Views & Reviews Review

Stop the medicalisation of old age

BMJ 2012; 344 doi: (Published 01 February 2012) Cite this as: BMJ 2012;344:e803
  1. Graham Mulley, emeritus professor of elderly medicine, Leeds
  1. g.mulley{at}

The “egregious marketing” of therapies for everyday ailments in older people, along with disease mongering and overtreatment, help no one. But which interventions lack proved benefit? Graham Mulley found answers in this iconoclastic book

How are we to ensure a long life and a healthy old age? It helps to have aged first degree relatives (genetics contribute to about 25% of lifespan). Much depends on where you live—which part of the city (Kensington or the east end of London), which town (people in Okinawa in Japan, Nicoya in Puerto Rico, Loma Linda in California, and Sardinia have the greatest longevity), and which country (you are likely to live longer in Japan or San Marino (an average 83 years) than in Malawi (47 years)).

Longevity is influenced by educational level, financial status, social engagement, having a job (and one you enjoy), skin colour, religiosity, and attitudes to life. It is wise to be prudent about weight, diet, and alcohol; to take regular exercise; and to avoid smoking.

Yet the explanation for the unprecedented increase in the numbers of very old people is not entirely clear. The early gains were …

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