OLD AGE.

"Old age" is the most diverse of all age categories, including people in their fifties through those past a hundred. It embraces some of the richest and the very poorest in all societies, the highly active and the severely decrepit. In the twentieth century this diversity expanded more than ever before. Survival to old age was more common in earlier centuries than is sometimes thought, but it was only during the twentieth century that most Europeans lived to old age and more people lived to be very old. In Britain at the beginning of the twentieth century an average of seventy-four people per year reached the age of one hundred; by the end of the century three thousand did so. Expectation of life at birth in 1901 was fifty-one years for men and fifty-eight for women; in 1991 it was seventy-six and eighty-one, respectively. In general, women outlived men. The pattern was similar elsewhere in Europe, though in Russia and some other former communist countries male life expectancy fell at the end of the century.

Longer life and fitness were due to unprecedented improvements in living standards, especially in income, diet, and hygiene, together with leaps in medical knowledge and techniques. Curiously, this achievement was widely received with concern about the "burden" of costs that growing numbers of older people would impose upon shrinking younger populations. This was partly because the rise in life expectancy in the first forty years of the century coincided with a general fall in the birth-rate. Fears that populations were aging and declining led, particularly in Nazi Germany and fascist Italy, to attempts to bribe women to have more children and penalize the childless with bonuses and medals for mothers of numerous children and tax penalties for celibacy. Elsewhere, particularly in Britain and France, the response was panicky predictions of the decline of the western powers as they aged, while Asian and African countries retained high birthrates and youthful populations.

These fears retreated after World War II, when birthrates rose. They returned at the end of the century, however, as births again fell. In the 1980s doom-laden predictions of the adverse social and economic effects of the aging of populations were issued by such institutions as the World Bank.

Aging occurred at a different pace and with different effects in different countries. France experienced a low birthrate much earlier than other countries. As early as 1836, 9 percent of the French population was sixty or older; by 1976, this had reached 18 percent. Sweden's over-sixty population did not reach 9 percent until 1876, but its age structure changed faster and it reached 18 percent in 1962.

Some people ended their longer lives in physical and/or mental decline, though only a minority experienced long periods of dependency. The incidence of conditions such as Alzheimer's rose, partly because more people survived the diseases that had ravaged younger people in previous centuries, such as tuberculosis, to die of sicknesses of old age.

DEFINITIONS OF OLD AGE

A new language emerged for the stages of aging. A term coined in France, and widely used elsewhere in the later twentieth century, described the period of active old age as the "third age"; it followed the "first age" of childhood and youth and the "second age" of adult maturity. The later, less active and independent phase of life was the "fourth age."

Most older people throughout the century inhabited the third age. But the definition of the age boundaries and characteristics of old age changed. Subjective and everyday definitions of who was "old" and when old age began had long been variable and depended more on appearance and physical capacities than chronological age. Such subjective definitions increasingly collided with more-rigid bureaucratic boundaries, which were driven mainly by the introduction and spread of pensions. By the 1960s a pension was the normal expectation of older people throughout Europe. Pensions were most commonly payable starting at age sixty or sixty-five, sometimes fifty-five or seventy. The first state pensions were introduced in Germany in 1889 for workers, mainly male, at age seventy, or younger if they were permanently incapacitated. Denmark followed in 1892 with pensions targeted at the poorest people, mainly female, at age sixty. In 1908 they were introduced in Britain starting at age seventy; this age was lowered to sixty-five in 1925 and, for women only, to sixty in 1940. Increasingly, in noncommunist countries, the pensionage became the normal age of retirement from paid work, and the prevailing pension age became, in popular as well as official discourse, the boundary between middle and old age. Yet no sooner were such usages established than they were rejected, by some, as defining older people negatively, as dependent on the state or on the young, for what they were not—no longer productive workers or citizens—rather than for their positive qualities. As a result of the search for more positive language, "seniorcitizen"became common usage in the United States and elsewhere, and "the elderly" gained acceptance in Britain, until the 1980s, when this also came to be seen as pejorative and was replaced by the ambiguous "older people." There were similar linguistic changes elsewhere in Europe.

