Dave Gobel tells me Aubrey de Grey (he of Strategies for Engineered Negligible Senescence fame on how to make our bodies youthful again) will be on the Colbert Report tonight. For those with access to the Comedy Central channel check it out. Steve Colbert should find some new humorous angles on living young for many centuries.
Biogerentology theorist Aubrey de Grey is co-author of a new book arguing we can defeat aging Ending Aging: The Rejuvenation Breakthroughs That Could Reverse Human Aging In Our Lifetime. Aubrey is also the focus of an article by Joel Garreau in the Washington Post: The Invincible Man: Aubrey de Grey, 44 Going on 1,000, Wants Out of Old Age
Aubrey David Nicholas Jasper de Grey, 44, recently of Britain's Cambridge University, advocates not myth but "strategies for engineering negligible senescence," or SENS. It means curing aging.
With adequate funding, de Grey thinks scientists may, within a decade, triple the remaining life span of late-middle-age mice. The day this announcement is made, he believes, the news will hit people like a brick as they realize that their cells could be next. He speculates people will start abandoning risky jobs, such as being police officers, or soldiers.
Aubrey believes (and FuturePundit agrees) that we can develop biotechnologies that will allow us to reverse aging and make us young again. This goal will be achieved within the lifetimes of at least some of the people currently alive. The sooner the general public realizes this the faster this goal will be realized.
Aubrey is attracting large donations toward the goal of reversing aging.
De Grey's original academic field is computer science and artificial intelligence. He has become the darling of some Silicon Valley entrepreneurs who think changing the world is all in a day's work. Peter Thiel, the co-founder and former CEO of PayPal -- who sold it in 2002 for $1.5 billion, pocketing $55 million himself -- has dropped $3.5 million on de Grey's Methuselah Foundation.
"I thought he had this rare combination -- a serious thinker who had enough courage to break with the crowd," Thiel says. "A lot of people who are not conventional are not serious. But the real breakthroughs in science are made by serious thinkers who are willing to work on research areas that people think are too controversial or too implausible."
Aubrey thinks once aging is conquered we will periodically retire and retool for different occupations.
"Another thing that's going to have to change completely is retirement. For the moment, when you retire, you retire forever. We're sorry for old people because they're going downhill. There will be no real moral or sociological requirement to do that. Sure, there is going to be a need for Social Security as a safety net just as there is now. But retirement will be a periodic thing. You'll be a journalist for 40 years or whatever and then you'll be sick of it and you'll retire on your savings or on a state pension, depending on what the system is. So after 20 years, golf will have lost its novelty value, and you'll want to do something else with your life. You'll get more retraining and education, and go and be a rock star for 40 years, and then retire again and so on."
Aubrey thinks people are heavily invested in believing that death from aging is inevitable. This position made sense back when death from aging really was inevitable. Best to rationalize that aging is a good thing if there's nothing you can do about it. Make your peace and find reasons to be happy with what you can't change. But the rate of advance of biotechnology is accelerating with DNA sequencers and microfluidic devices becoming more powerful in ways analogous to the rate of progress with computers. We can strive for goals that used to seem unattainable. We should start trying to conquer aging. It is a solvable problem.
Biogerontologist Aubrey de Grey and assistant Michael Rae have a new book out on how aging can be stopped and reversed entitled Ending Aging: The Rejuvenation Breakthroughs That Could Reverse Human Aging In Our Lifetime. I'm only on page 18 but it is pretty good so far. I'm going to write a series of posts about it as I read through the book.
In chapter 2 Aubrey discusses why people accept aging as inevitable and for the most part resist hearing arguments for why aging is defeatable.
There is a very simple reason why so many people defend aging so strongly - a reason that is now invalid, but until quite recently was entirely reasonable. Until recently, no one has had any coherent idea how to defeat aging, so it has been effectively inevitable. And when one is faced with a fate that is as ghastly as aging and about which one can do absolutely nothing, either for oneself or even for others, it makes perfect psychological sense to put it out of one's mind - to make one's peace with it, you might say - rather than to spend one's miserably short life preoccupied by it. The fact that, in order to sustain this state of mind, one has to abandon all semblance of rationality on the subject - and, inevitably, to engage in embarrassingly unreasonable conversational tactics to shore up that irrationality - is a small price to pay.
