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Should We Treat Aging?

"Should we treat aging?" is a rhetorical question here, but sadly it remains a straightforward open question for much of the world - when it is asked, they are quite serious in asking it. People expect there to be good reasons as to why aging should be left as it is, the cause of death for more than 100,000 people each and every day, and scientists restrained from working on therapies of rejuvenation. This is one of the uphill struggles taking place in the patient advocacy community for aging research, that most people don't consider themselves patients exhibiting the symptoms of degenerative aging, have little inclination to do anything about it, and are in fact initially hostile to the whole idea.

Here's an American Scientist article from researcher David Gems that asks the rhetorical question in the title of this post, and answers it for those who don't see things the way we do:

I am a scientist working in the growing field of biogerontology - the biology of aging. The cause of aging remains one of the great unsolved scientific mysteries. Still, the past decade has brought real progress in our understanding, raising the prospect that treatments might one day be feasible. Yet aging is not just another disease. And the prospect of treating aging is extraordinary in terms of the potential impact on the human condition. So, would it be ethical to try to treat it?

...

I argue for the recognition of an imperative to seek treatments that decelerate aging in order to alleviate late-life diseases. But at what point would such an imperative be fulfilled? Although decelerating aging would postpone the illnesses of aging, it would not make them any less awful. This means that achieving decelerated aging would not lessen the imperative. We would only be compelled to decelerate aging further, and then further still. Here the ethical calculus seems to set us inexorably on a road to ever-greater life extension. Could any sane authority ever opt to force others to forego treatment and suffer from avoidable age-related disease? Surely not.

So it is that decelerated aging would force a dilemma upon us. Should we alleviate suffering on a large scale and accept life extension? Or should we allow an immensity of avoidable suffering in order to avoid extending life? To my mind, the only reasonable course is the first. In fact, we should pursue it energetically, and begin to prevent illness as soon as is feasible. If not, we risk the fury of future generations for dithering. As for life extension, we will just have to take that on the chin. If we can prepare for it socially, politically and institutionally, and if we keep birth rates low, we should be able to ensure long, healthier, happier lives for our children and for our children's children.

In reading this, one must understand there there are a great many people in the world whose first, instinctive reaction to extending healthy human life is to reject it. For them, life extension is indeed a bad thing. Various strains of environmentalism are one of the main culprits here: so many minds are poisoned by the false ideas that spread from environmentalist and related Malthusian ideologies: that there are too many people, that people are intrinsically bad, that wealth and longevity are intrinsically bad, that economics is a zero-sum game, and so forth.

There's nothing wrong with liking trees and wild places enough to spend your hard-earned resources on helping to maintain them. But environmentalism has a way of veering off into the worship of death and destruction, a sort of modern penitent movement focused on the mortification of society as a whole. It's so widespread and embedded in our cultures now that even mild-mannered, everyday folk declare their support for shorter and fewer human lives, for abandonment of technologies that improve the quality of human life, and for relinquishment of technological development that will greatly improve life in the future.

In the long run, these are the ideas we must defeat and bury if we are to build the level of understanding and support required to speed the advent of rejuvenation biotechnology.

Comments

My big concern is that medical research depends so heavily on getting permission from policy makers who in turn could be influenced by neo-luddites.

If other people don't want to prolong their own lives, it shouldn't be an impediment on my desire to do so if that is a way I choose to go. The point is, the negatively inclined want to forbid this for ALL of us.

Posted by: Don Rodrigo at June 15th, 2011 2:44 PM

I question the validity of a lot of the research.

1. The idea that aging is not inevitable is based on the work of James Vaupel. It seems to me that all he really showed was that aging slows down beyond a certain point in fruit flies. He didn't really show that there is no natural species limit to life span; he showed that our previous ideas on the subject were wrong, ie, that cell division would cease at different fixed times for different species. So far everything that has been begotten and born has died.
2. And Vaupel didn't show that the fruit flies hadn't aged, sort of "withered." He showed that some lived much longer than anyone had thought possible.
3. The only evidence about quality of life is that some who outlive their generation by twenty or thirty years (which now means live to be 110) have decent lives. We always knew that was so; it appears in the Iliad with Nestor. But has it been shown that isolated individuals playing no part in the world with their friends all dead for a hundred years will be happy? In other words, we only know that public health initiatives from which everyone benefits might extend a generation's life and then certain individuals can live one or one and a half generations more and still be happy.
The rest is enthusiasm, not science, and reminds me of the Egyptians expending all that effort on pyramids and mummification.
So, should we fight aging as such? No. We should improve the general health and this will result in better life for all and longer life for some. That's how I read the research - I would really be interested in comments.

