Popular Science Publications Struggle to Grasp the State of Aging Research
As a rule, the journalistic community struggles to correctly represent any complex situation, community, or state of affairs. It is outsiders writing on a topic they generally know little of, under a deadline, and with few to no consequences attending mistakes and misrepresentations. To a journalist, any field looks like a confusing bristle of self-promoters and high-profile figures, all of them contradicting one another on points that require a good amount of technical knowledge to understand. It is the blind men and the elephant wherein some of the blind men have book deals to promote, or companies to talk up, and most of the others are just hard to find in the phone directory. The reality of it is under there somewhere, but no professional journalist has either the time or the motivation to find it.
This collection of articles from the MIT Technology Review (and those of us who have been around for a while will appreciate the irony of this particular publication grappling with the topic of treating aging as a medical condition) is fairly typical for the popular science media. It is a disconnected tour of some of the high points that will provide little anchoring context or understanding for those who are unfamiliar with the field. There is the sense that something is underway, yes, but the details are floating disconnected and the true shape of the whole is not conveyed.
What is the true shape of the whole? There is major change and progress ahead, the research community is moving towards literal rejuvenation of the old, and the advent of senolytic drugs to selectively remove harmful senescent cells from old tissues has woken up the scientific and development establishments to the potential to effectively treat aging. Yet near all of the higher profile researchers and other folk are largely working on approaches that are really not that exciting, not capable of producing rejuvenation, and will have only small effects in the grand scheme of what is possible. But because of the general sense of potential in the field, those approaches will be funded, promoted, and widely discussed, simply because they are interventions aimed at aging. It will be quite challenging for a time to sort out the wheat from the chaff.
What if aging weren't inevitable, but a curable disease?
A growing number of scientists are questioning our basic conception of aging. What if you could challenge your death - or even prevent it altogether? What if the panoply of diseases that strike us in old age are symptoms, not causes? What would change if we classified aging itself as the disease? David Sinclair, a geneticist at Harvard Medical School, is one of those on the front line of this movement. Medicine, he argues, should view aging not as a natural consequence of growing older, but as a condition in and of itself. Old age, in his view, is simply a pathology - and, like all pathologies, can be successfully treated. If we labeled aging differently, it would give us a far greater ability to tackle it in itself, rather than just treating the diseases that accompany it.
It is a subtle shift, but one with big implications. How disease is classified and viewed by public health groups such as the World Health Organization (WHO) helps set priorities for governments and those who control funds. Regulators, including the US Food and Drug Administration (FDA), have strict rules that guide what conditions a drug can be licensed to act on, and so what conditions it can be prescribed and sold for. Today aging isn't on the list. Sinclair says it should be, because otherwise the massive investment needed to find ways to fend it off won't appear.
Has this scientist finally found the fountain of youth?
Reprogramming is a way to reset the body's so-called epigenetic marks: chemical switches in a cell that determine which of its genes are turned on and which are off. Erase these marks and a cell can forget if it was ever a skin or a bone cell, and revert to a much more primitive, embryonic state. The technique is frequently used by laboratories to manufacture stem cells. But Izpisúa Belmonte is in a vanguard of scientists who want to apply reprogramming to whole animals and, if they can control it precisely, to human bodies. Izpisúa Belmonte believes epigenetic reprogramming may prove to be an "elixir of life" that will extend human life span significantly.
The transhumanists who want to live forever
James Clement, 63, is a spry man with a shaved head and clear eyes, who spends his days gulping vitamins and trying to figure out how to make people live longer, including himself, his parents, and even me. From a home and several outbuildings in Gainesville, Florida, Clement runs BetterHumans, which he calls the world's "first transhumanist research organization." With funds from wealthy elderly men he knows, he is independently exploring drugs known to extend the healthy life span of rodents. Using a calculator, he extrapolates what a suitable human dose might be, and then finds people who will take them.
Who wouldn't want to reach 110, if not 500? Unlike mere armchair futurists, the life extensionists are prepared to experiment on themselves, and others, using vitamins and prescription cancer drugs, as well as compounds available only by finagling them from chemical suppliers. Lately the idea of living longer, maybe a lot longer, seems more realistic. As biologists uncover the fundamental facts of life, even ivory-tower academics now claim they know what the molecular "hallmarks" of aging are. In their lab animals, at least - roundworms and white mice - they can regularly increase life spans by 20% or 30% and sometimes more.
Given these clues, Clement has financed and supervised four small studies, in volunteers, of treatments found to extend the healthy lives of rodents - the immune drug rapamycin, supplements that increase NAD+ levels, a combination of compounds that kill off senescent cells, and injections of plasma concentrated from umbilical cords. His aim is "to do as many small trials as possible" to generate and publish basic information on safety and possible benefits. With that, he says, people interested in life extension "can decide to take the risk."
It's like one of those Renaissance museums where you could find an ancient Roman statue next to a two headed sheep fetus.
Infotainment has played a role in taking already financially neglected research areas and distorting those important lines of research by regurgitating misconceptions; by making advanced technologies appear to be "science fiction", some people avoid getting their hopes up, because it's simple to justify not taking action if it's all "fantasy" anyway. Plus, it's easier to lazily repeat fallacies than it is to take the time to become well-informed.
