Why We Need a War on Aging

Based on presentation given at 2009 World Economic Forum in the Live Long and Prosper session, January 28, 2009 by Professor Julian Savulescu.

  1. There is no normal human life span, or if there is, it was very short.

Life-expectancy for the ancient Romans was circa 23 years; today the average life-expectancy in the world is circa 64 years.

For the past 150 years, best-performance life-expectancy (i.e. life-expectancy in the country where it is highest) has increased at a very steady rate of 3 months per year.

  1. Aging is the biggest cause of death and misery in humanity.

100 000 people die per day from age-related causes.  150 000 people die per day in total. Cardiovascular disease (strongly age-related) is emerging as the biggest cause of death in the developing world.

  1. Progress is possible

The goal should be to extend the HEALTHY, PRODUCTIVE lifespan, not to just keep people alive longer on respirators or in old people's homes. This is embodied in the concept not of life span but “health span”.  The easiest way to do this is to prolong healthy life not attempt to compress morbidity

The more we understand about the biochemical processes involved in senescence the more we find that they look like disease processes. The accumulation of lysosomal aggregates and amyloid plaques, extracellular protein-protein cross-linking, nuclear and mitochondrial mutations, cell atrophy, cell senescence, and cell loss without replacement: these processes may all be implicated in both pathology and senescence.   At the level of genetics and biochemistry, there simply does not seem to be any meaningful distinction between "processes predisposing to or constituting disease" and "normal aging".

 Aging is not an evolutionary adaptation. Aging, rather, is what happens when various bodily systems evolved to maintain health gradually accumulate defects and begin to malfunction. In the Pleistocene, when life-expectancy is estimated to have been a mere 20 years, too few of our ancestors survived to ripe old age for evolution to favor investment in stronger anti-aging defenses than those we now possess and are forced to rely upon, notwithstanding their evident inadequacy in the modern era where many causes of premature death have been removed.

 The tortoise, by contrast, whose ancestors were less accident-prone thanks to their protective shells, enjoys anti-aging defenses robust enough to give it a lifespan of upwards of 150 years. It is humbling to reflect that somewhere on the Galapagos Islands a giant tortoise might still be around who watched the landing of Charles Darwin.

We will all age, if we live long enough. We should understand why turtles age slower than us. And we should use that knowledge to stave off aging.

Last week brought exciting breakthrough. Scientists identified ajellyfish which could be immortal.

Turritopsis nutricula is the only known animal that is capable of reverting to its juvenile polyp state. Jellyfish usually die after propagating but Turritopsis reverts to a sexually immature stage after reaching adulthood and is capable of rejuvenating itself.

Theoretically, this cycle can repeat indefinitely, rendering it potentially immortal.  The jellyfish and its reversal of the ageing process is now the focus of research by marine biologists and geneticists. It is thought to achieve the feat through the cell development process of transdifferentiation, in which cells transform from one type to another.

The switching of cell roles is usually seen only when parts of an organ regenerate. However, it appears to occur normally in the Turritopsis life cycle.

Medically-induced rejuvenation of organs and tissues is no longer science fiction: it is simply the application of regenerative medicine to the molecular and cellular damage of aging. Just as for the repair and maintenance of man-made machines, this approach can in principle postpone age-related ill-health indefinitely. People would remain physically and mentally as vigorous and functional as young adults, and death would only be from causes that currently affect young adults, such as accidents. The consequent elimination of Alzheimer's disease, cardiovascular disease, type II diabetes, most cancers, arthritis and inumerable other age-related diseases would have astronomical economic benefits, vastly outweighing the expense of developing and delivering these therapies. Even for those who consider that the chance of success in developing these therapies is low, the risk/benefit balance of investing significantly in the attempt to develop them is unequivocally in favour of such an investment.

Anti-aging research is scandalously under-funded.  In the US, a vast proportion of the funding doled out by the National Institute of Aging is given to research on Alzheimer's disease. According to one estimate (from circa 2004), only about 0.02% of the money spent by the National Institutes of Health (of which the NIA is part) is spent on fundamental aging research. I think funding ought to be perhaps 1,000 times greater. Even if we only hastened progress to a cure for aging by one year, that is brought it forward by one year, that’s about 30 million lives saved. Every year we delay finding a cure, 30 million people die.

Objections can be overcome. Of course extending healthy lifespan might create various problems and challenges.  But for any possible problem that might arise, one question that we must not fail to ask ourselves is: "Is this problem so bad that it is worth sacrificing up to 100,000 lives per day to avoid having to solve it?"  If the answer is obviously no, then we should look for solutions.

Here are two final objections:

  1. Obligations to Future Generations

We have an obligation to die and turn the world over to the next generation.

How long each generation should live raises deep questions about intergenerational relations, quality of life and burden of care. However healthy and able older people may be economically productive, self supporting and a source of knowledge, experience and care for younger generations, liberating younger people to work. The answers are not clear, especially when life extension is coupled with life enhancement.

At any rate, since few of us believe there is a positive moral obligation to have children, that is to create future people, the obligation to create new generations must be weak

  1. Loss of Meaning

Many people fear that a longer life would result in boredom and a gradual loss of meaning. This would be more likely if one was a solitary Methuselah. But in a world where many of those close to us also lived longer, the greatest source of human well-being – deep human relations – would remain intact and arguably grow richer as that network expanded across generations.

There is little empirical support that longer good life loses meaning. Research shows that life-satisfaction remains relatively stable into old age. One survey of 60,000 adults from 40 nations discovered a slight upward trend in life-satisfaction from the 20s to the 80s in age

With the advent of human enhancement– enhancement of cognitive powers, physical abilities and control of mood – this is likely to be even less of a problem.

