A Rōsui By Any Other Name

At any age it's nice to have people who care (WSJ photo)

When my father passed away in 2019, the cause of death was listed as congestive heart failure. But we knew that the underlying reason was an attack of shingles that had hospitalized him a few months earlier.

Although the doctors declared him to be "recovered" from shingles, all his systems were weakened. He had become vulnerable to any infection or health problem that he might well have fought off a year earlier. Before shingles, he was "younger than his age;" after, he looked like his full 94 years.

More doctors are moving toward listing "old age" as the cause of death.

When a very old person dies without any obvious trigger, should doctors try to come up with a cause? Or is it acceptable to say that the person died of old age?

Doctors are increasingly going with the latter. The third-most-common cause of death in Japan last year was rōsui, a word that combines characters meaning “old age” and “decline.” It is generally translated as dying of old age, and it accounted for more than one in 10 deaths, trailing only cancer and heart disease.

“We would say these days, ‘She had all sorts of conditions but since she was old, let’s say she died of old age,’ ” said Akihisa Iguchi, a gerontologist and emeritus professor at Nagoya University. He said families are usually fine with that.

The basic arguments for and against "old age" as a cause of death are fairly clear:

It also gets at the choices families and doctors face when an elderly person grows frail, perhaps suffering from a variety of ailments that aren’t individually life-threatening. They must decide how aggressively to treat those ailments and how to ensure the person’s comfort.

Putting the name of a disease on a death certificate—such as respiratory disease or pneumonia, both on the U.S. top-10 list and common among the elderly—prompts questions about what was done to treat that disease. Death from old age, by contrast, suggests a kind of inevitability.

As for me, I'm not opposed to "old age" as the reason for my cause of death because at that point I won't care.

However, while I'm still breathing--and sentient--please spare my feelings by not saying that I'm suffering from old age. Use WHO's phrase, “aging-associated decline in intrinsic capacity.” Science-speak has a way of mellowing the harsh.