Lifespan Versus Healthspan: What Really Matters To Older Adults

As you’re most likely aware, an entire “anti-aging,” bio-hacking culture has erupted in this country, so that thousands of online influencers and billionaire tech entrepreneurs have invested millions, if not billions of dollars, trying to slow down and even reverse the biological aging process. While advances in science have been touted, and individuals have put themselves forth as “living experiments” in efforts to slow down their aging (even starting Don’t Die movements), the reality does not quite match these goals. A recent study published in NPJ Aging suggests that the upper human life span limit may be somewhere between 146 and 194 years. There are apparently critical DNA mutations that cause “bottlenecks” in efforts to extend human longevity, so that even if we were able to cure or eliminate all markers of aging (except these DNA mutations, which are too numerous to target), the farthest reaches of human longevity would likely only reach 194 years, which granted, is still more than double the average current human life span of 79 years. Of note, this new study used mathematical modeling to arrive at these calculations. There are no clinical trials to test these numbers, and “actual longevity therapies (to achieve these numbers) have yet to appear.” So, despite the adherents to the “Don’t Die” movement, there’s no realistic current chance that extraordinary longevity will be achieved anytime soon. For more on this study, pour yourself a green juice and click here.

What’s also important to realize is that currently, even with the achievement of longer lives, there’s still a significant gap between the number of years people live and the number of years during that lifetime that people experience a diminished quality of life due to illness and disability. According to a new study in Lancet Public Health, this “morbidity gap” has grown worse over time, as we continue to extend life expectancy, while years of good health don’t keep up with that expansion. So many of those years of extra life achieved don’t equate to healthier aging, just longer lives. In 2023, the average “morbidity gap” around the globe was 10.7 years, but in the United States, the numbers are worse, with the number of years lived with illness or disability rising to 14 years on average. The data also show that while women live longer than men, they also experience more years in poor health than men. Why this morbidity gap? Researchers point to lower back pain and other musculoskeletal disorders, along with mental health challenges, as contributing to the extra years of poor health.

Despite the longevity goals of many, what’s becoming more and more clear is that the quality of those longer years may be more important than the actual number of additional years of life achieved. Even the founder of the “Don’t Die” movement, tech entrepreneur Bryan Johnson, admits that he may be taking his longevity ambitions too far (especially as he has been recently diagnosed with an incurable autoimmune illness). The question becomes: in our quest to extend life expectancy, are we actually keeping people healthy in these longer lives? Longer lives don’t necessarily equate to better or higher quality lives. In fact, such model health care systems as The Mayo Clinic are now rethinking their orientation to caring for older adults, admitting that modern medicine needs to focus less on longevity as a goal and more on what it means to live those extra years in as healthy, functional, and independent a state as possible. That is, there is a need to focus less on how many years someone may live and more on a high-quality “health span,” recognizing that currently there’s a major gap between years lived and years lived well.

One additional recent study brings this point home. Published in PLOS One, this study out of England looked at general health care preferences for people aged 50 and over. With a survey of over 6,000 adults, the study found sharp differences between the way men and women approach the “lifespan” versus “healthspan” distinction in aging. Older women placed more importance and value on the quality of their lives than the length of life they will achieve, while men seemed to prioritize living as long as possible. While there was a wide variety of opinion on matters related to decision-making strategies, experimental treatments, and risks versus benefits, the takeaway was that older women were more focused on the quality of their lives, perhaps because, as we cited above, they experience more years of poor health than men tend to experience. While every older adult is entitled to his or her own opinion of where they find value in health care delivery and the goals of life expectancy, it would be wise for health care professionals to recognize what may already be apparent to many of their patients: that the quality of the years lived, hopefully in good health and with independence and purpose, may be the desired goal of care rather than squeezing out extra time, especially if those additional years are lived in disability and/or illness.