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1 From the Strang Cancer Prevention Center, Weill Medical College of Cornell University, New York, NY (RSR), and the Department of Social Medicine, Harvard Medical School, Boston, MA (RSB)
2 Presented at the Harvard College 50th Reunion, held in Cambridge, MA, June 6–9, 2005. 3 Reprints not available. Address correspondence to RS Rivlin, Strang Cancer Prevention Center, 428 East 72nd Street, Suite 600, New York, NY 10021. E-mail: rivlinr{at}yahoo.com.
In the United States today, more people are living longer, and persons 70 y of age and older are making up an increasing proportion of the total population. We are finally beginning to recognize that all older persons cannot simply be grouped together as a homogeneous 70 set. Rather, we tend to become more heterogeneous as we age, and we need to evaluate each individual's risk of disease as a distinct entity.
It is helpful as an overview to consider 2 groups of the older population, the "young-elderly," who are generally considered to be 70 to 85 y, and the "old-elderly," as those aged >85 y. Many of the elderly, particularly the young-elderly, are passionately devoted to finding out how to live productively and how to maintain their health and vigor for as long as possible.
With these considerations in mind, the 50th Reunion Class of 1955 from Harvard College organized a symposium held on June 7, 2005, in Cambridge, MA, titled "Keeping the Young-Elderly Healthy." Physician members of the Class of 1955 discussed various ways in which this goal can be achieved. Robert Blacklow moderated the symposium.
The major theme of the presentations was that even in one's 70s, there is much that can still be done to promote good health. Some older persons may react to advice given to them by their doctors by replying that "all this is fine for my children and grandchildren, but it is too late for me." The presentations uniformly supported the view that this attitude is totally misguided. Even if past behaviors were far from ideal, there are specific ways to improve health starting in one's 70s.
The articles included in this publication were selected from the presentations planned for the June 7, 2005, symposium with the recognition that they may be of wider interest to young-elderly and their medical providers than to just the aging alumni of a single college. The symposium begins with a review by Robert Blacklow of life expectancies during a 100-y period and the factors governing estimates of life expectancy for the future (1).
Kilmer McCully (2) then covers homocysteine, a potential risk factor for cardiovascular disease that has both genetic and environment determinants. Older individuals can favorably influence their abnormal homocysteine metabolism by specific measures. Robert Lees (3) then discusses cardiovascular disease and the likelihood that its rate of progression can be slowed or halted by specific measures taken by healthy elderly individuals. He also evaluates those noninvasive procedures of particular relevance to older individuals in tracking the status of their cardiovascular disease.
The symposium concludes with an overview of nutrition by Richard Rivlin (4), which highlights the evidence that it is not too late to make positive changes in diet and lifestyle to improve health. With respect to heart disease, osteoporosis, and cancer, the data clearly show that specific changes made by adults in their 70s can have a beneficial effect on future health.
The editors of this symposium are painfully aware that data about women college graduates are not included here. The reason for their exclusion is simple; namely, in September 1951, the Harvard College class was composed entirely of men. At that time, women attended Radcliffe College but were able to take the same classes as the male Harvard undergraduates. In recent years, both women and men have been admitted to Harvard College, enabling an artificial distinction to be obliterated. It is hoped that future studies tracking women college graduates will provide a greater understanding of those factors determining their life expectancies and how they compare with those of men.
The overall message from this symposium is one of optimism and hope: even with past behaviors that have been far from optimal, taking appropriate steps in one's 70s has a high chance of yield. It is not too late!
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