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Why not assume that medical advancements have lead to immortality?

cause they can still die ¯\_(ツ)_/¯

I mean death from old age.

Because its' immersion breaking. The millennia time system is meant to make us feel like these empires are truly epic and ancient, lasting throughout the ages. But with people who live for most if not all of those millennia, it doesn't feel nearly as awesome.