I had never considered that older might die purely because doctors may not see the need to dig in and diagnose them purely because they’re “old” and would “likely die soon anyway”. The older you get, the less medical intervention. With how much poorer we’re all getting it’ll probably only get worse.
And for-profit insurance companies (in the US) use QALY to decide what to treat and whom rather than leaving it to the discretion of patient's doctors to decide what care is necessary.
My mother and late grandmother both independently voiced that they experienced medical ageism and disrespectful, dismissive treatment by doctors, hospitals, and care providers.
I don't see any reason to believe that for-profit insurance is playing any role at all in that since countries with socialized medicine aren't regularly seeing 120 year olds.
Regardless, the USA is only a couple years behind and, with the way life expectancy is measured, that's much better explained by inner-city violence than it is by healthcare.
The US is an aberration because it has decreasing life expectancy, much higher rates of violence, paradoxically expensive and less effective healthcare, and a wider range of socioeconomics and lifestyles than other advanced economies. The US isn't "behind" so much as "falling" despite having every innate advantage apart from a political system that doesn't trade gold bars for votes from foreign countries.
While certainly a problem, I doubt this is the sole cause.
If mortality age is a normal distribution, you would see someone 125+ years old every now and then even just naturally. And you don't.
By contrast, standard deviation for height is somewher between 2 and 3 inches. If 70 inches is roughly median, 5 standard deviations is not unheard of. That's roughly 85 inches. 7' 2" is not exactly rare in the NBA and there are players a notch even above that--7' 5" is getting pretty rare.
Standard deviation for mortality distribution is about 8 years. If median is 75 years old, 115 shouldn't be that unusual and 123 should pop up occasionally. Yet, 115 is a staggeringly rare age to live to, and 123 is simply unheard of.
> If mortality age is a normal distribution, you would see someone 125+ years old every now and then even just naturally. And you don't.
Why would all-cause mortality be normally distributed? The causes of death at the low end and high end tend to be different, so I don't see why we would expect them to occur at similar rates.
> Why would all-cause mortality be normally distributed?
Erm, that is my point? They're not.
The human body has systems that break down. The immune system, for example, relies on a fixed number of stem cells that eventually die. Once you have zero of them, you're pretty much done. Also, I seem to remember that our ability to replace fat cells also declines with age (probably for similar reasons).
Consequently, outside medical interventions (or lack thereof) aren't really defining human lifetimes.
To continue your line of logic, it may be more informative to think from the causal side.
Life is effectively a mixture model combining two Poisson point process of things that can kill you (roughly, causes of infant mortality and causes of adult mortality)[0]. We've thankfully been able to shift the mixture weight pretty hard away from infant mortality with modern medicine and improved living conditions globally, but we're still linearly chipping away at an exponential problem (because events in Poisson point processes occur with exponential frequency - the most likely time for an event to occur is always, "now", even if the mean is every 79 years).
Even were we to completely eliminate all causes of death except things that can kill a healthy person in under a minute, we'd probably just end up with a prettier (probably a few decades shifted, possibly amplified[1]) Poisson distribution. It probably wouldn't be hugely different than what we have now, either - all the top causes of death have a "quick" option, and it doesn't take much cumulative probability of death to massively increase the probability your life will end before a certain age.
The article may be right that there is no cap to maximal age, but the likelihood of achieving ages greater than those seen may require significant time, even with the current population level, even if we started intervening generically. I would guess it will always be rare that people live to extreme age, even if that age manages to shift up another decade (shifting the average age of death into the high 90s).
[0] The resulting Poisson distribution of deaths is damped and left-skewed because deaths are not independent (saying which is to eliminate significant real-world detail), which is technically a requirement of Poisson point processes.
[1] Life saving measures are also not independent, which could be a significant factor if we could really recover from anything that required more than a minute to die.
This used to be a problem with my grandparents; the doctor always said ‘sure it hurts, but you are 80’ and send them away with an ibuprofen (and cancer but no biggy, they were indeed 80). That seems to have changed; my parents are treated the same as 20 year olds and they are 80.
