Life After 60 A Guide Part I

By Rakesh Mittal

Senior Citizens enter an unchartered territory at eligible age to be called so. Understanding of its various aspects and relevant intricacies would not only enhance preparedness but also give confidence to tackle eventualities. It has been attempted to include articl

• Language: English
• Publisher: Blue Rose Publishers
• Release date: Apr 18, 2024
• ISBN: 9789362612694

Book preview

AGING

AND

BACKGROUND

History of aging

Growing older and becoming old have varied greatly from place to place over historical time. The range of meanings ascribed to old age and the conditions experienced by older people at any given time and place diverge enormously.

Furthermore, the meanings and experiences of late life often are by - products arising from political, social, economic, cultural, and demographic factors that shape a particular society at a specific historical moment.

The oldest known document referring to aging is a description by the philosopher and poet Ptah-hotep, writing in Egypt in 2500 BCE: ‘‘how hard and painful are the last days of an aged man! He grows weaker every day.’’ This characterization challenges notions that the elderly in primordial times lived healthily and happily. Ptah- hotep characterized physical aging as bodily decline, a universally recurring but not ubiquitous a theme in the history of global aging.

Men over 50 thrived in Eastern households during ancient times. Confucius described moral development chronologically: ‘‘At forty I no longer had doubts; at sixty there was nothing on earth that could shake me; at seventy I could follow the dictates of my heart without disobeying the moral law.’’

Maturity, declared Eastern sages, deepened an elder’s affinity to family ancestors. So critical was age in the Confucian world view that older women prevailed over their sons and daughters.

Similar conditions existed elsewhere in the region. According to the Taoist tradition, extreme longevity was proof of sainthood.

In Indian culture, a few elderly hermits attained so much wisdom that their bodies were transubstantiated into immortality. Religious traditions, passed down from generation to generation, were thought to bind the old in a safety net.

Such respect for old age was not enduring in early Western cultures. Following Aristotle’s lead as well as findings by physicians in the fifth century BCE, the ancient Greeks deplored late life’s lamentable nature: they characterized older people’s bodies as abnormally cold and dry, and their bile black, thus making death the natural consequence of aging. The ancient Greeks believed that specific diseases afflicted the last stage of life. Hippocrates catalogued old-age maladies – such as cataracts, nephritis, vertigo, apoplexy, and poor mental health – in his Aphorisms (400 BCE). Thus, Hippocrates anticipated the observation by Seneca (4 BCE–AD 65) that senectus morbidus est – ‘‘old age is a disease.’’

Like the Greeks, the Romans portrayed old age in contrasting hews. At one extreme, Virgil (70–19 BCE) in the Georgics and Juvenal (60–130 AD) in his Satires bemoaned its infirmities. Cicero (106–43 BCE), on the other hand, argued in De Senectute that years of experience more than compensated for the physical decline that came with advancing years: ‘‘Old age is usually not only poorer, but is even richer old age, so far from being feeble and inactive, is ever busy and doing and effecting something.’’

Hebrew scripture provides another variegated treasure trove of late-life images and stories. ‘‘A hoary head is a crown of glory; it is gained in a righteous life,’’

The fifth commandment not only demanded respect for elders, but also implied that children would be punished if they disobeyed their parents. According to the Pentateuch, longevity was the Lord’s reward for faithful service. That Sarah and Ruth enjoyed the fruits of ripeness suggested that even in patriarchal societies, the advantages of age could accrue to women through God’s graciousness. Other passages in Hebrew scripture, however, paint a gruesome portrait of physical decline, fear of rejection, and increasing vulnerability with advancing years that anticipated the contrasts secular writers made between a green old age and second childhood.

Because living too long was risky business, prophets urged the children of Israel to care for helpless, decrepit widows. This modest gloss on texts suffices to establish an important generalization: the physical aspects of senescence, sometimes linked to chronological age, lay the foundation for a perception, both international and historical, that people who attained old age declined in the process.

Interpretations of this perceived reality varied. In the Koran, senescence meant ‘‘neither more nor less than one more sign’’ of Allah’s power. In most traditions, people of all ages presumed that diminished capacity inexorably led to disease, dependency, and death. As Jonathan Swift observed, ‘‘every man desire to live; but no man would be old.’’

Folk artists between the fourteenth and nineteenth centuries designed graphic renditions of the steps of ages, wherein toddlers traversed upstairs and then adults descended another set of stairs to death.

Lebbenstreppe were especially popular in central Europe. The number of steps ranged from four to thirteen. Icons differed for men and women, though some life stairs featured partners.

Children played with toys. Boys carried books while girls learned to spin. Men in their prime were soldiers; women, mothers. Artists made their aged subjects stooped; the elderly were assigned sedentary duties. At 70 or 80 the old ones were confined to their beds, dependent on others while awaiting Father Time to turn his sickle (a symbol of fertility) into an instrument of destruction. The message was clear: youth rose in due course to displace the control wielded by their elders.

Nobel Laureate Elie Metchnikoff in 1905 diagnosed old age as ‘‘an infectious, chronic disease which is manifested by a degeneration, or an enfeebling of the noble elements.’’

Four decades later a different prognosis was offered by geriatricians: ‘‘Senescence is not all decline…. With planned cultivation of these compensatory capacities, the increments can very nearly balance the decrements.’’

Alchemists’ attempts at pro longevity have proved ephemeral throughout the ages; nowadays public health, pharmacology, and modern science offer genuine hope that many vicissitudes of age might be controlled, if not eliminated. Indeed, some scientists go a step further, contending that anti-aging interventions can prolong healthful longevity, thus expanding the human life span.

