Spring Chicken Page 4
“The overall health of the population is growing worse, not better,” Olshansky asserted. “And it’s getting worse faster than we thought.” By his estimate, overall U.S. life expectancy could decline by between two and five years over the next couple of decades—a steep drop away from the Vaupel slope.
It’s not just in the United States, either: Obesity and diabetes rates are soaring in places like India, and even in the Japanese island of Okinawa, famed as a “Blue Zone” because of its large numbers of centenarians. Thanks in part to the heavy U.S. military presence, middle-aged Okinawans eat a fast-food-heavy diet and are now some of the least healthy people in Japan. The Blue Zone is turning into a red zone.
Everyone ages, but not everyone ages equally. In poorer countries, poorer states, and poorer neighborhoods, life expectancies tend to be far shorter than average; one study of London residents even showed that where you get off the Tube can make a huge difference in how long you live. Lower education levels, Olshansky says, are an even stronger predictor of early mortality. Still other research suggests that the educational level of one’s mother is a key determinant of late-life health. “America is diverging,” he said. “We’re going to see breakthroughs in longevity for some, along with a drop in life expectancy for large subgroups of the population.”
He eyed the last bite of my WhoopskiDawg, a massive Polish sausage buried in mustard and grilled onions. “How was that?”
“Jay Olshansky is a smart guy, and a friend of mine,” says Aubrey de Grey, his extravagant beard twitching with each sharp syllable. “But he says some incredibly stupid things. I mean, it’s almost embarrassing.”
The verdict is rendered more damning by de Grey’s clipped, British-boarding-school accent, a voice he has used to dismiss, dispute, and intimidate his critics and debate opponents for more than a decade and a half. We’d been chatting on the scruffy sofa in the offices of his foundation when an emergency struck: He ran out of beer. So we decamped to a nearby pub, which is relatively empty at four in the afternoon here in Mountain View, in the healthy, industrious heart of Silicon Valley.
He was referring to Olshansky’s insistence that lifespan itself is finite, somehow programmed into our genome with the immutability of a Biblical Commandment: Thou Shalt Not Live Longer than 120 Years. For Aubrey, potential human lifespan doesn’t end at 120; rather, that’s just a beginning. He is famous for, in reverse order, his beer intake (prodigious, yet somehow not debilitating); his beard (Duck Dynasty meets Osama bin Laden); and his views on aging, which were once considered extreme but are increasingly, if grudgingly, accepted by some mainstream scientists.
With his London Fog complexion, red-rimmed eyes, and heroin-addict build, the fifty-two-year-old de Grey looks distinctly out of place in the robust California sunshine, like a religious hermit on a cruise ship. In fact, he’s anything but reclusive: He’s just returned from a TED speakers’ reunion, before flying back to England. He maintains a grueling schedule of meetings, lectures, conferences, and interviews like this, which he conducts while also answering emails at the rate of about one every five minutes.
You might have seen him on 60 Minutes a few years ago when, pint in hand, he informed Morley Safer that some people who were alive now would live to be a thousand years old. In an article in a scientific journal published around the same time, he went even farther, claiming that people born at the end of this century might be able to enjoy lifespans of five thousand years or more. That is roughly equivalent to someone from the Bronze Age living long enough to open a Facebook account.
This kind of talk drives Olshansky completely bonkers—“He makes up numbers depending on who he’s talking to!” he sputtered—but de Grey answers such complaints with a simple argument: “Just because something hasn’t happened yet, doesn’t mean it won’t ever happen.”
Example A: powered human flight, first proposed by Leonardo da Vinci circa 1500, realized by the Wright brothers some four centuries later, propelled by jet engines just fifty years after that, and achieving supersonic speeds within another decade. Oh, and we’ve been to the moon. Each breakthrough, de Grey has written, was “technologically unimaginable to the previous milestone’s achievers.” Why should aging be any different?
The son of a single mother who styled herself an artist, Aubrey Nicholas David Jasper de Grey attended London’s plummy Harrow School on scholarship and studied computer science as an undergraduate at Cambridge. He embarked on a career as a software engineer, but he soon found himself gravitating toward an even more intractable problem: aging.
