Several days ago a politican (Dashel, I believe) made news by saying that elderly people are going to need to accept having medical conditions associated with aging without expecting treatment. He didn’t give any examples of conditions he thought would be best not to treat, but I got the vague impression this was directed towards medication.
If people didn’t have the access to modern medicines that they do now, but still had the same food and shelter conditions, how much would that reduce the average lifespan? When trying for the sympathy vote all politicians of every party trot out stories about how Edna has to choose between food and her pills…but how many elderly people are literally only with us still because of the handfuls of medications they take daily?
Well, my mom made it to 77 with a heart/vascular condition that, untreated, kills in the mid-40’s… I have a sister who would probably be dead two or three times by now if it weren’t for her defibrillator (alright, not a medication, but still treatment) who is only 51… and my dad is 80 and needs no medications at all. His father made it to 98 with no medications.
While there would, undoubtedly, be a number of folks living to extreme old age without drugs, a far greater number would need something. Keep in mind that some conditions - like high blood pressure, for example - won’t kill you immediately if you aren’t medicated but the wear and tear they impose over time can shorten the lifespan.
In some cases, the elderly might be better off with less drugs and a healthier lifestyle, but there’s no way to know how many would be able to make that change.
Genes make an enormous difference. On my dad’s side people routinely live into their 80’s and 90’s no matter what they seem to do or don’t do. On my mom’s side, without modern medicine about 50% would die in their 40’s, the rest would live into their 60’s or 70’s (I am really hoping I take after dad’s side of the family)
None of which gives you a definitive answer, but those are some of the factors involved.
Are you talking about drugs only once you get old, or the effect of drugs for the general population on average lifespan? When my daughter was about 6 she had scarlet fever. With antibiotics she was feeling better in 24 hours but a couple of hundred years ago people were dying from it. That’s just one example; there are other diseases that shortened the average lifespan in pre-antibiotic days.
Before insulin was discovered in the 1920s people with Type I diabetes did not live long at all once they stopped making insulin or in some cases they never made insulin at all.
It may be true that your grandfather wasn’t taking any medications chronically at age 98, I bet at some point in his life he got a polio vaccine or some penicillin for a pneumonia. It’s hard to quantify the effects those medications would have on the individual or the population as a whole. We’d be seeing tons of deaths due to infectious causes that would greatly lower the life expectancy.
Actually, I’m reasonably sure my grandfather, who was born in the 1870’s, never received a polio vaccine in his life, as he would have been in his 80’s when it was first distributed and he was (as I dimly recall) rather suspicious of such things. Granted, he probably did take some medications over the course of his life, but he had already lived a relatively long time before what we think of as “modern medicine”, including penicillin, was invented.
Just because we routinely prescribe antibiotics for something like pneumonia doesn’t mean everyone who gets those drugs would have died without them. Some would, some would have recovered. Frequently, it’s impossible to be sure which would be the case.
My father, however, would have died of peritonitis at a young age if a new, highly experimental drug had not just become available - that was penicillin.
My parents are Christian Scientists, which essentially means that they don’t use modern medicine. Both my mother and my father suffered from a life-threatening illness around the age of 55. (My mother died, while my father “caved in” to medication and is still here today.)
I don’t think anyone has the data to give a good answer to this question. Primarily because we don’t have a sizable population of people without medicine but with good modern hygiene and sanitation practices.
Forget antibiotics (which are amazing and changed the face of medicine), simply washing your hands after shitting and having good water treatment facilities has done more to extend our lifespan than any other single innovation or invention. So if we want to find out what the human lifespan is like without drugs, that should be the only variable that changes - we should still look at them with first world hygiene and sanitation. Where can we find that? I’m afraid the Christian Scientist population is probably too small to derive meaningful numbers from, plus, enough of them do “cave” to screw up the data. Still, might be a place to start.
However, the politician wasn’t suggested we do away with all drugs throughout the lifespan, merely some drugs at the end of the lifespan. So the question is: where do we want to *make *the average lifespan? If we’re going to withhold drugs we already have, it’s then up to us. Do we cut Granny off at 90? 80? 60? Entirely up to us.
A real understanding of life expectancy is pretty complicated. When we see the average person back-in-the-day had a life expectancy of 40, we assume that to mean that we’d probably expect to to die around age 40, right?