There are differences between useless supplements and possible-in-principle rejuvenation therapies, just like there are differences between both straight freezing and vitrification, and magical nanobots and atomically precise manufacturing, but it's rare for journalists to be corrected with the actual data; the nonsense and pessimism that's often seen in pop-science articles and their comment sections is a combination of misconceptions, surface-level knowledge, and psychological barriers (this isn't breaking news, but it's still problematic).
It's ridiculous how many sensationalistic pieces I've read where the writer dismisses SENS or biostasis because of out-dated debunked misinformation and it speaks volumes about the lack of substance that's involved in producing these dubious articles.
This blog and LEAF avoid dumbing down the research they talk about, while still being accessible, so thanks for that. :)
@Reason, what is your opinion on this debate of Aubrey de Grey and Vadim? Aubrey seems more optimistic and Vadim more pessimistic: https://www.youtube.com/watch?v=gV-6g5p8jAM
And the response of Aubrey: https://www.youtube.com/watch?v=AAEsQnoA5-M
Do you agree with Aubrey or Vadim? Thanks!
@Josep: Vadim is one of those who thinks aging too complex to intervene in all that effectively in the near future, and I don't agree with that. I think senolytics quite adequately demonstrate that the SENS approach is viable, that there are (comparatively) low effort, high reward points of intervention that bypass the need for more complete understanding and more complex interventions.
@josep i think you should watch this talk that featrures both aubrey and vadim. vadim thinks we can get a 20-30% increase in lifespan with what we know already , just that more sophisticated approaches will take longer
https://www.youtube.com/watch?v=Mje_To9DB3c
There's another article posted today on technology review with Ezekiel Emmanuel.
https://www.technologyreview.com/s/614156/a-doctor-and-medical-ethicist-argues-life-after-75-is-not-worth-living/
Some excerpts:
Q: Are the anti-aging drugs in development just a bid for immortality by the back door?
A: Certainly. You listen to these people and their lingo is not "We're just trying to get rid of problems." Right? It's "We want to live longer." I notice that almost all of these things-not all of them, but many of them-are based out in California, because God forbid the world should continue to exist and I'm not part of it!
The world will exist fine if you happen to die. Great people, maybe even people greater than you, like Newton and Shakespeare and Euler-they died. And guess what? The world's still there.
Q: What message do you think it sends when iconic innovators in Silicon Valley-people like Peter Thiel and Larry Ellison-are clearly fascinated by life extension and …
A: No, no-they're fascinated by their life extension! This idea that they're fascinated with life extension [in general]? Naw, they're fascinated by their life extension. They find it hard to even contemplate the idea that they are going to die and the world is going to be fine without them.
Q: You have described the "American immortal"-people interested in life extension and immortality.
A: There is this view that longevity, living forever-and if not forever, 250 or 1,000 years-is really what we ought to be aiming at. And once you've got cultural leaders, or opinion leaders, saying this, people glom onto it. And it feeds into a whole situation of "Yes, dying is a bad thing."
I do fear death. But I think I fear being sort of decrepit and falling apart more.
Q: Is it really a problem if one of these drugs like metformin shows a modest life-extending effect?
A: I think it would be, especially if what ends up happening is it adds a few years of life. Then the question is: What are the downsides of that? There may be a cognitive downside, maybe a little more mental confusion.
It's very funny-every time I talk to people, it's like, "Oh, yeah, definitely quality of life over quantity of life." But when push comes to shove, it's really quantity of life. "I might be a little more confused, but I'll take that extra year!"
Certainly not a favorable viewpoint. The answer to the last question about metformin really got me. Wish it was expanded on more. That said, people with views and positions of power like his are definitely going to be a challenge when it comes time for the ethics panel on any potential treatments.
@Ham: The same old BS about hubris, confusion, too much change and death is not that bad. It will be wiped out and quickly forgotten when the first treatments become available.
The idea that there can be a significant lifespan increase without a significant healthspan increase is biologically infeasible; the only way for people to live a lot longer (let alone indefinitely) is by staying truly healthy.
Bioethicists (who often ignore the "boring" technical details for "entertaining" fluff) attempt to trivialize actual progress in geroscience by emphasizing the uncertainty that's true for all of medical research.
They also criticize the popular lay techno figureheads (some of whom I think do more to hurt than help the cause) who focus on the longevity side benefit (calling rejuvenation biotechnology "immortality" and such), and then generalize every other advanced technology-supporting person based on the overly simplistic-thinking of certain people who are labeled as "futurists".
Regenerative medicine is all about good health, and since people who are perfectly healthy continue living, it's ridiculous to act as if those who support medicine for the elderly are somehow "greedy" when biological age-related illnesses (like Alzheimer's and macular degeneration) are what cause the most suffering.
How the Tithonus error remains an active fallacy to this day, in a world where a basic Internet search will debunk it with ease, shows how the biggest barrier to getting the research funded faster is clearly psychological.