and even today, by using an old Android API iirc
Nope, the required API to have your app in the Playstore constantly rises, and if you don't comply you get kicked. The current API version is something around 26, and definitely has the permissions model integrated.
What do you mean exactly? A running system shouldn't spontaneously break from not being updated. It's just that partial upgrades can break compatibility/dependencies, but running full system upgrades should be fine, as long as you pay attention to breaking changes and major version bumps. Also with timeshift it should always be possible to get back to a working state.