A longer, healthier life: Who's game?

Longevity isn't all it's cracked up to be. What's the point of living a long time if you're not healthy and independent?

As it turns out, that notion was at the heart of a controversial theory 25 years ago, when an upstart doctor named James Fries, now a professor of medicine at Stanford University, predicted that in the future people would live a lot longer than in the past. And, most importantly, they would enjoy good health.

Not so, his skeptics asserted. According to conventional wisdom back then, the longer people lived, the longer they would have to live with poor health and disabling diseases.

As infectious diseases from the early 20th century — flu, smallpox, TB — were beaten, they said, chronic illnesses such as heart disease, cancer and strokes would take their place, requiring ever larger amounts of expensive medical care.

This gloomy notion was called the "failures of success."

Well, look around: Dr. Fries proved them wrong.

In 1980, he proposed a hypothesis called the "Compression of Morbidity," which describes the state of aging today.

While more of us are living longer than ever before, disability and disease have been compressed into a shorter part our life spans. The reasons are twofold.

One is the rapid increase of medical advances, such as joint replacement surgery, better treatment of diabetes and hypertension, colon-cancer screening and the use of statin drugs to postpone heart disease.

But, second, and even more significant: prevention.

We forget how relatively recently we started hearing public-service campaigns touting the benefits of exercising, losing weight, wearing seatbelts, eating healthfully and not smoking. You may yawn when you hear them, because they seem so old news.

But in fact, information about how to prevent our own declines and disabilities by following good health habits is a new wrinkle in the world of successful aging. And it's profoundly changing how many of us grow older.

Here's proof:

One study has followed 1,700 University of Pennsylvania alumni beginning in 1986, when their average age was 68, to the present. Those who smoked, were obese and did not exercise were four times as likely to suffer from an accumulation of disabilities than those who were lean, exercised and didn't smoke.

Remarkably, those with the fewest risk factors experienced disabilities delayed by nearly eight years, compared to those in the highest-risk group. And chillingly, in my opinion, those in the higher-risk categories had a surge of even worse disabilities in the last two years of their lives, compared with those in the lower-risk group.

Another study followed 1,000 fitness-club members and a control group in the community starting in 1984, with an average age of 58. The fitness-club group delayed getting disabilities by more than 12 years, compared to those who didn't stay fit, showing that not only do healthy habits decrease the amount of disability, but they also delay its onset.

But can you be too old to benefit from exercise, good nutrition and other health habits? That is, can preventive measures be ineffective late in life? The answer is no.

Many large studies of programs that promote good health among very old adults have shown substantial, remarkable health improvement.

But more is obviously needed, especially when it comes to decreasing obesity and increasing exercise in this country.

How can we motivate the steadfast couch potatoes among us to get off their duffs and take better care of themselves? How can we save the nation from the enormous health costs brought by disability and lack of independence?

Education is the key. A 2001 study by the Rand Corporation reported that for every dollar spent on prevention, Medicare saved $4 on avoidable health-care services when it encouraged older people to adopt healthier lifestyles.

If you're curious how you're doing, there's now a quiz that will estimate your life expectancy.

At the nonprofit Alliance for Aging Research's Web site, www.agingresearch.org, you'll find "The Living to 100 Healthspan Calculator," by Dr. Thomas Perls.

The quiz translates Perls' longevity research into a practical and fun tool for estimating longevity potential. Best of all, it explains why each item is related to your longevity potential, and tells you what you can do to improve your odds. Plus, there's no finger wagging at your bad habits because it's anonymous.

It says I may live to 94.9. Hey, with good health and independence, I'm game.

Liz Taylor, a specialist in aging and long-term care, counsels individuals and teaches workshops on how to plan for one's aging — and aging parents. You can e-mail her with questions at growingolder@seattletimes.com or write to Liz Taylor, The Seattle Times, P.O. Box 70, Seattle, WA 98111.