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Life in the Age of Old, Old Age

By Susan Dominus, The New York Times Magazine

February 22, 2004

Nov. 22 was an odd date for celebrating the birthdays of the four Blaylock sisters, given that none of them were born on that day, or even in that month. But Joe Watts, the son of the oldest sister, felt the celebration should take place before the Iowa winter weather inconvenienced guests flying in from out of town, and besides, his mother, Audry, was turning 100 -- why wait? ''This is a very expensive party,'' Joe, who is 63, reminded her every so often in the weeks leading up to the event. ''So you better not die before this thing happens.''

Audry responded to her son's teasing with an easy irreverence, a kind of humor she developed only very late in life, in the two decades since she turned 80 -- practically another adulthood in which to try on a new self. ''Joe's always saying, 'Now, Mother, that suit we bought for the party was so expensive, I think we're going to bury you in it,''' she said the day of the celebration, as she finished getting dressed in her studio apartment. Clutching a railing in her bathroom, she peered into the mirror, evaluating the elegant, slightly stooped woman she saw there, checking the placement of a small gold pin on her lapel. ''So I said to him: 'I don't know, Joe. I wouldn't be so sure about who's going to bury whom.'''

With the help of a walker, Audry made her way down the long hallway of her retirement community, heading toward the lobby, where she greeted the two sisters who had already arrived. Charlotte, who would turn 98 in February, had been driven up that morning from a city two hours away, and Barbara -- on the brink of 83, she was still called the baby -- came from her home nearby. Florence, who would be turning 90, had flown up from Las Vegas and arrived a few moments later. Audry rushed over to greet her, but in the excitement the legs of her walker interlocked with those of Florence's, blocking their embrace. The two stood there, momentarily stymied, until an observant guest stepped in to disentangle them.

As the four sisters waited for Joe and his friends to finish decorating the dining room of the retirement home, they sat down to talk, a bit self-conscious as a photographer the family hired for the event started snapping shots of them. ''Oh, someone would take a picture just as I've got my mouth open,'' Charlotte said.

''Naturally!'' said Barbara, who gave Charlotte a high-five, and the two burst into laughter, their shoulders shaking nearly in unison.

Barbara and Charlotte have always been the more reckless sisters, the ones who married too early or too late, the ones who still collapse into giggles that leave them breathless and wiping their eyes. For the most part, Audry and Florence, whose prim bearings are remarkably similar, always were -- still are -- more serious, sharing a passion for books and an interest in current events. What all four have in common: perfect hearing and all of their own teeth. For their age group, the sisters are practically bionic.

As they caught up, the four women fell easily into the same roles that have probably characterized their relationships since President Harding held office. Eyeing Charlotte's walker, Florence and Audry asked their sister why she chose her particular model, which doesn't have a convenient built-in seat, as theirs do. Charlotte said she liked her walker just fine, thank you, and she wasn't going to buy another; she already had two. ''But with this kind, you can put stuff in the seat,'' Audry persisted. ''Yes, I see the good points,'' Charlotte replied, now impatient. ''I realize that.'' Living to 98, it appears, does not provide immunity from the ministrations of a know-it-all older sister. ''She's still telling us what to do!'' Barbara exclaimed, setting herself and Charlotte off into another round of shoulder-shaking laughter.

In the annals of human longevity, the Blaylock sisters represent a happy aberration, an anomaly so rare that they have donated blood for the sake of genetic research. They have all sailed past the current life expectancy of 79 for women in the United States, showing little serious wear along the way. The three sisters over 85 have beaten the unnervingly high odds of developing Alzheimer's (50-50 for people that age and older), and all four have survived bouts with at least one of the most common causes of death for women -- heart disease, cancer and stroke. It's tempting to say that the sisters look young for their ages, but in Audry's case, at least, there isn't much basis for comparison: there are fewer than 70,000 centenarians in the United States.

Over the coming decades, though, researchers expect that figure to jump. Even conservative demographers predict that there will be 10 times the current number of centenarians in 2050, when what remains of the boomers -- the generation born between 1946 and 1964, a group representing one-third of the U.S. population -- hits old, old age. According to United Nations population projections, close to 1 in 20 American boomers are expected to live to 100, thanks to breakthroughs in treatments for heart disease and cancer, lives relatively free of hard labor and longstanding memberships at the gym. Those centenarians may not even be the most senior members of society, either -- the National Institute on Aging predicts that the boomers will be playing bridge with a growing number of people 110 and older, or supercentenarians. Demography, of course, is a game of interpretation. (Some contrarian experts predict that life expectancy will decline if obesity rates keep escalating.) But if American demographers have made one mistake consistently over the past two centuries, it's underestimating the rate at which life expectancy has grown.

