Increasing work on the history of old age allows attention to some key conceptual issues, relevant also for gerontological perspective. Change over time must be characterized in terms of periodization, and possibly in terms of direction and causation as well. Historians are increasingly aware of the exaggerations in the conventional view of the advantages of old age in preindustrial Western society, given strong economic and cultural liabilities. Industrialization brought change, and probably some deterioration, but not a massive overturning, for the elderly were sheltered from some key economic shifts, while a traditional cultural pessimism about old age actually became more serviceable. Only when the attitudes of old people and about old age began to modernize, during the first half of the twentieth century in France and in the United States, was a decisively new historical period staked out, with changes in residential/household patterns and the development of retirement policy combining additionally toward this chronological break. Comparative differences in the modern history of old age in France and in the United States also highlight the importance of cultural factors in the basic position of the elderly. Although the directions of economic and demographic change were similar in the two countries, prior cultural differences continued to have an impact, revealed for example in medical practices toward the elderly. Tentatively, the, the causal importance of attitudes about old age can be posited.