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To be human is to age. Many of us are already deep within the clasp of aging, with declining power and faltering memory. But is an ongoing downward spiral of feebleness, illness, and (perhaps) senility truly inevitable? Or could we take advantage of the remarkable ongoing progress in multiple fields of science and technology, in order to delay, reverse, or even abolish aging? Might the first generation to break free from the grip of aging already be alive?
As a futurist, I’ll start with a prediction. Although the topic of the future of aging is currently only a fringe interest in public discussion, it’s set to grow in popularity in the next five years. Views which have for centuries been dismissed as ‘immature’ – views that aging could (and should) be challenged and defeated – will move centre stage. Rising awareness of the revolutionary possibilities of waves of disruption in healthcare will refocus minds splendidly. With a vision of a better future, we’ll set aside some of our present-day preoccupations. We’ll find a new cause to focus our energy on: the widespread availability of affordable, comprehensive, reliable rejuvenation therapies. People will start to proudly ‘come out’ as being in favour of the abolition of aging. A movement will blossom.
But the future of aging is far from being all rosy. The abolition of aging is only one of four scenarios that deserve our collective attention. The future contains threats as well as opportunities. Sometimes the scenarios that we initially thought would be wonderful turn out to have nasty stings in their tails. ‘Be careful what you wish for’, is a wise warning. Conversely, scenarios which initially repulsed us may, on cooler reflection, turn out to be attractive after all. In both cases, we need to set aside the waves of ‘future
shock’ which can paralyse our analytic capacities.
FOUR SCENARIOS
Consider Eve, born exactly forty years ago in the United Kingdom. Eve is aware that, when she was born, the life expectancy for females in the UK was 76. She knows that her present age – 40 – is more than half that figure. As her ‘big’ birthday has loomed closer, Eve has grown morose and thoughtful. More than half my life has passed by, she thinks to herself.
But Eve was intrigued to hear from a friend that life expectancy has been increasing, more or less constantly, since the 1840s. The ‘best practice’ life expectancy for women – the average age of death in the country at that time with the longest lived women – rose from the mid-forties around 1840 (in Sweden) to the mid-eighties around 2000 (in Japan). That’s an increase of 40 years over a passage of 160
years. (This data was assembled by demographers Jim Oeppen and James W. Vaupel.) Stated otherwise, it’s an increase of three months every year; an increase of ten years every forty years.
Eve therefore has the following scenario to consider: In the course of living forty years, she has gained an extra ten years of life expectancy. Her life expectancy has already risen to 86, assuming she remains statistically average. To make another assumption, if this striking trend continues, by the time she reaches the age of 80, she’ll have gained another ten years of life expectancy. Playing around
with simple maths, Eve realises she can expect, in this scenario, to live a total of 101 years. Wow, she muses.
I call this the optimistic scenario for life extension. We should contrast it with what might be called the realistic scenario that results from looking more closely at the figures for changing life expectancy in the UK.
Digging into the latest figures from the World Bank (http://data.worldbank.org/indicator/SP.DYN. LE00.FE.IN), Eve observes that female life expectancy in the UK has risen from 75.9 to 82.7 over the forty years of her life so far. That’s an increase of only 6.8 years, not a full 10 years. If that trend is extrapolated, Eve can expect to live to the age of 91.6. But there are caveats: the trend lines seem to be dipping, in more recent times; she might be ill with a chronic illness for many years before her death; and her pension may run out before the end of her life.
This is far from being the worst scenario for the future of aging. Recent newspaper headlines highlight a reversal of life expectancy trends for various demographics. ‘Life Expectancy for White Americans Declines’, reported the Wall Street Journal in April 2016. Earlier that month, the Telegraph ran a story ‘Alarm over sudden drop in female life expectancy’. The BBC recently raised the question, ‘Will today’s children die earlier than their parents?’ The answer, in my view, is ‘maybe’. The cause is poor lifestyle and poor diet, coupled with waves of depression and anxiety, leading to dangerous levels of addiction to alcohol and other drugs.
This pessimistic scenario involves not only declining overall life expectancy but also an unprecedented increase in what’s been called ‘the longevity gap’, namely the difference in life expectancy between the affluent and the poor.
Each of the scenarios mentioned so far – the optimistic, realistic, and pessimistic – involve extrapolation of various trends from the present into the future. The fourth scenario involves extrapolation of a different kind of trend, namely, the acceleration in the overall capabilities of technology. That scenario envisages a kind of phase transition ahead, in which each additional year of life will bring an increase of at least another year of life expectancy. That is, humans who are alive at that time can reach a ‘longevity escape velocity’, akin to the progress of sufficiently fast rockets through the Earth’s atmosphere to escape the hitherto all-conquering downward pull of gravity. In this abolitionist scenario, members of society, if they choose, will be able to remain in a youthful state indefinitely.
