[The benefits of aging. II. Aging and dying in our time: reasons for optimism?]

The increase of life expectancy is due to the successful treatments of infectious diseases and to the prevention of cardio-vascular (C-V) diseases. People are afraid that an increase of life expectancy would go together with an extension of years of chronic illness and disability. However the compression-of-morbidity hypothesis predicts that persons with better health habits and with a low level of C-V risk factors survive longer without a parallel increase of the period of disability. Depression decreases life quality of elderly people and increases sucidial risk as well as C-V mortality. The prevalence of depression varies between 10 and 20% in different european cities. Emotional well-being and vitality characterized by optimism and sociability seem to protect old people from adverse health outcome. There is a marked increase in epithelial carcinoma in old people. Some cancers (breast, colon) have a reduced aggressiveness in elderly patients. A better access to palliative care and a better control of terminal pain and suffering should restrain patients to ask help for assisted suicide. People who had near death experience recall they felt light and peace. These coping mechanisms seem to ease the passage towards death. Elderly people should be surrounded by a social and affective network in order to help them to cope with illness, dependance and loneliness and to keep their humour and optimism.