Posted by: Kathie at June 15th, 2011 4:03 PM

I personally want to live 300 years. This takes cures, and they'd have to come soon. But I imagine myself chatting with friends 250 years from now, remembering how foolish I was in my first 100 years.

Life is sweet, and there is nothing noble about dying. So yes, treat aging, research aging and stop its common ill effects.

Self-preservation isn't selfish. It's basic. We will need good health if we are to keep contributing in the later centuries of our lives. Let's work on it.

Posted by: Frank Warner at June 15th, 2011 4:22 PM

Imagine all the wisdom one could accumulate? Maybe people wouldn't be as depressed if they could continually reinvent themselves over hundreds of years.

Maybe we could get off this rock and increase the survival of the species exponentially.

Or maybe it's war all the way down...

Posted by: Bill at June 15th, 2011 5:53 PM

By all means, pursue this! But do so in the knowledge that, as with anything, the Law of Unintended Consequences will have the final say-so.

Adverse events are associated with every kind of medical therapy known to science. It is naive to think that lifespan extension therapy would be immune.

Posted by: Mike C at June 15th, 2011 6:01 PM

I like the idea of being vibrant and healthy into my 90's and beyond, but one look at current "life extension" healthcare should scare the crap out of you. All I see is decrepit folks with no minds left being kept alive by tube feeding. Yuk!

And just who is going to pay for all of these life extending treatments? My health insurance bill is already too high, and I'm healthy. If you're a zillionaire, fine, go for it. Out of your own pocket. Not out of my insurance dollars. Not interested. Nuh-unh.

And yes, I'm one of those environmentalists who think the burden we place on the planet is already too great and growing. Life extension perforce means an even more rapidly increasing population load - unless you are also counting on some sort of plague to wipe out the vast numbers of poor and underfed folks that you don't believe really exist.

Life extension may be a nice thing to dream of, but morally and ethically we should be putting many other goals ahead of it.

Posted by: Betsy at June 15th, 2011 6:18 PM

@Mike C: Being alive and having to figure out a solution for some unforeseen issues beats the alternative in my book.

@Kathie: You should look into the reliability theory of aging - that aging is simply accumulated damage at the level of cells and molecules, and the flailing of systems trying to adapt to that damage. So all successful damage repair will lengthen both life and healthy life, just as progress in damage avoidance (due to improved control over infectious disease) has lengthened both life and healthy life in the past. The future lies in repair biotechnologies, such those envisaged by the SENS Foundation, which is in fact working on viable ways to extend life by repairing the damage that causes aging. See:

http://www.sens.org/

@Betsy: The goal is to be young for longer, not old for longer, and the present technologies are indeed crude, not even any better than exercise and calorie restriction in their effects over the long term. See:

https://www.fightaging.org/archives/2004/03/the-ubiquity-of-the-tithonus-error.php

Also: overpopulation is nothing more than a myth. There are plenty of things wrong with the world we find ourselves in, including waste and poverty and inhumanity, but too many people is not one of the causes. See:

https://www.fightaging.org/archives/2006/09/overpopulation.php

and

https://www.fightaging.org/archives/2009/08/there-is-no-overpopulation-only-waste-corruption-and-inhumanity.php

Lastly, the effects of aging, which kills 100,000 people each and every day, fall disproportionately upon the poor. If you want to help the world's poor, there is no better way to do it - all other methods of giving aid are dust in the wind in the face of the suffering imposed upon the world's poor by aging.

Posted by: Reason at June 15th, 2011 6:47 PM

Reason,

You nicely demolish the "leftist" arguments against life extension. Good job! I did the same for the religious arguments in the other blog posting.

Posted by: Abelard Lindsey at June 15th, 2011 7:21 PM

You must understand that those 'environmentalists' who you say would reject a prolonged life would actually reject it for everyone else but themselves. Just look at how all of our 'environmental' spokesmen constantly preach to us about having to cut everything back and yet live like aristocratic pigs. They are all complete hypocrites who would gladly watch the rest of us die as they boosted their own lifespan.

Posted by: forrest at June 15th, 2011 7:59 PM

Where there is life, there is always hope.

Dying is always a catastrophic system failure. If it were otherwise, we would have our own "off" switch that we would be able to flip at will. It is never painless, unless there is a system fault causing it.

