I’m a sucker for stories about supercentenarians, people who live way beyond the century mark. So, I couldn’t help but dive into an article the other day seeking to explain how Maria Branyas Morera, the world’s oldest person, managed to live to the age of 117.

It’s not that I’m searching for lifestyle hacks that might allow me to become a supercentenarian or mining for some assurance that even my unhealthiest habits won’t necessarily constrain my lifespan (or “healthspan,” as the longevity gurus put it). I’m mostly fascinated by the utter capriciousness of the human body, how it ages so gradually in some people and falls apart too soon in the rest of us.

As Gretchen Reynolds reports in The Washington Post, Morera may have been the most closely studied supercentenarian in history. Manel Esteller, MD, PhD, and his team of researchers at the University of Barcelona School of Medicine got wind of the age-defying Catalan after she’d already eclipsed 110 years, and they reached out to her to better understand how she’d done it.

“They are so rare,” Esteller says. “And to have one close to us, we felt we should learn all we could about her.”

Morera was game and contributed frequent samples of her blood, urine, saliva, and stool in the months following her 116th birthday. She also allowed Esteller and his colleagues to peruse her health records and query her about her diet and other lifestyle habits. Their findings, published last month in the journal Cell Reports Medicine, illustrate the often-confounding forces that govern the human lifespan.

“[E]xtreme human longevity may be characterized by the coexistence of two distinct and potentially unrelated sets of features within the same individual,” Esteller writes. Morera displayed many of the “characteristic biomarkers of very advanced age,” such as shortened telomeres and cellular damage, but she also hosted specific genetic variants that have been known to protect the body from common age-related chronic illnesses.

“All these findings illustrate how aging and disease can, under certain conditions, become decoupled, challenging the common perception that they are inextricably linked,” he concludes.

But was it Morera’s diet and lifestyle choices that extended her life, or was she simply one of the lucky few whose genetic inheritance guarantees them a few extra decades? Researchers discovered it was a little bit of both.

Morera clearly won the genetic lottery. Her cells were free of the genes that have been linked to an increased risk of cancer, Alzheimer’s, diabetes, and a variety of other chronic diseases. In their place were genes known to help repair DNA, cool inflammation, dispatch dead and malfunctioning cells, and produce the mitochondria needed to power cellular energy.

And yet, her genetic makeup doesn’t solely explain her longevity, Esteller notes. She was the only one of her close relatives to live well beyond the average lifespan.

Looking at Morera’s lifestyle habits, she was an avid gardener, was physically active throughout her life, and enjoyed a strong social network. She also slept well, read widely, and played the piano. Morera embraced a typical Mediterranean diet — fish, olive oil, fruit — but ate sparingly. That is, unless you count her yogurt consumption: three servings of plain yogurt every day for the last 10 years of her life.

Maybe all that yogurt explains why her gut microbiome was so healthy. Researchers found a microbial mix there that has been associated with reduced inflammation and a strong immune system. She also hosted a robust population of T cells, a type of white blood cell that “remembers” past infections and actively fights new ones. These tend to decline in number and activity as we age, but hers still contributed to a very efficient immune response.

There are volumes of research suggesting that healthy lifestyle habits can lead to enhanced longevity. One 2024 study involving more than 276,000 U.S. military veterans concluded that adopting eight specific behaviors could keep you alive for about 87 years — 10 years longer than the average American’s life expectancy.

“There’s very clear evidence that, for the general population, living a healthy lifestyle” is key to extending one’s life, Sofiya Milman, MD, a professor of medicine and genetics at the Albert Einstein College of Medicine, tells The New York Times. But, she adds, “even if you do everything right,” you’re not likely to make it to 100.

Or maybe even past middle age. We’ve all known people who never smoked, ate right, hit the gym regularly, managed their stress admirably, imbibed moderately — and never saw their 65th birthday due to some random cellular mischief.

Only those, like Morera, who’ve been gifted with the right mix of genetic variants can dream of surpassing the century mark. And, in many cases, they get there despite bending many of the healthy-living rules the rest of us struggle to obey. “We have families where there’s a lot of smoking; we have some families where they’re couch potatoes,” says Michael Province, PhD, co-lead of the Long Life Family Study, which is analyzing the extended lives of more than 5,000 individuals blessed with longevity-enhancing genes.

I suspect I’m not one of the lucky ones. Mom made it to 82 but Dad died at 60, and I can’t recall any of their siblings enjoying an especially long and healthy life. Cancer took my brother at 73. Still . . . you never know, right? My maternal grandfather smoked cheap cigars and lived into his 90s, so maybe I’ve inherited some slight genetic advantage. I also eat a bowl of yogurt every morning.

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One of the underrated advantages of youth is the ability to sleep undisturbed through the night. In my early 20s, for example, I once slept through a minor early-morning earthquake in central Greece. Even into my late 30s and early 40s, my nocturnal obliviousness often insulated me from late-night infant squalls — much to My Lovely Wife’s dismay.