His interest was more than academic. In 1991, in his late twenties, he married Adelaide Carpenter, a Cambridge professor of genetics who was nineteen years his senior. Under her tutelage, he began educating himself, devouring journal articles about aging science and posting in the online forums of the time. He proved a quick study, publishing his first journal article in 1997, a new theory about the role of mitochondria, the little power plants in all of our cells. That paper later evolved into a book that was impressive enough to earn him a Cambridge PhD, under the university’s “special rules” for nonconventional students who had not actually studied there (the philosopher Ludwig Wittgenstein earned his Cambridge degree the same way). Armed with that credential, de Grey elbowed his way onto the stage of aging science, wielding a fast-talking debating style, fueled by more than enough arrogance to pull it off. “I am,” he assured me over beers, “the most important figure in aging today.”
Possibly. For the past decade or more, de Grey has been asking a simple but provocative question: What if we could somehow “cure” aging itself? What if we could defeat it completely, the way we beat smallpox and polio?
In a 2002 manifesto, which he expanded into his 2007 book Ending Aging, de Grey outlined a seven-point program by which it would be possible—theoretically—to do just that. His plan, which he calls SENS (for “Strategies for Engineering Negligible Senescence”), would basically engineer the effects of aging out of our very cells… somehow. One way, for example, would be to clear out the “garbage” that accumulates inside our cells, over time. “Your house works fine if you take out the garbage every week, because that’s a manageable amount of garbage,” he says. “It’s only if you don’t take it out for a month that you get into a problem.”
So all we need to do, to stop or slow these particular effects of aging, is figure out how to empty out our cellular garbage. Somehow.
To call SENS ambitious is an understatement: Another one of its seven pillars entails, in effect, curing cancer. But if it succeeds, de Grey insists, the Vaupel slope will actually get steeper, until eventually we achieve what de Grey calls “longevity escape velocity,” where each year we would gain more than twelve months of additional lifespan. And thus some of us might theoretically be able to stick around long enough to enjoy whatever it is that people will be doing in 3015 instead of checking Facebook.
Which sounds crazy, maybe even a little scary. Olshansky and twenty-seven other eminent scientists got together in 2005 and published an attack on de Grey and his SENS project, basically saying Whoa, slow down, cowboy: “Each one of the specific proposals that comprise the SENS agenda is, at our present stage of ignorance, exceptionally optimistic,” reads one of the milder passages. Words like nonsensical, fantasies, and even farrago (a confused mixture, or hodgepodge) were thrown around. “Journalists with papers to sell or air-time to fill too often fall for the idea of a Cambridge scientist who knows how to help us live forever,” they huff. They also point out that, by the way, de Grey isn’t actually a “Cambridge scientist,” as he has never held an academic appointment there, or anywhere else for that matter. (He was employed by the university, but as a computer technician in a genetics lab.)
Perhaps predictably, the attack had the opposite effect: It actually raised de Grey’s profile. Rather than ignoring him, the scientists had engaged him. The magazine Technology Review, published by MIT, offered a $20,000 prize to anyone who could def
initively refute de Grey’s theories to a panel of neutral judges. Three groups of scientists took the challenge, but none of their rebuttals was deemed sufficient to win the prize. Another victory for de Grey.
The controversy persists to this day, dividing the field of aging science into two camps: not merely pro- and anti-Aubrey, but those who think we can’t do much about aging, beyond maybe tacking on a few healthy years to our hard-won fourscore, and those like Aubrey, who think we might be able to do a lot more, perhaps even reengineering human biology to transcend all its previous limits.
