Biogerontology Paper Now Online

My paper entitled "Framing the Inborn Aging Process and Longevity Science" is now published on the "Online First" section of the journal Biogerontology. Here is the abstract:

The medical sciences are currently dominated by the ‘‘disease-model’’ approach to health extension, an approach that prioritizes the study of pathological mechanisms with the goal of discovering treatment modalities for specific diseases. This approach has marginalized research on the aging process itself, research that could lead to an intervention that retards aging, thus conferring health dividends that would far exceed what could be expected by eliminating any specific disease of aging. This paper offers a diagnosis of how this sub-optimal approach to health extension arose and some general prescriptions concerning how progress could be made in terms of adopting a more rational approach to health extension. Drawing on empirical findings from psychology and economics, ‘‘prospect theory’’ is applied to the challenges of ‘‘framing’’ the inborn aging process given the cognitive capacities of real (rather than rational) decision-makers under conditions of risk and uncertainty. Prospect theory reveals that preferences are in fact dependent on whether particular outcomes of a choice are regarded as ‘‘a loss’’ or ‘‘a gain’’, relative to a reference point (or ‘‘aspiration level for survival’’). And this has significant consequences for the way biogerontologists ought to characterise the central aspirations of the field (i.e. to prevent disease versus extend lifespan). Furthermore, it reveals the importance of shifting the existing reference point of the medical sciences to one that is shaped by the findings of evolutionary biology and biodemography.

Cheers,
Colin

Gene Therapy Success for Brian Disease

Naturenews reports on another important success for gene therapy-- treatment for ALD (adrenoleukodystrophy), a rare, inherited metabolic disorder that afflicts young males.

ALD results in severe degeneration of the structure that is crucial for brain-cell function and most die before adolescence.

Here is a sample from the news story:

Researchers have halted a fatal brain disease by delivering a therapeutic gene to the stem cells that mature into blood cells.

The gene was transferred using a virus derived from HIV, a technique that researchers have pursued for more than a decade but has not been successful in humans until now.

...."It's a huge advance," says Mark Kay, director of the Program in Human Gene Therapy at Stanford University School of Medicine in California. "If you look in general at the vectors we use for gene therapy, we've really come a long way. This is the first successful use of lentiviral vectors, and it gives me a lot more cautious optimism moving forward."

The research article of the study is published in Science (paper here).

Cheers,
Colin

Science Paper on Dynamics of Inequality

The latest issue of Science has this interesting article on the intergenerational wealth transmission and the dynamics of inequality. Here is the abstract:

Small-scale human societies range from foraging bands with a strong egalitarian ethos to more economically stratified agrarian and pastoral societies. We explain this variation in inequality using a dynamic model in which a population’s long-run steady-state level of inequality depends on the extent to which its most important forms of wealth are transmitted within families across generations. We estimate the degree of intergenerational transmission of three different types of wealth (material, embodied, and relational), as well as the extent of wealth inequality in 21 historical and contemporary populations. We show that intergenerational transmission of wealth and wealth inequality are substantial among pastoral and small-scale agricultural societies (on a par with or even exceeding the most unequal modern industrial economies) but are limited among horticultural and foraging peoples (equivalent to the most egalitarian of modern industrial populations). Differences in the technology by which a people derive their livelihood and in the institutions and norms making up the economic system jointly contribute to this pattern.

Cheers,
Colin

Nature Editorial on Gene Therapy

The latest issue of Nature has this insightful, and refreshing, editorial on renewing our optimism for gene therapy. Here is a sample:

In the early 1990s, when the first human trials got under way, it seemed to many that the era of gene therapy was at hand: the techniques of modern molecular biotechnology would make it possible to repair genetic defects by inserting healthy DNA directly into a patient's cells. The excitement was short-lived. Lasting effects proved difficult to obtain in early trials, and the community quickly grew sceptical. Then, in 2003, when it was announced that several gene-therapy patients in a Paris-based clinical trial had developed leukaemia, and that one of them had died, the mood became bleak. Subsequent reports of successful and effective gene-therapy trials have done little to lift the prevailing sense of doom. For most researchers, gene therapy now seems like a dead end.