Nowadays, however, it’s the rare morning that I awaken without having navigated a trip or two to the bathroom during the night. And most U.S. seniors will tell you they can only dream of experiencing the blissful slumber they enjoyed in their younger years. By some estimates, about half of the Medicare set regularly struggles to sleep uninterruptedly for the recommended seven to nine hours a night.

We can lay the blame for our sleepless nights on any number of age-related sources: hormonal disruptions, the side effects of prescription drugs, chronic pain, sleep apnea, restless legs syndrome. And there’s plenty of evidence to suggest poor sleep patterns can increase the risk of developing high blood pressure, cardiovascular disease, and type 2 diabetes. Chronic insomnia, new research suggests, may even accelerate the aging process in the brain.

Diego Carvalho, MD, and his team of researchers earlier this month released the results of a study showing the cognitive effects of sleeplessness among 2,750 older participants in the Mayo Clinic Study of Aging. After reviewing sleep patterns and cognitive assessments over a five-year period, they concluded that the brains of insomnia sufferers aged at a more rapid rate — the equivalent of 3.5 years — than those who slept more soundly. Not surprisingly, they were also 40 percent more likely to develop dementia.

“We found an association between insomnia, cognitive decline, and increased risk for cognitive impairment,” Carvalho, a sleep-medicine specialist at the Mayo Clinic, writes in the journal Neurology. “Insomnia with reduced sleep was associated with worse cognitive performance and poorer brain health at baseline.”

The neurological effects of poor sleep patterns are fairly well established. Inadequate shuteye can impede communication between nerve cells, reduce the brain’s ability to remove the toxins that accumulate during your waking hours, and erode the pathways required for creating new memories.

Sleep apnea can produce particularly damaging effects, according to a recent study out of the University of California, Irvine. By repeatedly causing a person to awaken during the night to catch their breath, the condition can lead to lower oxygen levels, damaging blood flow in the brain. This is especially true during periods of REM sleep, Bryce Mander, PhD, and his team learned.

The damage, measured by the presence of white matter observed during brain scans, primarily appeared in parts of the brain associated with memory. Study participants whose blood-oxygen saturation levels dipped below 90 percent most frequently during their REM sleep cycles displayed less volume in the hippocampus and reduced thickness in the entorhinal cortex — both of which explain their subpar performance on memory tests, Mander concludes.

“Obstructive sleep apnea is a sleep disorder that increases with age, and low oxygen levels during sleep can harm the ability of our brain and body to function properly,” he explains. “Our study found that low oxygen levels from obstructive sleep apnea, especially during REM sleep, may be linked to cognitive decline due to damage to the small blood vessels in the brain and the downstream impact of this damage on parts of the brain associated with memory.”

As disturbing as these conclusions appear, however, neither study can claim to show that sleeplessness causes cognitive dysfunction; rather, they show only that there’s a connection. Mander’s study, it should be noted, involved a mere 37 participants; and, as Carvalho tells The Washington Post, much more research will be needed to determine a conclusive link. “It could also be that poor sleep early on can be an indicator of cognitive decline,” he admits. “It’s very hard to untangle.”

While we wait for more evidence to accumulate, it’s helpful to review the time-honored tips for a good night’s sleep: maintaining a regular bedtime ritual and schedule, avoiding midday naps and late-evening screens, skipping caffeine and alcohol before bed, and getting some exercise.

And as the scientific community continues to churn out these sorts of reports, I might also suggest that we remind ourselves that the vast majority of research tends to be preliminary. Let’s not lose any sleep over it.

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I’ve been completely flummoxed lately by my aging body’s inability to shed what I have come to believe is a side effect of a drug I no longer take. It’s become quite a mystery.

I had reached out to my doctor a few weeks ago to discuss a blood pressure med and the neuropathy — a tingling and numbness throughout the left side of my body — I’d been experiencing since I began taking it. She promptly advised me to stop using the drug, a popular ACE inhibitor with a reputation for neuropathic annoyances, and prescribed what we both agreed would be a safer alternative.

In the days that followed, the episodes seemed to ease somewhat; during one three-day stretch, I suffered no attacks and figured the new drug had kicked in and the old one had exited my system. It was a short-lived reprieve, however. Last week, I was hit once or twice each day, sometimes with as much intensity as before.

Just as I was beginning to consider whether my symptoms may be something more complicated than a pharmaceutical hiccup, I happened upon a study published last week in the journal mSystems. The study found that a number of popular medications change the microbial balance in the gut microbiome, contributing to a variety of physiological and psychological ailments. And these drug-induced imbalances can remain for years after we wean ourselves from the medications.

“Most microbiome studies only consider current medications, but our results show that past drug use can be just as important, as it is a surprisingly strong factor in explaining individual microbiome differences,” notes lead study author Oliver Aasmets, PhD, a researcher at the Estonian Genome Center.

