We have learned a great deal from the BLSA and a growing body of aging research. But there is much more to explore. In 2009, while continuing other areas of research, the BLSA will begin to examine the genetic, environmental, social, and behavioral factors that preserve health and function for a rare fraction of the oldest old adults. The BLSA has developed the Insight into the Determinants of Exceptional Aging and Longevity (IDEAL) study, which will focus on people 80 years and older who are living free of physical and cognitive disease. Taking advantage of research strategies already standard for the BLSA, the aim of the new study is to identify factors that distinguish extraordinary health at very advanced age from non-"ideal" aging. Further, IDEAL aims to discover the physiological, environmental, and behavioral risk factors that result in the loss of exceptional aging status over time. Although research exists on the relationship between long life and functional decline, we still know relatively little about why certain individuals have excellent health well into their eighties while others experience disease and physical decline earlier in life.
Previous research findings looked at whether or not long life and healthy aging are familial traits. The National Heart, Lung, and Blood Institute's Twin Study, for instance, found extreme longevity has a relatively low inheritance (about 20 percent, although the genetic effect tends to be higher at older ages) while maintaining physical function in late life appears highly inheritable (50 to 60 percent). However, the study did not identify the specific factors contributing to longevity and healthy aging.
According to the NIA-supported New England Centenarian Study, centenarians (individuals 100 years and older) can be divided into three groups: "survivors," 42 percent of the study population; "delayers," 45 percent of the study population; and "escapers," 13 percent of the study population. Survivors had an age-related disease before age 80, delayers were not diagnosed with an age-related disease until after age 80, and escapers reached year 100 without ever having an age-related disease. In the IDEAL study, scientists will focus on individuals able to delay or evade disease and disability into their eighties — the delayers and the rare escapers.
The IDEAL study will offer a greater understanding of the mechanisms that are important to exceptional aging. There are many potential benefits of the IDEAL study:
- Scientists will be able to study traits that have long been of interest to the research community.
- Studying these participants over time will provide data needed to compare the delayers, who eventually develop disability, and the evaders, who never become disabled.
- Identifying factors that lead to "ideal" aging may be used to develop strategies for improving the health of all people as they get older.
In short, the IDEAL study continues the BLSA's research interest in advancing what is known about healthy aging. Findings from this study perhaps will translate into actions that preserve health and physical function for very long-lived individuals.
In Their Own Words: Reflections from the BLSA Staff
Dr. Jeff Metter
I have been with the BLSA since 1987, when I was hired as the study physician. During my time with the study, I have seen the BLSA make a number of changes to adapt to shifting times, research questions, and needs. The early years of the study focused on understanding the dynamic changes that occur within individuals as they age. In doing so, the BLSA made major contributions to our understanding of how individuals age and characterizing the aging process. As the study matured and our understanding of aging increased, research questions gradually began to examine the transitions between aging and disease.
I came to the BLSA from the Veterans Administration, where I was the physician on a chronic care ward, specializing in stroke and neurological disease. What was most striking to me at the time was the vitality of many elderly members of the BLSA as compared to those I knew from the VA. Individuals in their seventies and eighties were active, running businesses, and participating in activities not normally associated with older adults. In more recent years, I have seen people in their eighties and nineties with the same level of energy that I once observed in 70- and 80-year-olds. What I wonder now is whether our older population is healthier and more robust or I am now older and observing others in a different light. It is probably both.
Thank you to the BLSA participants for your efforts and commitment. The study would not exist without you.