Quotes of the Day

If one place on earth has vanquished nature and stopped the clocks, it is Las Vegas. Built on land without water or any reliable resource apart from the blazing sun, the resort entombs visitors in the permanent, cool, jangling dusk of hotel casinos. Its skyscape positions ancient Egypt near Renaissance Venice and fin de siècle Paris. I had come to this confected city to find out if the Cenegenics Medical Institute, "the world's largest age-management practice," could subvert the laws of human biology with similar ease. First I had to locate Cenegenics, and though you might think it would be easy to spot a building described by its tenants as "quite a lot like the White House," the cab driver took more than a few passes before we were able to pick out the right White House from the rows of White Houses that have sprouted in the Nevada desert.

That's the Vegas paradox: despite the mind-boggling range of architectural styles and eras represented, there's a remarkable uniformity to it all. The residents are similarly homogeneous. Perma-tanned and toned, many of them sport a uniface common to both genders and across the income range, from bellhops to casino owners. The uniface is defined by absences: its eyebrows have been plucked, threaded or waxed into submission; its fine little nose is free from bumps and bulges. Above all, it looks neither young nor old. It is ageless. It is amortal.

Amortality — the term I coined for the burgeoning trend of living agelessly — is a product of the world many of us now inhabit, a sprawl of virtual Las Vegases, devoid of history and shorn of landmarks that might provide guidelines for what is expected of us as the years pass. Youth used to be our last hurrah before the onset of maturity and eventual dotage, each milestone — childhood, adolescence, young adulthood, middle age, retirement, golden years, decline — benchmarked against a series of culturally determined ideals. But as our life spans have lengthened — across the developed world, we are now living 30 years longer than we were at the beginning of the 20th century — the ages of man have started to elide. If you doubt that statement, think how hard it is to answer the following questions: What's the best age to have children? Or to settle down with a life partner? Or to retire? When might a woman consider herself middle-aged — at 40, 50, 60? Does that differ for a man?

The meaning of age has become elusive, visual clues untrustworthy. Children dress like louche adults. Their parents slouch around in hoodies and sneakers. Rising phalanxes of Dorian Grays rely on exercise, diet and cosmetic procedures to remain transcendentally youthful, while glowing teens and 20-somethings are propelled by some of those same procedures into a semblance of premature aging.

The rules of age-appropriate behavior that used to be reliably drummed into us by parents and teachers, church and state, no longer hold sway. But we haven't lost faith; we've just transferred it, to scientists and celebrities. Hollywood is the home of amortality, the music industry its outreach program. "I think you should just keep going while you can, doing what you like," Mick Jagger observed at 66, ignoring his pronouncement in May 1975 that he'd rather be dead than be singing "Satisfaction" at — or presumably long after — 45.

Doing what you like might include adopting children at 49 and 50, like Madonna; becoming a first-time dad at 62, like Elton John; preparing to marry a woman 60 years younger than yourself, like Hugh Hefner; or, like Jagger himself, reversing the traditional order of marriage and bachelorhood. These are amortal choices. But amortality is not invariably synonymous with extended youth. Meryl Streep represents a different expression of amortality, a true agelessness. And Woody Allen exhibits one of the classic symptoms of amortality, constructing a personal and professional life full of distractions. He never rests. He has turned out at least one film a year for all but three of the last 40 years and performs regularly with a jazz band. As he told an interviewer, "When you're worried about this joke, and this costume, and this wig, and that location and the dailies, you're not worried about death and the brevity of life."

The defining characteristic of amortals is that they live the same way, at the same pitch, doing and consuming much the same things, from their late teens right up until death. They rarely ask themselves if their behavior is age-appropriate, because that concept has little meaning for them. They don't structure their lives around the inevitability of death, because they prefer to ignore it. Instead, they continue to chase aspirations and covet new goods and services. Amortals assume all options are always open. They postpone retirement by choice, not just necessity; one of the reasons the American Association of Retired Persons changed its name to AARP was that many in its demographic were, in fact, still working. And they're having children later than ever — and often relying on fertility treatments to do so.