As to when this might actually happen, the jury is most definitely out, and not even de Grey is expecting it to return with a verdict anytime soon. He himself has signed up to be cryonically preserved after his death, à la Austin Powers—that is, immersed in a tank of liquid nitrogen in the hope that, someday, he might be brought back to life. He’s not alone: Dozens of others, perhaps hundreds, have signed the forms and paid up to $200,000 for the procedure. The most famous cryonically frozen person, or part of a person, is Ted Williams’s head, which now resides in a liquid-nitrogen-cooled tank outside Phoenix. The only hitch is that the technology required to freeze and revive a living creature, even a mouse, does not yet exist. The idea that we might bring back Ted Williams’s head, and attach it to a new body—let alone that this would be on the to-do list of some distant future civilization—is perhaps even more far-fetched than the idea that we might engineer our way to immortality. So I didn’t take it as a great vote of confidence on de Grey’s part.
But in a weird way, although they disagree violently and completely, de Grey and Olshansky are actually saying the same thing, which is that aging is a problem that needs to be solved. Urgently, as a matter of fact. Regardless of what some mainstream scientists think of him, de Grey’s big contribution has been to make aging itself—so long accepted as a fact of human existence—a subject of outrage.
“Aging is the leading cause of death in the world today,” he writes in Ending Aging. Run down the list of the leading killers—cardiovascular disease, cancer, diabetes, Alzheimer’s, stroke—and you’ll find aging as a root cause or major risk factor in ailments that kill a hundred thousand people daily, worldwide. Or, as he likes to put it, “thirty World Trade Centers every day.”
Yet “old age,” itself, hasn’t been seen on a death certificate, as a cause of death, since roughly 1952.
De Grey thinks this is a product of society’s lingering denial that aging even exists. Statistics back him up: As this chart shows, one’s risk of developing nasty chronic diseases goes up exponentially with age, starting with heart disease in middle age, followed by diabetes, cancer, and eventually Alzheimer’s (as well as stroke and respiratory diseases, which also increase dramatically with age).
Add them all up, and it explains why your risk of dying doubles roughly every eight years, a phenomenon first observed by the gloomy nineteenth-century mathematician Benjamin Gompertz in 1825. When we’re young, the risk is fairly minimal; there isn’t much difference between age twenty-five and, say, thirty-five. But thirty-five to forty-five is a big jump, and by fifty our peers are popping up with breast cancers and colon cancers and high blood pressure and other scary ailments. (Not to mention the beginnings of arthritis, which doesn’t kill you but still hurts.)
Attacking these diseases one by one, the way Western medicine has done for more than a century, has only helped a little. Over the last four decades, mortality from heart disease has dropped by half, because Grandpa now takes a pill for his blood pressure, another for cholesterol, and he may even have had bypass surgery or a valve replacement, which were not options just a few decades ago. The fatal heart attack at fifty is a thing of the past, yet lifespans have not lengthened nearly as much as scientists had expected. The patient survives one disease, only to fall victim to the next in line.
“We saved people from cardiovascular disease, and then two years later they were dying of cancer or something else,” says Nir Barzilai, director of the Institute for Aging Research at Albert Einstein College of Medicine in the Bronx. Indeed, cancer is now the second-leading cause of death behind heart disease, and gaining fast—because people are surviving heart attacks and managing heart disease, and living long enough to get cancer instead. It’s like running a gauntlet, and at the end of it lurks the most feared disease of all, the cognitive decay we call Alzheimer’s, which affects nearly half of everyone who is lucky enough to make it past age eighty-five.
So if we achieve longer lifespans but spend more of those years in poor health, we will be no better off than Jonathan Swift’s Struldbrugs, a fictional race of humans who had been given immortality but not eternal youth, so they just kept getting older, and older, and older. The ideal is the opposite: To stay radiantly healthy right up until we are eighty-five or ninety (or whatever), and then go out quickly—preferably while riding a motorcycle, or maybe BASE jumping.
