You make your biomedical longevity decisions based on the information you have at the time.
If you lack any confirmed diagnosis that portends a shorter lifespan, it’s probably best to just use the mortality table based on income/wealth. People in the Top 10% of the economic pyramid tend to live 5 or 6 years longer than the average (median) American.
As I recount upthread. My plan was to wait until age 70 to start SS. After my amputation last year, I googled the life expectancy of above knee amputees and immediately filed for SS with a start date 6 months prior (age 68 and 11 months.) Now that my rehab has been going so well, my doctors don’t see any reason I won’t live another 15 or 20 years assuming I return to my previous level of activity, which is likely. So waiting until 70 would have been the smarter call in hindsight, based on today’s information.
Americans (including me) tend to underestimate their longevity. The $3.4 Trillion of money left on the table by Americans claiming SS at age 62 is a testament to that fact.
Now, here’s where biomedical literacy for any one individual starts to become as granular as analysis of circumstances using financial literacy. Your above knee amputation wasn’t a surprise, singular event, if my memory serves correctly … but rather an unexpected end result of a longer term ongoing problem?
A year or so before, you mentioned one leg being measurably larger than the other. As an answer to the flurry of concerned queries on that topic, your response was that your doctors had reassured you that there couldn’t be much of a problem if you could manage to walk 5 miles … which I seem to remember was your regular distance with your daily walks with your dog. I’m assuming that no real work up at the time was done to be confident in that reassurance, because you’d surely have mentioned all the skim and fraud involved.
Highlighting this in the context of education for those planning their retirement as mentioned upstream, since lifespan is more closely linked to any one individual’s medical status (known and acknowledged… or not) than online statistics would suggest. Reassurances notwithstanding.
And me. My mother’s mother died in her 20’s. My mother’s father died in his 50’s (heavy smoker/lung cancer). My father’s father died in his 60’s. (He was a drunk.) Only my father’s mother (barely) lasted into her 90’s. I therefore thought that my time was limited, indeed I always had a brooding feeling that I would die in my 40’s.
Clearly that didn’t happen; I’m pushing 80 soon enough, and both my mother and father lasted into their 90’s. (Not that I would have known that at the time I had to make SS decisions.)
Anyway, age is a great informer. You could learn a lot if you pay attention.
Sure, if you can reliably predict at age 62 whether the next 8 years for the stock market are up or down, that would be a great strategy.
Absent that ability, we know that having a larger inflation-adjusted pension improves portfolio survival. Unfortunately, the life annuities offered by commercial insurers are unattractive due to their many hidden fees and costs. Delaying SS to age 70 effectively allows you to buy one of these inflation-adjusted life annuities at a big discount to what an insurer would charge.
Not at all. I’m willing to get whatever tests are appropriate, but as long as I’m ambulatory, I’m going to shop around for the vendor that provides the service at the lowest cost to me.
At age 67, my PCP ordered an ankle-brachial index (ABI) of the right leg which measures the blood flow in the small arteries of the lower leg all the way down to putting a tiny blood pressure cuff on your big toe. That was completely normal. If we assume that my “decades old fossilized aneurysm” (34 mm x 30 mm at age 69) was growing linearly, it was probably 32 mm x 28 mm at the time.
The problem was that the half dozen doctors that looked at my leg over the previous 25 years kept attributing the swelling to the varicose veins I had in my right calf and venous insufficiency. Nobody thought to order a vascular ultrasound or a CT scan, until the AI app my ZOOMCare doctor was using called it “intermittent claudification” and gave me a referral to the vascular specialist for imaging and diagnosis.
I’m pretty sure that I’d still have my leg if the aneurysm was promptly handled on the day of the initial consult rather than giving me a 10 week treatment of angiograms and balloon angioplasties for a lipid problem I DON’T HAVE.
I had a consult with a new vascular specialist on Monday. My ZOOMCare PCP ordered a CT scan will full run-off back in June and it showed that the aneurysm I have in the iliac artery of my “good” leg has grown by 1 mm over the past year and it’s still small enough to just watch. They are going to do a vascular ultrasound of my remaining leg every 6 months to keep track of it.