Well, not really. A huge chuck of deaths occurred in early childhood. In some parts of the world today, more than 10% of people die as infants. Kids face another round of dangers at two or three when they start encountering infectious diseases. So all these young deaths really drag the average down. But if you did manage to live past these danger zones, your ran a good chance of living into a reasonably old age. So the reality is more like you stand a good chance of living until 1, or living until 60 (or whatever) and your chances of dying at 40 are actually pretty slim.
This is the interesting question, in my opinion. It’s a theme in some fiction, including Joe Haldeman’s The Forever War(spoilers in link). For me, at least there would be little motivation to work until I was 67 if I knew I would be left to die from any random infection after the age of 70.
I’ve found a bunch of bloggers who seem to be saying Senator Daschle’s book recommends pushing our elders out to sea on ice floes, but I find that hard to believe. Has anyone read his book?
You have to remember that it’s not just drugs that keep us old codgers soldiering on.
There’s the added advantage of clean fresh water,stricter hygiene controls regarding food productions/distribution and a host of other benefits that were not available yonks ago.
I’m going to play a bit of devil’s advocate here and point out that, by some measures, Americans are OVER treated for medical conditions. This was brought home to me by my mother’s recent final illness. The doctors and hospital were very insistent at running tests and treating a dying woman who repeatedly stated she just wanted to be left alone (and yes, she was aware of the consequences of being left alone). We had to FIGHT to get her into hospice, we were accused of “giving up” on our mother, and various other unpleasant things. Fact was, the ONLY thing that could have fix the immediate problem was surgery, and mom was far too frail to survive surgery. Nonetheless, it was poke-poke-poke with tests and useless treatments because of that urge to DO SOMETHING that doctors have.
We probably could have saved “the system” 10k or 20k easily if we had been able to get her into hospice a week or two earlier. She certainly would have been more comfortable and happier. I doubt it would have made a difference in her eventual date of death.
Yet, I have no doubt that other families in similar situations would yield to the doctors who want to keep fighting. That’s why the majority of old people die in hospitals and not at home. It would have cost, at least, tens of thousands of more and it doesn’t do anyone a damn bit of good. It’s a case where less really is more, but nobody wants to hear that because we’re all so used to measuring value in dollars.
On the opposite end of the spectrum, people with simple ankle sprains should not be getting MRI’s, but that’s certainly not unheard of, even common. The US probably has more MRI machines that all of Europe combined, yet we aren’t any healthier. A lot of testing and imaging technology really is overused, but again, we’re used to measuring in dollars and nothing else.
And finally, the links given whine about the government deciding what healthcare you do and don’t get, but right now that’s EXACTLY what private insurance companies do because, realistically, if you don’t don’t have insurance a lot of medicine is priced out of the range of all but the very wealthy. At least with the government there is an opportunity to change things by public consensus, votes, and the like but the public has no control over the decision-makers in private health insurance companies. How is that better?
**Broomstick’s ** story is a prime example of why everyone should have a health care directive listing what treatments he/she does and does not want, plus a trusted person around with a durable power of attorney for health care.
In response to the OP, I am quite sure that many of us oldsters are still living good, happy and productive lives specifically because of our meds. I know anectode != data, but my husband (now travelling in Portugal) would have died before the age of 50 without open-heart surgery. Because of the several meds he takes, his cholesterol, blood pressure and general cardiac health remains excellent. He’s going to be 67 in a few months, and clearly has more living to do. I’m quite sure there are many more like him.
I already mentioned that several times, but it’s untrue. Even though infant mortality dragged down life expectancy a lot, plenty of people did die in their 40s. Dying in their 40s from natural death was the average for the kings of France between 1000 AD and 1500 AD, for instance, and almost none or maybe none at all (can’t remember right now) made it to 60. Even letting out mortality during early childhood, people didn’t use to have long lives by our standards. Dying before 50 was quite normal.
“Accepting conditions that come with age” doesn’t necessarily mean abandoning lifesaving drugs or surgery. Most likely, it means that Daschle envisions doing without expensive drug regimens that treat the day-to-day symptoms of aging. This may, in fact, be the worse idea – most lifesaving treatments don’t restore the elderly to full health, but treating arthritis and other degenerative conditions associated with aging adds vitality and purpose to the the final years of life. Not to do so could consign otherwise healthy people to years, even decades, of needless misery.
I kinda think that people should be more willing to just give up when they can’t live outside a hospital, and that their loved ones should be more willing to let it happen – but I’m not sure I can advocate it as US fiscal policy.
I read somewhere that a big chunk of health care money is spent in the last few months of life and in many cases the money does no good, it just prolongs suffering in many cases
Quality of life dude, it’s all about the quality of life.