"We are on the verge of a revolution in medicine: understanding, treating, and ultimately preventing the causes of degenerative aging. But medical revolutions only happen if we all stand up in support of funding and research. We did it for cancer. We're doing it for Alzheimer's. We can do it for aging - and create an era of longer, healthier lives!"

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  • Thursday, December 23, 2004

    Plasticity of Longevity

    The transcript for the SAGE Crossroads interview with James Vaupel is now online. You may recall recent press on Vaupel's demographic research and suggestions that life expectancy in countries like the US could actually decline in years ahead. This interview serves to clarify his views and place those remarks in a wider context - Vaupel sounds like he agrees with the Reliability Theory of aging. Some excepts:

    It used to be thought that there was nothing that could be done about aging, and that there was nothing that could be done to extend the length of life for humans.

    But now we know that there is a lot that can be done about aging, and that people can live much longer than they used to live. So that's the plasticity of longevity.

    ...

    That life expectancy is a measure of current conditions. It is not a prediction about how long somebody will live. But it's a measure of how long a person, a baby would live if that baby was confined to this year, could not get out of this year, was stuck with the conditions of this year.

    So a more meaningful projection for most people would be, how long do we think that a newborn would live given mortality improvements?

    The result is quite astounding. The result is that a newborn baby, in the developed world today—Europe, Japan, the United States—of those newborn babies, half will probably celebrate their hundredth birthday.

    ...

    So the progress [in life expectancy prior to 1950] was largely due to saving lives below age sixty-five, especially children.

    But after 1950 the improvements to life expectancy have largely been due to saving lives after age sixty-five, to this extension of life, to this giving—adding years to the life of older people.

    So it's been a remarkable shift, and the shift has been due to the fact that since 1950 we've had various kinds of interventions that could help save people from heart disease, that could intervene with various infectious diseases that were killing very old people, so the antibiotics and so on helped older people a lot.

    When Vaupel makes predictions, I think it's important to note that these are extrapolations; they do not and cannot take into account fundamental paradigm shifts in medical science. This is illustrated by any number of other competent, well-informed folks - such as Ray Kurzweil - making very different sorts of analytical predictions about the future of medical technology and human life span. The following pretty much says it all regarding extrapolation:

    So when I'm criticized for saying that newborn babies will live to a hundred, I think the most powerful criticism is that I can't describe how they are going to live to a hundred. What's going to happen that will let them live to a hundred?

    Then what I say is that I think heart disease death rates are going to come down. I don't know exactly how. I think we are going to find a cure or a way of preventing Alzheimer's, but I don't know exactly how. I think we are going to find ways of preventing or treating cancer, but I don't know exactly how.

    So there are a lot of uncertainties about how this is going to be done. Basically, what I'm saying is that if life expectancy has gone up by two and a half years per decade for 160 years, it is likely to continue to go up. We are learning a lot about biomedical interventions, by health interventions. But I can't describe the details.

    I have to say that I fall into the school of making it happen rather than the school of making projections. The capacity to influence the aging process is clearly not too far away under the right circumstances - getting there is a matter of finding the funding and will, and sooner is better.

    Vaupel has a fairly sensible (if state-centric) view of the role of retirement in a longer life:

    Well, there's a notion that's been developed mainly over the last hundred years, to separate life into three boxes. The first box you get educated, so you finish high school, you finish college, you finish graduate school and you are educated.

    Then the second box is you work.

    The third box you spend decades in forced leisure.

    It doesn't make any sense to me to divide life up that way. But life has been divided up that way, and the number of people in most developed countries—once again, especially—this is especially Europe—the number of people who are working after age sixty has fallen dramatically, especially over the last twenty years.

    So people have sort of—people have developed an assumption that they have a right to decades of leisure at age sixty or age sixty-five.

    I don't see where this right comes from. People have a responsibility to contribute to society. We have to maintain the economy. If there are very large numbers of people who are not working at older ages, then that's going to be a burden on younger people.

    I would have said "responsibility to support themselves," but we all know my leanings in that area.

    One quote that jumped out:

    Suppose you wanted to live to a hundred or I wanted to live to a hundred. How could we do it? What can you do? There is actually very little that an individual can do to extend an individual's life span by twenty years.

    If the current human calorie restriction research continues to produce the same sorts of results as it has to date, then this lifestyle choice would seem to be a good shot at getting a fair chunk of those extra healthy years. Vaupel is right, however, in that what we have access to right now is pretty poor longevity medicine in the broader context of what is possible.

    In summary, James Vaupel comes across as bullish on the prospects for increasing healthy life span through improved medicine - but he's in much the same ballpark as folks like S. Jay Olshansky or Richard Miller when it comes to the expected timeframe for these improvements. There are a fair number of other interesting items in there to find, so go and read the whole transcript.

    Posted by Reason

     
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