondents; German men and women reported relatively stable levels of satisfaction throughout their lives. Dr Carlo Strenger, an Israeli psychologist, commented: ‘If you make fruitful use of what you have discovered about yourself in the first half of your life, the second half can be the most fulfilling.’
So if you are told you are looking well, and are feeling happy, enjoy it for as long as you can.
2. Ageing
‘The minute a man ceases to grow, no matter what his years, that minute he begins to be old’
Our bodies change as we age. Looking stooped, for example, is a common sign of ageing. Most medieval pictures of the old show a bent back and a stick, and this continued into the twentieth century. In ancient Roman times, Virgil complained that ‘all the best days of life slip away from us poor mortals first: illness and dreary old age and pain sneak up, and the fierceness of harsh death snatches us away.’ Plutarch too had a gloomy image of old age, likening it to autumn. When children are asked how they can tell when people are growing old, they list physical attributes. Here we look at the major and minor physical health changes that are linked to ageing.
Ageing is not a disease, but is a multi-factorial process that leads to the progressive loss of functions. We are all too well aware of normal bodily changes as we age. We initially get a bit slower and then a little grey and bald, and then wrinkles come and memory goes. Cross-sectional studies of ageing tend to depict an essentially smooth and progressive decline of physiological function with increasing chronological age. However, although the young have high functional values and the very old low, between these limits values are widely scattered. There is no simple linear relation between age and functionality. When I meet some old friends whom I have not seen for some time I sometimes say, ‘Shall we start at the top or the bottom?’ We then tell about the pain in our foot, and work up the body to describe how our brain has declined.
One of the fairy tales collected by the Brothers Grimm in the early nineteeth century, ‘The Old Hound’, illustrates changes brought about by age:
A hound who had served his master well for years, and had run down many a quarry in his time, began to lose his strength and speed owing to age. One day, when out hunting, his master startled a powerful wild boar and set the hound at him. The latter seized the beast by the ear, but his teeth were gone and he could not retain his hold; so the boar escaped. His master began to scold him severely, but the hound interrupted him with these words, ‘My will is as strong as ever, master, but my body is old and feeble. You ought to honour me for what I have been instead of abusing me for what I am.’
Another of Grimms’ fairy tales, ‘The Duration of Life’, collected from a peasant in his field in 1840, presents a pessimistic outcome but adds a playful teleological explanation:
When God created the world he gave the ass, the dog, the monkey and man each a life-span of thirty years. The ass, knowing that his was to be a hard existence, asked for a shorter life. God had mercy and took away eighteen years. The dog and the monkey similarly thought their prescribed lives too long, and God reduced them respectively by twelve and ten years. Man, however, considered the thirty years assigned to him to be too brief, and he petitioned for a longer life. Accordingly, God gave him the years not wanted by the ass, the dog, and the monkey. Thus man lives seventy years. The first thirty are his human years, and they quickly disappear. Here he is healthy and happy; he works with pleasure, and enjoys his existence. The ass’s eighteen years follow. Here one burden after the other is laid on him; he carries the grain that feeds others, and his faithful service is rewarded with kicks and blows. Then come the dog’s twelve years, and he lies in the corner growling, no longer having teeth with which to bite. And when this time is past, the monkey’s ten years conclude. Now man is weak headed and foolish; he does silly things and becomes a laughing stock for children.
There are few if any organs in our body that do not decline in their function with age, and many deaths are due to age-related illnesses. But not everything is bad news. A major study by ELSA (English Longitudinal Study of Ageing) in the UK is designed to find out about the health of the elderly, and participants are interviewed every two years. It is encouraging and impressive that 60 per cent of those aged 80-plus describe their health as good to excellent. But that does mean that 40 per cent have health problems. The study also found that while arthritis is age-related, joint pain and back pain were not, and were no more common among the elderly than the young.
The study looked at the proportion of people who remain free of certain diseases, including four eye diseases, seven cardiovascular diseases and six other physical diseases. Around half of those aged 50–54 still had none of those diseases, but only around one in ten of those aged 75–79. Wealth and education lead to longer physical functioning, possibly because both lead to better personal care. Money matters: people in the richest part of London live 17 years longer than those in the poorest parts. Individuals who are 50–59 years old and from the poorest fifth of the population are over ten times more likely to die earlier than their peers from the richest fifth. The poor are more likely to be unhealthy, despite a fairly even distribution in the quality of healthcare between different wealth groups.
In a different study, it was found that participants with a high IQ as a child were more likely to have better lung function at the age of 79. This could be because people with higher intelligence might respond more favourably to health messages about staying fit.
Disability and frailty are common problems for the elderly. Those who are ill experience ageing very differently from those who are well. There are 75-year-old joggers and 75-year-olds who are very frail. Frailty is a condition associated with ageing whose symptoms include weight loss, decreased muscle mass and strength, weakness, lack of energy and reduced motor performance. The condition seems to spring from a general weakening of the body, including the skeletal, muscular, blood and hormonal systems. The most commonly used measures of disability are reports of problems with the basic activities of daily living such as mobility, looking after oneself by preparing meals, shopping, managing money and taking medication. While disability indicates loss of function, frailty indicates instability and the risk of loss of function. The frail person is at increased risk of disability and death from minor external stresses. Frailty may also be identified by particular clinical consequences such as frequent falls, incontinence or confusion. In many cases a single factor, such as undetected cardiovascular disease, can be the reason why people become frail. Instead of having classic symptoms such as a heart attack or a stroke, people may have partly blocked blood vessels in the brain or the legs, the kidneys or the heart, which can result in exhaustion or mental confusion or weakness or a slow walking pace. It has been found that those people who had a positive outlook on life were significantly less likely to become frail.
As we age, our cells become less efficient and our bodies become less able to carry out their normal functions. Muscles lose strength, hearing and vision become less acute, reflex times slow down, lung capacity decreases, and the heart’s ability to pump blood may be affected. In addition, the immune system weakens, making it less able to fight infection and disease. Heart pumping giving maximum oxygen consumption declines about 10 per cent every ten years in men, and in females a bit less; maximum breathing capacity declines about 40 per cent between ages 20 and 70; the brain shrinks and loses some cells; kidneys become less efficient and the bladder gets smaller; muscle mass decreases by about 20 per cent between 30 and 70 years, though exercise reduces this; and bone mineral is lost from age 35; sight may decline from 40 and hearing declines when older. These changes in our bodies with age are not due to ill health but are, alas, normal, and they can cause health problems.
Once adults reach 40, they start to lose just over 1 per cent of their muscle each year. This could be due to the body’s failure to deliver nutrients and hormones to muscle because of poorer blood supply. Tendons, which connect muscles to bone, and ligaments, which hold joints together, become less elastic and are easier to tear. We
