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Discovering What It Takes to Live to 100
By Mary Duenwald
Dr. Thomas T. Perls, a geriatrician at Beth Israel Deaconess Medical Center, in Boston, and an assistant
professor of medicine at Harvard Medical School has a nationwide study of centenarians. He is getting DNA
samples, and psychological tests to measure her mental acuity and asking patients consider donating their
brains for research. He also interviews their closest living relatives.
About 14 percent of the women Dr. Perls has studied have stayed single for their 100 years. Could that be
because unmarried women lead relatively unstressful lives? Maybe, Dr. Perls said. "Or maybe the fact that they
are able to live independently means that they are able to manage stress better than the average person," he
said.
In contrast, the centenarian men in the study group are all married, or have been. But there are more than five
times as many women as men.
In nine years, Dr. Perls and his research staff have collected health data on some 1,500 centenarians. And the
work has led him to a series of discoveries about the very old. They are healthier than anyone ever thought
they were, first of all. They avoid the most devastating diseases of old age until the last few years of their lives.
And almost all of them seem to be exceptionally good at managing stress and getting along with people.
Even those unmarried women are never alone. "They're full of good humor and gregarious," Dr. Perls said.
"They're basically very happy, optimistic people. You look at a person like Mary Lavigne and you see she has
people taking her to lunch, people looking after her, because she's so nice."
Most notably, Dr. Perls and his colleagues have recently found, centenarians seem to carry a small handful of
genes that enable them to live to 100 or better.
In August, Dr. Perls and his colleagues - including two molecular geneticists, Dr. Louis M. Kunkel and Dr.
Annibale A. Puca of Children's Hospital in Boston - announced the results of a study of centenarians with very
old siblings. After examining their DNA, the researchers determined that a longevity-enabling gene might exist
in a certain small stretch of chromosome No. 4, one of the 23 pairs of human chromosomes.
The researchers hope that Centagenetix, the Boston-based company they founded, will home in on that gene
before next summer. Ultimately, the company hopes to identify a number of longevity genes, figure out how
they work and create drugs that mimic their actions.
Dr. Perls does not think that genes alone keep people alive for so long. Most of his subjects have healthy life
patterns. He has met some who live to a ripe old age even while smoking cigarettes or eating high-fat foods,
but, he said, "These are the ones who you would suppose really have some spectacular genetic stuff going
on."
Still, a great majority of his subjects never smoked. Few drink to excess. And though no particular diet seems
to ensure long life, obesity is never part of the picture.
But Dr. Perls is adamant that good habits alone cannot get a person to the century mark. He said: "If you do
absolutely everything right - you're Jack La Lanne, you've got the perfect diet, you're exercising for a really long
time, you're happy-go- lucky and incredibly nice, and you're thin, I would say that without the appropriate
genetic variations, it's still extremely difficult to get to 100."
The health histories of Dr. Perls's centenarians suggest that there are three kinds of people who achieve
extreme old age.
• Forty percent are "survivors," those who live with chronic diseases for decades, beginning in their 60's and
70's.
• Another 40 percent are "delayers," who put off illness until their mid-80's.
• And the last 20 percent are "escapers" - people who avoid all age-related diseases until they are over 100.
Until very recently, centenarians were not numerous enough for study. Today,
about 50,000
Americans are 100 or older, up from almost none at the turn of
the previous century.
By 2050, as many as 800,000 to one million Americans may still be alive at 100 or older, with improving health
care practices.
Dr. Perls became fascinated by the extremely old when he was a geriatrics fellow at Harvard, taking his turn
working at the Hebrew Rehabilitation Center for Aging in Boston.
That was in the 1970's, and like other physicians at the time, he assumed that his centenarian patients would
be the sickest. In fact, he had trouble finding them in their rooms. "One was playing the piano for everybody,"
Dr. Perls said. "Another one was a tailor, mending people's clothes."
In 1993, he began the New England Centenarian Study, which at first focused on eight Massachusetts towns.
One of the first things that he and Dr. Silver found was that
senility was not an inevitable
accompaniment to old age.
About 70 percent of the centenarian men, but only 30 percent of the women, were still clear-headed; the
explanation is not known, but the researchers suspect women with dementia are more likely to survive than
men with the condition.
Dr. Perls also found a surprising statistic about the centenarian women who were mothers. One in five of them
had had at least one child after the age of 40. In the general population, only about 5 percent of mothers give
birth that late.
"In other words, if you have a child after the age of 40, you have
about a four and a half times greater than average chance of
going on to 100," Dr. Perls said.
"It isn't just the act of having a child, we don't think. But late motherhood is a marker." It shows that the entire
body is aging slowly, he said.
