Leonard Cohen and smoking in old age

Leonard Cohen’s decision to take up cigarettes again at 80 reveals a well kept secret about older age: you can finally live it up and stop worrying about the consequences shortening your life by much. Risk taking is not such a risk anymore, given the odds. Of course some take that more literally than others. I don’t plan to do a parachute jump when I turn 90, as President Bush #1 did. However, a new breath of freedom (and less worry) is an unexpected and pleasant benefit of older age that isn’t well known.

Research findings confirm this is true. In recent studies of many adults from many countries, people were asked to rate their level of well being on a scale of 1-10. Researchers found a fascinating relationship between age and well-being. 20 year olds start out pretty high, after which well-being consistently goes down with age, bottoming out around the early 50’s. What happens next came as a surprise to many: after this trough, well-being actually goes up with age, with 85-year-olds reporting slightly higher well-being than the 20-year-olds. These are known as the U-bend studies, because well-being through adult life takes the shape of a “U.”

One question we can ask is: how can elders feel better when they are much closer to death than younger people? My personal and clinical experiences suggest that we accept the reality of death, which helps us enjoy each day and its positives more, because we appreciate their preciousness. Pleasure in listening to music, seeing a beautiful sunrise or hearing early morning bird calls elicits more enjoyment than when we were younger.

We live in the “now”. One woman expressed it well in our support group for aging and illness: “My papers are in order, my will and all that. Only, I just got four chairs recovered in my apartment. I want to stick around at least to see how they look with the new covers.” Concerns about career are gone; elderly parents are gone and adult children are on their own (hopefully). Elders begin to see life from a broader perspective than their own personal being—we are concerned about the future of the planet and the fate of our children’s children’s children whom we may never see.

At 86, I heartily endorse Cohen’s decision to forego all the illness prevention and screening that made sense in his 50s but not in his 80s when it is not likely to prolong life. For me, that means enjoying the pleasures of food and drink as I choose. My modern vegetarian-ish children chide me for the red meat on the table and insist I should be serving kale smoothies and brown rice for dinner and drinking bottled water with lemon instead of alcohol. My husband of 89 and I enjoy beef and wine for dinner, and we have no plans to change that. As to more wholesome drinks, as a Texan, I have drunk Dr. Peppers since the age of 10. I could easily be a poster girl for its benefits, but I am warned about the dangers I run every day of their poisoning my brain by the artificial “everything” in them.

As to fall prevention, which is a big concern of our children, I understand their wishes to prevent a broken hip, but I love most of my rugs and they are part of the pleasure in my home. I will compromise just so far in taking them up. I will be prudent but not coerced into a life style my children feel is more appropriate for us. My colleague, Dr. Mindy Greenstein, is a psychologist who works with me in a geriatric research group, and with whom I compare notes on aging from our middle and old old age perspectives. I complain that my children act too “parental” at times and I remind her that at 91, if her father eats another latke beyond what his wife deems appropriate, is that really a make or break issue in his survival? Children want to help us oldsters to outsmart the Grim Reaper, and that is very tender. But eventually he wins. So why sweat the odds? We are lucky—and happy—to be here in our upper 80s.

The bottom line is that Cohen has it right about the freedom to do things we want over 80, but wrong about paying too much attention to calculating the prevention risk ratio. The best story to put this into perspective is the old man who went to his doctor and asked. “Doc, if I give up alcohol, cigarettes and women will I live longer?” The doctor replied, “No, but it will seem longer.”