3 min readNew DelhiMay 16, 2026 08:00 PM IST
Clinical nutritionist and longevity expert Dr Rhea Kotecha recently shared an alarming fact about the future of our medical health. Speaking on Masoom Minawala’s podcast, she said: “Most people will die of what we call the four horsemen of ageing. The first one is cancer, the second is heart disease, the third is type 2 diabetes, and the fourth is dementia. Most people would be met with one of these four diseases and live a long, burdensome life.”
Curious, we reached out to a health expert who helped shed light on these four horsemen.
Dr Brunda M S, Sr. Consultant – Internal Medicine, Aster CMI Hospital, Bangalore, explains that the idea of the “four horsemen of ageing” — cancer, type 2 diabetes, dementia, and heart disease — is widely discussed by longevity experts like Peter Attia, and it is partly true because these conditions are among the leading causes of death globally.
DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.
Elaborating on potential reasons why this might be true, Dr Brunda said heart disease and cancer are consistently the top causes of death in most countries, especially as people grow older. These diseases are strongly linked to ageing, lifestyle habits like poor diet and lack of exercise, and long-term inflammation in the body, he continued.
“Type 2 diabetes also increases the risk of heart disease, kidney problems, and nerve damage, making it a major contributor to early death. At the same time, dementia, including Alzheimer’s disease, does not always directly cause death but leads to a serious decline in brain function, making people more vulnerable to infections and other complications,” he tells indianexpress.com.
Is this applicable to all?
However, he points out that it may not be completely true for everyone because causes of death can vary based on geography, genetics, and access to healthcare.
“For example, in certain regions of the world, infections, accidents, or lung diseases may still be major causes of death. But, not everyone will develop all or even any of these conditions, especially if they maintain a healthy lifestyle, manage stress, and receive proper medical care,” Dr Brunda highlights, adding that advances in medicine are also helping people live longer with these diseases or prevent them altogether.
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In simple terms, Dr Brunda concludes that while these four diseases are very important and common risks linked to aging, they are not the only reasons people die, and many of them can be delayed or reduced with better health choices.
DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.