The quickening pace of biotechnology might also add to the longevity boom. Some of the country's top cellular biologists will sit in their offices at Harvard and M.I.T. and announce, their faces alternately grave and gleeful, that within the next 10 to 30 years a drug will appear on the market that will slow down the process of aging. They point to recent examples of yeast cells and worms and lab mice whose life spans they have extended as much as five times as long with feats of genetic manipulation, and they suggest that they will be able to achieve more modest results in humans. They don't talk about immortality, but they do talk about healthy centenarians.

Even if those scientists are wrong -- medical history is filled with failed promises of just this sort -- the experience of old, old age, whatever its furthest reach, will no doubt change in the coming years. Even now, there are signs of preparations for a generation's worth of Audrys: retirement homes are busily upgrading their housing with cable and Internet access; economists are dutifully reporting on the enormous burdens Social Security will face; design experts are adding style to formerly utilitarian canes and bathtub rails, the better to seduce the powerful market of the elderly-to-be.

The rise of old, old age will also have more intimate, less easily quantifiable implications. How will the foreknowledge of an extra 15, 20 or 30 years shape the pacing of the lives that precede them? Will people save more for retirement, or plan on embarking on second careers the way they currently plan on a bungalow in Florida? If life suddenly offers a more generous gift of time, how might people decide to spend it? You can imagine tricky periods of transition, as children realize they have to rethink their assumptions about how long their parents' lives will affect their own -- consider the inheritance that never arrives, the matriarchal mantle that never gets passed down. The natural sequential phases of old and new generations -- the younger cohort's rise, the start of the older's descent -- may no longer fall so neatly in sync, creating tension or confusion. More optimistically, there may be second opportunities for reconciliations and resolutions, as families have the boon of extra years, and the wisdom that comes with it, in which to come to terms. The philosophical impact on family dynamics will be profound, as parents continue to lean on children long past retirement themselves, and people in their 80's learn what it means, at that age, to still be somebody's child.

Although he can easily afford to retire, Bill Landau nonetheless gets up every morning to practice law in Cambridge, Mass. His mind is nearly as sharp as ever, and his health is entirely intact, in curious contrast with the physical state of most of his friends. ''I've got one friend, they're drilling a hole in his head. Another one, with heart problems, he's got his stomach out to here,'' he said, both hands outstretched. ''Me, they joke I'm going to be the last one who turns the lights out.''

If he had his way, Bill would quit his job and spend his remaining years playing tennis in Florida with his friends or perfecting the magic show he occasionally performs for charities. Instead, he sticks with his job, for one reason and one reason alone: his father, Reuben, expects to see him there. Bill is 73. Reuben, the founder of the firm Landau & Landau, turned 100 in December. A small, almost entirely bald man who enjoys pinstriped suits and a cutthroat game of gin, Ruby, as his friends call him, devotes a few hours each day to trusts and estates, keeping the family business alive.

When Ruby started practicing law in 1926, his clients were young men, many of them Jewish immigrants working in what was then Boston's thriving garment business. One client was a blacksmith, another ran a repair shop for horse-drawn carriages. Though originally a litigator, Ruby adapted his firm to keep pace with his clients' growing businesses and eventually created a solid corporate practice that sustained, at its peak, almost 10 lawyers, many of whom were family. Today the firm has shrunk to a bare-bones staff of two: Ruby and Bill, who work out of an office otherwise known as Ruby's living room.

Ruby can move quickly, even without a walker. But most often he's quite still, as if conserving his energy. He keeps his gestures to a minimum, with the exception of a distinctive, oft-displayed shrug, his palms extended. Bill, on the other hand, seems to have more restless energy than even his tall frame can contain. On a recent visit to their office, as Ruby talked to me about his long career, Bill wandered around the house, shuffling papers, sitting down, standing up. Uncomfortable with the location of the La-Z-Boy, where he finally landed, he swiftly got up, hoisted the chair with one heave of his hand, moved it -- ''Jeez, that's heavy'' -- then plopped himself back down.

There came a point, years ago, when Bill surpassed his father in physical strength and vigor, but mentally that reversal has never come to pass. Ruby can recall the date and year of every one of his eight siblings' birthdays, deaths (only one sister survives) and wedding anniversaries. He can name every American president since 1900 in order and the year of their inauguration and exit and provide salient details about most -- all as a matter of course, not because he particularly tries. (''I can't do that,'' Bill said to me. ''Can you do that?'') When Bill can't find a legal file, he explained with pride, and maybe a touch of frustration, his father not only knows where to look but may also remember what color it is or precisely what documents you can expect to find inside. His mind would be remarkable for someone at any age -- a capacious, entirely rustproof steel trap.

