Monday, May 3, 2021

"Do Older People Have a Duty to Die?"

Do not, for the love of God and all you hold dear,I implore you, do not mention this to the FT's David Keohane.*

From The Journal of the American Medical Association, September 17, 2018

...With death inevitable, the modern attempt to counteract aging-related diseases reveals a phenomenon known as competing risks. When the risk of death from a disease decreases, the risk of death from other diseases increases or becomes more apparent. . . . For example, finding a cure for cancer may cause an unintended increase in the prevalence of Alzheimer disease.
The inescapable conclusion from these observations is that life extension should no longer be the primary goal of medicine when applied to people older than 65 years of age. The principal outcome and most important metric of success should be the extension of healthspan....

From Lifespan to Healthspan
JAMA. Published online September 17, 2018. doi:10.1001/jama.2018.12621
At the turn of the 20th century, life expectancy at birth in most of today’s developed nations ranged between 45 and 50 years, with women routinely outliving men. About 22% of all individuals born in 1900 in the United States died before reaching the age of 10 years, mostly from infectious diseases.1 Among those who survived into older ages in 1900, the common diseases of aging known today were present but less common.
When public health emerged in the late 19th century, including developments such as sanitation and clean water, early mortality swiftly declined. A rapid shift in the distribution of death from younger to older people occurred during the first half of the 20th century, and since then declining death rates at middle and older ages have led to survival into increasingly older ages. As a result, about 96% of infants born in developed nations today will live to age 50 years or older, more than 84% will survive to age 65 years or older, and 75% to 77% of all deaths will predictably occur between age 65 and 95 years.2
With declining early-age mortality and a shift in the age distribution of death, the population of the United States, and much of humanity in general, achieved exactly what was desired: the first longevity revolution. The 30-year increase in life expectancy at birth in the past 100 years is one of humanity’s greatest achievements.
 
Lifespan Limits and Decelerating Improvements in Life Expectancy
Over the past century, the relatively easy gains in life expectancy have been achieved by reducing mortality of younger people; more recently, scientists have focused on how much higher life expectancy can increase and what the maximum lifespan is for humans. The former is a population-based metric that involves national vital statistics for groups of people; the latter is the world record for longevity held by 1 person.
Regarding maximum lifespan, only a small proportion of all humans are capable of living to 115 years of age, with a small number of statistical outliers capable of approaching the world record of 122 years.3 Some experts suggest that if death rates plateau at older ages, lifespans may continue to increase. This latter view has been challenged because an unrealistically high number of people (estimated at 262 200) would have to survive to age 105 years for just 1 person to exceed the world record for longevity by 1 year to 123 years.4 As such, the probability of any substantial increase in maximum lifespan in this century is remote.
 
Regarding life expectancy, one view developed in 1990 suggested that the increase in life expectancy would soon decelerate because the easy gains had already been achieved.5 Any substantive future increases require improvements in mortality at older ages, although components of the human body (eg, brain, heart, knees) are not designed for long-term use. Others suggested that historical trends in the increase in life expectancy will continue indefinitely into the future due to yet-to-be-developed medical advances and improved lifestyles.
Not one of the anticipated high-life-expectancy scenarios is remotely plausible today. In fact, a new trend in the opposite direction has emerged in much of the developed world, indicating that death rates for many major causes of death have either leveled off, experienced declining improvement, or increased since 2008.
 
Biological Aging and Diminishing Returns on Life Expectancy... 

Related: April 30's ""How Long Can We Live?""  

 *See:
The Coming Battle Between The Boomers and the Millennials (yeah, I got your "kill the old" right here)

Demographics Rule: The Coming Battles Between The Juvies and The Geezers
Not exactly Crips and Bloods.
Or even Sharks and Jets, but important nonetheless....

Nov. 2016
Kill the old, eat avocados.

Important note: Upon double checking that last link it appears that, despite the use of the 'Kill the Old' construction favored by homicidal ageist gerontophobes worldwide, the post is actually by-lined Kadhim Shubber, which makes me wonder if Mr Keohane wasn't called in for consultation.