The Future of Treating Aging
Here find a sensible, readable paper discussing the years ahead in the treatment of aging as a medical condition. The potential to slow and reverse aspects of aging, demonstrated in animal studies in the laboratory, is now beginning to reach the clinic. A great shift in the provision of medicine, expectations for health in later life, and priorities in research and development will occur over the next few decades. Where we stand today, with senolytic drugs, the first form of rejuvenation therapy worthy of the name, in initial clinical trials, is merely the opening of a lengthy, world-changing process. The human condition will change for the better, in ways that are just as profound as those that attended the advent of antibiotics and the sudden ability to greatly control infectious disease.
Population aging is expected to yield a greater proportion of older adults in the United States than ever before. Therefore, the health of this age group, and that of the U.S. population more broadly, will depend greatly on improved prevention and management of chronic diseases. While age is known to be a risk factor for many conditions that affect healthspan and lifespan, age has been considered largely immutable, and the increased risk of disease has been accepted as a fact of life. However, recent developments in geroscience research suggest that the biological processes underlying aging may be more plastic.
The potential of this finding is significant in that appropriate interventions may enable a paradigm shift from the management of diseases associated with advanced age to broad prevention of many illnesses through which individuals may increase the number of years they live in good health. In terms of both humanistic and economic factors, there is an emerging incentive to develop treatments and monitoring techniques that can properly assess and treat the hallmarks of aging. While classifying aging as a disease could be detrimental to older adults, treating the underlying biological processes that occur in every individual may provide a means to broadly improve health, given the strong links between these processes and the development of chronic disease.
However, without key scientific evidence to clinically define biological aging, measure its progress and effects, and produce an appropriate indication for geroscientific treatments, regulatory approval ensuring the safety and efficacy of products will continue to be an obstacle. The development of gerotherapeutics that can be administered across the lifespan will require an in-depth assessment of biomarkers for the aging process, and the acceptance of these biomarkers by scientific communities as well as by the FDA. This challenge has drawn the interest of clinicians, patients, caretakers, entrepreneurs, sociologists, and government officials alike. Through deliberate collaboration among these important stakeholders, we will be able to pave a path forward to improve the healthspan of older adults and the population at large.
We may find, for better or worse, that the most (and earliest discovered) effective rejuvenation interventions are utilized at early ages, when the burden of damage is low, the state of current system resilience is high, and the presence of existing immune and other health management systems are still robust. That is: not overwhelmed, not overworked, not depleted. An interesting conundrum. Do we use resources to find solutions on those who least need their results, so that we may work with and improve the current 'in-situ' systems and see intervention results - possibly - sooner? Dare we try to create the ubiquitous 200-year old threshold by 2200 (at the expense of and) before we create the somewhat rare and expensive 130-year old by 2080?