England’s chief medical officer, Professor Chris Whitty, has called for a cultural shift in medicine away from maximising lifespan and towards improving quality of life in old age, arguing that sometimes this means “less medicine, not more”.
Speaking before the publication of his 2023 annual report, which this year focuses on health in an ageing society, Whitty said doctors needed to have more realistic conversations with patients about the risk of some treatments extending life at the expense of quality of life and independence.
“Modern medicine is amazing at keeping people alive and extending life … and this for some people is exactly the right thing to do,” he said. “But I think the question should be what do people want themselves, and, particularly if treatments have significant side-effects, you’re always going to have a trade-off.”
The Guardian reports that the wide-ranging report highlights the demographic timebomb faced by UK rural and coastal communities, whose populations are projected to age far more rapidly than those in urban areas.
These areas also tend to be underserved by healthcare and lack housing and transport infrastructure designed to allow older people to live independent, active, healthy lives for longer.
The report criticises the systematic exclusion of older adults from clinical trials and medical research, which Whitty said was often not scientifically justified.
He said there should be a move away from using arbitrary age cut-offs for participation in trials and from excluding people with multiple morbidities, which he said risked skewing results.
However, he stopped short of saying that inclusion of older people in trials should be mandated for publicly funded research.
The report also highlights health inequalities, with people in more deprived areas less likely to experience good health. Women in the most deprived 10% of areas of England have a shorter life expectancy and spend about a third of their life in poorer health compared with women in the most affluent areas, who spend a fifth of their life living in poorer health.
executive summary ageing report
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