Death; death by old age... Myth or not?

...How would you like to die, Tyrion son of Tywin?"
Tyrion Lannister; In my own bed, with a belly full of wine and a maiden's mouth around my cock, at the age of eighty.
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This is basically how everyone wants to die… by old age. This got me thinking, what exactly does it mean to die by old age?
An elderly person sleeps and doesn’t wake up and the report is… "she died of natural causes or old age".

By Andreas Bohnenstengel, CC BY-SA 3.0 de,

Old age... not a cause of death.
Old age is not a cause of death. As we age, our bodies get weaker and our immune system, alongside every other body system, wanes. This basically means the elder person is more susceptible to more sicknesses than the younger ones. Also, their clinical presentation is more severe with more complications.

So, died by old age or natural cause in actuality, is dying by any one or several illnesses that accompany old age. Sometimes, the illnesses are not diagnosed and no one knows the exact cause. People just say “passed away peacefully”, which also, isn’t always the case, as some of these processes may be painful.

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For better documentation and precision, the terms old age and natural causes are now rarely used and frowned upon and a specific cause of death is required from licensed practitioners. Now, instead of saying old age as the cause of death, the immediate and underlying causes of death are stated.

What do I mean? If an elder person had a heart attack and died, the immediate cause; cardiac arrest, and the underlying cause; heart disease, are clearly stated on the death certificate.

Sometimes, it’s easier said than done. At times, identifying the underlying cause of death isn’t so clear-cut as some people have several comorbidities.

As a Washington Post article states, “You know the cartoon where a character is driving an old car that suddenly falls apart, every bolt sprung, with the last hubcap rattling in a circle until it comes to rest? Some people die like that, too. The trouble is there’s not a good name for it.” source

Some people pass away in such a manner, there’s no pinpoint reason, it’s just the whole thing. There’s no nice name for it. When the cause of death is undetermined, as in such a case, we try to describe the ambiguity of the situation with words like multiple organ failure or debility. Any ambiguous word would do the trick.

When saying "natural cause" is appropriate.
There are sometimes when just saying old age or natural causes may be appropriate or just what’s needed.

When giving a public speech, I think it would be undesirable, for both the speaker and listeners to go into the details of an elderly person’s death, especially when it was pretty much expected.

A good case in point is the recent passing of her majesty, Queen Elizabeth II. The actual details of her ailment are really unnecessary and undisclosed, and the media reporting her death to be due to old age will raise zero complaints.
But on the death certificate, the cause of death is usually written out clearly.

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Simply put, a “natural” death is one that occurs due to an internal factor that causes the body to shut down, such as cancer, heart disease, or diabetes. It means there was no external reason for the death, such as a traumatic injury. source

Old age and natural causes are not always synonymous, as age is only a factor in a multifactorial equation. A 40-year-old could suddenly collapse and die from a heart attack, which we have established to be a natural cause.

Pathologists have classified death in 5 different manners. The designation into a class is based on the specific cause of death and the circumstances surrounding it. source
The manners of death include;

• Natural
• Accident
• Suicide
• Homicide
• Unknown.

Natural Death Endpoint.
Whether diagnosed or not, the death process due to natural cause usually follows a pattern and death usually ensues from any one of these source

• Cardiac arrest
• Respiratory arrest
• Cardiopulmonary arrest

In summary, death by old age or natural cause is simply a condition undiagnosed and eventually leads to death, or in some cases, diagnosed with no adequate curative therapy. Palliative therapy to alleviate pain and discomfort as well as to prolong life and improve quality of life is initiated until the heart eventually fails and stops.

Unfortunately, some practitioners pointed out that natural death, in some third-world countries, is more often than not, a painful process. This makes a lot of sense as health care in these regions is poor and inadequate. Also, palliative treatment isn’t prioritized due to the cost of therapy.