Most of us do need peace of mind. But watching people decay from aging does not give me peace of mind. Just how much aging causes pain and suffering is not something that most people appreciate. Do you know people who have daily pain from osteoarthritis? I do. Since friends know I follow things medical and biological I get requests from friends to look up on the internet info about side effects of pain killers and the like. Start taking note of people around you who use pain killers. You might be surprised at what you tally up.
Then there are the various infirmities and disablements. Know men who can't go far between toilet stops? Women who wake in the middle of the night from hot flashes that last for years? How about decaying eyes that need more kinds of corrective glasses for more reasons? The list goes on. Walk through a store and you'll see lots of people with lots of infirmities. The older they look the more problems you should suspect they have.
Some people say that aging is a graceful process that has dignity. Ever helped a person or a dog die from cancer? I've done both. Nothing graceful about it. Not dignified about it. I hate to recall the images of what I saw.
Aubrey calls on us to wake up out of our "aging is inevitable" trance. I'm hearing a variation on John Lennon in my mind: "Imagine there's no aging, It's easy if you try".
I've told you that we've recently reached the point where we can engage in the rational design of therapies to defeat aging: most of the rest of this book is an account of my favored approach to that design. But in order to ensure that you can read that account with an open mind, I need to dispose beforehand of a particularly insidious aspect of the pro-aging trance: the fact that most people already know, in their heart of hearts, that there is a possibility that aging will eventually be defeated.
Why is this a problem? Indeed, at first sight you might think that it would make my job easier, since surely it means that the pro-aging trance is not particularly deep. Unfortunately, however, self-sustained delusions don't work like that. Just as it's rational to be irrational about the desirability of aging in order to make your peace with it, it's also rational to be irrational about the feasibility of defeating aging while the chance of defeating it any time soon remains low. If you think there's even a 1 percent chance of defeating aging within your lifetime (or within the lifetime of someone you love), that sliver of hope will prey on your mind and keep your pro-aging trance uncomfortably fragile, however hard you've worked to convince yourself that aging is actually not such a bad thing after all. If you're completely convinced that aging is immutable, by contrast, you can sleep more soundly.
Aubrey argues that the chance of defeating aging within our lifetimes is a lot higher than 1% and on that I agree. Scientists are making advances in development of the tools we'll need to defeat aging. Impressive results are getting reported on stem cell therapies, growth of replacement organs in labs, and other pieces of the puzzle. We are looking at a scale of time that is on the order of decades, not centuries.
Anyway, the book is a good read so far. I recommend it.
Reason at Longevity Meme points to a new paper by biogerontologist Aubrey de Grey where Aubrey argues that biogerontology's ultimate goal should be the defeat of processes which cause aging. We should view aging as ultimately curable just as cancer researchers view cancer as ultimately curable.
An interesting position paper from Aubrey de Grey via the Annals of the NYAS: "The early days of biogerontology were blessed with an undiluted forthrightness concerning the field's ultimate goals, epitomized by its leaders. Luminaries from Pearl to Comfort to Strehler declared the desirability of eliminating aging with no more diffidence than that with which today's oncologists aver that they seek a cure for cancer. The field's subsequent retreat from this position garnered a modicum of political acceptability and public financial support, but all biogerontologists agree that this fell, and continues to fall, vastly short of the funding that the prospect of even a modest postponement of aging would logically justify. "
Aubrey goes on to point out that the last 20 years of advances in genetic manipulations that extended life of model organisms make the prospect of reversing aging a lot easier to imagine as doable. I would go further and argue that the general advance in biotechnology, with the continuing development of much more powerful tools to measure and manipulate biological systems at the molecular level, makes the idea of rejuvenation seem much more attainable.
The nature of general line of advance in biotechnology (e.g. in microfluidics and in nanotechnology) should lead us to expect orders of magnitude more powerful tools in a couple of decades. Just as the shrinking size computer technology allows computer chips, hard drives, fiber optics, and transceivers to go through long series of doublings in capability so does the miniaturized level at which biological instrumentation advances.
