Hacker News Reader

Comment by gogopuppygogo | Hacker News Reader

My grandfather was a nuclear scientist who worked on the Manhattan project. He ate right and exercised daily. He even maintained the community parks as a volunteer fixing things like tennis courts and fences.

He got Alzheimer’s. It dragged out for over a decade killing him slowly and hurting everyone who knew him.

My father decided he’d rather have a shorter but more quality driven life after that experience. He’s overweight, has a great outlook on his life, and is a joy to be around.

Not everyone wants longevity.

View on HN

Hi, psychologist here. Cognitive decline is not my specialty but I’ve taken doctoral level courses in it.

The problem with the “shorter higher quality life” position is that diet, exercise and health affect EVERYTHING. Exercise and diet are majorly implicated in both physical health decline and onset of dementia and Alzheimer’s. In fact, maintaining a healthy and active lifestyle is often found to be the number one protective factor against cognitive decline.

Unfortunately there’s no health strategy that reliably produces a shorter higher quality life. There’s only increasing health span through lifestyle.

Note: there are medical choices that increase lifespan but not health - medication and surgery that prolong unhealth. But that’s a whole different game than healthy lifestyle.

I suspect the causality flows (mostly) in the other direction for that correlation.

The set of healthy and active elderly people consists only of those who can be healthy and active, while the set of sedentary / overweight elderly contains both those who choose not to be, and those who are kind of stuck with it due to chronic illness. Which aren't sharp categorical distinctions, mind you, but it virtually guarantees that the latter set will have shorter lifespans and worse end of life outcomes, even though plenty of nonagenarians are overweight (though very few indeed are obese).

I stay in the game for what it brings me now. I can think of little so grim as going to the gym with the goal of living longer— but that's my personlity, someone else might find it motivating.

> ...The problem with the “shorter higher quality life” position is that diet, exercise and health affect EVERYTHING.

I would also include sleep in this list.

With advancing age the amount and quality of sleep seems to diminish. Maybe it's individual-specific and dependent on the life-style, in any case undersleeping effects eventualy catch on and affect the body and mind state.

My mother's dad died of stomach cancer, my mothers mom had a brain tumor and died of organ failure, my mother was an alcoholic and died of liver failure, my father was an alcoholic and died from massive organ trauma (he made a series of bad decisions in rapid succession), my father's dad had multiple heart attacks and died of complications from MDS, my father's mother is still alive. There's a history of mental illness, cancer, diabetes, and overall poor health on both sides of my family....

That said, I'm taking as good care of myself as I can without going to the extreme. I don't want to deny my one short, brief life the pleasures that are here to be experienced but I also don't want to artificially shorten my (already stacked against) life.

I have decided however that I won't be dying in pain in some hospital if I can at all help it. I've watched it happen. I'll either live somewhere that assisted is allowed, or I'll FEED MYSELF TO SHARKS...something, anything, other than the slow waste of a hospital.

As someone (~50) who has spent much of the past 2 months suffering in pain in some hospital, I endorse your decision. Several hospital-issued medication issues there that set me back.

I’m now at home, where I’m slowly healing just as well. As long as I can eat and drink (and failure to be able to do that is what sent me to hosp to begin with), I stay here.

I’m going to come out of this more healthy, I’m determined.

If you’re younger (or older!), I strongly endorse avoiding the pharma industry to the extent possible. The side effects will almost aways catch up to you at some point, usually during a crisis or other sickness. Work on your weak spots “naturally” (eg, if you’re anxious, master meditation and physical workouts). If you’re on a chronic drug, always carefully re-evalulate risks/benefits at least once a year, and find out if there are any new non-pharma approaches.

With a very few exceptions, pharma is about temporarily soothing symptoms while doing nothing for the underlying disease.

I'd say don't underestimate and write off medication.

You can master the art of balancing medication intake to fit your needs.

Sadly, the biggest roadblock in that case is having to deal with doctors and pharmacists who just won't give you what you need.

That’s how I felt in my 20s. What’s above is my opinion in my 50s, after multiple hospitalizations and serious chronic illnesses.

Best option of all is to stay fit. Some of mine were out of my control (genetics), but some were probably not. And the extent to which the genetic ones expressed was probably somewhat in my control.

Well, yeah, I'm talking after regular exercise and a good diet.

