Geographical Aging

When I was a fellow in medicine back in the 1990’s, one of my mentors, Dr. Morton D. Bogdonoff, was finishing up a project called “The Living at Home Program.” Funded by the Commonwealth Fund and the Pew Charitable Trust, it sought to keep elderly people in their homes as long as possible so that they could age in comfort and dignity in familiar surroundings. At home, properly supported, they could live longer and better than if they were institutionalized. There was an implicit message in the work, which I did not understand back then: where you age matters at least as much as your physiology.

In medicine there is the concept of biological age which speaks to that physiology. By assessing the strength of various organs like kidney or heart function and levels of inflammation physicians can calculate what your physiological age is. Importantly, your chronological age may not match your physiological age. And given this, a lot of effort has been expended to alter your biological age to expand lifespan and compress morbidity. We know the ministrations well: exercise; stay intellectually active; and drink a little red wine–a salubrious antioxidant to stave off inflammation,