Anything that we are good at treating doesn’t seem like an age related disease anymore, but we’re really clearing out the scourges if you look at historical cause of death statistics. We haven’t made any progress on Alzheimer’s, and have conquered yellow fever, consumption, diabetes, knee failure, glaucoma, smoking related lung cancer, prostate cancer, hookworm, environmental lead poisoning, environmental arsenic poisoning, black lung, breast cancer, and syphilis. So, if you know someone old and suffering, its probably alzheimers.
hn_throwaway_99 · 1d ago
Most of the conditions you've mentioned there have exogenous causes (i.e. diseases or environmental toxins), and I question your inclusion of many of the ones that don't (who thinks we have "conquered" breast cancer??).
But we have made very little progress in staving off degenerative-type diseases. Even the primary degenerative disease you mention, knee failure, we cure largely with a wholesale replacement. That obviously isn't applicable to organs we can't just swap out.
owenpalmer · 23h ago
Swapping out organs may be an option in the future. I'm getting a bioengineering degree so I can't work in organ engineering research. We're definitely not there yet, but there's a lot of interesting research happening in this area.
giantg2 · 23h ago
I agree. Rates of cancer and diabetes are up. We might have better treatments than in the past, but I though I even saw graphs showing that overall cancer fatalities rates are flat - a lower percentage of people die from it, but the increase in cases mostly offsets that (depends on the specific type).
BurningFrog · 22h ago
One angle is that as we find cures for other diseases, cancer rates go up because we live long enough to get cancer.
The sum of all causes of death will very likely continue to be 100%...
leereeves · 21h ago
> The sum of all causes of death will very likely continue to be 100%...
If not, we'll have a whole lot of new problems.
groby_b · 20h ago
"Conquered" is a loaded term, but a 43% reduction in mortality since 1990 is nothing to sneeze at.
The 5 year survival rate for localized (early stage) breast cancer is 99%
Did we remove it as a cause of death? No. But the prognosis is much less dire by now than it was even a few decades ago.
Very few causes are ever completely "conquered", they just move down in relative relevance.
hn_throwaway_99 · 18h ago
A huge part of that increase in 5 year survival rate is just earlier detection, though.
I fully acknowledge that we've made large strides in understanding and treating breast cancer, but in most cases, once it spreads it's still "game over", and so it is still an immensely fearful experience for people to go through. Contrast that with, for example, HIV. 35 years ago it was probably the scariest disease there was, considered a guaranteed death sentence. Now it is largely preventable with PrEP, and treatments are so good that it is a manageable condition with lifespans on par with HIV-negative people for most of those who diligently follow their treatments.
thinkingtoilet · 1d ago
We have by no means conquered prostate cancer. It is still extremely deadly.
hwillis · 23h ago
The average age of diagnosis is 67 and 95% of those men live as long as you would expect them to normally. It is certainly not cured, and treatment can be very disruptive and unpleasant, but it's definitely not "extremely deadly" with modern medical care.
fridder · 22h ago
Perhaps not but when it is aggressive, it is very deadly. They told my dad they were thinking he could have 10 years, he got three. Seems like when it stops responding to hormone suppression things can deteriorate quickly.
hwillis · 21h ago
Even with Gleason score 10 (<1% of cases) most patients will survive more than 3 years. Median survival for score 9 (~10% of cases) is ~10 years. Unfortunately your father was an exception. Cancer is an awful, crippling disease and I'm sorry it took your father.
It makes up for that in being common though. The most common cancer in male non smokers and fifth leading cause of death worldwide (presumably amongst males https://pmc.ncbi.nlm.nih.gov/articles/PMC6497009/)
hwillis · 21h ago
Death statistics are not a good measure in this case. The large majority of prostate cancer is very slow growing and occurs late in life. The goal of treatment is not to cure- just to slow it down. Many of those deaths are nearly at the age they would have died anyway and had a full life because of the less-aggressive treatment. Most people will live another 15+ years.
That stands in stark contrast to lung cancer, which has a median survival time of ~15 months. Pancreatic cancer usually kills you in less than a year. Colon cancer is better, but still only ~6 years. Leukemia and Lymphoma can occur in middle age or even in early childhood, and rob an entire lifetime.
AstroBen · 21h ago
> live as long as you would expect them to
We also need to think about quality of life, which tends to go way down after you're diagnosed with one of these diseases
Prevention and delay is significantly better than management or even curing
hwillis · 21h ago
For the majority treatment is pretty minor, which is reflected in all-cause mortality. Pill-based chemo is much more common now and patients do not need to relocate and isolate as much. Cancer is still terrifying, and in almost all other types of cancer people vastly underestimate the life impact of "survival". Young people with localized Hodgkin lymphoma have a ~90% chance that they will never have a recurrence, but the chemo (which is extremely well tolerated!) can still regularly be life-altering.
That said prostate cancer is most of the time not a big deal. Getting prostate cancer will still probably the most dangerous thing that ever happens to you (how many single events have a 5%+ mortality rate? besides birth) and should be treated incredibly seriously, but the odds are still good you'll be fine.
samastur · 23h ago
Not being extremely deadly is low bar since most of your life (with some luck) will be spent being old. I'd rather see my years being more than bearable.
hwillis · 21h ago
You certainly will not live most of your life over the age of 67.
windowshopping · 23h ago
I know, I read that list and I was like "what?" Since when is even half of that stuff "conquered"?
ryandrake · 23h ago
I agree. To me, using the very strong word "conquered" implies that a condition or disease is eradicated, like smallpox. Or, at the very least that we have a reliable way to prevent it.
CGMthrowaway · 1d ago
Worth adding to the list are osteoporosis, secondary infection, hearing loss, macular degeneration (need more advancement here), hypothyroidism, chronic kidney, acute consequences of heart disease/ stroke prevention.
Not all of the solutions can be called "cures" but a solution nonetheless is better than nothing and calling it "old age, shit out of luck."
genezeta · 1d ago
Parkinson's fairly frequent too.
close04 · 1d ago
> and have conquered yellow fever, consumption, diabetes, knee failure, glaucoma, smoking related lung cancer, prostate cancer, hookworm, environmental lead poisoning, environmental arsenic poisoning, black lung, breast cancer, and syphilis.
What's your definition of "conquered"? In the US breast cancer is the most common type of cancer, and together with lung cancers account for ~500k cases each year. 100k of those people will die within 5 years.
Now we created new issues to replace the old. Microplastic, PFAS, antibiotic resistance, obesity, etc.
And my knees want to have a word with your assessment :).
Qem · 1d ago
I also wouldn't count prostate cancer on the "conquered" group, as recent news about the great Scott Adams reminds us.
aesclepius · 1d ago
Scott Adams, the Holocaust-denying, vaccine-denying and anti-diversity, equality and and inclusion, cartoonist?
Qem · 21h ago
He's a flawed human. But his masterpiece, Dilbert, is a gift to humanity. I hope the legacy of his masterpiece will last much longer than that of any BS views he has.
leereeves · 21h ago
Wikipedia says DEI seeks to "promote the fair treatment and full participation of all people". That sounds great.
