Fight Aging!

Following on from a recent post on defining aging as a disease, I see that an article from Proto Magazine looks at the same question. This is really an examination of the slow boat mainstream of aging research: scientists who are careful to say in public that they are not in fact working towards greater maximum human longevity, but rather trying to achieve what is known as "compression of morbidity," wherein the period of illness at the end of life is shortened, but life span is not lengthened.

According to a Robert Wood Johnson Foundation estimate, some three-quarters of the $2.3 trillion the United States spends on health care each year goes to treat chronic diseases - most of which are diseases of aging. If scientists identify drugs that could push back the onset of several of those diseases, there could be an enormous economic benefit. But most people aren’t as frightened by aging’s economic burdens as they are by the prospect of lingering for years as mind and body fail. Avoiding that is the most tantalizing promise of longevity research, and in animals, at least, it seems possible. Describing an especially long-lived strain of mice, Washington University calorie restriction researcher Luigi Fontana says that as many as half die with no obvious cause of death. "There are no major pathological lesions," he says, comparing the manner of their passing with that of many human centenarians: They’re healthy until almost the very end.

Death itself is still inevitable and - in these seemingly symptom-free cases - a fascinating scientific puzzle. "Maybe it’s a systemic failure, where you can’t maintain homeostasis," Sierra says. But the puzzle of those deaths is perhaps less important than their nature. "The fact that we can’t ascertain the cause of death might be a good thing," he says. "We all want to die in our sleep, in perfect health. That’s the ideal."

No, no, no. Not an ideal at all - unless you have very little imagination and drive. The reason we strive for engineered longevity is so that we never find ourselves in the position where dying in our sleep looks like a worthy goal to aim for. To be at that point implies you have already given up, a long time ago.

Firstly, the mystery of centenarian deaths is no longer a complete mystery, thanks to the work of the Supercentenarian Research Foundation: the oldest old, who survive or evade all other forms of age-related disease, die from a form of creeping amyloidosis:

What kills most of them, he says, is a condition, extremely rare among younger people, called senile cardiac TTR Amyloidosis. TTR is a protein that cradles the thyroid hormone thyroxine and whisks it around the body. In TTR Amyloidosis, the protein amasses in and clogs blood vessels, forcing the heart to work harder and eventually fail. "The same thing that happens in the pipes of an old house happens in your blood vessels," says Coles.

Secondly, there is every reason to believe that compression of morbidity is actually impossible. If you look at considerations of the mechanics of aging such as reliability theory, and the demographic data accumulated over the past decades, it becomes very clear that (a) aging is simply an accumulation of biochemical damage, and (b) less damage means both a longer period of health and longer overall life expectancy - you can't separate the two.

Compression of morbidity is something of the declared goal of those in the mainstream of aging research who don't want to talk about extending life span, however, which makes it a little more than a matter of statistical interpretation. When a researcher talks about compression of morbity, that is something of a cipher, an identifying mark as to where he stands on the topic of engineered longevity: possibly in favor, but not willing to risk offending conservative funding organizations, possibly against. Either case has much the same result - a researcher who isn't working as freely as he might to extend human longevity.

Like compression of morbidity, the designation of aging as disease is also a marker for where a scientist stands in the politics of aging and longevity research. Scientists are people too, and their organizations are rife with the normal human failings, infighting, and pressure to conform to old, broken worldviews - just like the rest of us. Be aware of this, and you'll be able to more easily read the tides of the scientific process, and the output of research programs.