Aasmets and his team analyzed stool samples and prescription records from more than 2,500 participants in a national biobank database and found that a majority of medications caused changes in the gut’s microbial mix that remained for as long as five years after participants stopped using the drugs. The types of meds whose effects were found to linger included antibiotics, psycholeptics, antidepressants, proton pump inhibitors, and beta-blockers.

“The long-term effect of drug exposure may have a major influence on our physiology, highlighting the need to understand the full extent of such effects across diverse drug classes,” Aasmets writes.

And yet there’s no specific mention of ACE inhibitors and their effect on our microbial mix in his report, nor of calcium channel blockers — the two drugs I’d been taking for the past couple of years to ease my hypertension. Indeed, digging into other research, I discovered that ACE inhibitors tend to contribute to a healthier gut microbiome. The same goes for the angiotensin receptor blocker (ARB) I’ve been taking since dropping the former drug. So maybe it’s not about some lingering drug-induced microbial mix-up after all.

Or is it? What about the statin I’ve been faithfully taking for the past two years?

A 2024 study found that statins — specifically the atorvastatin I’ve been using — may cause gut dysbiosis. Researchers found that participants using this medication hosted an overabundance of six specific bacteria when compared with untreated patients. The results, researchers note, could “influence the gut-brain axis.”

“The interplay of bacterial species and their abundances may have a greater impact on brain diseases than individual drugs or bacterial strains,” they concluded.

Perhaps that explains the results of a 2022 study in the International Journal of Molecular Sciences that found “patients on statin therapy may develop a peripheral neuropathy, complaining of numbness, tingling, pain, and tremor at hands or feet, as well as unsteadiness during walking.” While relatively rare, the authors add, “the incidence of polyneuropathy has been reported more frequently with atorvastatin than with fluvastatin.”

Hmmm.

If my recent experience amid the Medical-Pharmaceutical Complex has taught me anything, it’s the folly of accepting too readily particular scientific conclusions. There are no doubt a handful of studies challenging the above results. But there’s no future in passively accepting a puzzling medical condition, either. That’s what doctors are for, right?

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My Lovely Wife and I eat our breakfasts in shifts. I rise a good deal earlier than her (she’s a night owl) and typically finish my morning meal and clean up the dishes by the time she’s ready to consider her menu options. It’s been the daily drill around here for as long as I can remember and generally suits our individual temperaments: I’m a get-it-done-and-move-on kind of guy; MLW actually spends some time deliberating about what she’d like to eat and savors all the healthy fare that ends up on her plate.

I’ve never given much thought to the particular benefits or liabilities of our divergent morning meal schedules, but new research suggests seniors and their caregivers should be paying attention to evolving eating patterns in later life. They may signal the presence of various chronic illnesses.

A study published last week in the journal Communications Medicine concludes that meal timing among seniors tends to evolve gradually, as they grow older, toward later breakfasts and dinners. And those delayed morning meals are especially significant, lead study author Hassan Dashti, PhD, RD, argues. They are associated with physical and mental health conditions that result in a higher risk of mortality.

“Our research suggests that changes in when older adults eat, especially the timing of breakfast, could serve as an easy-to-monitor marker of their overall health status. Patients and clinicians can possibly use shifts in mealtime routines as an early warning sign to look into underlying physical and mental health issues,” says Dashti, a nutrition scientist and circadian biologist at Massachusetts General Hospital. “Also, encouraging older adults in having consistent meal schedules could become part of broader strategies to [promote] healthy aging and longevity.”

“Our research suggests that changes in when older adults eat, especially the timing of breakfast, could serve as an easy-to-monitor marker of their overall health status.”

Dashti and his team analyzed data from a University of Manchester longevity study, which included nearly 3,000 British adults with an average age of 64. The participants answered questionnaires detailing their mealtime patterns, lifestyle habits, and medical conditions at approximately five-year intervals over the course of 20 years and submitted blood samples as well.

After accounting for various demographic variables, the researchers concluded that participants whose breakfasts occurred later and later as they aged were more likely than early eaters to suffer from depression, fatigue, and oral health ailments — all of which could affect one’s appetite, sleep, and ability to prepare and enjoy a meal. These people were, perhaps unsurprisingly, also slightly more likely to die during a 10-year follow-up period.

But was it the delayed breakfasts that caused the ailments or the ailments that caused the delayed breakfasts? Anorexia of aging — loss of appetite and reduced caloric intake — is a fairly common syndrome among seniors, and Dashti acknowledges that it could contribute to delayed mealtimes. The study, however, didn’t specifically account for the prevalence of that condition among participants, making the results less conclusive. “Although the observational design cannot establish directionality,” he writes, “it is more likely that the onset of disease leads to shifts in meal timing rather than shifts in meal timing contributing to the onset of disease.”

That’s certainly plausible, but what’s left unclear is why those ailments would especially burden seniors who, on average, delayed their breakfast meals by less than 16 minutes and dinners by barely seven over the course of two decades. We’re talking here about a relatively modest change in habits. Perhaps that explains why the difference in 10-year survival rates — 86.7 percent for late eaters and 89.5 percent for early ones — is barely perceptible.