One final, essential point on the physical ravages of age: although not articulated fully in the historical literature, since women for much of world history have been invisible in texts and missing from public records, a gender bias persists over time and across space in characterizing senescence.

Ageism has affected older women more than men, in part because the latter possess resources that compensate for losing good looks. Contemporary culture by and large marginalizes older women, who comprise the majority in both developing and advanced industrial societies.

Just as the physical attributes of old age represent salient traits of the last stage of life, so too do the demographic realities of human longevity put numbers to its diverse dimensions. Anthropological and historical research suggests four generalizations about demographic patterns of aging:

1. Old people have existed throughout most of recorded history, but they have constituted a very small percentage of the total population in any given time or place – less than 2% of the total, usually far less. Reaching old age was a rare event when the odds of surviving to age 1 were poor. If a person reached the age of 20, then his or her chances of surviving to age 40 and beyond were significantly improved.

2. Since at least till 1700, written records in Europe and North America (such as laws, diaries, and encyclopaedias) have loosely placed the onset of chronological old age around 65, give or take 15 years. There is little evidence indicating that chronological old age occurred before age 40, though ethnographies of contemporary men and women who controlled physical and economic resources, and who gained favourable status through the tasks that they performed, were considered to be in their prime.’

3. The greatest increases in life expectancy at birth and in life expectancy at age 40 have occurred in the twentieth century. Since 1950 there have been gains in life expectancy at age 60. Three quarters of all gains in longevity have been attained since 1900. Since the end of World War II, sharp declines in fertility rates have been a major factor increasing the proportion of old people in a given population.

4. Along with gains in adult longevity has been the aging of population structures themselves. Rates of societal aging vary among and between mature and developing nations. Thus, Japan, which as late as 1950 had only 5% of its population over 65 now has the greatest percentage of elders in its midst, surpassing even Sweden. Life expectancy in Japan rose from 50 to 78 for men and from 55 to 83 for women from 1947 to 1995. ‘‘From a historical perspective population ageing represents a human success story,’’ contended a National Research Council report (2001).

These generalizations affect how people around the world have perceived aging and how older people have interacted with younger persons.

Consider first that, until recently, few human beings attained old age. The paucity of elders consigned them to the role of strangers in the land of the young – and even to themselves. ‘‘Old age is the most unexpected of all things that happen to a man,’’ declared Lev Trotsky, age 56, in 1935.

Viewing the aged as strangers has lent itself to a less sanguine interpretation of aging over time – one of wariness, even fear. Just as many people treat aliens with suspicion, projections and fears cause older persons to be viewed as potential witches or burdens on the community.

Legends and case studies indicate that parricide has occurred in places with scarce resources. Portraits of age drawn by elders can be as gloomy as the ones younger people imagine.

John Burroughs, shortly before his death at age 84, wrote: ‘‘the octogenarian has no alternative but to live in the past. He lives with the dead, and they pull him down.’’

However, two people at the same age in the same place and historical moment may share no other common attribute than the number of years they have lived. Such diversity has always existed across cohorts. Some people mature fruitfully as they grow older; others decline slowly; still others are victims of an unexpected mishap. Many older people try to maintain lifestyles that they adapted in middle age. Others opt, by choice or circumstance, for radical changes in what they think, feel, live, or do. Some move on; others become stuck in helplessness.

The heterogeneity that inheres in late life may have grown richer in recent decades. A subtle revolution is in the making, which results from societal aging.

With the years added to adult life expectancies since the mid-nineteenth century, age-based differences within elderly populations everywhere have widened.

Secondly, when the aged were few in number, their problems were manageable. It mattered little if the potential contributions of the aged were squandered. Now that the elderly is an increasingly larger subset of the population, their wants, desires, and needs can no longer be discounted. People during the past century came to believe that they would reach the age of 65. They considered a good retirement a right. These demographic and economic expectations alone justify the hypothesis that the great watershed in the history of aging, particularly in developed countries, occurred during the twentieth century.

There is another twist to the development on the occupation front.

Agricultural pursuits, which have been the most prevalent mode of economic activity everywhere throughout recorded history, generally provide favourable opportunities for elderly men and women. Farming is hard work, especially at harvest time. Nonetheless, there are many tasks entailed in keeping a farm running that can be accomplished by people with diminished capacities – if they have the requisite expertise. For example, the aged can supervise the work of others and keep records. The insights accrued over a lifetime of observing nature’s bounty and brutality have historically solidified the popular perception of the elderly as veterans of productivity. Control of the land, moreover, assured older people a measure of economic security. Children worked the land for their parents or grandparents with the expectation that in due course they would gain title to the family property. Elders wisely transferred property only after making due provisions for themselves in their declining years or for a spouse’s widowhood.

After the Industrial Revolution, the economic status of older people changed, for better and for worse, especially insofar as new modes of production and consumption altered prevailing ways of doing business.

Economies of scale made hand-made goods a luxury. In a world dominated by bureaucratic procedures rather than personal or familial connections, it became more difficult for elders to adapt to the changing marketplace. Many old workers became obsolescent. In the initial phases of industrialization, it was common for workers and manager to treat the aged as if they were disabled.

Retirement became both a reward for faithful service and a tool for getting rid of worn out workers.