Why shouldn't we treat aging as curable? The amazing physicist Richard Feynman gave a speech in 1959 entitled There is plenty of room at the bottom where he argued that we can develop the ability to manipulate matter at the molecular level. A continuing trend in technology since that speech has been the development of tools to better measure and manipulate increasingly smaller amounts of material. That trend made possible the sequencing of whole genomes and will eventually make possible sequencing of each person's genome for a very low cost. That trend is also going to lead to technology that allows us to make nanodevices that can repair human tissue at the level of individual cells and molecules.
Given this miniaturization trend and how far Feynman thought it can go I do not see why rejuvenation therapies are either impossible or a distant prospect. For many parts of our bodies we will develop the means to grow replacement parts. For other parts we will develop the means to send in stem cells to replace lost cells. For still other parts we will develop the ability to repair individual cells using gene therapy, nanodevices, and other methods. We need to start looking at aging as curable and start demanding bigger efforts to develop the cures.
Good news. Big money is starting to support research to conquer aging and make us young again.
Peter A. Thiel, co-founder and former CEO of online payments system PayPal, and Founder and Managing Member of Clarium Capital Management, a San Francisco-based hedge fund, today announced his pledge of $3.5 Million to support scientific research into the alleviation and eventual reversal of the debilities caused by aging, to be conducted under the auspices of the Methuselah Foundation, a charity co-founded and Chaired by Dr. Aubrey de Grey.
Mr. Thiel commented, "Rapid advances in biological science foretell of a treasure trove of discoveries this century, including dramatically improved health and longevity for all. I'm backing Dr. de Grey, because I believe that his revolutionary approach to aging research will accelerate this process, allowing many people alive today to enjoy radically longer and healthier lives for themselves and their loved ones."
Mr. Thiel will donate a total of $500,000 over the next three years to fund pilot research projects intended to deliver early stage validation of the "SENS" approach to combating the debilitation caused by aging.
Additionally, from now until the end of 2009, Mr. Thiel promises to match every Dollar donated to the Methuselah Foundation for SENS research with a 50 cent matching contribution from himself, up to a maximum of $3 Million of matching funds.
Dr. de Grey said, "I am extremely grateful to Peter for his bold and visionary initiative. I have been working with leading biologists and biochemists around the world in identifying promising research projects, and with this generous donation we will go to work straightaway."
SENS (Strategies for Engineered Negligible Senescence) is a set of approaches to repair the body and reverse the aging process to make bodies fully young again. Click through on one of the SENS links and read all about it if the term is new to you.
I expect Thiel's donations to be the first of many very large donations aimed at reversing the aging process. The large number of multi-millionaires are very sharp people who know they really can't take their money with them when they die. So why not use a piece of their wealth to take a stab at making their bodies young again?
The full reversal of the aging process is an achievable goal. We will develop the biotechnologies to grow replacement parts, to do gene therapy, to send in stem cells to do repairs, and to remove the junk that accumulates in cells and between cells as we age. Daily announcements from biological resesarch labs demonstrate progress toward many of the technologies needed to reverse the aging process. Some people who are alive today will live to see the conquest of aging and the end of death from old age.
Businessweek has a debate between a couple of finance experts on the financial implications of an aging population. University of Pennsylvania Wharton business school finance professor Jeremy Siegel sees everyone working longer.
The age wave is the most severe in Japan. By mid century, 75 to 80 will be most populous age group there, and the number of workers per retiree will fall to one-to-one. The big questions facing the developed world are, who's going produce the goods, and who's going buy the assets. If there are not enough workers earning income, then there aren't enough buyers of all the stocks and bonds that are going be sold. It's the flip side of same question.
I built a model to show how much longer Americans will have to work because of the coming shortage of workers. Life expectancy will continue to rise. But the retirement age will rise substantially more, I believe, from 62 today to 73 or 74 in the future. Of course, some say it will rise just because people live longer. But it has to rise more than that. The age Americans spend in retirement will shrink from 14.4 years today to 9.2 by mid century.
I certainly agree that retirement ages must rise. Western nations should start raising retirement ages now. We need to move toward eligibility for state-funded retirement programs based on physical and mental inability. Healthy people should work unless they save enough to retire.
Junk bond king Michael Milliken sees a rosier future where biotechnogical advances that lead to slower aging will translate into higher economic output and better lives.