TL;DR: It's taking the standard premise that there's no such thing as dying from old age, and applying it to examining treatment for elderly patients. The current conception of a human lifespan is within the context of a world where medical interventions are preferentially given to the young instead of the old. Thus, a doctor might not recommend a course of treatment for a 100-year-old (who may be much younger, biologically) because of an incorrect belief about human lifespan, the 100-year-old dies soon as a result, and the cycle continues.
There are a lot of stats here that point to their conclusion very strongly, and my own experience in healthcare has mirrored that, even though I never thought of it that way at the time. I would need to see much, much more research on this rapamycin drug to be convinced about that part, but the arguments about current medical care are sound.
This makes perfect sense to me. I have a genetic disorder and there is a phrase -- "the normal progression of CF" -- which essentially means "Quit bitching about wanting your doctor to actually help you get better. You have a sentence of death. Just politely die on time instead of pointing out that if we don't ever try to get you better, it should be no surprise when we don't."
Recently in the news for lifesaving drugs that cost $330k annually for the rest of your life and also make you hella fat. But let's focus on the positive: You might be allowed to live now.
Such a horrible state of things. This is one area where I'm hopeful about using AI for healthcare - AI, by programming, wouldn't be able to be apathetic which seems to be a defining characteristic of many healthcare professionals.
Now we only need to program the spirit of the AI to focus on healthspan instead of disease management..
The author gives evidence that many old people refuse further treatment that would extend their lives, shortening their potential life span. Then they conclude "These centenarians should seek thorough medical care, ... This, however, will require the revolution of policies, ethical standards and legal issues to ensure maximum longevity." So people should be forced to live as long as possible? My grandma wanted to die because she could not take the physical pain, plus was lonely after grandpa died 10 years earlier. But she was not allowed. Requiring people to live longer than they wish is cruel.
don't worry, it will only be for those who can afford it. the rest will be given help with suicide, if not just encouragement for it.
At some point there could be "vampires" ruling/owning everything and everyone.
Whenever I suggest adults should be in control of their own lives, I get a response along the lines of “we’d see mass suicide if people had an easy option to end their life”.
Ok, so let’s think about that. There may be thousands of people whose lives are so bad they’d take an easy way out if it were available. So the idea is to keep that option off the table, so those people are forced to live out the rest of their lives suffering?
To anyone who holds this opinion, I’d really like to know why. What reason could you possibly have to prefer someone you don’t even know to live in suffering opposed to them having control over their own life?
Exactly. Their body their choice. And if there are thousands of people going out this way it should be a trigger for society to do better and work on reducing the suffering.
These maximalist individual freedom ideological positions always astound me. Like people haven't thought one step past "you should be able to trade with anyone, anything, and put it into your body." Should you be able to buy an instant feel-good suicide pill at the corner store? That way anyone who is having a temporary tough time has a one-way door to ending their entire life that future them would've been glad they hadn't ended?
We already see what a catastrophic mess there is when people can buy instant feel-good fentanyl pills that wreck the rest of their entire life.
Because who would serve them their fast food and receive unwanted abuse if not some miserable wretch who isn't allowed to die? I wonder what the working pool would look like if a policy like this were adopted.
* Reduced suffering, the methods available for assisted suicide are as painless as you can get. You go under anesthesia and just never wake up.
* Less room for accidentally surviving. I can't even imagine the horror of surviving a gunshot to the skull.
* Less trauma for those around you, no body hitting the street or washing up on shore, no discovering your friend or kid who has bled out in the bathroom.
* Closure, some methods of suicide the family has no way to know for sure what happened and might assume they disappeared or otherwise foul play.
* More opportunity to help people find alternatives. They don't have to take them but you have a more structured opportunity to talk people off a ledge and have a cooling off period to avoid rash decisions.
* You have documentation of freely-given informed consent. Someone who commits suicide by more painful methods when easily accessible painless death becomes inherently suspicious.
* Estate planning can be built in so it's less of a mess for next-of-kin.
In the Netherlands, a friend's mother was recently able to end her life at age 95, via euthanasia assisted by her regular doctor.
Her husband had died some years before, and she had just been diagnosed with the early signs of dementia. She decided she had had a good life already, and that now was the right time to go, while she was still in control of her life.
