Fact of life #1, Little old ladies drive their car to church on Sunday and never get the car warmed up.
Fact of life #2, Little old ladies rarely, if ever check anything under the hood.
Car does not get driven enough to get to a normal service interval in several years and the mess inside of the engine is the usual result. That is one reason I am always suspicious of really low mileage elderly driven cars. Usually what happens is someone buys the car and then drives the car normally and all that crud breaks loose, usually with catastrophic results.
Dave