....To reverse this trend, it is time for researchers and industry to refresh their perspective on gene therapy and to consider its successes with as much intensity as its setbacks. The focus on adverse events has had positive consequences: researchers dissected the exact molecular mechanisms that led to cancer, designed better vectors, devised animal models to test these vectors and developed sophisticated assays for monitoring patients. As a result, both scientists and clinicians now have a battery of extraordinarily refined tools for preclinical and clinical studies of gene therapy. The field is ripe for further successes.

Cheers,
Colin

21st Century Humanism

As a humanist I believe in the equal worth of all human beings. My humanist sentiments open my eyes to the problem of global poverty, the pervasiveness of patriarchy and the dangers of extremism.

My humanist sentiments also open my eyes to the shortcomings of evolution (evident by the prevalence of chronic disease in late life) and the prevalence of "ageism". In this post I will address these latter concerns.

If humanists reflected critically and consistently upon their basic moral convictions, I believe they would become strong advocates of aging research and the aspiration to decelerate human aging. However, most humanists are not (at least yet) strong advocates of this scientific research; indeed many probably oppose this research or at the least do not think it an important priority. In this post I will explain why this is a mistake given the foundational moral premises of humanism.

What separates me from those humanists who ignore or eschew aging research is that I am a 21st century humanist, while they are 20th century humanists. A 21st century humanist endorses the aspirations of 20th century humanists (e.g. racial equality, the elimination of gender, the elimination of world poverty, etc.), but we go one step further by incorporating the challenges of an aging world and the rapid advances in biomedical science into our purview of the demands of justice (see this excellent article which played a major role in bringing me around to thinking more rationally about these issues).

A 21st century humanist recognizes the fact that no person, regardless of race, gender, nationality or *age*, deserves to suffer morbidity and mortality. And thus we ought to aspire to reduce these risks when it is feasible to do so, whether it be by providing access to clear drinking water, bed nets to protect against malaria or developing new drugs that re-programme our metabolism and help protect against chronic diseases.

For the first time in human history, most disease and death this century will occur in late life. Aging will cause hundreds of millions of cancer deaths, strokes, bone fractures, infections, etc. Furthermore, these chronic diseases are extremely costly. The Centre for Disease control estimates that chronic diseases account for 70% of all deaths in the United States and the medical care for people with chronic diseases account for more than 75% of the nation’s $2 trillion medical care costs. (source)

20th century humanists seek to mitigate socially created harm and oppression, whereas 21st century humanism extends the concern for the equal worth of all beyond the harms created by social institutions. 21st century humanism also seeks to mitigate the adverse consequences of natural selection- in particular, the evolutionary neglect that leaves humans vulnerable to late-life morbidity and mortality.

The average age of life expectancy, at birth, in the world today is 67. This means that most people born today will live long enough to suffer one of the chronic diseases of aging, like cancer or heart disease. This is a fate suffered by millions every year now, especially in the developing world (contrary to what most people in the developed world think).

21st humanists ought to be among the strongest and loudest advocates of biogerontology. For the goal of "healthy aging" is one that follows from the core humanist sentiment that the worth of all human life, regardless of chronological age, is equal. Once humanists open their eyes to the reality of today's aging world, appreciate the incredible advances that are being made in the biomedical sciences, and discard their ageism, perhaps they will embrace a public philosophy well suited for meeting the full range of challenges we face in the "here and now" (and in the years to come).

Cheers,
Colin

Biogerontology Paper on Framing the Inborn Aging Process

My paper entitled "Framing the Inborn Aging Process and Longevity Science" has been accepted for publication in the journal Biogerontology.

This paper integrates insights from economics, psychology, evolutionary biology, demography, and epidemiology in an effort to help equip us for tackling this century's greatest challenge-- the rapid rise of chronic disease that accompanies population aging.

