Increasing The Odds Of High-Quality Longevity

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vnatale
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Increasing The Odds Of High-Quality Longevity

Post by vnatale » Sat Sep 19, 2020 7:35 pm

What age are you using for retirement planning? I had been using 100 but after seeing this 99 year old Yankees fan sing the National Anthem last week I have a new role model! I'm raising my age to 110!


Increasing The Odds Of High-Quality Longevity

https://www.fa-mag.com/news/increasing- ... 44981.html




For financial advisors, the biggest challenge facing today’s clients is increasing the odds that long lives are high-quality lives. “Most of you are going to sail through your 80s into your 90s, and some will live into your 100s,” Dr. Laura Carstensen, professor of psychology and public policy at Stanford University and director of its Center on Longevity,


Rising longevity is not universal. The sad reality is that childhood obesity and the opioid epidemic are combining to curtail longevity for major segments of the middle-age population. Moreover, if disparities in longevity are increasing almost as fast as life expectancy itself, one thing remains constant. “The death rate is still 100%,” she said.


Cognitive decline is slight among those who don’t experience dementia, Carstensen maintained. It is the ability to process new information and novel concepts that erodes. That’s partly because, like an old computer, an older person has a store of knowledge that’s much greater.

On the dementia front, there is good news. Dementia has been declining significantly and is down 24% since 1970. But this figure needs to be understood in context, Carstensen explained. There are more people with Alzheimer’s because there are so many individuals in the target age population today, but the incidence is declining.


Science indicates there is a 25% to 50% correlation between genes and longevity, so it’s not linear. Many argue the correlation between life expectancy and education is a more accurate predictor.

Vernon argued that most people need to lengthen their planning horizons and frame out the rest of their lives. One way to achieve that is to think about how much their life has changed in the last 20 or 30 years.
Above provided by: Vinny, who always says: "I only regret that I have but one lap to give to my cats." AND "I'm a more-is-more person."
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Re: Increasing The Odds Of High-Quality Longevity

Post by Libertarian666 » Sun Sep 20, 2020 8:27 am

vnatale wrote:
Sat Sep 19, 2020 7:35 pm
What age are you using for retirement planning? I had been using 100 but after seeing this 99 year old Yankees fan sing the National Anthem last week I have a new role model! I'm raising my age to 110!


Increasing The Odds Of High-Quality Longevity

https://www.fa-mag.com/news/increasing- ... 44981.html




For financial advisors, the biggest challenge facing today’s clients is increasing the odds that long lives are high-quality lives. “Most of you are going to sail through your 80s into your 90s, and some will live into your 100s,” Dr. Laura Carstensen, professor of psychology and public policy at Stanford University and director of its Center on Longevity,


Rising longevity is not universal. The sad reality is that childhood obesity and the opioid epidemic are combining to curtail longevity for major segments of the middle-age population. Moreover, if disparities in longevity are increasing almost as fast as life expectancy itself, one thing remains constant. “The death rate is still 100%,” she said.


Cognitive decline is slight among those who don’t experience dementia, Carstensen maintained. It is the ability to process new information and novel concepts that erodes. That’s partly because, like an old computer, an older person has a store of knowledge that’s much greater.

On the dementia front, there is good news. Dementia has been declining significantly and is down 24% since 1970. But this figure needs to be understood in context, Carstensen explained. There are more people with Alzheimer’s because there are so many individuals in the target age population today, but the incidence is declining.


Science indicates there is a 25% to 50% correlation between genes and longevity, so it’s not linear. Many argue the correlation between life expectancy and education is a more accurate predictor.

Vernon argued that most people need to lengthen their planning horizons and frame out the rest of their lives. One way to achieve that is to think about how much their life has changed in the last 20 or 30 years.
My mother is 94 and still living in an independent apartment, although in a retirement community that has medical and rehab services.
Her male cousin just turned 100, and another female cousin just died at the age of 97 after being obese for quite some time.
I'm withdrawing about 2.5% annually and planning for the possibility of living to 110.
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Re: Increasing The Odds Of High-Quality Longevity

Post by vnatale » Sun Sep 20, 2020 9:34 am

Libertarian666 wrote:
Sun Sep 20, 2020 8:27 am
vnatale wrote:
Sat Sep 19, 2020 7:35 pm
What age are you using for retirement planning? I had been using 100 but after seeing this 99 year old Yankees fan sing the National Anthem last week I have a new role model! I'm raising my age to 110!


