It’s just a number

Robert Kahn is 95 years old. But as he leans back in his office at the University of Michigan Institute for Social Research (ISR) to consider a question, or avidly discusses a research problem with colleagues in the hall, his age seems irrelevant.

Kahn came to U-M in 1948 to pursue a PhD in social psychology and to join ISR’s early founders. Over the next 40 years, until he was obliged to retire in 1988 at the age of 70, he built an illustrious and far-ranging career as a professor of psychology and public health and as a research scientist whose areas of interest spanned organizational and social psychology, electoral politics, survey methodology, public health, and aging.  Currently he is professor emeritus of health services management and policy at the U-M School of Public Health; professor emeritus of psychology in the College of Literature, Science, and the Arts; and a research scientist emeritus at ISR’s Survey Research Center.

After his official retirement, Kahn continued to work at ISR, writing grants, conducting research, and analyzing data. Kahn’s 1998 book, Successful Aging, written with John W. Rowe, MD, challenged the notion that genes are the primary determinant of how well people age. Instead, the authors pointed to exercise, social engagement, self-efficacy, and social support.

Kahn and his wife, Bea, relied on all of those when they faced a daunting recovery in 2006 after being hit by a car in an Ann Arbor parking garage. As their long rehabilitation began, Kahn challenged himself to apply the lessons of his own book to regain his health and get back to work. In a 2008 interview, at the age of 90, Kahn described how his daughters and extended family took leaves of absence to help him and Bea in their recovery. “The emotional effect of that is beyond words,” he said, adding that after living through the experience, “I think I could do a better chapter on social support.”

Most recently, Kahn has been studying whether applying the principles of Successful Aging could enhance and extend the physical and mental health of seniors. With the backing of Lawrence Landry, the former chief investment officer of the MacArthur Foundation, Kahn and fellow ISR researcher Toni Antonucci helped design a program to create a successful aging culture in older adult communities.

Landry launched Masterpiece Living, as it was called, in two Florida retirement communities in 2002 (see sidebar). The communities improved residents’ diets, offered tailored exercise programs, gave medical feedback, and created peer support groups, among other measures. The program worked and has since been extended to 70 communities nationwide.

With the growing success of the original project, Kahn and Antonucci now have an $886,000 grant from the MacArthur Foundation to see whether the approach can accomplish as much for low-income seniors. Eventually, Kahn would like to make the array of health opportunities and advantages available to all of the elderly, whether in retirement communities or not.

In October 2012, Kahn sat down with writer Susan Rosegrant to build on an interview they had done four years earlier. Following is an edited version of that conversation.

Note: One month after this conversation took place, Kahn’s wife, Bea, died after a short illness at the age of 94.

Susan Rosegrant: What has changed in the last four years? Are you still exercising regularly?

Robert Kahn: I do a half-hour on a treadmill at a modest pace. It used to be running; now it’s walking slowly—two-and-a-half miles an hour. And then I push weights for another half hour. The weights are not as heavy as they used to be, but they feel as heavy.

My cardiologist tells me that I’m not trying to build muscle. He gives me advice, which is not as brief as what Angus Campbell [the first director of ISR] always used to give me when I would ask about something, but close: “Don’t do anything dumb.”

SR: Over the last four years you’ve seen more friends and relatives die. Has that changed your feelings about your own life or death?

RK: No. Not really. There’s so much in the world, not to mention the rest of the apparent universe, which is a total mystery to us. I don’t see that admitting ignorance about it is particularly frightening.

I ran across an interesting exchange between Benjamin Franklin—some months before he died, as it turned out—and Ezra Stiles, who was then the president of Yale University. Franklin was giving his library to Yale, and Stiles, who was also a minister, was questioning Franklin in their written correspondence about whether he was in fact a believer in the afterlife. Franklin was pretty clearly among the deists in our so-called cohort of founding fathers, and Stiles pressed him to say what he believes. And Franklin replied that he hasn’t given these questions a great deal of study, and now at this late stage in his life, he doesn’t plan to undertake such studies, especially since he will shortly be getting the answer directly. [Laughs] It’s not an exact quote, but it comes close.

SR: How much of successful aging is luck?

RK: I think there’s a big element of luck. When you and I last talked about the accident that Bea and I had had, the medical expertise and the familial support which we talked about was, I suppose you could say, a different kind of luck.

If you look at life expectancy and medical costs internationally, you know that the United States is not doing well. We spend more and we get less. So that’s not luck, unless you assume these political decisions are also a crap shoot. That’s within our control societally, but not individually. So there are the things we can do for ourselves, there’s the availability of expertise to help us, and then there is indeed the random event.

SR: Is there any research on aging that hasn’t been done that you’d like to see undertaken?

RK: What I want is to see what it would take to enlarge the health opportunities for people regardless of where they’re living and what their income is. So that’s very applied stuff.

In contrast to that, I’ve read some articles of E.O. Wilson’s on consilience, and I’m now toiling through his book on that subject. Essentially he’s an eminent biologist who is trying to think about what combination of disciplines it would take to bring everything together—to have a single set of concepts that describes everything we know about the world.

He thinks natural science has been moving along these lines. Social science by and large has not. If you look at the vocabularies of the different disciplines, sociologists are talking one language and psychologists another and political scientists a third, and they’re all looking at the same world that they’re trying to explain. So I think Wilson has a good point when he says we’d better work our way out of separate and limited languages. It’s relatively easy to point out that we’d like to get past that; it’s not at all easy to think about how to do it.

