Researcher S. Jay Olshansky is one of the principals behind the Longevity Dividend initiative, a long-running lobbying and advocacy initiative that seeks to push a great deal more government and philanthropic funding into aging research. The specific focus is on modestly slowing aging via near term interventions with the goal of adding five to seven years to healthy life spans over the next few decades, something I regard as far too unambitious. The TAME metformin study is an example of the Longevity Dividend portfolio, for example. Olshanksy is perhaps the canonical example of a researcher who advocates for longevity science, but thinks that radical life extension of decades or more or the outright defeat of aging is not achievable within our lifetimes, and doesn't think that the SENS approach of damage repair is any better than the mainstream approach of slowing aging. His views are well known within the research community, but it is always interesting to see him talk informally on this topic:
I study the upper limits of longevity and ask which populations are living longer and why, and what that means for society. Living a longer life is a monumental achievement of public health and modern medicine - it is exactly what we set out to achieve more than a hundred years ago when life was short. More people today are living to 65, 85, and 100 and beyond than ever before, but it has created a Faustian trade. In exchange for our longer lives, we now live long enough to experience heart disease, cancer, sensory impairments, and Alzheimer's disease. The fact is that our bodies were not "designed" for long-term use. While improved lifestyles can enhance health and quality of life, the aging process marches on unaltered beneath the surface - leading to the diseases and disorders we fear most. My research focuses on investigating ways to extend the period of healthy life and compress sickness and disease as much as possible to the very end. Recently I have teamed with a group of researchers to study the ability of the diabetes drug metformin to do just that; although metformin is just one of many research pathways scientists are pursuing to slow biological aging. My research suggests that slowing down aging will be the next great public health advance in this century because it targets multiple age-related chronic diseases. Importantly, this approach to public health can save far more health care dollars than treating one disease at a time. The time has arrived to take a new approach to chronic fatal and disabling diseases.
When will an aging intervention come online? No one can know the answer to this question in advance since it takes years to study the safety and efficacy of potential interventions. However, we're no longer talking about something theoretical here. We can observe decelerated aging today in people that, in many cases, may be your friends, relatives, or even yourself. Centenarians today are in all likelihood living that long because their bodies and minds are not really 100+ years old - they might very well be 10, 20 or even 30 years younger. Scientists are studying the genetics of these long-lived subgroups in order to discover (and perhaps recreate) their genetic advantage for the rest of us. It's an exciting time to be involved in aging science, and I'm optimistic that an intervention that slows aging in people will arrive in time to positively influence most people alive today. However, the short answer is no, we're not ready for metformin as the next equivalent of a baby aspirin. We can't know the answer to this until the research is done and the data thoroughly analyzed. While I would encourage everyone to remain excited about this work, keep in mind that no intervention of this kind should be taken today without approval and evaluation by your personal physician. There is a tendency in this field for the entrepreneurs to try and take over as soon as the science offers a glimmer of hope, so I would urge extreme caution. In the interim, please try and help out the world of aging science by following the work and encouraging the effort.
By 2050 I'd be surprised if we could achieve anything more than a few years of additional healthy life, even with a breakthrough in aging science. This may not sound like much, but keep in mind that in long lived populations, it takes very large reductions in death rates to achieve even a 1 year increase in life expectancy. A 1 year increase in healthy life expectancy is even more difficult to achieve. My personal view here is that if we continue with the current medical model of attacking one disease at a time, we will not see an extension of healthy, but instead, the exact opposite - a prolongation of the period of frailty and disability. This is the very reason we're working so hard now to change the culture of thinking on this topic.
The idea that the first person to live to 150 or 200 or 1,000 or 10,000 years has already being born is hype cooked up by some who want to advocate for radical life extension. All of these numbers are made up out of thin air - they're designed to get the attention of the media, and frankly, this makes it more difficult to get funding for aging science because funders have no interest in creating a new set of challenges that would come with people living for hundreds or thousands of years. Keep in mind that life extension is not the primary goal of aging science; health extension is the primary goal. Aubrey de Grey is a friend, but we do have healthy disagreements. We need this kind of open dialogue in science, and it should be conducted with respect and decorum. Having said that, don't expect radical life extension any time soon. Think about it for a moment. Even if you had an intervention in hand that could make people live for 1,000 years, how could anyone prove that using the tools of science? You would have to wait for 1,000 years to make that statement, which is why I say that anyone making these claims is making up numbers out of thin air. The fact is, even if a genuine magical elixir found its way into anyone's lab, the scientist who discovered it wouldn't know its effect - even if the intervention could talk and declare its effectiveness. Our goals in aging science must be measurable using the tools of science!
I've listened to my friend Aubrey de Grey speak many times. He's quite good, right up until the last 15 minutes when he starts talking about escape velocity and 1,000 year lifespans and made up numbers. It's somewhat difficult to ignore the very point that Aubrey emphasizes. With regard to his effort to reverse or repair the damage caused by aging rather than delaying it, I'm hopeful that he's right. No one can know whether his approach will work until it's tested, which is what I like about Aubrey. He's not selling anything yet - he's operating within the bounds of science and setting forth testable research hypotheses. I think Aubrey's work, or at least the 7 deadlies idea he supports, should be one of the projects pursued by the Longevity Dividend Initiative, but like everyone else, this science would have to survive peer review.
I'm actually pleased that Google's Calico and Venter's Human Longevity have come into the mix. Competition is good; the presence of funds to accelerate aging is good; there are a lot of outstanding scientists already in this field, and I expect we'll soon attract many more. It's the next great frontier of human biology. Having said that, I'm very careful about claims that are made here, which is why I shy away from exaggeration and I think the rest of us should as well. Someone will eventually develop a breakthrough in the field, and when that happens, it will fundamentally change the way in which we think about aging, disease and longevity. Someone will win the race, and perhaps there will be more than one winner, but when that happens, we all win. The fact that there is a race at all is what is so exciting now. While I don't expect 120 is in the cards, I do expect many of us to benefit from an intervention that extends our healthy life and preserves our youthful vigor for a longer period of time. I expect the competition to go on even after the first intervention makes its way into the marketplace. I see a healthy sector moving forward.
This may very well become the next great public health paradigm - we made the case for this in 2008. We are in fact going to high net worth individuals with the suggestion that they can get in on the ground floor of what could prove to be one of the most important accomplishments in medicine in the modern era. Just as Bill Gates has made his impact in public health by attacking infectious diseases in the developing world - and there are very few examples like this - we expect someone to step up to the plate and make a declaration just like President Kennedy did years ago when he decided to send someone to the moon and return them safely. The time has arrived to fundamentally change the way in which we attack disease, and once done, it's fairly easy to make the case that the modern era will have witnessed one of its greatest accomplishments. I don't think the money for this effort will come from governments (not enough funds and too slow); it's going to come from a high net worth individual with a vision and the funds to back it up. The question now is, who will it be?