The Great Good of Greater Healthy Longevity

It is a strange world that we live in, in which we have to argue - actually debate with people who earnestly hold the opposing view - that more of us living for longer, in better health than is the case today, is a good outcome. That it is worth aiming for, a great good, a sign of progress, a cause worth devoting a life to. That less suffering and less death in this world of ours would be a good outcome. How is this not self-evidently true in everyone's eyes? After all, you won't find many people out there arguing for the reinstatement of the shorter, less healthy lives that our ancestors lived. Few of the world's advocates are earnestly interested in rolling back the medical progress that has been achieved to date, with the aim of making more people ill, and reducing life expectancy.

Every death is a tragedy, and aging and its consequences kill far, far more people than any other cause. More than all of the other causes lumped together, in fact. Dealing with the mechanisms of aging should at this point be the primary focus of the efforts of our species to improve our lot in the world. That it isn't demonstrates that we are not particularly rational, either individually or as a collective.

So why is it so hard to obtain support for straightforward progress in medicine, where that progress implies longer, healthier lives? The entire point of medicine is to evade death and illness, to improve health. This is also a primary rationale and outcome in numerous other sizable human industries, such as farming. Success in cancer research implies cancer patients becoming cancer survivors, living longer in good health. The same is true of any other well-supported and publicly approved field of medicine for age-related disease. And yet bring up the lengthening of human life as a direct goal, and suddenly there is opposition.

After watching this behavior in puzzlement for more than two decades, I'm still little closer to understanding it. At this point, I think it has much to do with a bias towards the status quo, rather than any of the details of the situation. It is the fear of change that leads to rejection of all change, whether or not it is beneficial.

How Long Can We Live?

Longevity scientists who favor the idea of living for centuries or longer tend to speak effusively of prosperity and possibility. As they see it, sustaining life and promoting health are intrinsically good and, therefore, so are any medical interventions that accomplish this. Biomedically extended longevity would not only revolutionize general well-being by minimizing or preventing diseases of aging, they say, it would also vastly enrich human experience. It would mean the chance for several fulfilling and diverse careers; the freedom to explore much more of the world; the joy of playing with your great-great-great-grandchildren; the satisfaction of actually sitting in the shade of the tree you planted so long ago. Imagine, some say, how wise our future elders could be. Imagine what the world's most brilliant minds could accomplish with all that time.

In sharp contrast, other experts argue that extending life span, even in the name of health, is a doomed pursuit. Perhaps the most common concern is the potential for overpopulation, especially considering humanity's long history of hoarding and squandering resources and the tremendous socioeconomic inequalities that already divide a world of nearly eight billion. There are still dozens of countries where life expectancy is below 65, primarily because of problems like poverty, famine, limited education, disempowerment of women, poor public health and diseases like malaria and H.I.V./AIDS, which novel and expensive life-extending treatments will do nothing to solve. Lingering multitudes of superseniors, some experts add, would stifle new generations and impede social progress.

Comments

It seems that many of the people against life extension simply put up excuses based on their background and obsessions, instead of really analyzing the question. Since the NYT is a woke newspaper, it chooses as reasons to oppose LF ecology and inequality, even if it has to go against the data to argue so.

Posted by: Antonio at May 10th, 2021 4:10 PM

I get this completely, I feel like I am in a world that has gone completely mad, but when I talk to people about this subject I'm the one that's looked at as mad. And I work in healthcare! It's like we are just going through the motions of treating people and going to the source of the problem is some kind of taboo. I did convert one extraordinary janitor who stands tall among the others and likely has saved many more people than the doctors just by keeping the place clean and sanitary.

Posted by: Corbin at May 10th, 2021 5:04 PM

Preaching to the choir here...

But frankly radical changes are scary and always bring unintended consequences. Some changes are unquestionably 99% good like antibiotics and vaccines. We have some negatives there like abuse in animal farming of antibiotics and some rare side effects of vaccines (and much more harmful antivaxers ;) ) , mostly due to bad practices and implementation.

Once a technology or improvement is is proven to be good nobody in their right mind and without crazy anti-human agenda will agree that reversing them will be a net positive.
Plastics create quite a few ecological problems but without them we would either have to scale back on economic activity or cause even more ecological damage. Cell phones and mobile internet can empower billions of people and encourage distracted driving. If we take the example of the cell phones there were very little perceived downsides before they have become mainstream .

For anti-aging we have this instinctive knee-jerk reaction . What if people never die? omg we fill up the earth in just ... one lifespan :) hehe.
Here I will try to give a more original argument. If we manage to slow the aging by say 8 years over a typical life expectancy the people will not live forever. The same death rate will catch up in about 8 years according to the Gompetz law. And currently at age of 60 there the mortality hazard is about 1%. (https://en.wikipedia.org/wiki/File:USGompertzCurve.svg ) . While it would be extremely nice to make everybody like 20 years old, the biggest value (improvement in quality of life/adjusted live years) comes from making the 90s the new 80s, 80s the new 60 and 60s the new 40s. With each step we will have diminishing returns . And since it will take many decades to be able to make the 80s the new 40s we will have enough time to adapt to the change.if the 80s are the new 40s then it means that the age of marriage will be shifted by a couple of decades, easily. That alone would take care of overpopulation. And arguably, if one can expect to live 100 years then one should be caring much more about the climate, etc...

