Peter Attia Split Death into Four Types: Death, Cognitive Death, Physical Death and Emotional Death
The edition of the ‘Drive,’ podcast where Peter Attia described the four types of death, is a powerful episode.
To start with, nobody explains the difference between lifespan and health span better than Peter.
When you look beyond the obvious death, there are three more ways to die. They are cognitive death, physical death, and social death. This discussion addresses a major fear of life extension. The fear that a long life will be spent in a frail, isolated or cognitively impaired state. Ageing exists in a social context, as well as in our bodies.
You’ll find Peter Attia’s four types of death below – followed by a dive into how I believe each should factor into longevity and health span science.
What Are Peter Attia’s Four Types of Death?
Here is a quick summary, each is discussed in detail below:
Type 1 – Death: This is the final death, when your body finally ceases to function. Your lifespan ends here.
Type 2 – Cognitive Death: Brain function decline leads to memory loss, inability to process information and ultimately, the loss of self.
Type 3 – Physical Death: This path starts with declining strength and stability – and ends in frailty. The end-state is when you are unable to function physically, becoming dependent on others.
Type 4 – Emotional Death: Unresolved trauma, emotional pain or a lack of social connections range from unhealthy to existentially unbearable. When the thought of living a long life is more painful than joyful, you are suffering from an emotional death.
Health Span = Avoiding the Types 2, 3 and 4
In the ageing field, improving health span is a clear first goal. What it lacked was a useful definition. Here is what the Cambridge Dictionary has:
“The number of years that someone lives or can expect to live in reasonably good health.”
Defining ‘reasonably good health’ is left open to debate. Especially when you add the ‘for their age’ proviso.
Using Peter Attia’s types of death, a definition like this one makes more sense:
“The number of years lived or that you expect to live while physically independent, mentally alert and free from emotional or physical pain.”
Drilling down from here, adding definitions to mental, physical, and emotional death clarifies the definition of health span.
Cognitive Death and Health Span
Alzheimer’s disease is a huge killer, sited as 11.5% of all deaths in developed countries. This is the most obvious form of mental death – though far from the only one. Dementia, memory loss and declining cognitive function all subtract from the quality of life.
There is good news in this area.
Research into declining mental function was boosted by the new generation of MRI scanners. New pathways, drug treatments and ways to spot and treat symptoms early will all be revolutionised in the coming years. That said, we are still waiting for a cure.
Lifelong Learning Helps
Neuroplasticity (the ability to create new neural pathways, central to learning and new skills), is more malleable in older people that you’d think. I recommend this video by Dr Andrew Huberman. He goes through how focus boosts learning, getting right down the level of individual brain cells.
Finally, while neurones have unique qualities, they are cells. Behaviours like fasting, exercise, optimising sleep, and the right balance of vitamins / minerals work for neurones too.
Physical Death and Health Span
This is the easiest form of creeping health span decline to measure.
Measuring strength, endurance, and stability are standardised. The ability of someone to live an independent life is a significant inflection point.
Physical decline quickly becomes a destructive loop. The stairs become a challenge, so people move to a bungalow. That lack of exercise then contributes to further physical decline – and so on. Add an injury or a fall, and physical death is close.
Some loss of muscle mass and a decline in stability is expected as we age. How quickly they decline is very much controllable. Regular exercise, stability training and a healthy diet all count.
Recovery after illness or accident is another critical point. Health services can fix the damage after a fall. Whether individuals are left sedentary, to slowly decline in physical ability is something that must be addressed.
Emotional Death and Longevity
We can diagnose mental illness with a degree of rigour. The Diagnostic Statistical Manual (DSM) is now in its 5th edition.
What this does not measure is how emotional health affects quality of life. At one end of the spectrum, unaddressed extreme trauma makes life unbearable. Within the social context, the net negative effects of trauma, loneliness or emotional disconnection is far harder to measure.
Some people view extending lifespan as a horrific proposition – their emotional experience of life means that physical and mental health span factors become secondary.
Peter Attia has taken something we all intuitively know – and made it a significant component of our overall health span. Emotional well-being is far from ‘fluff.’ It is a vital component of healthy aging.
I look forward to exploring purpose, social isolation, and loneliness in later life in depth here at the Age Well Times. In a world that focuses on longevity drugs and skin creams, I enjoyed stepping back and thinking about the social and emotional components of a long and meaningful life.
In the meantime – if you are yet to discover the excellent work of Peter Attia, his YouTube channel is the best place to jump in.
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