The challenge is to create longer and better life. But that too is within our grasp. We should aim for drugs to prevent normal memory decline, interventions to keep us physically and mentally active. Viagra is a good example. It deals with one effect normal human aging. 20 million men in the US find it of benefit and it no doubt contributes to meaning in their lives in some way.

And surely it is up to individuals to decide whether their lives come to lack meaning. For our part, we would take the longer life.

Our goal should be more, much more, longer and better life. We need a war on aging.

Billions of dollars have been spent preparing for a flu epidemic. The Spanish flu killed 20 million people. Aging kills 30 million every year. It is the most under-researched cause of death and suffering relative to its significance. Whatever breakthroughs occur in medicine or health care generally, at the moment we face the inevitability of ageing. That might not be necessary.

Authors:

Julian Savulescu, Programme on the Ethics of the New Biosciences, James Martin 21st Century School, University of Oxford

Nick Bostrom, Oxford Future of Humanity Institute, James Martin 21st Century School, University of Oxford

Aubrey de Grey, Methuselah Foundation

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6 Responses to Why We Need a War on Aging

  • Dennis Tuchler says:

    Short of fiddling with the genes that set the life clock, the only way to extend life without the decline of physical and mental ability that make the aging person a pure consumer of wealth (whether that person’s or others’) is to make the aging person dependent on drugs and government help.

    This drug-induced super-aging will increase the drug costs borne by the government under medicare or such other governmental medical care program. Such programs will be immortal and will grow and grow as the political clout of the super-aged grows with their share of the population. Similarly, government-provided pensions will increase in total amount and in amount paid to each aged person. This aid will not be limited to those in financial need. Rather it will be seen by its partisans (and the old folks) and it seems to be now, an “intergenerational contract”, which burdens the earner to care for the oldster, with the promise that the next generation will be similarly burdened.

    Moreover, I doubt the aged will cotton to an increase in the retirement age or some limit on government drug subsidy.

    Of course, if things go well, life will be boring and euthanasia societies will spring up, but I doubt their effect will help the plight of those who work.

  • Roko says:

    A worthy goal. Let me know if I can be of assistance, this will go up on my blog.

    One question to consider is this: why is this such a hard idea to sell? Many people who I have broached this topic with either:

    (a) are totally apathetic and/or quickly change the subject

    or

    (b) find some obscure argument that they claim is totally compelling as to why we shouldn’t do this. I have heard the usual ones: death gives life meaning, we must kill ourselves to make way for future generations, we mustn’t do anything about the problem until every last African is well fed, death is a great way to get rid of dictators (and these people will claim that dictators are bad because they kill a few thousand people a year), etc, etc.

    or

    (c) will argue at great length that curing human aging and death is *obviously* impossible and that I need to come to terms with my mortality, even in the face of fairly strong arguments to the contrary and even when I know much more about the relevant science than they do. People sometimes make up arguments on the spot as to why SENS and/or cryonics won’t work.

    There is probably an underlying psychological explanation for this behavior. (a), (b) and (c) probably correlate with three distinct ways of coping with our mortality:

    (a)-type people , who are usually young, can just pretend it doesn’t exist. There’s no way in hell they’ll get involved with the anti-aging movement, because then they would no longer be able to pretend that death doesn’t exist.

    (b)-type people, typically religious or environmentalist or very left-wing, have decided that death is a good thing after all, and they are frightened that their protective worldview will collapse if the anti-aging movement succeeds. These people may actually sabotage the movement, bomb rejuvenation clinics, etc. Imagine all of these youthful, wise, rich, popular, happy, successful 100 year olds swanning around in the year 2050 as living proof that death is actually not a good thing. That would be anathema to the (b) worldview.

    (c)-type people, usually materialist rationalists, can cope with mortality, but only if it is TOTALLY unavoidable and thus not to be worried about. The idea that aging might be cured at some point in the future is poison to their particular psychological defense: it is only by living with the absolute certainty that death is unavoidable that they can relax about it.

    I think that the most potent weapon in the war on death right now is to examine the psychology of those who support it, and find ways of giving people viable psychological niches that are compatible with doing something about death. This will involve talking to some psychologists and perhaps doing some research.

  • matthew says:

    Addressing the question of “why” is important to the public’s perception of life extension, and the answers presented here are a wonderful contribution to the discussion. Is it going to be helpful to associate this issue with the many other failed wars on _____ (drugs, terror, poverty, etc.)? Or does this title reflect the audience this was meant for?

  • Andrei says:

    Surely the main issue here is the extra pressure on resources that this would create.

  • brokenportal says:

    Tuchler, so you think that we shouldnt extend our healthy life spans because the therapies will burden society? As technology and science advances, the cost of things goes down. We need to get these therapies worked out asap so we can work on driving the cost down.

    Roko, if you want to be of assistance then get with any of the communities springing up every where around the net that support this. I suspect you already are signed up at many.

    I see a lot of whys, and what ifs and maybe we shouldnts and that kind of thing surrounding this subuject. The bottom line is that life fun. If we can figure out a viable feasable way to keep it going then we should, and we are, the only thing standing between us and indefinite life spans now is the amount of time people are willing to put into it.

  • Great post! I agree we must get serious about longevity science if we hope to reduce the growing disease-burden of chronic diseases like heart disease, cancer, stroke, AD, etc.

    And we must change the (dire) funding situation for this science. I recently posted two videos on this same topic which some might find of interest at:

    http://video.google.ca/videoplay?docid=6968661969726548993

    AND

    http://video.google.ca/videoplay?docid=-8236911481893124472

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