If only it actually worked that way instead of being code for favoritism for a few demographic groups, ignoring many other people who are excluded, and actively discriminating against straight white men.
Scott Adams is right to challenge it.
Edit: Disney exec admits on hidden camera "Certainly, there have been times where, 'there's no way we're hiring a white male for this'"
For anyone who saw the flagged comment: I found this: Scott Adams has questioned the methodology behind the figure of 6 million Jews killed in the Holocaust, suggesting it may not be as well-documented as commonly believed. However, he does not outright deny that the Holocaust occurred, stating that "no reasonable person doubts that the Holocaust happened."
myrion · 23h ago
There's no much difference between the two positions, and the former is very much a lead-in to the latter.
shermantanktop · 23h ago
Denial of facts usually starts with reasonable-sounding inquiry into the details, which makes nuanced discussion of data very hard. Asking if the real number was maybe 5.75 million puts you in company with deniers.
cogman10 · 22h ago
He has a lot of weird anti establishment takes. For example, that evolution isn't real [1]
I'm not 100% on the reasons. Seems like he simply has a lot of hubris.
That's another misrepresentation. In that link he says "To be fair, there’s still plenty of evidence for evolution."
It sounds like he's a skeptic who demands proof of the things we're not supposed to question. That's a good thing.
But some people don't like it and misrepresent his words to try to discredit him.
Edit: I agree that Adams is not a scientist and doesn't understand how science works. That article gets an F in my book. Nonetheless, suggesting that asking questions is the same as claiming something "isn't real" is, itself, an anti-scientific view.
I don't know about fossils, but a lot of current scientific thinking probably is still wrong. We recently had a big scientific revolution when genetic sequencing revealed that much of the thinking at that time was wrong.
Also, it's absurd to interpret his comedic exaggerations literally.
cogman10 · 21h ago
> I was having a hard time with the idea that some goober in tan pants would dig up a bone fragment in Africa and know it was his own (great X 1,000) grandmother.
...
> But personally, I’m cautious about any theory that keeps the same conclusion regardless of how many times the evidence for it changes. There was a time when the seemingly straight line of fossil evidence was the primary foundation for the theory. Now it seems that that straight line was like Little Billy from Family Circus finding his way home from the playground
This where he's simply wrong and misunderstands what paleontologists and biology experts have always said.
No serious expert in the field has dug up an australopithecus specimen and said "See, here is my great grandmother!". It's absurd to think that. Adams has likely seen the march of progress and thought "Oh, this is what the experts think happened". But that's simply not true and never has been.
Evolution simply posits gradual change over generations. A result of that is a messy family tree with a lot of dead "branches".
But further, the concept of "species" has always been a messy one. A prime example of this is the fact that Neanderthals breed with the Denisovans and some of their offspring have survived to today. 2 different species closely related enough that they could have viable offspring. That makes for a messy tree.
This is an obvious fact to any biologist and isn't the least bit outside of what the theory of evolution predicts. Again, the only real prediction of evolution is that speciation happens gradually as a result of changes in generations. It doesn't predict "straight lines" like Adams asserts, it never has. Nor does it exclude the possibility for the same features to evolve multiple times. It never has.
So, when he goes out of his way to write an article "fossils are bullshit" what exactly do you think he's trying to communicate? He doesn't outright deny evolution is a thing, but he does explicitly voice doubts about evolution being a solid theory.
Now, that doesn't mean that we aren't constantly learning new things from new fossils. That's the nature of science. Adams being concerned that new data updates a theory is a severe misunderstanding of exactly how scientific research works.
jajko · 1d ago
> So, if you know someone old and suffering, its probably alzheimers.
Thats very far from reality, I presume you don't know many old people or speak to them about their ailments?
QuadmasterXLII · 23h ago
It could just be genetic luck, and the privelege that most people I interact with have access to the best treatment for diseases that have treatments, but around me the worst suffering is mostly alzheimers, striking in the late 70s to 80s.
AnimalMuppet · 1d ago
You're right that there is far more to it than Alzheimers. Still, Quadmaster has half a point. It's probably not consumption (tuberculosis), or hookworm. It's much less likely than it was to be black lung. Even smoking is decreasing, though it will take another generation for that to show up in the old people.
So we're making progress. But we don't see it, because that becomes the new normal, and we see all these remaining things that cause problems for old people.
close04 · 1d ago
TB killed 1.25 million in 2023 and the WHO considers it the world’s leading cause of death from a single infectious agent, outpaced only temporarily by COVID.
GoatInGrey · 1d ago
It's safe to say that they were speaking from the perspective of developed countries where the mortality rate of TB is roughly 0.2 per 100,000. Which makes the case that we know how to make it statistically insignificant, but the infrastructure to apply that knowledge is not perfectly distributed.
amluto · 21h ago
> we know how to make it statistically insignificant
TB is weird. We do indeed know how to actively manage it (e.g. screen people regularly and treat detected cases), but countries like the US don’t do that. Nonetheless TB does not cause much disease in the US.
Every time I’ve tried to figure out why this is, I’ve come to the tentative conclusion that no one really knows. Maybe it’s the general lack of malnutrition?
const_cast · 13h ago
TB is a bacteria and people in developed countries generally get treated when they have symptoms of infections. But underdeveloped countries don't have the resources for that, so infections are just "powered through". In addition, a lot of it comes down to resources we take for granted, like sanitation, running water, soap, population density, etc. We have cleaner air, cleaner water, and are more conscious about spreading diseases because we are wealthier.
close04 · 23h ago
> they were speaking from the perspective of developed countries
But that's just creatively selecting the data that supports the point. You can do that with everything else. We solved a lot of things "in the lab" or "in mice".
Did you know that we conquered Alzheimer's? It's safe to say I mean in countries like Guinea-Bissau, Somalia or Chad with under 100 cases per 100k people.
thaumasiotes · 1d ago
> Still, Quadmaster has half a point. It's probably not consumption (tuberculosis), or hookworm. It's much less likely than it was to be black lung.
But that's not because we got better at treating hookworm or black lung. The big ideas there are "wear shoes" and "don't work as a miner". You don't have to treat a problem you never have.
(Wikipedia: "There is no cure or discovered treatments for pneumoconiosis.")
Most of the things you listed aren't aging related
QuadmasterXLII · 22h ago
“Aging related” just means we don’t know what causes it, and yes we are much better at treating things when we know their cause. For example, right now parkinsons is aging related and we can’t do a thing about it, but there is increasing evidence that it is caused by some pollutant or toxin. If we find the toxin, then parkinsons will stop being age related. Mesothelioma is a historical case of this: for 100 years it was an untreatable aging related disease, it’s now obviously not an aging related disease, and the treatment is don’t breath asbestos.
chaosbutters314 · 1d ago
you forgot HIV/AIDS. we have the tools to basically snuff it out in 60-80 years if every male was on prep
mattmaroon · 1d ago
I think there’s a good chance we snuff it out in 80 years even if they aren’t. Actual cures seem to be on the horizon.
pureagave · 23h ago
Why would every male need to be on prep?
const_cast · 13h ago
To prevent HIV so then we abolish it. Like how we got rid of Polio and such.
