Extending The Finish Line

I am slower and weaker than I used to be. I don’t hear or see as well. I am more forgetful and not as mentally agile. My blood sugar is a tick higher than I’d like. A pacemaker assists my heart. Am I ill or simply getting older? 

Depends on who you talk to. 

There’s a debate within the medical community about aging and its effects. Most doctors and health organizations classify conditions such as osteoporosis, type 2 diabetes, dementia, and macular degeneration as the result of aging and general biological decline. A group of researchers and medical types, however, view aging itself as a disease, with an array of accompanying conditions. 

“The only way to prevent these illnesses linked to aging is to attack the principal cause – aging itself. It is time to start working toward solutions to this universal human tragedy,” reads the website for the Healthy Life Extension Society, a Belgian-based collective whose monthly newsletter is titled “The Death of Death.” 

Harvard Medical School geneticist David Sinclair is a mega star in the aging-reversal community, starting companies and labs and raising tens of millions of dollars in funding, all while plowing ahead with research. He wrote a New York Times bestseller, “Lifespan: Why We Age – And Why We Don’t Have To.” He focuses on enzymes (sirtuins) and their activators that have shown promise in slowing the aging process and maintaining cell health. He and his colleagues published a study that identified a cause of aging that’s potentially reversible. He also claimed that a plant-derived molecule found in red wine can activate a specific sirtuin and inhibit the ill effects of excess weight in mice. He talks up the idea of extending life to age 150 by the end of the century, and of getting booster shots when we begin to show signs of aging. 

“Does that sound like science fiction? Something that is very far out in the future?” Sinclair wrote in his book. “Let me be clear: it’s not.” Sinclair’s claims, and hucksterism, get some eye-rolls and pushback within the scientific community, which is generally more buttoned down and hyperbole-averse. But he is undaunted. In a 2019 feature in Boston Magazine, he was asked why he takes unapproved drugs as part of his health regimen. He responded, “I take them because I am a scientist. (Pause) And because I would like to outlive my enemies.” 

One issue is that the concepts of aging and health and disease can be vague and fluid. People who are the same chronological age can be of vastly different biological ages, due to cell deterioration, or the presence or absence of various physical conditions. The World Health Organization defines “health” as “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” But “disease” is sometimes defined merely as the opposite of health, or as a sickness or illness with specific symptoms. 

There was a recent kerfuffle in the area of disease-labeling. The WHO publishes a catalogue used to standardize disease diagnoses. They planned to replace the diagnosis of “senility,” which they believed outdated, with the more expansive “old age.” The description included the word “pathological,” which could have been interpreted as suggesting that old age itself is a disease. A segment of the medical community pushed back, reasoning that it could lead to inadequate care for patients. Rather than pinpointing a specific ailment, they said, physicians could chalk up a condition as due to advanced age. Daniel Belsky, an associate professor at Columbia University’s school of health, said in a piece in MIT Technology Review: “Aging is a cause of disease, not a disease itself.” In the end, the WHO backed off. The catalogue doesn’t use the term “old age” or contain language that suggests aging is a disease. Instead, the catalogue calls it “aging-associated decline in an intrinsic capacity,” a phrase that rolls off the tongue like water down a mountain stream. 

It’s easy to dismiss the dispute as a semantic taffy pull by the white coats. Except that WHO designations are needed to register new drugs and therapies. Recognition, as it were, can lead to funding for research and treatment. Linking old age more directly to disease, some researchers argue, helps overcome regulatory obstacles and creates paths for drugs designed specifically to treat aging. 

Age-reversal R&D may not need a financial push. Silicon Valley has invested in anti-aging research for years and boasts a handful of recent startups, including one that’s looking into cellular reprogramming with a reported hefty investment from Jeff Bezos. The NIH asks scientists to apply for funding for age-related research. Saudi Arabia recently announced a $1 billion annual initiative to study and extend health span, the amount of time that a person is judged to be in “good health.” Which may be the real reason Phil Mickelson and Co., signed on with LIV Golf. 

There are ethical concerns related to extending life and monkeying with human cells, starting with: Just because we can, does that mean we should? How long do we want to live, anyway? Sure, life is precious and all that, but do you want to be 120 and still telling your 93-year-old son to turn down his music? Granted, it might be interesting to hang around a little longer to see if the Seattle Mariners can win a World Series or what 100-year-old David Simon might create. However, the planet could do with fewer humans, not a surge of centenarians gumming up the works. And for those of faith, a better existence awaits. 

Not to hasten anyone’s journey. 

Expect to hear about treatments that slow the aging process, first in lab animals and perhaps then in people. It’s probably too late for me, but you never know. Maybe I become the old guy jogging around the neighborhood who no longer needs reading glasses or hearing aids, but still can’t remember where he put his keys.