maester aemon

HBO/Game of Thrones

Ever ask someone how their family member passed away and hear them say they simply “died of old age”?

As it turns out, that’s almost never quite what’s going on from a medical perspective. Aging – in and of itself – is not a cause of death. (There is a phenomenon known as “geriatric failure to thrive,” which scientists are studying, but it’s extremely rare.)

When most of us say that someone died of old age, what we really mean is that someone died as a result of an illness (like pneumonia) or as a result of an event (like a heart attack) that a healthy, stronger person would likely have survived.

These are often quiet deaths, like what happens when an older person’s “heart just stops in their sleep.” This usually means that the person had a heart attack in the middle of the night. Another example is if someone “had a bad fall, and it was just downhill from there.” The person likely broke a hip, survived surgery, but then got pneumonia in the hospital and died from the infection.

Most often, what claims the lives of older people is actually an accumulation of things.

“As you get older and older, you’re more likely to get heart disease and cancer,” Amy Ehrlich, a professor of clinical medicine at the Albert Einstein College of Medicine and a geriatric physician at Montefiore Medical Center, told Business Insider last year. “But we also see a lot of things like falls, where someone falls and ends up with serious trauma like a hip fracture. That’s hard to recover from when you’re 104.”

This presents us with a new question:

If we don’t die as a result of aging, then what the heck is aging?

melisandre game of thrones

“Game of Thrones” character Melisandre (“the Red Woman”) doesn’t appear to age, thanks to magic. HBO

Humans didn’t always live long enough to age. We used to die long before our skin began to sag or our muscles began to wither, succumbing instead to diseases for which we now have vaccines, like tuberculosis or smallpox, or we died from gastrointestinal infections, which can cause diarrhea.

Somewhere around the 1950s (at least in America and other wealthy countries), we started living nearly twice as long as our ancestors had just a century before. We now spend a massive portion (nearly half!) of our lives getting old before we die.

What if it didn’t have to be like this?

What if we experienced aging and then came out of it – or didn’t age at all? That’s how some animals do it.

2014 study comparing the mortality rates of 46 different species found that some organisms don’t age – their mortality rates stay constant from around the time they’re born until around the time they die. Others enter a period of aging (like the kind most of us experience around age 65) and then come out of it, continuing their lives.

Here’s a chart from that study showing what aging looks like in a modern-day human. (Mortality rates are in red, fertility rates in blue.)

aging_1Nature

See that sharp rise in the thin red line? We have an incredibly long aging period.

But lots of other creatures’ life spans look nothing like this. Take a look, for example, at the “immortal” hydra (second column, second row), a tiny freshwater animal that lives to be 1,400 years old. It’s just as likely to die at age 10 as it is at age 1,000:

aging hydraNature

Or the desert tortoise, which has a high rate of mortality in early life, but whose rates of mortality decline as it ages. This means that if you’re one of these critters who’s lucky enough to survive your early years, you will likely carry out your remaining (healthy) days until you reach the end.

aging tortoiseNature

What does this mean for the pursuit to ‘stop aging’?

Some scientists think we can use this knowledge to stop aging, or at least prolong life.

“Aging is not a relentless process that leads to death,” Michael Rose, an evolutionary biologist at the University of California at Irvine and the director of its Network for Experimental Research on Evolution, told Business Insider last year. (Rose didn’t work on the study above, but he has published a series of papers and books on aging and evolution.) “It’s a transitional phase of life between being amazingly healthy and stabilizing.”

Other researchers, like biologist and theoretician Aubrey de Grey, want to use our knowledge of these organisms to extend our lives. The proportion of people who die of age-related problems is high in wealthy countries, says de Grey in his recent film “The Immortalists.” “It’s absolutely clear that it’s the world’s most important problem.”

But we are not hydra or tortoises, and, for now, we can’t do away with aging. For us, aging is real, and it is long. Fortunately, many older people can still live healthy, happy lives.

“If someone’s 104, there’s not a whole lot you can do,” says Ehrlich. “But someone who’s 83? There’s plenty you can still do.”



About the author
Erin Brodwin I'm a Brooklyn-based, Los Angeles-raised science and health journalist reporting for Business Insider's Science section. My work has appeared in Business Insider, Scientific American, Popular Science, Newsweek, Psychology Today, Mic.com, and the World Science Festival. I'm also a Punch Sulzberger Scholar. I received a master's degree from the City University of New York's Graduate School of Journalism, focusing on health and science, and a bachelor's degree from the University of California, San Diego in Race and Gender Studies and Environmental Science. You can read more about me here.