People have always expected the aged to make provisions for their old age. Generally, this has meant that the old had to work until they were disabled or dead. Pensions, public and private, have made it possible for people to look forward to a sunny retirement. But for most humans internationally and historically, the dream of genuine economic security has not been realized. A majority of older persons have lived at subsistence levels, rarely confident that they could or would outlive their resources.

Further, the elderly everywhere throughout history have held many important leadership positions – in African and Southeast Asian tribes, in the papacy and episcopacy, and in democratically elected offices. The aged putatively have the requisite experience, having risen through the ranks, and the wisdom, having dealt with all sorts of situations and personalities. Despite the gradual aging of most populations, however, there has been universal preference for making older persons leaders. Experience counts in heated contests. The most important political old-age development has been in the area of social welfare. States provide for those aged considered deserving and/or needy. Public old-age relief typically began in the local community. Institutions such as a religious organization or charity set aside funds (thereby supplementing resources provided by family, friends, and neighbours) to shelter, feed, or provide medical care to elderly indigents. Over time, local entities – the country, a city, a state, a district – made allocations, sometimes also erecting facilities to house the old. State governments or regional polities provided a third layer of non-familial support; granted pensions to their employees, and smaller government units gave assistance to the elderly poor who met stringent eligibility requirements.

Military or veteran’s pensions have been important sources of old-age relief. The precedent for giving loyal bureaucrats retainers so that they might become superannuated dates back to twelfth-century China and fifteenth-century France. By the 1800s, poor, aging veterans began to qualify for stipends or land grants comparable to those awarded to wounded soldiers and sailors.

In the twentieth century, virtually every nation has enacted some sort of old-age assistance program to deal with dependency and launched old-age insurance plans to enable workers to prepare for their later years.

The historical timing and scope of such schemes depended on the country’s population structure, the ideology of the ruling party willing to enact such provisions, and the treasury’s current and anticipated funds. The growth of old-age interest groups ensured the liberalization of public benefits. With population aging and the staggering cost of elder care, however, many nations (rich and poor) are rethinking the entitlements that government officials feel that they can afford to contribute to the well-being of elderly citizens.

In summary, Late-life wisdom and experience count in agricultural settings, in certain political milieu, and in religious institutions. Kin ties often improved work opportunities in urban settings. The elderly, especially men, have retained and increased their power as long as they remained vital.

The young have typically respected the value of aged mentors. They count on the stories that elderly men and women tell to help them to clarify options and to identify pitfalls that lie ahead. Customs are transferred from generation to generation. The historical record suggests that senior professors, elderly clergy, and retired military sometimes have been recruited in times of crisis to assist younger leaders.

Postmodern cultures of consumption have attempted to manufacture perceptions of a good old age in order to capitalize on the wealth of growing numbers of older men and women in aging societies.

However, the term ageism continues to identify a prejudice comparable to sexism and racism.

Contemporary ageism is not the same as Ptah-hotep’s, but it serves to remind us that humans everywhere tend to value those (again, there is a gender bias) who demonstrably contribute to another people’s well-being. People of all ages tend to disesteem those whose vulnerabilities cannot be masked by a sunny disposition, good health, and economic well-being.

We are entering a new phase in the history of aging, shaped by a long past of cultural and structural lags in integrating the old into communities. Cross-domain relationships – between health and retirement decisions and between family structure and well-being in older age – have always mattered.

History provides a baseline to imagine our future selves.

History of gerontology

Gerontology refers to the study of aging, research, and scholarship in all its aspects.

Gerontology is an ancient subject but a recent science. In the earliest recorded histories there is evidence that humankind speculated about aging and the association of infirmities and death with advanced age.

The processes of aging are complex, and combined with the uncertainties about death, a fertile ground for myth, fantasy, and wishful thinking has always existed. These speculations have given rise to myths about the prolongation of life and the nature of death.

The term geriatrics refers to a branch of medicine that specializes in the care and treatment of the diseases and health problems of older persons.

Gerontology and its background may be divided into several periods: (1) the mythic period from prehistory to the Greco-Roman era; (2) the philosophical period, from Greco-Roman days to the Renaissance; (3) the Renaissance; (4) the early scientific period, from about 1600–1800; (5) the expansion of empirical research, from 1800 to about 1930; and (6) modern gerontology.

From very early writings it may be concluded that humankind has always speculated about the causes of events and offered explanations that attributed causality to mythical forces. Aging is no exception.

One of the earliest writings that discussed aging is the epic of Gilgamesh that dates to around 3000 BC. The hero of this Babylonia poem, Gilgamesh, becomes obsessed with the thought of immortal life and of finding the secret to it. As ancient people saw others grow old and die and observed changes in themselves they wondered how they might avoid death.

One mythic explanation is that humans once had the gift of immortality but lost it in a fall from grace by offending the gods or God. This led people to attempt to regain immortality by pleasing the gods, offering sacrifices, praying, or doing heroic deeds in accord with the customs of their culture.

Other myths were that people living in remote parts of the world still retained the secret of very long life or that somewhere there were healing waters, and bathing in them would restore youth if not bestow immortality. Throughout the ages, such myths have led to geographic explorations to find fountains of youth, though these have never yielded the sought-after secret cure or reversal of aging.

The myths about aging and mortality can be divided into three main types: (1) antediluvian, which hold that in the past people lived much longer; (2) hyperborean, in which it is believed that people live much longer in some remote part of the world; and (3) the fountain type, in which healing waters or substances are thought to exist somewhere.

Myths and legends were held in which longevity is extended by means other than those under humans’ control.

