Most of the people Dr. Claudia Kawas refers to as "trailblazers" enter her Laguna Woods medical clinic haltingly, often with walkers or canes, or clutching the hand of someone with a steadier gait. Some don't come into the clinic at all; they're at home, bedridden.
But the trailblazer description is fitting. It refers to a group of Americans who have far exceeded average life expectancy and are now showing others not only what it's like to reach very old age -- but also, maybe, how to get there.
Kawas, a professor of neurology, neurobiology and behavior at UC Irvine, is the architect of a $9-million federally funded study monitoring the health and well-being of people 90 and older in Laguna Woods. Her work is part of a growing body of research into the phenomenon she calls extreme aging.
"In order to understand aging, you need to understand how to age well," Kawas says. "These people are the fastest-growing segment of the population, but we don't know much about them. We don't know how many are demented or how many of them are walking around well."
A description of extreme aging is starting to jell, however, thanks to Kawas' data and that of a few other longevity studies. And the information is timely. Just under 2 million Americans are 90 and older, but that number is expected to grow to 10 million by 2050.
Understanding the health needs and quality of life among the very old is essential, Kawas says. But relatively little is known about the status of this group. For example, when she first began the project, Kawas was able to locate only a couple of studies on dementia rates in people older than 90 -- a key area of concern for researchers.
More research has been done since then. But, she says, "We still don't know if the dementia rate increases, decreases or stays the same after 90. If half of all these people have dementia, that will be 5 million people with dementia in 2050. That's double what we have now. We have a public health issue looming here."
Making sense of the numbers is only possible by examining one 90-plus-year-old at a time -- something Kawas' staff does patiently. Their subjects are residents of the enormous Leisure World retirement community in Laguna Woods. The study, called the Leisure World Cohort Study, actually began in 1981 when USC researchers started collecting health and lifestyle data, via mailed questionnaires, from about 14,000 Leisure World residents.
