Fight Aging!

When considered in the grand scheme of things, there is presently little that can be done to alter the personal trajectory of longevity. A recent study on survival to 90 years of age well illustrations the bounds of the possible: given today's medical technology, personal choice on lifestyle and fitness can shift the odds in the range between 1% and 30%. Which is to say that even given an optimal life, two thirds of enthusiasts will not make it to their 90th birthday. We can shift the quality of late life, and we can add or subtract just a handful of years of life expectancy.

Even the advent of the first rejuvenation therapies does not greatly change this picture, as they each tackle only one facet of the cell and tissue damage that causes aging. I think it plausible that we'll find out - much later - that first generation senolytic therapies are capable of adding, say, five years to life expectancy. That sounds reasonable for something that can significantly reduce the chronic inflammation of aging. This is a big deal in a world in which the only other available strategies, such as exercise, or staying thin, also seem to be able to move life expectancy by a single digit number of years. Perhaps three, perhaps seven, certainly not more than ten. But these are small numbers against the bigger picture of the passage of centuries.

Medical control of aging to the degree that will enable a life span of centuries is possible to achieve, given suitable advances in biotechnology. The SENS research program tells us how to go about achieving that goal - it is just a matter of time, funding, and will. The will might be lacking in the broader population. Studies suggest that most people want a little additional longevity, something that falls within the bounds of conformity. They want to live a little longer than their peers, to be that little higher in the hierarchy, but not so much longer that it becomes gauche. Yet all of these individuals will make use of rejuvenation therapies when those treatments are available and widely accepted by the medical community, regardless of how many years are added. Therein lies one of the challenges in assessing attitudes towards longevity.

Motivation for Longevity Across the Life Span: An Emerging Issue

In an attempt to integrate some of the different lines of reasoning and research findings, we submit that there exist three widespread classes of attitudes, expectations, and preferences with regard to a possible extension of human lifetime in modern societies that may reflect different schools of thought, such as essentialism, medicalism, and stoicism. The different primary motives that are associated with the three perspectives on longevity and life-time extension are infinite life (striving to overcome biological degeneration and health declines), healthy life (motivation is conditional on physical and mental health), and dignified life (a wish for dignity and meaning even when there is loss and vulnerability). We submit that these three primary motives can be used to characterize different scientific approaches on longevity, as well as individual attitudes and preferences toward longevity in everyday thinking. We refer to such perspectives as mindsets that involve sets of representations, attitudes, and ways of thinking about the meaning and value of a prolonged life.

An essentialist mindset views aging as a degenerative process that is inevitably associated with physical loss. It reflects the idea that aging is a determined and undesirable process, and that the human mind is held captive in a deficient biological organism. Accordingly, pathological aging cannot be differentiated from normal or healthy aging. One implication is that aging per se is viewed as pathological and ought to be pushed back, for example, with antiaging medicine. Consequently, radical extensions of the life span are expected when antiaging research is successful. Recent studies suggest that the prevalence of essentialist mindsets can be estimated in the range of 3-10% of respondents who wish to live forever or wish to "overcome" the natural aging process.

A medicalist mindset involves that human aging is viewed as burdened only when pathology occurs, and that pathological aging is different from normal aging. In this perspective, aging is associated with age-related health risks, and defined as a medical challenge. One implication is that successful aging may be defined as an absence of disease and disability. On an individual level, medicalism is reflected in an appreciation for an extended lifetime if health functioning can be maintained, and degenerative diseases such as dementia can be avoided. Another implication might be that when endorsing a medicalist mindset, individuals may prefer to avoid the vulnerability of old age and wish to die rather than to become chronically ill or demented.

The stoicist mindset for living long reflects the idea that withstanding the challenges and risks of a long or prolonged life is part of the conditio humana, which involves striving for meaning in life, and for acceptance of one's actual life condition. The challenges, needs, risks, or tasks within the aging process may thus appear manageable or at least bearable as long as there is meaning in life and a sense of grace. Preserving dignity and meaning in a prolonged life is pivotal to a stoicist mindset. Thus, having a worthy and dignified life may be emphasized over the absence of chronical diseases in late life. Regarding the desired extension of lifetime, we submit that holding a stoicist mindset may involve that individuals express a valuation of life per se and "as it comes." This may also involve a discomfort or unwillingness to reflect about lifetime extension rather than about dignity and meaning in life.