The numbers, however, are not really the point, Dashti argues. It’s more about observing changes in eating patterns as a way to identify developing health troubles.

“Up until now, we had a limited insight into how the timing of meals evolves later in life and how this shift relates to overall health and longevity,” he explains. “Our findings help fill that gap by showing that later meal timing, especially delayed breakfast, is tied to both health challenges and increased mortality risk in older adults. These results add new meaning to the saying that ‘breakfast is the most important meal of the day,’ especially for older individuals.”

Maybe even if you’re eating it in shifts.

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This may come as a surprise to anyone who has found themselves at the mercy of our fractured healthcare system in recent years: Providers have been vigorously encouraged to improve the quality of care they offer. The results of the various edicts and guidelines passed down from public and private public health authorities since the early 1990s have been decidedly mixed — especially among vulnerable older adults.

For those patients, it’s not about doing too little. It’s about doing too much.

Prodded by strict quality-care protocols, practitioners in skilled nursing facilities (SNF) routinely deliver inappropriate treatments and prescriptions to ailing seniors whose life expectancy, frailty, and cognitive impairment call instead for a less aggressive approach. And, as geriatricians Joseph Ouslander, MD, and Michael Wasserman, MD, write in the Journal of the American Geriatric Society, this is especially common among those diagnosed with chronic hypertension and all forms of diabetes.

By some estimates, the incidences of hypotension (low blood pressure) and hypoglycemia (low blood-sugar levels) that result from overtreatment range as high as 40 percent of these older patients. “This translates into tens of thousands of emergency department visits and hospitalizations annually and results in excess morbidity, mortality, and healthcare costs,” Ouslander and Wasserman argue.

Chief among the forces that encourage providers to pursue an overly rigid treatment regimen despite an older patient’s vulnerability is a set of quality-care metrics that 90 percent of U.S. health insurers monitor closely to ensure their own financial viability. The Healthcare Effectiveness Data and Information Set (HEDIS), created in 1991 by the National Committee for Quality Assurance (NCQA), has become the leading performance indicator in the U.S. healthcare industry. It’s key to health-plan accreditation, Medicare ratings, and regulatory compliance.

Report a subpar HEDIS rating, in other words, and your bottom line could suffer.

The ratings are so influential, Ouslander and Wasserman note, that clinicians are forced to “choose between using a treatment that is no longer appropriate for the patient and can cause unnecessary and morbid complications on the one hand and achieving a high score on the [quality measures] on the other.”

HEDIS does include some exceptions in its guidelines for treating vulnerable seniors, but they require specific diagnoses and additional administrative documentation. And because the exceptions don’t apply to many patients, some physicians will refuse to handle these cases. “Clinicians can sometimes work around this conundrum,” the authors note, “but [quality measures] that do not incentivize inappropriate treatment would be a better solution.”

Citing data from a 2014 U.S. Department of Health and Human Services report, Ouslander and Wasserman note that more than one in five Medicare beneficiaries treated at SNFs suffered at least one instance of hypoglycemia due to overtreatment during the month they were surveyed. About 40 percent of those episodes were related to medications prescribed according to accepted industry guidelines. Extrapolating those results based on the estimated 1.5 million patients treated at SNFs, they conclude that more than 10,000 older adults would have suffered iatrogenic hypoglycemia in any given month.

More recently, a 2020 study of nearly 7,000 patients at Veterans Administration (VA) SNFs reported that more than 40 percent of those diagnosed with advanced dementia and limited life expectancy may have been overtreated for diabetes. And even when it became clear that these patients were being overtreated, physicians moderated the dosage in fewer than half of the cases.

Hypertension is even more common than diabetes among older adults, and the authors cite a litany of studies demonstrating the harmful effects — kidney failure, falls, and fractures — of overtreating high blood pressure among vulnerable seniors. One 2024 JAMA report tracking antihypertension treatment of nearly 30,000 VA nursing home residents over the course of 13 years found that it increased the risk of “severe, morbid, and costly falls, and other adverse effects” by as much as 140 percent.

I wouldn’t consider myself a vulnerable senior, but my own experience after a hypertensive crisis echoes some of those concerns. After running numerous cardiological tests in the emergency room, a doctor informed me that I would be prescribed lisinopril, a popular ACE inhibitor, to lower my blood pressure. When I queried her about the well-known side effects of this group of drugs and suggested maybe trying an ARB instead, she shook her head: “That’s not what the guidelines recommend,” she told me.

The drug, when paired with a calcium channel blocker, certainly did the trick; my blood pressure reliably descended into healthier territory and generally lingered there. But not long after I began taking the meds, I began to experience frequent bouts of peripheral neuropathy — a tingling and numbness all along the left side of my body. And as those episodes began to increase in frequency and intensity, I was forced to consider a tradeoff: less-effective blood pressure management or relief from an increasingly worrisome side effect.

