Suppose you read the following sentence in an article about company management: “This factor is central in achieving successful bankruptcy.” It sounds rather weird, doesn’t it? What if you read this about football team training? “Contrary to popular belief, it is possible to lose a game in a successful way.” These are so-called oxymorons—by Oxford’s definition, “figures of speech in which apparently contradictory terms appear in conjunction.”
The contradictory nature of the statements above is more than just apparent—bankruptcy is the exact opposite of “success” for a company, and the same goes for losing a game for a football team. One can get very creative with these: “a blockbuster fiasco”; “the façade of the building deteriorated nicely”; and so on. Examples closer to home would be “healthy aging” or “aging gracefully”.
Sometimes, semantics do matter
The examples above are, admittedly, cherry-picked extreme cases. You can definitely say that a building’s façade has aged nicely; the intended meaning is that, while the façade has indeed deteriorated with time, the decay could be much worse than it is, and the original looks of the building can still be somewhat appreciated. Notwithstanding that, if the façade of your house deteriorated, however graceful or disgraceful that was, you probably would—and should—consider renovating it before it started crumbling.
Similarly, expressions such as “healthy aging” and “aging gracefully” signify that while the aging processes are making no exception for you, you’re relatively healthy and/or the cosmetic signs of aging aren’t as pronounced as they could be. This, of course, betrays the obvious reality that, in general, this kind of aging isn’t the norm but rather a special case. If things were the other way around, you wouldn’t find any articles stating the obvious fact that it’s possible to age gracefully; rather, you’d find articles saying that disgraceful or unhealthy aging, however exceptionally, may happen too.
This choice of words is rather problematic, especially now that the dawn of rejuvenation is visible on the horizon. The terms “healthy aging” and “successful aging” really are sharp contradictions in terms. If you read the scientific literature on aging, most if not all papers giving general introductions to the phenomenon define it as a chronic process of damage accumulation or a progressive decline in health and functionality. If we try to replace these definitions in the two expressions above, the results are frankly hilarious: “a healthy chronic process of damage accumulation” and “a successful progressive decline in health and functionality”. What’s that even supposed to mean? Given that this progressive decline in health and functionality happens of its own accord and it invariably kills you, one would think that you really don’t need to put any special effort in achieving it, and it appears to be “successful” enough without any need for external intervention.
Too late to change
It’s of course good that healthy aging, as defined as a mitigated and relatively disease-free decay process, is actively promoted. However, this unfortunate terminological choice perpetuates the false dichotomy between aging and age-related disease; it reinforces the completely unsubstantiated belief that you can age biologically and yet retain your health. To put it bluntly, it’s one of the reasons why you have people saying that when their grandfather died, at age 95, he was “perfectly healthy”. If everything with him was in perfect working order, what did he die of, exactly? Some may think he just died of “old age”, as if old age were a separate cause of death entirely, but that’s not the case. Death by old age is just an expression to mean that he died of one of the many health issues that, in humans, generally manifest only after the seventh or eighth decade of life.
Just like the term “life extension”—albeit somewhat improper—has become a proxy for the application of regenerative medicine for the prevention of age-related diseases, so “healthy aging” and similar phrases have become synonymous with “being less sick than you could be”, even though they really sound more like “getting sick in a healthy way”. The only way to eradicate these misleading expressions is to successfully explain the true nature of aging to the public.
This lousy choice of words probably owes its existence to another such poor choice—one that, given how long ago it was made, is entirely understandable: namely, the choice of the word “aging” to indicate the decline in health that we experience with the passing of time.
The key word here is “with”. Age-related decline comes with the passing of time, but not because of it. Time passes virtually at the same rate everywhere on Earth, yet the degree of age-related decay varies considerably not only from species to species—with examples of very few species that age barely or not at all—but also from individual to individual within the same species. Presumably, primitive humans noticed the gradual onset of decay in every individual past a certain age, and, not knowing better, simply ascribed it to the passing of time, given the obvious correlation between the two phenomena.
Hence, we’re now stuck with the term “aging” and all the misconceptions that come with it—such as conflating the ill health of old age with the greater wisdom that may, though not necessarily, come with time, as though they were two sides of the same coin. However, they are, in fact, two entirely separate things: the latter is the product of your life experiences and is, in no negligible part, under your control; the former is entirely biological and largely beyond your control. The passing of time is, of course, a necessary condition for biological aging to take place, but it is by no means a sufficient one; the same can be said about accruing life experiences.
A minor hitch, not a roadblock
This inappropriate terminology may well make it harder to get across the message that biological aging is just bad for you, and no excuses can be made for it; people are far too used to the groundless idea that chronological and biological aging are, in general, the same, inevitable phenomenon that comes with pros and cons. Still, this is hardly an insurmountable problem, and it will hopefully begin to erode once the first rejuvenation treatments show their efficacy in disease prevention. We might be stuck with inadequate terms for now, but, hopefully, a handful of decades into the future, we will think of healthy aging in the same way that we currently think of phlogiston: there’s no such thing.