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Cause of Death in Very Old People

Robert R. Kohn, MD, PhD
JAMA. 1982;247(20):2793-2797. doi:10.1001/jama.1982.03320450027027.
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According to the Vital Statistics, white women have a modal life span of 85 to 90 years, with most individuals dying at around the same age from either ischemic heart disease, cerebrovascular disease, pneumonia, or accidents, or at earlier ages from malignant neoplasms. White men die earlier than women, and nonwhite populations contain two or more subpopulations that die earlier than white populations. Major causes of death listed in Vital Statistics show similar patterns in the aged for all populations. A review of autopsy findings in 200 persons older than 85 years yielded a very different pattern. No acceptable cause of death, other than complications of the aging syndrome, was identified in at least 30% of the cases. Vital Statistics for the aged is misleading because diagnoses are not definitive. Physicians accept causes of death in the aged that would not be acceptable in younger persons, and the role of aging processes themselves as cause of death are not appreciated. Aging is characterized by a universal progressive decline in physiological function to the point where life cannot be maintained in the face of otherwise trivial tissue injury. It is proposed that senescence be viewed as a disease and be accepted as a cause of death.

(JAMA 1982;247:2793-2797)


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