A by-product of prosperity, amortality influences behaviors across the socio-economic spectrum and from youth to old age. But as amortals get older without "getting old," they become more conspicuous. Upturning conventions of aging isn't necessarily a bad thing, given the maturing profile of the world's population. By 2050, more than a fifth of humanity will be 60 or older, and in the U.S., the 60-pluses will make up 27% of the population. The amortal impulse to stay active, if properly directed, could help ease the anticipated labor shortage and curb swelling health care costs, but amortality is not without its risks. Amortals have a dangerous habit of trusting that science will be able to deliver them from the consequences of aging or, at a minimum, allow them to select the timing and manner of their passing if the range of products and programs promising to preserve us should fail.

Gains in longevity have been achieved by eliminating or neutralizing many threats to our lives, but the main threat — aging — has proved more resistant to intervention. In 1961 a microbiologist called Leonard Hayflick made a depressing discovery. He found that most human cells are able to divide only a limited number of times, so that even if we get through life without contracting a single disease, we'll die when enough of our cells cease dividing. Although our life expectancy continues to increase, by two to five years per decade in the developed world, the Hayflick limit would appear to doom us to a maximum of around 120 years.

But that doesn't stop amortals from aspiring to spend as long in their bodies as possible. There's a thriving specialist health care sector promising to help us do so, and Las Vegas is one of its hubs.

Life, but Not as We Know It

eighty percent of cenegenics patients are men who go there in search of Life. That's Dr. Jeffry Life (his real name), the star of a press campaign in which the physician wears snug shorts and a vest with scooped armholes, a style popular in New York City's Greenwich Village. His face is avuncular. His body is that of Mr. Universe in his prime. One advertisement for the clinic reads, "70 Years Old and Still Going Strong. Happy Birthday, Dr. Life!" I don't encounter Dr. Life in the flesh until the end of my visit, and there's little flesh on display as he goes about his doctoring in a suit, but you can see the muscles straining at the material.

Cenegenics describes its program as a "unique and balanced combination of nutrition, exercise and hormone optimization," which sounds good for just about anyone, so I submit myself as a guinea pig. My day at the clinic involves detailed blood work, scans and tests and would usually cost $3,400. (I accepted a free consultation.) At 49, my physical condition turns out to be good but not "optimal," the Cenegenics buzzword. My consultant, Dr. Jeffrey Leake, another paragon of muscularity, tells me that the transition to "optimal" would entail a fierce program of exercise and losing 10 to 15 lb. (5 to 7 kg). Although my body mass index was logged at 19, toward the lower end of the normal range, one of the scans detected visceral fat, invisible from the outside but a hazard for heart disease, diabetes, hypertension and bad cholesterol.

Leake also proposes starting me on two steroid hormones — DHEA and testosterone — in pill and cream form, respectively. "We will monitor for possible side effects of androgen therapy, which are acne, oiliness of skin or deepening of the voice," he e-mails later. The sex hormone estradiol, like testosterone, could improve my bone density, he adds. "And if applicable — only after a comprehensive evaluation reveals an adult-onset growth-hormone deficiency (GHD) — we may consider supplementing with a third, growth hormone."

Underpinning these recommendations is the notion that hormone supplementation can return us to our "natural" state of youthful vibrancy, as if aging itself were against nature. It's an enticing sales pitch that helps persuade patients to sign up for further consultations and supplies of supplements that typically add up to around $1,000 per month.

Clients often arrive on Cenegenics' doorstep in bad shape; commitment to the program — not least to paying for it — helps impose a discipline that they may have lacked. Weaned off junk food and coaxed into the gym, converts are likely to show clear benefits. But there is another reason Cenegenics patients often achieve such dramatic results, and it's the same reason tiny East Germany carried off so many Olympic gold medals. Testosterone and other steroids routinely prescribed to Cenegenics patients promote muscle mass. But taking testosterone can also cause depressed sperm production, elevated bad cholesterol, shrunken testicles, water retention and bad skin. (I declined Dr. Leake's prescription.)

As to growth-hormone supplementation, the jury is still out. A 1990 study of its effects on a group of men ages 61 and above, published in the New England Journal of Medicine, was broadly favorable. Subjects showed marked increases in lean body mass and no apparent side effects. But it was a small study, of short duration, as its author, Dr. Daniel Rudman, pointed out. His decorous note of scientific caution was destined to be ignored, and the study is now routinely cited in sales pitches for growth-hormone supplements.