Myths about longevity have usually been linked with a belief in an ‘Abode of the Blessed,’ where the pure have extended life. Elements of this pattern have been widespread, appearing in Persian, Teutonic, Japanese, Hebrew, Hindu, and Chinese myths.

Alexander the Great (356–323 BC) is described as having had an encounter with a fountain of life and Ponce de Leon (1460–1521) purportedly discovered Florida while looking for a fountain that the North American Indians believed was rejuvenating to those who drank or bathed in its waters. It is surprising how many cultures have passed on legends that describe rejuvenating waters that flowed out of an earthly paradise or described mysterious substances that have the power of prolonging life.

Myth and magic and wishful thinking about longevity and death apparently pervaded all societies in pre-scientific eras.

Today these myths may still underlie the popularity of healing spas, diets, exercise programs, and vitamins of special potency. It shows that there is a link between these high contemporary interests and the underlying fear of old age and dying that must have preoccupied some of our preliterate ancestors and still are important to our contemporaries.

A review of Indian perspectives on aging and the meaning of life, in which the ideal life pattern is described as consisting of four stages: student hood, householder, forest dweller, and renouncer.

By the beginning of the Christian era an Indian system of belief had evolved that encouraged conformity to these four stages of the life course. Individuals were expected to fit into a cosmic order, dharma. It is of interest that early phases of life include pleasures and increasing wealth, but later phases require detachment or renunciation. Meaningfulness in later life is attained by a transcendental detachment from the requirements of daily living. As an alternative to the transcendental detachment in the later years, one may attempt to derive meaning from world-directed acts; however, in the classical Indian view of life, in the final stage of life, old age, the individual transcends and renounces the world.

In Hinduism and Buddhism, there is the tenet that the force developed by an individual’s actions, karma, provides the energy for the series of rebirths and deaths until the individual achieves spiritual liberation. Reincarnation in a different body form represents the transmission or embodiment of the soul into a new structure. The reincarnated form would be an outcome of the individual’s actions during a previous life.

Indian thought about old age and death accepts the idea of a preordained cosmic order in which the individual lives through stages en route to some ultimate transcendental state. Thus, the background for Indian thought is a mixture of philosophy, religion, and the mythology of a long-existing culture.

There has been some filtration into the West of the idea of reincarnation, though the West has been influenced by the Christian view that the individual is ultimately resurrected for eternal life. Both Hinduism and Christianity regard the conditions of future existence as being a consequence of present moral behaviour.

The Greek and Roman philosophers dealt with questions about the nature of aging and death. The contributions of philosophy and the beginnings of science derived their strength from the rigor of the reasoning and its logic but not data. Underlying their views is the realization from personal observations that there is a pattern to changes in life marked by stages, cycles, or seasons of a life. Increasingly, in the Greco-Roman views of life there was a separation of the physical or physiological aspects from the moral or religious points of view.

In the fourth century BC the Greek philosopher, Epicurus (341 –270 BC) thought that if people developed the right attitude about the end of life and death, they lost their fear of them and lived a more peaceful life. Accordingly, Epicurus thought that a short life could be just as happy as a long one so that prolongation of life was not important. Aristotle (384–322 BC) was more interested in the natural phenomena of old age and thought that the old body was cold and dry leading to death. He had a rather fixed view of cosmic relationships and avoided the idea of humankind’s rebelling against nature or attempting to ameliorate the course of aging. Cicero (106–42 BC) thought that death was a blessing because it freed our immortal souls from their bodily prisons, and he attempted to rebut major objections to old age, including the one that old age interferes with the enjoyment of sensual pleasures. He expressed the opinion that this is a good loss because it permits the older person to concentrate on the promotion of virtue and reason. Greco-Roman philosophers’ worldview of old age was that it was inexorable. Beginning at conception, the physiological process of drying out and growing old, continued inexorably until death. The stages of life were nature’s milestones, marking the diminution of natural heat and increased desecration.

Each change dictated its own behaviour pattern. This approach to aging and the life cycle took shape in an intellectual world without boundaries between science and philosophy; hence it combined the physical and the moral, interpreting behavioural signs in the light of physiology as well as individual character. In addition to the philosophers of the era, physicians also contributed their observations about the course of life and the afflictions of the body. The most significant of these was Galen (129– 199), who became a model for physicians and for medicine. He believed, like others of his time, that the body dried out as it grew old. Although this suggests that the adding of moisture to the body might extend life, he did not attempt to interfere with what were regarded as the inevitable changes in the body’s balance of heat and cold and the drying out of tissues. Two elements in early thought about aging led to the position that attempting to modify the course of life is undesirable. The first of these is that it is against the will of God; the second is that it is against the law of nature.

‘‘Galen’s writings were dominated by teleological arguments, which emphasize that nature always acts for the best. To the question whether old age is a disease, Galen replied that, ‘it is not a disease because it is not contrary to nature’’’.

In the late middle Ages, Galen’s interpretation of the biology of life was shared by an Arabic philosopher and physician, Avicenna (980–1037). He believed that the drying-out process began in the embryo and continued as a beneficial influence until growth and development ceased at about the age of 30. It was further thought that as the innate moisture of the body dries up, its innate heat decreases, and the aging body becomes cold and dry. This led to a pessimistic outlook about the capacity of medicine to interfere in the decline of function of an aging body. It was thought that extending the life was not a legitimate medical goal, because each individual had a predetermined fixed term of life. All societies and cultures have been impressed with cycles of the life span and its conclusion with death, although the interpretations or attributions of the forces behind patterns of change have varied.

