Would you want to live to 100?
Remarkably, two in five girls born today will live for a century, and boys are close behind. But, asks Jeremy Laurance, is longevity all it's cracked up to be?
Jeremy Laurance is a writer on health issues. He is former health editor of The Independent and the i and has covered the specialism for more than 20 years. He thinks the harm medicine does is under-appreciated, the harm it prevents over-rated, and that cycling works better than most drugs. He was named Specialist Journalist of the Year in the 2011 British Press Awards.
Tuesday 22 January 2013
Human beings have dreamed of delaying the ageing process for millennia. From olive leaves in ancient Egypt to the alchemists' "elixir of life", vast resources have been spent – and still are today – on tonics, potions and vitamins in the attempt to stave off the ravages of the years.
Now we know the secret. Quietly, without fanfare, we are putting it to work. Life expectancy soared by 30 years in richer nations during the 20th century and shows no sign of slowing. In some countries it has increased by three months a year for the last 160 years.
When the British tradition of sending a telegram from the monarch to all new centenarians began in 1917, King George V dispatched 24 celebratory messages. By 1952, the number had increased 10-fold and by 2011 it had increased almost 40-fold to nearly 10,000.
Professor John Appleby, chief economist at the King's Fund, the health policy think tank, cites the figures in the British Medical Journal today and asks: "Where will it all end?"
That is an economist's question. For those of us alive today who may yet reach 100, there is another question: would we want to?
The Office for National Statistics has estimated that nearly 40 per cent of girls born this year will live to be 100, rising to 60 per cent for those born in 2060. Boys are not far behind. What we cannot know is whether, if asked, they would choose to live so long.
Jonathan Swift understood the question. Gulliver's Travels features a race of humans, the Struldbrugs, who were normal in all respects except one – they did not die. But their immortality, instead of being a blessing, was a curse, because they continued to age.
"At 90, they lose their teeth and hair; they have at that age no distinction of taste, but eat and drink whatever they can get, without relish or appetite. The diseases they were subject to still continue... the question therefore was not, whether a man would choose to be always in the prime of youth, attended with prosperity and health; but how he would pass a perpetual life under all the usual disadvantages which old age brings along with it."
In a recent article, Walter James, who celebrated his 100th birthday last year, wrote movingly of the deprivations of age, not on his body or mind, but on his emotions.
Though he still shops, cooks and looks after himself, does the crossword, enjoys a glass of whisky and can recall events from his past with clarity, what he cannot recover are the feelings and sensations that accompanied the events.
Recounting his sporting successes and sexual adventures, he notes the absence of the excitement and exhilaration that went with them. "My memory has kept the bones but lost the flesh around them."
He adds: "Perhaps the greatest loss is what it is like to be in love. I can remember the routines of being in love, the shared meals, concerts and theatres, walks in the country.
"But writing all this is like taking a book down from the shelf and leafing through its pages. What escapes me is that extraordinary sense, which so many share, of being in love."
Such observations are bound to make those younger wonder – is ageing, at the rate those of us fortunate enough to live comfortable lives in the West are achieving, something to be celebrated or feared?
The pace of advance is astonishing. As recently as 1980, scientists believed that age 85 would mark a natural limit for average life expectancy. In Japan that barrier was passed for women in 2007.
In the UK, average life expectancy for both sexes born today is over 90.
What is the secret – the elixir of life? It is not some fancy nostrum. Just better standards of living, education and healthcare. Dull, perhaps, but marvellously true. In the early part of the last century, improvements in infant and child survival contributed most to growing life expectancy, but since the 1950s the biggest gains have been in the over-80s – the pay-off for improvements in how we eat and drink, where we live and what we do. What worries most people about ageing is losing their faculties and the ability to perform the daily tasks of living – eating, dressing, bathing and getting around. The trends in this regard are worrying.
The good news is that despite increases in cancer and chronic conditions such as diabetes and arthritis, earlier diagnosis and improved treatments have rendered these conditions less disabling.
In the future, more of us will fall ill, but the illnesses should affect us less. The result is that we may live to see our great-grandchildren and even our great-great-grandchildren.
The bad news is that there are large differences between countries in healthy life expectancy beyond 65 – that is, years spent without disability – and the UK performs poorly compared with some of our European neighbours such as Italy and Belgium.
According to the 2010 Global Burden of Disease study, over the last 20 years healthy life expectancy in the UK has increased for women by 3 per cent at birth while overall life expectancy has increased by 4.6 per cent.
If ageing is to be celebrated we need answers to the personal, social, financial and health challenges it poses. One suggestion, proposed by Professor Kaare Christensen, of the Danish Ageing Research Centre, is to extend working lives by shortening the working week. It would be a way of keeping more people busy, solvent and socially engaged.
"The 20th century was a century of redistribution of income," Professor Christensen says.
"The 21st century could be a century of redistribution of work. Redistribution would spread work more evenly across populations and over the ages of life.
"Preliminary evidence suggests that shortened working weeks over extended working lives might further contribute to increases in life expectancy and health."
Work till you are 100? Now that would deserve a celebratory telegram.
Case study: Every day is dicey at my age – but if your faculties are intact, life is well worth living
Chapman Pincher, writer and historian specialising in espionage.
"If I live to March, which I have every intention of doing, then I will be starting my 100th year on the planet. When you reach my age you're grateful for every day.
I hope it will all go on a lot longer: I certainly don't want to pack it in yet, though it may pack me in.
It is the people you meet who make a life. If you meet dull people it'll be a dull life. I have known some extraordinary people.
I've always worked seven days a week, first as a teacher and scientist and then on Fleet Street – and an extraordinary life it's been. I still work every day and aged 98 I'm still producing some great big hairy books.
It's a case of 'use it or lose it', you see, and I have never ceased to use it. Everything depends on whether you retain your mental faculties or not. I am fortunate in that mine appear to be very much intact.
I can still remember the names of all the boys who were with me at school, I can recall every day of childhood, my career, friendships.
I remember practically every conversation I've ever had – in my entire career as a journalist I never took a single note.
Every day is dicey when you reach my age. Although I'm still up and mobile, I can't leave the house anymore but people come and see me.
I use the internet, and I'm on email.
Being 98 doesn't feel much different from being 40, except of course that you can't do physically everything you once could do.
But you learn to adapt and to grab it while you can."
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