Ageing and medicine: quality versus quantity?

Saturday 30 October, 10.30am until 12.00pm, Lecture Theatre 1

‘No pleasure is worth giving up for the sake of two more years in a geriatric home at Weston-super-Mare,’ quipped Kingsley Amis. We all know we are living longer, but what about the quality of our extended lives? The figures are staggering: average life expectancy has extended by as much as 30 years in developed countries during the 20th century; more than half of all babies born in wealthy nations since 2000 will live to see their 100th birthdays. In the UK by 2031, more than a fifth of the population will be over 65 and the fastest growing population will be those aged 85 and over. While these statistics might be seen as cause for celebration, society seems ambivalent. Our doubts are not simply caused by headline scaremongering about massed ranks of the elderly being a drain on pension funds and the NHS. We are also, understandably, concerned that living longer does not necessarily guarantee healthy and happy lives; medicine faces increased challenges from age-related diseases such as diabetes, heart disease, cancer and Alzheimer’s.

Accordingly, medical researchers are broadening their perspective from finding cures and extending longevity to include a concern with quality of life, or well-being, the current buzzword. It is argued that life-long clean living - exercise, moderation in all things and a healthy diet - reduces the risk of age-related illnesses, as well as helping people exceed average lifespans by up to a decade. Now, ageing experts encourage the young and middle-aged to take responsibility for their own future health by being careful today, and pensioners are expected to be au fait with foods that lower cholesterol levels, boost immune systems, improve digestion.

While ‘well-being’ may seem uncontentious, this approach still presents ethical dilemmas for medicine. What constitutes ‘quality of life’? Are we in danger of assuming quality of life is purely a corporeal thing? Might a few more years enjoying one’s grandchildren, even if very infirm, be a worthy aim of medical intervention? And what of new research that emphasises biological and genetic rather than environmental factors behind longevity? Some critics of public health initiatives fear they needlessly take the fun out of living, however old we are. Smoking in ‘old people’s homes’ is routinely banned, while a recent government health report targets ‘late-onset problem drinking’. When poet Jenny Joseph wrote, ‘When I am an old woman I shall wear purple…spend my pension on brandy,’ she captured the pleasurable prospect of growing old disgracefully. Is this just a selfish and silly cliché, neglecting the need for us all to consider what effects our longer lives may have on carers and NHS provision?

Listen to session audio:


Craig Fairnington
associate fellow, Academy of Ideas; university finance and accommodation officer

Virginia Ironside
journalist; agony aunt, Independent; author, The Virginia Monologues: why it's great to be sixty

Irma Kurtz
writer; broadcaster; agony aunt, Cosmopolitan Magazine; author, About Time: growing old disgracefully

Professor Jeremy Myerson
Helen Hamlyn Professor of Design, Royal College of Art

Professor David Oliver
national clinical director for older people, Department of Health; consultant physician, Royal Berkshire Hospital; visiting professor, medicine for older people, City University, London

Dr Marcus Richards
programme leader, Medical Research Council’s Unit for Lifelong Health and Ageing; reader in cognitive epidemiology, University College London

Helen Birtwistle
history and politics teacher, South London school

Produced by
Helen Birtwistle history and politics teacher, South London school
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