The twenty-first century will see an unprecedented
population of old people, when those
born in the 1940s and 1950s reach their
seventies and eighties. This demographic
bulge of the elderly, already beginning to
appear in Japan and America, will create many
social and economic problems, among them
severe strain on health care systems.

As people age they become obsessed with
living as long as possible, but what people really
want is to have a healthy, productive,
meaningful old age. Simply extending longevity
without addressing quality of life would not be
desirable. A large market now exists for "antiaging
medicine." Many physicians, alternative
medicine providers, and manufacturers of dietary
supplements cater to this market. A professional
society of anti-aging medicine exists in America
along with a scientific journal devoted the
field. This has produced a backlash among
mainstream scientists, who claim that there is no
evidence to support the concept of anti-aging
medicine.

Clearly, most of the products (and concepts)
marketed by the anti-aging industry are
worthless or, in some cases, harmful. Moreover,
because aging is a natural process, to try to
oppose it seems unwise. An important question,
however, is whether any ongoing medical
research suggests that it is possible to extend
longevity or lifespan. Work in the field of human
genetics suggests that it might be. Also, work
in the field of nutrition, especially on the
health-protective effect of antioxidant nutrients,
is encouraging.

Studies of healthy old people consistently
identify two lifestyle factors that are common
in this population: maintenance of physical
activity throughout life and maintenance of
social and intellectual connectedness. I would
add from my own experience that a sense of
humor and a sense of purpose are also
predictive of healthy aging. These factors may
even be more important than good nutrition.

Individuals who wish to increase their
chances of becoming healthy old people must
learn to make appropriate lifestyle choices as
well as to be wary of sellers of anti-aging
medicine. Societies that face dramatic
increases on numbers of the elderly must think
about implementing social policies that favor
rather than interfere with healthy aging. For
example, the strong trend in America to house
old people only with other old people reduces
their social connectedness and may undermine
their sense of purpose in living.

Given the increasing costs to society of
growing numbers of old people who are
infirm or ill, research on the factors associated
with healthy aging should be a high priority.
It is also important to assess the claims made
by the anti-aging industry and to counter them
when appropriate.

Integrative Medicine, an increasingly popular
movement that combines the best ideas and
practices of conventional and alternative
medicine while emphasizing healthy lifestyle
and prevention offers a model for addressing
these priorities.