The Greeks and Romans and the Hindus believed that death was part of a natural cosmic order. In Christianity, a different causal attribution was made, that because of sin humankind had fallen from a state of grace in the Garden of Eden and lost immortality and was destined to live a life on this earth plagued by many problems. Eternal life could come only after death and after a life lived according to religious tenets. For many centuries religion and the practice of medicine shared similar views of the preordained character and length of human life.

The religious and theological underpinnings of Western medieval life encouraged the view that one should not tamper with God’s will. This position not only discouraged attempts to modify the course of life but also discouraged science generally because its attempts to understand nature were intrusions into the organization of the cosmos as designed and desired by God. Although both the Old and the New Testaments project the view of the fall of humankind and the loss of immortality due to sinfulness, the resurrection of the righteous for eternity is emphasized in Christianity and the New Testament. This views the human body and its afflictions as of little importance in comparison with the soul, which is eternal. Victory over death was achieved by resurrection and eternity by God for the righteous. Translated into the attitudes of educated persons, this discouraged experimentation and explanations cast in terms of natural causes. If one attributes the downfall of humankind from Eden as based on pride, then pride is the paramount sin of the scientist because scientists presume to be able to ascertain causal relationships and thereby God’s purposes.

Concept of apologism and pro longevity developed in contrast… The position of the apologist is essentially that study and manipulation of the body to produce longevity is a violation of the natural order. If humankind became mortal and died because of sin, attempts to modify the course of life are not only likely to be unproductive but they are presumably sinful in and of themselves. By extension, old age and death are beneficial in that it brings us closer to resurrection and eternal life with God. The apologist’s position not only deterred the development of science, but it also discouraged the transmission of earlier myths about eternal life that had been passed on in the folklore of many cultures.

Just below the surface, in medieval society, however, there was evidence that early myths still persisted about eternal life and legendary places in the world where long life was attained. Columbus, for example, in 1498 reported that on his third voyage he located a terrestrial paradise in Venezuela.

A relatively recent novel, the Lost Horizon, by James Hilton, deals with the myth of Shangri-La. This was the name of a place in the Himalayas where people reportedly lived a very long time.

Medieval theology did not stamp out the desire to believe and perpetuate myths of eternal life on earth or an interest in finding pathways to increase longevity. It did, however, discourage the study and gathering of systematic data on the conditions of life that might lead to life extensions. In the sixteenth and seventeenth centuries in France and Austria, the Huguenots, a Protestant sect, were expelled and persecuted for their beliefs that encouraged a look at the natural sources of conditions of human life. At that time, the Roman Catholic Church, which dominated Christianity, did not favour the collection and examination of data on the length of human life and its variations in different places and conditions. As recently as the eighteenth and nineteenth centuries, there was evidence that the dominant theology of the West discouraged an empirical approach to demography and epidemiology that could ascribe the length of life to natural phenomena.

Unlike the mythic period, the Greek and later philosophers entered into disputations about their conceptions of aging. Lacking evidence from empirical science, it was the tightness of their logic or elegance of their reasoning that was translated into proof of the validity of their opinions. This was a marked advance in understanding because it brought the circumstances of aging into normal discourse and its causes into disputation rather than leaving them in the hands of temple priests who assigned causes to deistic power or offenses. The philosophers coupled their everyday observations with their abstractions in attempting to weigh evidence before arriving at conclusions. One of the early observations was that in death the body is cold. Hence the loss of heat became an early focus. Aristotle regarded old age as the time when our heat is diminished. Much later this same idea was expressed by Benjamin Franklin (1706–1790).

The fourteenth century was the beginning of a revival of literature, learning, and art in Western Europe. Stimulated by the prosperity of the Italian economy and its culture many new expressions were spawned in art, literature, architecture, and science. In the sixteenth century, the Renaissance was joined by a Reformation Movement in which Protestant churches separated from the Roman Catholic Church. The Reformation brought with it a new freedom of thought but also new tensions about social controls, religious beliefs, and desirable life activities; though it still carried with it an emphasis on doing good works during one’s lifetime. There are many exceptions to this simple view of the evolution of Western ideas about aging and death. Medieval alchemists thought about pro longevity and apparently had done things to lengthen life. In China, there was no theological resistance to the exploration of natural experiments, and their alchemists also attempted to modify the course of life by using various natural substances. In the Old Testament of the Bible, there is an account of the attempt to rejuvenate the aging King David (c. 1000–762 BC) by placing a young virgin in his bed. There had long been an assumption that inhaling the breath of a young maiden was a stimulus to longevity. This practice, called gerokomy, was recommended by a seventeenth-century Dutch physician who suggested that an aging burgomeister lie between two young virgins, presumably so that he would obtain maximum benefit, to restore his vitality.

The influence of the Renaissance and the Reformation freed investigators to pursue the gathering of data. Data or information could then be used for sorting out valid from invalid views of the causes of natural events.

The use of data probably distinguishes more than anything else the approach to present-day thinking in contrast to that of the Greeks and Romans (i.e., it is not only logic and richness of thought that matters but the availability of data on which to revise thought).

It also differs from classical Indian thought about old age and death, which assumes that there is a preordained cosmic order in which each individual lives through stages en route to some ultimate transcendental state. Thus, the background for Indian thought is a mixture of philosophy, religion, and the practices of a long existing culture, although it did not stimulate scientific research on aging.

