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Diabetes, and high cholesterol are often diseases that cannot be detected on the face; its often deeper inside. So, selected President Nathan is still sick, and he's probably even sicker than LKY; his existence is dependent on a cocktail of drugs.
Without the drugs to help his body deal with the illness, its doubtful that he can live as long as he has now. Its not even adding the fact that Nathan is also older than LKY.