PrEP just happens to actually work here, but I guess condoms could too. But historically that's not gonna happen.
It's probably not worth the effort, though. But we can, and do, eradicate diseases via preventative mechanisms. Which is astounding.
david-gpu · 1d ago
Look at how hard it has been to eradicate diseases that only require a couple of doses of a vaccine. How feasible do you think it would be to provide daily prep to every male in the world? Even in developed countries with free vaccinations we are suffering from measles outbreaks in 2025.
ryandrake · 23h ago
For diseases like measles, it's entirely due to human stupidity and society's unwillingness to oppose the stupidity and take the public health steps necessary to eradicate the disease. I agree with you. We're never going to complete any global public health project that relies on uninformed (or misinformed) people making voluntary decisions.
SoftTalker · 22h ago
Most free countries have decided that freedom includes people having a right to be stupid, at least up to a point. And we've had several generations now raised on the "my body my choice" mantra so reversing course will take some time.
fragmede · 23h ago
Are those really developed countries? A decent free public school education is a requirement for a nation to be considered developed.
david-gpu · 22h ago
>> Even in developed countries with free vaccinations we are suffering from measles outbreaks in 2025.
> Are those really developed countries? A decent free public school education is a requirement for a nation to be considered developed.
Here's some data:
In 2025 1, 2,755 measles cases (2,429 confirmed, 326 probable)
and 0 rubella cases have been reported in Canada. [0]
Education in Canada is for the most part provided publicly,
funded and overseen by federal, provincial, and local
governments. [1]
Medicare is a term that refers to Canada's
publicly funded health care system.
Instead of having a single national plan, we have 13
provincial and territorial health care insurance plans.
Under this system, all Canadian residents have
reasonable access to medically necessary hospital and
physician services without paying out-of-pocket. [2]
Interesting, I wouldn't classify IPF (idiopathic pulmonary fibrosis) as a disease of aging in the same way as the other diseases (MASH, Alzheimer's, etc..) like the author did here. Although I do appreciate the intent to show how limited we are. It's kind of like how cancer is clearly a disease of aging but it wasn't included in here because people think of it differently.
I treat a lot of old people, and IPF is at least a couple orders of magnitude rarer than the other conditions listed. Age does play a role because it shows up when people are older, but there is something else at play in it (autoimmune, genetics) that makes people hit the unlucky lottery.
I bring this up so that people reading this don't conflate normal aging related changes to the lungs with IPF. IPF is a horrible disease that kills the person in a few years (2-5 after diagnosis).
bentt · 1d ago
We are bad at most things that are complex and require behavior change. Maybe our best victory in recent years has been the vilification of tobacco. It didn't get any less physically pleasurable to smoke, but the combination of political, social, economic, and medical pressure has turned the tide.
It takes a lot.
steveBK123 · 1d ago
And none of these changes are permanent!
Look at the cultural attitudes towards smoking pot. Often the same cities/governments/people what were fining cigarette smoking out of existence suddenly have a hands-off attitude towards pot.
In NYC its illegal to smoke or drink in parks, but you can walk through a park reeking of pot and see cops writing tickets to the 2 kids who hid their beer too poorly.
david-gpu · 23h ago
I suggest reading about the different effects of smoking typical amounts of tobacco vs cannabis, and comparing the magnitude of the damage, both at the individual and societal level.
I really dislike the smell of cannabis and can count with the fingers of one hand how often I vape it per year, so I am not exactly an advocate, but comparing it with tobacco is silly.
steveBK123 · 23h ago
I'm doubtful of any motivated reasoning/research that one type of smoke in your lungs is dramatically better than another type of smoke in your lungs... compared with.. no smoke in your lungs.
Have an edible, do whatever you want in your own home, enjoy.
But don't rationalize the laissez faire attitude towards one type of secondhand smoke over another.
const_cast · 12h ago
It's just simple math.
Look, I was a Tobacco smoker, and the level of addiction you have with Tobacco is on another level.
I was smoking easily 20 cigs a day. I don't know anyone, even the most stoner of stoners, who smokes 20 joints a day. That doesn't even sound, like, logistically possible.
Obviously smoking anything is bad, but getting an order of magnitude or more less smoke HAS to be a big win.
Also nicotine. Nicotine even by itself is a problem. Don't listen to Zyn bros, nicotine is in fact evil and it does destroy your cardiovascular system over time.
david-gpu · 22h ago
How much does a typical cannabis smoker consume per day? How much does a typical smoker consume per day? See the difference in magnitude?
Also, second hand smoke where? Do you often have people smoking indoors with you?
nonameiguess · 22h ago
It's not just the relative harm of a particular dose. People lighting up a joint a day, let alone per week, are not being exposed to anywhere near the dose of the classic multiple pack a day chainsmokers that used to be everywhere and now hardly seem to exist. Even if they're equally harmful per unit, they're not equally harmful as habits to have.
jf22 · 1d ago
Not to nitpick but smelling like pot is not a crime.
steveBK123 · 23h ago
Smoking in public parks is
DSMan195276 · 23h ago
Smelling like pot in a park doesn't mean you smoked in that park though, you can walk through a park smelling like cigarettes too.
steveBK123 · 23h ago
OK for the pedants let me be more clear - "NYPD writes tickets to people drinking beers in the park but not to smokers, for reasons".
Anecdote lines up with actual data from GOOG:
In a three-year period, the NYPD issued a total of 440 tickets for public smoking violations.
vs
In the period between January and March of this year, the NYPD wrote over 7,000 tickets for public drinking. This represents a significant increase compared to the same period in 2022, with roughly 5,000 more tickets issued.
jf22 · 21h ago
You'd need to know the frequency of each crime to determine if enforcement was different.
jaapz · 1d ago
But smoking pot is equally unhealthy as smoking tobacco
chownie · 23h ago
Nope, that's a plain lie. Cancer risks don't line up between the two at all.
You're right - it might actually be worse, but is still not well studied.
chownie · 20h ago
Ctrl+F "cancer"
1 result, in the footer, unrelated to the page content
So what you actually meant was "it's definitely not as bad as cigarettes" given your lack of evidence despite the link ? Or what, this makes no sense
vharuck · 1d ago
Yup. A lot of people blame environmental hazards for perceived clusters of cancer patients in neighborhoods. But behaviors are much bigger contributors to cancer risk these days. The best ways by far to avoid cancer these days are (1) don't smoke, (2) maintain a healthy BMI, (3) don't drink, and (4) eat plenty of vegetables. If you want to further reduce your risk of dying of cancer, (5) get the recommended screenings, and (6) get regular physical checkups and talk to your doctor about any new health problems.