In Great Britain, the views of Francis Bacon (1561–1626) encouraged the growth of natural sciences and serious inquiry into the processes of aging. In Italy in 1558, Cornaro (1284–1367) published his Discourses, which was very influential in Western Europe. Cornaro believed that longevity could be extended by simple reforms of an individual’s life habits. He believed that some very simple hygienic practices would influence the length of life and the condition of a person’s health.

This view has its counterparts today, that personal dietary habits, exercise, and activity patterns, exposure to noxious environmental influences, and stress influence how long and how well we live.

The Renaissance and Reformation permitted a shift in attitudes that supported the growth of natural science and the gathering of systematic data. Although the observations of Galileo (1564–1642) on the organization of the planetary system led to a conflict with the Roman Catholic Church, later observers were able to interpret the organization of the planetary system with impunity and freedom from persecution.

As learned scholars began to make systematic observations in areas other than astronomy, a burgeoning period of science ultimately reached the subject matter of aging.

In England, Isaac Newton (1642–1727), a member of then-religiously dominated Trinity College, Cambridge, explored physics and developed laws about the force of gravity. His life exemplified both the quest for understanding in natural terms and the conviction that relationships can be expressed lawfully. Scholars believed that every event or act is the inevitable outcome of its antecedents. The successes of astronomy and the physical sciences in explaining natural phenomena encouraged the growth of science in new directions in biology and medicine. Scientists had the conviction that everything was knowable; all things were deterministic and lawful. This encouraged the growth of new perspectives on the issues of aging, longevity, and death.

The expansion of mathematics and sciences occurred rapidly after the seventeenth century. European universities added many faculty members whose expertise and commitment were to science. This expansion originated in the physical sciences. It was followed by biology and then by psychology and the social sciences, although some remaining unease was experienced in the relationships between philosophy, theology, and by the growth of the behavioural and social sciences. As late as 1937, philosophers at Oxford University stated there could never be a science of the mind and voted down the creation of a department of psychology. Less threatening to the belief structure of organized religion was the study of mathematics, chemistry, and physics than was the study of human behaviour.

The studies of British biologist Charles Darwin (1809–1882) perhaps epitomize the weakening of philosophical and religious presuppositions in characterizing the status of humankind in the universe. Through his observations of various species, Darwin concluded that there had been an evolution of species from simple early forms to later more complex species, including human. Although this did give humans a superior position in the sense that it was a late evolved species, it clearly broke with the creationist tradition, which regarded humankind as a unique and immediate purposive product of a Divine Being. In 1825 Gompertz published his paper on the lawfulness of human mortality and age. He described the relationship between age and death rates, now often referred to as Gompertz’ law. He pointed out that death rates fall from birth to about age 10 and then rise and accelerates until the end of the life span. His quantitative description of the life course of mortality was a lasting contribution to the study of aging. It should be remembered, however, that the quantitative description of the course of death rates over the life span does not in itself reveal the causes of mortality. The expansive period of science in the nineteenth century was based upon the conviction that all phenomena of nature are lawful and that these laws can be determined through scientific investigation. The first application of this point of view in the study of aging was done by a Belgian scientist, mathematician, statistician, and astronomer Adolphe Quetelet (1796–1874). He published his views with supporting data in Paris in 1835. The translated title of his book is On Man and the Development of his Faculties. The determinist point of view is clearly expressed in his provocative opening: ‘‘Man is born, grows up, and dies, according to certain laws which have never been properly investigated, either as a whole or in the mode of their mutual reactions,’’ (Quetelet, 1842, Edinburgh translation).

He could be regarded as one of the earliest quantitative workers in the field of exact social science, but he also dealt with issues of mortality and functional capacities. Trained as a mathematician he developed the concept of ‘‘the average man’’ around which were distributed measurements according to the law of accidental causes. In this he anticipated the work of Gauss, whose work on the binomial distribution, which is commonly known as the normal or bell-shaped curve. Quetelet reviewed mortality data in relation to age, sex, urban, rural, and national differences. He was convinced that little is beyond knowing if one attends to observation and to describing statistical and mathematical relationships. He clearly adopted a deterministic and organismic perspective about human development and aging.

But they neglected to put forward, with sufficient prominence, the study of physical development, and they have neglected to mark by numbers how individual man increases with respect to weight and height – how, in short, his forces are developed, the sensibility of his organs, and his other physical faculties. They have not determined the age at which his faculties reach their maximum or highest energy, nor the time when they commence to decline. Neither have they determined the relative value of his faculties at different epochs or periods of his life, nor the mode according to which they mutually influence each other, nor the modifying causes.

In like manner, the progressive development of moral and intellectual man has scarcely occupied their attention: or have they noted how the facilities of his mind are at every age influenced by those of the body, nor how his faculties mutually react.

