Going, going, gone
- Crossing Frontiers: Gerontology Emerges as a Science by Andrew Achenbaum
Cambridge, 278 pp, £35.00, November 1995, ISBN 0 521 48194 5
Ageing can be avoided, but only at the unacceptable cost of dying young. Otherwise, it is inescapable, and it starts younger than we think. If ageing is defined as the sum of those intrinsic processes in the organism that lead to increased probability of death from natural causes, it begins in our early teens and is continuous thereafter. And it picks up speed not only because the physical processes accelerate but also because experienced time is subject to inflation: the successive issues of the London Review of Books that punctuate our trajectory from maternal perineum to council crematorium will seem to come faster and faster.
The dread of getting old is a universal, if intermittent preoccupation. ‘As I give thought to the matter,’ said Cicero, ‘I find four causes for the apparent misery of old age: first, it withdraws us from active accomplishment; second, it renders the body less powerful; third, it deprives us of almost all forms of enjoyment; fourth, it stands not far from death.’ But this preoccupation has emerged only recently as a major theme for scientific investigation. Gerontology – defined, in Crossing Frontiers, as ‘the study of ageing from the broadest perspective’ – is a neonate among the sciences. Indeed, according to Andrew Achenbaum in his perceptive, beautifully written and superbly organised history of American gerontology, it has not yet fully emerged as a science.
There are many reasons why ageing is attracting so much scientific and quasi-scientific attention. For a start, getting old now seems even less of a good thing than it may have done in the past. Death in secular societies is a terminus, not a gateway; we cannot redeem the impoverishments of its anteroom by thinking of them as preparation for the eternal reward. Wrinkles are harbingers of a slide to nothingness, not marks of a transcendence to come. To grow old, as Simone de Beauvoir said, ‘is to define oneself’ and being defined, even self-defined, is privative as well as positive. The ascent to seniority prunes possibility: the old are what they are and, to a lesser extent, what they have been, though past achievements rarely compensate, often seeming more past than achievement. Even for those whose lives have been successful, the accumulation of experience, connections and possessions may seem an inner obesity rather than an increase of spiritual substance, and the many-paged CV a mere waste product. No wonder we prefer to think of ageing as a problem (with the implication of solubility) rather than as the common and permanent condition of humanity.
A more pertinent reason why old age has attracted scientific attention, and research funding, is that there are more old people about. Two-thirds of mankind’s improvement in longevity has occurred in this century and for the first time in history, most middle-aged citizens in some developed countries have more living grandparents than children. And there has been a sharp rise – set to continue for many decades – in the numbers of the very aged: in the UK, the over-85s have increased more than five-fold since 1950; and the Queen sends out ten times as many congratulatory telegrams to centenarians than she did when she came to the throne. For some (with a frequency unprecedented in history), old age is the time of a first encounter with serious bodily difficulties.
This triumph, which has many causes – the application of technology to physiological needs and physical safety, social welfare policies, public health measures and, more specifically, scientific medicine – has been read by many commentators as a disaster. There is much negative hyperbole about the economic threat of non-productive old people, with their burdensome pensions and, more important, their revenue-consuming illnesses and disabilities. The view that added years have been bought only at the cost of added troubles is at odds, however, with the facts. There is already evidence that the period of disability before death is shrinking despite an increased lifespan; that there is, to use Fries and Crapo’s phrase, a ‘compression of morbidity’.