Squaring the Mortality Curve or Extending Longevity?

Healthy Life Extension

Funding Aging Research

Squaring the Mortality Curve or Extending Longevity?


posted on February 4th, 2013

Dear Future Centenarian,

Both.

The majority who die from aging don™t usually do so comfortably or quickly. They linger with pain and accelerating debilitation until life ends.

There are those who prefer to spend scarce resources to œsquare the mortality curve. That means instead of lingering for years, they suggest that a better alternative is to keep people healthy as long as possible and then have them pass relatively quickly and peacefully.

That™s actually a good option if we had a choice¦ and if it were simply either/or. But what about a third choice¦ unwinding the mysteries of the aging process so we age without aging?

Now I™m all in favor of squaring the mortality curve. Anything we can do to avoid suffering and premature death is obviously positive. But not at the expense of solving aging. Dying badly or dying comfortably is still dying. And we aim to avoid premature death at all costs.

And by œpremature, I mean dying from aging. Someday, it will be unheard of. And the sooner we can speed up that day™s arrival, the more lives we™ll preserve.

Reason uncovered some interesting data on this topic:

http://www.fightaging.org/archives/2012/12/compression-of-morbidity-versus-increasing-longevity.php

Back in the Fight Aging! archives, you'll find a post on breaking out historical data on increases in human longevity into two components: firstly an increase in the average years lived, and secondly a reduction in early mortality - that more people are reaching ever closer to the average.

This second statistical behavior is often presented as compression of morbidity (squaring the mortality curve), with the goal being to reduce the time spent in ill health at the end of life.

There is some debate over whether compression of morbidity is in any way a realistic or even useful goal for medical science, as opposed to aiming for increased human longevity through repair and reduction in the ongoing damage that causes aging.

If you consider aging in terms of reliability theory, for example, it seems dubious that one could engineer the machineries of human life to last a set time and then fall apart very rapidly at the end - at least not without deliberately making it fall apart at the end. If all you are doing is consistently removing damage, then you extend the length of life, but don't do much about the time taken to fall apart when you stop repairing damage.

In any case, here is a recent paper that revisits this structural decomposition of increased longevity. The researchers here suggest that it is longevity, not compression of morbidity, that is the important factor:

In low-mortality countries, life expectancy is increasing steadily. This increase can be disentangled into two separate components: the delayed incidence of death (i.e. the rectangularization of the survival curve) and the shift of maximal age at death to the right (i.e. the extension of longevity).

We studied the secular increase of life expectancy at age 50 in nine European countries between 1922 and 2006. The respective contributions of rectangularization and longevity to increasing life expectancy are quantified with a specific tool.

For men, an acceleration of rectangularization was observed in the 1980s in all nine countries, whereas a deceleration occurred among women in six countries in the 1960s. These diverging trends are likely to reflect the gender-specific trends in smoking.

As for longevity, the extension was steady from 1922 in both genders in almost all countries. The gain of years due to longevity extension exceeded the gain due to rectangularization. This predominance over rectangularization was still observed during the most recent decades.

So maintain you healthy habits, but never lose sight of what™s going to preserve your existence, not just delaying what most still regard as œthe inevitable.

More Life,
David Kekich
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