Is Longevity Inherited?

[W2R]

[Admin hat on]

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[athena53]

Your patient whom you have followed since he was 25, is now 43 and just showed up with obstructing colon cancer with incurable spread throughout the body. You never asked about family history which it turns out includes a father and two uncles who each had colon cancer in their 40's. Had you known that you might have followed the medical standard practice of recommending a colonoscopy starting in the patient's 30's, something you never would routinely recommend to someone so young otherwise.

Darn, that's sad- for both the doctor and the patient. You'd think that someone with that family history and with all the public education about colon cancer would have taken responsibility to get themselves tested early. When I had my first colonoscopy around age 55 and they found a moderate nasty (not cancerous but could have been if left untreated for 5-10 years), I told DS it was important for him to get tested in the recommended time frames. He's 30 now but you can bet if I'm around when he has to get his first one I'll be nagging him. That's what mothers do.


And it's too bad the doctor of the father/uncles didn't emphasize the need for family members to be cautious. I know one young woman who developed colon cancer (seems to have survived it after extensive treatment) and was advised to tell her family members they should be checked. It turned out her father had it, too- much earlier stage and more easily treatable.

 

[NW-Bound]

I find the study recounted by Gawande perplexing, and struggle to find a possible way to reconcile with popular belief that genetics matter, but am not successful.

Let's read the statement again.

"... only 3 percent of how long you’ll live, compared with the average, is explained by your parents’ longevity; by contrast, up to 90 percent of how tall you are is explained by your parents’ height. Even genetically identical twins vary widely in life span; the typical gap is more than fifteen years.”​

Suppose they did not discount death due to accidents, then this finding would still be significant. It would mean that the extraneous non-medical factors are so overwhelming that good genes hardly matter, unless you never leave your home so you can avoid that proverbial bus.

I assume that they discount death due to unnatural causes, meaning accidents. Then how can this be explained?

I think you get more from your genes then you get from your behaviour. That is yes it is inherited.

Now if you smoke 5 packs a day good genes may not help you.

If you are a smoker, good genes may not help you live longer than the average, but should we not expect that you still live longer than the smoker with bad genes? Statistically, would that not show up?

I believe this finding.

If your parents smoked or drank too much or didn't exercise, your lifestyle impact on longevity will easily outweigh the genetic inheritance. Look around - how many people live exactly like their parents?

Siblings could live very different lifestyles - if one leads a healthy lifestyle and the other is a couch potato, there goes the correlation to genes!

Again, good genes should still show up statistically that it helps.

Well, it does, but the quoted study says a measly 3%.

Does this mean that the health factors that lead to the premature death of a parent do not play a significant role in the health of their children, or does it mean these factors are still inherited but modern medicine is able to treat these conditions and minimize the impact?

I would think that the parents' age was compared to their peer, while the children's age was compared to the average lifespan of the younger generation. This way, the benefits of modern medicine get accounted for equally for people with good and bad genes.

 

[NW-Bound]

We all know people who smoke and get to live till 80 or 90. Conversely, we also know people who are not smoker, yet die of lung cancer.

We have been told that eating vegetable helps with colon cancer risks, but I have read blogs of young colon cancer patients who died in their 20s and 30s, and they were vegetarian. Recently, a study in Europe that follows a large group of people (hundreds of thousand, if not millions) over a couple of decades has found little correlation of colon cancer avoidance to vegetable consumption. Regarding red meat, they said that it was not a strong factor, but could not be ruled out. This led me to believe that the linkage is not that strong.

And people talked about families having 2 or 3 generations of unusual long or short longevity, but is that meaningful statistically? One can always roll head or tail 2 or 3 times in a row. Are you going to roll head or tail again the next time?

I fear there's a lot more randomness in health and longevity than we care to acknowledge.

PS. This does not mean one should live with abandon. Rather, I am going to stay as healthy as I can, and to avoid bad habits. It's just that I cannot be cocky sure that it will get me to live to 90 or even 80.

 

[Big_Hitter]

what is the number one underwriting criterion for life insurance?


(family history?)

 

[eta2020]

And not just health/longevity is genetic.

So is beauty and intelligence.

It is good to pick healthy, good looking, educated and smart parents. At least that is the way looks to me.

 

[NW-Bound]

You left out rich parents, which reminds me of this music: Summertime by Ella Fitzerald and Louis Armstrong.

Time for some music. It's appropriate too, for where I am. Temperature hits 88F today.

