Will Anti-Aging Drugs Lead To A Brave New World?

April 30, 2015 | By Neil Howe

This editorial originally appeared in Forbes.

Ponce de León’s Fountain of Youth may soon be more than just a myth. According to Aubrey de Grey, a leading anti-aging researcher, there is likely a person alive today who will be immune to aging.  This optimism stems from the promising field of longevity research, which has shed its reputation as a quackery-ridden fringe science. If clinical trials of anti-aging drugs prove successful, it would utterly transform society in far-reaching ways. Could today’s generations live to see a world where 100 is the new 60?

There has been a growing push to examine the basic molecular processes behind aging and find ways to counteract them. Some treatments already exist as on-label drugs for other conditions, while others are experimental. The goal is to target aging itself as a major risk factor for the chronic diseases that cut lives short. “Drugs that lengthen health span,” The Atlantic proclaims, “are becoming to medical researchers what vaccines and antibiotics were to previous generations in the lab: their grail.”

Of all these possibilities, rapamycin has emerged as the most promising. It inhibits a gene called mTOR, which switches the body’s resources from “growth” to a more stress-resistant “maintenance” mode. This reflex taps into the same biological processes triggered by “caloric restriction,” a faminelike diet that, while known to reliably extend life span in a variety of organisms, would basically require humans to starve themselves. In a study funded by the National Institutes of Health, male and female mice given rapamycin in late middle age lived 9 percent and 14 percent longer, respectively, than untreated mice. As Businessweek explains, this is roughly equivalent to giving 60-year-old women a drug that enables them to live to 95.

What’s more, rapamycin has also produced encouraging results in human trials. A recent study of elderly patients found that small doses of a rapamycin-like drugimproved their immune response to a flu vaccine by 20 percent, sating worries that it would suppress immune response. Pharmaceutical companies large and small, from Novartis to Calico, are now pouring resources into a field Big Pharma has long viewed with suspicion.

A scientist examines human cells under a microscope. (Photo by Ted S. Warren via AP)

But many scientists remain unconvinced.The history of anti-aging research is littered with misfires. Rapamycin isn’t without side effects: In mice, it limited fertility and increased the likelihood of developing cataracts and diabetes. The last focus of such hype, the “red wine pill” resveratrol, ended up failing in human trials. Everything from gold to vitamin C to growth hormones has been touted for its supposed life-extending properties—often by hucksters.  And the fact that anti-aging drugs will likely first find their way to consumers as repurposed versions of existing medications does not add to their credibility.

In the eyes of these researchers, we’re no closer to finding an “elixir of life” than we were thousands of years ago. “There are no interventions that have been documented to slow, stop, or reverse aging in humans,” S. Jay Olshansky, a professor of public health at the University of Illinois at Chicago and a famed critic of life-extending treatments, tells Businessweek. “The batting average is zero.”

Even those who are optimistic caution that there is much scientists still don’t understand.A team of German researchers, for example, recently argued that therapamycin’s effect on mice is largely due to the fact it inhibits tumors that represent their main cause of death. Moreover, even if it does slow aging, it might take decades for researchers to definitively establish its real effects. And in the end, these treatments might not make as much of a difference as the life-extending behaviors doctors have always recommended: exercise regularly and eat healthy food.

Despite the doubts, some companies are jumping into the market. Though scientists agree that evaluating the safety and efficacy of these treatments will take years, if not a lifetime, the biotech startup Elysium Health has already launched Basis, an over-the-counter “nutraceutical” that aims to mimic the effects of caloric restriction. These supplements don’t require FDA approval—and it’s likely that other startups will go this route in order to capitalize on burgeoning demand even as research continues.

Say that longer life spans do eventually become reality. How would society change? Clearly, the average age of society would rise. This shift would extend a transformation that we’ve been experiencing in the Western world for nearly two centuries, due to gradually increasing average life spans and declining fertility—which today is being exaggerated by the bulge of Boomers entering old age.

But the results would be far more extreme. Extended families could grow to encompass five or more generations. Workers might not retire until well after their 100th birthday. Political and corporate leadership would be dominated by the old. Federal entitlements like Social Security and Medicare would need a total overhaul—and private companies that offer guaranteed age-related payouts such as defined-benefit pensions would face potential financial ruin.

More generally, a grayer world would fundamentally redefine how we see different life stages and relationships. Raising children, for example, might no longer be considered the all-consuming event around which life is organized.

Throughout the centuries, writers from Jonathan Swift to Kurt Vonnegut have portrayed worlds ruled by ageless centenarians. These depictions have been almost uniformly dystopian. Drugs that truly slow aging, however, would offer an alternative vision. With people living longer and in good health rather than simply biding time at the end, the overall well-being of individuals and their families might just rise.

The biggest challenge may not be figuring out how to accommodate more robust old, but how to square their interests with those of younger generations. This would first involve redefining entitlements so that decades-long retirement would not overburden the young. More complicated would be finding solutions to interpersonal issues like wealth accumulation within families and convincing older leaders to step aside for up-and-comers. Those at the top would have to purposefully make room for young blood and fresh ideas in order to keep innovation thriving and everyone happy—for as long as they live.

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