Richard Faragher is Professor of Biological Gerontology at the University of Brighton and is Chair of both the British Society for Research on Ageing and the International Association of Biomedical Gerontology.
Over the last decade new data on the biology of ageing have profoundly altered how we should think about the process. The single most important observation to emerge is that lifespan is highly malleable. In flies, worms and mammals it has been shown that mutations in a few key genes (usually those which code for proteins involved in nutrient sensing by cells) lead to large (~40%) increases in lifespan. Crucially, so far as we can tell, these longer lives are the result of extended periods of health. This shows us that (i) healthy lifespan can be extended (ii) that by implication the same thing would be possible in humans. Thus, better outcomes for our older people would be possible if the funds required to understand how these mutations bring about increased health were made available. At the moment they are not.
Based on the available data from other species it would clearly be wrong to say that extension of human lifespan beyond 120 years was impossible. However it is not possible now and is not likely to be possible within a 10-20 year timescale. I regard attempting to forecast scientific progress beyond 3-5 years as an enterprise so fraught with risk and uncertainty as to be little better than an attempt to write ‘realistic’ science fiction.
This being said, there are a range of potential interventions that, if brought into the clinical arena, would have the potential to improve the health of the elderly within a reasonable (~5 year) timescale. These will not lengthen maximum lifespan but would ensure that thousands more people have much better health in old age. These show that ageing research has the potential to deliver benefits both in the immediate and distant future.
I regard concerns about “immortality” as flawed on two levels. The first is that most people who talk about ‘living forever’ don’t realise how long ‘forever’ actually is. In about 6 billion years the Sun will go off the main sequence and life on Earth will end. In about another 150-300 billion years the Universe itself will end. I won’t be around for either event.
Closer to home, arguments about immortality usually ignore the problem of the Self. The philosopher John Locke argued that a person today can only be held to be the same person at an earlier time in so far as they share memories. Since we normally forget things I am not the same person I was when I was aged three. I would not be the same person I am today at age 300. The usual conception of ‘immortality’ does not allow for this.
However, extended healthy lifespan would have the beneficial effect of none of the ‘mental tenants’ of the body in question worrying about growing sick or experiencing long periods of morbidity. Within these constraints I regard life extension as a morally worthwhile goal.
It is currently possible, but rare, to age in relatively good health. For most people growing old is associated with a significant risk of developing a plethora of degenerative conditions and functional impairments. This burden of morbidity is probably the most distressing aspect of old age and it incurs very significant costs on the health care system. For example, patients over the age of 65 are prescribed between 60 and 67% of all medicines purchased by the NHS. Inaction on ageing will serve only to increase the scale of costs and the sum of human misery.
Fortunately, research into the biology of ageing shows that it is possible to extend lifespan and compress morbidity. This should serve as a green light to prioritise research in this area. However budgets for ageing research are very small within science and minute compared to the scale of the problem. The British Council for Ageing estimates that only ~1/3000th of the annual health costs of ageing badly are spent on research to make the problem go away. I see this as monumentally short sighted.
Many gerontologists worry about “negative attitudes about ageing and the aged” and are concerned that older people are portrayed as frail and unhappy. Whilst they are right to worry about the effects of such stereotypes on how the elderly are treated this ignores the fact that these stereotypes are prevalent because they are basically accurate. If “successful ageing” is defined as maintenance of normal function, avoidance of disease and social engagement then 80% of people fail to age well. Growing old is thus a miserable experience for most of the population. Saying that it isn’t like that for everybody and so we should be more upbeat about later life is like saying poverty isn’t a problem because a few people are very rich.
However, the biology of ageing tells us it doesn’t have to be this way. Thus I would like people to be more realistic about the present mess we’re in but less pessimistic about the future so that a real drive to improve later life can be made.