Summertime
And the livin' is easy
Fish are jumpin'
And the cotton is high

Oh your daddy's rich
And your ma is good lookin'
So hush little baby
Don't you cry​

 

[Amethyst]

If people were bred for traits, we could predict traits more confidently. But, people are usually mutts. Which is a good thing.

 

[NW-Bound]

But aren't we all descendants of Adam and Eve?

Ah hah! Then, that explains why longevity has nothing to do with genes. They are all the same.

 

[Amethyst]

Well, according to my Bible (see the "begats" section), the earlier descendants of A&E (or of Cain and Abel and their unnamed sisters, one supposes) were living to be 800 - 900 years old. Obviously, we've been doing something wrong of late.

A.

But aren't we all descendants of Adam and Eve?

Ah hah! Then, that explains why longevity has nothing to do with genes. They are all the same.

 

[athena53]

And people talked about families having 2 or 3 generations of unusual long or short longevity, but is that meaningful statistically? One can always roll head or tail 2 or 3 times in a row. Are you going to roll head or tail again the next time?

I fear there's a lot more randomness in health and longevity than we care to acknowledge.

You're right- I bragged about my great-grandmother and my still-active parents in their 80s, but my Uncle (mother's brother), a magnificent specimen who ran marathons and didn't allow white bread in the house, dropped dead of a heart attack at age 42. (I later heard that he was getting signs of cardiac problems and ignoring them.)

 

[ERhoosier]

IMHO- It is too simplistic to generalize population-based observations of family/genetic effects on life span to any specific person. For an unfortunate child dying of a uniformly fatal inherited condition, life span was (almost) 100% determined by genetics. OTOH- For a healthy child who died in a car wreck, genetics had essentially zero influence on their life span. Obviously, genetic influence on LE for the vast majority of folks will fall somewhere between those extremes. And their LE will be influenced by personal behaviors like smoking, diet, and exercise.
In the future, some genetic influences may affect LE less as medical science advances. Members of families prone to serious problems like cancers, heart diseases, etc. may begin living longer, on ave, as those problems are detected earlier and treated more successfully... or even avoided in the 1st place. But that assumes folks won't use those medical advances as an excuse to start smoking, eating poorly, and drinking heavily.
Optimal LE will always depend on doing the best you can with the genetic hand you've been dealt

 

[ItDontMeanAThing]

My training in research methodology and statistics says comparing a random sample of people to their parents is a great way to find little relation between a rare trait and genetic inheritance. The Christian Albrechts University study had the right idea, study the antecedents of really old people.

We have the family tree of one grandmother back to 1793. The percentages of those who died in childhood or in war were comparable to their generations. About 80% of everyone else lived into their 80s and early 90s in eras when that was unusual.

That longevity may explain why everyone underestimates my age. I've never told people the age of when I was first able to buy alcohol without an ID check, or the age when it last happened because no one would believe me. There was a downside. When I was 40, young women got creeped out when they realized I was 15 years older than they thought, while the women my age were dismissive until I mentioned my age. I think they thought I was cougar hunting.

 

[RAE]

You're right- I bragged about my great-grandmother and my still-active parents in their 80s, but my Uncle (mother's brother), a magnificent specimen who ran marathons and didn't allow white bread in the house, dropped dead of a heart attack at age 42. (I later heard that he was getting signs of cardiac problems and ignoring them.)

Running marathons, and other "long-term excessive endurance exercise" can damage the heart. Lots of studies coming out now that confirm this. Here is one: http://www.mayoclinicproceedings.org/article/S0025-6196(12)00473-9/abstract

I believe in moderate exercise myself, but definitely not running marathons, and that type of extreme cardio.

 

[athena53]

Running marathons, and other "long-term excessive endurance exercise" can damage the heart. Lots of studies coming out now that confirm this. Here is one: http://www.mayoclinicproceedings.org/article/S0025-6196(12)00473-9/abstract

I believe in moderate exercise myself, but definitely not running marathons, and that type of extreme cardio.

I'd seen those results, too. My limit is my 35-mile charity bike rides, although I do have 2 scheduled one weekend after the other this summer. It's about 4 hours of riding (with breaks) but I finish feeling comfortably worn out and hungry- not near-death. I once worked for a guy who ran a 50-mile race. We all told him he was nuts. He's in his late 30s; I wonder what shape he'll be in 20 years from now if he keeps that up.

 

[braumeister]

I once worked for a guy who ran a 50-mile race. We all told him he was nuts. He's in his late 30s; I wonder what shape he'll be in 20 years from now if he keeps that up.

Chalk it all up to individual differences.
I have a friend who recently signed up for a 50 mile race, and he's in his 70s. He also did back to back (Saturday/Sunday) marathons last year. He does at least ten marathons a year, and has for years.

