Or to put it another way, is every death attributable to some disease. Heart disease, etc.
When I was younger nobody wandered what a 90 year old died from. They just assumed it was because he was 90. It was his time.
In my state, a death report must be made, and the death report must report the mode of death, vis: ‘respiratory failure’. The report should specify an antecedent cause, vis: ‘COVID-19’ where the mode of death does not un-ambiguously describe a cause of death. ‘Strangulation’ would be a mode of death that is an unambiguous cause-of-death.
'Old age" would not add information to the cause-of-death report, so it’s not a valid antecedent cause. But no antecedent cause would be required if the patient was under care for respiratory failure due to old age: old age is an implicit antecedent cause.
Looking at it from a different angle: post-mortems are not required to determine cause of death for most cases. Even when required, may be refused by the family: even when requested by the family may be refused or mishandled by the facility. Implicitly, family and medical facility and state are accepting ‘old age’ as the antecedent cause, even though medically, it is known that post-mortem examination for old people often shows that assigned cause of death is incorrect or incomplete.
It would today just be classified as “multiple organ failure”. I’m still not sure what exactly my grandfather really died of, as he never had anything by itself that would cause his death, but it was clear over the last couple years of his life that his body was unable to maintain itself and more and more of it was failing to work as intended. He didn’t die specifically of old age, but it was basically a failure to maintain homeostasis brought on by advanced age, with no outside agent causing it, nor there being a specific critical point of failure as in heart disease…
“Old age” as an official cause of death was banned by the WHO in the 1970s.
I didn’t find anything that said the WHO banned it in the 1970s, but you might have a cite.
Was “old age” ever allowed as an official cause of death in the first place in the U.S.? This page says that in 1951 “a federal Public Health Conference on Records and Statistics standardized causes of death throughout the nation and defined 130 acceptable diagnostic causative conditions. Old age was specifically omitted.” That implies it was allowed before, but doesn’t confirm it. They may just have wanted to officially leave out an occasional informal practice.
That is more or less how my mom passed, in her mid 90s, she just sort of ‘wound down’, her nurse told me she went to bed and simply passed in her sleep. I rather like that idea, no pain, no trauma, no [cancer oriented] shuffle through a bunch of doctors [which for me will be a serious possibility.]
Don’t they call it “natural causes”?
I couldn’t find a cite, but I did vaguely remember reading it somewhere.
“Natural causes” is plausible enough for an obituary, but not nearly specific enough for a death certificate.
I haven’t looked at it in a while, but if memory serves my wife’s death certificate had three lines for “cause of death” - something like “due to” and “resulting from”. She had Parkinson’s which took a bad turn and spent her last three months in home hospice care, not really conscious.
My grandfather died at age 102. The listed cause of death was “Hypernatremia,” which is a fancy word for too much sodium in the blood The actual cause of death was because he stopped eating and drinking, dehydrated himself (causing his sodium levels to rise,) and simply slipped away.
“Natural causes” is quite general, and includes a lot of specific causes. It means not murder, not suicide, and probably not an accident.
In the sense of just listing it on a death certificate? Probably not. They can tell a lot these days, and will do their best to identify the exact cause.
But in practical terms, most people die of “old age”, in that they get old, their bodies malfunction, and they eventually die because of it. For example, looking at @Kent_Clark’s grandfather, they list “hypernatremia”, but in realistic terms, “old age” is as good of a reason as any. My own grandmother died of something specific I’m sure, but the fact of the matter is that she was 93, and something was going to get her at some point strictly because she was so old. So “old age” is effectively the cause of death in her case too.
I have a parent going through that, and with the way my health is at the age of 33, I will likely be going the same way… Death due to malignant disease and organ failure is NOT fun… Watching someone going through constant surgery, pain, and a slow, dramatic, uncomfortable decline has convinced me to store a dose of something to mercifully put myself out of my own misery should it ever happen to me… I’m glad it’s got a long shelf life, especially with how potent it is. I guess I officially have one thing I can thank China for, now, lol! Most likely, anyway… It seems like that’s where most of it’s coming from… If you know what I’m talking about. Hopefully it’s just legal to put terminally ill people out of their misery by the time it happens to me…
As recently as the end of the 20th century, in England it was acceptable for a physician to cite “old age” as an official cause of death. This was how the infamous Dr. Harold Shipman often claimed his victims died in his care.
See this 2001 article from the British Medical Journal insisting that “old age” should no longer be accepted as an official cause of death:
I’m not certain that it isn’t acceptable today in the UK.
ETA: I found this:
It says:
Old age, ‘senility’ or ‘frailty of old age’ should only be given as the sole cause of death in very limited circumstances.
So yes, it seems that in England it’s still okay in some circumstances to have “old age” as the cause of death.
Part of my job is filling out Death Certificates on people who have died and reviewing Death Certificates filled out by other doctors. While I don’t use it myself, I can tell you that “Old age” as a cause of death is alive and well. More often people write the medicalized variation, “Senescence”, or the empirical version, “Failure to thrive”.
In the ICD-10 it’s an R54.
Nowadays I get the impression its more common to ascribe death due to diseases of old age. Although we more or less try to convince ourselves they are diseases of lifestyle (lifestyle plays a role, but old age is the main culprit).
Vascular diseases, various kinds of cancer, lung failure, kidney failure, failures of the brain (dementia). Fundamentally the bodies self repair mechanisms fail with age, and various organs start to fail.
The death rate from vascular disease, cancer, organ failure, etc for people under 50 is a fraction of what it is for people in their 70s, 80s and 90s.
Not sure whether you’re asking:
“are modern official record keepers still allowed to use the term?”, or
“do doctors still just shrug and use the term “old age” when telling the family what happened or do they get more specific?”
I think the first question’s been answered, but I’d say the answer to the second question depends on how much information medical people had around the time of death. Two family members of mine in their late lives had quite extensive medical exams, diagnoses, treatments, and overall histories that resulted in very specific causes of death listed on their death certificates. They knew what the pre-existing condition/s was/were, and had a very detailed written history on which to assign the cause of death when the person eventually succumbed.
I could imagine it being harder for those medical personal to do so for an elderly deceased person with little to no medical history who didn’t go to the doctor for anything, lived a healthy lifestyle, seemed healthy to family members but just died in their sleep one night at 95. Are they going to do a bunch of tests to get to the root of why someone that old died if there is nothing else suspicious? The family might get such a general diagnosis in a case like that.
Unfortunately, my grandfather was in a lot of pain. Or at least, he claimed he was, and could (or did) not move around very well at all. He had multiple hospitalizations for falls in the last couple years, and they kept sending him to rehabilitation, when it was increasingly clear he was just getting too old to heal himself.
Out of curiosity I looked up my parents’ death certificates. My dad’s was practically a novel. His certificate says he died of:
Respiratory failure
Pneumonia
lung cancer
colon cancer
hypertension
It would be funny if it weren’t so morbid (oh heck, it IS funny - my father would have been the first to laugh). Geez, did they leave out anything? Might he have had a hangnail or something that they should have mentioned?
My mother’s certificate is shorter and arguably more gruesome: respiratory failure and brainstem hemorrhage.
ETA: both of them were 78 when they died; my father in 2008 and my mother in 2013.