In an effort to sensitize medical students to the problems of the frail elderly, a simulation experience known as the Aging Game is a required portion of the Introduction to Clinical Medicine course for medical students at Duke University. The immediate positive effect of the Aging Game has been documented (Journal of the American Medical Association, 262, 1507-1509), but its long-term impact has not been established. To obtain follow-up, a brief 10-item questionnaire was mailed to all medical students. Both objective and subjective data were collected to ascertain the impact of the Aging Game over time (class years two through four), and objective responses were analyzed by the Mantel-Haenszel chi-square test of general association. The lasting effect of the intervention was confirmed over the 2-year follow-up period. The experiential nature of the intervention and the resultant increase in empathy for the frail elder explain the success of the Aging Game,