Ruby, like Bill, has also been blessed with remarkable physical health. ''As long as I've known him, he's never had a sniffle -- nothing,'' Bill said. ''It's just amazing. He's never missed a day of work.'' Strictly speaking, Ruby did miss several months of work, about four decades ago, when he suffered a heart attack. (His wife did not survive her own heart attack 17 years later.) A methodical, disciplined man, Ruby, since his recovery, has followed his doctor's orders to exercise and eat well. Even after he slipped on a patch of ice and broke his leg at age 89, he continued to walk every morning from his home in Cambridge to his office in downtown Boston -- just over an hour's trek -- then back again at the end of the day. ''And he did that in rain or snow,'' Bill said, dropping a box of Russell Stover chocolates onto the table, then choosing one himself. Ruby shook his head and grimaced: ''I haven't touched the stuff in 40 years.''

In keeping with doctors' orders, Ruby also eliminated much of the stress of his work, which meant shifting a good deal of responsibility to Bill, a practice that continues, even though Bill is now more than 10 years older than Ruby was at the time of his heart attack. Bill sighed when the subject of work came up. ''Yeah, for 40 years, I've been doing my work and his,'' he said. After the heart attack, it was Bill who took on the strain of tough negotiations, phone calls delivering bad news. It's still Bill making those calls today.

Bill cupped his hand around his mouth, then stage-whispered to Ruby, sitting close by, ''Hey, Dad, I want to quit.''

''I don't tell anybody what to do,'' Ruby said.

There is something paradoxically paternalistic about Bill's willingness to yield to his father's will. Later in the day, as he gave me a ride back to my hotel in Boston, Bill explained why he continues to fulfill this particular filial obligation. '''Dad, let's retire,''' I tell him,'' he said. ''But he says, 'What would I doooooo?' Just like that. 'Doooooo.' How do you say no to a 100-year-old man? You can't. I can't. I can't be that selfish. Besides, he'd disown me.'' When he pulled over to the curb to drop me off, his attention briefly strayed as he played with the fancy steering wheel in his new car: he flipped it up, then flipped it down, enjoying a toy whose novelty hadn't yet worn off. The relationship between father and son is complicated, occasionally vexing. Practically speaking, Bill said he no longer feels that his father can go on working without him. But after so many years as the founding partner, Ruby is still, at some level, more senior, line editing some of Bill's documents, offering advice, supplying facts long forgotten by his son. And he keeps taking assignments, much to Bill's dismay.

''We have mostly a professional relationship,'' Bill insisted. But if Ruby weren't his father, wouldn't he have dissolved the partnership years ago? ''Yeah, I guess that's true,'' he said. ''I guess I never thought of that.'' He flipped the wheel up, then down. ''I guess you could say it's like I almost never grew up.''

Other than their long lives, Ruby and Audry might seem to have little in common. Audry is the soul of Midwestern modesty, a woman who has rarely left Iowa and devotes part of her morning to her tattered, rubber-band-bound prayer book. Ruby is an analytical, world-traveled New Englander who spends much of his time reading The Wall Street Journal and well-thumbed, torn-apart copies of Foreign Affairs. (He finds them easier to carry that way.)

But the two centenarians also share a remarkable number of habits and traits that gerontologists associate with longevity. Both Ruby and Audry have enjoyed strong social networks: for decades, Ruby was active in the Jimmy Fund, a charity organization he helped found, while Audry kept herself busy with half a dozen charities and social clubs. They have both stayed close to their large extended families, and both have kept their minds regularly active long into old age: Audry plays bridge with the same steady passion that Ruby applies to gin (and the same skill, according to her opponents). Both have also remained thin for most of their lives, although in Audry's case not because she particularly tried: to this day, she opens up every sandwich she is served and slathers it with an additional layer of butter.

Asked why they think they have lived so long, neither Audry nor Ruby claimed to have the slightest idea. Ruby, in particular, bristled at the suggestion that he regard his age as an accomplishment. ''I don't take any pride in my age,'' he said. ''What did I do? To be proud of it, I'd have to be able to attribute it to something I did.''

Ten years ago, Tom Perls, director of the New England Centenarian Study at the Boston University School of Medicine, started researching the lives and habits of centenarians, trying to determine the key to their unusual longevity. Although Perls's research confirms that behaviors like exercising and avoiding smoking are likely to improve health at any age, his work also makes a strong case for a genetic component to longevity. Male siblings of centenarians, he explains, are 18 times as likely as other men born around the same time to live to 100. Female siblings are 8.5 times as likely as other females born around the same time to do so.