Such changes were driven by perceptions of the dissonance between language that described people above a certain age as helpless and dependent and the visible reality that increasing numbers of them were not. Change was encouraged by articulate older people themselves as well as by professionals in the internationally growing field of gerontology, a creation of the mid-twentieth century, who were devoted to studying aging and old age and advocacy for older people when required.

WORK, RETIREMENT, AND PENSIONS

Retirement itself was new on a mass scale. At the beginning of the century those who could afford it chose when to retire. State officials and high-status employees in the private sector generally had secure pensions and a fixed retirement age, commonly sixty, sometimes fifty-five. Poor people worked for as long as they were able, sometimes to very late ages, generally at increasingly degraded tasks with diminishing incomes. In largely rural Finland, as in most other countries, old women worked as laundresses, cleaners, hawkers, laborers, or hod carriers on building sites. Old men took casual jobs as laborers on building sites or in road construction, work that disappeared during the long Finnish winter and that was seasonal everywhere. With unemployment normally came destitution.

If the poor old had surviving families (many did not given the high death rates of the early twentieth century), they were likely to also be too poor to give more than minimal support. Public welfare was minimal, and was generally stigmatizing. Better paid, mainly male, skilled workers often belonged to pension savings schemes. The first state pensions were designed to diminish this degradation and to raise the status of people whose poverty was not their own fault. But pensions were rarely enough to enable old people to give up work, nor were they intended to be. They did (as was intended) assist children in supporting aging parents, or supplement personal saving.

In capitalist countries in the 1920s and 1930s, occupational and private pensions and retirement at around age sixty to sixty-five spread through the lower levels of "white-collar," mainly male, workers. Poorer manual workers also increasingly left permanent paid work at earlier ages than before because high unemployment left them unable to find other jobs once unemployed.

The Soviet Union, by contrast, was committed ideologically to the valorization of work and workers and to exhibiting the long-lived vitality that was possible in a workers' democracy. The country also needed maximum employment if it was to expand its economy, and it could not easily afford to pay large numbers of pensions. Hence it had a strong incentive to keep people at work until as late in life as possible. In 1935 Joseph Stalin proclaimed the importance of exploiting to the full the experience of older workers. In the Soviet Union, "pensioner" was a respectable identity, implying age and seniority rather than dependency. The social security system was designed to encourage people to work as long as possible; turning them into welfare dependents, it was said, would rob them of full participation in Soviet society. Instead, as they became unfit for their accustomed jobs, they were transferred to lighter employment. A skilled electrician might become a watchman, a carpenter, or a toilet attendant—as he might in the west, without the accompanying ideological rhetoric. A difference from the west, though, was that old people were officially represented as privileged citizens. Their lives were often very poor, though this was also true of younger Soviet workers. After World War II pensions improved somewhat for Soviet citizens who were too old to work, especially for professionals and those who were deemed to have given distinguished service to the USSR, but pressure on older people to keep working remained strong.

Soviet political leaders practiced what they preached, if in greater comfort. Stalin himself died in office in 1953 at the age of seventy-four, as did Leonid Brezhnev in 1982 at age seventy-six. Elsewhere, Winston Churchill had reached the state pension age of sixty-five in 1939 when World War II began, and he sustained a punishing workload as war leader for the next six years. He became prime minister again in 1951 at age seventy-seven, though by then he was in poor health; he retired, reluctantly, four years later. Charles de Gaulle became president of France in 1958 at age sixty-eight and remained in office for eleven years. Old men dominated the politics of many states in the mid-twentieth century, sometimes, especially the dictators, outstaying their capacities for the role, as did Francisco Franco, who in 1975 reluctantly gave up control of Spain when he was close to death at age eighty-three.

It was only after World War II, especially from the 1950s on, that improved pensions were introduced in all European countries (more quickly in some than others) and that retirement at age sixty or sixty-five became a normal phase of life for most people. However, simultaneously, many governments, including those of Britain and France, reversed their previous attitudes and argued that earlier retirement should be discouraged. It was believed that the shrinking numbers of younger workers, due to the low prewar birthrates, necessitated older people staying in the workforce to sustain the buoyant postwar international economy.

