Take Optimal Care of Your Health and the Odds of Reaching Age 90 are Still Poor with Today's Medical Technology

It is important to take good care of your health. This means the simple, sensible lifestyle choices: stay fit, stay lean, don't smoke, and so on. If you don't do this, then you'll have a shorter and less pleasant life. You'll spend much more on medical expenses. It is worth the effort to evade those outcomes. But don't believe that you are going to beat the odds on longevity in any exceptional way just because you took good care of your health. You'll likely beat the odds in a minor way, but two thirds to three quarters of the healthiest people in the world die before reaching age 90. That fraction only increases for everyone else, as today's open access paper well illustrates.

The point to take away from this is not to fixate on the world of health and lifestyle. Just do the simple, sensible things, and don't make a big deal of it. Have a reasonable expectation of the outcome. If far greater healthy longevity is the goal, then the only way you, I, or anyone else can achieve it is through the development of rejuvenation therapies that can repair and reverse the causes of aging. Aging is a process of damage accumulation, followed by all of the harmful downstream consequences of that damage. Repairing that damage periodically is the only way that we will be able to reliably live much longer in good health. While the first, crude rejuvenation therapies exist, senolytic drugs that can destroy some of the senescent cells that harm tissue function in later life, they are only a first step on a long road. A lot of work lies ahead. Consider helping.

Survival to Age 90 in Men: The Tromsø Study 1974-2018

The 738 oldest men who participated in the first survey of the population-based Tromsø Study (Tromsø 1) in Norway in 1974 have now had the chance to reach the age of 90 years. The men were also invited to subsequent surveys (Tromsø 2-7, 1979-2016) and have been followed up for all-cause deaths. This study sought to investigate what could be learned from how these men have fared. The men were born in 1925-1928 and similar health-related data from questionnaires, physical examination, and blood samples are available for all surveys. Survival curves over various variable strata were applied to evaluate the impact of individual risk factors and combinations of risk factors on all-cause deaths. At the end of 2018, 118 (16.0%) of the men had reached 90 years of age.

Smoking in 1974 was the strongest single risk factor associated with survival, with observed percentages of men reaching 90 years being 26.3, 25.7, and 10.8 for never, former, and current smokers, respectively. Significant effects on survival were also found for physical inactivity, low income, being unmarried, high blood pressure, and high cholesterol. For men with 0-4 of these risk factors, the percentages reaching 90 years were 33.3, 24.9, 12.4, 14.4, and 1.5, respectively. Quitting smoking and increasing physical activity before 55 years of age improved survival significantly.

The main finding of this study is the huge reduction in observed life length for men with two or more of the risk factors identified in this study, i.e., current smoking, physical inactivity, low income, being unmarried, high blood pressure, or high total cholesterol. Reported in adult mid-life, these risk factors started to take their toll as early as approximately 55 years of age, and over time, more and more lives were lost. The large effect of lifestyle characteristics at adult middle-age was further underlined by the decreasing survival time and smaller number of men reaching 90 years of age that was observed with increasing number of risk factors. Although each of these risk factors alone was associated with premature death, their massive joint effect emphasizes the benefits of eradicating as many of them as possible.

Comments

Senolytics alone will not do miracles. My estimate is that they will make people live 5 to 10 more years. Even a super agressive kurzweilian regimen of 50 differents senolytics wont make you live to 120.

Posted by: Jonathan Weaver at June 19th, 2019 4:12 PM

The senolytics could help and give like + 5 to 10 years and there might even make somebody who would normally love up to 120 can reach 130 but in the general case will add just a few extra years. Alternatively, they might "square" the survival curves and bring higher benefits to those who would have died prematurely otherwise. That some would be impressive . Does it work as a miracle... Depends on your yard stick. Do antibiotics qualify for a miracle drug in the point of view of 19th century , it even the 1920s?

Posted by: Cuberat at June 19th, 2019 4:41 PM

@David Permisov: That's true, but at the same time there's a very robust body of evidence behind the theory that senescent cell buildup contributes substantially to degenerative aging. Unity hasn't even demonstrated that their drug candidate is killing senescent cells.

Posted by: Dylan Mah at June 19th, 2019 5:03 PM

@Reason: saying that the odds of reaching age 90 are still poor (only 25-33%) with today's medical technology is misleading... risk of death was greater at younger ages in the cohort under exam and this affected numbers early.

