Aging with Grace: The Nun Study and the Science of Old Age. How we Can all Live Longer, Healthier and more Vital Lives, David Snowdon, Fourth Estate, London (237 pp. including index)

The real questions which hover over this book, but never descend to the printed page are: what is the purpose of our lives? Is there any point to a long life if it is not productive and fulfilling? And what does “productive and fulfilling” mean in this context? Today, some people speak of “human flourishing” without even attempting to describe what is meant and, more, why it should matter to us. Because this is a study of nuns (religious sisters) it comes close to but never quite touches the central point: we are made to know, love, and serve God. Within that context, whether we live for a day, a year, or a century, is of secondary concern. However, if we do live long lives, then to be able to know, love, and serve God with the best possible mental, physical and emotional health is less fearsome than the prospect of doing so in bad health. In particular, if we collapse mentally, we may live a decade or more, but our potential to serve God will effectively be lost.

Now to the book itself. I am not fond of its discursive style, but there is enough substance between the covers to compensate. It begins in the middle of the story, so to speak, a device which I do not at all find engaging. He was an academic in the field of epidemiology (how often do diseases appear in various groups of people, and why) who had been studying religious groups, relatively homogenous groups with membership lists and records. The nuns had similar histories, lifestyles, work, incomes, and health care. Therefore, differences in their health as they aged could reasonably be expected to be due to fewer factors than might otherwise be the case, making it more possible to identify whatever contributed to their conditions.

The sisters were very cooperative, most of them allowing their brains to be investigated after death. This led to observations such as that it was possible, at least in the case of Sr Bernadette, for her mental health to have been good, although her neocortex showed, in abundance, the signs associated with Alzheimer’s. Snowdon comments: “It was as if her neocortex was resistant to destruction” (99). This is a warning sign that there is still much unknown about Alzheimer’s. It may turn out that something fundamental is missing from our theories.

It was also tremendously fortunate that when each sister had joined the Order (the School Sisters of Notre Dame), they had written a one page autobiography. These documents, written at about the age of twenty, proved invaluable. What they came to identify as the “idea density” (measured in each ten words) was a rather reliable indicator of how well the sister concerned would be able to continue into old age with good mental health (109-114).

Perhaps most surprising to Snowdon was how those who had expressed the most positive emotions when young lived the longest lives (193-194). Of course, there are questions about how one identifies “positive emotion,” but I think Snowdon does a very creditable job, and makes a convincing case. He is correct to say that, from the point of view of ordinary thinking: “This is a most extraordinary finding: a writing sample from early adult life offered a powerful clue as to who would be alive more than six decades later” (193). As he indicates on the next page, it may not be so much a state of happiness as a positive outlook on life, that matters. I wonder if it might not be a positive outlook in relation to having a purpose in life: being able to feel the reality of my aim in life, and that I am realising it to the best of my ability? In this respect, of course, the spiritual aspect is critical. It can provide me with an aim, and the supernatural hope to continue even if my efforts are not greeted with success, for the true criterion of success is the judgment of God.

There is a curious passage towards the very end of the book: “Evidence is now starting to accumulate from other studies that prayer and contemplation have a positive influence on long-term health and may even speed the healing process. We do not need a study to affirm their importance to the quality of life” (202). This insight seems to have come late in Snowdon’s work, and not to have been fully integrated. From my perspective, even more important than the quality of life is the quality of spiritual life.

I have no doubt at all that what we might call a “powerful soul” can keep a person alive when their body might otherwise have failed, and what is more, keep them spiritually vigorous, and living with a sense of purpose. Such a person is also a powerful influence on those around them.

There is much other useful material in this book. For example, he makes suggestions for diet and exercise; noting that, of people in the same industry, those who were sedentary had a higher risk if heart disease than those who were active (26, also 38). Since dietary advice changes, and is to a significant extent dependent upon a person’s individual make-up and history, I shall not refer to it in any detail, except to say that the value of fresh vegetables and fruit is highlighted.

For me, the spiritual side of this story is the most significant. It was edifying to read how the nephew of one of these good women, a priest, said of his aunt that she “already lived partly in heaven” (3). But how sad to think that these sisters, who obediently attended conferences on “religious renewal” (77), are now dying out. The truths of religion are ageless: they do not need “renewal” but use.