Reducing one's cancer risk is well within the power of any person. But "People should just have more willpower" is an ineffectual public policy.
a2tech · 1d ago
All the cool kids are back to smoking because vaping became too mainstream.
dagw · 1d ago
Yea. My daughter is 15, and while I don't think she smokes, when we've talked about the dangers of vaping and smoking, she has said that she would never vape, just because it's so lame, but that she finds smoking so much cooler.
shafyy · 22h ago
She's right, smoking is much cooler.
Qem · 1d ago
Electronic cigarretes should be made at least as bad smelling as the original ones. Without the foul stench that acted as a barrier of entry before, I suspect vaping has potential to eventually get >50% of the population hooked.
jaapz · 1d ago
In the Netherlands, we banned flavoured vapes. Now every 12-16 year old has a vape dealer. Just banning is not enough. Society needs to decide vaping is as bad as smoking.
Currently it's still somewhat accepted to vape inside of public buildings. Which, IMHO, is insane
const_cast · 10h ago
> Currently it's still somewhat accepted to vape inside of public buildings. Which, IMHO, is insane
Well because second hand smoke is so obvious and real and second hand vape... I mean... I'm not convinced it even exists. I see the vapor for about 2 seconds then it's gone. I can sniff as hard as I want, I'm not smelling anything.
But smoking? Woof. I could tell someone smoked 2 hours ago from 10 feet away. My fingers used to smell like ash 24/7. Even walking past someone 20 feet away, outside, in the wind, you can clearly smell cigarette smoke.
So I don't think it is the same.
Workaccount2 · 23h ago
Unfortunately the evidence that vaping is as bad as smoking is mostly from faulty studies, p-hacked studies, or misinformation. Which will ultimately blow up in the face of those trying to push it. The same way "Weed will make you jump out a window" just made kids blanket distrust all "weed is bad" messaging.
I'm not arguing for or against vaping, just stating that the negative health effects from vaping appear to be rather minor. In it's pure form its just nicotine and propylene glycol. Nicotine is well studied and similar to caffeine in harm (outside the addiction) and PG is used in medical inhalers (along with almost everything else, seriously its used in food and cosmetics everywhere).
lolc · 23h ago
> Society needs to decide vaping is as bad as smoking.
Why though?
jmward01 · 1d ago
I like this article, but it, like a lot of things in medicine, seems to focus on the wrong question. It isn't about disease x, it is about quantity and quality of life. I thought the part about Geographic atrophy drugs really emphasized this well. The drugs do -something- but have no impact on quality of life. I really want drug trials to focus on these two things and not proxies like 'lesion growth' which doesn't appear to have a meaningful impact on quality of life. If quality and quantity of life are improving then we can say that we are improving medicine otherwise we are just increasing medicine or worse, medicine is hurting as quality of life drops due to medical procedures that provide no real benefit but have real cost.
bluGill · 1d ago
Quality of life is what everyone cares about, but is is expensive to study. We want this things like lesion growth becuase they are much easier/faster, and thus cheaper to study. There is only so many people who can do this research, and the more work they have to do in one study the less work they can do in others. You can study lesion growth with just 100 people that you follow for a year or two - this is possible for just one person (though for double blind reasons you still want a small team). To study quality of life there are so many other variables that you need tens of thousands of subjects that you follow for a decade just so you can be sure that you can statistically isolate the non-factors.
Thus last I checked statins were only proven to prevent heart attacks in males under the age of 65 who have already had a heart attack. That is a large enough group to show results, and their change of heart attacks is known to be higher than normal so you don't have to study as well. Does this really mean other people should take statins, and if so who - hard to know. Our best evidence after years of study is that high cholesterol increases your odds of a heart attack, but a few people live to their 80s with high cholestrol without ever having a heart attack and nobody really knows why. (I haven't looked at the above in about 10 years so I might not know about some more recent science) We would like better study about statins and quality of life, but those are really expensive, and that is depsite statins being cheap and a lot of people willing to take part in a study.
jmward01 · 18h ago
I agree with the need for proxies, but if they are used then there needs to be strong evidence that they are valid and studies should report both the proxy results and the implied quality/quantity of life results based on the proxy results. This would help to put the true potential impact into perspective AND help with followup studies that can more easily check the actual impacts observed verses the predicted impact based on the proxy values. Keeping the focus on quality/quantity at every stage, especially if it is just mentioning that there isn't a strong connection between the study objective and real utility, is deeply important.
narrator · 22h ago
We'd be much closer to a cure if there wasn't that research fraud about the causes of Alzheimers that led science down a dead end for years[1].
My mother is in the early stages of Alzheimer's. It's terrible. I wouldn't recommend my experience on anyone. That might sound selfish, but it's just so painful to watch her deteriorate, knowing there's nothing that can be done. I watched her take a cognitive test recently - draw a clock, put the hands at 10 after 5. She worked on it for a minute or two, struggled, got it all wrong, then forgot what she was doing. It was one of the most painful things I've ever witnessed.
Sorry for the non-constructive comment. I guess the only constructive-ish thing is to recommend that if you've got elderly loved ones exhibiting short-term memory issues, get them tested ASAP. Then, get the "legal stuff" started right away (powers of attorney).
quesera · 18h ago
That's awful. I've recently gone through a similar process with an aging relative.
Two takeaways for me:
The things the medical industry will do to keep people "alive" are extraordinary, and expensive, and (in some cases) abuses of the concept of "living".
Moving to a sane jurisdiction where assisted suicide is legal is the only possible (but not guaranteed) strategy to approach this problem in a dignified way.
(OK, some people will argue that suicide is never dignified or moral or whatever, but I am not interested in their opinions about what I can do with my body in this situation, or really any others)
Elaris · 23h ago
Reading this article reminded me of my grandparents. In their time, people feared tuberculosis or stroke. Now, when I visit nursing homes, I hear more conversations about memory loss, knee pain, and insomnia.
Even my mother now often has trouble sleeping, which has become a daily annoyance in her life.
We have indeed made great progress. Many diseases that would have killed people in the past are now controllable and even less common. But at the same time, it seems that we have replaced a new batch of problems: Alzheimer's, loneliness, polypharmacy, insomnia.
We live longer, but are we really living better?
bombcar · 22h ago
Loneliness seems to stand out as one that we could "treat" if we really wanted to, as a society.
The problem is it's not something you can pay someone to solve.
Larrikin · 1d ago
Whatever happened to those blood transplants people were getting from younger people? Logically it made sense, but I'm guessing after further study it didn't pan out? Or was it just a trend that didn't get any follow up?
GoatInGrey · 1d ago
There is still ongoing research and testing. It's at a state where we know it has some effect, but we don't know what exactly it is doing and therefore do not have a clear path to optimization.
There's weak science behind it. Basically it works, but you need to be a crazy person to think that it is a novel way to cheat death. Death remains undefeated.
Treating aging is not the same as treating death. The reason the two are colloquially linked is because aging has been by far the dominant driver of death for all of human history. To your point, aging has never failed to kill a human.
There are a couple reasons to believe that aging is malleable.