Last week, while awaiting a refill of my lisinopril prescription — and noticing a slight easing of the neuropathic episodes — I emailed my doctor to suggest we discuss my medication at our upcoming visit. Her prompt reply was slightly surprising: “Lisinopril is not my favorite blood pressure medication,” she noted, recommending three ARB drugs. I chose one and picked up the meds the next day. Early results seem promising. No noticeable side effects.

I suspect Ouslander and Wasserman would be pleased.

“To truly protect vulnerable older adults from preventable harm, we must rethink how we manage chronic conditions like diabetes and hypertension,” Ouslander says. “This means moving beyond one-size-fits-all targets to evidence-based, personalized treatment plans shaped by shared decision-making, supported by appropriate technology, and backed by policies prioritizing patient safety over rigid metrics.”

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My octogenarian pal Leo gave up his car keys a few years ago when Parkinson’s made driving a highly questionable endeavor. He’s been relying upon friends to ferry him around to his many and varied destinations ever since. During the early phase of his chauffeured life, I would drive across town to pick him up for our monthly lunches and deposit him back at his apartment after we’d eaten, enjoyed espressos at a nearby coffee shop, and stopped at the office to make some copies of news clippings (he’s an inveterate collector and distributor of printed matter). It seemed at the time to be more of a social excursion than a service.

More recently, however, those monthly forays have expanded to include a trip to the grocery store and maybe a stop at the pharmacy. And it’s not uncommon now to get a phone call from him out of the blue lamenting the emptiness of his pantry: “Just need a quick trip to the store, Boss.” One night, he desperately needed me to give him a ride home from a downtown restaurant after the car belonging to his evening chauffeur was towed from a no-parking zone. These trips are more service than social.

I’m not complaining, mind you; it feels good to help my old buddy. And there’s a fair amount of evidence suggesting that such charitable efforts may benefit the giver as well as the receiver. Recent research, in fact, argues that volunteering our services — at certain levels of commitment — confers particularly healthy rewards to seniors.

The results of two studies released earlier this month focus specifically on improvements in stress levels and cognitive functioning among older volunteers. Led by Sae Hwang Han, PhD, an assistant professor of human development and family sciences at the University of Texas at Austin, both research projects describe the physiological and psychological mechanisms by which helping others contributes to the health of the helper.

In the first study, focusing on the effects volunteering has on chronic stress and the systemic inflammation that triggers it, Han and his team analyzed data from the U.S. Health and Retirement Study (HRS) to track helping habits and levels of C-reactive protein (CRP), an inflammatory marker, among thousands of older volunteers over the course of several years. They found that seniors’ charitable services “buffered the adverse relationship between chronic stress and inflammation at higher CRP levels.”

Writing in the journal Psychoneuroendocrinology, Han explains how volunteering and other prosocial behaviors activate a network of neurobiological systems, including the hypothalamic-pituitary-adrenal axis, the sympathetic nervous system, and the immune system, to boost the health of the helper. The study’s findings, he notes, have “important implications for individuals at greater risk of inflammation-related health issues.”

That neurobiological network also plays a role in the relationship between volunteering — in moderation — and cognitive function. In a subsequent study, published in Social Science & Medicine, Han and his team mined HRS data again to determine whether formal and informal acts of helping may delay the development of dementia. What they found offers some valuable nuance to prospective older volunteers, whether their work is part of a formal association or simply a matter of helping a friend or family member.

“Results indicated that transitioning into volunteering and informal helping were both associated with a higher level of cognitive function and a slower cognitive decline, and [they] highlighted how sustained engagement in helping can yield cumulative cognitive benefits that progressively become greater over time,” Han explains.

But the nature of the transition and the amount of time an older volunteer commits can both affect cognitive function, he adds. Abrupt life transitions of any sort in later life have been shown to be detrimental to well-being; diving too suddenly into a formal volunteering role or an ongoing informal one can be similarly damaging. And the time spent in helper mode can also skew the rewards: The benefits tend to increase with the amount of time spent volunteering over the course of a week, but they may begin to dissipate after about four hours.

“Everyday acts of support — whether organized or personal — can have lasting cognitive impact,” Han concludes. “What stood out to me was that the cognitive benefits of helping others weren’t just short-term boosts but cumulative over time with sustained engagement, and these benefits were evident for both formal volunteering and informal helping. And in addition to that, moderate engagement of just two to four hours [per week] was consistently linked to robust benefits.”

I’m not sure that my monthly excursions with Leo — even when combined with the intermittent rescue missions — amount to enough consistent helpfulness to sustain what remains of my modest brainpower or to cool my aging body’s inflammatory impulses. There is, however, that weekly visit from our 8-year-old grandson, which I’d like to think offers a helpful respite to his busy parents.

Trouble is, Han and his colleagues may be right about moderating the duration of your volunteering. After trying to keep up with The Little Guy for five-and-a-half hours every Sunday, I often notice that my helpfulness doesn’t seem to be offering me much help at all.