The process and safeguards have been formalised and are uncontroversial in the main. Some doctors opt not to be part of this for their patients. That's their right. Usually a colleague steps in to guide the patient through the process.
In our friend's case, her children supported her in this decision. Her friends were also aware she was planning to end her life. Her funeral was a celebration of her life, not shock at her death.
Increasing max/avg/median lifespan without major improvements in battling dementia it is a rather dystopian vision. And even if we are not talking full blown Alzheimers, declining mental capabilities is a big issue: My own grandmother turns 102 this year and even though we as a family feel really blessed, I would say the last 5 years have been a slow but constant decline in mental capabilities. It went hand in hand with decline in eyesight and hearing. So: not hearing much anymore, not able to read or really watch TV and all your friends and relatives have passed for years. I really don't know if I would whish her getting 120...
This. The rates of chronic fatigue, mental illness, dementia are all massively increasing, with increasing evidence linking them to persistent infections and gut dysbiosis, and nobody cares to fix it.
Seeing everyone scrambling to drag life out without doing anything about its quality is just absurd.
There's a topic called "blue zones" which examines regions where people live healthy dementia free for far longer than surrounding communities. it's not clear how much research is active, but it is an investigated topic.
Despite all the good reasoning about it being impossible to live that long, what does it for me is that people in her town, where she was well known, would have had to have not noticed Jeanne die and her daughter take her place. Including her doctor.
Not saying she definitely isn't a fraud, but the evidence against her is more hypothetical and the evidence for her is more solid.
Well, you can argue both ways. For me I think it's fake basically due to the photos. The mum and daughter look similar but not identical and to my eyes the later pictures are the daughter. Re the locals not noticing, if you thought someone looked a bit funny would you just think that's a bit odd or publically accuse them or fraud? Personally I'd do the thinking it odd and ignoring it thing.
About 20 years ago I was watching the local news (small town in Brazil) and one of the things they showed was a farmer's 130th birthday. He had been bedridden for nearly a year at that point but everyone commented how he had been still working hard until that happened. They showed his wedding picture where his wife, now herself an old lady, looked like a teenager while he looked pretty much like the old guy he was during the interview. His youngest son was 30 at the time, which is another thing people who wouldn't believe his age would accept.
It might have been fraud for 15 minutes of local fame. This wasn't national or international news and nobody had any interest in a book of records. But it seemed real to me.
I feel that humans have "best before 40" label on them. All the later age numbers are pretty random, but 40 years is hardwired (although not directly, just as a sum of problems that are not weeded out by the selection pressure)
41 comments
[ 3.0 ms ] story [ 87.7 ms ] threadMy mother and late grandmother both independently voiced that they experienced medical ageism and disrespectful, dismissive treatment by doctors, hospitals, and care providers.
FWIW, USA is ~47th globally in life expectancy.
Regardless, the USA is only a couple years behind and, with the way life expectancy is measured, that's much better explained by inner-city violence than it is by healthcare.
If mortality age is a normal distribution, you would see someone 125+ years old every now and then even just naturally. And you don't.
By contrast, standard deviation for height is somewher between 2 and 3 inches. If 70 inches is roughly median, 5 standard deviations is not unheard of. That's roughly 85 inches. 7' 2" is not exactly rare in the NBA and there are players a notch even above that--7' 5" is getting pretty rare.
Standard deviation for mortality distribution is about 8 years. If median is 75 years old, 115 shouldn't be that unusual and 123 should pop up occasionally. Yet, 115 is a staggeringly rare age to live to, and 123 is simply unheard of.
Why would all-cause mortality be normally distributed? The causes of death at the low end and high end tend to be different, so I don't see why we would expect them to occur at similar rates.
Erm, that is my point? They're not.
The human body has systems that break down. The immune system, for example, relies on a fixed number of stem cells that eventually die. Once you have zero of them, you're pretty much done. Also, I seem to remember that our ability to replace fat cells also declines with age (probably for similar reasons).
Consequently, outside medical interventions (or lack thereof) aren't really defining human lifetimes.
Life is effectively a mixture model combining two Poisson point process of things that can kill you (roughly, causes of infant mortality and causes of adult mortality)[0]. We've thankfully been able to shift the mixture weight pretty hard away from infant mortality with modern medicine and improved living conditions globally, but we're still linearly chipping away at an exponential problem (because events in Poisson point processes occur with exponential frequency - the most likely time for an event to occur is always, "now", even if the mean is every 79 years).