Of particular interest to Perls are centenarians who are practically disease free, like Ruby, who complains only about his flat feet, or Audry, whose only serious ailments are arthritis and a touch of angina. ''We've studied people who throw atomic bombs at their bodies, like one guy who smoked three packs a day for 50 years and had no lung disease, no heart disease, no brain disease,'' Perls said. ''You ask some of these people how they got to be 102, they say it's because they drank three martinis a day. What do they have that protected them?''

One popular theory of longevity holds that centenarians are blessed with any number of unusual genetic mutations, each of which protects them from common chains of biological mishaps that lead to disease -- they may have a gene, for instance, that produces a kind of cell that is thought to protect artery walls, thereby fending off illnesses like heart disease, stroke and diabetes. Nir Barzilai, director of the Institute for Aging Research at the Albert Einstein College of Medicine, recently identified such a gene, finding it in 30 percent of the centenarians he studied, compared with 8 percent in a control group of 70-year-olds.

Attached as he is to his finding, Barzilai concedes that it may not be the only explanation for why some people seem to age so slowly. He brings up a particularly memorable research subject, a 107-year-old man with unflawed vision, mental acuity, hair that never turned fully gray, but no sign of the beneficial gene Barzilai identified. It's not that he looks like a 107-year-old man who happens to have no disease -- he looks and seems, in every way, like a man 20 years his junior. Rather than possessing genes that protect them from various common diseases of old age, some centenarians, like Barzilai's dark-haired 107-year-old, may have genes that grant them a slower internal clock, systemwide, providing for cells that actually age more slowly, for whatever reason -- better repair mechanisms or a boosted ability to fend off damage at the outset. (To support this notion that some people age more slowly than others, Perls frequently cites his finding that women who give birth in their 40's, whether for the first time or not, are four times as likely as other women to make it to 100. That's not because giving birth late in life is protective, Perls says; it's merely an indication that these women's reproductive systems are aging at a lackadaisical pace, as is the rest of their bodies.)

Perls and his colleagues often emphasize that there's a difference between the supersurvivors who lived to be 100 at the turn of the millennium, on the strength of their genes alone, and those who will reach that point midcentury, as so many boomers theoretically will. Ruby and Audry survived to 100 without almost any medical intervention -- even when Ruby suffered his heart attack, the only things that saved him were luck, a body primed to heal and his own caution. Many of the boomers, on the other hand, will be living on what S. Jay Olshansky, a demographer at the University of Illinois at Chicago, calls ''manufactured time'' -- years gained from technological advances, better heart and cancer care, better testing, practical applications of stem cell research, improved surgery techniques. ''You'll be seeing many, many more extremely frail and disabled elderly individuals who wouldn't have made it out to these ages if it hadn't been for medical technology,'' Olshansky said. There will be more centenarians, he predicts, but a higher percentage of those centenarians will need continuous care for longer lengths of time, and that care will be expensive.

When some people imagine the year 2050, they see changes and sacrifices made to accommodate a country in which one-quarter of the population is past 65: doorknobs replaced by levers that arthritic hands can handle, more construction of one-story homes, assisted-living facilities that house not just parents but also their 70- and 80-something children, highway signage that will better suit seniors' peripheral vision. ''You know that crawl in tiny print you see at the bottom of the screen on CNN?'' said Robert N. Butler, founder of the International Longevity Center. ''That probably won't last.''

For Laurence Kotlikoff, a Boston University professor who pioneered an economic analysis known as generational accounting, some aspects of the future have little to do with feats of the imagination and everything to do with the certainties of addition (how much the country will earn in the future) and subtraction (how much we will spend). ''You know what Florida looks like?'' he said. ''The whole country's going to look a lot older than that.'' His soon-to-be-published book, ''The Coming Generational Storm,'' predicts that the average American will be crippled by skyrocketing taxes imposed to balance an already outsize fiscal gap, as well as by the inevitable crush of health care costs coming down the pipeline for such an enormous aging population. In 2030, he maintains, the number of retirees will have doubled, but based on current birthrates, the number of people working -- the ones who pay payroll taxes -- will have increased by only 18 percent. Kotlikoff estimates that the fiscal gap will be $51 trillion, most of which will result from the high costs of Medicaid, Medicare and Social Security.

Rectifying the situation would be so painful that it's almost impossible to imagine the politician who could start trying. If both personal and corporate federal income taxes were increased permanently by 78 percent, maybe -- only maybe, Kotlikoff says -- we could close the gap. Otherwise, he foresees a black market tax-evading economy, widespread poverty, slow business development (with high taxes, there's low incentive), as well as potential social tensions between the old, which would be mostly white and relatively wealthy, and the young -- mostly poor blacks and Hispanics, heavily burdened with the financial cost of caring for a class of people to whom they have little allegiance.

