Intrinsic and extrinsic mortality reunited.
Intrinsic and extrinsic mortality are often separated in order to understand and measure aging. Intrinsic mortality is assumed to be a result of aging and to increase over age, whereas extrinsic mortality is assumed to be a result of environmental hazards and be constant over age. However, allegedly intrinsic and extrinsic mortality have an exponentially increasing age pattern in common. Theories of aging assert that a combination of intrinsic and extrinsic stressors underlies the increasing risk of death. Epidemiological and biological data support that the control of intrinsic as well as extrinsic stressors can alleviate the aging process. We argue that aging and death can be better explained by the interaction of intrinsic and extrinsic stressors than by classifying mortality itself as being either intrinsic or extrinsic. Recognition of the tight interaction between intrinsic and extrinsic stressors in the causation of aging leads to the recognition that aging is not inevitable, but malleable through the environment.
Department of Gerontology and Geriatrics, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, the Netherlands; Leyden Academy on Vitality and Ageing, Rijnsburgerweg 10, 2333 AA Leiden, the Netherlands. Electronic address: j.j.e.koopman@lumc.nl.
Jacob J E
JJ
Koopman
Leyden Academy on Vitality and Ageing, Rijnsburgerweg 10, 2333 AA Leiden, the Netherlands; Max Planck Institute for Demographic Research, Konrad-Zuse-Straße 1, 18057 Rostock, Germany; Max Planck Odense Center on the Biodemography of Aging, Department of Epidemiology, Biostatistics and Biodemography, Institute of Public Health, University of Southern Denmark, J.B. Winsløws Vej 9, 5000 Odense, Denmark.
Maarten J
MJ
Wensink
Department of Old Age Psychiatry and Neuropsychiatry, GGZ inGeest, PO Box 74077, 1070 BB Amsterdam, the Netherlands.
Maarten P
MP
Rozing
Department of Gerontology and Geriatrics, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, the Netherlands; Leyden Academy on Vitality and Ageing, Rijnsburgerweg 10, 2333 AA Leiden, the Netherlands.
David
D
van Bodegom
Department of Gerontology and Geriatrics, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, the Netherlands; Department of Public Health, University of Copenhagen, Gothersgade 160, 1123 Copenhagen, Denmark.
Rudi G J
RG
Westendorp
D000375:Aging / Q000502:physiology*; D035843:Biomedical Research / Q000379:methods; D002423:Cause of Death; D004777:Environment; D059647:Gene-Environment Interaction; D006801:Humans; D008954:Models, Biological; D009026:Mortality; D011634:Public Health; D013312:Stress, Physiological; D009626:Terminology as Topic
Aging; Extrinsic mortality; Gene–environment interaction; Intrinsic mortality; Partitioning of mortality