The second is that nature has examples of biological immortality. Planaria are a fascinating one as they have among the trashiest, most mutated genome on the planet. They're even polypoid, where they have multiple sets of chromosomes, but they're simultaneously the best regenerators on the planet. Despite having a discrete nervous system and centralized brain, you can slice a planaria into hundreds of pieces, and each of those will regenerate into a full, functional adult. They don't age, they don't get cancer. The issue is that we have no idea how this happens. So there is still a lot for us to learn about the fundamentals of aging and regeneration overall.
1970-01-01 · 23h ago
You 2nd point sounds like a quest for literal reincarnation. It is great sci-fi material; When the organism is no longer a single unit, at no point does death occur. The organisms survive continuously, yet they lose no external feature. Is it cheating death? Well, what happens when the original mind meets its millionth copy?
preachermon · 23h ago
> aging has been by far the dominant driver of death for all of human history
not dominant if mean life expectancy is < 40. Aging only has an impact after age 55.
(and if 55 seems young, you have a cushy life)
quesera · 19h ago
Assuming that infant mortality is not on the minds of most adults (w/r/t their own survival), aging becomes the dominant driver.
preachermon · 23h ago
One, ethics
Two, ethics,
Three, it took something like 10K young people per old person to make it work, and it was at best a proof of concept
Four, ethics
otikik · 22h ago
Yeah, Peter Thiel does not have problems One,Two and Four. And Three is a minor inconvenience.
directevolve · 22h ago
Why do you think there’s an ethical problem with this type of blood transfusion?
lenerdenator · 23h ago
Treating?
We're great at that.
Curing?
Horrible.
Which is a real problem seeing as how people want to spend as much money as possible for diminishing returns on lifespan.
tsoukase · 15h ago
Alzheimer's, Parkinson's, secondary progressive multiple sclerosis, ALS and all other neuro-degenerative diseases are age related and incurable.
We are far from aproaching their causes, much more their cure.
I believe they share the same underlying mechanisms (loss of neurons), though in different regions, and their cure is equivalent to immortality.
BobBagwill · 23h ago
I have this age-related eye disease where all the text on a web page appears to be in a tiny, spindly font, and it appears to fade in as it scrolls. I would blame my eyeglasses, but I'm not wearing any. :-)
projektfu · 23h ago
I'm experiencing that as well. I think the best solution is to get off the computer.
mixmastamyk · 23h ago
Scroll fade is likely due to a low quality screen, and could be replaced with a newer one.
BobBagwill · 57m ago
Nah, JK, it's a stupid CSS trick.
catigula · 23h ago
Unfortunately there's no current or proposed medical treatment for the inevitability of death and degradation on that path, so the only real treatment is philosophical.
At least in Western society, if any of you have experienced this struggle with an older relative burning through resources to desperately cling to life you know that we seem to lack some fundamental ability to approach or handle this topic philosophically.
In no time I'll in the same boat. Secular society doesn't really have a great answer here.
quesera · 19h ago
My secular answer is to live in a jurisdiction which allows assisted suicide, and to have a clear plan registered with my doctors, lawyers, and family.
My fear is that I will lose the decision-making agency quickly and unexpectedly and have my clear wishes disregarded for some stupid technical reason which would require someone to take professional or legal risk to fulfill them.
I've built a room in my house which is designed to be easily disconnected from the building HVAC such that I can safely discharge, and then automatically vent to outdoors, bottles of compressed gaseous nitrogen or helium.
For safety, the prep for discharge requires a few minutes of work, with hands and brain that are at least marginally nimble. I worry very much about the risk of waiting too long, or having a debilitating issue crop up unexpectedly (I am presently of sound mind and body, and not old).
catigula · 18h ago
I'm sorry but this answer is very abnormal for most people so it's not a great application of philosophy.
quesera · 18h ago
I would argue that it is the philosophy that is lacking.
We are afraid of death. That's stupid. Any life model that fails to account for death, is flawed in the extreme. I prefer mine, but I certainly would not impose it on others.
absurdo · 23h ago
I don’t expect life and death to care about the philosophy a human ascribes and it’s not a treatment to anything. It’s beyond human beings.
catigula · 22h ago
No, the philosophy is for the human, not the concept.
cyanydeez · 1d ago
Its good to know the same forces making software terrible are at work in the pharma business
knowitnone · 22h ago
Medically speaking, "Geographic atrophy" is very poorly named. It is not descriptive at all.
JLJ0 · 19h ago
Wow I have BSD, the early stages of MD and Bronchiectasis all by my early thirties, interesting to see similar diseases at the top of the article. I guess I will just pray to the Omnissiah.
Theodores · 1d ago
The non-communicable chronic diseases are what my parents new, when they were still alive.
Recently I had to get my late father's paperwork in order and this meant going through lots of medical stuff. There was also paperwork regarding my mum, it was IPF that got her.
I also had to take a sack full of pills down to the chemist to get disposed of. This is in the UK where we have the NHS. The NHS would prefer to have people in good health whereas I suspect that the private healthcare system of the USA prefers to have people in bad health and medically dependent. It is just a different business model.
What surprised me about the NHS paperwork was how much of it was focused on lifestyle choices, so that means living a physically active life and eating certain foods.
My dad did the doctor visits and the pills but he did not do the lifestyle recommendations. He would behave like a tired toddler if you put fruit and vegetables on his plate. He was also heavily car dependent, as if any other mode of transport was not 'manly' enough for him. We had concerns for other road users with his driving but we could not get him to take the train, never mind walk as far as the nearest shop, five minutes away.
Alcohol was another cause for concern. Although never drunk, he would drink every day. He would have it with his greasy food, thinking he was eating like a king.
I know diet and nutrition is controversial, however, the NHS were wanting him to eat five portions of fruit and vegetables a day, and there were forms so that he could fill in how many grains, nuts, seeds, potatoes, vegetables and pieces of fruit he was eating. He wasn't eating any of those things, he was on the saturated fats, which invariably come from animal products. There were no checkboxes on the form for meat, cheese or processed foods, which is no surprise since there is no fibre in any of this stuff. There aren't any antioxidants either.
The NHS prefers lifestyle interventions rather than pills. This varies by doctor, but, this is the general idea.
Age related diseases are not due to age, in this day and age. They are down to poor lifestyle choices, cancer and all. Forget genetics too, sure, some people win the lottery, and others lose the cancer lottery. But the more you know then the more you realise that no amount of pills, procedures and testing will spare anyone from blocked arteries due to saturated fats with side portions of bad cholesterol.
It is the same with alcohol. If we treated pensioners as if they were under age, to ban them from obtaining alcohol, then there would be a lot of miserable pensioners but they would be living a lot longer. Same with processed food and animal products, if we banned pensioners from such things then they would be miserable but live out to be a hundred years old.
Face to face with my dad's NHS paperwork made me realise that I knew what I was reading all along. For decades we have known what gives you the non-communicable chronic diseases. We have also known that it is fibre and phytonutrients from whole foods that enable your body to protect itself against things such as inflammation.
