A good life sell by date?

How long is a good life?

In the last 100 years life expectancy in Western nations has increased by at least 20 years.

Antibiotics, cancer drugs, vaccination, transplants, pharmaceutical drugs…scans, robot operating, laparoscopic operations…

Sewage systems, food health and longevity, health care, diet, less pollution…

We have made huge advances advances post 1945. We can keep people alive longer, long enough to have good retirement years. Long enough to develop more diseases, but live with them.

There has been massive investment in developing treatments, and massive profits for pharma companies and investors.

Who paid for it all? Well we did, of course, we taxpayers. And rightly so.

But, and of course there is always a but, has the enormously expensive search for longevity been worth it?

As I near my 74th year I wonder. When is the price of living no longer balanced by the benefit? I mean, there will come a time for all of us who do not die of a sudden catastrophe when we might think we’d be better off dead.

We have got so good at prolonging life we may have forgotten that it may not be for the best.

Take dementia. The extended life expectancy post war has led to huge rises in dementia diagnoses. Not surprising if dementia is related directly to age, though it isn’t.

If, however, some dementias, in particular Alzheimer’s Disease, may be partly just natural ageing of the brain speeded up by life style and environmental factors, we may have brought this huge rise in dementia upon ourselves.

I don’t think it is good enough to just say that we live longer therefore we have longer to develop dementia. There are causes, but we don’t know what they are.

We know that excess amyloid and tau tangles can be found in most (though not all) dementia brains, and in cerebrospinal fluid. We don’t know why that amyloid and tau get there in some people and not in others. We don’t know why dementia can occur in brains that subsequently show no excess amyloid and tau.

We know that it is the aim of pharma to find a ‘cure’ for dementia. It has long been the magic, the holy grail of research to find the cure. After all, we’ve done it for polio, smallpox, malaria, scarlet fever, and many other diseases.

But…but those cures or treatments were only found when scientists worked out what the cause was.

With dementia it’s different, and governments and researchers and pharma companies are so desperate for success that they have convinced themselves that a cure can be found. So they grasp at any straws that blow along.

What we really need is to establish the causes of dementia. Take Alzheimer’s. It occurs far more in poor communities, in polluted environments, in obesity and diabetes, and in chronically stressed individuals.

As has been pointed out by many health journalists, public health work has all but stopped in the last fifteen years. We pour money into research for all sorts of diseases, and into treatments, but we don’t spend money to keep the population healthy. We spend to pick up the pieces, not to prevent people breaking.

We sell off public assets like water so that rich investors can become richer. Result? Appalling decline in water quality.

We allow the food industry to create and sell us food that is very unhealthy, but cheap and addictively filled with salt and sugar. We allow them to advertise this food, even though we know it is killing us.

We have motorways slicing through housing, hidden only by fences which certainly do not contain the fumes.

People complain when a scheme to reduce air pollution is introduced and costs us a bit and interrupts our lives.

We see the government reduce benefits for the poor and disabled, and use mean tests which are designed to keep people off benefits. Poor.

If you are one of the several million living in or near poverty how on earth can you afford good health?

We will see a tsunami wave of dementia in the next twenty years as post Thatcher babies reach old age. We will see a big rise in strokes too, I read the other day, as a result of untreated high blood pressure and diabetes.

Our health and care services will be overwhelmed (aren’t they already?)

We cannot afford to NOT invest in public health and the causes of poverty.

Back to the first question then.

Do I want to be kept going when I’m falling apart?

How will I know when enough is enough?

Today there’s a debate in parliament on assisted dying. I hope our MPs ask themselves why we are so convinced we should keep people alive past their good life sell by date.

(I have started reading ‘American Dementia’ (by Daniel George and Peter Whitehouse), a brilliant book about health and dementia and the profit driven quest for a miracle cure, which has to an extent informed this blog.)