Thomas Cole, a gerontologist and professor of medical humanities, had two hip replacements, two back surgeries and a bad case of pneumonia in his 60s. He became depressed and wondered what the future held.

“I wanted to know what was ahead of me,” says Dr. Cole, co-editor of “The Oxford Book on Aging” and author of “The Journey of Life: A Cultural History of Aging in America.” For guidance, he turned to 12 men, all high-profile and in their 80s or older—a period some are calling the Fourth Age, considered the last of four stages of adulthood. He wanted to learn how they dealt with decline and whether they could find meaning in life even as it was nearing its end.

In his recently released book “Old Man Country: My Search for Meaning Among the Elders,” Dr. Cole, now 70, found that some issues that consumed him were no longer important to many of the older men, and that they generally weren’t afraid of dying—but were afraid of dementia.

In an edited interview, Dr. Cole talks about his conversations with these men and why their perspectives matter, as the percentage of people aged 85 and older in the U.S. is growing quickly.

Thomas Cole


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Thomas Cole, 70, has written about aging for more than 40 years.

You selected highly accomplished people like Paul Volcker, former head of the Federal Reserve, Ram Dass, a teacher of Eastern spirituality—both of whom have since died—and journalist Hugh Downs. Why not a broader cross-section of people?

I picked these people because I admired them and wanted to hear what they had to say. I also had a hunch they were just as fragile as anyone else. They all faced the same questions all men do: Am I still a man? Do I still matter? Am I loved? What is the meaning of my life? We ask those questions throughout life but they become more pressing because the finish line is in sight.

How do they reconcile manhood with declining physical abilities?

The issue of manhood seems to evaporate more than I would have thought. In the Third Age [65-80], men continue to try really hard to maintain their middle-age strength and potency. In the Fourth Age, for the most part, they are no longer interested in manhood as a defining category. If their capacity for sexual intercourse was gone, so be it. They have other ways to keep their relationships strong. There’s no sense of failure.

Were there any exceptions to this?

One refused to say he was old. He was in his early 80s and going to the gym. He married a woman 20 years younger. He died a couple years ago from cancer. I wondered how he would have adapted to becoming frail. People do adapt even if they are terrified. At a certain point, you stop trying to hold onto what is gone. You embrace what is. Hugh Downs said he exercises every day to maintain his muscle strength, but accepts the biological process of old age.

What about fear of death?

It was common to hear: “I don’t want to die, but I’m not afraid of dying. I’m ready.” I was heartened because I think fear of death is a problem for all of us. The possibility of that fear dissipating as we get older is a testimony to the importance of a well-lived life. They would say, “I’ve had a good life. In some way, I’ve left the world a better place. I’m loved.”

Do you think men and women age differently?

I can’t speak with any authority on this, but I think many stereotypes are valid. Women are more connected to friends and family. They’ve been caregivers and can let themselves be cared for. Men, especially in that generation, live for work. They’re often disconnected from their feelings and don’t want to accept the need for care.

But those traditional gender scripts aren’t as rigid when people get to be in their 80s. Men do take up more house chores. They are better at caregiving and express more emotions.

Where do they find meaning in their old age?

From loving and being loved. Their world and aspirations shrink a little bit. Therefore love takes on larger meaning. Paul Volcker, who was still working, found meaning in being involved in things and feeling needed.

You’re written about aging for more than 40 years. How have your own views on aging changed?

I’ve become more compassionate towards others and to my own body. In the past, when I saw an old man or old woman on a walker, or using a cane, I used to avoid them. Now I look at a person like that and think “OK. That could be and will be me.” I feel solidarity rather than fear. Of course, frailty is not something I hope for or look forward to.

How have our attitudes as a society changed?

Not enough. We have ideals for the “young old,” these useful aging people who go to classes and exercise, travel and volunteer. It’s fine to aspire to that. But we still fear the other half of that equation—the “old old.” We don’t take seriously the importance of lives of people who are frail and dying and suffering from dementia.

After you talked with these men, did you feel more reassured or more concerned about entering the Fourth Age?

I’m less afraid. I know that many of these changes are inevitable and I will have to face them, and that’s a scary thing. At the same time I’m reassured because I see how old men do face them and how they continue to flourish. It’s mostly because they have good and positive answers to these questions: Am I loved? What’s the meaning of my life? Am I still relevant? Am I still a man?

Write to Clare Ansberry at clare.ansberry@wsj.com

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