Nevertheless, retirement at sixty or sixty-five gradually became almost universal. Workers wanted a period of rest after long working lives, understandable because manual workers who were in their sixties in the 1950s might have been working since the age of twelve or thirteen. Nowhere did their pensions make retired workers rich, but they did enable them to survive without working, and, as living standards improved, more were helped by their children. But the sudden experience of limitless leisure late in life was not always easy. Many of this first generation of early retired manual workers expressed bewilderment, even depression, in the face of their newfound, unaccustomed leisure. Also, employers were not persuaded of the value of older workers except in traditional marginal jobs, and, increasingly, modern technology provided efficient alternatives to aging cleaners or frail watchmen. There was a shortage of younger workers due to low prewar birth rates and the increasing number of young people staying longer in education after the war. In expanding European economies employers compensated for the shortage of younger workers by employing women and immigrants rather than older people.

Through the second half of the twentieth century Europeans lived longer and were fit to later ages, but instead of working longer, they retired earlier than ever before. This process speeded up in the 1980s. By the 1990s almost one-third of Western European workers had retired permanently by the age of sixty. Some left willingly, on comfortable pensions, to enjoy relaxation, travel, and consumption. A new generation of WOOPIES (well-off older persons) was identified by advertisers, but they were a minority. Others gave up work more reluctantly.

It was sometimes argued that early retirement was the unavoidable consequence of changing technology: skills and knowledge became obsolescent ever faster, and older people could not keep pace. But the evidence pointed in the opposite direction. Older workers suffered from the belief of employers and others that they had declining abilities and low adaptability, but, whenever it was put to the test, older people, even those in their seventies or older, proved highly adaptable and capable of learning new skills. In fact, they were well adapted to the hightech labor market of the late twentieth century, which required brain power rather than physical power. However, they were rejected from a shrinking labor market because they were more costly than younger people. But by the end of the century it was recognized that when they left the workplace, their experience and often greater reliability, compared with younger workers, departed as well. Also, enterprises and governments became concerned about the growing costs of pensions and the falling numbers of younger workers capable of paying the contributions required to fund the pensions of older people; accordingly, in the 1990s they sought to cut pensions. Both state and employer pensions were substantially cut in Britain and Denmark, though in France, Germany, and other Western European countries workers defended their pensions more successfully.

This alarm was due to the rising proportions of people sixty and older. In 1960, the percentages of these older people in the total population were 16 percent in France, 17.3 in Germany, 13.6 in Italy, 18 in Sweden, and 16.9 in the United Kingdom. By 1990, they were 19.1, 20.4, 20.2, 22.8, and 20.7, and they were projected to rise by 2020 to 26.1, 18.2, 30.3, 26.5, and 24, respectively, with corresponding reductions in the numbers of people aged fifteen to sixty, who were of actual or potential working age.

Workers, governments, and employers now had incentives to reverse the trend of the previous half-century by delaying retirement and extending the normal working life.

MEDICINE AND OLD AGE

Longer, active lives were partly due to changing medical knowledge. Only in the twentieth century did medicine achieve the capacity to diagnose and cure extensively, and only in the midcentury did medical services become easily and cheaply available to people of all ages in most countries. Many of these advances benefited younger people, enabling them to survive to later ages, but diagnosis and treatment of conditions common among older people, such as heart disease, hypertension, and cancers, improved, and they also gained from such new procedures as implantation of cardiac pacemakers and joint and organ replacements. Hormone replacement therapy was hailed as bringing the longed-for rejuvenation to post-menopausal women, though by the end of the century there were reports of adverse side effects. Modern technology could also be used to keep older people alive but with a poor quality of life, posing new ethical dilemmas for medicine.

In the beginning of the century a specialized medicine of old age, known as geriatrics, developed internationally. The term was coined in the United States in 1909 by an Austrian-born medical practitioner, Ignatz Nascher (1863–1944). Nascher believed that doctors paid insufficient attention to the ill health of older people: because they did not have long to live, it was not thought worthwhile to cure them. The persistence of this belief slowed acceptance of his work and ensured that geriatrics remained marginalized internationally. Nascher believed that the health of older people could be improved by better diet, exercise, and mental stimulation and demonstrated its efficacy through experiments with older people in New York.

