real enemy is not death

[Guest guest]

The real enemy facing humanity is not

death but ageing, says Guy Brown

 

 

IN GREEK mythology, Tithonus was a handsome mortal who

fell in

love with Eos, goddess of the dawn. Eos begged Zeus to

grant her

lover eternal life. Perfidious Zeus made Tithonus

immortal, but

did not grant him eternal youth. As Tithonus aged, he

became

increasingly debilitated and demented, eventually

driving Eos to

distraction with his constant babbling.

 

Tithonus's fate now threatens us all. We can look

forward to an

ever-increasing lifespan, but at the cost of

progressive

enfeeblement, ill health and dementia.

 

Until about 200 years ago, the average human lifespan

was about 30

years. People died young, and they died relatively

rapidly,

mainly from infections. During the 20th century the

average

lifespan in the world doubled, and people in developed

countries

now tend to die old and slowly from degenerative

diseases brought

on by ageing.

 

It was once thought that humans had a maximum lifespan

that we

would hit at some point, as death from disease was

eliminated.

Many limits have been suggested, but each has been

shattered by

experience. Average lifespan has been increasing at

the

staggering rate of 2.2 years per decade (or 5 hours a

day) for

the last 100 years. There is no sign of this slowing

down, even

in the countries where life expectancy is highest

(Science , vol

296, p 1029).

 

This has profound consequences for humanity. In the

UK, for

example, if current trends persist, the number of

people more

than 65 years old is predicted to triple from 4.6

million now to

15.5 million in 2074, while the population aged over

100 will

increase 100-fold from 10,000 to 1 million. The future

is not

just old, it is extremely old. We are voyaging into a

new realm

of human life that has hardly existed before and about

which we

know very little.

 

Unfortunately this increase in lifespan has not been

matched by an

extension of health. The years we gain are mostly

spent with

disability, disease and dementia. Between 1991 and

2001, life

expectancy in the UK increased by 2.2 years, but

healthy life

expectancy increased by only 0.6 years; people

experienced ill

health for an extra 1.6 years of their lives. This is

because we

have not been able to slow the ageing process; much of

the

increased lifespan is due to increased survival with

chronic

diseases. In 1980 James Fries, an expert in chronic

diseases at

Stanford University School of Medicine in California,

and others

predicted that the diseases and disability of ageing

would become

compressed into a short period before death as the

average

lifespan approached the maximum lifespan. But because

there

doesn't seem to be a maximum lifespan, this idea of

" compression

of morbidity " has turned out to be a mirage.

 

Instead, the increase in lifespan is combining with an

increase in

degenerative disease with age to generate an

" expansion of

morbidity " . The prevalence of most degenerative

diseases, such as

cancer, and vascular and neurodegenerative disease,

increases

roughly exponentially with age. For example, the

prevalence of

Alzheimer's is about 1 per cent at 65 years of age and

approximately doubles every five years after that, to

around 25

per cent for 85-year-olds. In the US, 46 per cent of

people over

85 years of age are thought to have Alzheimer's. There

are an

estimated 5 million people with Alzheimer's in the US

today, and

as people live longer this number is projected to rise

to 12.5

million by 2050 (Journal of Psychiatric Research , vol

36, p 281).

 

Older people also decline physically. They are more

prone to

chronic diseases such as arthritis and rheumatism,

osteoporosis,

high blood pressure and heart failure, diabetes,

varicose veins,

ulcers and strokes. They are much more likely to have

disabilities such as deafness, blindness and

immobility. Of

Americans older than 80 years, 74 per cent have a

disability.

They are also more likely to be forgetful, confused or

depressed.

Almost a quarter of non-institutionalised Americans

over 85 are

thought to be severely depressed.

 

Medicine has become very good at eliminating acute

causes of death

such as infections, but the downside of this success

is that

people live long enough to suffer from degenerative

disease.

What's more, many acute forms of death have been

converted to

chronic ill health or disability. Heart attack has

become heart

failure; stroke has become vascular dementia.

Diabetes, AIDS and

even some cancers have been converted from acute

causes of death

to chronic disabilities.

 

Another unfortunate factor is that it is much more

profitable for

pharmaceutical companies to develop drugs that keep

patients

alive but uncured, rather than curing the disease,

which loses

the customer. The situation is not helped by the

charities and

funding agencies that focus on preventing death rather

than

disease or ageing.

 

The root cause of the impending Tithonus crisis,

therefore, is our

failure to tackle ageing. It is tempting to think that

ageing is

" natural " , but the opposite is the case. Ageing is an

artefact of

culture. It is very rare in wild animals and was rare

in humans

until 200 years ago. As the population inexorably

ages, maladies

that were formerly rare or non-existent become

commonplace.

 

If current trends persist, people born in the

developed world

today could expect to live 100 years, but are likely

to spend

their last few decades with increasing disability and

deteriorating health, and face a 25 to 50 per cent

chance of

dying with dementia. Imagine the consequences if this

nightmare

becomes a reality. Imagine the psychological

consequences of

expecting to develop dementia. Imagine the economic

consequences

of providing one-to-one round-the-clock care for

decades on end

for millions of demented or disabled people.

 

Yet we are doing absolutely nothing about it. Death,

dying and

dementia are nowhere on the political agenda. We are

too afraid

to think about the three Ds, and that suits the

politicians fine

because they are not easy problems to solve. We need

to stop

turning a blind eye to the multiple miseries at the

end of life

and attack ageing and the diseases of ageing head-on.

Research

funding needs to be redirected here rather than aimed

simply at

preventing death. We have to develop alternative

routes to drug

development for therapies that don't make economic

sense for the

pharmaceutical and biotech industries to pursue.

Hospices ought

to be as ubiquitous and well-funded as maternity

hospitals. The

aged should be reintegrated into society or whatever

society they

want and they should be able to choose how they die.

 

Last but not least, we need a new attitude to death.

Death is not

the enemy; it is an integral part of life. It is

ageing and its

diseases that we should be fighting. The Tithonus

scenario means

that attacking them will be at least as important in

the 21st

century as efforts to tackle terrorism and global warming.

 

Did you know?

[Guest guest]

The real enemy of humanity is ego.

 

Jane

 

_____________________________

The real enemy facing humanity is not

death but ageing, says Guy Brown

[Guest guest]

Here,here!! Well stated, Jane. It is probably this 'me-first ' attitude

which causes personal suffering as well as the greed of the world. all

the best, Chamae

 

______________________

The real enemy of humanity is ego.