When it comes to public discussion of extending healthy life spans through medical science, the tide is slowly turning. As a serious scientific goal, this used to be mocked when it was ever discussed at all. Now healthy life extension is discussed both seriously and more often. But it is still the case that the majority of the public puts little thought into the intersection of aging and progress in medicine, and when pushed for an opinion express disinterest in living longer. This is obviously problematic for those of us who do see the possibilities in longevity science: radical life extension could be achieved within our lifetimes given enough funding and support, but that support is slow in arriving.
There are a range of opinions as to why the broader public doesn't leap on the idea of living longer, healthier lives with great enthusiasm and approval. It is somewhat odd when seen from a logical perspective as, after all, there is widespread grassroots support for the development of better treatments for age-related diseases. The average person on the street thinks that progress is being made on the prevention and cure of heart disease, cancer, and so on, and that this is a good thing. But ask them about aging and extended life and you'll hear that nothing should be done, and they are set to die on the same schedule as their parents.
Most advocates for the development of rejuvenation therapies think that the biggest issue is that most people still think that living longer will mean being older for longer rather than being younger for longer - that it will mean more misery and pain and increasing decrepitude. Yet this has never been the message propagated by the scientific community: scientists are working on means to make people younger for longer, or to reverse aging so as to restore youthful vigor and capabilities to the old, and have always presented their research in terms of health and youth. "Older for longer" is a myth, and probably not even something that could be achieved at all, were someone foolish enough to try, but it persists nonetheless.
Surprisingly, most people do not want to have their life spans extended. In my opinion, this pessimistic view stems from several factors. First, when forming a conscious and subconscious opinion about life expectancy, most people use as benchmarks their parents' and grandparents' life spans, and the national average. The line of thought is usually: "I am 40, my grandmother lived to 92, my dad is 70, and I heard that the average is about 78, so I should live to somewhere between 80 and 95. But I am not sure if I want to live that long, because my grandmother was very frail in her later years."
These perceptions are fostered by researchers who look at historic trends and project only marginal increases, or even decreases, in future life expectancy. These researchers predict that recent behavioral changes, like high-calorie diets and sedentary lifestyles, as well as pollution and other environmental factors, will outweigh life-extending advances in biomedical sciences. But the past 20 years have demonstrated that those relying on historical trends to make predictions about science and technology are often proven wrong.
People may also believe an extended life span will extend frailty and boredom in old age. But biomedical advances are not all the same. The current paradigm in biomedical research, clinical regulation and healthcare has created a spur of costly procedures that provide only marginal increases late in life. The vast percentage of lifetime healthcare costs today are spent in the last few years of patients' lives, increasing the burden on the economy and society and further contributing to the negative image of life extension. In the near future, however, the focus of biomedicine will shift to extending healthy, productive lives and keeping people young and occupied for as long as possible.
The preventive approaches available today, including improved diet and exercise and more advanced early diagnostics, may have the potential to add 10 to 20 years to our life spans. But future generations will more likely rely on biomedical interventions to prevent the loss of functionality with age and to maintain or even improve their performance on all levels. The lowest-hanging fruit is regenerative medicine, which will likely allow most of the organs in the body to be replaced or rejuvenated.