In 2003, the New England Journal of Medicine returned to the subject. This time, the conclusions weren't quite so encouraging. Growth hormone changes body composition but doesn't appear to improve function. And there are niggling concerns that growth hormone could accelerate the growth of cancer: a correlation between the development of prostate cancer and higher growth-hormone concentrations "does not demonstrate causality by growth hormone," the article noted, "but it does raise concern about giving older men growth hormone." The alternative? "Going to the gym is beneficial and certainly cheaper."

Biology Is Destiny
There is only one documented way to lengthen life — caloric restriction — and that hasn't been conclusively proven to work for humans, just for smaller organisms. No wonder there was so much excitement around a compound called resveratrol, which seems to mimic the effects of such a diet without the need for a punitive regimen. David Sinclair, an alumnus of MIT, now at Harvard University, spearheaded research on resveratrol, which is found in red grapes and activates sirtuins, enzymes involved in regulating metabolism. In 2008, Sinclair sold his company, Sirtris Pharmaceuticals, to GlaxoSmithKline for $720 million. But last year, a second-stage clinical trial of one Sirtris resveratrol drug was halted amid safety fears after causing kidney damage in cancer patients. Two other compounds remain in development.

One problem with potential elixirs of youth is the danger that they may indeed stop aging — by killing the patient. Research into an enzyme called telomerase that appears to "immortalize" cells by lengthening the telomeres — the repetitive sequences of DNA at the end of each chromosome, which shorten when cells divide — has shown promising results. A study published in Nature last November indicated that mice with suppressed telomerase production aged swiftly but could be rejuvenated if the telomerase supply was restored. But high-strength compounds "are believed to be too toxic for human use. We need to do a lot of medicinal chemistry before we can get them to preclinical trials," e-mails Jon Cornell of Sierra Sciences, a Nevada-based biotech company focused on telomere research. In the meantime, both resveratrol and telomerase are available in weaker formulation as dietary supplements. TA-65, a nutraceutical that "can improve not only cell longevity but quality of life," according to its manufacturer's website, "does have a telomerase-activating effect," Cornell tells me. "But TA-65 is very weak compared to some of the other chemicals we've discussed." Why does Bill Andrews, Sierra Sciences' founder and an eminent geneticist and molecular biologist, endorse TA-65? "It's better than nothing," Cornell replies.

As Young as They Feel
A friend spots a bumper sticker on sale in Australia: I refuse to get old. Such slogans used to be ironic in intent. Amortals adopt them as mission statements, and the amortal form of positive thinking — refusing to contemplate age and death — can bring positive results, up to a point. "Strictly speaking, longevity is measured in numbers: it is the arithmetical accumulation of days, weeks, months and years that produces our chronological life," wrote the psychiatrist and gerontologist Robert Butler in his last book, The Longevity Prescription. "Yet aging — or, more accurately, its converse, staying young — is in no small measure a state of mind that defies measurement."

That isn't a platitude, as Harvard psychology professor Ellen Langer set out to prove back in 1979. Her experiment, designed to see to what extent people think themselves younger or older, started with the retrofit of an isolated hotel in New England. The fixtures and fittings were exchanged for 1959 period equivalents; the refrigerator was stocked with foodstuffs available 20 years earlier. Then came the guests: men in their 70s and 80s, instructed not to view this as an exercise in nostalgia but to pretend they had traveled back two decades in time.

This pretense proved decisive. A control group, taken from the same demographic, arrived to stay in the hotel after the first contingent had left. Their experience differed only in one key respect: they were allowed to acknowledge that this was an experiment and to reminisce about the world the retrofit evoked. In just a week, both groups chalked up physical and cognitive improvements. But the changes were much more pronounced among the time travelers.

It's a result that goes some way toward explaining the extraordinary sense of well-being that radiates from the residents of Sun City Shadow Hills, a community for "active adults aged 55 and better" in California's Coachella Valley, where retirement has been successfully reimagined not as a cessation of work but as a long whirl of absorbing activity.