Death by oxygen displacement is generally painless because humans have no mechanism for detecting oxygen levels. Instead, we rely on testing carbon-dioxide levels to determine when we are at risk of asphyxiation. This makes us very vulnerable to death by oxygen displacement, or by loss of pressure, as we simply have no biological mechanism to warn us when these conditions exist. Rabbits, on the other hand do have a direct oxygen sensor, and react in pain and terror to being exposed to a low oxygen environment.

Quality of life arguments are tricky, and tend to be extremely subjective. Is my quality of life poor because my lungs are failing, or is it good because I have all of my fingers and my knees are still good? If having hands meant that you had arthritis, which would you pick? What about being physically fit, but retarded? What marks the balance for worth living, and not worth living, and would you really kill everyone who didn't meet that metric, regardless of their age?

It wasn't that long ago that being forty was called "toil and travail". In some parts of the world, it still is.

Posted by: Voyager at June 15th, 2011 8:45 PM

"To treat aging" sounds like euphemism here. "Should we treat aging as a disease?" is the more important question. I think almost everyone agrees that we should treat the aged for the symptoms of their agedness.

I'd say "yes, we should treat aging as a disease, even death as a preventable event, if we can." My mother died on the third. She didn't die of old age- she was only 66- but of a cancer. I would have liked to see her live to be a little old lady, but... I would have preferred that she not age, and not die.

My Mom died at my sister's place in College Station, TX. My sister is doing her grad work in neurobiology there. The last few days her friends came by to bring food. A lot of them were grad students, and a few were working on cancer in one way or another. One had lost her father to cancer a year before. We sat outside in the Texas heat and talked about future cancer treatments.

It might seem incongruous to bring up cancer in a comment on a post about treating aging. I think that cracking cancer is the first step in that direction though. I think we will have real cures for certain cancers very soon, but that a general cure might be a ways off. One thing I learned (well, that I learned better, if you will) in Texas is that researchers are too insulated from research in other disciplines that might be important to their work. But this is not the place to get into that.

As a matter of philosophy I think life should be extended as long as is possible (assuming it is worth living- I also learned some things about that in Texas.) I suppose I have a fairly philosophic view of things- we live for a while and then we die. But I would be happier if that weren't the case. I wish my Mom were still alive, and I can't imagine a few decades changing that.

One of the last things my Mom said to me was "If wishes were fishes..." Maybe we should be casting nets.

Posted by: Tagore Smith at June 15th, 2011 8:52 PM

Responding
Reason You Say: ...Kathie, You should look into the reliability theory of aging - that aging is simply accumulated damage at
the level of cells and molecules, and the flailing of systems trying to adapt to that damage.

I've read up on that theory and I stick to my point that if we look at the whole natural organic world, we see that all species die. Ours could not be different - unless we are basically different. No scientific evidence for that.

Put it another way: if we could abolish aging in humans we could abolish it in fruit flies. Before we invest huge sums in "repairing" the vastly complex human organism, why not repair a fruit fly showing that it could be done?
Here's another point - Vaupel's associates are now talking about methylation of genes over the life span as a influence on behavior - sometimes good, sometimes bad. But if we go about blindly "repairing" genes, isn't it possible we'd de-methylate (?) important adaptations and thus change behavior patterns? Suppose we could "reset to factory specs" a human being - isn't it possible that that would involve another behavior pattern?
What would another behavior pattern with the same memory be like in a human being? Isn't it possible we'd reset memory to zero - so we wouldn't go on, we'd go back to learning how to read at 110. New themes in science fiction!
But seriously, shouldn't we try it on mice first? And get some real results before we invest in a crash program?

Posted by: Kathie at June 16th, 2011 6:35 AM

@Kathie: If you look at the roadmap for the SENS Foundation, you'll see that the proposed crash program of development is in fact to make rejuvenation work in mice. (There are good reasons to start with mammals rather than flies - flies are very useful for understanding many of the basic cellular processes, less so for development of therapies that can be ported to mammals). That will take perhaps a billion dollars and ten to twenty years, estimating from the best of present knowledge. Of course that billion dollars has yet to arrive; their budget for 2010 was a mere million. But you should read the SENS Foundation site:

http://www.sens.org

And the annual reports for 2010:

http://www.sens.org/node/2011

Posted by: Reason at June 16th, 2011 6:49 AM

Kathie: I think you're right to point out that there are a lot of unknowns here. I don't think we're really all that close to curing aging or death. Life expectancy keeps increasing, but that has a lot to do with lower infant mortality rates, antibiotics, etc. We haven't been pushing back the top ages people live to, so far, and we don't know how to, yet. Since we don't know how to do that we aren't yet in a position to know what complications are going to arise in doing that. I do think it is very unlikely that reversing aging would reset the "mind."