Infant mortality was much higher (it decreased by 95+% since 1915), and even if the healthiest middle aged individuals in the cohort didn't need statins or beta blockers, they couldn't benefit from other chemopreventive interventions, which were unavailable at the time, for issues other than high cholesterol and high blood pressure.

And of course early detection, new surgical techniques, and immunotherapy started impacting death rates from cancer after most men in the cohort had died from cancer.

Finally, while I couldn't read the whole article because of the paywall, it seems that the study says nothing about diet and BMI, whose impact, however small, would make a difference in the percentages.

My point is, it is not super helpful to try and predict life expectancy using data from past cohorts even if we believe that there won't be any improvement whatsoever on today's medical knowledge.

Posted by: Barbara T. at June 19th, 2019 6:27 PM

Hi there! Great study over a long time. Just a 2 cents.

''Significant effects on survival were also found for physical inactivity, low income, being unmarried, high blood pressure, and high cholesterol. For men with 0-4 of these risk factors, the percentages reaching 90 years were 33.3, 24.9, 12.4, 14.4, and 1.5, respectively.''

It is surprising (or not so surprising (how fragile we are)) that just 1 single risk factor messes things.
It's funny that you have more chance of reaching 90 if you have high blood pressure, than if you are unmarried (14.4 vs 12.4). Shoot...1.5% if you have high cholesterol (I might as well be dead, here I was taking I would reach 100 lol...might as well laugh instead of cry to death). Atherosclerosis is the most killer of men. More so than smoking or having hypertension as shown here.
They did not talk much of cancer, so I am guessing cancer was overall not strong enough, because with it you don'T reach 90. Unless it's controlled and not ultra-invasive type of cancer. They should have given more infos about cancer and other CVDs (just going from quote here). Obviously, they survived their cancer(s) or CVDs to make it to 90, but it would fleshed things more.

It's telling that high cholesterol is the Least of all survivor - yet here i am talking about it and having survived it (but still living of the damage of it).

1.5%... my odds are not so good after readin this.

My take is that unmarried men can suffere of diseases quicker because of loneliness or become bitter/angry...'grumpy hermit'. And not 'Getting any'...while at the same time, sex causes aging...
so it's rather ambiguous...I think the strongest element is that the married men, if are in a healthy loving relationship, obtain satisfaction, love but also, Reduction of Stress = reduction of stress/oxidative stress/stress hormone = reduction of mTOR. When you are alone, loneliness can stress you overtime, you are alone, doing it all Yourself...no support...it's just you.
And,, some days, you do get angry - alone. Are there bad relationships/toxic...that stress you..absolutely, it's why it is better to be alone than badly accompanied..that stresses you out.But, in men, the statistics show a more favorable effect on women 'on men'...meaning the health promoting effect protects them - but when alone, unmarried, unless you Are Really Careful..and do everything right...your health can degrade faster -alone, as man. This effect is less visible in hermit women who live alone their whole life, single and that's it, no partner. That's because women, at the start, having double XX chromosomes are more protected than men, men have Xy configuration, which means compromised genome (y is less than X cap) thus are handicapped from birth. Women are advantaged genetically wise because of natural selection/for specie survival/women matter by birthing, men less so, once they procreate nature sees less point to men than women - who can continue to birth/make survivability of the specie. Hence, men handicapped by this genomic 'handicap' made by nature, on purpose. Thus, women live longer lives in general and 10 centenarian women for 1 centenarian man is a tell-tale tale that women are biologically younger/neotenous - earlier and for whole life (like 'extra telomere' right off the bat, that helps, later), some women are in their late 40s and look 19 years old (like eternally young/due to high estrogen/TERT activation/keep juvenility features into very late adulthood)...some no and look early 60s...but more women, overall, live longer lives than men (because of these genetic reasons).