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The notion that “lifelong learning” might be a salutary pursuit for older adults has been promoted for so many years that it’s almost descended into cliché. You know the advice: take a cooking class, learn how to crochet, fashion a few pieces of ungainly pottery to hide in the far reaches of some cupboard. It gets you out of the house, exercises your gray matter, and maybe brightens your day.

That’s the idea, anyway. Several years ago, My Lovely Wife and I spent a few humbling weeks trying to learn French in a community education class. The only benefit I could discern from that futile pursuit was that it effectively suppressed any interest in expanding my educational horizons in the future.

I may be an outlier, of course. Those who have championed this idea argue that it sharpens the cognitive tools we all need to function effectively in our later years. And there’s some evidence to suggest they aren’t necessarily overpromising: A 2014 study, for instance, found that seniors who took classes in quilting and digital photography enjoyed “a significant increase in episodic memory” when compared with a control group. I’ve mostly blocked episodic memories of those French classes — but maybe that’s just me.

Other research has suggested that such cognitive challenges may also lead to better mental health among seniors. And just last week, University of California, Riverside, psychologist Rachel Wu, PhD, and her team released the results of two studies showing the emotional effects of continuing education on older adults during a particularly stressful period — the COVID pandemic.

Researchers found that those who engaged in various adult-education pursuits prior to and during the pandemic reported better mental health — fewer episodes of loneliness and depression — than those who didn’t attend such classes. “People who were actively learning fared better in terms of mental health outcomes, especially older adults who might otherwise have been more vulnerable to isolation and stress,” notes lead study author Lilian Azer, PhD.

Those emotional benefits, however, took some time to accrue; in some cases, an entire year passed before participants were able to report improved well-being. That’s because cognitive challenges (like learning French) can generate more frustration than satisfaction. But, as Wu explains, the process can make the aging brain more resilient. “Learning can be difficult and uncomfortable in the short term,” she notes. “But that short-term discomfort actually helps protect us in the long run.”

And there’s the rub: Seniors generally recoil from uncomfortable situations. It’s the basis of what’s known as the socioemotional selectivity theory, which posits that the older we get the more likely we are to prefer emotional satisfaction over exploring new challenges. That makes perfect sense, Wu admits, but it can leave us more vulnerable than necessary when a crisis strikes.

“If we only do what feels good in the moment, we might be giving up the ability to adapt when life throws something big at us,” she says. “You don’t want to wait until you have to learn something in a crisis. Seek out challenges. Keep growing. That’s how you stay ready.”

MLW and I may have flunked French, but we’ve not completely abandoned learning opportunities. She’s a frequent attendee at local art classes and recently revisited a long-delayed knitting project. You’ll not find me sitting in a classroom somewhere or laboring over a ball of yarn, but I might argue that I encounter enough cognitive challenges in my editorial work to maintain my generally sunny disposition and keep my aging neurotransmitters in decent repair.

Who knows? Someday I may even brush up on my high school Spanish.

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When Surgeon General Vivek Murthy, MD, in 2021 issued a stark warning about a mental health crisis among U.S. teens and young adults, public health organizations rallied to the cause. Within a couple of years, government agencies were able to report a significant decline in the suicide rates of young people. It may be time for a similar effort targeting an even more suicide-prone demographic: seniors.

Men over the age of 75 are more likely than any other age group to die by suicide, according to the Centers for Disease Control and Prevention. About 94 out of every 100,000 deaths in this age group are self-inflicted. And the rates of suicide among Americans 55 and older have risen significantly over the past two decades. The rate for men between the ages of 55 and 64 rose by 25 percent to 26.6 per 100,000 deaths; suicides by women 65 to 74 years old increased by 44 percent — though they remain relatively rare at 5.6 per 100,000 deaths.

Social behavior experts explain this gender variance in several ways. For example, although aging delivers disease and disability to both men and women, men tend to adapt to it less gracefully, Yeates Conwell, MD, a psychiatry professor at the University of Rochester Medical Center, tells STAT News: “Because the male identity is so wrapped up in the ability to care for oneself, that transition to being a care receiver and needing more help from other people can be difficult.”

Women also tend to cultivate social connections more readily than men, and those relationships can help ease the loneliness that often triggers suicidal thoughts, explains Igor Galynker, MD,  director of Mount Sinai’s Suicide Research and Prevention Laboratory. “Men spend their life achieving and neglect social connections,” he says. “Women retire a lot better; it’s less traumatic for them. Men are so invested in their work [that] they lose both social connections from work and the meaning of life.”

And when loneliness and depression set in, guys tend to act on suicidal thoughts more quickly — and effectively — than women. Though the number of suicide attempts differ little between older men and women, men are far more likely to use a gun, which typically guarantees a fatal result. “It doesn’t offer many opportunities to change one’s mind,” says Rosie Bauder, PhD, MPH, an assistant professor of psychiatry and behavioral health at the Ohio State University College of Medicine.

