4.1 HOW LONG WILL WE LIVE?

Discovering Development: Take the Longevity Test • Average and Maximum Longevity • Genetic and Environmental Factors in Average Longevity • Ethnic Differences in Average Longevity • Gender Differences in Average Longevity • International Differences in Average Longevity

4.2 HEALTH AND ILLNESS

Defining Health and Illness • Quality of Life • Changes in the Immune System Chronic and Acute Diseases • The Role of Stress • How Do We Know? Negative Life Events and Mastery

4.3 COMMON CHRONIC CONDITIONS AND THEIR MANAGEMENT

General Issues in Chronic Conditions • Common Chronic Conditions • Current Controversies: The Prostate Cancer Dilemma • Managing Pain

4.4 PHARMACOLOGY AND MEDICATION ADHERENCE

Patterns of Medication Use • Developmental Changes in How Medications Work Medication Side Effects and Interactions Adherence to Medication Regimens

4.5 FUNCTIONAL HEALTH AND DISABILITY

A Model of Disability in Late Life • Determining Functional Health Status • What Causes Functional Limitations and Disability in Older Adults?

SOCIAL POLICY IMPLICATIONS

Summary • Review Questions • Integrating Concepts in Development • Key Terms • Resources

"WHEN YOU GET REAL OLD, HONEY," SAID ELIZABETH (BESSIE) DELANY, "YOU LAY IT ALL ON

the table. There’s an old saying: Only little children and old folks tell the truth." And tell the truth she did. Along with her sister Sarah (Sadie), Bessie Delany told the story of more than 100 years of living through segregation, discrimination, the civil rights movement, and the women’s movement. Imagine the stories they could tell: They were born more than a decade before the first airplane flew, and they lived to see men walk on the moon.

Each of them rose to professional prominence, Bessie as the second African American woman to be licensed as a dentist in New York, Sadie as the first African American to teach domestic science on the high school level in New York City public schools. They never married. Their story became two best-selling books and a highly successful Broadway play.

Sadie and Bessie Delany were blessed with very long, full lives. Sadie died in 1999 at age 109, and Bessie died in 1995 at age 104. They certainly had excellent genes, but there’s more to living a long and healthy life than that. We’ll discover in this chapter that longevity depends on a complex set of variables. Sadie and Bessie’s good health meant that they enjoyed good quality of life and avoided chronic disease. Compared with most older adults, they had little experience with medications, a potential source of problems for many older people. That Sadie and Bessie were independent and lived that way puts them in the majority of older adults who are not disabled.

Will you live to be 100 years old? If you are lucky enough to experience the right confluence of genetics, psychological characteristics, and socioeconomic factors and avoid key events at particular points in your life, you just might. Whether your life will be a big hit remains to be seen.