In 1974, it cost $100 million to sequence a gene. Today, it cost $3, and by 2013, it will be 3 cents.
We also constantly underestimate life expectancy. In Japan today, the quality of life lasts longer than anywhere else. They have 73.6 healthy years before becoming disabled (by old age), vs. 67.6 in the U.S. But even in the U.S. there have been big gains. The share of men in poor or fair health has gone from where it was at age 60 20 years ago to age 72 today. That's 12 years of increased quality of life. In 1970, a 59-year-old man had the same probability of dying as a 65-year-old today. The same is true with women. We're living longer and more productive lives.
I think all the conventional ways to project future increases in life expectancy are greatly underestimating the effects of coming advances in biotechnology. Our knowledge is not simply increasing with the same fixed amount of knowledge added to the sum total of our knowledge every year. Rather, the rate at which we can collect knowledge is increasing. That trend looks set to continue for decades to come.
Look at Milliken's example of the dropping cost of DNA sequencing. Orders of magnitude increases in capabilities in biotechnology mirror the orders of magnitude increases that happen in electronics technology. The advances in semiconductors for manipulating things at very small scales that drive the rapid advances for electronics are also enabling the construction of devices for biotechnology such as DNA gate arrays and microfluidics devices. The electronics revolution is being repeated in biotechnology.
Just as the discovery of antibiotics made many infectious diseases suddenly curable the same will happen with diseases of aging. Got a bad heart? Grow a new one or send gene therapy in to instruct your cells in how to repair themselves. Bad liver or bad kidneys? Again, grow replacements or fix them. All the problems that must be solved to reach that point are solvable. Therefore we will solve them.
People who do not see this biotechnological revolution in rejuvenation on the horizon are akin to someone in 1965 saying that of course computers must take up whole rooms and that we'll never have desktop computers which are many orders of magnitude faster than 1965 mainframes. We are going to gain the ability to manipulate cells and genes on a level that will allow us to repair our aged bodies. There's nothing about the nature of physical reality that precludes our developing the ability to do this.
If you want to learn about how human aging will become curable and whole body rejuvenation will become possible read about Aubrey de Grey's Strategies for Engineered Negligible Senescence.
Biogerontologist Aubrey de Grey says the highly goal directed engineering effort which he calls the coming "War On Aging" will begin in about 10 years.
Aubrey de Grey of Cambridge University, UK, has presented a cure for aging - Strategies for Engineered Negligible Senescence. The plan's focus is not to interfere with a person's metabolism, but to repair damage to the body over time, at the cellular level, rather than dealing with the aging process in its later stages.
"My point here is just that this is goal-directed rather than curiosity-driven," de Grey said. "I view medicine as a branch of engineering."
...
De Grey calls the time during which the technologies will experience the most development the War On Aging.
"I use the phrase to describe the period starting when we get results in the laboratory with mice that are impressive enough to make people realize that life extension is possible, and ending when the first effective therapies for humans are developed," de Grey said. "I estimate that the War On Aging will start 10 years from now, subject to funding of research, and will last for 15 years, but this latter estimate is extremely speculative."
When he refers to a point when the War On Aging ends my guess is that he's referring to the point where we have achieved the ability to extend life faster than the rate at which calendar clock time advances. From an article of his published in PLoS Biology Aubrey says if we can extend life expectancy in a year by more than a year's time then Aubrey calls that point "actuarial escape velocity" which is the point at which we can repair aging damage faster than it accumulates.
...that in which mortality rates fall so fast that people's remaining (not merely total) life expectancy increases with time. Is this unimaginably fast? Not at all: it is simply the ratio of the mortality rates at consecutive ages (in the same year) in the age range where most people die, which is only about 10% per year. I term this rate of reduction of age-specific mortality risk ‘actuarial escape velocity’ (AEV), because an individual's remaining life expectancy is affected by aging and by improvements in life-extending therapy in a way qualitatively very similar to how the remaining life expectancy of someone jumping off a cliff is affected by, respectively, gravity and upward jet propulsion (Figure 1).