Unlike the ongoing campaign to reduce teen suicides, however, there’s been little interest in developing public health strategies to address the same issue among older Americans. Gun-control measures, such as extreme risk protection order laws, which allow police to confiscate firearms from people at high risk of suicide, could save some lives. And some experts advocate for therapeutic interventions to help men adapt more easily to the mental rigors of aging. But, as researchers at Mass General Brigham Hospital note in a recent study published in the American Journal of Geriatric Psychiatry, there’s been little progress on making these and other options more visible.

“As clinicians and researchers in geriatric psychiatry, we frequently work with older adults who express suicidal thoughts,” notes lead study author Ipsit Vahia, MD. “Our team was interested in understanding how an older adult in the community may seek resources around suicide prevention and what they are likely to find. What we uncovered was an imbalance in who online suicide prevention efforts are targeted towards and a great unmet need for older adults.”

Vahia and his team conducted online searches to identify the most visible organizations focused on suicide prevention. Among the seven groups they reviewed, five seemed to recognize older adults as a high-risk population, but none of them posted any information on public health campaigns focused on seniors. And only two of the organizations provided any resources for this cohort.

“Public-facing suicide-prevention campaigns have a record of effectiveness, and the need for such campaigns targeting older adults is greater than ever,” Vahia says. “Our hope is that shedding a light on this imbalance may lead to major suicide-prevention organizations considering ways to make their resources more easily accessible to older adults.”

In his warning about teen mental health in 2021, Vivek Murthy was referring to the COVID pandemic when he wrote, “It would be a tragedy if we beat back one public health crisis only to allow another to grow in its place.” The rise of elderly suicides suggests a tragedy he may not have imagined has emerged, fully grown.

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Despite mastering the tonal nuances of the flutophone as a sixth grader, I’ve never mustered any enthusiasm for learning to play a musical instrument in the years that followed. It’s not that I lacked the opportunity. There was that harmonica that fell into my possession sometime in my 20s and the upright, untuned piano my brother foisted upon me and my young family in my 40s, but my tepid attempts to produce a melody from either of these instruments proved futile.

This set me apart from the other members of my family. For years, My Lovely Wife played the cello, my daughter could coax a tune from a clarinet or violin, and my son could elicit a pleasant riff from his guitar. None of their musical initiative or talent rubbed off on me, a fact that hadn’t raised the slightest concern until I stumbled upon recent research that now has me wondering whether my cognitive faculties may suffer as a result.

A study published last week in PLOS Biology suggests that older adults who continue to play music into their later years reap particular cognitive rewards that elude their nonmusical counterparts. All that music making apparently reinforces their brains against the neurological erosion that typically accompanies old age.

Yi Du, PhD, a psychology professor at the Chinese Academy of Sciences, and her research team recruited 74 volunteers and divided them into groups of older musicians, older nonmusicians, and younger nonmusicians. To determine cognitive performance, the team used MRI monitoring to measure the response of the auditory dorsal stream in the brains of participants while they identified syllables that were masked by noise. The results were noteworthy: The older musicians displayed a level of focused neural connectivity similar to the younger participants, while older nonmusicians showed all the typical age-related connectivity issues.

“Just like a well-tuned instrument doesn’t need to be played louder to be heard, the brains of older musicians stay finely tuned thanks to years of training,” Du explains. “Our study shows that this musical experience builds cognitive reserve, helping their brains avoid the usual age-related overexertion when trying to understand speech in noisy places.”

Still, she acknowledges that the study’s results suggest only an association between long-term musical proclivity and a younger, healthier brain. They don’t necessarily prove a cause-and-effect relationship.

Du’s research builds on a study published in 2023 out of the University of Geneva, which suggests that it’s never too late to take up an instrument — or simply listen to music on a regular basis — in an effort to maintain some cognitive coherence as we grow old.

For that research, Clara James, PhD, and her colleagues assembled 132 healthy older adults between the ages of 62 and 78 who were not musically inclined. Half of the volunteers were enrolled in piano lessons, while the other half attended classes devoted to active music listening and analysis. Six months later, researchers found that all participants displayed increased volumes of gray matter in four areas of the brain associated with working memory and high-level cognitive functioning.

There was a significant caveat, however: There was no improvement in the part of the brain devoted to sound processing. The practicing pianists exhibited a stable amount of gray matter in that region, while the active-listening group showed some shrinkage. “In addition,” notes lead study author Damien Marie, PhD, “a global brain pattern of atrophy was present in all participants. Therefore, we cannot conclude that musical interventions rejuvenate the brain. They only prevent aging in specific regions.”

That’s no small thing, of course; the aging brain needs all the help it can get. But those studies aren’t going to persuade me to reacquaint myself with the flutophone. It would really annoy MLW, for one thing. Plus, there’s always some flotsam floating around in the current of scientific knowledge that will allow me to rationalize almost any behavior.

In this case, I’ll cozy up with the results of a 2020 study of older Taiwanese adults that found “those with higher reading frequencies were less likely to have cognitive decline.” I’ve enjoyed an after-dinner reading ritual for nearly 20 years. And sometimes I even listen to music while I turn the pages.

