The “Very Old”

To the Editor: I was surprised to learn from the article by Anna-Karin Berger, M.Sc., and associates (1) that I have reached “very old” age. It is true that an older cousin told me a few years ago that after 75, it is all downhill, but at 77, I am still waiting for that to happen. I could point to my own activities after age 75 (a new career, my first competitive orienteering, among others), but perhaps it might be more convincing to recall that Sophocles wrote Oedipus Colonnus at 90, Bernard Baruch continued to be an adviser to presidents at the same age, and Bernarr MacFadden died swimming a river in his late 80s.

I suggest that the very old must be defined operationally rather than by an author’s fiat. In a previous article, Journal authors defined the very old as those over 85 (2). In fact, neither 75 nor 85 is a number based on observed changes. The assumption that a period of human life can be termed very old age and that this period can be defined by a number of years needs to be validated before it can be used as a basis for statistical research.

Over a century ago, Otto von Bismarck defined retirement age as an arbitrary number of years. That number has frustrated legions of healthy men and women and is now liable to bankrupt our Social Security system. I hope geriatricians will resist efforts to create another arbitrary standard that may turn out to be equally destructive.