This paper is probably my most ambitious paper to date, and was a real labour of love. Here is the abstract:

The medical sciences are currently dominated by the “disease-model” approach to health extension, an approach that prioritizes the study of pathological mechanisms with the goal of discovering treatment modalities for specific diseases. This approach has marginalized research on the aging process itself, research that could lead to an intervention that retards aging, thus conferring health dividends that would far exceed what could be expected by eliminating any specific disease of aging. This paper offers a diagnosis of how this sub-optimal approach to health extension arose and some general prescriptions concerning how progress could be made in terms of adopting a more rational approach to health extension. Drawing on empirical findings from psychology and economics, “prospect theory” is applied to the challenges of “framing” the inborn aging process given the cognitive capacities of real (rather than rational) decision-makers under conditions of risk and uncertainty. Prospect theory reveals that preferences are in fact dependent on whether particular outcomes of a choice are regarded as “a loss” or “a gain”, relative to a reference point (or “aspiration level for survival”). And this has significant consequences for the way biogerontologists ought to characterise the central aspirations of the field (i.e. to prevent disease versus extend lifespan). Furthermore, it reveals the importance of shifting the existing reference point of the medical sciences to one that is shaped by the findings of evolutionary biology and biodemography.

Cheers,
Colin

Cancer Funding in Canada

Today's Globe has this interesting piece on how small the portion of cancer research spent on childhood illness is. A sample:

One dollar in every $30 invested in cancer research goes specifically to research on childhood and adolescent cancers, according to a new report.

In 2007, $13.2-million of the $402.4-million that was invested in cancer research in Canada was aimed at understanding the causes and improving the cancer of younger patients, the study from the Canadian Cancer Research Alliance shows

Now the fact that only 3% of cancer research focuses on childhood illnesses will surprise, and no doubt trouble, many people.

Let me first address the sensibility that spending only 3% of cancer funding on childhood and adolescent cancers is unfair. What most people don't realise is the fact that cancer is predominately a disease of aging. Like other chronic diseases (heart disease, AD, etc.), most people who die of cancer are over the age of 65. So if one wants to spend money on things that will help save more young lives then one should support tackling more prevalent risks. Look here, for example, to see what kills more young people than cancer. For every young person ages 14-24 that dies of cancer, 6 die in accidents, and 3 die from suicide.

Furthermore, the death rates for the young in Canada are very low, especially compared to the morbidity and mortality rates of the aged. This is not to suggest that we shouldn't do more to reduce early life morbidity and mortality (we should), but that any response should be proportionate to the risk. A 20 year-old smoker has a much lower risk of cancer and death than a 75 year-old active, non-smoker. Why? Because aging is the major risk factor for disease and death in Canada.

So while the intuition that it is unfair to spend so much on cancer research for the aged rather than the young misses the mark, there is a legitimate complaint to make here. Once we make explicit the point that cancer research aims, primarily, at benefiting people in late life, how much bang for the buck will it actually yield? Would we be better served investing more money in aging research rather than cancer research?

Imagine, as fantastical as it is, there was no cancer in Canada. That all 200+ types of cancer were eliminated overnight, just like that. How much longer could Canadians expect to live? 10 years? 20 years? 40 years? The answer will no doubt surprise you. If there were no cancer to kill us the *average* life expectancy would rise by about 3 years.

Why is the number so low? Because removing cancer as a cause of death will simply delay, by only a few years for most people, one of the other chronic diseases of aging. So a 75 year-old who doesn't die of cancer will probably suffer a stroke or heart attack a few years later. See this paper in Science for an overview of the estimates of the upper limits of human longevity.

Aging limits average life expectancy to around 85 years. To add real quality of life in late life we need to tackle the major cause of chronic diseases--- aging itself.

So the real problem with the current approach is that by aggressively going after each specific disease of aging, rather than the aging process itself, we pursue a sub-optimal approach to health extension. One that requires much more funding and yields smaller health dividends. Retarding aging would help delay, simultaneously, most these afflictions, thus freeing up more money to spend on improving the lives of young Canadians.

Thus everyone, young and old alike, would benefit from a more inclusive approach to medicine. To get there we need doctors and medical researchers (and politicians and the general public!) to adopt a Darwinian-based approach to health and disease.

The funding numbers for cancer research reveal that cancer research is really striving to help the aged. But the problem is it focuses only on the proximate cause, rather than the ultimate cause, of mortality. If you really want to improve the health prospects of people in late life we should search for ways to modulate the biological clocks we have inherited from our Darwinian past.

Cheers,
Colin