It was shown that mental stimulation - by a woman - talking with a man..and not just a woman..woman/man..whoever...just 'talking' with someone creates neuronal improvement...so you can bet living alone as unmarried man will accelerate loss of brain function. Yet...my uncle was married whole life and still died of Azlheimer's..goes to show, it's a clusterf...You need to stimulate your brain to stop brain degenerescence mucvh quicker..in men. thus, having a wife/married...but for single people (like me), you have to be more careful...

so how do to that...family support..friends..etc...make 'conversation' something 'Special' that you want to do (even if you don't want at all..and you could not care about anyone/outside...your 4 walls...being hermit is great for 'ignorance is bliss...'..but ignorance can kill you..like not walking to keep up/live a sheltered lonely life as man...it could hurt you. By having a 'network/cast of friends..family..' you mitigate that..that's what studies showed, you can avert the problem of being single and dying younger..if you keep a 'social' aspect intact and do not live 'closed door' and never talk to anyone ...like a monk...even monks are not that hermit after all..they congregate still...it's whyn you are TRULY alone and never talk to anyone ever...that can be bad in long term..you must stimulate brain to compensate this lack 'of human connection/talking..etc..'. It's also why I recommed to not leave Internet completely 'go in the dark'..because you cut the 'entire social world' outside..and you become a hermit recluse..what you have to do is to remove the 'Stressful' elments (no drama) in your life pertaining to social world (like Twitter Facebook 'online dramas' or 'online dramatic news'...stresful...avoid that) concentrate on nurturing health promoting relationships, this will reduce your stress levels and you will have less 'high blood pressure' becaus of that.

But that's not enough...I did these things and tried to reduce stress..and be happy and everything and high cholesterol happned anway because I was consuming junk food/cholesterol rich food and have predisposition for it..so it meant..that I had to cut the main cause...and that's what I did.

For men with low income, it'S a good sign...you still have solid chance..because if you keep positive despite having no money..you have better outlook and mental health..it helps over long term..again less stress. Lacking money = Mental Financial Stress = No sure if will have a place to live or be fed / live another, fed = Resource Lack Fear.

Physical inactivity and smoking are self-explanatory, we need a few thousands 'footsteps' each day...and mild/moderate to slightly intense exercice is good to improve fitness/health. Quitting smoking, best thing you can do because many carcinogens in cigs...it's funny that I can die more than everybody else simply because I have the most killer disease (high cholesterol/atherosclerosis/embolism). They did not talk of type II diabetes, but it surely an important one..it contributes to aging and many problems (collateral)..but if you control diabete it's mostly ok (my father has type II diabetes and is 72, is mother lived to 92 and his dad died at 56 pf liver cirhosis (alcoholic)...yeah it's bizarre and all over the place). Don'T drink too muhc, just a bit of alcohol, and red wine/quecertin/resveratrol has benefits, there are some forms of red wine with no alcohol in it. just the red grape juice. Alcohol is a killer too (of men mostly), like it did for my grand-dad; there is a 'dose-response' with it...less than a few % of alcohol a day..otherwise studies showed the inverse effect where high alcohol causes High Cholesterol LDL and oxidative stress (fatty liver...cirhosis/or atherosclerosis).

Just a 2 cents.

Posted by: CANanonymity at June 19th, 2019 10:10 PM

Really? I'd say someone who doesn't take drugs, drinks moderately, exercises, has a healthy diet and controls their weight has a very good chance of making 90 years with ZERO other interventions.

Posted by: Mark at June 20th, 2019 4:20 AM

@Mark
Has a chance. With access to the nicer medical help has a good chance. But still not 90%

Posted by: Cuberat at June 20th, 2019 7:30 AM

I think 90 years is achievable, not for everyone, but for the majority (which will be mostly women). We can look at life expectancy in Okinawa 30 years ago, it was close to 90 and they didn't have todays healthcare or screen for cancer. All of them didn't eat healthy or exercised daily.

Posted by: Peter Lind at June 20th, 2019 4:41 PM

@Peter Lind
There might be a huge selection bias with the Okinawa cohorts. The ones reaching 90 years must have survived the world war II. So the week and disease prone individuals were filtered out before. And until 30 years ago the Japanese had to move more and their food was relatively more expensive.

There's also a theory that a lot of the longevity in Japan might be attributed to pension fraud where the deads are underreported and the proposal care takers keep collecting the pensions. And for people reaching the and over 90, it means that they have lived through many periods were the birth and age records could be corrupted.