Even were we to completely eliminate all causes of death except things that can kill a healthy person in under a minute, we'd probably just end up with a prettier (probably a few decades shifted, possibly amplified[1]) Poisson distribution. It probably wouldn't be hugely different than what we have now, either - all the top causes of death have a "quick" option, and it doesn't take much cumulative probability of death to massively increase the probability your life will end before a certain age.
The article may be right that there is no cap to maximal age, but the likelihood of achieving ages greater than those seen may require significant time, even with the current population level, even if we started intervening generically. I would guess it will always be rare that people live to extreme age, even if that age manages to shift up another decade (shifting the average age of death into the high 90s).
[0] The resulting Poisson distribution of deaths is damped and left-skewed because deaths are not independent (saying which is to eliminate significant real-world detail), which is technically a requirement of Poisson point processes.
[1] Life saving measures are also not independent, which could be a significant factor if we could really recover from anything that required more than a minute to die.
This has given me a lot to think about.
This guy mostly publishes solo. It’s a bit unusual.
https://www.youtube.com/watch?v=e-if3zjYSfY&t=28s
Recently in the news for lifesaving drugs that cost $330k annually for the rest of your life and also make you hella fat. But let's focus on the positive: You might be allowed to live now.
Now we only need to program the spirit of the AI to focus on healthspan instead of disease management..
Whenever I suggest adults should be in control of their own lives, I get a response along the lines of “we’d see mass suicide if people had an easy option to end their life”.
Ok, so let’s think about that. There may be thousands of people whose lives are so bad they’d take an easy way out if it were available. So the idea is to keep that option off the table, so those people are forced to live out the rest of their lives suffering?
To anyone who holds this opinion, I’d really like to know why. What reason could you possibly have to prefer someone you don’t even know to live in suffering opposed to them having control over their own life?
We already see what a catastrophic mess there is when people can buy instant feel-good fentanyl pills that wreck the rest of their entire life.
* Reduced suffering, the methods available for assisted suicide are as painless as you can get. You go under anesthesia and just never wake up.
* Less room for accidentally surviving. I can't even imagine the horror of surviving a gunshot to the skull.
* Less trauma for those around you, no body hitting the street or washing up on shore, no discovering your friend or kid who has bled out in the bathroom.
* Closure, some methods of suicide the family has no way to know for sure what happened and might assume they disappeared or otherwise foul play.
* More opportunity to help people find alternatives. They don't have to take them but you have a more structured opportunity to talk people off a ledge and have a cooling off period to avoid rash decisions.
* You have documentation of freely-given informed consent. Someone who commits suicide by more painful methods when easily accessible painless death becomes inherently suspicious.
* Estate planning can be built in so it's less of a mess for next-of-kin.
Her husband had died some years before, and she had just been diagnosed with the early signs of dementia. She decided she had had a good life already, and that now was the right time to go, while she was still in control of her life.
The process and safeguards have been formalised and are uncontroversial in the main. Some doctors opt not to be part of this for their patients. That's their right. Usually a colleague steps in to guide the patient through the process.
In our friend's case, her children supported her in this decision. Her friends were also aware she was planning to end her life. Her funeral was a celebration of her life, not shock at her death.
Seeing everyone scrambling to drag life out without doing anything about its quality is just absurd.
https://en.wikipedia.org/wiki/Blue_zone
Human bodies seem to pack up with age regardless of how much you spend on healthcare.
I suspect major change may come more from a merging with AI scenario rather than better healthcare.
https://www.newyorker.com/magazine/2020/02/17/was-jeanne-cal...
Despite all the good reasoning about it being impossible to live that long, what does it for me is that people in her town, where she was well known, would have had to have not noticed Jeanne die and her daughter take her place. Including her doctor.
Not saying she definitely isn't a fraud, but the evidence against her is more hypothetical and the evidence for her is more solid.
It might have been fraud for 15 minutes of local fame. This wasn't national or international news and nobody had any interest in a book of records. But it seemed real to me.