Quick answer: What matters more than simply living a long time is ‘healthspan’ — the number of years lived in good health. That should guide personal lifestyle choices (exercise remains the single biggest lever), and it also matters in medical decision-making, especially for very elderly or frail patients where doing everything medically possible isn’t always the right choice.
When I was a boy I always got a Guinness book of records for Christmas. I loved reading all about the weird and wonderful records that people achieved. This week, I read about a remarkable record, although it appears the man in question wasn’t too bothered about receiving it!
Liverpudlian Mr Tinniswood became the oldest man alive in the world today, at 111. The previous world record holder, Venezuelan Juan Vincente Mora died aged 114 this week. Spain’s Maria Branyas Morera, who recently celebrated her 117th birthday, is the world’s oldest living person overall. The oldest man ever was Jiroemon Kimura who was born in Japan in 1897 and lived for 116 years and 54 days before dying in 2013. Frenchwoman Jeanne Calment, born in 1875, was the oldest person to have ever lived, dying in 1997 at the age of 122 years and 164 days. Scientists think that the first person who will live to be 150 has already been born!
Aside from not drinking or smoking, Mr Tinniswood didn’t appear to have any magical reasons for his long life, and put it down to luck. When interviewed he wasn’t too bothered about the record either. He did say a life of moderation was important however.
What is ‘healthspan’ and why does it matter more than lifespan?
In my personal view, I really don’t mind how long I live, and have no particular desire to live a very long time, provided I have a good quality of life. So called ‘healthspan’ – the amount of years a person has with good health, if far more important to be than lifespan.
I have written many times about how to improve lifestyle for healthspan, and will continue to update you with new evidence as it comes out (spoiler – exercise will always come top).
How does this apply to real medical decisions?
A good example of the ethical dilemma that we sometimes face in cardiology cropped up this week whilst on call which highlights this issue. I saw a man well into his 90s, who sadly had had a big stroke, and was significantly disabled as a result. His heart was going very slowly, and I was asked about putting in a pacemaker to treat it. He had no obvious symptoms of a slow heart rate (although communication was difficult). My own view was that if I was in his position, I absolutely would not want a pacemaker. Although the feeling of the healthcare team initially was that he should have one (because that’s how we treat slow heart rates) when I asked each of them in turn if they personally would want one in the circumstances, not a single person said yes. Just because we can do something in medicine, it doesn’t mean we should. There are often no black or white answers however, and others may feel differently. Perhaps a case to ponder, and think how you would wish to be treated if such a situation arose. It’s always good to know in advance what a patient’s wishes may be in advance.