Hard as it is to believe, in some regards this is the best-case scenario: none of these numbers take into account the possibility that scientists may figure out a way to make people live even longer.

"It's too conservative to say it's a matter of 'if,''' said Lenny Guarente, a professor of cellular and mollecular biology at M.I.T., when I asked him about the creation of drugs that will slow the process of aging. ''It's really a matter of 'when.''' Sitting in his kitchen in Brookline, Mass., on a Sunday morning, Guarente, co-founder of the biotech firm Elixir Pharmaceuticals, estimated that age-slowing drugs would be available sometime between 10 and 15 years from now. He said he believes that science will not only engineer an extension of the average human life span -- two decades, perhaps -- but also (and more important) grant a significantly increased quality of life during those additional years.

In the world of pharmaceutically assisted longevity that Guarente envisions, all elderly people will die the way centenarians die now, which is usually quickly -- from pneumonia or the flu or a heart that simply can't pump one more time. It's not that old age will drag out, Guarante explained: youth will last longer. ''People in their 80's won't just feel like they're 60, they'll look 60,'' he said. ''Absolutely.'' Tall, entirely bald at 51, Guarente seemed tickled by the possibilities of his research: he winked for emphasis, gave his eyebrows an occasional wag.

Before Guarente entered the field of longevity, the conventional wisdom held that aging was a series of haphazard declines, a result of renegade genes ungoverned by natural selection. Generally, natural selection works by weeding out the carriers of genes that cause disease. If a genetic mutation kills an organism before it gets to the age of reproduction, that mutation never gets passed down. But genes that influence diseases of old age, which kick in long after the years of fertility, escape that net. An organism with a late-in-life cancer gene, for example, may nonetheless reproduce in its youth and pass on that same internal ticking time bomb.

The same logic suggests that nature cannot actively select for longevity, but Guarente and others wondered if, in fact, it could. Maybe during periods of famine, when giving birth would be precarious for fragile offspring, certain genes could trigger a slowing down of the aging process, thereby extending the reproductive phase until times of scarcity had passed. That age-slowing gene would prove advantageous and would continue cropping up in offspring.

Over a plate of pastries in his kitchen, Guarente described the effects that scientists have witnessed when they put mice on famine-like diets with extremely reduced calories: the mice live 30 percent longer, with little disease, and then die very quickly -- of what, the scientists don't even always know. Similar results have been seen in creatures ranging from yeast cells and worms to dogs and monkeys. In the course of his research, Guarente says, he came to believe that there may be a particular gene, sensitive to the metabolic reactions of starvation, that would trigger a chain of life-extending, energy-preserving biological maneuvers. By discovering such a gene, cellular biologists might be able to find a way to trick the human body into activating the defenses that calorie reduction seems to marshal.

In the past few years, Guarente made great strides toward this goal, first finding a single gene that could extend the longevity of yeast cells, then finding a strong link between the activity of that gene and calorie consumption. Beginning to fill in the pieces of the puzzle, Guarente recognized the commercial significance of these discoveries and quickly founded Elixir with another scientist and an experienced venture capitalist.

As Guarente was in the middle of explaining his biotech's latest discoveries, his son, a college junior named Jef, wandered into the kitchen with the family dog, a 6-month-old cocker spaniel that was giving his leash a serious workout. Jef was wearing low-slung cargo pants, and he had spiked hair that had been arranged with care into a gelled chaos. He wasn't so sure about the merits of his father's project, he volunteered. His tone was nonchalant, but it announced a challenge.

''What's wrong with finding the cause of aging?'' his father asked.

''There's nothing wrong with finding the cause of aging,'' Jef said. ''Information is good. But eventually it'll lead to a drug to cure the problem. An antiaging drug -- it's a troubling thing. For one thing, it's a rich person's drug.''

Jef's flat affect gave way to a little more volume as he raised a concern that critics have often voiced about luxury biotechnologies -- that they'll only heap more advantages on the wealthy. ''It'll lead to social problems,'' he continued, ''when rich people are living longer than the poor.'' In the scientific community, Jef's father may be a champion of progress, but to Jef, at that particular moment, he was just another old guy feeding into the hands of old-school capitalists, same old story -- old.

Not necessarily, his father replied -- wouldn't Jef have to make that point about most drugs that have been developed to combat disease?

Jef cut him off before he could continue. ''Americans are already pretty good at surviving -- why don't we focus on surviving as a species? Look at malaria,'' he said, picking a disease that significantly shortens global life-expectancy averages. ''There are all these diseases that kill people before they even get old.''

