Health In Later Life

It’s not just longevity, it’s the years of good health that are important

A recent post, anticipating a 100-year life, reminded me that it isn’t only lifespan that’s important for the enjoyment of life: healthspan (meaning our years of good health) is just as important. Adding more years of life achieves little if those years are unhealthy. So I’ve assembled some thoughts on healthspan. Far too many, it turns out, for a single blog post. So I’m going to divide it up into three posts, of which this is the first.

This one is on the fact that many people naturally interpret lifespan as the healthy years – in a sense, this is the setup for the following two posts. The second one will be about aging with dignity: the notion that medical procedures have length of life as their goal rather than enhancing our psychological well-being. And the third will be about the fact that, while lifespan is easily measured (at a given moment we’re either alive or we’re not), healthspan is much more difficult - indeed arbitrary, in a sense – because our degree of health is not precisely defined.

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OK, on to the first one. And I’ll present it as an interview. Before writing my Life Two book I conducted a number of interviews, and assured those with whom I spoke that I would assemble their thoughts with the thoughts of others as being those of fictional composite characters, the purpose being to ensure that nobody would be able to identify them from what the fictional composites said.

So here’s a portion of the resulting interview, with an interviewer and three composite panelists. The Interviewer starts by asking Panelist One what the phrase “your future life expectancy” brings to mind.

Panelist One: That’s how long I’ll live. And you know, that keeps me awake at night!

Interviewer: Why is that? 

Panelist One: I’m sitting in a genetic pool with great activity. My great-grandmother went to 112, and at 99 was cross-country skiing to get around. So I’m going to have to cope with probably a very long life. I’m amazed at people who say: plan as if you’ll live to age 90. That’s not nearly long enough for me! I notice long-lived people all around me. A family friend, still living in her own home, is 107. I’m very, very cautious about this – and afraid.

Interviewer: Why afraid? Is a really long life not something you want?

Panelist One: Of course, it’s what we all want – until we think about it. But it has a couple of bad aspects, potentially. What if my body outlives my mind? That scares me. And then there’s the financial consequences. What if things become much more expensive? You know, all in all these thoughts make an annuity almost an automatic decision for me.

Interviewer: Gosh, you’ve thought about this very deeply! Let me turn to Panelist Two next. How about you? Same sort of family history, or different?

Panelist Two: Same sort, kind of. Not as extreme – yet. My parents are 84 and 74. I’m a health and fitness person, so I ought to have a long life. The first ice storm of winter makes me think about how I’ll have to walk on ice at 85 – that’s when I think about longevity. My friends joke and say: no need to worry, you’ll be in a home! I compare the amount of stress across the generations.

Interviewer: Meaning what, exactly?

Panelist Two: Do I have more stress than my parents? Certainly I have a different kind of stress – things are physically laborious for my parents, and for me it’s mental stress, whereas they’ve stayed mentally innocent. So if I end up with physical stress too, that’s bad.

Life expectancy to me is not so much about length of life as about quality of life. It’s only a healthy lifespan I’m interested in. This year my husband and I visited friends in Iceland, which is surely unusual – but we did it because one day it’ll be too late.

Expectancy is full living, enjoying things while we’re healthy, not just extending life regardless of its quality.

Interviewer: And Panelist Three, how about you? What are your thoughts on the subject?

Panelist Three: Life expectancy to me implies life balance. How many years will I live? My parents went at 77 and 84. My mom had dementia. My older brother died at 70, of a rare form of dementia. My older sister is developing dementia at 76. Fortunately, no sign in my other siblings. But I don’t want to plan beyond 80. It’s not likely to be a healthy life. I don’t want to be in a retirement home. It’s only a healthy lifespan I’m interested in. Quality of life is all-important – without it life is nothing.

Interviewer: I’m not sure what I expected. But my takeaways are these (and yours may be different). First, while the numbers are important, it’s the quality of life that really counts. Second, the numbers could be big ones – and the longer we live, the tougher things get, potentially, both financially and psychologically.

The question of our future health is a scary one, and there are few population statistics that tell us much about that issue if we’re currently healthy, as we’ll see later.

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Takeaway

People naturally interpret lifespan as the healthy years.