The escape velocity cusp is closer than you might guess. Since we are already so long lived, even a 30% increase in healthy life span will give the first beneficiaries of rejuvenation therapies another 20 years—an eternity in science—to benefit from second-generation therapies that would give another 30%, and so on ad infinitum. Thus, if first-generation rejuvenation therapies were universally available and this progress in developing rejuvenation therapy could be indefinitely maintained, these advances would put us beyond AEV.
How can this be accomplished? Read about Aubrey's Strategies for Engineered Negligible Senescence (SENS) for achieving this goal. Also, Aubrey and Dave Gobel founded the Methuselah Mouse Prize to encourage scientists to extend the lives of laboratory mice.
The prize seeks to encourage development of technologies that will also extend human lives. But its most important effect will be in terms of how those advances come to be viewed by the general public. The sooner scientists extend the lives of lab animals the sooner the public will wake up to the feasibility of radically extending human lives. This realization on the part of the public will eventually lead to widespread public demand for the War On Aging. Anyone who donates to the Methuselah Mouse Prize is helping to make the War On Aging begin in earnest sooner rather than later. Anyone who promotes the message that ‘actuarial escape velocity’ (AEV) is achievable via SENS technologies within the lifetimes of most of the people alive today also is effectively arguing for the coming War On Aging.
Stop being a pacifist where death is concerned. Join the supporters of the War On Aging. Time to go into battle against the Grim Reaper.
Update: Jay Olshansky, Daniel Perry, Richard A. Miller, and Robert N. Butler, arguing for a more modest goal of decelerating the rate of aging say that the future costs of an aging population will increase so much that the costs of an accelerated pace of aging research are easy to justify in terms of potential future costs avoided.
Consider what is likely to happen if we don't. Take, for instance, the impact of just one age-related disorder, Alzheimer disease (AD). For no other reason than the inevitable shifting demographics, the number of Americans stricken with AD will rise from 4 million today to as many as 16 million by midcentury.4 This means that more people in the United States will have AD by 2050 than the entire current population of the Netherlands. Globally, AD prevalence is expected to rise to 45 million by 2050, with three of every four patients with AD living in a developing nation.5 The US economic toll is currently $80-$100 billion, but by 2050 more than $1 trillion will be spent annually on AD and related dementias. The impact of this single disease will be catastrophic, and this is just one example.
$1 trillion per year in future costs for Alzheimer's alone demonstrate the scale of the potential savings that could come from therapies to decelerate and even reverse aging. Already today's cost of diseases run into the trillions in health care costs plus additional even higher costs of lost productivity and strains on families and friends who help out the sick and invalid. Our spending on anti-aging research should be in the hundreds of billions of dollars per year.
Chronic diseases will kill 35 million in 2005.
By the end of 2005, twice as many people will have died from chronic diseases as from all infectious diseases, starvation and pregnancy and birth complications combined, international experts have warned.
The “neglected epidemic” of chronic disease will take 35 million lives in 2005, out of the total 58 million who will die globally. And contrary to popular belief, most of the deaths - 80% - from chronic conditions such as heart disease, diabetes and cancer will be in low to middle-income countries.
Obesity and the demon tobacco are big contributors to ths trend. But, while the article does not state this, this is really a success story in one sense: More people in less developed countries are living long enough to get diseases of old age.
Deaths from infectious diseases and starvation continue to be viewed by most people as morally more objectionable. Death from heart disease, cancer, and other diseases associated with aging continue to be seen as natural and inevitable. This view that these diseases are natural leads to the view that they are not morally undesirable. Whereas deaths from infectious diseases are seen as morally repugnant and to be fought against much more strongly.
As more diseases of old age become manipulable by biotechnology this belief in their naturalness and in their inevitability will wane. If more people could make that mental shift sooner then the result would be much greater political support for increased funding of research aimed at developing rejuvenation therapies.
Real estate investment banker Robert Klein, who initiated and providing funding for California's $3 billion Stem Cell Research and Cures Initiative which won 59% of the vote in a statewide referendum, argues that medical research costs should be seen more like an investment and less like an expense.