Increasing The Odds Of High-Quality Longevity

https://www.fa-mag.com/news/increasing- ... 44981.html




For financial advisors, the biggest challenge facing today’s clients is increasing the odds that long lives are high-quality lives. “Most of you are going to sail through your 80s into your 90s, and some will live into your 100s,” Dr. Laura Carstensen, professor of psychology and public policy at Stanford University and director of its Center on Longevity,


Rising longevity is not universal. The sad reality is that childhood obesity and the opioid epidemic are combining to curtail longevity for major segments of the middle-age population. Moreover, if disparities in longevity are increasing almost as fast as life expectancy itself, one thing remains constant. “The death rate is still 100%,” she said.


Cognitive decline is slight among those who don’t experience dementia, Carstensen maintained. It is the ability to process new information and novel concepts that erodes. That’s partly because, like an old computer, an older person has a store of knowledge that’s much greater.

On the dementia front, there is good news. Dementia has been declining significantly and is down 24% since 1970. But this figure needs to be understood in context, Carstensen explained. There are more people with Alzheimer’s because there are so many individuals in the target age population today, but the incidence is declining.


Science indicates there is a 25% to 50% correlation between genes and longevity, so it’s not linear. Many argue the correlation between life expectancy and education is a more accurate predictor.

Vernon argued that most people need to lengthen their planning horizons and frame out the rest of their lives. One way to achieve that is to think about how much their life has changed in the last 20 or 30 years.
My mother is 94 and still living in an independent apartment, although in a retirement community that has medical and rehab services.
Her male cousin just turned 100, and another female cousin just died at the age of 97 after being obese for quite some time.
I'm withdrawing about 2.5% annually and planning for the possibility of living to 110.
Thanks for affirming that I'm not being outlandish in my thoughts on this!

Vinny
Above provided by: Vinny, who always says: "I only regret that I have but one lap to give to my cats." AND "I'm a more-is-more person."
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Re: Increasing The Odds Of High-Quality Longevity

Post by WiseOne » Sun Sep 20, 2020 8:40 pm

I'm not sure I buy the declining Alzheimer's incidence story. The number of people with dementia is exploding and driving a big increase in memory care facilities. Even with the boomers moving into old age, there is something fishy here.

First up: statistical bias in counting who has Alzheimer's in population studies. Turns out if someone has dementia they are less likely to fill out and send back a survey (duh):
https://pubmed.ncbi.nlm.nih.gov/31612352/

And if AD cases are dropping, how is it that deaths from AD jumped 55% from 1999 to 2014 - after adjusting for age? Maybe AD is progressing faster than it used to, or yet again, we have a counting problem.

https://www.alzforum.org/news/research- ... eaths-rise

And, there is the well documented, strong association between Alzheimer's and type 2 diabetes - so much so that AD is often referred to as "type 3 diabetes", and metabolic mechanisms have been proposed and are being investigated. Since type 2 diabetes is increasing dramatically, it's hard to imagine that dementia (including Alzheimer's) isn't as well. Like I said, something just doesn't add up.
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Re: Increasing The Odds Of High-Quality Longevity

Post by Mark Leavy » Sun Sep 20, 2020 8:56 pm

WiseOne wrote:
Sun Sep 20, 2020 8:40 pm
And, there is the well documented, strong association between Alzheimer's and type 2 diabetes - so much so that AD is often referred to as "type 3 diabetes", and metabolic mechanisms have been proposed and are being investigated. Since type 2 diabetes is increasing dramatically, it's hard to imagine that dementia (including Alzheimer's) isn't as well. Like I said, something just doesn't add up.
Completely without research to back me up, I'm convinced that AD is a late stage metabolic disorder and that the correlation with Type 2 diabetes shares a common causal agent.
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Re: Increasing The Odds Of High-Quality Longevity

