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Ben Elton has a routine about public health warnings that claim even moderate drinking can cost two years of your life. "Oh, how terrible, two whole years," riffs the iconic comedy writer. "They don't say which two years but I'll tell you, it's the f***ing last two and frankly I'd be very happy to be done with those - so give me a drink!" It's familiar territory for the 66-year-old Young Ones creator, instinctively funny, justly angry and carrying a social message - the sort of material he's been killing audiences with since finding fame as the motormouth in the shiny suit in the 1980s.

But it's not just a routine; Ben's take on our longer lifespans, the flip-side of which so often is dementia, was informed by his own parents. And it's been on his mind while writing his brilliant new memoir, What Have I Done?, having first been inspired by the death of close friend Rik Mayall in 2014, then by the passing of his mother, Mary.

"When you're young you think you're going to live forever - you get to 66 and you know damn well you're not," he grimaces. "Like anyone my age, you're getting more and more conscious of your own mortality, particularly if you're burying parents who in any other era would have died at 70 and are now staggering on until 95 in misery.

"My father Lewis suffered from complete Alzheimer's so if I have one piece of advice, it's don't get your heart fixed in your mid-80s like my dad. The old pig's valve kept his heart going long after his brain had gone and that's medical science today - it's prolonging physical longevity without any thought for our ability to appreciate or understand we're alive."

This, he believes, is a "moral and philosophical madness" and has made him a passionate "100% believer in properly regulated voluntary assisted dying", for which the Express has been campaigning alongside Dame Ester Rantzen with the Give Us Our Last Rights crusade.

"This idea the dying need to be protected from avaricious relatives and feeling a burden needs properly interrogating," he continues. "A lot of them do feel like a burden, because they're done! There should be a structure, properly regulated, which allows for the agency of the individual to be at the forefront of the debate, rather than the potential criminality of those who surround them."

For a man who has made his living from the creative power of his imagination over four decades - "knob gags have been very good to me," he admits - dementia is something Ben, like many Britons, puts high on his list of existential fears. "I don't know anyone who doesn't say, 'If I ever lose my marbles and any chance to enjoy my life, for God's sake push me under a bus'," he says. "Well, you can't push someone under a bus because you'd go to prison and rightly so, but we need to acknowledge that nobody wants to live beyond their capacity to appreciate their lives.

"If medicine can keep my dad alive, nine years after his brain said, 'Time's up, I'm f***ing off', then surely medicine could also allow someone whose brain is still able to make this decision?"

It's compelling stuff, more so when sitting opposite him over a coffee. But if all this makes it sound like Ben's autobiography is a bit gloomy, think again.

What Have I Done? is easily one of the most honest, thoughtful celebrity memoirs of the decade, as befits the writer who co-created The Young Ones, Blackadder and Mr Bean, among a grand total of seven sitcoms, 16 novels, five musicals, including Queen mega-hit We Will Rock You, plus five plays and stand-up tours too numerous to recall.

It's filled with huge characters and celebrity anecdotes, from perhaps his most formative experience, meeting Rik at Manchester University ("Hey fresher, shagged any chicks yet?"); to saving Stephen Fry's life during a late night cocaine binge (Fry taking the drugs, not Ben); and snogging his unrequited crush Emma Thompson.

It's also an exhaustive, warts-and-all take on what, by any standards, has been a seriously successful career - just sometimes, it doesn't feel that way. For despite his many hits, Ben admits he seems to divide people.

For every die-hard fan of Blackadder or Upstart Crow - his Shakespeare sitcom and the foundation of what his musician wife Sophie Gare memorably dubbed the "Benaissance" - there's a mealy-mouthed critic or an Alexei Sayle, though in fairness, the comic apologised for his brutal attacks against Ben in his influential 1980s magazine column. You're left, however, with the painful sense the bad reviews have endured in the memory.

"I've gone into it more than some people think I should," he admits. "Rob Brydon rang me and said, 'I'd no idea you'd got all these awful reviews'. What he was really saying was, 'Did you need to dig up that old hurt?'

"I thought about that a lot, because nobody cares anymore. But my friends in the business said, 'You cop it worse than anyone.' I'd write a play or a novel and it would be viewed through the prism of the bit of me that was famous - the loudmouth, leftie stand-up. That perception did lead to a lot of unfairness to other people; the lesson learnt was, 'Don't work with me because you're gonna be collateral damage.'"