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A recent national survey reports that the percentage of older Americans who say they regularly feel lonely has decreased to pre-COVID levels, findings that may seem worthy of some celebration until you realize that about one in three of this cohort still struggle with loneliness.

“At the surface, this might seem like great news, that we’re back to where we were before COVID-19 struck. But that baseline was not good, and it was especially bad for some groups of older adults, who continue to have very high rates of loneliness and social isolation,” says lead study author Preeti Malani, MD, MSJ, a professor of internal medicine at the University of Michigan Medical School. “One of the biggest differences now is that we have greater recognition of the impact of loneliness and isolation on health especially as we age.”

Malani’s team reviewed data University of Michigan pollsters had collected annually from 2018 to 2024 from six separate sets of respondents ranging in age from 50 to 80. The results, published in JAMA, revealed that the percentage of those who said they often felt lonely rose from 34 percent in the first year of the survey to as high as 42 percent during the height of the pandemic, before settling back to 33 percent last year.

Among the loneliest were those who said their mental health (75 percent) or physical health (53 percent) was fair or poor, as well as respondents who were either unemployed or receiving disability payments (52 percent). Perhaps surprisingly, younger respondents (ages 50 to 64) were more likely than seniors to report loneliness.

“These trends make it clear: Clinicians should see loneliness and isolation as a key factor in their patients’ lives, especially those with serious physical or mental health conditions,” notes Jeffrey Kullgren, MD, MPH, an associate professor of internal medicine at the University of Michigan who directed the poll. “We should consider screening our patients for these issues and connecting them with resources in their communities, whether that’s a senior center, veterans’ groups, volunteering opportunities, or services offered by an area agency on aging or other community organizations.”

Big Tech has a better idea, though: Just hook up these lonesome souls with an AI-powered buddy.

As Samantha Rose Hill, PhD, observes in The New York Times, these companies are simply responding to a promising marketing opportunity. Well-intentioned concerns about a loneliness epidemic effectively transform a personal emotion into a clinical pathology while encouraging the growth of what she describes as a “loneliness economy.”

“The prescription given for loneliness is connection,” notes Hill, an associate professor at the Brooklyn Institute for Social Research, “and Big Tech has found a way to seize the vulnerability of lonely people eager to escape their predicament.”

Indeed, the market for AI-powered “companions” is expected to grow from $10.8 billion in 2024 to $290.8 billion by 2034. Among the more popular of these is ElliQ, a product of Intuition Robotics designed to provide social engagement throughout the day — initiating conversations, suggesting healthy activities, offering interactive games — while also reminding its lonesome buddy when it’s time to take their meds.

For those yearning more for cuddles than conversation there’s Lovot, a 17-inch-tall robot engineered to provide the companionship of a pet without the associated responsibilities. You can hug it, play with it, and talk to it — though it won’t talk back — while it adjusts in real time to your routines and behaviors. Plus, if you find yourself growing perturbed by its constant, nagging presence, you can simply switch it off. Try that with a pesky puppy.

Onscreen, Inc., the purveyor of multiple versions of an online AI persona named “Joy,” touts its product as “a reliable senior AI companion designed to engage with older adults on a wide array of topics.” Just submit your specific interests into the program, click on the mobile app, and enjoy a lively conversation while sitting in front of your TV.

“We’re not here to pretend AI is human,” Intuition Robotics CEO Dor Skuler tells Forbes. “We’re here to help people feel less alone.”

The service is a boon for caregivers, the company claims on its website: “By providing information about [a senior’s] interests, dislikes, and even extended family, conversations with Joy become increasingly meaningful and engaging. Additionally, as Joy and your loved one continue to interact, Joy’s memory will grow, enabling her to have more meaningful exchanges. Our vision is to have Joy age alongside your loved one, being there for them as needed.”

Even the most enthusiastic AI boosters recognize widespread concerns over data privacy and the psychosocial dangers of a growing dependence on digital companionship. But the loneliness epidemic offers them an emotion-laden market.

“We’re not here to pretend AI is human,” Intuition Robotics CEO Dor Skuler tells Forbes. “We’re here to help people feel less alone.”

But faux humanity is not really the issue, Hill argues. “The danger is not that AI will replace human connection,” she writes. “The danger is that it will make us forget what actual connection requires while eroding our ability to think for ourselves by training us to depend on AI for the simplest of tasks and interactions.”

Real-world relationships — unlike AI-generated interactions — challenge our vulnerability and deliver routine disappointments, she explains. This requires negotiation, patience, empathy, and a variety of communication skills you’ll never need to successfully navigate a digital companionship. That’s because that type of relationship is completely one-sided — what Hill calls a “loneliness loop.”

“AI companions don’t make loneliness go away; they just create a distraction, allowing the users to fixate on a reflected image of themselves,” she argues. “Eventually, that creates isolation from others. It’s a godlike seduction: to remake relationships in one’s own image. No risk, no mess, no friction. But also, no reality.”

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