Post by Libertarian666 » Mon Sep 21, 2020 7:49 am

Mark Leavy wrote:
Sun Sep 20, 2020 8:56 pm
WiseOne wrote:
Sun Sep 20, 2020 8:40 pm
And, there is the well documented, strong association between Alzheimer's and type 2 diabetes - so much so that AD is often referred to as "type 3 diabetes", and metabolic mechanisms have been proposed and are being investigated. Since type 2 diabetes is increasing dramatically, it's hard to imagine that dementia (including Alzheimer's) isn't as well. Like I said, something just doesn't add up.
Completely without research to back me up, I'm convinced that AD is a late stage metabolic disorder and that the correlation with Type 2 diabetes shares a common causal agent.
Sounds right to me. I would bet that it has something to do with insulin surges messing up the brain.
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Re: Increasing The Odds Of High-Quality Longevity

Post by WiseOne » Mon Sep 21, 2020 8:32 am

Libertarian666 wrote:
Mon Sep 21, 2020 7:49 am
Mark Leavy wrote:
Sun Sep 20, 2020 8:56 pm
WiseOne wrote:
Sun Sep 20, 2020 8:40 pm
And, there is the well documented, strong association between Alzheimer's and type 2 diabetes - so much so that AD is often referred to as "type 3 diabetes", and metabolic mechanisms have been proposed and are being investigated. Since type 2 diabetes is increasing dramatically, it's hard to imagine that dementia (including Alzheimer's) isn't as well. Like I said, something just doesn't add up.
Completely without research to back me up, I'm convinced that AD is a late stage metabolic disorder and that the correlation with Type 2 diabetes shares a common causal agent.
Sounds right to me. I would bet that it has something to do with insulin surges messing up the brain.
Yep, insulin resistance in the brain is one of the possible mechanisms. FWIW I also think this hypothesis is heading in the right direction. And I'm kinda disgusted that most AD researchers are still chasing tau protein (a side effect not cause) and genetics (an amusing sideshow mostly) instead of this.

When my mother refused to be put on Aricept for her now-obvious cognitive impairment, I did some digging in the literature and found a small study comparing that medication to exogenous beta hydroxy butyrate (ketones) for effectiveness in mild cognitive impairment. It found them equally effective, and the bhb is easier to get and has far fewer (i.e. no) side effects. So I tried my mom on bhb and she is noticeably better when she takes it. One scoop in the morning in a glass of water, another in the evening if I can wheedle her into it (adding a shot of vodka helps). I tell her it's "brain food" which is a lot more acceptable to her than "a medication to treat your Alzheimer's." I also have been trying to get her to minimize her carb intake, e.g. I get her frozen packages of cauliflower rice from Trader Joe's and tell her look how much easier this is to prepare than actual rice. She's all over that.

Because I've been staying with her lately for various reasons, I've been able to really make sure to implement this plan. Results so far are amazing, she's still got the short term memory problems but she is much sharper the past few days than she has been for a long time. AD fluctuates so too soon to judge, but if this keeps up for another week I'll declare it a success.
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Re: Increasing The Odds Of High-Quality Longevity

Post by pp4me » Mon Sep 21, 2020 9:01 am

My parents lived to 92 (Dad) and 98 (Mom). Neither one had Alzheimer's despite high carb diets with non-diet coke being their favorite drink and a bowl of ice cream every night before bed. Grandparents on both sides had the same longevity with my paternal grandmother dying a few days before her 100th birthday.

So I guess it would be safe to say that I have good genes for longevity.

Unfortunately, I would not rate the quality of life of any of them after the age of 90 as anywhere near High. Both my parents died after long stays in nursing homes and had nearly used up all of their savings by the end. My grandmother lived with us for a while before she went into a nursing home until we couldn't take the smell from her bowel incontinence any more. At one point I think my Dad was on about 20 different medicines. During the last year of Mom's life she was talking about committing suicide.

