by futurist Kit Arrow
Jeanne Calment of France was born in 1875, and died in 1997, at the age of 122, the oldest verifiable age for a human being. She was alive for the Boer war, the establishment of the Nobel Prize, the founding of the National Geographic society, both World Wars, the emergence of women’s suffrage, the Civil Rights movement, both the rise and the fall of the Iron Curtain, and even lived long enough to see Tiger Woods win his first Masters tourney. She lived longer than anyone else for whom we have records, and did most of it without the benefits of modern medicine. Life expectancy when she was born was just over 45, so she managed to live almost three times as long as she was expected to. It was truly remarkable, a unique circumstance.
Well, unique at the time. There are scientific and technological techniques being developed that will eventually make Jeanne Calment’s death at 122 seem like a life cut tragically short. Indeed, some very smart people claim that the first person who will outlive old age, and live forever, has already been born. I’m skeptical, but I do admit that living to 150 or beyond is starting to look possible.
Aging is not a simple thing; it’s a combination of a dozen or more disparate things. Damage to DNA, environmental factors, toxin accumulation, even complex factors such as telomere length and epigenetics contribute to the aging process. But we know more about these factors and how they interact than ever before, and we are beginning to discover ways of treating them. In short, we are beginning to think of, and treat, aging like a disease – identifying the symptoms, discovering the root causes, and, over time, developing a cure. So where are we with these treatments, and what might they mean to you and how long you might live?
1) Beating cancer with instant diagnosis
Cancer is one of the leading causes of death worldwide, accounting for 8.2 million deaths in 2012, according to the World Health Organization. It’s in the top 5 killers in almost all rich nations, and a significant factor everywhere. There are historical records of cancer treatment dating back over 3,000 years, showing it has been a persistent problem for as long as we have records. And we’re getting better at fighting it. Cancer treatment is huge right now. Hardly a week goes by without a breakthrough in cancer treatment, leading to treatments with fewer side-effects that are better at managing or curing the disease. As technology progresses, doctors and oncologists are better able to target cancer treatments, reducing the impact on the body. Nanotechnology is improving this as well, with silver-bullet treatments that seek out individual cancer cells and attack only them.
But the real breakthrough we’re waiting for in cancer treatment is instant diagnosis. One of the issues with cancer is that it much easier to treat when it is caught early, and becomes much harder once the disease spreads, known as metastasizing. There are tests being visualized that will allow you to check for cancer in less than ten minutes with only a drop of blood. We are still years away from such an instantaneous test, which will one day be in doctor’s offices. Yet, why only use it for cancer diagnosis? Why not have broad-spectrum tests that test for all common ailments? [Note: This may be happening already. See, for instance, this. For that matter, once they make it to doctor’s offices, why not put them in the home? Why not test yourself daily on self-sterilizing equipment that tells you if you should go to a doctor, and why. Rather than waiting to catch stomach cancer, for instance, when it reaches stage 4, why not catch it at stage 1? Treating stage 4 cancer involves long, painful and expensive treatments, with only mixed success. Finding and treating cancer in stage 1, before it grows to appreciable size, means we will probably be able to treat it with a one-week regime of pills instead.
2) Treating organ replacement like swapping spare parts
Organ replacement is not a young field. There are records of transplants going back to apocryphal times, with more notable successes recorded since 1883, when the first thyroid transplant was recorded. Georg Schöne discovered immune rejection, one of the great problems of organ replacement, in the early 1900’s, though methods for dealing with this problem weren’t developed until many decades later.
Eventually we ended up where we were twenty years ago, with good immunosuppressant drugs, and a sophisticated method of matching tissue types to reduce immune rejection. Now we are moving towards a system where undifferentiated stem cells from our own bodies can be used to create organs that are a perfect match for our own, but which are healthy and free of any disease or damage due to aging. This process exists, and will soon be undergoing FDA trials in the US, and similar trials in other parts of the world. These organs will be produced using 3D printers, on demand, will be 100% compatible with the recipient, and will not require someone to die for them to be available.
Twenty years from now, your local hospital or doctor will keep a stock of pluripotent stem cells taken either from bone marrow for older patients, or umbilical cells for younger patients. If there is a serious health issue, your stem cells will be used to print new tissues or organs to replace the damaged or aged tissues. This will also revolutionize plastic surgery, because it will no longer be necessary to harvest skin or hair from other places in the body, it will be possible to have follicle and tissue implants grown from the stem cell stock. Accordingly, as well as allowing us to swap in spare parts for aging organs, it will allow for dramatic changes in the treatment of victims of fires and massive facial trauma, among others.
