Regarding the Queen’s death certificate, old age is not a disease and therefore should not be used as a cause of death (Queen Elizabeth died of ‘old age’ death certificate says, 29 September). A broad coalition of gerontologists and ageing and human rights groups strongly object to the use of old age or ageing as a diagnostic factor because it legitimises and magnifies ageism, bolsters the false claims of the anti-ageing industry, obscures the multiple causes of later-life ill health, and detracts from treatment and prevention. Although old age is a risk factor for many diseases, it is heterogeneous, with individual variation and many positive associations, such as subjective wellbeing. Its use as a cause of death is inaccurate and misleading.
In contrast, frailty is more homogeneous, evidence-based and clearly defined, and derives from multiple factors, socio-economic and biological. Frailty is not an inevitable consequence of old age and can be both prevented and treated. Near the end of her life the late Queen clearly exhibited well-known signs of frailty such as poor mobility.
Alan Walker
Professor of social policy and social gerontology, University of Sheffield
• When my mother died earlier this year, the cause was certified as being “the frailty of old age”. The deputy registrar told us that in the past doctors would record a death of an elderly person without an obvious medical cause as being “taken by a visitation of God”. I am sure Mum, and indeed the Queen, would have been content with that.
Ian Jones
Shrewsbury, Shropshire
• The subheading on this article was amended on 4 October 2022. An earlier version said “birth certificate” where “death certificate” was meant.
