Quotes of the Day

Margaret Dell is 96, but you'd need to check the birth date on her driver's license to believe it. Sporting a baseball cap with a Harley-Davidson logo on it, she is the designated driver for her seventy something friends who no longer feel comfortable behind the wheel. Last winter a snowfall threatened to keep her from her appointed automotive rounds. She took a shovel and cleared a path to her car. Driving keeps Dell young. That and knitting. She constantly knits. She makes baby booties and caps and blankets for friends and family whenever a baby arrives—the newborn getting an early blessing from the ageless. And every month, she donates several blankets to a charity for unwed mothers. Driving, knitting ... and tennis. She plays two or three times a week. She has a much younger doubles partner who "covers the court. I'm a little afraid to run too much because of the circulation in my legs," she explains.

When she was in her 80s, she played in a doubles tournament that required that the ages of both partners add up to at least 100. Her partner was in his early 20s; they won the tournament.

A lifetime nonsmoker and nondrinker, Dell lives alone in a two-story house in Bethesda, Md., her bedroom on the second floor. "I could stay on the first floor, but I try to make myself walk up those stairs and keep going that way." She buys her own groceries; don't even ask if you can shop for her. At home she likes a chicken or turkey sandwich for lunch. If she eats at the country club after tennis, she usually finishes only half and saves the rest for dinner.

(The doggie bag is the senior citizen's medical-supply kit.) Driving, tennis, knitting ... and eating chocolates. She keeps them in a drawer by her easy chair. "I am very bad about those Hershey Kisses," she confesses. "And I love those little Dove ice cream things. I take one before I go to bed." That's the only medication Dell will take without a fight. She's no fan of doctors. Some years back, she took a fall, and her doctor prescribed an MRI. "I just refused to go," she says. "They were having a party. It was my 90th birthday." And the party girl left his office. Fortunately, nothing was broken. But Dell knew that.

More than what she knows, it's how she glows that impresses people.

"She has a light in her eyes that is very alive, alert and interested," says Carole Dell. "It radiates over her whole face. Her face is kind of timeless. It's deeply lined, but she's actually beautiful." Spoken like a proud daughter-in-law with 96 reasons to be proud. Ninety-six and counting.

How does science explain someone like Margaret Dell? How can a woman closing in on the start of her second century be so robustly, almost defiantly, healthy, while men and women decades younger are languishing feebly in nursing homes, plagued with failing bodies and failing minds and wishing they hadn't been so unlucky as to live so long?

For most of human history, a long and healthy life has been shrugged off as a gift from the gods—or maybe the undeserved reward for a lifetime of plain cussedness. But to gerontologists, the vagaries of aging have become the focus of intense scientific research.

Scientists are as obsessed with the question of why the superold survive and thrive as Ponce de Leon was to find the Fountain of Youth. They want to understand why the Japanese islands of Okinawa are home to the world's largest population of centenarians, with almost 600 of its 1.3 million inhabitants living into their second century—many of them active and looking decades younger than their actual years. Like weekend visitors on the summer ferry to Martha's Vineyard, scientists and sociologists clog the boats to Sardinia and Nova Scotia, Canada, to see why those craggy locales harbor outsize clusters of the superold. (Gerontologists are not so beguiled by the Russian Caucasus, where exaggerated longevity claims sparked a series of Dannon yogurt commercials 30 years ago.)

As well as studying these populations intensively to unlock their secrets, scientists have also taken a hard look at the very old in the U.S., most notably in the New England Centenarian Study, led by Dr. Thomas Perls, a geriatrician at Boston University, and in a major study under way at the National Institute on Aging. While the very old are happy to offer homespun explanations for their longevity—"I never took a drink"; "I drank a shot of whiskey every day"—experts are trying to unravel and understand the biological factors that allow some people to reach 100 while others drop off in their 70s or 80s. Researchers are particularly interested in determining which factors allow up to 30% of those who reach 100 to do so in sufficient mental and physical health: a whopping 90% of centenarians, according to Perls, remain functionally independent up to age 92. "It's not 'the older you get, the sicker you get,' but 'the older you get, the healthier you've been,'" he says. "The advantage of living to 100 is not so much how you are at 100 but how you got there."

