Life extensionism is a global movement with long-term traditions. The idea, that aging is similar to a disease and should be treated as such, was first suggested in early 1900s by Elie Metchnikoff, the Nobel Laureate in Physiology/Medicine of 1908 for the discovery of phagocytosis, a vice director of the Pasteur Institute (Paris).
Since then, the study of aging biology has revealed the underlying processes of aging, such as DNA damage, toxic proteins aggregation and cross-links, cellular senescence, nutrient sensing deregulation and others, and proven the plausibility to address these processes to modify the dynamics of aging. Even though aging itself is not introduced as a disease in the International Classification of Diseases (ICD), there is no doubt that aging is the major cause of many severe diseases and the global community can benefit from bringing aging under medical control. Many existing drugs have been found to be geroprotective (protecting the body against different aging processes).
However, what would happen if scientists applied geroprotective technologies to humans, remains a subject of numerous misconceptions.
Please take a look at this picture by the Buck Institute for Research on Aging – one of the biggest aging research centers located in the USA.
The upper line represents the human life course as it was before the development of modern medicine. Somewhere around their 50s people started to develop different age-related diseases, then died from them some 15-20 years later.
The second line (red one) is how things are now. People reach their 50s, age-related diseases start to manifest, but modern medicine allows us to slow down their progression, so people live longer – but this is the period of illness that is extended. This is exactly why Brian Kennedy from the Buck Institute calls our healthcare system a “sickcare” system: we are keeping people alive for longer, but we are keeping them sick. This is why the “silver tsunami” represents such a burden for our system of healthcare and social support: we have many people living longer in disability. This situation is going to get worse in the coming decades, as the number of people aged 60+ is going to reach 30% of the global population by 2100. There will be a lot of disabled people around, if we keep things as they are and don’t move towards preventive medicine.
The third line is what scientists are trying to achieve by developing interventions to address the aging processes. These interventions are meant to be applied in middle age, before the manifestation of age-related diseases, in order to extend the healthy period of life, or healthspan, while the period of illness is postponed and will remain relatively short. This could allow people in their 50s to look like they are 30, and in their 70s also look younger, be stronger, and feel as good as in their 50s. The onset of severe age-related diseases like cancer, osteoarthritis, dementias, stroke and type 2 diabetes could be postponed to the late 90s. Life extension in this scenario would result in better health throughout life, allowing people to remain active and able to contribute to the economy – which could ease the burden on healthcare and social services. We believe this is a goal worth fighting for.
And the fourth scenario is what we strive for in future: healthspan might be extended even more, while the period of disability could be made shorter. This is what scientists call “compressed morbidity”. For how much longer people would live in this last scenario is an open question. It depends on technological advances. They might look like 50 y/o in their 90s, and find themselves wind surfing together with their great grand children.
So what we mean by life extension is actually the extension of the healthy and productive period of life, free of disease and disability. In this “extended” society the majority of people could enjoy their lives for much longer and actively contribute to the development of the economy regardless of their chronological age.