Looking for cures is grift. There is no cure or treatment for those that spend hours a day consuming toxins whilst they pretend they are living like a king just because they are eating heavily marketed animal products that are sold as 'good for protein'. With health and longevity, you can't have your cake full of transfats and eat it.
projektfu · 22h ago
Except they are due to age. While lifestyle changes may make some conditions less likely or less severe, don't kid yourself into thinking you can avoid them all forever. Nor is lifestyle change an easy path for most people. If it were, many of the lifestyle diseases would be gone, because we know so much about them. Of the diseases in the article, only NASH (non-alcoholic steatohepatitis, called MASH in most of the article, presumably a typo) seems to be strongly related to lifestyle.
The government (or society, whatever) could reduce lifestyle diseases by closing the roads so that people do not drive, requiring jobs to be 50% physical, turning off electric lighting after 9pm, banning overly tasty packaged food, observing a sabbath, etc. Like that will ever happen. The studies are clear, so why don't we do this?
GLP-1 agonists are showing us that behavior has deeper roots than simple choice. People on these medications are able to choose the healthier choice without feeling something lacking, but when they are discontinued they typically return to old habits.
In the meantime, there have been successes at treating lifestyle diseases and giving people better, happier lives. I wish they could stop their behaviors, but I like that they have a chance to treat atrial fibrillation, coronary artery disease, etc.
lm28469 · 23h ago
> Age related diseases are not due to age, in this day and age. They are down to poor lifestyle choices, cancer and all. Forget genetics too, sure, some people win the lottery, and others lose the cancer lottery. But the more you know then the more you realise that no amount of pills, procedures and testing will spare anyone from blocked arteries due to saturated fats with side portions of bad cholesterol.
I wish more people understood that. Medicine definitely has its place but if you don't put in the preventative work on your side it's a losing battle.
I know 80+ years old who go skying every single day in winter, still chop their own fire wood, &c. Meanwhile there are plenty of ~50 years old who are already in worse health/shape, eat like shit, sleep like shit, never exercise, complain about their bad backs and bad knees, bad digestion, &c.
Medicine is very good at keeping you alive, but if you want to keep a good quality of life there is nothing medicine can provide that is even remotely as good as being fit. And even if you lose the genetic lottery: medicine will be much more effective if you have a clean base, you better go to chemo with an extra 20kg of muscle rather than 20kg of fat, high blood pressure and diabetes
orangecat · 22h ago
Age related diseases are not due to age
30 year olds don't get Alzheimer's no matter how unhealthy their diet and lifestyle is. There are things you can and should do to improve your odds, but overall old people are going to be less healthy than young people.
meroes · 23h ago
Ya for Alzheimer's, the two people in my family who've had it had bad diets (think dining out lavishly every night or sugar-addiction) and poor hygiene (like having every single tooth pulled). I also suspect chronic lack of sleep is my dad's worse health trait. I don't get why they don't work on this stuff personally.
sobadically · 22h ago
It’s only bad if enough people agree it’s bad. I personally don’t care if old people die since the existing old people refuse to pass better healthcare.
Like Kirk said; let them die. They don’t want to care about themselves, neither do I.
Physics doesn’t care about any of us. Only we do. If we want better healthcare do the political work to make so we can put agency into better healthcare and less agency into Wall Street’s war against line go down we’ve been waging for generations.
quesera · 19h ago
The old people with the power to "pass better healthcare" have excellent health care for themselves.
But we have made very little progress in staving off degenerative-type diseases. Even the primary degenerative disease you mention, knee failure, we cure largely with a wholesale replacement. That obviously isn't applicable to organs we can't just swap out.
The sum of all causes of death will very likely continue to be 100%...
If not, we'll have a whole lot of new problems.
The 5 year survival rate for localized (early stage) breast cancer is 99%
Did we remove it as a cause of death? No. But the prognosis is much less dire by now than it was even a few decades ago.
Very few causes are ever completely "conquered", they just move down in relative relevance.
I fully acknowledge that we've made large strides in understanding and treating breast cancer, but in most cases, once it spreads it's still "game over", and so it is still an immensely fearful experience for people to go through. Contrast that with, for example, HIV. 35 years ago it was probably the scariest disease there was, considered a guaranteed death sentence. Now it is largely preventable with PrEP, and treatments are so good that it is a manageable condition with lifespans on par with HIV-negative people for most of those who diligently follow their treatments.
https://pubmed.ncbi.nlm.nih.gov/29976500/
That stands in stark contrast to lung cancer, which has a median survival time of ~15 months. Pancreatic cancer usually kills you in less than a year. Colon cancer is better, but still only ~6 years. Leukemia and Lymphoma can occur in middle age or even in early childhood, and rob an entire lifetime.
We also need to think about quality of life, which tends to go way down after you're diagnosed with one of these diseases
Prevention and delay is significantly better than management or even curing
That said prostate cancer is most of the time not a big deal. Getting prostate cancer will still probably the most dangerous thing that ever happens to you (how many single events have a 5%+ mortality rate? besides birth) and should be treated incredibly seriously, but the odds are still good you'll be fine.
Not all of the solutions can be called "cures" but a solution nonetheless is better than nothing and calling it "old age, shit out of luck."
What's your definition of "conquered"? In the US breast cancer is the most common type of cancer, and together with lung cancers account for ~500k cases each year. 100k of those people will die within 5 years.
Now we created new issues to replace the old. Microplastic, PFAS, antibiotic resistance, obesity, etc.
And my knees want to have a word with your assessment :).
If only it actually worked that way instead of being code for favoritism for a few demographic groups, ignoring many other people who are excluded, and actively discriminating against straight white men.
Scott Adams is right to challenge it.
Edit: Disney exec admits on hidden camera "Certainly, there have been times where, 'there's no way we're hiring a white male for this'"
https://www.msn.com/en-us/money/companies/watch-disney-exec-...
I'm not 100% on the reasons. Seems like he simply has a lot of hubris.
[1] https://dilbertblog.typepad.com/the_dilbert_blog/2007/03/fos...
That's another misrepresentation. In that link he says "To be fair, there’s still plenty of evidence for evolution."
It sounds like he's a skeptic who demands proof of the things we're not supposed to question. That's a good thing.
But some people don't like it and misrepresent his words to try to discredit him.
Edit: I agree that Adams is not a scientist and doesn't understand how science works. That article gets an F in my book. Nonetheless, suggesting that asking questions is the same as claiming something "isn't real" is, itself, an anti-scientific view.
I don't know about fossils, but a lot of current scientific thinking probably is still wrong. We recently had a big scientific revolution when genetic sequencing revealed that much of the thinking at that time was wrong.
Also, it's absurd to interpret his comedic exaggerations literally.
...
> But personally, I’m cautious about any theory that keeps the same conclusion regardless of how many times the evidence for it changes. There was a time when the seemingly straight line of fossil evidence was the primary foundation for the theory. Now it seems that that straight line was like Little Billy from Family Circus finding his way home from the playground
This where he's simply wrong and misunderstands what paleontologists and biology experts have always said.