Posted by: Cuberat at May 10th, 2021 5:37 PM

btw
,this statement is true:
"we will not witness anyone older than Calment anytime soon."

since the oldest confirmed person alive (Mrs Tanaka is 118 y.o) we will need at lest 4 years for her to surpass the Calment's record. And since we have no approved anti-aging therapies at the moment it will take some years to get the treatments approved and verified , then applied to the existing and very frail supercentenarians . Say at least 10 years to start using senolitics and 10 years more to surpass the 122 years record.

Posted by: Cuberat at May 10th, 2021 5:48 PM

Reason wrote: " I think it has much to do with a bias towards status quo. ... It is fear of change that leads to rejection of all change, whether or not it is beneficial."

For me and for many others indeed it is "fear of change" that motivates me to reject aging and death. I accept some positive change such as : growing from childhood to adulthood.
But once I am an adult I don't want to change, and aging is the biggest change that one experiences: gradually turning from young, strong healthy person to weak, unhealthy old person, and eventually turning from being alive to being totally dead.

To maintain "status quo"means to be perpetually young, strong, healthy and never die - eternal life. These changes (Aging and death ) are imposed on humans , most humans don't choose these changes.

So, why most people are opposed eternal life ?- it is because they believe that aging and death are natural, normal, and inevitable and every thing " natural " is good for nature, society, universe (and individuals don't matter in the grand scheme of things).

Doctors who are working hard to save lives are not actually "saving lives". They are Only saving particular individuals from a particular disease ( Covid or Cancer), but the same individuals who were saved from one disease, soon will die of another, or eventually die of aging - the mother of all diseases, so their lives are not saved. To save lives means to give someone eternal life - a guarantee that you/ they/ I/we will never die.

Most readers of this website believe in SENS program for rejuvenation and life extension.
Extending human life by a few years ( 5, 10, 20 … to the age of 122) is meaningless or has very little meaning, unless that extra few years are used for research and treatment and extending life by another 20 or 50 years and then using those extra to extend by another 100 years and so on infinitely - infinite progress towards eternal life, one step at a time. Engineered Negligible Senescence means aging (senescence) becoming so slow and imperceptible that one becomes ageless, immortal - living for ever. This is what it means to save lives - the meaning of salvation.

Posted by: Nicholas D. at May 10th, 2021 10:20 PM

You can sell the drugs based on indications.

If you look at the SGLT-2 inhibitors they were first approved for type II diabetes. Then in the cardiovascular safety trials they showed remarkable benefits in heart failure and chronic kidney disease(CKD). So Astra and Lilly started these huge trials in heart failure and CKD for people both with and without diabetes. Those trials just read out, and they did work for those conditions.

So then the drugs get approved for those added indications.

Later you can ask the question what about people with risk factors for those conditions. Do the drugs reduce the risk of getting those conditions for people who have risk factors. If the drugs work for that too, yet more people can go on the drugs.

Because aging effects basically everything, age can be one of the risk factors. Even without that, by using biomarkers you can see which people are starting to become at risk for developing conditions.

What I see is in time we'll get more drugs like this that are broadly improving health and therefore both helping people who already have conditions, plus reducing the risk of developing the conditions for those who don't yet have them. So the market approaches the entire population.

Say we identify someone who has risk factors for CKD, possibly even showing early deterioration. Most likely that person would want to take a drug that reduced their chance of developing CKD, if the drug had low to no noticeable side effects. Eg.. a low dose of a drug.

Posted by: aa3 at May 11th, 2021 6:23 AM

I think another reason it's a hard sell is because to accept that death is bad also means having to acknowledge a fantastically great horror that all those who have died before us are gone forever never to be seen again, not even in an afterlife, there's a point that the mind shuts down and retreats from reality at any cost even if it means more death.

Posted by: Corbin at May 11th, 2021 2:48 PM

Hi Nicholas! Just a 2 cents.

That is what I tell my self too/I concur/seconding. How can we talk about 'cure' or 'curing' anything...yes, we may cure diseases...but aging, as the main element that ends up killing us in the end, is still not cured. And may end up uncurable in our lifetime (I hope not,..for our sake..our life's sake) simply because curing aging is an immense ordeal that has never been accomplished. It's on the 'going to the moon and flying to another planet' (kind of) level 'miracle'...
It's possible yet miraculous/extremely hard/rare...no ordinary event.

If we cure aging - Life - as we know it, will never be the same anymore.