This seems like real science-fiction stuff, yet these techniques already exist, and the implications are staggering. You have type 1-diabetes? Here’s a new pancreas, don’t sweat it. Heart attack? You’re scheduled for a replacement next week. Lost a breast due to cancer? We’ll grow you a replacement. It will still involve surgery, which always involves risks, but these will be lower than living with a problematic heart or pancreas.
3) Nanomaterials and nanomachines
Nanotechnology is a huge, emerging field, and a great deal of work is being done in it. While nanomachines, which are devices only a few molecules long, are still very primitive, we have seen notable success with nanomaterials, using the molecular properties of various substances for a number of different processes. Nano-adhesive plasters, for instance, have been used to stop bleeding in blood vessels, or even prevent it by being put in place beforehand. This kind of bleeding can be lethal, and small tears frequently grow, requiring dangerous and specialized surgery to fix. Nano-adhesives work like a band-aid, but for a major artery or vein instead of an external cut or scrape.
Next, certain types of metal oxides, including zinc and silver, if included as particles with antibiotics, can reduce or overcome antibiotic resistance in bacteria. That means that the superbugs out there with massive levels of antibiotic resistance will become treatable again. This doesn’t mean they aren’t a problem, but at least they aren’t going to be a world-ending pandemic, and we won’t be returned to the world we had before antibiotics, where people could die of a cut or simple staph infection.
Do you have allergies? Many people do, and they range from getting watery eyes and sneezing when exposed to ragweed, up to anaphylaxis and throat swelling shut if stung by a bee or from eating shellfish or peanuts. These reactions are caused by an overactive immune response, triggering a large-scale release of histamine. Research has found that carbon Buckyballs, a nano-substance, can inhibit the histamine release, preventing and potentially eliminating many allergic reactions.
We can do all of this now, with nanoparticles rather than nanomachines. Ray Kurzweil, a computer engineer, inventor, and futurist who works with Google, predicts that we will one day have nanomachines, tiny, microscopic devices that will roam through our bloodstream, and repair our bodies for us as needed. He believes that by 2030, old age will be finished. I think he’s optimistic as to time scale, but is nevertheless on the right track.
4) Epigenetics and cellular causes of aging
Richard Dawkins and Peter Medawar, two very smart guys, have explored the idea that convincing your body’s cells they are young might turn back the clock for you. This is the field of epigenetics, based around the concept that there is more to genes than DNA. Indeed, there is a school of thought that DNA represents a computer, and can trigger specific actions to protect the body, depending on external conditions. This seems to be true, with various proteins silencing genes and preventing them from being active at various times, for instance.
One of those genes is for a protein called telomerase. Telomerase is responsible for rebuilding the ends of DNA strands after replication (the ends being called telomeres). However, these proteins aren’t 100% effective, and our genes start to get cut off, causing DNA transcription errors as vital parts of the DNA are removed. This is one of the characteristics of an aging body: systemic errors in cells cause organs to stop functioning. Dolly the sheep, the first cloned mammal, was cloned from an adult cell with shortened telomeres, which shortened her life. (She was, in essence, born old.) Yet, while absence of telomerase is certainly a cause of aging, presence of it does not stop aging, making it only one of many different cellular factors.
If we can successfully unlock the various non-genetic causes of aging, there is no reason to believe we can’t turn our body clocks back, and find the eternal youth that has eluded seekers since Ponce de Leon and before.
Yet, resetting the body’s timers is less certain, and less clear than organ replacement. We have found at least two cellular systems that act as clocks, telling cells when to stop replicating and die, and it’s quite possible we will find more. Human aging is a very complex process, and it is far more likely that we will be able to pause aging rather than reverse it, at least initially. This won’t please the Boomers all that much, but it is a huge advance.
To sum up, there is ample evidence to show that extreme longevity, if not physical immortality, is possible, and may happen sooner than we expect. We are already living longer, significantly longer than the generations before us. For the first time in recorded history, average life expectancy passed 60 in the 1900’s. We’re past 80 in many parts of the world, and much of the rest of the world is now catching up. And even more interestingly, life span, the maximum limit that we believe anyone is able to live, is also increasing. As medicine brings more of us to greater ages, science is pushing back the limit of maximum age, and possibly removing it entirely.
5) The biggest obstacle: your mind
But lest I leave you with the impression that it’s all good, and just a matter of time before we can live for decades or even centuries longer, there is at least one major stumbling block for which we haven’t even the beginnings of a solution: the brain and the mind. It is true that we could grow you a replacement brain from your own stem cells, much as we can grow you a replacement heart or kidney. Yet it’s not the physical organ – the brain – that’s important so much as it is its contents: your mind. At present, we have no idea how to transfer your mind from its present container into any kind of replacement.
