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Can 'old age' be the cause of death?

Emma Brown

We operate here on the Washington Post obits desk with certain ironclad rules.One of them is that we never write that a person died of "natural causes" or "old age" (or "heart failure," since in the end, everyone's heart fails).

"We have to use a specific medical cause of death," we tell families, who are often exasperated by that news -- especially when the deceased was elderly and no one really knows exactly what the final straw was.

"He was just old," families often say. Or: "She was 97. Her body just gave out!"

We reporters nod and apologize, and then ask them to check the death certificate for the official cause.

But in a story that ran in today's Post, our colleague David Brown reports that as more people live longer and died without an obvious cause, doctors around the world are beginning to wonder whether "old age" should be an official cause of death.

"Part of the reason it's important is that mortality statistics are the backbone of public health," writes Brown, a physician who writes about science and medicine for The Post.

"Without knowing how the members of a population die, and at what ages, epidemiologists can only guess how many deaths are potentially preventable. On the other hand, good mortality data can identify overlooked problems and help public health agencies decide where to direct effort and money."

Brown goes on to identify some of the problems associated with using the "old age" terminology in data-gathering efforts. But if the World Health Organization adopts "old age" as a cause of death, perhaps we will do the same.

By Emma Brown  | September 19, 2010; 1:32 PM ET
Categories:  Emma Brown  | Tags:  cause of death, david brown washington post, world health organization cause of death  
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It would be better to allow multiple equal causes of death on a certificate, as even younger people can have a large number of ailments that make it difficult to determine a cause of death. When a 72-year-old has COPD, congestive heart disease, atherosclerosis, recurrent (from 31 years earlier!) cervical cancer, recurrent breast cancer, and arthritis so bad that she's bedridden, what do you do when she dies in the middle of the night? One of two things: you can suggest an autopsy that nobody wants or can afford, or you can pick a cause of death at random from the list.

Posted by: Blurgle | September 19, 2010 2:51 PM | Report abuse

My mother - who missed her 90th birthday by 3 weeks - died a week ago. According to the death certificate (an autopsy was not done), the cause of death was "failure to thrive" syndrome, which startled me at first until I read about it. She just went downhill over a period of seveal months - slept most of the time, hard to arouse, poor appetite.

Posted by: swissmiss150 | September 19, 2010 4:10 PM | Report abuse

If for no other reason, epidemiology needs a more precise, even multiple, "cause(s) of death" data. This helps clinical as well as statistical studies.

Posted by: staywell | September 20, 2010 11:32 AM | Report abuse

Dr. Brown said, "Without knowing how the members of a population die, and at what ages, epidemiologists can only guess how many deaths are potentially preventable."

There's no such thing as a preventable death. You can only put it off for a while.

Posted by: elizabeth42 | September 20, 2010 12:20 PM | Report abuse

Can an obituary say that a person died of "multiple conditions"? Surely at an advanced age, everyone really does suffer the cumulative effects of a number of problems, interacting with one another. Saying someone died of "congestive heart failure" or whatever makes it sound as if that person could have lived, if only that disease were more readily treatable. Clearly that's misleading, for a person who is in fact significantly older than the normal age of death.

Posted by: seismic-2 | September 21, 2010 10:52 AM | Report abuse

How does a reader find a simple list of recent deaths of ordinary people in your obituary section? You have lots of descriptions of noted/famous/pompous people, but where do I learn about the common folk who lived in our community and have died? It isn't obvious to me.

Posted by: citizen-gk | September 23, 2010 9:54 PM | Report abuse

Citizen-gk, you can look in the paper and see many local deaths on any given day.

Online, local deaths account for the vast majority of our coverage. The obits we highlight at the top of the obit Web page almost always feature a story about a local person.

And we have an area of the page just under the big picture that says, quite boldly, "Local Deaths."

Posted by: Adam Bernstein | September 24, 2010 11:11 AM | Report abuse

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