I don't think that you're correct when you say that all species age and die. That's true of all species that reproduce sexually (shades of Adam, Eve, and the apple) but it's not true of species that don't. In a very real sense there is only one amoeba, and it is immortal.

Beyond that, different species age and die on different timetables. My cats have bodies and brains that are almost indistinguishable from mine, on a molecular level. But they will be ancient at 25, if they live that long. This suggests that aging is not an inevitability. If humans live four times longer than cats I don't see any reason to believe that future humans couldn't live four times longer than present humans.

I came up with the idea of actuarial escape velocity on my own, when I was quite young. I thought myself very clever. I was a bit crushed when I read a John W. Campbell editorial in an issue of Astounding from the fifties proclaiming that "the first immortal might already have been born." But I was pleased that someone else was thinking along the same lines.

I don't expect to live indefinitely. I was born too soon for that (though I suppose I might as well have my head frozen when I die, on the off chance that that will work out- even if it doesn't it will make good material for a 27th century dissertation on the bizarre burial rituals of the 20th.)

I'd like to think that some of the babies born today might live indefinitely, but I don't think we are yet in a position to have a good idea of how hard the aging/death nut is to crack. I've always thought that the "singularity" was basically religion for atheists, so I'm not counting on it to bail us out of those difficulties.

But the evidence suggests that aging can be prevented, and that humans could live indefinitely. And there is a lot of hostility to that idea- it bothers people that we might change that basic dynamic. That's understandable- people living even to the age of five hundred would be, I imagine, very different from people who die, on average, in their seventies. We innately fear the unknown because the unknown is often worth fearing. But we are innately driven to explore because the unknown can be very rewarding.

I think our first step on the road to semi-immortality should be figuring out how to let everyone live out their natural lifespan (which is about 110 years as far as I can tell) in comfort and dignity. It's a worthwhile goal on its own, it might be achievable even in my lifetime, and we will learn a lot in doing so. It's also a lot easier to get funding for "geriatric" or "cancer" research than for "longevity" research. That's too bad, but you work with the world you have.

Practical matters aside, there is a philosophical question. Should we want to live indefinitely? I don't think there is any way of settling this question empirically- it is a matter of preference. Given effective anti-aging treatments I would certainly let you age and die if you wanted to, as long as you let me and mine stay indefinitely young.

Posted by: Tagore Smith at June 16th, 2011 10:09 AM

At any given point, a person making a choice to live longer seems reasonable. A free being should have that choice. What you are advocating here is something else - that all of us should chip in for research so that those who choose to live indefinitely can do so.

Your arguments are not terrible, certainly. Postponing suffering could be framed as a no-net-benefit scenario, yet I think you are correct that it is something better. If the startup and decommissioning costs of a human being - measured in pain, dollars, inconvenience, whatever - are X, then spending that for 200 years of life rather than 20 seems beneficial. That may not be a linear computation; there may be a law of diminishing returns. Still, it's something.

You also argue that we learn other important things about reducing suffering while we study aging. You are hoping, not unrealistically, for important side benefits.

There are weaknesses here, and throughout the life-extension advocacy community, however. You don't know that it will work, and you don't know whether it will be bane or boon to mankind. Much of the criticism of others revolves around imagining what terrible motives they have and telling each other how stupid they are. Confirmation bias is very powerful in such matters, and I think prevents advocates from genuinely examining what back doors they leave open where thieves might come in. Abelard, for example, is quite certain that the only people who have thought about the topic of life-extension for the last few thousand years are all delusional, and none of their thoughts should be regarded as potentially instructive. Well, he's a man who knows (wink, wink, nudge, nudge, eh?), so we should certainly take what he says to the bank.

Frank and Bill, making the positive case, imagine how totally awesome it would be, dude, to live for a long time. Entirely too much of that, though often phrased differently, dominates anti-aging advocacy. I don't make people say those things, it's what keeps popping out of everyone's mouth, so I have to assume it resides near their hearts. Even the better thinkers in the field, if you let them keep talking long enough, reveal this oversimplification: "it would be cool, and the people against it are stupid." It's not a sin, but it's not much of a reason, either.

As to helping the poor by combatting the effects of aging, not really. Good government and free markets would help many of them whose poverty comes from the bad decisions of others. For those whose poverty comes from their own bad decisions, I think improving their chronic medical conditions is less than half the issue.