People like Ray Kurzweil, who is one of the leading proponents of immortality, basically punts on this question by saying that computer technology will reach the stage where we will be able to upload our minds to a computer, as well as supplement our brains by having them interface with computers. The problem is that we really don’t know, at a fundamental level, how the brain works, or even what the mind is. And we are only able to interface directly with the brain in very crude ways, allowing quadriplegics to direct a wheelchair or a robot arm with a few, very simple thoughts. The subtleties of thought, or even what thought is, are, at the moment, beyond us.
So perhaps the last great hurdle ahead of us is how to replicate the mind. And while Kurzweil and others are largely correct about the speed at which IT is progressing, it will take a conceptual breakthrough to enable us to replicate our minds, and breakthroughs cannot be predicted. This one might happen tomorrow – or it might not happen for centuries to come. Or, if our spiritual traditions are correct, it may not be possible at all.
Implications of longevity
What will dramatically increased longevity mean for those of us young enough and wealthy enough to afford it? Let’s assume for a moment that we can all live to 150 years old in 30 year-old bodies before we finally die. What implication does that carry?
For starters, retirement age will have to be abolished, or at least dramatically changed. Retiring at 60 after working for a company for 30-40 years, and then expecting them to support you for the next 90 years is ridiculous. If lifespan doubles, so should retirement age. So, if we do push age up to 150, don’t expect a pension forever. We will see either limits on how long you can collect a pension, or a significantly increased age of retirement, or both. Furthermore, retirees today may be financially active, but they aren’t part of the labor pool. This could put us in the opposite crisis that we found ourselves in 2008 – too few workers for too many jobs. Having money is not the same as being productive. Wealthy or not, our society may not be able to afford to let people retire.
Next, let’s discuss the 1%. None of these treatments will be free, and most will cost dearly at first, although they will steadily come down in price. Therefore, only the richest of us will be able to afford many of these treatments when they first become available, though quality of life and health care for those of us lower down the financial scale will continue to improve over time as a result of the expensive longevity discoveries. But techniques like reversing or stopping the body’s clock certainly won’t be covered by Medicare, and will initially only be available for the super-rich. This group is already not terribly popular, so how much more anger will be caused when they literally buy youth for themselves? I’m not a sociologist, but I don’t expect that finding out the person who embezzled your pension fund did 5 years in a white collar jail, and then bought those years back with interest, would go over well, for example. Yet, expensive prolonged life will encourage just this kind of win-at-all-costs mentality.
Luckily, progress does wonders for cost. In the 1940s, a course of penicillin could cost thousands of dollars, and in 1940 dollars at that, which led to an expanding black market for antibiotics. Today, it’s cheaper than a cup of coffee, and just about as easy to find legally. Geriatric treatments that cost millions today will drop to the equivalent of a few thousand a decade or two down the line, and eventually be trivial, costing so little that it would be unthinkable to go without.
Life and health insurance, actuarial science, and gerontologists (doctors who deal with aging), are in for a shock. Pension managers will have to entirely re-design portfolios and entitlements, because accruing principal over 30 years probably won’t to be enough to support you for 90. Life insurance will have to change dramatically, since the payout is based on a life expectancy of 70-80, not twice that. Government agencies, always slow to change, will have to adapt their already strained budgets to deal with a massive wave of what are currently considered senior citizens. The Medicare system will need a serious overhaul before this technology comes along, or it will collapse under the pressure. Gerontologists, on the other hand, will be fully employed for as long as they like.
While there are implications and consequences to deal with, longevity is coming. Possibly for an elite few who can afford it, hopefully for the majority of us, but it is on its way. We are living longer, living better, aging more slowly, and hopefully enjoying it more. If you are reading this, don’t be surprised to see 120. Don’t be shocked to live longer than that. But in any event, you should certainly plan for the possibility.
And what comes next? If we can live to 150, can we live even longer? And what about things like Alzheimers, senility, and other brain malfunctions? These are issues for a later blog post.
© Copyright, IF Research, March, 2014.
Reference Material
http://www.computerworld.com/s/article/9244884/The_first_3D_printed_organ_a_liver_is_expected_in_2014
http://www.sciencedaily.com/releases/2013/03/130327133341.htm
http://www.nature.com/news/chemical-clock-tracks-ageing-more-precisely-than-ever-before-1.13981
http://2045.com/
http://www.who.int/mediacentre/factsheets/fs297/en/
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