In the end, Sophie told him to go ahead and share the many brick-bats he endured while outwardly remaining the relentlessly upbeat chap so many know and love. "Everybody is insecure, everyone has imposter syndrome," he insists. "I'm certain even Donald Trump occasionally wonders if he's going to keep on getting away with it.

"So I don't think I'm an insecure person, I think I'm healthily, moderately secure. I'm certainly not cocksure but I know my value. Nobody wants to come across as cocksure! I make this joke, if Stephen [Fry] is asked about one of his projects, he says, 'Oh, it's awful, it's nonsense, I wish I hadn't written it.' But I can't help being excited."

As part of the 'alternative comedy' scene - though he's not a huge fan of the term - Ben brought observation and principle to stand-up, both guided by his middle class, socialist upbringing in south-east London.

He says today: "Comedy was far too reliant on sexist tropes," he says today. "I think it was original, and I'm proud of those gags. I never ever lectured anybody on stage, occasionally I was accused of such, but my routines were funny and you didn't have to agree with me politically."

He didn't keep a traditional diary but recorded his appointments over 45 years and it's clear he loved writing his memoir - the "most satisfying experience I've had sitting at a keyboard ever". "Maybe that's a reflection on my own narcissism, but I enjoyed looking back," he adds. Ben's clearly something of a cross between a swan and a shark - gliding seamlessly between his successes while paddling furiously below the surface in the first metaphorical incarnation, relentlessly moving to his next project in the latter.

"I'm quite good at working hard, but I've never worked as many hours as somebody who has even remotely a normal job," chuckles the father-of-three grown-up kids.

"If you sit down and concentrate you can get an awful lot done. People have often said, 'Are you driven?', 'Are you an -aholic of some kind?' and I don't feel any of that. I know how to stop work, I know how to sit and have time with my family, I can go to the pub or cook a meal - I have lots of leisure."

His happy, ordinary childhood doesn't figure hugely in his book. Things really began to happen when he arrived at Manchester University in September 1977. Meeting Rik, two years older and already an established star, was "love at first sight". The pair, who nicknamed one another "King" (Mayall) and "Farty" (Elton), soon bonded, going on to create The Young Ones together.

It was a friendship for the ages but 21-year-old Ben was heartbroken when Rik made him part of a three-way writing team for The Young Ones with his then girlfriend. The hurt was compounded when he wasn't allowed to play Mike as he'd planned.

"It was a very complicated relationship, a relationship based on deep love but in which there was a real power imbalance, because he was older," Ben says today.

That doesn't detract one iota, he insists, from his love and respect for Rik, who died tragically young at 56 in 2014.

"Rik's ego could be beautiful, it led him to a comic exuberance which was unparalleled, but his kind of belief in his own instincts led him to make quite a lot of wrong choices - but it didn't affect my love for him. In a way, I had to get out because it was a slightly dysfunctional relationship."

Years later, Ben was gutted when the BBC vetoed Rik for the lead in The Wright Way, his short-lived health and safety sitcom. "It was a devastating blow both for Rik and me because I had longed to finish the job I started, which was to get another thing right for Rik's particular and very specific talent," he says.

Today, though he has no complaints, he feels the BBC is making a strategic error chasing a "fantasy" youth audience rather than looking after its loyal 50-plus viewers. As for the state of the nation, he's as outspoken as ever. "All the good stuff I grew up with, people don't see around anymore. So people are suffering. And that's a big opportunity for those who want to find someone to blame," he says.

"And the other bloke [Farage] is offering simple solutions, which will not solve the problems. The world isn't like that, you just can't just 'get it done.'"

Furthermore, Ben is terrified about the implications of unregulated AI and believes strongly that smartphones are damaging childhood. "If a terrorist organisation came on the telly and said, 'We've invented a machine that will put you out of work in 10 years', we'd send in the SAS. But it's a tech bro in California literally saying, 'Humans will be surplus to requirements.' I'm terrified, horrified and furious. There's a reason the Greeks wrote the myth of Pandora's box - every single evil it released is coming back to bite us."

• What Have I Done? by Ben Elton (Macmillan, £25) is out now

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