I also saw a cardiologist on Wednesday to evaluate a low resting heart rate (bradycardia), and to see if I needed any preventive screening to look for any aneurysms besides the ones in my legs. He told me that the only screening imaging they do is the abdominal aorta, which I had done with a clean report at age 67. Given my history of exercise, he wasn’t particularly worried about the slow heart rate, but he ordered a 14-day heart rhythm study just to be safe.
He also looked at all the records for my 23-day hospital stay and the operative report (and pathology on the severed limb) for the popliteal bypass surgery and amputation and said, “I’m still not understanding why you lost your leg.”
Actually not. If you’re trying to predict your longevity to inform your financial decisions, waiting for the wisdom of age is too late. That’s why it makes sense to use the large body of actuarial science available to you, rather than “what feels right”.
If you have a medical diagnosis that portends a shorter lifespan, you use that to inform your financial plans. If you’re father was a drunk and you aren’t, that’s much less informative of your longevity.
That’s why in the absence of a medical diagnosis, the best you can do is to follow the actuarial science and the mortality tables for the general population. That doesn’t mean that won’t get get some illness in the future, but it does lessen the odds that you’ll be among that large group of people who took SS at age 62, and then collectively left $3.4 Trillion on the table because “it feels right” financial planning underestimated their longevity.
I have passed age 62 and chose to NOT take social security. And I think I need to explain why. If I take social security now, I’ll get about $3000/mo, and a bit more as each month passes. We can’t live, even minimally, on $3000/mo. At some point, after I hit age 70, my wife will be eligible to take half of my benefit. So, if the SHTF* and all goes to hell, and there is zero income from all our assets, we can’t live on $3000/mo (or $3200, or $3400, etc). But if I wait till age 70, I’ll get about $5000/mo. And we probably can live minimally on $5000/mo, and certainly if it turns into $7500 a few years later when my wife is eligible, we could manage fine.
So, to me, it is INSURANCE, insurance to be able to live, perhaps minimally, but to be able to. And isn’t that the exact purpose of why social security was created?
* SHTF = something way worse than The Great Depression or The Great Stagflation.
There was a time when people thought that longevity was a more or less inheritable trait. (Accidents, foolishness, etc aside). I recall being told that because three of my grandparents died young that I would probably have a shorter than average lifespan. It turned out not be true (well, I have a couple years to go to get to “average”) but it still infused a belief in me at the time.
I thought to ask the machine if that was common, and surprisingly it says no, that science now has ratcheted up the percentage of heritability for survivorship:
Overview
A generation or two ago, both scientific consensus and popular belief held that **heredity was far less determinative of lifespan** than we know it to be today. \[[1] (https://www.scientificamerican.com/article/how-long-you-live-may-depend-much-more-on-your-genes-than-scientists-thought/)\]
For the last 30 to 40 years, the dominant rule of thumb taught in medicine was that longevity was only 20% to 25% genetic, leaving roughly 75% to 80% up to environment, lifestyle, and choice. Some large-scale pedigree studies from that era even suggested the genetic influence might be as low as 6% to 10%.
2. The Modern Scientific Revision
Major genetic research has turned the old consensus on its head. By utilizing advanced mathematical modeling to strip away extrinsic deaths and isolate “intrinsic mortality” (how our bodies naturally age on a cellular level), researchers found that human lifespan is actually about 50% to 55% heritable. [1, 2, 3]
Past vs. Present Consensus
Metric
A Generation Ago (1980s–2010s)
Today’s Scientific Understanding
Estimated Heritability
6% to 25%
50% to 55%
Dominant Factor
Lifestyle & Environment (Diet, exercise, wealth)
Equal Split (Biology sets the baseline; lifestyle dictates if you reach it)
Data Limitation
Skewed by high rates of infection, trauma, and unrecorded causes of death.
Filtered to focus purely on biological aging rates.
As modern medicine and safer environments have minimized external threats, the “noise” has cleared. We now see that your inherited DNA dictates roughly half of the variation in how long you live, placing lifespan on the same highly hereditary playing field as height or cognitive traits
@Goofyhoofy …I think one explanation for the general lack of appreciation for genetic influence on lifespan is that there are so many in the population who’re lifestyling themselves to premature morbidity and mortality that their behaviors have overtaken the narrative. Even among some of the folk who ought to know better…i.e. those in the medical profession who we’ve chosen to help us address issues before they become a problem (those of us who do, that is) To the extent that you can present to your primary care physician with an elevated LDL-C and, if they see a fit, healthy looking specimen with a history of healthy lifestyle choices, a misplaced reassurance of rude good health is likely to be given rather than the appropriate extra bit of thinking and investigations.
