The Golden Triangle

Life is a triangle made of wealth, love, and health. The dynamics vary as you get older—the first two are thin on the ground until you reach your twenties, the last becomes increasingly scarce as you age.

One thing you can be sure of is you rarely have all three at the same time—if that’s where you are, my friend, you’re in a wonderful place—and one that doesn’t last.

About fifteen years ago I started thinking seriously about ageing—we live longer now, unless we’re felled by the reaper, so definitions are in order—particularly in the age of euphemism, where old people are pensioners, seniors, mature, seasoned, or in late adulthood

My first criterion was whether you had any pills on you—excluding MDMA and birth control (ladies only, otherwise see the section on dementia below). The second was if you had more than one thing wrong with you, and the third whether your ailments took more than three weeks to disappear.

I started classifying typical diseases by decade—I could be more proactive if I knew what to expect. Of course, hospitals and insurers the world over have those records, but they’re surprisingly hard to come by.

Business Insider reviews the panorama for Australia—probably a good proxy for the Western world. Below forty years of age you lead a blessed life—although cash is probably scarce. As for love, I’m sure you’re familiar with roulette.

So here’s the skinny: during your forties, look forward to back pain, diabetes, stroke, and cancer. In your fifties, expect eye problems, and a higher prevalence of cancers—mainly colon and breast, but also prostate. The sixties is a golden age for operations, including cataracts and joints. Oh, and then there’s coronary heart disease, chronic respiratory problems, and lung cancer. When you reach your seventies, the danger of falls is greater—think fractures, injuries, and disability. The list extends into the eighties (it won’t in Africa), and introduces dementia as a major player.

Aussies in their eighties typically have five chronic diseases—presumably the accompanying dementia doesn’t help them recall what they are.

Some years ago, an American in his seventies told me over a glass of red wine that ‘old age is not for sissies.’ I quipped, “It is in San Francisco”—but his point was well taken.

Percentage of different causes of death in the UK—changes over seventy years compiled by the Nuffield Trust (data from the Office of National Statistics).

The chart looks a  bit like Joseph’s technicolor hospital quilt, and you must always be suspicious of percentages—like a bikini, what they show is suggestive, what they hide is vital.

The main finding from the data is that although the population has increased by fifty percent in the last seventy years, the total number of deaths has only increased by ten percent. The chart reveals three striking things.

First, the increase in lung disease—chronic obstructive pulmonary disease, or COPD, which makes it increasingly hard to breathe—has increased by about 40%. Please note that percentages of percentages are an even more dangerous game. To even the score for my bikini comment, I would say these are like men—properly manipulated, you can get them to do anything you want.

As an example, you often see ads stating Drug X reduces your risk of a heart attack by 20%. If your risk level is 1 in 10, or 10%, then it goes down to 80% of (times) 10%. In other words, you’ve moved from 1 in 10 to 1 in 12.5, which is an improvement, but hardly an earth-shaking event.

What strikes me here is that COPD is the artist formerly known as smoker’s lung, emphysema, chronic bronchitis etc etc. For it to have increased when smoking has decreased so significantly is food for thought.

Dementia has quadrupled percentually—if the number of deaths has only increased by ten percent, then that’s a big change—we’re four times madder than we were.

These things have gone up at the expense of two ogres—heart disease and strokes.

The final sinner is the number one offender, up from 17% to 28%, over a quarter of the death toll. The Big C is also the weirdest of all. I remember in almost graphic detail the lectures on cancer when I was at university—more than I can say for much of the other stuff.

Cancer cells are the wild ones, the equivalent of societal misfits. They don’t follow rules, they don’t make concessions. They don’t listen to others, they don’t stick with the pack. In many ways, they’re a throwback to single-celled organisms—they fend for themselves.

Because of these traits, cancer cells inside an organism clump to form tumors, blocking, bashing, and bursting whatever gets in the way. They drift off, and the body’s transport system obligingly conveys them to wherever they’re headed.

Once arrived at their new destination, they barge in through the door and set about destroying their new house.

After everything’s been ruined, there’s no home left—it’s the cancer’s turn to die. There’s no better description of Mr. C, and no better display of understated British humor, than the poem written by the eminent physiologist J.B.S. Haldane in 1964. He died that very same year.

The India Road, Atmos Fear, Clear Eyes, and Folk Tales For Future Dreamers. QR links for smartphones and tablets.

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