Well, someone who abused the sh*t out of his body for decades with Hardcore BB drugs and narcotics, overeating and stomping around @300 pds for years should definitely be worried at 53 years old 
Very good post, affeman.
That being said, I don't recall Dave Palumbo using anything close to "brave" doses since 2011. If I recall correctly, he was carrying decent size [maybe 240-lb, while pretty lean] at a Bros Versus Pros contest that Ronnie Coleman attended, which was either 2011 or 2012.
He has been small prior to that [starting around 2009], and small ever since then.
The last time he competed was, I believe, in 2004 at the NPC USA.
He was still pretty massive [offseason, but still pretty lean] in 2007, when I saw him for the first time in at the Arnold Classic, when he was still with MD.
He maintained what size roughly through to the end of the year, and was basically reducing in body weight starting around 2008, and has been a pretty healthy weight since 2009 - again, if I recall correctly on that time as the start date.
So Dave has been basically focused on being light and healthy for over a decade now - closer to 15 years, really.
And Dave didn't just lose a bit of weight - he straight up got almost as small as possible. I don't know what Dave weighs, but he is probably under 200-lb.
I respect that, because Dave is probably the only bodybuilder [aside from Shawn Ray] who basically decided that he doesn't care in the least what anyone thinks of his look - it's JUST about health to him.
So given Dave has focused on health, and being so slim for so long now, why would he be unwell?
I think Nasser El Sonbaty said that Dave used rec drugs in his Bodybuilding.com interviews - did Dave abuse drugs so badly, that his health is still compromised to this day because of it? Has he chemically altered the structure of his heart and/or enlarged his organs so badly, that he has to be this cautious just to give him any chance?
I hope that's not the case. Firstly, because it would be sad for Dave to pass away young after all the effort he has put on his health lately, and it would be sad if the only former massive bodybuilder who adopted healthy habits only did so because he had to. I always thought Dave did that because he wanted to, and that it reflected a lot of confidence on Dave's part.
A 2004 interview with Dave:
https://www.bodybuilding.com/fun/drobson65.htmThe last photo is probably close to the weight Dave was when I first saw him, at the 2007 Arnold Classic expo. His handle "Huge285" made sense...he looked to be about 285-lb at 5'10.5".