It's pretty obvious even to nonscientists that how you get there depends partly on the genes you are born with and partly on lifestyle—what and how much you eat, where you live and what types of stress and trauma you experience. How much depends on each factor, though, was unknown until Swedish scientists tackled the problem in 1998. They did it by looking at the only set of people who share genes but not lifestyle: identical twins who were separated at birth and reared apart. If genes were most important, you would expect the twins to die at about the same age. In fact, they don't, and the average difference convinced the scientists that only about 20% to 30% of how long we live is genetically determined. The dominant factor is lifestyle.

"You could have Mercedes-Benz genes," says Dr. Bradley Willcox, of the Pacific Health Research Institute in Honolulu, "but if you never change the oil, you are not going to last as long as a Ford Escort that you take good care of. Those who have healthier genes and live healthier lives—those guys really survive for a long time."

Studies of Seventh-Day Adventists in Utah support this finding. Those unusually clean-living Americans are genetically diverse, but they avoid alcohol, caffeine and tobacco—and they tend to live an average of eight years longer than their countrymen. All of this is good news, with a Surgeon General's warning attached: you can't change your genes, but you can change what you eat and how much you exercise. "The lesson is pretty clear from my point of view in terms of what the average person should be doing," says Perls. "I strongly believe that with some changes in health-related behavior, each of us can earn the right to have at least 25 years beyond the age of 60—years of healthy life at good function. The disappointing news is that it requires work and willpower."

At least that's true for many Americans, whose fat- and calorie-packed diets and largely exercise-free lives are a prescription for heart disease and plenty of other ills. For Okinawans, by contrast, the traditional way of life seems tailor-made for living forever—one day at a time.

Each day, Seiryu Toguchi, 103, of Motobu, Okinawa, wakes at 6 a.m., in the house in which he was born, and opens the shutters. "It's a sign to my neighbors," he says, "that I am still alive." He does stretching exercises along with a radio broadcast, then eats breakfast: whole-grain rice and miso soup with vegetables. He puts in two hours of picking weeds in his 1,000-sq.-ft. field, whose crops are goya—a variety of bitter gourd—a reddish-purple sweet potato called imo, and okra. A fellow has to make a living, so Toguchi buys rice and meat with the profits from his produce.

Since his wife Kame's death seven years ago, at 93, he has done all the housework himself. He rejected his children's suggestion to come live with them because, he explains, "I enjoy my freedom." Although his doctors insist Toguchi is in excellent health, the farmer takes no chances. "If he feels that something is wrong," says his daughter Sumiko Sakihara, 74, "even in the middle of the night, he calls a taxi and goes to the hospital." But he doesn't want the other villagers to worry, so, she says, "he writes a note explaining where he is and tapes it to the shutters."

At 12:30 Toguchi eats lunch: goya stir-fry with egg and tofu. He naps for an hour or so, then spends two more hours in his field. After dinner he plays traditional songs—a favorite is Spring When I Was 19— on the three-stringed sanshin and makes an entry in his diary, as he has every night for the past decade. "This way," he says, "I won't forget my Chinese characters. It's fun. It keeps my mind sharp." For a nightcap he may have a sip of the wine he makes from aloe, garlic and tumeric. And as he drifts off, he says, "my head is filled with all the things I want to do tomorrow."

Scientists working for the U.S. National Institutes of Health and Japan's Ministry of Health have been following oldsters like Toguchi since 1976 in the Okinawa Centenarian Study (OCS) and they've learned that he's typical. Elderly Okinawans tend to get plenty of physical and mental exercise. Their diets, moreover, are exemplary: low in fat and salt, and high in fruits and vegetables packed with fiber and antioxidant substances that protect against cancer, heart disease and stroke. They consume more soy than any other population on earth: 60-120 g a day, compared to 30-50 g for the average Japanese, 10 for Chinese and virtually 0 g for the average American. Soy is rich in flavonoids—antioxidants strongly linked to low rates of cancer. This may be one of many reasons why the annual death rate from cancer in Okinawa is far below the U.S. rate.