''It's true my drug wouldn't impact malaria,'' Guarente said, starting to sound irritated. He looked hard at the puppy, which was now off its leash and chomping on the Sunday paper. He swept up the dog and held it tight in his arms, tamping down its youthful exuberance. ''It's a good debate,'' he said, in a futile attempt to signal finality.

Jef pressed on. ''I mean, you're messing with something that could cause overpopulation,'' he said. ''That's not something I'd want to be messing with. Do we really want all these geezers fighting for resources, destroying the environment?''

''I think society benefits,'' Guarente said. ''People who are mature are major contributors to society -- they're around longer, they have cumulative wisdom and I think progress will go faster.''

''That's an optimistic solution,'' Jef said, leaning against the kitchen counter.

''I'm an optimistic person.''

''I try to be a realist. But it's impossible to know.''

There was a pause in the conversation. ''Didn't I read something about a Yale study that found that optimists live significantly longer than pessimists?'' I interjected.

''Yup!'' Guarente said. He looked triumphantly at his son, whose arms were now crossed. Guarente smiled. He winked.

Diana Aharonian's front door opens onto a beige-carpeted stairway, a striking incongruity in the home of a woman on the verge of turning 102. ''All day long, I'm up, I'm down, I'm up, I'm down,'' Diana said, standing at the door to greet her daughter, Natalie, and me.

The house, a small modified red-brick Colonial in Wellesley, Mass., actually belongs to Natalie, who bought it 19 years ago, at age 56, imagining that she would move into it herself -- eventually. Now Natalie is 74, her mother is still in good health and Natalie continues to share an apartment nearby with a friend. Every morning after breakfast, Diana dusts the tasteful furnishings Natalie chose for her future home: a Steinway grand piano, a curved mahogany desk, a low velvet-upholstered couch. It's a home full of objects preserved with respect and care: the unchipped Diana's china, purchased 70 years earlier; a fresh red-leather-bound photo album inscribed 1967; and Diana herself, of course, neatly dressed in a black houndstooth skirt, her gray hair still streaked with black.

Natalie has been wholly devoted to her mother since she was 20, when her father, a shoe factory foreman, died of cancer. Her piano professors at Wellesley College, which she attended on scholarship, told her she could go as far as she wanted -- ''I coulda been a contendah,'' she said, smiling -- but she decided that she needed a more stable job to support her mother, who was then barely getting by and let Natalie know she needed her. A few years later, a serious boyfriend moved across the country but Natalie stayed behind rather than leave her aging mother.

Now retired from her job as admissions director at Wellesley, Natalie stops by to see her mother several days a week, and when Natalie's not there, she is frequently running errands on her mother's behalf, picking up medicine at the pharmacy or checking in with her mother's doctors. In recent years, as Diana's cousins and siblings and sisters-in-law have died, Natalie has become one of the few people her mother sees, particularly since her mother is now too frail to leave the house very often.

An end table in Diana's house prominently displays a photo of Natalie at 22, smooth-armed and smiling, her hairstyle unchanged to date. In front of that photo are two baby pictures, nearly identical: one of Natalie -- and the other? ''I had a little boy,'' said Diana, seated to my right to take advantage of her better left ear. ''Dickie died when he was only 3. He'd say the smartest things.''

''Guess which one is which,'' Natalie said, holding out the two pictures, nearly identical. ''That's Dickie,'' she explained, pointing. ''He's the one who's smiling, the little devil. Isn't he something?'' She and her mother laughed. Natalie noted that she was born one year, to the day, after her brother's death. ''No, not to the day,'' her mother said. ''Yes, Mom, it was,'' she insisted. One way or another, that was how she had heard the story.

At first slightly disengaged as we talked, Diana became coherent and quick when she described her son and the tragic way he died, in a freak fall while in the care of a baby sitter. It's a well-worn memory, a loss she reflects on frequently. Optimists may live longer, but Diana admitted that left to her own devices, she's prone to sink into fits of regret or depression. ''I think about the worst things,'' she said. ''I don't think about the good things, do I?'' She looked for confirmation to Natalie, who nodded. Diana told the story of a doctor who informed her, when she was in her mid-60's, that she would probably live to 100. '''Don't wish that on me,' I told him,'' she said. Perhaps because Diana is a bit hard of hearing, she fixes her attention closely on whomever she's talking to, and her gaze took on a particular intensity. ''All those people who want to live to 100 -- what's so good about it? Tell me -- why do they think it's so great? I feel alone, I can't go to the store myself. I'm a burden. No, I don't think I'm happy I've lived so long.'' As for people in their 30's who think they'd like to live that long -- don't they realize the world is just getting worse and worse? Don't they read the papers? ''I don't think you're going to like it here when you're 100,'' she said to me. ''The world is going to be upside down.'' If 100 is too old, what would Diana suggest is a more suitable point at which to die? She thought for a moment. ''Ninety,'' she said. ''That's a good age. That's old enough.''

