There is a certain constituency in this world of ours whose members look at the far side of middle age with a fatalistic gloom, envisaging the last, decrepit light before the darkness. The age of 75 stands out in the present discussion on this topic only for a noted op-ed touting a hoped end to life at that point. That voice isn't alone. Many people, perhaps even most people, express the desire to die on some schedule in late life, if asked. Perhaps a few years older than their peers, because hierarchy is important to we primates, but nonetheless, the present view is that after middle age we should be shutting up shop, tiding up the shelves for the next tenant, and generally getting out of the way, in the most permanent fashion possible.
This view starts with the desire not to suffer, and then broadens out from that into a consensus view on the shape of human life that is considered less carefully and challenged perhaps less often than it should be. Everyone is taught from youth - via schooling, stories, myth, and the all too real health issues of older relatives - that old age is a degeneration, a fall into a broken body and a broken mind, filled with pain and an ultimate return to the weakness and dependency of childhood. That this is set in stone, never to be changed. This is an insufferable fate for most, and so it is decided that death, historically the only other option on the table, is a liberation.
But there are other options on the table when taking into consideration the fact that we live in an era of exceptionally rapid progress in all technologies. There is cryonics, for one, potentially reversible low-temperature preservation of the body and brain for a future capable of rebuilding and restoring a youthful life. Then there is progress in more established medical science: simply said, the therapies for age-related disease and dysfunction ten years from now will be far better than those that exist today, and that trend will continue, decade by decade. We are also presently in the midst of an enormous and beneficial disruption in this trend, in that the research and development community is now directly targeting the mechanisms that cause aging, whereas in the past they did not.
I am middle aged. My old age, creeping ever closer with each passing year, will likely be one of comparative fitness, vigor, and youthful function. The nascent longevity industry of today, producing a handful of ways to turn back the molecular damage that causes aging, will become a world-spanning colossus in the years ahead. It will provide a broad range of effective rejuvenation therapies that will put an end to the chronic inflammation and immune system failures of aging, to the frailty and loss of mitochondrial function, and a host of diseases and declines and causes of suffering and mortality will near vanish along the way. The first rejuvenation therapies already exist; the first few score companies developing such therapies already exist. It is easy to see a lengthy future from where we stand now, if one only cares to learn a little about the work presently underway.
Ezekiel Emanuel is best known for writing a controversial article in 2014, headlined "Why I Hope to Die at 75", in which he strongly rejects the desire to live beyond the age of 75 and expresses his opinion that continuing to live after such an age is meaningless. At age 63, he is getting closer to the age at which he thinks life is pointless, and I believe that a large reason why he is so pessimistic about life beyond 75, whether he realizes it or not, is based on the current state of medicine. This line of reasoning does not take into account how medicine, and in particular how we treat aging could change in the next decade or two.
Current medicine does a great job at keeping people alive for longer, but they often have to live with one or more chronic diseases. Given that, I am not surprised that Emanuel is not enamored with living a long life, especially as that could entail being disabled, bed-bound, or otherwise suffering a poor quality of life as the result of debilitating age-related diseases. However, things could be different in the not so distant future, and being 75 could see the majority of people far more fit, healthy, and vibrant than ever before in human history thanks to advances in aging research. Therapies that directly target aging could potentially make people biologically younger (in particular their immune systems) and much more able to withstand COVID-19 and other diseases.
The decline of the immune system is a key reason why the elderly are most susceptible to infectious diseases such as COVID-19, and there has been considerable interest in the rejuvenation of the immune system in recent years. Dr. Greg Fahy from Intervene Immune has had some early success with thymus rejuvenation in a small human pilot study and demonstrated that it is possible to cause the thymus, which shrinks and loses its capacity to produce T cells during aging, to regrow and resume production of those cells. Another example of immune rejuvenation is currently being developed by Samumed, a biotechnology company that is developing drugs that target the Wnt pathway to restore it to youthful function.
These are only some of the examples of why healthy life expectancy could rise significantly in the near future, and there are plenty of reasons to remain future positive. This is the future direction of medicine and healthcare, a world where being 75 does not mean you are thrown on the scrap heap and where people like Emanuel will no longer feel that life has no meaning. I am confident that in such a world, being 75 would not be the burden he thinks it will be, and this is why I hope to be alive at 75.