But it's not just what Okinawans eat; it's how much. They practice a dietary philosophy known as hara hachi bu—literally, eight parts out of 10 full. Translation: they eat only to the point at which they are about 80% sated. That makes for a daily intake of no more than 1,800 calories, compared to the more than 2,500 that the average American man scarfs down. And as scientists have learned from lab animals, the simple act of calorie restriction can have significant effects on longevity.

Aging Okinawans also have a much lower incidence of dementia—Alzheimer's or other forms of senility—than their U.S. and European counterparts do. Part of that may also owe to diet; it's high in vitamin E, which seems to protect the brain. But perhaps just as important is a sense of belonging and purpose that provides a strong foundation for staying mentally alert well into old age.

Okinawans maintain a sense of community, ensuring that every member, from youngest to oldest, is paid proper respect and feels equally valued. Elderly women, for example, are considered the sacred keepers of a family's bond with the ancestors, maintaining the family altars and responsible for organizing festivals to honor them. OCS data show that elderly Okinawans express a high level of satisfaction with life, something that is not as true in Western societies, where rates of suicide and depression are high among the elderly.

Need convincing evidence that our modern lifestyle can shorten lives?

Look what happens when Okinawans move permanently off the island.

They pick up the diet and cultural behaviors of their adopted country—and within a generation, their life-spans decrease and their rates of cancer and heart attack zoom. Even on the island, young males are following the seductive, virulent American style and renouncing imo for hamburgers. "Okinawan male life expectancy used to be No. 1 in Japan," says Dr. Makoto Suzuki, leader of the study of Okinawan elders. "It started to decline 10 years ago and hit 26th out of 47 prefectures in the 2000 census. I expect it to decline even further in the next census."

Oldsters in Sardinia, another wellspring of longevity, have many similarities to their Okinawan counterparts—except that the Sardinian ratio of centenarians is about equal for men and women (in most societies, 100-plus females outnumber males by 3 or 4 to 1).

They maintain very active lives and powerful social networks; extended family and friends are available to share troubles and take some of the emotional burden out of life. Says researcher Gianni Pes, part of a team from Sardinia's University of Sassari, which is studying the group: "The 100-year-olds are less depressed than average 60-year-olds."

That makes perfect sense to Leonard Poon, director of the University of Georgia Gerontology Center. Since 1988 he has studied American centenarians—he calls them "expert survivors"—and compared them to people in their 80s ("master survivors") and to relative youngsters in their 60s. Poon found that out of 16 personality traits, the experts exhibited four coping mechanisms. First, he says, "centenarians are more dominant. They want to have their way," and they are not easily pushed around. Many are characterized by "suspiciousness. They do not take information on the superficial level" but will question an issue and think it through. They tend to be practical rather than idealistic. And in their approach to life, they are likely to be more relaxed. In other words, they are strong but not inflexible characters.

Poon also determined that people whose age reaches three figures tend to have a high level of cognition, demonstrating skill in everyday problem solving and learning. That's another reason exercise is important: to keep plenty of blood flowing to the brain as well as to stay in shape. Many of his subjects aren't rich; some of them have homes with mud floors. But they make good out of making do. "Many have their own gardens," he notes. "They can their own vegetables.

They're living down to earth."

Like the Okinawans, Sardinians and Nova Scotians, the U.S. centenarians enjoy a strong social-support system. Few Americans live in a village anymore, but having outlived family and friends of the same age, the superold find new helpers and confidants among people younger by a generation or more. It might be someone to help with groceries or car trips or simply a sympathetic voice on the other end of the line. Maintaining a connection with the world, with younger people, keeps their outlook youthful.