To Klein, medical research should be viewed as a part of the public infrastructure, like a dam or a bridge. "You've got to stop 'expensing' research," he says. "You've got to put it in the state constitution and authorize state bonds for it as a capital asset." The approach protects controversial areas of study and allows the state to account for costs over decades instead of every year. With this philosophy, Klein proposed a way for citizens to demand long-term funding. For nine months he worked with scientists, patient advocates and a team of prominent lawyers, and they eventually crafted Proposition 71 for the 2004 ballot.
Think of it this way: If potholes in the roads were causing damages to vehicles that far exceeded the cost of fixing the potholes then the political cry would go out to fix the potholes. Well, the cost of diseases and aging - both for expensive treatments and for the costs of disability - run into the trillions of dollars per year. So why do the US National Institutes of Health get less than $30 billion dollars per year while US federal, state, and local governments spend somewhere in the neighborhood of $700 to $800 billion per year for medical care and nursing care? Why does the private sector spend even more while the government also spends money to provide income to old folks who are too aged to work?
While we can not allocate money to repair and rejuvenate bodies as quickly as potholes can get repaired we can allocate money to achieve repairability of human bodies within the lifetimes of most of us. The idea of developing the means to grow replacement organs or send in cells or gene therapy to do repairs of tissue is no longer the distant imagining of science fiction. Such therapies are already available for a few diseases and more are under development. For example, two teams in Pittsburgh Pennsylvania and Innsbruck Austria have working cell therapies for repairing sphincter muscles to cure urinary incontinence.
The faster we develop therapies built upon the rapid advances in biotechnology the sooner we will start reaping the return on our collective investments in therapies that repair and rejuvenate aged, malfunctioning, and diseased body parts.
In 2003 health care spending made up 15.3% of the US economy and is projected to rise to 18.4% by 2013 with further increases beyond 2013. Currently US federal biomedical research spending (almost $29 billion out of an almost $11 trillion economy) amounts to less than a third of a percent of GDP. Why spend over 30 dollars delivering care with today's lousy treatments for every dollar spent on research to develop newer, better, and more cost effective treatments? Imagine we spent $30 dollars on car repairs for potholes for every dollar we spent fixing potholes. Our current policies are about that dumb. Effective treatments will be cheaper treatments. Also, effective treatments will boost productivity and economic output by boosting the level of function of the labor force and by allowing people to work more years. Biomedical research will pay back many times over.
My modest proposal: Fix medical research spending levels as a fixed percentage of major medical entitlements spending programs. For example, make Medicare and Medicaid each spend 10% or even 15% of their budgets on biomedical research. When their entitlements spending for provision of care goes up then their funding of research should go up in tandem by proportionate amounts. A 10% allocation of medical entitlements program spending to research would more than double current biomedical research funding. If the same pattern was repeated by other Western governments the increase in biomedical funding would greatly accelerate the rate of progress in developing therapies.
Writing in the European Molecular Biology Organisation's journal EMBO Reports Cambridge UK biogerontologist Aubrey de Grey makes the case for pursuing complete human rejuvenation as an achievable and desirable goal in an article entitled "Resistance to debate on how to postpone ageing is delaying progress and costing lives".
Before moving on to discuss the second, widely overlooked, source of political resistance to funding ageing research, we can already note how the traditional gerontological rhetoric has become an albatross—and perhaps always was. "Ageing is not a disease", as I noted earlier, has long been a slogan of gerontology. Politicians may be inclined to feel that, well, if ageing is not a disease, it is probably not something we ought to be spending much effort combating, then, is it? When we reflect that this is a gut feeling that most people, and thus most politicians, probably have at the outset—what Miller (2002) termed "gerontologiphobia"—and also that when money is tight its allocators seek excuses to narrow the list of candidate recipients, we see clearly that describing ageing as "not a disease" has severe rhetorical drawbacks, regardless of the value it may once have had in distinguishing biogerontology from other biomedical research.
This problem is in my view dwarfed, however, by the second difficulty that politicians may have in embracing biogerontologists' arguments: the merit of spending money in pursuit of a given goal depends not only on that goal's desirability but also on its feasibility. Those of us who do not suffer from gerontologiphobia are persistently awed by the logical contortions that gerontologiphobes perform when asked to justify their pro-ageing stance. Similar awe—although that might not be the word they would use—may be felt by politicians who encounter the efforts of gerontologists to extract from available data an argument that their work will probably cause substantial compression of morbidity in the foreseeable future.
