Over the course of human history
most people died before the age of 10 with an exceptional few
living into their 60s and 70s. Around a 150 years ago
a remarkable shift occurred and the average length of life
began to increase. Every decade about two years were added to average life
expectancy.
This trend continued in Western Europe and North America
until by the close of the 20th century life expectancy had doubled for
most people
in the developed world. In those additional 30 years of life that
we added in the 20th century
we call the first longevity revolution. It was primarily improvements in public
health like clean water,
sanitation, indoor living and working environments, controlled
air temperature. these are all things that created very harsh conditions for
people
in the early part of the 20th century. We wanted to live longer we didn't want our
children to die, we succeeded
In doing this, we got exactly what we wish for.
Today the numbers of people living to old age and super old age
are rising around the globe. To live a long life
is a monumental achievement and longer lifespans are precious gifts for
everyone
But
there is another side to the story. Fifty percent of the children born now
will live naturally to over a 100 years but if we don't
increase healthspan
what it means is that individuals are going to still succumb
to cancer, heart disease, diabetes and/or degenerative disease
at some point between their 40s in their 70s.
Developed nations are spending a growing share of their total wealth
trying to hold back a fast approaching silver tsunami
of chronic diseases and disabilities of aging.
Baby Boomers who were born post-World War II are now aging into what we
sometimes referred to as retirement age
post 65 and we're seeing this in some of our social programs and the
upheaval
that's gonna cost to society is tremendous.
This is referred to as the silver tsunami and it should also be said that
this is not a phenomenon that's unique to the United States. We're seeing
this around the world
in many countries. Escalating costs of health care and long-term care for
growing populations of older people
are driving government spending to new heights. A tide of chronic diseases
borne of the longevity revolution
is what lies at the heart of the European debt crisis,
a harbinger of what may await many nations including the health care system
of the United States. One of the major concerns with an aging population is
that Medicare costs are spiraling out of control.
They're going up by tens of billions of dollars on a yearly basis and it's
threatening to break our
federal budget. Right now we're spending 19 percent of our GDP on
health care and it's going to keep going up.
We live in a world that's exquisitely designed to support
young life and we need to very quickly develop a culture
that supports us all the way through. As a geriatrician
I have seen people coming into the office... and I think it's an experience
all of my colleagues
have experienced...who have multiple things going on what we call multiple chronic
conditions
and all those things combined make for a real challenge to optimize quality of life and health
for that individual and to manage it in the constraints that are
provided in the current medical environment.
Magnified by hundreds of millions of people around the globe the illnesses
and infirmities of old age are a gathering storm a dependency
leading to lower quality of life and towering social burdens.
Taking on the bulk of this burden are members of their families
the majority if whom are women. For families and caregivers
of frail older individuals there are real challenges to quality of life.
The individual who is requiring care
doesn't have autonomy and independence that they're accustomed to.
The caregivers are often very stressed
and that stress translates into problems with their health,
challenges with maintaining employment,
challenges with being properly reimbursed.
it gets to be a real conundrum.
With age people face multiple threats at the same time to life
and health which means that even total victory over cancer,
cardiovascular disease or dementia would not extend high quality of life;
there's always another disease of aging awaiting to take its place.
Aging is a major risk factor for
old diseases that we are afraid of and we die from
and unless would change the rate of aging
all we're going to hope for is exchange one disease for another,,
because the only way to treat all of them, to prevent all of them
is delaying action the aging. The questions then become
what can be done to help insure a longer healthspan
and what research is most likely to produce innovations for a
better future. Scientists, politicians, doctors
increasingly agree that that investment must be made in medical research that
aims to better understand how the
aging of our bodies leads to the diseases that threaten
not just our lifespan but our healthspan.
We are no genetically hardier than our ancestors were 10,000 years ago.
This increase, dramatic increase in life expectancy came about because of science
and technology
and wide scale behavioral changes in social norms.
that improved the safety
of the world in which we live. So science and technology got us here and now we
need to apply science and technology
again in order to make sure that these added years improve quality
of life at all ages
not just in old age but again all the way through.
If invest now in figuring out ways to extend healthspan so that these
people are still highly functional and have low health care costs. We'll find it
it could be a very positive thing, but we have to really invest now into
finding ways to keep people healthy longer. Scientists who study aging are in
general agreement
that the process isn't set in stone that the aging process can be sped up by
genetics
or poor lifestyle choices but that it can also be slowed
down. This means that research that's slows aging
has the potential to extend healthy years of life and simultaneously
postpone
the costly and harmful conditions of old age.