With so much evidence that lifestyle is the key to healthy aging, it might be tempting to ignore the role of genes altogether. That would be a mistake. Brothers of centenarians are 17 times as likely to live to 100 as are people without 100-year-olds in the family, while sisters of centenarians are 8.5 times as likely to live into their second century. Given statistics like that, says Winifred Rossi, director of the National Institute on Aging's study on exceptional survival, "we are interested in looking for some kind of genetic component to longevity." Her approach is to look at family members, especially the children, of centenarians. Says Perls, who does similar research: "Kids of centenarians who are in their 70s and early 80s are very much following in the footsteps of their parents, with a 60% reduced risk of heart disease, stroke and diabetes. They are the model for successful aging and a great group to study."

Indeed, despite what the Swedish and Adventist studies suggest, there's evidence that in some families, at least, genes exert pretty powerful effects on life-span. The centenarians registered in the New England Centenarian Study, for example, showed no consistent patterns in diet, exercise or healthy habits that could explain their extended years. About 20% had smoked at some point in their lives, and some had eating habits that should have made them obese or unhealthy but somehow did not. At least 10% to 15% had a history of heart disease, stroke or diabetes for more than 20 years. Something in that group's genes was protecting them from succumbing to diseases that had felled the average American decades earlier. "These people still get to 100," says Perls. "They seem to have a functional reserve or adaptive capacity that allows them to get disease but not necessarily suffer from it. The key seems to be resilience."

Some of that resilience may be linked to human leukocyte antigen (HLA) genes, a group clustered on chromosome 6 that affects vulnerability to such autoimmune diseases as lupus, rheumatoid arthritis and multiple sclerosis. Centenarians living in Okinawa, for example, have variants of HLA that tend to protect against those diseases. Perls has found a region on chromosome 4 that centenarians and their siblings and children in the U.S. seem to have in common and that sets them apart from shorter-lived individuals. The finding has not yet been replicated by other groups, but Perls expects to publish a paper in the next month detailing his results.

What exactly that stretch of DNA does remains to be discovered, but it may be a key not just to long life but also to the resilience found among U.S. centenarian-study participants, with their 20% smoking rate and imperfect eating habits. That group may be especially genetically blessed, and researchers are eager to tap its secrets.

We certainly need them. For as medical science adds years to our collective lives, we chip away at them by doing things—stewing at our desk jobs, eating fatty processed foods, blowing a gasket in a freeway traffic jam, exercising no more than our fingers at the computer—that centenarians can't imagine. Most of them were born into an America as remote from today's metaphorically as the craggy villages of Sardinia, Okinawa and Nova Scotia are geographically. In the early 1900s people walked miles to work not by choice but out of necessity; cars were still a luxury. People tilled the fields because their farmer parents needed cheap help. People ate what they grew because it was there. Most labor was manual then, and most nutrients were natural. Preserved food was what Aunt Maud sealed in a jar.

Tobacco and alcohol were available, but most of today's centenarians didn't indulge to excess.

They trigger our awe and our nostalgia as representatives of a flinty, hardscrabble culture that hardly exists today. They lived out a parable of man at one with nature. They used their bodies as they were designed and programmed over the millennia: for walking, for working, for being fed from the earth's natural bounty. It makes one wonder whether the next generation of oldsters will last quite as long. They will need not just the luck of the genetic draw but also the strength to renounce the lure of fast-food days and couch-potato nights that add yards of butt lard and shorten life-spans by years.

Will Americans in the supersize age resolve to go medieval on their own bodies? It would help, if they want to live to 100. As Poon says of his research pools, "I don't have any fat centenarians." And if research really does extend life by a vigorous couple of decades, the new millions of centenarians will need a support system that spreads beyond family and friends to include a hugely expensive Social Security and Medicare apparatus. The coming gerontocracy won't come cheap.

But that's for the future. Any child of today who hopes to live into the 22nd century without the aid of medical miracles should look to the past, and consider the lessons today's centenarians took from the 19th century. There's a poetry of common sense in their scheme for immortality. Eat sensibly. Keep walking. Keep knitting. If you can't keep friends, make new ones. Plan so much invigorating work that there's just no time to die. And no regret when you do.

• RICHARD CORLISS AND MICHAEL D. LEMONICK