I've seen people give in to stuff like wrist magnets and rejecting vaccines because they didn't like "chemicals in their body".

Why have this whole industry if people reject it?

I personally have the opposite problem - I can't get what I need.

I managed to a few times and can tell my life is noticeably worse without medication. So I guess this is the result of my experience so far.

Seeing people with access to prescriptions or suppliers who simply refuse to try "chemicals" because they can't be arsed to experiment or even learn how they work makes me sad.

The challenge with such recommendations is that the reader must be able to understand which medicine can be safely skipped. I do not believe most people can make this choice safely.

For many conditions, such as arthritis, taking daily medicine is required and skipping that would decrease quality of life dramatically.

However, if you've a sore head then potentially skipping some medicine is fine.

>> With a very few exceptions, pharma is about temporarily soothing symptoms while doing nothing for the underlying disease.

I think you're quite mistaken. Pharma is about improving the quality of life and health outcomes for the patient. Some diseases cannot be magically fixed with drugs, e.g., Parkinson's, etc.

> such as arthritis

Which arthritis med, exactly? So many have been pulled off the shelf by the FDA.

But Levadopa for Parkinson’s (which I’m highly likely to get if I live long enough), and its newer analogues, may be one of the few worth the trade. Grandparents on both sides w/Parkinson’s.

99% of the other drugs are not worth the tradeoffs, for most people.

When I said Arthritis I actually meant Rheumatoid Arthritis (RA), where Sulfasalazine is the recommended and effective drug treatment. I don't know much about osteoarthritis (OA) so cannot comment on it.

>> But Levadopa for Parkinson’s (which I’m highly likely to get if I live long enough), and its newer analogues, may be one of the few worth the trade. Grandparents on both sides w/Parkinson’s.

I'm very sorry to hear that. Are you taking any "precautions" to (potentially) delay or mitigate the onset of Parkinson's, e.g., healthy eating, exercise, etc? Do you think knowing what you know has had an impact on how you lead your life currently (#Yolo)?

Note: I'm a researcher in an adjacent field (digital health) and so please don't take anything above as medical fact.

> or I'll FEED MYSELF TO SHARKS

Highly likely that you won't. Standing there, ready to go, your survival instinct will go into overdrive and suddenly living a bit longer regardless of the pain won't seem so bad.

Yeah no one actually wants to be torn apart by wild animals.

I thought that was a completely obvious stand-in for some gentler not-medically-assisted suicide but nothing is obvious here on Hacker News...

Oh, I thought it meant suicide by drowning (and becoming fish food). Pretty high chance of success... if you can take the leap. It's harder than you'd think.

My 'final resort' would involve a tank of nitrogen fwiw.

No part of my hindbrain is upset by switching breathing gasses, and by all reports there is no more pleasant way to check out.

Again, at the last moment, your primitive brain will disagree. Better make sure you can't back out heh.

No, that's the thing: it won't.

You can't detect the lack of oxygen, only the buildup of carbon dioxide. You just get tired and pass out, it takes about two minutes. There's no panic.

If I'm ready to log off because my life has become weakness and pain, I'm not going to chicken out. But I'm not afraid of death, it's the dying I'm not so stoked about.

I've also done some eldercare. I will be dying at home. All relations know that under no circumstances will I end up in a retirement home, or worse. That's a fate worse than death.

I've asked my family doctor to help plan ahead. So that it's my decision. Like getting a home euthanasia kit. Or whatever.

All of that advance planning might go out the window if you start to suffer from dementia and are judged to be mentally incompetent. Those relations could end up putting you into an elder care facility because you're unable to care for yourself and they don't want to facilitate your suicide. Most jurisdictions that allow assisted suicide require the patient to be of sound mind.

Yup. I worry about that. Happened to one of my relations (whom we were caring for). My primary motivation to preplan. Will keep my kit secret. I don't want to solely trust my relations to honor my wishes. But nothing's certain.

Yeah, I was replying to the 'superager' submission and my observations in connection. People can do whatever they want, particularly when you hit 60 :-).

These two things are not in opposition. I eat whatever and whenever I want... because I also enjoy large amounts of physical activity that burn it all off.

A stroke from a bad diet can stop you from being the same at a younger age than some people expect

Reply on news.ycombinator.com