Woody Allen and ageing

"In my next life I want to live my life backwards. You start out dead and get that out of the way. Then you wake up in an old people's home feeling better every day. You get kicked out for being too healthy, go collect your pension, and then when you start work, you get a gold watch and a party on your first day. You work for 40 years until you're young enough to enjoy your retirement. You party, drink alcohol, and are generally promiscuous, then you are ready for high school. You then go to primary school, you become a kid, you play. You have no responsibilities, you become a baby until you are born. And then you spend your last 9 months floating in luxurious spa-like conditions with central heating and room service on tap, larger quarters every day and then.. Voila! You finish off as an orgasm! I rest my case."

This quote is from Woody Allen and was sent to me by one of the participants to our meeting. It is very timely as at my work I was joking earlier this week about the possibility of deageing. Especially deageing after reproduction seems a real option to me, meaning that when the kids grow older, you have more energy again. I must admit that I am a bit obsessed with growing older, approaching 50, and want to do everything to stop the process. And to find out that I have a bit more energy again, because my kids can pee, eat and move on their own gives a feeling of, well, comfort (and living in Geneva for most of the week also helps in this respect, although I miss them a lot at the same time).

But on a more serious side, it is also something we should deal with at WHO. In our discussions on how to structure the meeting, we are struggling with finding an alternative for the old models where you relate age and disease to various forms of care. If you have chronic diseases, find some disease management programme, If you are frail, you need to have home or institutional care, and if you are dying, the palliative care guys are waiting for you. As I said already in my earlier blog, it is all a bit sad and focused on the average patient.

What we really want is to find the right mix of support, assistive devices and care for you to remain longer independent. If your functions decline, and that is going to happen to all of us, how can we compensate for that as much as possible? I am not going to tell you what is our new model (will be released soon), but it is going to radically alter the lives of older people worldwide (ok, this may be an exaggeration).

However, I am convinced that you can start already now in trying to shift the age where you become dependent and frail. By taking care of the FIELDS of ageing (Food, Intake, Exercise, Liquids, Drugs and Stress, see earlier blog) it must be possible to stay in better shape and to be better able to cope with getting older. Just like people who are in good shape often recover faster after an operation, fitter people will probably face serious decline much later in life.

A word on dependency, as we struggle with that as well. What is it after all? There is much written about this in the literature. Dependent is often explained in terms of dependency on other people with performing activities of daily living. But can you be dependent on assistive devices as well? Are more resilient people with similar declined functions less dependent? And how to define the border line? Does frailty implies that you are also dependent? And is the wording (dependent) not a terrible way to speak about people?

Enough questions and I am not qualified enough to answer them. But we will address them during our meeting in April.

For now I wish everybody a happy Easter. After all, Easter always represents a new beginning, and the start of spring. In fact Easter is THE feast of deageing. Or as Woody Allen says "I don't want to achieve immortality through my work... I want to achieve it through not dying."