Based on data from the Medicare Current Beneficiary Survey, investigators found that, even as life expectancy has increased over the past two decades, people have become increasingly healthy later in life.
“With the exception of the year or two just before death, people are healthier than they used to be,” “Effectively, the period of time in which we’re in poor health is being compressed until just before the end of life. So where we used to see people who are very sick for the final six or seven years of their life, that’s now far less common. People are living to older ages and we are adding healthy years, not debilitated ones.”
“There are two basic scenarios that people have proposed about the end of life,” “The first argues that what medical science is doing is turning us into light bulbs — that is, we work well until suddenly we die. This is also called the rectangularization of the life curve, and what it says is that we’re going to have a fairly high quality of life until the very end.
“The other idea says life is a series of strokes, and medical care has simply gotten better at saving us,” “So we can live longer because we’ve prevented death, but those years are not in very good health, and they are very expensive — we’re going to be in wheelchairs, in and out of hospitals and in nursing homes.”
Different studies have produced competing results. One reason for the confusion, is that such efforts are simply looking at the wrong end of someone’s life. “Most of our surveys measure health at different ages, and then use a model to estimate how long people have to live,” he said. “But the right way to do this is to measure health backwards from death, not forwards. We should start when someone dies, then go back a year and measure their health, then go back two years, three years, and so on.”