The more centenarians Dr. Perls met over the years, the more obvious it seemed that longevity could be
inherited. He often recalls the day he spotted a photograph in The Patriot Ledger in Quincy, Mass., of a man
celebrating his 108th birthday with his 103-year-old sister.
The two of them turned out to have had four siblings who lived past 100, plus another sister, still living at 97.
Among these siblings' first cousins were seven centenarians and 14 others who lived to be at least 90. Two
other families among his subjects included similarly large collections of extremely old people.
Dr. Howard Fillit, director of the Institute for the Study of Aging, in New York, said the age of Dr. Perls's
subjects had been the key to his discoveries. "It was Tom's great insight to recognize the value of studying
families with large numbers of 100-year-old people," Dr. Fillit said.
By 1998, Dr. Perls had accumulated enough data to demonstrate that a person with a centenarian brother or
sister was four and a half times as likely as the average person to live to be at least 91. This year, he has
refined the statistics further: male siblings of centenarians have a chance 17 times as great as the average
man's of living to 100. And female siblings are eight times as likely to reach 100.
On a walk through the Harvard Medical School campus four years ago, Dr. Perls described his centenarian
families to Dr. Kunkel, the molecular geneticist. "We went back to my office and drew out the pedigree," Dr.
Kunkel said. "To me, it was clearly genetic. I was pretty confident that if we looked for a gene, we would get
something interesting."
Ultimately, Dr. Kunkel and Dr. Puca examined the chromosomes of 303 people in 137 families. At least one
sibling in each family was 98 or older; the others were at least 90.
In those families, a stretch of DNA on Chromosome 4 stood out; another stretch, on Chromosome 2 was also a
candidate, though not as strong. Now, Centagenetix will try to replicate the study with more subjects, and zero
in on the gene or genes in those sites that may affect life span.
Dr. Perls says he will not be surprised if the gene they find somehow accomplishes the twin goals of slowing
the aging process and protecting against disease.
One way such genes may operate, Dr. Perls said, is by limiting the activity of free radicals, which are unpaired
electrons that cause corrosive damage to tissues throughout the body. Studies on laboratory creatures - mice,
worms, yeast and fruit flies - have shown that certain genes can shield against free radical damage and prolong
life span.
"We already know that free radical damage has an important pathogenic role in heart disease and stroke," Dr.
Perls said, "and it may also play an important role in Alzheimer's disease. There's been pretty good research
showing that it plays an important role in aging."
Though the gene study has clearly taken center stage, Dr. Perls's work with centenarians has raised many
other questions that he hopes to investigate. For example, he said, he would like to study the theory that it may
be possible for people to build a "cognitive reserve" that enables them to avoid dementia in old age.
He described a 103-year-old man who, in psychological tests, showed no signs of senility. Yet after the man's
death, when his brain was examined in autopsy, it was found to be laced with the tangles of dead cells that
characterize Alzheimer's. Perhaps the man had been able to strengthen other parts of his brain - to build a
cognitive reserve - to get around his disease.
Dr. Perls would also like to learn more about the psychology of longevity - how attributes like spirituality,
optimism, humor, financial security, stress management and friendships help people live to be 100. "It would be
very interesting to find out, no matter how good your genes are, what environmental things are a must," he
said.
What are the chances that Dr. Perls himself, now 41, has some genetic propensity for longevity? It is a
question he has definitely thought of. The good news is that his great- great-grandmother lived to 102. His
mother is in excellent health at 78. Signs are even better for his wife, who gave birth to their youngest of three
children when she was 41.
But whatever his genes have in store, Dr. Perls intends to do what he can to stretch their potential. In the past
year, he has dropped 30 pounds from his 5-foot-11 frame, reaching a trim 170, by taking up spinning classes
and coaching his 9-year-old's soccer team.
The way to lengthen your life, Dr. Perls pointed out, is to add healthy years. "Even if we can't live to be
centenarians," he said, "we can all be centenarian-like, in that we can try to compress the time that we're sick
toward the very end of our lives."
New York Times December 25, 2001
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Dr. Mercola's Comment:
Good luck to Dr. Perls in his search for a gene solution. He might come up with something in the
genetic area, but I doubt it. More than likely the information he retrieves regarding associations of
longevity will provide the answers.
He already has a few.
If you are obese, you can pretty much kiss goodbye to ever seeing age 100. It just doesn't happen.
It is also quite fascinating that if a woman has a child after 40, there is over a 400% increased likelihood
she will live to be 100. Amazing.
It is my belief that living to 100 is not something inherited, it is something earned.
In 2050 there will be about one million people in the US 100 years old. I hope to be among that group by
following some simple measures.
• Following the proper eating plan
• Adequately resting
• Regularly exercising
• Addressing the stress in one's life
I would encourage you to do the same.
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