Desmond O’Neill: Optimal ageing and the midnight sun

Desmond O'NeillHelsinki in summer is a delight, its streetscapes of Russian influenced architecture illuminated and lifted by the interplay of the midnight sun and the ever present sea. The occasion was the triennial joint congress of five Finnish societies for research in ageing, a vibrant meeting of over 800 scientists, researchers, and clinicians.

Once again, I was reminded of why meetings and congresses make sense, even with all the video- and tele-conferencing possibilities open to us. The interaction of delegates, the emergence of fresh ideas, the sense of community, the human interest, and in particular humour, are a formidable counterblast to the inevitable routine and the grind of research and practice.

The science was balanced with a social programme that was stylish, humorous, yet which still contained seeds of purpose. At an elegant buffet in Alvar Aalto’s iconic Finlandia Hall, we had a charming if naughty conjurer, a gymnastic group whose average was 78 (and whose spry spokesman was 90), and an Italian infused dance band.

As an invited lecturer, finding local resonances has many benefits. In addition to returning the compliment of hospitality and engaging the hearers more fully, it opens new horizons and avenues of thinking. In Finland, there is no shortage of interesting examples of ageing.

At a societal level, an interesting metaphor for the life course review of ageing—the importance of time and experience to modulate painful experiences and reconcile the contradictory—can be seen in the long time span, usually many decades, it takes for a society to assimilate and openly discuss the value and significance of painful experiences.

The excellent current exhibition in the Ateneum—the Finnish national gallery, the first museum in the world to hold a Van Gogh—recognises and values the intermingling of Russian and Finnish aspects of the art in the Presidential collection, a metaphor for these influences in everyday life.

At least four major figures in Finnish public life are also valuable in illustrating aspects of ageing. Alvar Aalto’s key late works in Helsinki, including the Finlandia Hall, are highly visible markers of late life creativity, matched by the wonderful series of self-portraits by the painter Helene Schjerfbeck throughout her nine decades of life.

Field Marshall Mannerheim is another prime example of the longevity dividend, with his greatest achievements all occurring after the age of 72. His house in Helsinki, preserved as a museum, is an effective distillation of a remarkable life in extraordinary times.

But it is Sibelius who provides a more challenging, if potentially revealing, interpretation of the subtleties of ageing. Most great artists continue creating into later life, with Elliott Carter providing the most extreme example, composing into his 103rd year. However, after his seventh symphony was completed when he was 59, Sibelius wrestling with an eight symphony for a number of years.

Sometime in the early 1940’s, he suddenly decided to burn a large number of manuscripts, including the work so far on the eighth symphony. His wife, Aino, provided a telling commentary of this episode: “..after this my husband became calmer and gradually lighter in mood.”

This is as neat an example available of the resistance of later life to fall into easy and simple categories: yet a deadening simplification is one of the biggest challenges older people face from policy makers.  Although concepts such as “successful” ageing, and “active and healthy” ageing may seem on the surface to be an improvement on earlier tropes, a moment’s reflection gives grounds for concern.

Are those who do not meet the parameters of “successful” ageing to be considered as “failed” ageing?  Are those who are not, through any fault of their own, neither active nor healthy in later life in some way to have achieved a lesser citizenship? Is Sibelius’s more happy state not a form of ageing that we should also laud, even if less apparently productive? Eminent commentators such as Alan Walker have noted how official conceptions of active ageing are strongly “productivist” rather than embracing a wider view of ageing.

To my way of thinking, we need to think of forms of expression that value older for what they are, regardless of their state and productivity, without in any way lessening our public health impulses to promote activity, social engagement, and health to the greatest extent possible, and as desired by the older person.

“Optimal ageing” is a more flexible and less productivist phrase which relates to the values and wishes of the person to a greater extent than external concepts such as “successful” or “active:” it can also apply to all the examples of optimal ageing that Finnish culture has so obligingly provided for us.

Desmond O’Neill is a consultant physician in geriatric and stroke medicine, and immediate past president of the European Union Geriatric Medicine Society.

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  • Mainak Mukherjee

    “Optimal ageing” is a more flexible and less productivist phrase which relates to the values and wishes of the person to a greater extent than external concepts such as “successful” or “active:” I agree.