Unfortunately, the medical research establishment still insists on attempting to tackle the diseases of aging singly: The National Institutes of Health comprises separate, multibillion-dollar institutes for cancer, for diabetes, for heart and circulatory diseases, and so on. This is known as the silo model of medical research, because each disease is isolated from the others. Even now, relatively few mainstream scientists—let alone politicians or policy makers—recognize aging as a crucial underlying risk factor that links all of these problems. The National Cancer Institute gets more than $5.8 billion in funding each year, the National Heart, Lung, and Blood Institute gets $3 billion, and the National Institute of Diabetes and Digestive and Kidney Diseases gets $2 billion. Americans spent more on plastic surgery in 2012 ($11 billion) than we did on government-funded scientific research into the diseases of aging. Meanwhile, the National Institute on Aging gets just $1.1 billion, most of which is earmarked for Alzheimer’s disease. Actual research into the biology of aging itself commands just $40 million or so, a tiny slice of the pie; it’s possible to spend more on a Manhattan apartment.
Which is a shame, because some researchers are beginning to realize that aging itself is the primary risk factor for diabetes, heart disease, cancer, and Alzheimer’s—and that something within the aging process itself may link all of them. Each one has a long, invisible beginning, where the disease is developing but we don’t have any symptoms. The cellular dysfunctions that lead to Alzheimer’s begin decades before we notice any cognitive changes; the same goes for heart disease and diabetes. The thing is, by the time we actually develop the disease, it is almost too late to do much about it. So what if we looked deeper, at whatever it is about aging that makes us prone to these diseases?
In the lab, scientists have made huge strides toward reversing aging, vastly lengthening the lifespans of worms, mice, and flies, often with remarkably simple genetic interventions. In lower animals, and even in mice, knocking out a single gene can nearly double a creature’s lifespan, or more. To Aubrey de Grey, that’s only a good start. He’s proposing a radical reengineering of human biology, one that may or may not ever be possible, with the goal to eliminate or reduce the cellular effects of aging. Nonetheless, it’s a provocative idea, and it set up a long-running debate between those who think we can fundamentally alter the aging process itself, and those who feel the best we can do is to live a lot healthier for a little longer.
The American public thinks the latter option sounds like quite enough. A 2013 Pew Research survey found that Americans’ “median ideal lifespan”—how long they actually want to live—is ninety years, or about ten years more than we’re living now. That’s a big jump. But only 8 percent wanted to live past a hundred, perhaps fearing that they, too, will end up like Struldbrugs, teetering and groaning into an artificially prolonged senescence. As Jonathan Swift intuited, immortality has a limited appeal. On the other hand so does dying younger. When public-health thinker and physician Ezekiel Emanuel declared, in an essay in the Atlantic, that he wanted to die at age seventy-five—arguing that “over r
ecent decades, increases in longevity seem to have been accompanied by increases in disability”—the backlash was fierce.
Some religious conservatives have lined up against aging research, too. In their view, tampering with aging violates God’s will (though they did not make the same argument against antibiotics tampering with God’s microbes). The last pope spoke out strongly against life-extension science, and President George W. Bush’s official Council on Bioethics—the same folks who effectively banned embryonic stem cell research in the United States—issued a 2003 report declaring that, basically, aging research would result in nothing more than vast numbers of unhappy old people hanging around, getting sicker and spending everyone else’s money and making grumpy remarks at holiday dinners.
They were of course dead wrong: Surveys have actually found that in general, older people are far happier than their middle-aged kids and grandkids. More to the point, the council’s report and the public’s skepticism reflects a common fear that Emanuel shared: that longer life will equate to longer unhealthy life. The fear is not entirely unfounded: Who would want to spend their extra ten or fifteen years in a nursing home?
The scientists you’ll meet in Spring Chicken see a very different, and much happier, future of aging. They feel as if they’re on the verge of major breakthroughs in our understanding of the aging process, and how we might even begin to modify its course in a way that could enable most people reading this book to live longer, healthier lives—more like my grandfather, and less like my great-uncle.
Even Jay Olshansky agrees, despite his reputation as a pessimist. “I think we’re close to a breakthrough, the impact of which will rival the discovery of penicillin,” he declared unexpectedly, during our Chicago sausage binge. This breakthrough, probably a medication of some sort, most likely affecting metabolism, would enable most people to delay the most debilitating diseases of aging, at least for a while. Moreover, it would not only transform health care, but the economy, producing what he calls a “Longevity Dividend” in the trillions of dollars. “But we’re not there yet,” he cautioned.