Quirino demurtas is 96, elfin, clear- eyed, with a full head of suavely combed white hair, and he is happy to explain the reason for his long and healthy life: "I don't really believe in medicine." I am sitting with him in a particularly centenarian-rich part of Núoro called Ogliastra. Bounded by mountains on three sides and the sea on the fourth, some call the region an island within an island. It once took 12 hours to get here from Cágliari by train, but I drove up in two, along a perilous Roman road twisting through spirelike balding mountains of rosy granite, often with nothing but a wire or a hedge separating my Fiat from a deep ravine. I am still dizzy.
"For years I would not take any medicines at all," Demurtas tells me. "I don't think they do much, and lots of times the doctor is using you as a guinea pig." Like me Demurtas has asthma. Like me he has been known to smoke. Unlike me he still does. "But I never inhaled," he points out, with Clintonian pride. Given all this I am frankly amazed by his good health and confused about why he is here, in his town's bright new clinic, allowing himself to be treated like a guinea pig. He enjoys it here, Demurtas explains. Besides, he says, "I am friends with Dr. Pilia's mother."
Dr. Pilia is Giuseppe Pilia, a dashing young geneticist who, after several years at Washington University in St. Louis, returned to his native village with funds from the U.S. National Institute of Aging to tease out some of the factors contributing to his neighbors' extraordinary health. This clinic now occupies what was once Pilia's old elementary school, and with help from his mother ("She knows everyone!" he explains, with a quick roll of the eyes) he has already lined up 6,000 of the region's 10,000 residents as subjects.
Pilia takes me upstairs to show me the two new sonogram machines his staff is using to measure the thickness of the citizenry's artery walls. Typically, the older the person, the thicker and stiffer his arteries, and the more likely he is to suffer a heart attack. Some people, though, maintain svelte arteries well into their middle years, making arterial thickness a good indicator of a person's "real," or biological, age, as opposed to the one on his birth certificate. I ask Pilia if he can show me Demurtas's arteries, and he has an assistant pull the sonogram results. The thickness of a healthy artery falls within a range of .3–.8 mm; thicker than .8, you have trouble. Pilia and I see that Demurtas comes in at .62 mm.
"You mean he has the arteries of a 50-year-old?"
"Right," says Pilia, considering Demurtas's ranking for the first time himself. "Wow."
So then the question becomes, how is it that Demurtas's arteries (if not Demurtas himself) are aging at half the rate of those of a normal man? Pilia says that genetics undoubtedly plays a part, but if previous longevity studies are an indication it won't be a huge part. For example, in a 1997 study on the island of Okinawa (the site of another famous centenarian cluster), 94 percent of the centenarians had the same average-to-poor genetic profile as the rest of the population.
That leaves plenty of room for environmental factors. Factors, for instance, like Demurtas's less than buoyant outlook on life. "If you ask around they will say people in Ogliastra are, well, depressed," says Pilia with a dry laugh. But, he points out, it's a depression without anxiety or much artery-constricting stress. Sardinia has seen a great deal of hardship over the centuries. There have been earthquakes, famines, and a near-endless string of invaders, starting with the Phoenicians and the Romans and continuing through the Spanish, the House of Savoy, and today's tourists, scientists, and journalists. Along the way the people of the interior seem to have adopted the attitude that whatever the foreigners can screw up they usually will, so you might as well focus on the few acres of rock and lichen you can control. It's similar to the conclusion that came out of a big U.S. study earlier this year discounting the role of positive emotions on cancer survival. A relentlessly upbeat attitude has probably been overrated in our society. If you really want arteries that will let you live to 100, you'd do better to follow the example of a Sardinian peasant and respond to everything, good and bad, with the same sort of droll fatalism. As Demurtas put it to me, "A girl once asked me, 'How can I live to be your age?' I told her, 'Don't die too early.'"