Imagine, for a moment, what might happen if science succeeds in eradicating disease and people live far longer than they do today.
Do we toast to the extra years spent embracing loved ones and traveling the planet (maybe other planets?) and learning new skills and reading books (now in pill form!) and enjoying this life that so often seems too short?
Or do those extra years of life present a new slate of problems?
How long people might soon be living, and in what condition, is a matter of debate and mostly guesswork.
Though the average life expectancy in the U.S. today — 76 for men, 81 for women — is 30 years more than it was a century ago, mostly due to a drop in infant mortality and advances like refrigeration and antibiotics, eradicating disease doesn’t mean human health and life spans are on a perpetual rise. Accumulated damage to cells inevitably breaks a body down. The oldest human confirmed to have lived was a 122-year-old French woman who attributed her longevity to eating chocolate and drinking port.
European researchers, writing in the medical journal The Lancet in 2009, predicted that if the trajectory of the past 160 years continues, half of babies born after 2000 will live until at least 100. Their estimate was criticized by several aging experts who thought it overblown, while others think that science is advancing so fast that the first people to live to be 150 are alive today.
Regardless, there is no doubt the population is aging in record numbers. The number of centenarians in the U.S. is expected to increase sixfold in the next 40 years, from 104,754 in 2009 to 601,000 in 2050, according to the Census Bureau.
What might the world look like with a bunch of centenarians running around?
That depends, importantly, on whether they are indeed running or being wheeled around. As medicine strives mightily, and expensively, to cure the nation’s top killers — cancer, heart disease, stroke — some biogerontologists worry the 10 to 15 extra years people might gain when they’re spared from those illnesses would be spent playing whack-a-mole with all the other unpleasantries of old age, including dementia, failing sight and hearing, and weakened immune systems unable to fight infection, said Jay Olshansky, professor of epidemiology in the School of Public Health at the University of Illinois at Chicago. The resulting strain on support services as the frail live on could be a nightmare.
“Do we really want to continue to push out the envelope of survival only to see other things crop up that we may not like?” said Olshansky, co-author of “The Quest for Immortality: Science at the Frontiers of Aging.”
Health extension
To pave a path to a different future, a central theme in biogerontological research today is to focus less on treating the diseases that kill people and more on halting or reversing the aging process that underlies those and many other ailments. The hope is that longer lives are not spent bedridden or puttering around on hover chaise longues.
Olshansky, who within the field is seen as a realist, believes that within a decade there could be a pill that moderately decelerates the rate of aging by about seven years — so, for example, a 60-year-old would have the health profile of a 53-year-old. Average life expectancy would nudge up to about 85 for both sexes, he predicts, and — importantly — people would be sick for a shorter time before death.
He calls the resulting benefit to society the “longevity dividend,” as healthy older people could remain in the workforce longer, continue to make and save money and relieve pressure on health care and entitlement programs. Rather than burdens, their wisdom and experience would make them “gold mines for society,” Olshansky said.
There are such people now, who are still hopping on the bike at the gym and running businesses at 100 years old thanks to unique genetics, said Dr. Nir Barzilai, director of the Institute for Aging Research at Albert Einstein College of Medicine in New York, who researches “super agers.” They still get sick but often not until the last year of life; the medical costs in the last two years of life for someone who dies at 100 are a third of the medical costs of someone who dies at 70, he said.
Barzilai aims to use the relevant genes to develop drugs to prevent chronic debilitating age-related diseases, which might have the side effect of prolonging life. Other researchers are aiming to bottle the anti-aging benefits of calorie-restricted diets.
“If you don’t delay aging, you’re not going to do anything,” Barzilai said. “The best that could happen is that if someone doesn’t die of cardiovascular disease, they die from Alzheimer’s.”
Elderly boom
The impending boom of older people will require that society further adjust to optimize elderly engagement and well-being. Basically, as goes Florida, so goes the nation.
“Every part of our lives has to be designed for older adults,” said Dr. Linda Fried, dean of Columbia University’s Mailman School of Public Health and co-director of the International Longevity Center there.
That includes ensuring accessible transportation, multigenerational housing arrangements, flexible work opportunities and social institutions that keep older people active. With programs like ExperienceCorps, an AmeriCorps initiative that sends older adults into disadvantaged elementary schools to tutor kids, centenarians may one day be leading the volunteering charge.
“It’s one thing to age well and be able to stay connected and socially engaged and another thing to age lonely,” said Fried, co-founder of ExperienceCorps.
George Magnus, senior economic adviser at UBS Investment Bank and author of “The Age of Aging: How Demographics Are Changing the Global Economy and Our World,” imagines a burgeoning centenarian population begetting other social changes: the marginalization of must-have brands, high-tech gadgets and fads in favor of cheaper goods and services; a flourishing trade in eating out, leisure and travel; expanded retirement communities that leave cities empty of older people. Further, more younger women may have to stay home from work, as they usually shoulder the burden of caring for elderly family members, he added.
One danger is the potential for older people to outnumber working-age people. Then society wouldn’t be able to generate the output, income and health care facilities to support the older population, Magnus said.
To cope, people would have to work longer or technology would have to advance to the point where productivity is much higher. Today, in the U.S., there are almost five people of working age for each retiree; by 2050, the ratio will fall to almost three working-age people to one retiree, according to Census figures.
Brave new world
But even healthy longer lives might present new challenges, particularly if the budding field of regenerative medicine succeeds in using stem cells, gene therapy and organ replacement to extend life by decades or centuries more.
“Longevity is great on a personal level, but it creates a social problem,” said John Martin Fischer, distinguished professor of philosophy at the University of California at Riverside, who is in the process of doling out a $5 million grant he won to oversee a study on immortality.
As generations pile up, overcrowding and overpopulation could burden already strained environmental resources, he said.
“We would have to live more frugally, use fewer resources, live more wisely and more simply,” Fischer said.
Unemployment could worsen as people delay retirement or young people compete with more experienced 80-year-old career-changers. There could be issues of social justice if not everyone has the resources to access treatments to extend health and life, Fischer said.
Marriage might be restructured as a long-term rather than lifelong contract. But maybe not. Fischer notes that though there would be challenges to keeping a marriage fresh and vital — just as there are now — there also would be more incentive to do so, as losing a spouse of 100 years would feel exponentially tragic.
“I think that if you’re married that long, then it will be very painful and difficult to just take a new direction,” Fischer said.
There are ethical questions, as well.
For example, if you rejuvenate an aging brain with fresh neurons, thus wiping out old memories, “who are you?” Barzilai said. “Are you you?”
At the end of life, decisions would have to be made about when to stop rejuvenation efforts, said Greg Stock, a bioethicist and former director of the Program on Medicine, Technology and Society at UCLA. Society might become divided along moral disagreements about whether we should extend life at all, he said.
Stock believes social structures would adapt to new expectations around inheritance, continuing education, childbearing and multiple careers. Concerns people have that they would be bored living so long are “wrong-headed,” Stock thinks, because the pace of life would spread out and there would always be challenges.
Aubrey de Grey, chief science officer of the SENS Research Foundation and one of the more optimistic regenerative researchers, believes a comprehensive intervention at middle age to repair the molecular and cellular breakdown of a person’s body and return the person to the health of young adulthood, is just 25 years off. Eventually, some 900 years from now, he thinks people could live to be 1,000 years old.
De Grey said he isn’t concerned about an overburdened planet full of bionic humans. He thinks the changes will happen slowly enough that society will adjust and be so sophisticated that it has more efficient ways to use resources.
“This will have a tiny effect compared to the effect that the Internet has had in the past 20 years,” de Grey said.