All of this has left me with the attitude of quality over quantity when it comes to longevity. In other words, enjoy life while you still can.
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Re: Increasing The Odds Of High-Quality Longevity

Post by Libertarian666 » Mon Sep 21, 2020 9:15 am

pp4me wrote:
Mon Sep 21, 2020 9:01 am
My parents lived to 92 (Dad) and 98 (Mom). Neither one had Alzheimer's despite high carb diets with non-diet coke being their favorite drink and a bowl of ice cream every night before bed. Grandparents on both sides had the same longevity with my paternal grandmother dying a few days before her 100th birthday.

So I guess it would be safe to say that I have good genes for longevity.

Unfortunately, I would not rate the quality of life of any of them after the age of 90 as anywhere near High. Both my parents died after long stays in nursing homes and had nearly used up all of their savings by the end. My grandmother lived with us for a while before she went into a nursing home until we couldn't take the smell from her bowel incontinence any more. At one point I think my Dad was on about 20 different medicines. During the last year of Mom's life she was talking about committing suicide.

All of this has left me with the attitude of quality over quantity when it comes to longevity. In other words, enjoy life while you still can.
I would say that with those genes, if you follow a reasonably healthy diet, you should probably have pretty good quality of life until extreme old age.
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Re: Increasing The Odds Of High-Quality Longevity

Post by Xan » Mon Sep 21, 2020 9:31 am

pp4me wrote:
Mon Sep 21, 2020 9:01 am
My parents lived to 92 (Dad) and 98 (Mom). Neither one had Alzheimer's despite high carb diets with non-diet coke being their favorite drink and a bowl of ice cream every night before bed. Grandparents on both sides had the same longevity with my paternal grandmother dying a few days before her 100th birthday.

So I guess it would be safe to say that I have good genes for longevity.

Unfortunately, I would not rate the quality of life of any of them after the age of 90 as anywhere near High. Both my parents died after long stays in nursing homes and had nearly used up all of their savings by the end. My grandmother lived with us for a while before she went into a nursing home until we couldn't take the smell from her bowel incontinence any more. At one point I think my Dad was on about 20 different medicines. During the last year of Mom's life she was talking about committing suicide.

All of this has left me with the attitude of quality over quantity when it comes to longevity. In other words, enjoy life while you still can.
IIRC, WiseOne has written before about how respiratory diseases like the flu are a pretty good ticket out for old folks. I'm guessing she'd put COVID-19 in this category.

I read an article quite a while back about a fellow who was planning to change his medical plans at age 75. At that point, nothing which is intended to prolong life. Yes, treatment for a broken arm or for discomfort or dental stuff or whatever. But no heart bypasses, stents, no CPR, and I think even antibiotics for infections were on his list.

I'm not sure what I think of it, other than that it's an interesting idea.

I also recall seeing that some huge percentage (75%?) of people who receive CPR are dead within six months. At this stage of my life, in the unexpected circumstance that I might need CPR, I would very much like it (it's likely to be caused by an electrical shock or something), but as it gets more likely that some problem with my body might cause my heart to stop... Maybe I'll declare no CPR.
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Re: Increasing The Odds Of High-Quality Longevity

Post by WiseOne » Mon Sep 21, 2020 10:38 am

Xan wrote:
Mon Sep 21, 2020 9:31 am
I also recall seeing that some huge percentage (75%?) of people who receive CPR are dead within six months. At this stage of my life, in the unexpected circumstance that I might need CPR, I would very much like it (it's likely to be caused by an electrical shock or something), but as it gets more likely that some problem with my body might cause my heart to stop... Maybe I'll declare no CPR.
For CPR that takes place outside a hospital setting, the rate of meaningful survival is vanishingly small, like 1%. That's meaning any kind of quality of life...people who do survive are generally left in a vegetative or minimally conscious state. It also depends on age - the ones I've seen who do ok are all under age 50 and the arrest was due to something like drowning rather than an underlying serious medical condition.

CPR in a hospital setting turns out a bit better because it's started much more quickly, but survival depends on the underlying reasons for the cardiac arrest. I could believe 75% survival for that, but again not sure how many of those have a meaningful quality of life.