Every night around midnight, Diana wakes up for about two hours, and that's when she has to fight the worries. Sometimes she plays word games to calm herself down. ''Take a word like 'sentimental,''' she explained. ''There's a lot of words in there -- 'stale,' 'slate,' 'steam.' I think of words and then I fall asleep.'' And sometimes she thinks about Natalie. ''When I think about the good things, it's always about Natalie,'' she said, making eye contact with her daughter. ''All the things she got out of college, all the organizations she headed, these are the things I think about it, and I feel fortunate. It's the only time I'm happy, when I think of all the nice things she's done in her life for me,'' she said. ''No daughter could have done more.''

It's obviously a close relationship between mother and daughter -- at times, too close. Diana recognizes that she was probably too hard on her daughter, too demanding throughout her life. ''Some parents give their children more freedom,'' she said, only after Natalie left the room to prepare tea. ''I think I've been too strict.'' When Natalie returned, she knelt down to pour tea into the china cups she had already placed on the coffee table. ''Where's my tea?'' Diana suddenly demanded, then rejected the cup she had been poured. ''I like it weak.'' Natalie patiently took that first cup for herself. She poured her mother another.

An hour or so later, sitting at an Au Bon Pain in town, Natalie described the path of her life, while Wellesley students, as confident and beautiful as she was at their age, strode by. Although she has no regrets about the care she has given her mother, like anyone, she thinks about what she has given up: marrying, going to law school, enjoying a period when she felt carefree. Particularly frustrated in her 40's and 50's, she said that she made peace with her relationship to her mother sometime in her 60's. ''I know I've done everything I can,'' Natalie said. She took her mother on vacations, she lived with her for long stretches, she still visits her every other day, shops for her groceries, keeps her supplied with a steady stream of the 1,000-piece puzzles that occupy her days. ''If she's not happy now, it's not my problem.''

Her mother was always hard on her, Natalie said, but instead of alienating her, it made her only want to work harder for her approval. Maybe it's all because of Dickie, the brother who died 76 years earlier, she said, becoming unexpectedly emotional. ''I always felt like, well, even if I couldn't live up to him exactly, at least I could, you know, try to be halfway decent.'' Her almond-shaped eyes, suddenly red, filmed over with tears. A minute later, reflecting on her mother's earlier praise, she brightened a bit: ''What she said about me today, I'll think about that a lot. I don't get a lot of that. That was a real pleasure.'' Three-quarters of a century: I pointed out that that's a long time to be working for one woman's approval. ''I know,'' Natalie said, laughing, wiping her eyes. ''Can you imagine?''

Life-extending technology is a serious enough prospect to have merited its own chapter in ''Beyond Therapy,'' a report on biotechnology issued last fall by the President's Council on Bioethics. Having considered the potential social costs of what it calls ''age-retardation,'' the council's report, a government document of exceptional eloquence, mostly urges caution. What if we find ourselves careless with our time on earth, because we expect to have so much more of it? What if the increased life expectancy we see in developed nations like France is somehow causing their lower birthrates, robbing people of the urgency to reproduce? What about marriage -- would the possibility of 90 years of marriage, or more, be enough to fend people off that commitment for good? In one particularly psychoanalytic passage, the council offers a disturbing vision of how increased longevity might stunt the development of a society's younger generations: in a world populated by able-bodied and able-minded centenarians, their aging children might remain ''functionally immature 'young adults' for decades, neither willing nor able to step into the shoes of their mothers and fathers.''

But scientists working in the field say they are only trying to pursue the same goal that doctors have had since they started practicing medicine -- eliminating disease. David Sinclair, an assistant professor at Harvard Medical School, recently went on N.P.R. to defend his work in antiaging medicine, debating Leon Kass, the chairman of the Council on Bioethics. ''We won't be seeing any Methuselahs any time soon,'' Sinclair says. ''But we could see a big improvement in the health of the elderly. If our work gives many people another 5 to 10 years of healthy life, I will have achieved my life's goal.''

A former student of Lenny Guarente's, Sinclair is now his chief rival, having founded a competing biotech company called Sirtris. He recently found that resveratrol, a compound commonly found in red wine, activates the same longevity-triggering reactions in yeast that calorie reduction does. Handsome, endowed with a charming Australian accent and only 34, Sinclair is often called upon to speak to Harvard trustees and donors, delivering both the face and the promise of youth in one appealing package.

