Concept-mapping longevity — the four horsemen of a long healthy life

Rasmus Ursem
5 min readMay 10, 2023

I recently read “Outlive” by Peter Attia, MD. The topic of longevity, lifespan, and especially healthspan has interested me for more than a decade and Peter’s book is a comprehensive walkthrough of the latest research on this topic. A key point in the book is to switch from diagnostic-treatment oriented medicine to prevention-oriented medicine.

This is the first article in a series where I will use concept maps to illustrate and summarize the main aspects of longevity as this is an excellent way to create a visual understanding of this many-faceted topic.

Disclaimer: Please consult professionals (your doctor, personal trainer, etc.) before applying any of the methods mentioned here.

The four horsemen of longevity

Peter mentions four key reasons that shorten people’s lifespan and especially healthspan by 1–2 decades. They are:

  1. Cardio-vascular diseases.
  2. Cancer diseases.
  3. Neurodegenerative diseases.
  4. Metabolic diseases.

Interestingly, the metabolic diseases (diabetes 1+2, fatty liver syndrome, etc.) act as promoters for the other three.

The four horsemen above are “slow deaths”, i.e., progressing over several years or decades. They contrast “fast deaths” typically resulting from accidents or acts of violence. Somewhat surprisingly to me, the “slow deaths” may already start when you are in your teens though most go unnoticed and are not a life-threatening problem until small symptoms may start to appear in mid-life. To extend our health span to becoming a fit centenarian, we need to slow the disease development as much as possible.

The five approaches to slow disease development are:

  1. Exercise and activity.
  2. Nutrition, food, and drink.
  3. Sleep.
  4. Emotional health and stress.
  5. Medical supplements.

You are probably well aware of these if you are just remotely interested in longevity. Nevertheless, Peter’s book contains several insights and perspectives, which I will briefly describe below and elaborate on in subsequent articles.

The four horsemen and the five countering approaches may be visualized in the following concept map, in which I…



Rasmus Ursem

Computer & data scientist, writer, thinker, photographer, and generally curious about life and the wet matter between our ears — in short, I’m a poly-geek :-)