It comes down to what a former mentor of mine used to say: "No user-serviceable parts inside." There really are very few major wins in medicine.
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Re: Increasing The Odds Of High-Quality Longevity

Post by flyingpylon » Mon Sep 21, 2020 2:19 pm

Xan wrote:
Mon Sep 21, 2020 9:31 am
I read an article quite a while back about a fellow who was planning to change his medical plans at age 75. At that point, nothing which is intended to prolong life. Yes, treatment for a broken arm or for discomfort or dental stuff or whatever. But no heart bypasses, stents, no CPR, and I think even antibiotics for infections were on his list.

I'm not sure what I think of it, other than that it's an interesting idea.
Perhaps it was this article by Ezekiel Emanuel: Why I hope to die at 75

Ironically, Ezekiel Emanuel was also one of the primary architects of Obamacare.
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Re: Increasing The Odds Of High-Quality Longevity

Post by Xan » Mon Sep 21, 2020 2:28 pm

flyingpylon wrote:
Mon Sep 21, 2020 2:19 pm
Xan wrote:
Mon Sep 21, 2020 9:31 am
I read an article quite a while back about a fellow who was planning to change his medical plans at age 75. At that point, nothing which is intended to prolong life. Yes, treatment for a broken arm or for discomfort or dental stuff or whatever. But no heart bypasses, stents, no CPR, and I think even antibiotics for infections were on his list.

I'm not sure what I think of it, other than that it's an interesting idea.
Perhaps it was this article by Ezekiel Emanuel: Why I hope to die at 75

Ironically, Ezekiel Emanuel was also one of the primary architects of Obamacare.
That's it!
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Re: Increasing The Odds Of High-Quality Longevity

Post by Libertarian666 » Mon Sep 21, 2020 2:37 pm

flyingpylon wrote:
Mon Sep 21, 2020 2:19 pm
Xan wrote:
Mon Sep 21, 2020 9:31 am
I read an article quite a while back about a fellow who was planning to change his medical plans at age 75. At that point, nothing which is intended to prolong life. Yes, treatment for a broken arm or for discomfort or dental stuff or whatever. But no heart bypasses, stents, no CPR, and I think even antibiotics for infections were on his list.

I'm not sure what I think of it, other than that it's an interesting idea.
Perhaps it was this article by Ezekiel Emanuel: Why I hope to die at 75

Ironically, Ezekiel Emanuel was also one of the primary architects of Obamacare.
If he gets to 75 and can't afford assisted suicide, I'll be happy to chip in.
In fact, I'll be happy to chip in now if he doesn't want to wait.
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Re: Increasing The Odds Of High-Quality Longevity

Post by flyingpylon » Mon Sep 21, 2020 5:09 pm

Libertarian666 wrote:
Mon Sep 21, 2020 2:37 pm
flyingpylon wrote:
Mon Sep 21, 2020 2:19 pm
Xan wrote:
Mon Sep 21, 2020 9:31 am
I read an article quite a while back about a fellow who was planning to change his medical plans at age 75. At that point, nothing which is intended to prolong life. Yes, treatment for a broken arm or for discomfort or dental stuff or whatever. But no heart bypasses, stents, no CPR, and I think even antibiotics for infections were on his list.

I'm not sure what I think of it, other than that it's an interesting idea.
Perhaps it was this article by Ezekiel Emanuel: Why I hope to die at 75

Ironically, Ezekiel Emanuel was also one of the primary architects of Obamacare.
If he gets to 75 and can't afford assisted suicide, I'll be happy to chip in.
In fact, I'll be happy to chip in now if he doesn't want to wait.
Who says anarcho-capitalists don’t have a heart? ;D
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Re: Increasing The Odds Of High-Quality Longevity

Post by pp4me » Mon Sep 21, 2020 6:05 pm

75? That just gives me 4 more years.

AFAIC right now my benchmark is when I can no longer wipe my own ass.
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Re: Increasing The Odds Of High-Quality Longevity

Post by Libertarian666 » Tue Sep 22, 2020 7:07 am

pp4me wrote:
Mon Sep 21, 2020 6:05 pm
75? That just gives me 4 more years.

AFAIC right now my benchmark is when I can no longer wipe my own ass.
So we're practically twins!
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