My heads-up on my “borderline high cholesterol” came just about 20 years ago. Having just sold my practice, I had decided my high, “key man” type of life insurance was no longer necessary and a much lower, 10 year term policy was in order. Had the routine, home based physical, with the nurse who performed it opining that I’d surely have the lowest possible premium. A reassurance that turned out to be incorrect…got a phone call from the insurance company to say I still qualified for a low premium but not the lowest, based on a finding of borderline high cholesterol. Only total cholesterol was measured so the phone call was also to advise me to see my doctor. I did and very promptly and, with my new lipid panel before him…with something like LDL-C of 130 mg/dL, HDL 80 or so and trigs about the same and an hs-CRP .8…he got very shirty that some insurance company actuary was practising medicine. Even did the ASCVD calculator thing that had me at low risk for cardiovascular events over the next 10 years. Reassurances all round that my lifestyle was more than enough to negate that allegedly borderline LDL-C. Well, we know how that idea worked.
If I’d known then what my diy doctoring alerted me to about 4 years ago, I might’ve opted for earlier social security.
It’s me birthday today. I’m 74. My mum (the apparent gift giver with the FH genetics) died a few weeks before her 79th birthday. However the early signs and symptoms of “galloping atherosclerosis” started to show in her very early 60s (1980s) with intermittent claudication, hard to control high BP, stroke etc. So, even with almost 5 years to go to match her for longevity, I guess I’m ahead of the game with none of the above…yet.
Happy Birthday! May you have many more! I appreciate you bringing medical aspects to the conversation. May we all live long enough to make a late SS declaration make sense.
(HINT: even if you took it early, living long enough for the above to be true is a long life, indeed)
Separately:
I’m watching a whole slew of people making a great retirement on less than $3500/mo.
When a house costs less than $100K (in many cases, less than $60,000) the rest of the math is pretty straightforward.
And the other thing is that it’s CHEAP INSURANCE. By waiting until age 70, you’re effectively buying an inflation-adjusted life annuity at a big discount to what a commercial insurer would charge for the same monthly benefit.
Yet we see a huge difference in longevity based on income, even if it’s not inherited wealth.
{{ Q.What’s more important in determining my health: my genes or my lifestyle?
A. They’re both important and, although you can’t do much about the former, you can do a lot about the latter. In addition to lifestyle, life circumstances - such as income level and marital status - also have a large influence.
For the rare individuals who live to be 100 or older (centenarians), genes appear to be the dominant force in determining longevity. For example, some centenarians are smokers, but they have genes that allow them to overcome smoking’s adverse effects. As you might expect, scientists are trying to identify the protective genes that centenarians have. }}
If you have a family history of heart disease, and have been diagnosed with it, you use that to inform your longevity.
If Dad was a drunk, and you’re not. Your family history has less effect on your health. Your wealth and lifestyle can overcome it.
As the Harvard article states, “For the rare individuals who live to be 100 or older (centenarians), genes appear to be the dominant force in determining longevity.”
If you’re just trying to get to 85 or so, being wealthy gives you a big leg up.
Per my mention of diy doctoring, this medical writer is one source of information that I’ve followed for a while. This particular article … and included hyperlinks … is on point WRT genetic influences on coronary artery disease, along with the usual insight that you can actually see a lot when you look…
Prevention of Coronary Heart Disease: The Importance of Imaging and Advanced Biomarkers – The Skeptical Cardiologist https://share.google/CJQQAVMeo4TYIy5A7
…and another gem on the topic of false reassurances (as mentioned upstream). This drifted across my Facebook radar screen today…purely fortuitously (unless these devices can intuit what a person is interested in) and seems to have a pretty decent take on the potential for missed diagnoses when no one looks beyond the superficial appearance of health.
Apologies if it doesn’t work for non Facebook users. I don’t know how to do a workaround if that’s the case.
I swear, my “personal quote” from my old TMF profile …the more I learn, the less I seem to know … keeps rearing it’s head. Srsly, I wish I could just condition myself to stick with Google’s AI overview…at least then I’d be confident in my pretend opinion, no matter how wrong it might be!
