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Cause of Death in Very Old People

Valery A. Portnoi, MD
JAMA. 1982;248(19):2448-2449. doi:10.1001/jama.1982.03330190018009.
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To the Editor.—  Dr Kohn's suggestion to include a diagnosis of senescence as a cause of death in advanced age deserves several comments. Natural death secondary to the self-destruction of the aging organism is not a new idea, what is new is only the "set time" of natural death at age 85 years.1 In the 17th century, old age was given as a cause in death certificates side by side with other causes such as fever, vomiting, convulsion, or fright. The time of death of old age was considered at slightly older than 60 years.2 It was a time when tuberculosis was considered as an irreversible age-related condition, which is in the same vein as arteriosclerosis according to Kohn. Yet, a notable decline in mortality was observed during the last decade in the age group of 85 years and older. The death rate for this age group fell


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