Time Is Not On McCain's Side

Science is telling us something that we already know. Old folks, whom we love, just aren't as fit as the years pass by. And that includes Old Man McCain, who is running to the best the oldest man ever elected President.

As people reach their 70s, the decline becomes quite precipitous.

The longitudinal declines per decade in women and in men aged 70 years are substantially greater than those predicted by cross-sectional analyses. For example, in 40-year-old men, baseline peak O2 averaged 3114 mL/min and decreased by 260 mL/min (8.3%) over 10 years.

In contrast, the 70-year-old men started with a peak O2 of 2244 mL/min but lost 521 mL/min (23.2%) over 10 years.

The accelerated loss of aerobic capacity with advancing age has important clinical ramifications. The ability of older persons to function independently in the community depends largely on maintenance of sufficient aerobic capacity and muscle strength to perform daily activities. The perceived degree of effort and breathlessness of a given activity is determined by its oxygen cost relative to a person’s peak O2.

Tasks perceived as requiring substantial effort in deconditioned individuals tend to be avoided, setting off a vicious cycle of further reduction in aerobic capacity, causing further avoidance of physical activity and further loss of muscle mass and strength. Thus, accelerated loss of aerobic capacity translates into low levels of physical activity, slow walking speeds, and early exhaustion—3 of the 5 criteria now used to define frailty.

(Click on image to see larger version)

Conclusions— The longitudinal rate of decline in peak O2 in healthy adults is not constant across the age span in healthy persons, as assumed by cross-sectional studies, but accelerates markedly with each successive age decade, especially in men, regardless of physical activity habits. The accelerated rate of decline of peak aerobic capacity has substantial implications with regard to functional independence and quality of life, not only in healthy older persons, but particularly when disease-related deficits are superimposed.

McCain has had cancer for over fifteen years. As we've said many times, he should be out on the links in Phoenix, enjoying his retirement right now. Telling old war stories. Putting back a few cold ones. Maybe playing card tricks with his grandkids.

He shouldn't be running for the most grueling job on Earth.