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The Good Life With a Bad Ilness

The American Geriatrics Society does not normally conjure images of revolutionary fervor, but the venerable organization last week released a report that may shake things up a bit in the longevity industry.

Analyzing data from the Cardiovascular Health Study, researchers focused on three distinct groups of people 65 years old and older and concluded, rather surprisingly, that it’s not serious chronic diseases that will necessarily make your life short and miserable in your golden years. It’s all about the stuff doctors can’t diagnose — and how much you’re able to stay active.

So, just because you happen to be burdened with heart disease or type-2 diabetes or COPD doesn’t mean you’ve been sentenced to a poor quality of life during the years you have left.

Among the three groups the study identified, it was the so-called “adapters” — folks with higher levels of of chronic illness but also higher activity levels — who stayed healthy and able longer (55 percent of their remaining years) than either of the other groups. “Expected agers” (higher disease and frailty levels) stayed healthy and able for 47 percent of their remaining years, a full 10 percent longer than the “prematurely frail,” who boasted lower incidences of chronic disease but higher levels of frailty.

The numbers are probably less noteworthy than the assertion they seek to illustrate:

“Although diagnosed disease burden, usually represented as comorbidity count, has been used for decades as a predictor of morbidity and mortality, influencing researchers, providers, and payers, it is an imperfect representation of physiological fitness and does not explain most of the variance in these outcomes.”

These findings should cheer geezers who have subjected themselves to blood tests, colonoscopies, PSA screenings, mammograms, and other preventive health measures that often yield frightening diagnoses and even more fearful treatments. I find it particularly encouraging, given my disinclination to visit doctors at all and my current affinity for some moderate level of physical fitness.

If there’s a downside to these findings, it’s that “sub-clinical” diseases — illnesses that have not caught the attention of physicians — may have more impact on one’s mortality than we’ve been led to believe. “Adapters having much lower levels of subclinical disease in several organ systems than expected agers and prematurely frail individuals having the highest levels of subclinical disease exemplify this,” researchers point out.

The good news for adapters, however, may or may not be tempered slightly by the knowledge that when those sub-clinical illnesses catch up to you, the end is going to come pretty quickly. As researchers note, “It may be that adapters truly have adaptive factors that compress morbidity and mask the effect of underlying disease, which may ultimately present as a catastrophic illness followed shortly by death. Adapters may die before they manifest phenotypes of frailty.”

I’ll be celebrating my 65th birthday in a couple of months, so who knows how many years I’ve got left. But I take heart in the fact that, despite my high blood pressure, my genetic risk of colon cancer, and dark rumors of metabolic syndrome, my remaining years might not be too bad. A guy can’t really ask for anything more than that.

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