Because people won't die anymore, of 'aging'...yes of 'extrinsic death' (accidents..homicide...risks taken by the person when going out of their home)...but 'dying of aging'?...it will be done for.
Ever.
Forever.

People will be around for - However - long they want to - Still - be around...ok, we may still die of external risks...but the 'intrinsic/internal' problem 'Aging/Body decaying' causing death in the end...will be over.

This will Transform the way we live - because we won't die anymore (of aging). It will make many things Need to Change - like govs for starters. This is will affect the economies of the world. Because life is related/linked to 'resource' availability/unavailability (in capitalistic countries -> money). It's why people are against it and say : ''Living forever??? -> No way, resource drought, planet will be exhausted of its resources as we plunder it and 'live on forever''

I am not of this opinion, I understand the reasoning behind it, but I think it is diminutive and restrictive; saying we will Absolutely destroy earth and make it be an 'overcrowded dump' with 'too many 'forever living' people in it'...think China (1Billion people) or India (1B+) -> but More Packed. Much More. Maybe we will reach 70+Billions on Earth if we live forever, but we will have moved to Mars or Moon by then...found another place to live (if too packed and resources emptied). Maybe we will live in the bottom of ocean/abyss - lots of space; or maybe 40,000 feet in the air - free space (flying castles/flying cities).Obviously, a lot of that is humanly 'unhabitable' and not really the best place for humans to live on/at...likewise..on Mars...but we have to make it be Habitable. Space will have to be made (if we grow...to a 'never-dying population' of 500 billion)..

It will be strange: your great-great-great-great-great-great-great.....great...grand-mother will be alive,
while you too.

Fun Times. There will be a new meaning to 'patriarch and matriarch' -> Ultra-Matriarch (greatgreatgreatgreatgr...............great grandma).

It's kind of like the Army. You have the General at the top, Commander, Lieutenant, Colonel...Sergeant..Officer, solider..down to bottom rung. Or monarchy: Emperor, High King, King, Vice/Assistant/Regent, Consort, etc...The Army/Monarchy element will be stronger because your ancestors will be no more 'ancient/ancest-ors/antecedent' but still 'present/today'.

The Oldest of Old...will Still be around. And it shall not be a 'bad' thing anymore
''When are they going to die these old ones? And be replaced by a 'new king'''...
''new blood/young blood''

''Hail the King/Queen. Long live the King/Queen - and still living...'' (and not :''The King is dead. Long live the King''). It will be Literal(ly) -> Living and Long Live (forever/never dying).

Until Then...we can only hope that this miracle happens the quickest possible. For now, we are still 'mortals'...I mean even if we solve aging we are Still mortal - we can die of an accident, homicide, external factors...that cause death (unrelated to internal biological aging process).
But. we will not die of this Internal process anymore that is the Largest Killer in humanity since its inception. Everyone dies, of aging. No way out of it/no (other) choice.

What I fear is that DNA repair strategies fail miserably to make any lifespan extension, it's quite possible that it will be the case; because we have program (every life form) and our program supercedes that; if we can't Re-Rig it, I don't see much improvement from other strategies (such as DNA repair/junk removal); it's as if, it'S a Package Deal; like CAlorie Restriction; it works because it acts On Everything, it's why it works at extending lifespna a bit...otherwise it would do almost nothing, only improve health but little to no lifespan extension...and that's another problem, it'S possible that DNA repair will be Limited in its capacity to make lifespan extension;
in other words it may only do 'midl Average' lifespan extension and almost zilch on the Maximum lifespan extension; it's why it may Not Even Break the 122 years old 'hard soft' limit (not hard limit..but not soft soft neither...), it might make us live to 130-140-150 tops...and Only if we started in Young Age..not in Old age...that is the main element that comes out of Many STudies..if we cannot Reverse the 'Age' of the Old Cells/Old Organs..in old people...it is quasi impossible to make them 'Become Young Again'...that is where the program comes in.
It's Why I say, that people below 50 years old...Stand a Chance of reaching 150 years...those above that age, the chance drastically reduces. BEcause, time has passed and is inscribed/the program has unfolded, if it cannot be Refolded to its original 'folded position' then..it may be impossible to 'stop' the 'rest of the program of unfolding'. It'S why I am curious how scientists will play on these several 'planes' of aging from program(ming), clocks, repair, junk and whatnot...list it's long an arm. That's what I fear that it's too much and we Still To This Day, can't beat aging, because just wayyyyy to hard. And thus, we Might make young people today (below 50) reach 150 as the 'best' we can get (for the next 30-40 years)...I hope not.

Just a 2 cents.

Posted by: CANanonymity at May 11th, 2021 4:46 PM

Post a comment; thoughtful, considered opinions are valued. New comments can be edited for a few minutes following submission. Comments incorporating ad hominem attacks, advertising, and other forms of inappropriate behavior are likely to be deleted.

Note that there is a comment feed for those who like to keep up with conversations.