 

[eytonxav]

So for those of us that have family history of longevity, this could be bad news; while those of us with shorter family longevity, it might be good news. My family is a mixed bag, so who knows.

 

[bjorn2bwild]

Tinkering with the formula is irresistible.
This study focuses on a new class of drugs designed to clear the accumulation of immortal 'senescent' cells associated with aging. Pairing cancer drug, dasatnib, with antioxodant quercetin achieved "remarkable" results with a single dose.

Scripps Research, Mayo Clinic Scientists Find New Class of Drugs that Dramatically Increases Healthy Lifespan

 

[W2R]

Tinkering with the formula is irresistible.
This study focuses on a new class of drugs designed to clear the accumulation of immortal 'senescent' cells associated with aging. Pairing cancer drug, dasatnib, with antioxodant quercetin achieved "remarkable" results with a single dose.

Scripps Research, Mayo Clinic Scientists Find New Class of Drugs that Dramatically Increases Healthy Lifespan

Wow, this sure sounds promising. Imagine, lessening frailty and increasing cardiovascular ability in old age.

 

[Katsmeow]

Coincidentally, I just finished reading Being Mortal yesterday (a really good book). I was also surprised by the longevity and family history percentage given.

But, I think when you factor in all the things that affect how long you live then I can see it. It isn't by the way just that people sometimes die of accidents. I can see that many deaths may be due to illnesses that are not really related that much to family history.

We think of family history as affecting things like heart disease. But, what about the person who dies of the flu? I would think that family history wouldn't be all that relevant.

Also, bear in mind that some people may take "good" family history as a reason not to be concerned about certain things and may take "bad" family history as a reason to be concerned. My husband's father had heart disease (before 60) and died of a heart attack (mid-70s). DH has always been very aware of that and he has been careful to do things to avoid coronary problems. Imagine someone with no family history of heart disease. That person may not be so careful. In fact, that person may be over-confident and feel they don't have to do anything to try to avoid heart disease and may live a less healthy lifestyle.

 

[W2R]

Coincidentally, I just finished reading Being Mortal yesterday (a really good book). I was also surprised by the longevity and family history percentage given.

But, I think when you factor in all the things that affect how long you live then I can see it. It isn't by the way just that people sometimes die of accidents. I can see that many deaths may be due to illnesses that are not really related that much to family history.

We think of family history as affecting things like heart disease. But, what about the person who dies of the flu? I would think that family history wouldn't be all that relevant.

Also, bear in mind that some people may take "good" family history as a reason not to be concerned about certain things and may take "bad" family history as a reason to be concerned. My husband's father had heart disease (before 60) and died of a heart attack (mid-70s). DH has always been very aware of that and he has been careful to do things to avoid coronary problems. Imagine someone with no family history of heart disease. That person may not be so careful. In fact, that person may be over-confident and feel they don't have to do anything to try to avoid heart disease and may live a less healthy lifestyle.

That is such a good and valid comment. Heredity and environment are, I think, trumped by the influence of sheer luck or chance. People may die unexpectedly soon or late, despite all probabilities.

 

[Brat]

My DS's MIL shared with us the fact that no one in her family lived much into their 70s and that she didn't expect a long life. She is about 67 now, quite a bit more than chubby, and has a long list of health issues. I suspect she is managing her choices based on her expectations.

 

[bjorn2bwild]

A few interesting quotes from the book "Supercentenarians', co-authored by James Vaupel. PDF version here -

MPIDR - Supercentenarians

The record holder in longevity is still the French woman Jeanne Calment, who died in 1997 at the age of 122. The book "Supercentenarians" celebrates her life - how she met the painter Vincent van Gogh when she was 13, how she later allowed herself one glass of port and one cigarette a day, and how she liked good food and wine, including cakes and chocolate, which she ate every day.

Chris Mortensen’s long life is also detailed in the book. Born in Denmark, he died at 115 in the United States. Still the record holder as the world’s oldest living man, at his advanced age he still smoked cigars.

So far the only thing for certain is that being a woman is clearly advantageous, since ninety percent of those celebrating their 115th birthday were women. Having ancestors who lived exceptionally long played as little a role as economic background and half of the supercentenarians had no children.

 

[HFWR]

My family is a mixed bag, so who knows.

Mine too! Oh, we were talking about longevity...

 

[Derslickmeister]

Longevity is definitely not a trait in my family history. I can only find one Uncle that made it into his 80s. Most males (including my father) have checked out in their early 70s, others died in accidents...