TWO DISRUPTIONS
To understand which future scenarios are credible, we have to do more than extrapolate current trends. Indeed, some trends may slow down or stop; other trends could intensify. Futurists seek to raise awareness of factors that can act either as brakes or accelerators for trends. It’s also possible that trends which are dominant at one of major companies. Examples abound of once-great companies that stumbled in the face of exponentially improving technology – consider Kodak, Blockbuster, Nokia, Palm, Britannica, Yahoo, and many more.
It is my contention that not one but two major disruptions lie ahead in the field of healthcare. The first will allow a transition from the realistic scenario for the future of aging to the optimistic scenario. The second will allow a further transition to the abolitionist scenario. If neither transition succeeds, the pessimistic scenario may actually become the most likely outcome, due to increased social inequality,
alienation, and disintegration.
To explain these two disruptions, we need to characterise the present state of healthcare. It focuses on tackling individual diseases, rather than addressing aging. This ‘disease-first’ mentality has had a string of renowned successes, especially for infectious diseases. But progress against chronic diseases – such as heart disease, dementia, and cancer – has been disappointingly slow. All this time, aging has been pushed to the back of the queue for medical research dollars.
However, a new conception is starting to become ascendant. This recognises that chronic diseases all become more prevalent (and more severe) in older people. Importantly, aging can be analysed as a series of degradations happening at the molecular and cellular levels of the organism. These degradations include factors such as chronic inflammation, weakening of the regenerative mechanisms of stem cells, macromolecular damage, and deterioration of the metabolism, proteostatis, and the operation of epigenetics and regulatory RNA. Slowing down these lower-level degradations ought, therefore, to slow down the onset and decrease the severity of chronic diseases.
This approach has gained credibility due to discoveries, from the 1980s onwards, of various mechanisms that can, indeed, slow down aging in various organisms, including fruit flies, nematode worms, yeast, and rodents. These mechanisms involve changes in the DNA of the organisms, the applications of various drugs, and even changes in lifestyle (such as diet). Critically, slowing down aging is compatible with the organisms remaining in a good health state overall.
From only a handful of researchers doing serious work in this field in the 1980s, the community of scientists aiming to delay aging has grown roughly tenfold every decade since then. If this trend can continue (and I realise that’s a big if), there may be around one million people doing good work on these lines by 2040. In that case, expect major progress in the treatment of all sorts of chronic disease.
The second disruption that I foresee switches the focus from delaying aging to reversing aging. Rather than slowing down the degradation of molecular and cellular processes, this approach aims to undo such degradation – akin to refurbishing a veteran car and giving it a new lease of life. What makes this transition credible is the maturation, in the next few decades, of a number of new disciplines: 3D printing of new body parts, nanotech interventions for lower-level repairs, stem cell therapies, genetic reprogramming, synthetic biology, and – perhaps most important of all – deep learning AI with the ability to spot patterns in vast biomedical data that
previously eluded human observation. As greater proportions of healthcare professionals become proficient in these emerging technologies, the prospects for abolishing aging – perhaps by as early as 2040 – will increase.
OUR CHOICE
Behind many cries of ‘it can’t be done’ – referring to the supposed impracticality of the kinds of regenerative biomedical interventions that I have just discussed – often lies the belief that ‘it shouldn’t be done’. The abolition of aging would, supposedly, be bad for the planet as a whole, for human social interactions, and for the sheer meaning of what it is to be human. Critics raise concerns about overpopulation, excess waste, unequal access to premier healthcare, disruption to pension schemes, social stagnation due to people remaining in positions of power indefinitely, the onset of boredom, and a view that life without death would, somehow, become meaningless.
These criticisms take some time to refute comprehensively. There is often an important nugget of truth in what the critics assert. Suffice to say that over the course of 385 pages in my recent book The Abolition of Aging, I do my best to present all these criticisms fairly and fully, before giving my responses. In short, I argue that rejuvenation is a noble, highly desirable, eminently practical destiny for our species – a ‘Humanity+’ destiny that could (with sufficient 12 focus) be achieved within just one human generation from now. As I see it, the abolition of aging is set to take its place on the upward arc of human social progress, echoing developments such as the abolition
of slavery, the abolition of racism, and the abolition of poverty.
For millennia, people from all social classes took slavery for granted. Thoughtful participants saw drawbacks with the system, but they assumed that there was no alternative to the basic fact of slavery. They could not conceive how society would function properly without slaves. Even the Bible takes slavery as a given. There is no Mosaic commandment which says ‘Thou shalt not keep slaves’. Nor is there anything in the New Testament that tells slave owners to set their slaves free.
But in recent times, thank goodness, the public mind changed. The accepting-slavery paradigm wilted in the face of a crescendo of opposing arguments. As with slavery, so also with aging: the time will come for its abolition. The public will cease to take aging for granted. They’ll stop believing in spurious justifications for its inevitability. They’ll demand better. They’ll see how rejuvenation is ready to be embraced. The sooner, the better.