The desire to prolong active life, even to reveal the secret of rejuvenation, received stronger support in the Soviet Union, driven by the conviction that Bolshevism could revolutionize even the life span. Soviet gerontologists argued that human kind had the capacity to live much longer than the current norm, to age 120 and beyond, and that Soviet society could demonstrate its superiority by bringing this about. Statistics that demonstrated that the average Soviet life expectancy had improved since the Revolution of 1917 were invoked, though similar or greater gains were evident in non-communist countries. Experiments with hormones and glandular grafts from monkeys as a means to restore youthful vigor were encouraged. The Soviet press publicized feats of longevity that allegedly demonstrated that Soviet citizens were achieving exceptional life spans. A succession of Soviet medical researchers in the 1930s, 1950s, 1960s, and 1970s sought the secret of the apparently long life spans of Caucasian peasants, without success.

Geriatrics aroused more attention in non-communist countries as the numbers of older people, and the costs of their medical care, increased. By the 1930s large numbers of stroke patients were filling hospital beds because improvements in drug treatments kept them alive but did not restore their mobility. The increased use of physiotherapy and other forms of rehabilitation, pioneered in Britain, freed patients from hospitals in growing numbers. With the introduction in Britain in 1948 of a National Health Service that provided free health care for all citizens, and the establishment of similar systems throughout Europe, such practices became more widespread. Greater access to health care for poorer aging people revealed that attention to quite mundane but disabling conditions affecting their hearing, eyesight, teeth, and feet could greatly improve their lives. Conditions that had long been regarded as natural features of aging, to be endured, could be cured.

The outcome by the end of the century was the simultaneous survival of the largest numbers of fit people in their sixties and seventies ever known, and the largest numbers of chronically ill older people ever known. Many who recovered from acute conditions that would have killed them in earlier times succumbed to chronic disorders such as arthritis, diabetes, or Alzheimer's. But the majority of people surviving to their eighties and nineties at the end of the century did not suffer from acute illness and regarded themselves as in good health and capable of independent activity. For most people, even at very late ages, death was not preceded by a long period of serious dependency, though all of these experiences varied by age, class, and gender.

LIFESTYLES

More old people lived alone in the later twentieth century. This was often interpreted as meaning increasing loneliness, especially when linked to the falling birthrate, increased divorce, and increased geographical mobility. Some people were old, alone, and lonely. Many older people, however, preferred independence to dependence on their children. They were in frequent contact with family and friends even when they lived alone. Family size fell over the course of the century, but more older people than ever before had at least one surviving child following the decline in the high infant mortality rates that had been the norm throughout history. Children did not necessarily live close at hand, but improved communications enabled families to keep in ready contact by telephone or, later, e-mail, and to get together by fast means of transport. Separation was not initiated only by younger people. Increasingly, affluent older people in northern Europe moved to enjoy retirement in Spain or southern France, often returning close to their families as they entered the "fourth age."

Older, like younger, people changed their appearances. How they were represented and represented themselves changed as their styles of life became more varied. Older people in the later twentieth century tended to look younger than people of similar age in earlier times, not least because they were healthier and had their natural teeth rather than false teeth or none. Medical specialists suggested that seventy-five-year-olds in 2000 were physiologically similar to sixty- or sixty-five-year-olds in 1900.

The age-specific dress codes of earlier centuries disappeared, more gradually both in the countryside than in the towns and in poorer than in richer regions. It became easier for men and women to disguise the signs of aging, as cosmetics and hair dyes improved in range and quality and became cheaper and more readily available starting in the 1930s. Cosmetic surgery became more effective and cheaper and was increasingly used by the end of the century.

Some argued that a "cult of youth" forced older people to disguise their ages, denying them the possibility to "grow old gracefully" and "naturally." Others responded that there was nothing "graceful" about the "natural" aging of all too many old people in the past, and no obvious reason why at a certain age they should become less free to alter their appearance or be bound by more-rigid style conventions than the young. At the end of the century more older people had more freedoms than ever before and age boundaries were being destabilized.

See alsoChildhood and Adolescence; Demography; Public Health; Social Insurance; Welfare State.

BIBLIOGRAPHY

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Pat Thane