No serious expert in the field has dug up an australopithecus specimen and said "See, here is my great grandmother!". It's absurd to think that. Adams has likely seen the march of progress and thought "Oh, this is what the experts think happened". But that's simply not true and never has been.
Evolution simply posits gradual change over generations. A result of that is a messy family tree with a lot of dead "branches".
But further, the concept of "species" has always been a messy one. A prime example of this is the fact that Neanderthals breed with the Denisovans and some of their offspring have survived to today. 2 different species closely related enough that they could have viable offspring. That makes for a messy tree.
This is an obvious fact to any biologist and isn't the least bit outside of what the theory of evolution predicts. Again, the only real prediction of evolution is that speciation happens gradually as a result of changes in generations. It doesn't predict "straight lines" like Adams asserts, it never has. Nor does it exclude the possibility for the same features to evolve multiple times. It never has.
So, when he goes out of his way to write an article "fossils are bullshit" what exactly do you think he's trying to communicate? He doesn't outright deny evolution is a thing, but he does explicitly voice doubts about evolution being a solid theory.
Now, that doesn't mean that we aren't constantly learning new things from new fossils. That's the nature of science. Adams being concerned that new data updates a theory is a severe misunderstanding of exactly how scientific research works.
Thats very far from reality, I presume you don't know many old people or speak to them about their ailments?
So we're making progress. But we don't see it, because that becomes the new normal, and we see all these remaining things that cause problems for old people.
TB is weird. We do indeed know how to actively manage it (e.g. screen people regularly and treat detected cases), but countries like the US don’t do that. Nonetheless TB does not cause much disease in the US.
Every time I’ve tried to figure out why this is, I’ve come to the tentative conclusion that no one really knows. Maybe it’s the general lack of malnutrition?
But that's just creatively selecting the data that supports the point. You can do that with everything else. We solved a lot of things "in the lab" or "in mice".
Did you know that we conquered Alzheimer's? It's safe to say I mean in countries like Guinea-Bissau, Somalia or Chad with under 100 cases per 100k people.
But that's not because we got better at treating hookworm or black lung. The big ideas there are "wear shoes" and "don't work as a miner". You don't have to treat a problem you never have.
(Wikipedia: "There is no cure or discovered treatments for pneumoconiosis.")
https://www.youtube.com/watch?v=XPZwRF7yRAQ
PrEP just happens to actually work here, but I guess condoms could too. But historically that's not gonna happen.
It's probably not worth the effort, though. But we can, and do, eradicate diseases via preventative mechanisms. Which is astounding.
> Are those really developed countries? A decent free public school education is a requirement for a nation to be considered developed.
Here's some data:
Sources:[0] https://health-infobase.canada.ca/measles-rubella/
[1] https://en.wikipedia.org/wiki/Education_in_Canada
[2] https://www.canada.ca/en/health-canada/services/canada-healt...
You are welcome.
I treat a lot of old people, and IPF is at least a couple orders of magnitude rarer than the other conditions listed. Age does play a role because it shows up when people are older, but there is something else at play in it (autoimmune, genetics) that makes people hit the unlucky lottery.
I bring this up so that people reading this don't conflate normal aging related changes to the lungs with IPF. IPF is a horrible disease that kills the person in a few years (2-5 after diagnosis).
It takes a lot.
Look at the cultural attitudes towards smoking pot. Often the same cities/governments/people what were fining cigarette smoking out of existence suddenly have a hands-off attitude towards pot.
In NYC its illegal to smoke or drink in parks, but you can walk through a park reeking of pot and see cops writing tickets to the 2 kids who hid their beer too poorly.
I really dislike the smell of cannabis and can count with the fingers of one hand how often I vape it per year, so I am not exactly an advocate, but comparing it with tobacco is silly.
Have an edible, do whatever you want in your own home, enjoy. But don't rationalize the laissez faire attitude towards one type of secondhand smoke over another.
Look, I was a Tobacco smoker, and the level of addiction you have with Tobacco is on another level.
I was smoking easily 20 cigs a day. I don't know anyone, even the most stoner of stoners, who smokes 20 joints a day. That doesn't even sound, like, logistically possible.
Obviously smoking anything is bad, but getting an order of magnitude or more less smoke HAS to be a big win.
Also nicotine. Nicotine even by itself is a problem. Don't listen to Zyn bros, nicotine is in fact evil and it does destroy your cardiovascular system over time.
Also, second hand smoke where? Do you often have people smoking indoors with you?
Anecdote lines up with actual data from GOOG: In a three-year period, the NYPD issued a total of 440 tickets for public smoking violations.
vs
In the period between January and March of this year, the NYPD wrote over 7,000 tickets for public drinking. This represents a significant increase compared to the same period in 2022, with roughly 5,000 more tickets issued.
You're right - it might actually be worse, but is still not well studied.
So what you actually meant was "it's definitely not as bad as cigarettes" given your lack of evidence despite the link ? Or what, this makes no sense
Reducing one's cancer risk is well within the power of any person. But "People should just have more willpower" is an ineffectual public policy.
Currently it's still somewhat accepted to vape inside of public buildings. Which, IMHO, is insane
Well because second hand smoke is so obvious and real and second hand vape... I mean... I'm not convinced it even exists. I see the vapor for about 2 seconds then it's gone. I can sniff as hard as I want, I'm not smelling anything.
But smoking? Woof. I could tell someone smoked 2 hours ago from 10 feet away. My fingers used to smell like ash 24/7. Even walking past someone 20 feet away, outside, in the wind, you can clearly smell cigarette smoke.
So I don't think it is the same.
I'm not arguing for or against vaping, just stating that the negative health effects from vaping appear to be rather minor. In it's pure form its just nicotine and propylene glycol. Nicotine is well studied and similar to caffeine in harm (outside the addiction) and PG is used in medical inhalers (along with almost everything else, seriously its used in food and cosmetics everywhere).
Why though?
Thus last I checked statins were only proven to prevent heart attacks in males under the age of 65 who have already had a heart attack. That is a large enough group to show results, and their change of heart attacks is known to be higher than normal so you don't have to study as well. Does this really mean other people should take statins, and if so who - hard to know. Our best evidence after years of study is that high cholesterol increases your odds of a heart attack, but a few people live to their 80s with high cholestrol without ever having a heart attack and nobody really knows why. (I haven't looked at the above in about 10 years so I might not know about some more recent science) We would like better study about statins and quality of life, but those are really expensive, and that is depsite statins being cheap and a lot of people willing to take part in a study.
[1]https://www.discovermagazine.com/the-sciences/false-alzheime...
Sorry for the non-constructive comment. I guess the only constructive-ish thing is to recommend that if you've got elderly loved ones exhibiting short-term memory issues, get them tested ASAP. Then, get the "legal stuff" started right away (powers of attorney).
Two takeaways for me:
The things the medical industry will do to keep people "alive" are extraordinary, and expensive, and (in some cases) abuses of the concept of "living".
Moving to a sane jurisdiction where assisted suicide is legal is the only possible (but not guaranteed) strategy to approach this problem in a dignified way.
