How to live a long time AND DIE FAST

Sadly we all have to die but most of us seem keen to defer that for as long as possible.

However no one especially seems keen on getting old, decrepit and dependent which presumeably goes along with living a long time.

The best plan then would be to live a long time in good health but die fast at the very end! A subtext to athleticism is often that it will prolong life and hopefully health as well and there is good evidence to support this.

Regular aerobic intensity exercise may be worth 7 to 11 years of extra life, especially if kept up in the latter years.

However if that just means another 7 or so years of dependent care, is it worth it? Thankfully it seems like it is, regular exercise is beneficial in so many ways, that it certainly increases both quality of life and longevity.

A group of individuals, mostly men, whom have been well studied over a long period are airline pilots and these studies give clues as to the best strategy to "live a long time and die fast".

Airline pilots are a select group and unsurprisingly live longer than there peers, often late into their 90s.

More interestingly they seem to spend remarkably little time in dependent care compared with their peers whom on average only make the early 80s before shuffling on.

Various things could contribute to this, wealth being one and also it has been suggested airline pilots may, on average, have better genes than the rest.

If there is any genetic effect it is likely to be small although hard to prove.

It is very clear however that two other things are the main contributors to their long life and health.

One is the pilots ongoing certification requires regular annual physicals above and beyond that joe average is likely to get.

It seems almost certain that this contributes to both longevity and health by both early detection and treatment of disease and by an educated awareness of health factors that contribute to poor health.

Many countries now have no upper limit on the age of commercial pilots so long as they pass their rigorous heath assessments.

Reassuringly they usually have an upper limit on the combined ages of both pilot and co pilot in any cockpit as I am not sure I would be happy to be flown by my dad and his octogenerian mates no matter how many health checks they had passed!

The other factor is that pilots almost universally love flying as a job and also possibly the money and status which comes with the occupation.

This means they remain strongly motivated to keep themselves fit and healthy so they can remain certified.

They are therefore less likely to smoke, gain weight and much more likely to exercise and eat well than their peers.

The combination of regular checkups and motivation to care for yourself certainly add to longevity and health.

Wealth (as pilots have above average incomes) and possibly genetics may have a small effect too although this is not certain.

None of this really is surprising but what is more fascinating is the lack of need for dependent care in these same pilots in the final decades of their lives even though they may be much older for much longer.

How can this be? It would seem logical the longer you live the higher the chance of age related illnesses such as arthritis, most cancers and alzheimers to name but a few, all of which would seem to make dependent care more likely.

It does seem however that the above factors on average make those diseases less likely or that early detection and good treatment do make a difference.

However no one lives forever and our cells will only regenerate so many times before telomeres in our chromosomes stop further cell division.

Genetically we are programmed to last only so long else we would be in the way of the next generation!

It would seem most of us have a genetic life expectancy of about 90 to 100yrs maximum, although individuals may vary considerably.

But if we can keep everything ticking over, this age is realistic in useful health but the bodies ability to repair or regenerate is minimal.

If something happens then, say pneumonia, a fractured hip, stroke cancer or heart attack the body will have no potential for recovery.

Critically, medical interventions will not work if the bodies cells are unable to cooperate and repair and the stress will tend to cause a cascade of failures in many organ systems that were on the edge that result in death.

This is living a long time and dying fast!

The alternative is to get preventable diseases at a younger age where medical interventions will work as the cells have good regenerative powers still.

Recovery from the effects of obesity, diabetes, cancers, strokes or heart attacks in younger patients is often now good with better treatments but rarely is function back to pre illness levels.

Future episodes of the same or other illnesses are also far more likely.

Each episode will in most cases erode functioning but medical care will nowadays often prevent death.

This is probably why on average the person dying younger requires more dependent care as their last decade or so is likely to be a series of medical events with relative recovery between.

Bruce Mclaren, the famous NZ race car driver and designer was quoted as saying “the ideal race car would complete the race, cross the line first and then disintegrate.”

Living a long time and dying fast is similar, we should aim to live an active optimal lifestyle, be medically aware and prudent so we live to our cellular potential.

Done well and with some luck we should avoid dependency and die quickly of everything at the end.

Dr Neil Averis is a doctor at Health & Sport Central, Christchurch (formerly Gloucester Sports Clinic - renamed and relocated following the Christchurch quakes). He has completed the Coast to Coast five times and is an Ironman finisher.