A construction magnate named Del Webb opened the first Sun City community in Arizona in 1960. "An old fellow came up to me once with tears in his eyes and thanked me for building Sun City," recounted Webb, interviewed for a 1962 TIME cover story. "He said he was planning to spend the happiest 40 years of his life there." Webb died in 1974, but his creation lives on. There are now more than 50 Sun Cities dotted across America. Sun City Shadow Hills, launched in 2004, is among the newest. Driving along its flawless red macadam streets in yellow sunshine beneath unrealistically blue skies, you start to wonder if you've strayed onto a back lot at a Hollywood studio. Distant figures shimmer in the heat haze on the fairway, and a golf buggy hums along a perimeter road, but the sidewalks are empty. Then you ring the doorbell at Patti and Phil Wolff's house and discover a fair chunk of Sun City's boisterous population ensconced in their large open-plan kitchen. At the back of the house, there's a lush garden their next-door neighbor describes as "bitchin'," and a barbecue sends aromatic smoke signals to the rest of the community that one of Patti's famous meals will shortly be served. Patti, 63, describes one of her most ambitious catering challenges: a 2010 dinner-dance that drew 81 guests, organized by the Rainbow Club, the community's gay and lesbian social club. "When they told me what it was going to cost per person just for the food, I said, 'Oh, come on, I can do that for half. And give you choices,'" she says.

Her husband Phil, also 63, is a different kind of dynamo. Connected to the mains, he could power his whole street and its air-conditioned residences and 24-hour sprinkler systems. He plays softball, is a regular at the state-of-the-art gym at Sun City's 35,000-sq.-ft. (3,250 sq m) Montecito Clubhouse and indulges a passion for cycling, racking up as many as 175 miles (280 km) per week. "Basically, he does so many things that I hardly see him," says Patti. "It's like if he was back at work again."

The couple's action-packed lifestyle comes thanks to their erstwhile employer, telecom company Pacific Bell, which featherbedded them into early retirement. Several of the friends around their table still work. Larry Johnson, 63, once the manager of a funeral home in Oregon, these days offers a similar service for pets, assisted by his partner Bruce Atkinson, 66. "Hundreds of people [in the area] have old dogs and cats, and eventually those dogs and cats will die, so Larry gets a lot of business," says Atkinson.

The same forces that keep Johnson's business ticking will eventually disrupt the idyll that he and his friends have built. For the moment, their community offers the ideal support network for widows and widowers, but as their numbers inevitably swell, the network will contract. On a recent night out at another Sun City development called Palm Desert, Johnson and Atkinson caught an uncomfortable glimpse of the future. "We were standing there, and we both made the comment, 'God, these are really old people,'" says Atkinson. Palm Desert opened 12 years before Shadow Hills; the average age of its residents is higher. And because ownership of Sun City properties is restricted to the 55-pluses, the communities age and risk dying off together. Yet it is the absence of young people that — for a while, at least — revitalizes Sun City residents, permitting a powerful illusion of agelessness. Shielded like Langer's test subjects from reminders of their chronological age, they become amortal.

Keeping On Keeping On
It's a startling statistic: the fastest-growing segment of the world population is the very old, with the number of centenarians projected to reach nearly 6 million by 2050. But as John F. Kennedy observed in a 1963 address to Congress, "it is not enough for a great nation merely to have added new years to life. Our objective must be to add new life to those years." Life spans have lengthened; health spans have not kept pace. Genes and luck play a role in how we age. Lifestyle and the wealth required to enhance it are also key factors. Science may yet devise an elixir that allows us all to be Mick Jaggers, doing what we like, seemingly indefinitely and without penalty. But the swelling ranks of amortals who already assume it's possible to keep on living agelessly may find themselves instead subsumed into another phenomenon of our times: the living death before death, sometimes lasting decades, that increased longevity without extended vitality represents.

Yet the trend of amortality is accelerating: you can't just close your eyes and wish us back in Kansas among kindly folk who obligingly conform to outdated expectations of age. Look around our virtual Vegases and you'll see cause for optimism too. Amortals, as they advance in years, hold the key to transforming perceptions by showing what older people can do and showing older people what they can be. They're inclined to keep working, rather than vegetating. They may not age gracefully, but nor do they trade their sense of adventure for dignity. Thanks to amortality, our graying world may not prove too gray a place.

Adapted from Amortality: The Pleasures and Perils of Living Agelessly by Catherine Mayer, © 2011. Published in the U.K. by Vermilion

• Catherine Mayer
• More people are behaving as if they'll never grow old. Is that such a good idea?