Sinclair, like his mentor Guarente, is not concerned that unleashing a life extender might create financial havoc. He cites studies finding that the longer people live, the shorter their final period of illness, and therefore the cheaper their care. Sinclair also points to the economic benefits of offsetting expensive costs like medical school. ''By the time you get out of medical school,'' he says, ''you've spent a third of your life just studying to be a doctor. It would be amazing to be able to use those skills for another 25 years.''

Ronald Lee, a demographer at U.C. Berkeley, says he believes that people are already starting to factor in those extra years. In a paper titled ''Rescaling the Lifecycle,'' he argues that the uptick in enrollments in both college and graduate education suggests that young people's choices are already reflecting longer life spans: the longer you'll live, the better investment those years of education are. He sees ''proportional life cycling'' in the mating trends of 20- and 30-somethings -- the way they delay marriage and childbirth, move back home after college, prolong adolescence to its absolute limit. It's as if people in their 20's and 30's have somehow internalized the possibility that they'll live well into their 90's or beyond and can therefore meander their way through the phases of life.

Sinclair's projections sometimes sound grandiose, although he delivers them with a certain bashful wonder. ''People have been trying for at least 20,000 years to do what we're doing, probably longer -- since humans ever existed,'' he says. ''And it really feels like we're close.'' But talking to Sinclair, I confess that I find his pronouncements unsettling rather than inspiring. It's not so much that I worry about birthrates or threats to the institution of marriage. The discomfort that I and so many others share stems from something vague and possibly indefensible, something about the natural course of events, the familiarity of an arc that's thought to be inviolable. You work hard to accept and internalize and rationalize the limits of mortality -- so hard that perhaps it's a challenge to let those limits yield even a little. What if there were a pill -- and some of us didn't want to take it?

And yet it feels ungenerous, even close-minded, to deny the wonder of those extra years of health. People at the turn of the century never expected the elderly to live into their 80's in the numbers they do now -- maybe they would have found those extra years unnatural, years we now feel are all too short. So long as there is finitude in life, it seems somewhat arbitrary to decide when the curtain should drop, at what point time becomes so excessive that it invites waste. Is it possible to imagine old, old age as an idyll? I picture parking lots replaced by sparkling tennis courts, 90-year-old women jumping the net, their brown hair still soft. Their memories are sharp. Their futures are gentle.

The elderly, studies have found, tend to die around their birthdays or other significant events, suggesting an almost biological impulse toward symmetry and closure. Audry and her children had worried about the toll the birthday party might take on her health, but it wasn't until about a month after her actual birthday that she suffered a serious setback. Audry twisted her body the wrong way and found herself in such excruciating pain that it took the medics a full half-hour just to get her onto the stretcher. Although she is entirely free of osteoporosis, the doctors told her she was riddled with arthritis. She spent a grueling few days at a nearby care center, exhausted, slowly recovering. At the time, her son Joe said, it was touch and go. His mother hadn't been entirely lucid, and he didn't know whether she would fully recover.

Eventually, she improved enough to leave the care center and return to the quiet of her studio apartment. A few days after she moved back, I called, unsure of what I'd find. Not only was she lucid, she was also full of news. She had run into an old bridge friend at the care center, and they had had a grand time. She and her doctor had had a good laugh about her regular checkup suddenly being moved up, thanks to the crisis. Still, it was a relief to be home. Her first night back, Joe asked her if she wanted him to stay over. ''I told him, 'You need your rest, you better go home,''' Audry told me. ''But then I thought about it and said, 'Would you feel better if you did?' He said, yes, he thought he would, so he did. And I felt better, too.'' Every night that first week, Joe squeezed into a small recliner and slept beneath one of his mother's thermal blankets.

Joe and Audry have grown particularly close since Audry's husband, a banker, died in 1976, when Audry was 72. Almost immediately after his father's death, Joe noticed a change in his mother, once, as he put it, a woman ''who knew her place in a patriarchal family.'' She started her new phase of independence by figuring out how to balance a checkbook, handling, for the first time, her financial affairs. She started going out for lunch with friends or to see some theater in Des Moines. ''I mean, she went out before Father died,'' Joe said, ''but always as a wife or mother, never just with friends.''

For Joe, it was a pleasure to watch his mother's latent personality -- independent, opinionated, funny -- emerge. ''I don't think I changed,'' Audry maintained. ''I just think he didn't get to see that side of me.'' But in this new phase of their relationship, Joe was emboldened, for the first time, to drink in front of his mother, to smoke, to talk about relationships in his life that his mother knew weren't heading toward marriage. For the 28 years Audry has been a widow, she and Joe have developed a new kind of mother-son rapport, one that benefits from the experiences and perspectives of age that both have had time to acquire.

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