The Old Enemy: Aging


The last ten years’ progress in biotechnology and medicine has outpaced the previous ten years significantly. The same thing is true of the ten years prior to that ten years. The next ten years, it’s safe to say, will see greater progress than any other period in history.

Powered by exponential advances in the biological sciences that are outperforming Moore’s Law, we are winning the war on diseases. The war isn’t over, but I’m on record predicting that companies currently in or near human trials will make cancers, antibiotic-resistant bacterial infections, virus-borne diseases, fibrotic diseases, and even Alzheimer’s manageable threats within the next decade.

To one degree or another, most biotechnologists are growing increasingly optimistic about our ability to deal with the old killers. The successes we have already experienced—falling mortality rates for cancers and cardiovascular disease, for example—are working a change in the way the scientific community thinks about medicine.

The most important change is a growing recognition that we need to switch our focus from battling individual diseases to increasing health. This may seem like a minor difference in language, a semantic subtlety, but it’s not.

Internationally, drug regulatory systems are based on the old defensive model. Regulators recognize specific maladies and approve or reject therapies based on very narrow criteria. From the filing of investigational new drug (IND) applications to clinical trial designs, the system is a series of boxes that force innovators into the disease/drug model of medicine.

While many researchers are pursuing methodologies for maximizing health to preclude serious illness, our system is biased against this more systemic approach to healthcare. The consequences of this institutional bias are an increasingly serious problem as the population ages.

This is why I was glad to see a recent commentary, “Medical Research: Treat Ageing,” in the important journal Nature
. Written in two parts by different groups, the introduction makes the challenge clear. It states, “By 2050, the number of people over the age of 80 will triple globally. These demographics could come at great cost to individuals and economies. Two groups describe how research in animals and humans should be refocused to find ways to delay the onset of frailty.”

I’m not, incidentally, holding Nature’s commentary out as infallible. There have been numerous instances in the past that I’ve disagreed strongly with Nature commentaries. Nevertheless, the publication has sway, so I’m pleased to note that this article recognizes the need to delay frailty, which is associated with the onset of serious disease. Another way to phrase the goal of delaying frailty and death is “life extension,” though the term has not enjoyed much respect in the past.

The ongoing demographic change referred to in the Nature commentary, which others have called “The Grey Tsunami,” is forcing serious people to finally embrace goals that were once considered slightly weird, at best. In the past, life extension was often considered the domain of the deluded fringe, driven by entirely selfish motives. Today, life extension presents itself as the only real means of solving the biggest challenge facing civilization: our rapidly aging population.

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