Quetelet perspectives on aging as resulting from ecological interactions of heredity, behaviour, and the environment are congruent with late twentieth-century thinking. Quetelet had been in contact with Charles Darwin’s cousin Francis Galton (1822– 1911), another outstanding intellectual pioneer of the nineteenth century. It is of interest to note that both of them were interested in quantifying the relationship of functional aspects of organisms with the age of the organism. Galton like Quetelet had broad interests. He was originally trained in medicine and mathematics and later studied geography, anthropology, and psychology. He became increasingly interested in anthropometric measurements and, like Quetelet, included measurements of physical and mental functions in his research. An Englishman, Galton sponsored an exhibition of health in London in the 1880s and gathered considerable data on such things as the upper limits of hearing and changes that occur with advancing age. Galton used the term human machine, which undoubtedly reflects his earlier background in physiology. He was interested in fitting the facts of both development and aging in human beings into a broader framework of human evolution and science. One of his major contributions to the study of aging was his gathering of data at the International Health Exhibition of London of 1884. Over 9337 males and females aged 5–80 years were measured on 17 different functions. Because of his exposure to large masses of data, Galton developed an index of correlation to measure the degree of association of two variables (e.g., age and strength). This was a large step forward because it enabled scholars to separate factors according to the degree to which they were related to age or to some purported causal factor of aging. Galton was very impressed with the power of biometrics and left his personal fortune to create the first university chair of biometrics. Karl Pearson (1857– 1936) was its first occupant who extended the statistical methods for the analysis of research data, including the development of a quantitative correlation measure whose limits of error could be specified. Galton’s interests later turned away from the study of development and aging to the application of Darwin’s ideas of evolution. He attempted to develop principles of eugenics for application in the population at large. He wanted to encourage selective breeding of the population so that persons with high intelligence levels would have more offspring. In the nineteenth century, studies of aging were carried out by men like Galton and Quetelet who had high social status and who had the personal funds to finance them. There were no major organized laboratories that conducted research on aging for significant periods of time.

Shortly after Gallon’s work, a physician at Cambridge University, Humphrey, conducted a major survey of the health of older adults. The work, although admirably pioneering and comprehensive, lacked the quantitative synthesis provided by Quetelet and Galton.

In America, the statesman Benjamin Franklin (1706–1790) had earlier stimulated considerable speculation about reviving organisms that were showing no signs of life but might still be resurrected. Because of his involvement with the discovery of the lightning rod and thereby controlling the flow of electrical discharge, he thought that the loss of electricity or the loss of vitality might be the cause of aging. This example underscores many uncertainties in the field of gerontology. That is, it is uncertain whether a particular characteristic of the organism associated with advancing age is the cause of general aging or is a result of it. This dilemma is seen, for example, in the earlier emphasis on heat and the body, which led to the assumption that loss of heat, was the cause of aging and if heat were replaced, aging would be stopped or reversed.

In a similar way because sexual intercourse seems to decline with age, it was thought that stimulating increased sexual activity might fend off the more general effects of aging.

At the beginning of the twentieth century, a number of biologists began to write prolifically about aging. Their underlying theme was the identification of causes of aging or the transformations that occur with age in the human species. The writing of the day was surrounded by a great deal of optimism about the potency of science. No problem appeared to be beyond its understanding and perhaps even the extension of the human life span was potentially under humans’ control. There was considerable public interest in prolonging life and even bringing back to life persons who had died.

But serious scholars were becoming more cautious in their expectations that life extension or rejuvenation would be easy or within immediate reach.

The Nobel Laureate in physiology, Minot, stated both his optimism and his passion with regard to growing old, which he called senescence. We should, indeed, like to have some principle given to us which would retard the rate of senescence and leave us for a longer period the enjoyment of our mature faculties I can venture to suggest to you that in the future deeper insight into these mysteries probably awaits us and there may indeed come a time when we can somewhat regulate these matters. (Minot, 1908: 248) The views of Minot deeply influenced the earliest American psychologist G. S. Hall (1844–1924), president of Clark University. As a developmental psychologist, Hall is credited with initiating research on adolescence. Near the end of his life, Hall (1922) reviewed much of the available information and the then contemporary thinking about aging in his book Senescence: The Second Half of Life. Senescence was a term that he adopted from his reading of biologists of his time. He also included his personal psychological interpretations. ‘‘As a psychologist I am convinced that the psychic states of old people have great significance.

Senescence, like adolescence, has its own feeling, thought, and will, as well as its own psychology and the regime is important, as well as that of the body. Individual differences here are probably greater than in youth’’ (Hall, 1922: 100). In this statement Hall anticipated many later psychologists who also pointed to an increase in individual differences that can occur in many traits with advancing age.

In Russia in the 1920s, the Nobel laureate in physiology, Ivan Pavlov (1849–1936), and his colleagues had observed that older animals learn differently and develop conditioned reflexes differently from young animals. They thought that the process of inhibition was more vulnerable to age than was facilitation. This would be reflected in the fact that old habits would be more difficult to eliminate than recent ones. They anticipated somewhat a later development in interpreting the slowness of speed of behaviour with advancing age by pointing out that when a nerve process is slowed or delayed, remaining traces of each stimulus overly influence succeeding stimuli. Pavlov’s views about aging were not shared by American researchers. He and his followers believed that the role of the central nervous system (CNS) is important in governing the process of aging of the organism. American physiologists had tended to regard aging of the CNS as resulting from the aging of other organs and the circulatory system rather than its being a primary manifestation of the decline in the regulatory capacity of the CNS itself. More recently the CNS has come to be regarded as an important organ in the aging of primates.

One of the first laboratories for the systematic study of aging was established in 1928 in the psychology department at Stanford University under the direction of Walter R. Miles (1885–1978); it was supported by the Carnegie Foundation of New York. The motivations behind the establishment of The Stanford Later Maturity Study were many, but an important influence was that in California men over the age of 40 at that time were having difficulties finding work because it was assumed that they were too old. The Stanford laboratory produced about eight doctoral dissertations on various aspects of aging, including such topics as the relations of age to creativity, learning, extinction of learned responses, and motor skills. In the 1930s new support for the systematic study of aging came through the activities of the Josiah Macy, Jr. Foundation of New York. The Foundation had supported studies of degenerative diseases related to aging, but the director, Dr. Ludwig Kast, believed that degenerative diseases were part of a manifestation of the process of aging. With this in mind he encouraged scholarship and research on aging. The study of aging was encouraged as a parallel to the already vigorous areas of research on childhood growth and development. E. V. Cowdry, a cytologist at Washington University in St. Louis, was urged by the Macy Foundation to organize the publication of a major integrative volume of the information on aging. He was encouraged to enlarge his initial conception of the book, which dealt primarily with biomedical aspects of aging, to include environmental influences and social, psychological, and psychiatric issues as well. This encouragement led to a subsequent multidisciplinary scientific conference and to the collation of the literature on aging from the various sciences in the pioneering volume Problems of Ageing, edited by Cowdry in 1939.