(OK, some people will argue that suicide is never dignified or moral or whatever, but I am not interested in their opinions about what I can do with my body in this situation, or really any others)
The problem is it's not something you can pay someone to solve.
https://onlinelibrary.wiley.com/doi/10.1111/acel.70103
https://longevity.technology/news/human-trial-finds-therapeu...
https://en.wikipedia.org/wiki/Young_blood_transfusion
There are a couple reasons to believe that aging is malleable.
One is that we know how to de-age human cells using the same factors that fertilized oocytes use to de-age the underlying egg cell (typically many decades in age). https://en.wikipedia.org/wiki/Induced_pluripotent_stem_cell
The second is that nature has examples of biological immortality. Planaria are a fascinating one as they have among the trashiest, most mutated genome on the planet. They're even polypoid, where they have multiple sets of chromosomes, but they're simultaneously the best regenerators on the planet. Despite having a discrete nervous system and centralized brain, you can slice a planaria into hundreds of pieces, and each of those will regenerate into a full, functional adult. They don't age, they don't get cancer. The issue is that we have no idea how this happens. So there is still a lot for us to learn about the fundamentals of aging and regeneration overall.
not dominant if mean life expectancy is < 40. Aging only has an impact after age 55.
(and if 55 seems young, you have a cushy life)
Two, ethics,
Three, it took something like 10K young people per old person to make it work, and it was at best a proof of concept
Four, ethics
We're great at that.
Curing?
Horrible.
Which is a real problem seeing as how people want to spend as much money as possible for diminishing returns on lifespan.
I believe they share the same underlying mechanisms (loss of neurons), though in different regions, and their cure is equivalent to immortality.
At least in Western society, if any of you have experienced this struggle with an older relative burning through resources to desperately cling to life you know that we seem to lack some fundamental ability to approach or handle this topic philosophically.
In no time I'll in the same boat. Secular society doesn't really have a great answer here.
My fear is that I will lose the decision-making agency quickly and unexpectedly and have my clear wishes disregarded for some stupid technical reason which would require someone to take professional or legal risk to fulfill them.
I've built a room in my house which is designed to be easily disconnected from the building HVAC such that I can safely discharge, and then automatically vent to outdoors, bottles of compressed gaseous nitrogen or helium.
For safety, the prep for discharge requires a few minutes of work, with hands and brain that are at least marginally nimble. I worry very much about the risk of waiting too long, or having a debilitating issue crop up unexpectedly (I am presently of sound mind and body, and not old).
We are afraid of death. That's stupid. Any life model that fails to account for death, is flawed in the extreme. I prefer mine, but I certainly would not impose it on others.
Recently I had to get my late father's paperwork in order and this meant going through lots of medical stuff. There was also paperwork regarding my mum, it was IPF that got her.
I also had to take a sack full of pills down to the chemist to get disposed of. This is in the UK where we have the NHS. The NHS would prefer to have people in good health whereas I suspect that the private healthcare system of the USA prefers to have people in bad health and medically dependent. It is just a different business model.
What surprised me about the NHS paperwork was how much of it was focused on lifestyle choices, so that means living a physically active life and eating certain foods.
My dad did the doctor visits and the pills but he did not do the lifestyle recommendations. He would behave like a tired toddler if you put fruit and vegetables on his plate. He was also heavily car dependent, as if any other mode of transport was not 'manly' enough for him. We had concerns for other road users with his driving but we could not get him to take the train, never mind walk as far as the nearest shop, five minutes away.
Alcohol was another cause for concern. Although never drunk, he would drink every day. He would have it with his greasy food, thinking he was eating like a king.
I know diet and nutrition is controversial, however, the NHS were wanting him to eat five portions of fruit and vegetables a day, and there were forms so that he could fill in how many grains, nuts, seeds, potatoes, vegetables and pieces of fruit he was eating. He wasn't eating any of those things, he was on the saturated fats, which invariably come from animal products. There were no checkboxes on the form for meat, cheese or processed foods, which is no surprise since there is no fibre in any of this stuff. There aren't any antioxidants either.
The NHS prefers lifestyle interventions rather than pills. This varies by doctor, but, this is the general idea.
Age related diseases are not due to age, in this day and age. They are down to poor lifestyle choices, cancer and all. Forget genetics too, sure, some people win the lottery, and others lose the cancer lottery. But the more you know then the more you realise that no amount of pills, procedures and testing will spare anyone from blocked arteries due to saturated fats with side portions of bad cholesterol.
It is the same with alcohol. If we treated pensioners as if they were under age, to ban them from obtaining alcohol, then there would be a lot of miserable pensioners but they would be living a lot longer. Same with processed food and animal products, if we banned pensioners from such things then they would be miserable but live out to be a hundred years old.
Face to face with my dad's NHS paperwork made me realise that I knew what I was reading all along. For decades we have known what gives you the non-communicable chronic diseases. We have also known that it is fibre and phytonutrients from whole foods that enable your body to protect itself against things such as inflammation.
Looking for cures is grift. There is no cure or treatment for those that spend hours a day consuming toxins whilst they pretend they are living like a king just because they are eating heavily marketed animal products that are sold as 'good for protein'. With health and longevity, you can't have your cake full of transfats and eat it.
The government (or society, whatever) could reduce lifestyle diseases by closing the roads so that people do not drive, requiring jobs to be 50% physical, turning off electric lighting after 9pm, banning overly tasty packaged food, observing a sabbath, etc. Like that will ever happen. The studies are clear, so why don't we do this?
GLP-1 agonists are showing us that behavior has deeper roots than simple choice. People on these medications are able to choose the healthier choice without feeling something lacking, but when they are discontinued they typically return to old habits.
In the meantime, there have been successes at treating lifestyle diseases and giving people better, happier lives. I wish they could stop their behaviors, but I like that they have a chance to treat atrial fibrillation, coronary artery disease, etc.
I wish more people understood that. Medicine definitely has its place but if you don't put in the preventative work on your side it's a losing battle.
I know 80+ years old who go skying every single day in winter, still chop their own fire wood, &c. Meanwhile there are plenty of ~50 years old who are already in worse health/shape, eat like shit, sleep like shit, never exercise, complain about their bad backs and bad knees, bad digestion, &c.
Medicine is very good at keeping you alive, but if you want to keep a good quality of life there is nothing medicine can provide that is even remotely as good as being fit. And even if you lose the genetic lottery: medicine will be much more effective if you have a clean base, you better go to chemo with an extra 20kg of muscle rather than 20kg of fat, high blood pressure and diabetes
30 year olds don't get Alzheimer's no matter how unhealthy their diet and lifestyle is. There are things you can and should do to improve your odds, but overall old people are going to be less healthy than young people.
Like Kirk said; let them die. They don’t want to care about themselves, neither do I.
Physics doesn’t care about any of us. Only we do. If we want better healthcare do the political work to make so we can put agency into better healthcare and less agency into Wall Street’s war against line go down we’ve been waging for generations.
So they do care, just not about you and me.