Brian Kennedy formerly headed the Buck Institute, but these days can be found leading the Center for Healthy Aging at the National University of Singapore. The Life Extension Advocacy Foundation staff recently had a chance to conduct an interview, and you should read the whole thing. Kennedy has an interesting view of the field, for all that he is largely focused on calorie restriction mimetic approaches that, to my eyes, are not likely to produce large enough benefits to really change the trajectory of human aging.
Do you consider aging to be a disease or, at least, a co-morbid syndrome?
I think you can make an argument that it's a disease, and you can also make an argument that it's a risk factor for disease, but to me, fundamentally, it doesn't matter. It's the biggest driver of chronic diseases, loss of function late in life, and has a huge impact on life quality and health care costs. So we have to do something about aging, whatever you call it, and I don't think it's so important what we call it; it's more important that we all agree that we have to slow down this process.
I think that the regulatory declaration of aging as a disease could certainly have a positive impact, because if aging is a disease, then it's much easier to develop therapies and get reimbursed for therapies, so I'm totally supportive of that effort. I think that, however, we don't call cholesterol a disease, but we treat cholesterol because it's a risk factor, so the FDA does approve interventions on targeted risk factors as well. I think we have to differentiate whether we're discussing this from a conceptual point of view or from a regulatory point of view. Either way, we need the FDA to recognize the fact that aging is driving these other diseases that they care so much about, whether they want to call it a disease or recognize it as a validated risk factor. Either way, something has to happen so that we can develop interventions.
We sometimes hear people say that we don't know enough about aging to do anything about it; however, others argue that we know enough now to start testing interventions and moving forward. Would you agree that we are at the point where we can start doing this?
I'm totally committed to the idea of testing candidate interventions in humans. I think we're totally ready to do that; we have a range of safe interventions that we can test, so we have very low risk of doing harm, and the field will move forward dramatically if we can validate even one or two of these strategies. I believe exercise is more or less already validated, but what I'm talking about are some of the small molecule strategies and other kinds of interventions that are being developed. If we can validate that a couple of those work, I think it'll have a huge positive impact on the field.
Singapore is projected to have a population made up of nearly 50% of senior citizens by 2050; what do you think will be the biggest challenge facing the elder care sector?
I think that we have to change the system. You can't just build hospitals, because there are multiple challenges with that. First of all, you have a lot of sick people on a small island; it's hard to treat all of them. There are not enough doctors and not enough hospitals; there are not enough caregivers to take care of older people. Perhaps most importantly, there are not enough younger workers to keep the economy going to pay for all the costs of the older people. We have to change the paradigm. I don't think there's any solution on Singapore except keeping people healthy longer. We're going to have to raise the retirement age. The people that are working later, they're already doing that, and that's not going to work unless those people are healthy and functional. We think we're trying to provide an essential component of what Singapore and other countries like it need to get through this demographic crisis that's happening in the next 30 or 40 years.