Everybody dies. The question is, when? If you are between 40 and 70 years old and live in the UK, you can now find out your own odds, and maybe improve them, by going online and filling out .
At least, that鈥檚 the idea. The questionnaire tells me I have the same life expectancy as someone a sprightly eight years younger than me. Or that I鈥檓 hurtling towards oblivion as fast as someone five years older. It all depends on how pessimistically I view the rather broad questions involved.
It鈥檚 the first product of the UK Biobank project, the most massive collection of health data ever attempted. Simply answer a dozen, sometimes surprising, questions about your health and lifestyle, and Ubble (the UK Biobank Longevity Explorer) will tell you how much chance you have of dying in the next five years.
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There are dozens of studies on how individual factors such as smoking affect life expectancy. The UK Biobank turned that around by collecting a whopping 655 demographic, health and lifestyle variables for half a million people across England and Wales between 2007 and 2010. Usually epidemiologists ask something like: 鈥測ou smoke, how much more likely are you to die soon than someone who doesn鈥檛?鈥� With the biobank data they can ask: 鈥測ou鈥檙e dead, how much more likely were you to have smoked (or 654 other things) than someone your age who is alive?鈥� That way, for the first time, they can see which variables are the most important.
Death calculator
Andrea Ganna and Erik Ingelsson of Uppsala University in Sweden have now found which factors were most frequent among the 8500 Biobank participants who have died so far.
Surprisingly, the strongest predictors were a dozen or so conditions that require little or no medical measurement. Simply feeling that you are, all told, in good health 鈥� and that you walk briskly 鈥� means, according to the data, that you are more likely to have a greater life expectancy. Otherwise, major illness and smoking are the biggest risks.
This could simply be because of the information that has been collected for the biobank. People weren鈥檛 asked to include lab tests results of, say, kidney function, which might provide better predictions.
The advantage of the associations found so far, however, is that you can simply ask people about them, allowing Ganna and Ingelsson to create Ubble. Depending on your answers, it calculates whether you have the average British life expectancy for someone your age, or whether you might expect more years, as though you were younger 鈥� or, horrors, fewer, like someone older.
Biological age
It isn鈥檛 clear, though, how this information can help you stave off your more or less imminent demise. Kevin McConway, a statistician at the Open University in the UK, observes that a brisk walking pace is associated with a lower risk of death because it reflects your underlying health, not because it causes it: walking faster won鈥檛 change the underlying health. Of course, the exercise is probably a good idea 鈥� but surprisingly, exercise isn鈥檛 among the top predictors of survival.
Moreover, much of what the questionnaire asks is too late to change. For me it turns out that, stress and college fees notwithstanding, having had the kids takes three years off my Ubble age. If I hadn鈥檛, though, I can鈥檛 exactly go back and rectify that.
You can have fun with the website by going through it repeatedly, seeing what would happen if you had done things differently. If I had 10 kids rather than two, the impact on my Ubble age, if not my bank balance, would have been the same as having had none. And strange anomalies crawl out of the statistics. Studies of smoking and health suggest that that one cigar in my misspent youth shouldn鈥檛 affect my health now 鈥� yet Ubble says it effectively makes me a year younger.
My main problem is the ambiguity of the questions. I had a lung infection this year, but the antibiotics worked; I have a twinge in my knee, but that鈥檚 not unusual at my age. So should I report my overall health as good or fair? Like many ageing baby boomers, I have been on blood pressure pills for years, and they work well 鈥� so do I have a long-standing infirmity or not?
Glass half full
The side of the fence I come down on matters: the more optimistic answers make me effectively five years younger. Similarly, various events in the past two years may or may not count as 鈥渟erious injury, illness or assault鈥� 鈥� and if they do, that makes me five years older, in terms of life expectancy, than my actual age.
Does this ambiguity make a difference? 鈥淧eople may understand questions differently, but they are still predictive,鈥� says Ingelsson. 鈥淭he data is what it is.鈥�
Simon Thompson at the University of Cambridge, who wrote an accompanying commentary on the tool, agrees. 鈥淭he subjective views of the individual are what the questionnaire is based on,鈥� he says. For whatever reason, the answers people give correlate reliably with life expectancy. Maybe optimism is good for you.
What is not clear is whether using the questionnaire will make people live healthier lives, or just deepen computer-related health paranoia. But researchers have only just begun to mine the UK Biobank data and more specific, and useful, associations of risks and disease are likely to emerge.
Meanwhile, I don鈥檛 advise smoking a cigar to shave a year off your score. It was foul, and certainly didn鈥檛 get me any closer to having those kids.
Journal references: The Lancet, DOI: 10.1016/ S0140-6736(15)60578-5; commentary DOI/10.1016/ S0140-6736(15)60578-5