So in some sense we're playing whack-a-mole you know you knock out one
disease and then people gonna die of another disease or develop another
disease, what if we can slow
that biological process. Scientists have found that
alterations in cell replacement and repair,
stress response and inflammation are key influencers
in the development of cancer, heart disease, diabetes
and other debilitating and costly conditions of later life.
These are also the essential changes taking place in our aging bodies
that lead to loss of strength, changes in vision,
arthritic joints and other declines.
But is it really possible to do this, to slow the rate of aging to protect against
disease?
We are now coming to realize that aging appears to be
a modifiable risk factor potentially so we have
some reason to be optimistic that in humans we might be able to delay age
related
diseases as a group by targeting fundamental aging mechanisms.
This would be absolutely transformative so
what was science fiction just a few years back is
becoming reality. Even a marginal delay in the declines of aging could give us a
profoundly effectuve
and efficient means to prevent postpone or reduce
the impact of diseases that threaten healthy lives. However
the great majority of US federal medical research funds
goes to the study of chronic diseases in isolation from each other
and largely divorced from the underlying aging processes that
lead to them all. As American taxpayers
we are already supporting medical research
through the National Institutes of Health, the NIH
is the envy of the world and Congress allocates over $30 billion a
year to the effort
Both by history and by habit most of
our national investment in medical research is aimed at
research that is specific to individual diseases.
What is driving all of these diseases that we are seeing in an aging society
is the same damage taking place in our aging bodies.
In order to make the greatest progress that we need to make
we need to get those scientists out at their silos.
We need to foster more collaboration, more sharing of information,
setting common goals, having them pursue the goal of healthier aging for our
population
across-the-board It is an achievable goal
and it's one that could be the ultimate legacy of this generation.
But there is evidence that priorities are beginning to change.
Three or four years ago I started a group
at the NIH, a trans_NIH group called geroscience.
That's the science that addresses the
intersection between the basic biology of aging
and why does it become a risk for diseases. There was a lot of enthusiasm so plenty of different
institute directors
joined. So basically we're trying to do some
work within the NIH to try raise consciousness in our institutes
about the importance of aging
for their interests. What if science succeeds in resetting the aging clock in
each of us
so that it takes 70 or even 80 years to reach
age 60 in body and mind, what would that kind of future look like?
A future not just a long lifespan but a long
healthspan. My vision for healthy aging is my grandmother.
She lived independently in her house for 72 years.
She had to go into assisted living six months before she died.
She was active in a bowling league until the mid 90's.She drove a car
until her mid-90s. She was mentally
sound up until two days before she died.
Aging research has the potential to
develop strategies to help people have that kind of a life where
they're still active and happy and engaged
in their 90s and I think if we could achieve that goal
that would be a major victory
on all fronts. There's no question
that healthspan, extension of a healthy lifespan
pays economic divisions that would extend for generations. We have
estimated in
our own research that a minor deceleration in the rate of aging, very
small
change, for the US would add over seven trillion dollars to
the national economy over the next couple of decades.
And we actually think that's an underestimate. We think that would actually be
significantly larger.
So the benefits in terms of economic value and
in terms of a personal value, just how you enjoy your life
is tremendous. We all know this personally
and imagine this at a population level, not just applying to an individual
but over 300 million people. Some of our brightest and most dedicated research scientists are
working on ways to
unravel the secrets of aging so we might finally realize our collective and
ancient wish
for more years of quality life. We're talking about a fundamental game-changer
in the world of public health that will change the way in which we live our
lives
and that's the way I see a successful intervention to slow the biological
process of aging.
An intervention that slows aging,t if it occurs in the century and I think it
will
I think it will occur in the lifetimes of most people alive today
will be in my view the most important
medical discovery in history.
The potential of aging research is not to make us older for a longer time.
We want to slow the hands of time so that we might enjoy more years
of healthy, vigorous life. Why shouldn't this be our next great national priority?
I love working with older people as a geriatrician
but I'm growing maybe a little bit tired
of trying to prescribe better wheelchairs, better walkers, ways of
preventing falls, ways of preventing incontinence,
ways of preventing age-related diseases. I'd much rather have a way and so would
all my clinical colleagues
have a way where we can stop those things from even becoming an issue in
the first place.
It can happen with your help. To learn more and get involved
visit healthspancampaign.org
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