At the time Cowdry’s book on aging was published, there was a developing concern about the increased role of chronic diseases as a public health problem. Although earlier, infectious diseases were the major influences on mortality in the world, heart disease and cancer were increasing as common causes of death. The developments in the study of aging that had occurred during the 1930s resulted in the desire to create an organization to promote research on aging.

A guest researcher at the Department of Anatomy at Oxford University, Korenchevsky, visited New York and requested that the Macy Foundation sponsor the organization of a Club for Research on Aging. Similar clubs were being organized in Europe. It was thought that such a club would be an organization where men could discuss and dispute aspects of aging as gentleman scholars and researchers. There was established The Club for Research on Aging in New York, which evolved into a conference series on aging supported by the Macy Foundation both before and after 1940. By 1940 thinking about aging had become more sophisticated and systematic. Both the Public Health Service and the Josiah Macy, Jr. Foundation regarded the processes of aging as multidisciplinary in character. That emphasis has been continued into the present, although many scientists in the various disciplines find it difficult to adopt a multidisciplinary orientation and to regard aging as a multifactorial process having both genetic and environmental basis.

Earlier views of aging frequently adopted the medical model, which held that aging is the product of disease. The current view is that manifestations of aging involve many factors that interact to modulate mortality and morbidity. In 1941 the United States Public Health Service had organized a conference on mental health aspects of aging. At about the same time the Surgeon General of the U.S. Public Health Service negotiated the establishment of a Section on Aging within the National Institutes of Health. In 1941 Dr. Nathan W. Shock was recruited to head the unit. His efforts to initiate research on aging were delayed by America’s entry into World War II, which occurred at the same time the research unit was to begin its work.

Shortly after World War II ended in 1945, activities in gerontology began to accelerate. Medicine’s increasing interest in the age-associated degenerative diseases, the increase of an older population which portended an older society, and general scientific advances made new methods of study available to students of aging. One of the leaders in the Macy Foundation’s efforts to develop research on aging was Lawrence K. Frank. He was one of five sponsors involved with the founding of the Gerontological Society in New York in 1945. About the same time the American Geriatric Society was founded with both organizations publishing journals. The International Association of Gerontology was founded shortly thereafter.

Lot of research work has taken place since then. Because of the importance of knowledge and research on aging for the well-being of present and future generations, there seems little doubt that gerontology will remain a high priority in academic and professional settings.

In conclusion, Gerontology, the study of aging, has roots that extend far back in history. Humankind has apparently always speculated about the duration of life and the nature of death. In many early cultures myths were created about longevity and death that were passed as legends that explained humankind’s mortality. These legends also were presented in religious teachings (e.g., that humankind at one point had immortality but through weakness and sin was reduced to mortal existence).

Gerontology appears to be on an expanding growth course for both scientific and practical reasons. There has been increasing scientific interest in understanding processes of aging from molecular biological processes through behavioural, social, and humanitarian factors. Developing and developed societies show increasingly larger numbers of older persons who have changing interests and needs. Serving older populations brings with it concerns about increasing standards and efficiency based upon scientific knowledge. Understanding and explaining the processes of aging has proven to be complex.

Aging may be one of the most complex topics undertaken for research in the life sciences.

Perhaps in reaction to the complexity of the subject, investigators have increasingly studied limited aspects of aging. Thus, recent gerontology has been characterized as having many aspect studies and aspect theories. It may also be said that gerontology is a field that is data rich and theory poor. Aided by developments in statistical modelling and analysis, subsystems of the organism may be characterized in terms of causal complexes or subgroups of interacting variables. The interrelationships of these aspects or causal complexes may lead to an interaction with the models developed in physics dealing with chaotic processes and events. The increase in initiation of longitudinal studies of human populations that embrace genetic, behavioural, social, and other influences may lead to a more organismic approach to aging in place of the present aspect specialization. The duration of humankind’s life increasingly seems to be placed in an ecological context that embraces explanations arising from species and unique individual genetic background together with influences from behavioural and social processes and physical and social environments.

It is foolhardy to predict the precise character of gerontology in the twenty-first century, but it seems highly likely that it will show increasing activity and intellectual and scientific sophistication that will provide the basis for significant advances in humankind’s quality of life.

Evolution and comparative biology

From the perspective of evolutionary biology, the most important feature of the organism is its fitness: net reproductive output, measured from one generation to the next.

Evolutionary biologists commonly study components of fitness, such as viability and fertility. The characters of interest to an evolutionary biologist studying aging are the age-specific components of fitness: age-specific survival probability and age-specific fecundity.

The definition of aging that is normally used in evolutionary biology is a persistent decline in age-specific fitness components, both survival and fertility characters, as a function of age, in which this decline is not due to any external factor, such as deteriorating environment, pathogens, and so on.

Late life is a post-aging period