On the other hand, smoking and expose to cancerogenic chemicals was so widespread before that only by taking these changes in our lifestyle cold bring a few more years of life expectancy. And if we add the improved health Care then we have to at a few more years. There are better medicines , detections and such. The operations are less invasive and the diseases are better understood. (Probably due to the better understanding there are more cases reported and detected )

There are also bad tends where the health care becomes more expensive father than the inflation and takes ever career portion of the works GDP. ( The US might be more expectative than the test or OECD counties but all of them face huge cost problems) we love longer. Become older and need more healthcare. And the better the health care the older the population becomes. And without rejuvenation and anti-aging therapies in 20 years the current students will collapse and there would be very some very painful societal adjustments.

Posted by: Cuberat at June 20th, 2019 9:06 PM

@Cuberat: that the Okinawa cohort we are talking about went through war means that more of them died young than they would have under different circumstances. Which means that natural life expectancy for them could be even higher than 90 - not lower. Life expectancy is calculated from birth, not from after the weak have been weeded out.

Posted by: Barbara T. at June 20th, 2019 9:45 PM

Cuberat, I view the rising health spending as a rational decision. In a society where everyone has enough food, shelter, clean water, etc.. what really matters is health care. Well the other big one is entertainment, which is also growing by leaps and bounds.

As a higher percentage of the economy gets spent on health care, it means a higher percentage of the workforce is devoted to health care. I view that we need a vast expansion of researchers in health care, especially pharmaceuticals. Right now just 2% of the economy is prescription drug spending. I view it should be 10% of the economy. And I think it will get there, just it will take a long time, the next stop is 3% of the economy.

The other thing about costs, is that a cost to one person is revenue to another.

Posted by: aa3 at June 21st, 2019 1:23 AM

Senolytics look to be an important piece of the puzzle. You know in advanced areas of medicine, we are already into the era of polypharmacy. You take several medicines each with different mechanisms of action that are beneficial to the disease.

Each new advance by the pharmaceutical corporations is another drug you take, in addition to the drugs you are already taking. The standard of care advances in this way.

Sometimes with say diabetes it takes 3 or even 4 medications to get the persons' glucose levels under control. That is the way I see anti-aging medicine going.

Posted by: aa3 at June 21st, 2019 1:34 AM

The post makes a fair point. Too many people on here assume they'll make it to 90 as a foregone conclusion. That said, a truly health conscious person (which the people in this study were not) should be able to increase their odds beyond 25-33%, even with today's technology.

Virtually all these deaths would've been caused by cancer, heart disease, or stroke. Aside from the 4 risk factors mentioned, doing things like getting cancer screenings, monitoring your own BP frequently with apps, knowing the signs of stroke or heart attack and living near medical help, having a cellphone/lifealert ready along with an emergency asprin, stress reduction techniques, etc should help up the odds.

Posted by: kel at June 21st, 2019 4:12 PM

Can, I think 1.5% is the survival rate for someone with 4 of the 5 risk factors, not the rate for someone with only high cholesterol

Posted by: JohnD at June 21st, 2019 6:03 PM

Jonathan Weaver, look at japanese. They do take only one single senolytic, wogonin, and some of them do live up and beyond 120 in good health.

Posted by: SilverSeeker at June 24th, 2019 10:30 AM

My immediate experience with aging involves my mother in mid 90's... about the only exercise she gets is getting to the bathroom...short-term memory is poor..still seems "rational" but might be starting to forget people. Still gets out and plays cards/bingo...can boot her computer and play solitaire.

A neighbor is 89...now having walking issues...seems mentally glued together.

I have neighbors on 3 sides that have congestive heart issues (70s-80s?)...seems to be an epidemic.

Really looking forward to getting older....LOL. I'm just working to get to 80 or so....then will think about it a bit more....

I do take many supplements...try to stay active and do all my repairs...house...cars...computers..etc. My belief is that repairing and fixing stuff keeps one on one's toes...where the rubber meets the road...you either fix or do something right...or you can be in deep do-do real quick. Play video games and read way too many emails.

So eat your veggies...keep up your protein levels...keep moving...challenge yourself in various ways...but use some wisdom to understand the kinds of things you don't do well and avoid them?

No longer do politics....can't beat stupid with a stick. Do not believe that socializing is all that positive...seems the only people I know end up dumbing me down more than anything....that's an advantage of the "online world"...at least there are some people and ideas you can relate to...

Don't know everything but still trying to learn...seems that the more knowledge you have when you die...the more of a winner you are.... ;-) Probably beats trying to be stupid?

Posted by: norm at June 25th, 2019 8:15 AM

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