Although the concept is much older, the term 'compression of morbidity' was introduced by James Fries in a paper published in 1980: "Present data allow calculation of the ideal average life span, approximately 85 years. Chronic illness may presumably be postponed by changes in life style [...] Thus, the average age at first infirmity can be raised, thereby making the morbidity curve more rectangular. Extension of adult vigor far into a fixed life span compresses the period of senescence near the end of life" (Fries, 1980). Even ignoring the questionable assumption of a fixed lifespan, we immediately see that Fries is not predicting that combating ageing will compress morbidity. Instead, he stresses "changes in life style"—not a noted sphere of biogerontological influence. Fries's hope that US morbidity would be compressed has been realized in the meantime, and the details of that change duly support the theory that lifestyle, rather than biomedical progress, is responsible. All the compression observed is in mild to moderate disability, which is substantially achievable by lifestyle changes, whereas absolutely no compression of severe morbidity has occurred (Fries, 2003).
Aubrey thinks many biogerontologists entered the field when there was little hope of ever stopping or reversing aging. Therefore most entered to satisfy their curiosity rather than to achieve goals which have practical uses.
I suspect that, in their heart of hearts, many of my colleagues in biogerontology secretly realize or at least fear the futility of compressing morbidity by manipulating ageing. These people face an unenviable problem: they are scientists trapped in a biomedical discipline, so their path of least resistance may be to submit to the gerontologiphobia of society and not rock the boat. I should explain what I mean by this. When many of today's senior biogerontologists entered the field, serious postponement of ageing was not realistic, and they therefore became biogerontologists partly—and in most cases, I believe, mainly—with the curiosity-driven motivations of a basic scientist rather than the goal-directed ones of an engineer or clinician. They find discovery fulfilling, and seek only the resources to carry on discovering more. Any talk of actually doing something about ageing is then a Fig leaf—the sort of camouflage that all scientists use to make society value their work without fretting that there is no guarantee that it will ever be useful. Perhaps this is why those who propound the most blatantly invalid reasons why our hitherto minimal rate of progress in postponing ageing cannot be accelerated—reasons transparently based on misuse of logic (Hayflick, 2004) or of extrapolation (Olshansky et al, 2001)—are often allowed to carry on espousing their views without challenge. There may be a tacit hope that the blinding unjustifiability of their pessimism will distract the attention of the funding bodies from the subtler contradictions in what mainstream gerontology is saying to justify its existence.
But we no longer live in that era when rejuvenation was absolutely out of the question. Biotechnology has come so far that genomes can be sequenced at increasingly faster speeds and for declining costs. Technologies developed for the semiconductor industry are being adapted to make microfluidic devices which allow increasingly precise and cheap manipulation of biological systems down at the scale of cells and molecules. Computers allow automation and scaling of processes which required enormous quantities of manual labor in past decades.
The accumulation of tools for biological science and biotechnology is enabling more ambitious undertakings. Many scientists are already attempting to develop treatments that effectively reverse some processes of aging. Scientists working today will find ways to, for example, grow replacement organs and to send stem cells into the body to do repairs. Freshly grown replacement organs and other freshly grown body parts will entirely reverse the age of whatever parts of the body they replace. Immunotherapies to remove extracellular junk have been tested in animals and humans and continue to be developed.
Today scientists are working on parts of the rejuvenation puzzle. Most do so in order to treat specific diseases which are the result of aging (e.g. heart disease, kidney failure) rather than as part of a systematic attempt to roll back all of the causes of aging. Their work is still very valuable. But the lack of widespread embrace of the larger goal of full rejuvenation inevitably means that little effort goes into some of the therapies needed for full rejuvenation. Unless the goal of full rejuvenation becomes the goal of biogerontology the gaps in the current efforts will go unaddressed for years to come.