SR: I was going to ask about one of the best books you’ve read recently, but it sounds like that would do it.

RK: But for more recreational reading there’s a professor of philosophy at Princeton named Rebecca Newberger Goldstein who wrote a book, which I think is only partly successful but very interesting, called 36 Arguments for the Existence of God. The book is fiction, but each chapter is an argument that philosophers have been debating.

Newberger Goldstein is a student of [Baruch] Spinoza [the 17th-century Jewish-Dutch philosopher]. That interested me because Einstein at some point was asked whether he believed in God and he said, “I believe in Spinoza’s God.” So that led me to go rummaging around to see what I could learn about Spinoza. I hadn’t known much, except the family was Sephardic Jews who came out of Spain and eventually landed in the Netherlands, as many people did looking for tolerance. So he was a philosopher and he certainly believed in God, but he did not believe in a God that was interested in the specific behaviors of individuals or who had selected any particular bunch of people as chosen. God was what he saw in nature.

So when Einstein said he believed in Spinoza’s God, that’s what he meant, that there was something that explained this impossibly complex universe that we have only a little fragment of knowledge about.

SR: Do you believe in Spinoza’s God?

RK: Yeah, I think that’s pretty good. But I think that qualifies you as kind of agnostic.

SR: In health care for the aging, is there a specific advance that you think is most needed, or is it an array of services that would come through something like the Masterpiece Living approach?

RK: I don’t think the single payer approach or any version of it—even if we were about to have it, which seems most unlikely—would solve all our health care problems. Other countries, while they’re doing better than we are, still have the problem of greatly increasing costs.

I noticed that England recently has decided that they will not cover the costs of Aricept and other drugs that are currently used for Alzheimer’s. The drugs are very expensive and they don’t work. The most that can be claimed for them is some alleviation of symptoms in some cases. You get lots of expense, lots of side effects, and very little impact. So I think various tough decisions have to be made. That doesn’t prevent people from buying that stuff if they have the money and want to, but it kind of sets limits on what will be provided, and I think we’ll have to do that. Our current arrangement, which has 45-plus million people without health coverage, should be a national embarrassment.

SR: Some older people talk about feeling invisible out in the world as they age. Do you think that’s a common perception among seniors?

RK: I must have heard of this, but I haven’t thought about it. It’s not something I’m experiencing. As I walk around the halls here at ISR I can imagine somebody a few generations younger saying, “Who’s that old character staggering around the place?” But that strikes me as more humorous than threatening.

SR: Do you feel like the Western view of aging is particularly bad? Sometimes we hear that in Eastern countries, there’s a better perspective, more respect, perhaps.

RK: I really don’t know to what extent that’s true, although we’re a pretty youth-oriented society.

SR: You don’t walk around thinking, “Damn those Western-society attitudes toward aging. They’re making my life miserable.”

RK: [Laughs] Life is not like that. My life is not like that.

SR: We talked last time about how your daughters helped you and your wife recover after that bad car accident, and you said it gave you an even deeper appreciation for the importance of social support. Has your sense of that increased even more in the last four years?

RK: It’s certainly not diminished, and in some ways it’s increasing.

Bea and I moved from a large house that I can now see was terribly inconvenient for older people to a condominium at the age of 70. A long time ago. And we deliberately looked for a condominium that was in walking distance of the campus, which was on a bus route, in case we could no longer drive, where the units were on one floor. So now I think we have to consider what’s the next move. At what point do we no longer want to be doing our own shopping, cooking our own meals, and so on. And, to pick up your point about social support, we are in the very fortunate position of having daughters and a son-in-law who want us to move in and be a multigenerational household.

SR: What advice would you give adult children facing the aging of their parents?

RK: One obvious answer is for the adult children to find out what the situation looks like to the parents. What would they really like, what do they need now, what do they think they might need? What are they worried about?

SR: Those conversations probably don’t often happen.

RK:  I think they probably don’t. And there needs to be a clear exchange about what each needs and wants. Some of our old friends, near contemporaries, have already been very careful in laying out with their kids who wants this, who wants that. We have not done any of that. On the other hand, we want our daughters to have unlimited powers of attorney. In some families there’s not enough trust to do that. The absence of specific plans of that kind can make things very complicated.

So it’s easy to say that one piece of advice is to have frank talk, but how about families where there hasn’t been any such talk for the last 50 years? How do you start?

SR: Any advice for your peers?

RK: [Chuckles] I was tempted to give you Angus’ quote again: “Don’t do anything dumb.”

I think the main advice to my peers would be to urge candor in speaking to their children. What people want is very different. Our son-in-law’s mother said that she wants to know exactly what’s going on [if she’s ill or near death]. “Even if I’m in a coma, I want you to talk to me.” And she wants life to be continued under any circumstances. Bea and I have made very different decisions. Don’t resuscitate. Don’t do any unnatural prolongation of life.

But when I think back to my own grandfather and father—my mother died too suddenly—I don’t think we had those conversations. And I don’t think they’re easy, but I think they’re worth trying.

SR: What things in your life give you the greatest pleasure?

RK: That’s a very easy question. The answer is clearly within the family. When I think about it, in spite of the hours and effort that I’ve put into my own career, what I most wanted to be—more than a successful researcher or successful ager—was a successful father and husband.

On the whole, I think we’ve been lucky.

(This article appears courtesy of the Fall 2013 issue of Findings, the alumni magazine produced by the School of Public Health. )

Photo credit: Martin Vloet, Michigan Photography.