Some of the researchers involved in the Longevity Dividend initiative have taken the sensible approach of distilling into a new book their view on aging research, the existing evidence, the bounds of the possible in the near future of longevity science, and what should be done to treat aging. They should have done this years ago; it might have greatly helped efforts to lobby for greater funding of favored programs on aging and longevity in the National Institutes of Health. Certainly, the creation of Ending Aging was a very important foundation for the growth of support for SENS research; a well-assembled book is a solid point of reference that keeps on providing worth to those involved in advocacy for the cause it details.
So that said, the Longevity Dividend view is one of aiming for marginal, unambitious gains. It is an outgrowth of the mainstream position in aging research that sees the only viable path ahead as being a slow, expensive process of tinkering with the operation of metabolism so as to slightly slow the aging process - to slightly slow down the accumulation of cell and tissue damage that causes aging. This, of course, will be of little use to the people who are already old, heavily damaged, when the first treatments eventually emerge, and of not that much greater benefit to everyone else. Adding a couple of years to life expectancy doesn't change the big picture all that much at all. Further, the Longevity Dividend typifies the very conservative mindset of Big Government science: change must be small, everything is infused with politics and lobbying of formal hierarchies, and the pace of progress in persuasion is slow and expensive.
So while it is great that there are more researchers out there working to propagate the view that aging can and should be treated - there is still a long way to go yet to persuade the rest of the world to agree with that scientific consensus - in all of this the Longevity Dividend is really the antithesis of the SENS advocacy and rejuvenation research that I see as the most promising way forward. SENS comes as an outside influence on the present funding establishment and its rigid limitations, using philanthropic donations to create radical change, and engineer effective progress towards ways to repair the damage and end aging: to bring aging under medical control and prevent and reverse all age-related disease, not just slow it down a little. In any case, that is my opinion. You can see what you think now that the Longevity Dividend argument is laid out in a coherent fashion and at length:
Aging is one of the greatest challenges currently facing society. People are living longer than ever, but many of the later years are fraught with frailty and disease, placing an enormous burden on health-care systems. Understanding the biological changes that occur during aging and developing strategies to address them are therefore urgently needed.
Written and edited by experts in the field, Aging: The Longevity Dividend from the Cold Spring Harbor Perspectives in Medicine collection, examines the biological basis of aging, strategies that may extend health span, and the societal implications of delayed aging. Contributors discuss genetic variants that accelerate or protect against aging, biochemical pathways that modulate longevity (e.g., mTOR), biological consequences of aging (e.g., decline in stem cell function), and various animal models used to study aging processes. They emphasize that age-delaying interventions will yield greater health and vitality than disease-specific treatments. Drugs that may promote health span or longevity (e.g., metformin) and efforts to prevent and treat frailty (e.g., through exercise) are explored.
With the general realization that the population of our planet is rapidly becoming older, economists, population health experts, epidemiologists, policy planners, physicians, scientists, and others have started considering implications of this "silver tsunami" for the society. At the level of physiological functioning and health maintenance in old age, it became apparent that this increase in longevity will be accompanied by multiple comorbidities in a significant proportion of the older population.
Therefore, developing strategies to maintain optimal health in an increasingly aging population is becoming a global strategic imperative. This book represents the latest concerted and broad effort to shine a light on the potential of biology of aging research to implement what could be a revolutionary change in improving the health span of older adults. It is a culmination of more than 25 years of effort by the editors of this volume to draw broader attention to this issue. Specifically, beginning in 1990, S. Jay Olshansky and colleagues, many of them coauthors of this volume, started to make a powerful case for why and how research into life-span and health-span extension, as part of the larger field of biology of aging, may have a unique potential to provide broad and far-reaching benefits to the aging human population. The effort, aptly named the Longevity Dividend Initiative, has already made substantial headway in the larger community of researchers and is beginning to extend to policy makers and society overall. This book is part of a groundswell of recent activities to help scientists and public advocates of science reach the tipping point and bring about a coherent, conceptually innovative, scientifically based, and publicly as well as industry-supported and sponsored strategy to deal with health issues central to older adults from a revolutionary standpoint.
The argument for the Longevity Dividend is that the payback to society and individuals from extending health span via fundamental interventions based on knowledge of biology of aging will be considerable and broad. This argument, in its entirety, seems intuitively appealing to the point of being a "no-brainer": The current approaches to treating age-related diseases that produce the highest morbidity and mortality in the older adult population are only incrementally effective at increasing life span and minimally effective in increasing health span, defined as the fraction of life span spent in good health and prosperity. In fact, curing all cancers, for example, although desirable, merely replaces cancer with other chronic morbidities such as Alzheimer's, cardiovascular diseases, metabolic diseases, and so on. By contrast, in numerous laboratory animal models, including some studies in nonhuman primates and humans, interventions based on manipulations of nutrient sensing and cellular metabolism have shown not only longevity extension but also significant postponement of multiple age-related diseases (including cancer, Alzheimer's, cardiovascular, and metabolic diseases). This, therefore, is close to, or achieves, health-span extension.
The promise of translating these interventions to human subjects, then, starkly contrasts with current, disease-specific research and treatment approach. Simply put, the choice would come down to the two extremes: (1) the current health-care approach, with most individuals enjoying a relatively long life span but reduced health span with multiple comorbidities and increased, ballooning health-care costs; or (2) the biology-of-aging-based health-span extension, which, if successfully translated to humans, would provide increased health span at a fraction of today's health-care cost, with a vigorous and engaged older adult population and even a potentially productive older workforce.
At present, two key issues stand in the way of broad application of health-span extension to humans. First, we are still not at the point of having applications that are distribution-ready. Second, serious additional roadblocks exist to implementation, including the omnipresent lack of funding for research and, even more so, advanced-stage clinical testing. There also remain ingrained views in society that aging is immutable and/or that intervening in the aging process will produce deleterious and unwanted consequences such as further overpopulation and shortages of resources. Yet the increase in human longevity during the last century was one of humanity's most remarkable medical and technological accomplishments. As valuable as oil, gold, diamonds, fresh water, and clean air may seem, life itself is likely to be our most precious commodity - and we managed to manufacture more of it during the last 150 years than during all of humanity's existence prior to the 19th century.