I think if a person immerses themselves into the character (e.g. RPG games or The Sims) then they tend to only use the information and environment that is available to them to 'play' the character. I guess it depends on how the lifecycle ends (since you have hinted at different stages of life and disease) and how the game resets or starts over again (i.e. if you can 'continue' or have to restart). These are interesting questions to consider but hopefully we get more discussions and ideas about it :)
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That's true, people do get into it, or what's the point. My concern is that multiplayer aspects could disrupt this because you might be playing with your friends / clan / crew and talking to them outside the game with TeamSpeak, Discord or Mumble. So it's something to consider.
Very interesting questions posing interesting problems with hopefully interesting answers!