Healthy aging may depend on past habits

Men younger than 50 can exert substantial control over their eventual physical and mental health after age 65, according to the most recent analysis of an ongoing 60-year-long study.

Those men who relatively early in life developed good habits, such as exercising regularly and coping flexibly with distressing situations, were healthier and happier in their senior years than those who had not developed such habits, conclude George E. Vaillant and Kenneth Mukamal, both psychiatrists at Brigham and Women’s Hospital in Boston.

The trick is to reach senior status. Factors largely outside of personal control influence men’s survival and overall health before age 65, the researchers report in the June American Journal of Psychiatry. Life-prolonging factors in the pre-senior years include having had long-lived relatives and warm family relationships as a child. Among life-shortening influences are experiencing bouts of major depression and developing a high blood-cholesterol concentration.

For those who live to be senior citizens, however, earlier habits mold the quality of life. “A successful old age may lie not so much in our stars and genes as in ourselves,” Vaillant says.

In 1937, researchers recruited 237 Harvard University sophomores and 332 teenage males from poor, urban families. Participants, all of them white, received regular physical and mental evaluations for 60 years or until their deaths.

Overall, the Harvard men lived about 10 years longer and experienced physical and mental disabilities at later ages than their counterparts.

Seven largely controllable behaviors measured before age 50 correlated with good physical and mental health between ages 75 and 80 for surviving college men and between ages 65 and 70 for surviving urban recruits. These variables included abstaining from smoking, drinking in moderation, controlling body weight, graduating from high school, having a stable marriage, and coping effectively with stress.

Education had a particularly prominent impact on successful aging, Vaillant notes. Physical and mental health declined no more rapidly among the 25 city men who completed 16 or more years of education than among the college men.

Men under 50 years old who practiced health-promoting behaviors also reported the greatest number of friendships and regular social contacts at age 70. Prior research suggested that social involvement improves adults’ overall health. “Good social supports in old age may be in large part a result of the same earlier good habits that preserve physical health,” Vaillant says.

On a more ominous note, men who suffered periods of major depression before age 50 faced an increased risk of either dying before age 70 or experiencing physical and mental illnesses as seniors. The study doesn’t examine whether, or to what extent, depressed men received mental-health treatment.

The role of personal control in fostering a healthy old age needs to be examined in women and in men of different races, the researchers note.

That kind of data is emerging from a related long-term study of both men and women recruited from a Seattle health maintenance organization in 1956.

Midlife traits, such as having a stable marriage, a flexible coping style, and a lack of heart disease and other chronic illnesses, strongly correspond with a person’s ability to live independently as a senior, regardless of his or her sex, says psychologist K. Warner Schaie of Pennsylvania State University in University Park, who directs the Seattle study.

In another related report published recently, nuns who expressed a deeply held, positive outlook on life as young adults lived longer than those who took an emotionally neutral stance (SN: 5/26/01, p. 324: Look on the bright side and survive longer).