Posted by: Assistant Village Idiot at June 16th, 2011 10:21 AM

@Tagore
For a long time last century, life expectancy increased steadily mostly due to lower infant death, thanks mainly to sanitation (doctors washing hands was the biggest life saver), vaccines, and antibiotics.
But for the past twenty years or so, infant mortality has no longer been the driving force behind life expectancy increase; it is, instead, due to decreased mortality in the old adults.
Reason, do you have an article and graph on this shift?

Posted by: Hervé Musseau at June 17th, 2011 1:58 AM

Reason: You say check the SENS site which I did and here are my comments specific to the site.

Being 67, I'm not opposed to research to improve things for the aged. I think that de Gray has made an important contribution by showing that deposits build up in the brain or elsewhere and wreck functioning and that these could (probably) be understood and eliminated in the aged by an extension of research and knowledge. The Foundation is making a contribution by saying that this is important now because we are now living longer. Fine. Great.
But allied with this is the proposal that given enough money and a crash program we could achieve immortality for some of those now alive. What piece of published science really shows how this generation of human beings now alive could achieve what no other organic species has? It isn't enough for me to read that some aging processes which lead to death can be genetically reversed by human ingenuity. That doesn't make me think that if enough money is spent all processes which lead to death can similarly be reversed. What goes through my mind is: why should we think that any generation of the human species will be different in their bodies to all other organic beings? and still be organic? Lions, bugs, flowers,pines, cycads, moss, mould - they have a life cycle and they always die and so will we. For an engineer like deGray a life cycle is just a sort of strength of materials issue but in my opinion the organic life cycle is far more than that.
You say bacteria are immortal in a way. I am sure that human beings want and would pay for personal immortality (see the Egyptians) but not genetic immortality of a bacterial type and I'm not even sure anyhow that that first bacteria you mention is still around with an unchanged genetic program.

We wish for more but science is not about wishful thinking - is it?

Posted by: Kathie at June 17th, 2011 10:43 AM

Kathie: I don't see any reason to think that reversing aging isn't possible, though I'll grant that it might be very difficult. That no other species has done so doesn't seem very meaningful to me- no other species does molecular biology. I wouldn't bet on it happening in my lifetime though, or even in the lifetime of anyone now alive.

Posted by: Tagore Smith at June 17th, 2011 2:03 PM

Aging is a genetic disease - that's why we all age in similar ways. Cancer is also a genetic disease, probably the obverse of aging.

When one of our body's systems malfunctions, it's not a "system" failure but a failure of a cell type (or multiple cell types) to do its job. If the cell type can be corrected, youthful performance can be restored.

One of the forefronts of medicine is genetic-tuned therapies. Our expanding knowledge of cell mechanics will lead to genetic life extension treatments.

In 1911, few people foresaw worldwide jet travel and rockets into orbit in 50 years.
In 1961, few people foresaw handheld computers tied into a worldwide information and communications network in 50 years.
In 2011, few people foresee practical life extension and rejuvenation treatments in widespread use in 50 years, but it is coming. This is the century of molecular biology.

Of course there will be well-publicized failures along the way, and lots of fraudulent "cures." There will also be mountains of pages of philosophical hand-wringing, but when the first real successes are marketed, they will be deluged with money. Extra life is one thing that everyone will open their wallets for. It will also be the best possible path into the future for the human race.

Posted by: Tom at June 17th, 2011 2:38 PM

@Katie: Everything eventually dies. However, some species have a lifespan measured in centuries, and some even in millennia. A few species even do have an indefinite lifespan, ie they don't die of age, only of accident or predation or some catastrophe to their habitat. That's what we should be striving for.

Posted by: Hervé Musseau at June 20th, 2011 2:03 AM

The easy answer is to question the sense of the opposite.
Ask anybody if they would like to die aged 20... or less. They would find the idea ridiculous, wouldn´t they ? So why would anybody want to die aged 70 or 90, if they could live longer.
And also, the productive time of a human being, compared to the time growing up, and being a "burden" could be drastically improved.
If we would change our profession every few decades, we would increase general knowledge. We would also increase general concern for health,peace and nature, since we wouldn´t waste just a few years, but many!
The only argument I can think of that is pro aging, is evolution. Faster generation change means faster adaption. Well, and of course, if a dictator wouldn´t die of old age some day, might also be a drawback ;). But on the other hand, who would want to be a dictator, who is highly probable to be assassinated in the near future ?!? But there are always some power mongers, who don´t care about anything else.

Posted by: Marcel at August 30th, 2013 2:19 AM

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