Heart Disease And 5 Other Things That Trigger Death At Old Age

This question originally appeared on Quora. Answer by Ray Schilling.

When I was in general practice, I looked after a sizeable number of people in nursing homes. A lot of them were disabled following a stroke, heart attack or other illnesses. I saw them on a monthly basis. Many of them died of “old age”. But the real reason was not just their aging. There were the following medical conditions that were underlying.

1. Heart failure. About half of them with this condition die within 5 years despite the best medicine we used to stabilize them. This has not changed today.
2. Kidney failure. With aging there is less and less filtration capacity of the kidneys until a point in time is reached where kidney failure kills the patient. These patients’ health is too fragile to consider a kidney transplant or dialysis.
3. Liver failure occurs in those patients who had too much alcohol during their life and the liver developed liver cirrhosis. Another cause for liver failure is liver cancer or liver metastases from other cancers. In obese people fatty liver disease can be followed by liver failure.
4. Brain disease: stroke is very common in old age either from hardening of the arteries or from uncontrolled high blood pressure. The older the patient is, the more devastating a stroke is. Alzheimer’s disease can be another reason for premature death compared to those who don’t have it.
5. Bone marrow failure. With old age there is loss of some of the stem cells. This is particularly devastating in the bone marrow that has had a high turnover of cells all during their lives. But without enough blood cells there can be bleeding from a lack of platelets, serious infections from a lack of granulocytes and lymphocytes. Some patients die of leukemia (a blood cell cancer).
6. Apart from these problems there can be osteoporosis with brittle bones. A lack of balance with old age can lead to serious falls with bone fractures. When this affects the hips, there is a high risk of mortality in the order of 50% with total hip replacement.

The key is to keep all your organ systems going by eating a Mediterranean diet, exercising regularly, taking vitamin D3, and replacing missing hormones (bioidentical hormone replacement therapy).