Aubrey argues that the many different diseases associated with aging could be more effectively treated by rejuvenating the body rather than attack each disease. This idea can be grasped by looking at just a single organ, the liver for example. The liver can fail due to many reasons (e.g. a variety of pathogens, alcohol, trauma from an accident, genetic defects, environmental toxins, cancer, and still other diseases). Treatments can be developed for each disease and many labs are working on all these causes of liver failure. But a replacement liver will fix just about all of them. Even if the pathogens that cause liver damage can not be removed when a liver is replaced the pathogens take decades to destroy the liver. So a replacement liver would buy additional decades of life during which to find a cure for the pathogens. For cancer discovered at an early stage before metastasis a replacement liver would even effectively cure liver cancer.
Aubrey says we should not feel ashamed to declare the defeat of aging as a worthy and achievable goal.
Just as the purpose of oncology is to defeat cancer, the purpose of biogerontology is, and should be declared to be, to defeat ageing. Vintage cars do not age, because their owners have the dedication and expertise to give them the necessary maintenance. We will in due course have the expertise to maintain ourselves with similar fidelity, and few can doubt that we will then also have the dedication. Hastening that advance, therefore, is a legitimate and honourable goal of which we have been ashamed for too long.
I agree. The desire to live is not dishonorable. The desire for youthfulness is not decadent. We should pursue the goal of full rejuvenation and defeat all human diseases in the process.
Also see Reason's coverage of Aubrey's article.
A UC Irvine scientist claims aging is not a medical condition.
James McGaugh, director of the Center for the Neurobiology of Learning and Memory at the University of California-Irvine, bristles at the notion of people with normal brains taking medication to boost their brainpower. After all, he says, no one regards the slowing down of the body with age as a medical condition.
I disagree! So do many others. Aging is a medical condition because an aged body does not function properly. A body that does not function properly has a disease. A disease is a medical condition.
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"Does Michael Jordan have age-related physical impairment?" McGaugh asks.
Yes, of course he does. Jordan's problem with his knees is obviously age-related. His general slowing down and less endurance are age-related. It is not a coincidence that as the years passed and his body aged he became impaired as compared to what he used to be able to do.
Just as Jordan may not be as agile on the basketball court as he used to be, McGaugh says, there's strong evidence that memory processing slows with age.
Yes, our brains age. The aging of our brains is a medical condition. Consider this recent report on gene expression, brain aging, and damaged genes.
To investigate age-associated molecular changes in the human brain, Dr. Bruce A. Yankner, professor in the Department of Neurology and Division of Neuroscience at Children's Hospital Boston and Harvard Medical School, and colleagues examined patterns of gene expression in postmortem samples collected from thirty individuals ranging in age from 26 to 106 years. Using a sophisticated screening technique called transcriptional profiling that evaluates thousands of genes at a time, the researchers identified two groups of genes with significantly altered expression levels in the brains of older individuals. A gene's expression level is an indicator of whether or not the gene is functioning properly.
"We found that genes that play a role in learning and memory were among those most significantly reduced in the aging human cortex," said Yankner. "These include genes that are required for communication between neurons."
In addition to a reduction in genes important for cognitive function, there was an elevated expression of genes that are associated with stress and repair mechanisms and genes linked to inflammation and immune responses. This is evidence that pathological events may be occurring in the aging brain, possibly related to gene damage.
The researchers then went on to show that many of the genes with altered expression in the brain were badly damaged and could not function properly. They showed that these genes also could be selectively damaged in brain cells grown in the laboratory, thereby mimicking some of the changes of the aging brain.
Is gene damage a medical condition? More generally, is brain damage a medical condition? Yes, of course. If you have something in your body that is damaged then you have a medical condition.
I am amazed to see scientists promoting a naturalistic fallacy that if some process is natural it must be normal and must not be treated. Imagine making that argument about, say, a troubled pregnancy: "Sorry maam, we can't intervene to save you or your baby from preeclampsia because in our view your illness is a natural result of an interaction between your genes and your environment." Or imagine saying this about a bacterial infection: "We can't give your daughter an antibiotic to kill the Group A streptococcal infections that is causing scarlet fever because infections are natural and have been happening for all of human history. So she'll just have to die since there is no medical condition here." You'd be thought either crazy or incredibly unethical if you said such things. But today too many scientists, doctors, and members of the public at large think of aging as an inevitability to be embraced as part of the natural order. Well, aging is not inevitable. It is one big medical condition that we need to cure. Aging reversal will some day become possible and we ought to be trying much harder to make that day come as soon as possible.