Wired on the Longevity Dividend

I see that Wired is running a piece espousing the Longevity Dividend. The Longevity Dividend is an argument developed by a group of gerontologists and aimed at regulators and politically-influenced funding groups. It deliberately steers clear of talking about extending life span, instead presenting increased funding for applied aging research as a form of investment that will greatly reduce later government medical program expenditures through reducing incidence of age-related disease. In that sense it is a form of compressed morbidity viewpoint, the theory that the period of life spent in age-related frailty and suffering from age-related disease can be compressed down without extending life span. This runs contrary to aging-as-damage theories, which instead state that any intervention that reduces the level of accumulated damage will tend to extend overall life span in addition to its other beneficial effects.

As to my personal view, I'll say that there are many strategies by which one can advance a cause - here, the cause of longevity science. Advocacy strategies that water down or omit core goals and facts in order to achieve wider circulation will do little to change the marketplace of ideas, however, and it is change in the marketplace of ideas that drives progress. The best progress in advocacy is made by planting your flag as far out as is supported by the evidence, and then defending that point against all naysayers.

But of course only the boldest of folk are willing to do that. Large institutions, such as government funding sources and the associated research communities, are ruthless in punishing members who publicly step one iota behind the limits of tradition and convention - hence the softly softly approach by those who have the most to lose.

Back to the topic at hand, here's the article in Wired:

As politicians try to reform a health care system that could swallow one-fifth of the nation’s economic output by 2020, they should consider making a small bet with a potentially huge payoff: research that could slow the process of aging.

"There will never be enough money for the federal government to pay for the demands of health care, because of chronic age-related diseases," said Doug Wallace, a cell biologist at the University of California, Irvine.

Wallace specializes in mitochondria - cellular power plants that float outside the cell nucleus, turn glucose into usable energy, and wear down over time. He thinks their malfunction underlies nearly every disease whose risks spike after middle age, from cancer to heart disease to dementia.

..

In papers published in The Scientist and British Medical Journal, Olshanksy and International Longevity Center president Robert Butler wrote that drugs that delay aging’s onset by seven years are now a realistic possibility.

They’re currently in the process of calculating this longevity dividend’s economic benefits. Even if the figures aren’t finalized, however, they’re likely to be massive. For Alzheimer’s disease alone, they estimate that the cost of care will rise to $1 trillion by 2050. The Robert Wood Johnson foundation estimates two-thirds of rising health costs come from chronic diseases.

“We need a method of molecular pre-emption. If we’re going to be able to afford health care, that’s what we’ve got to do. That’s going to provide the maximum cost savings, not managing symptoms or curative treatment,” said former National Institutes of Health chief Elias Zerhouni at a symposium held last Friday by the Jackson Laboratory.

I'll point you to a good quote from a little while back:

I say if this were a privatized system, we would all say "gee it’s wonderful. All these people want more health care, this industry is thriving". Let me put one other analogy. Suppose we made cars a government entitlement. Instead of cheering when auto production went up, we’d say, "Oh my God, we can’t afford this!". How you finance it may greatly affect the psychology and actually the freedom of the economy to take advantage of these new opportunities.

Centralized government control destroys everything it touches; it's just a matter of time for US medical institutions. It will be the tragedy of the commons writ larger than ever, a system in which every local, personal incentive is aligned against progress. So we will have little progress - and consequently much suffering - until some revolution sweeps this all away.

Comments

As a sociologist, I would argue that the Longevity Dividend argument can advance our common dream much more safely than the approach you advocate (talking freely and honestly about significant life extension). Firstly, people tend to oppose revolutionary challenges of the status quo, while they usually accept incremental changes of their values and norms. If you say you want to help those who suffer from Alzheimer or cancer, you won't create the same kind of opposition as you would by saying "we want to live for a thousand years". Secondly, both corporations and elected officials are short-sighted. They will be more willing to invest in the aging-related research if you promise them small yet tangible returns in a short time than if you talk about much higher returns achievable in twenty years.

Posted by: Sociologist at August 10th, 2009 2:27 PM

The counterpoint being that when people are geared up to work on incremental change, then incremental change is the best possible outcome. If all the effort goes towards efforts that are not intended to extend healthy life span, then don't expect to see much in the way of extended healthy life span at the end of the day.

You have to explicitly work towards the goal you intend if you want to make progress in that direction.

Posted by: Reason at August 10th, 2009 2:51 PM

What we need is to get policy makers to accept aging as a disease. However we will not achieve this any time soon if we use the word "aging", since it is such a loaded word.

We also cant simply substitute another word with "aging" as people will simply come to the conclusion that our alternate word = "aging".

What we need to do is divide aging into a few separate umbrella diseases. Eg. group together all diseases for which there is substantial evidence that they are caused by mitochondrial dysfunction. Create a short, catchy term for our new umbrella disease and get the required funding.

Posted by: Marco Da Silva at August 11th, 2009 4:41 AM

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