Monday, May 12, 2008

Are You Guilty of Gerontologiphobia?

Ask yourself the following questions:

(a) Do you think it would be a good thing if fewer people died of cancer?

(b) Do you think it would be a good thing if fewer people died of heart disease?

(c) Do you think it would be a good thing if fewer people died of diabetes?

(d) Do you think it would be a good thing if fewer people died of infection?

(e) Do you think it would be a good thing if fewer people died of bone fracture?

Now ask yourself this:

(f) Do you think it would be a good thing if all of the above (a-e) could be accomplished?

I suspect most people would say “yes!”; that it would be wonderful to accomplish such laudable goals.

What if I told you that we could possibly achieve these goals but it would take some public funding, some time and some potential risks?

Assuming the money, time and risks were not too substantial, you probably would say “Let’s go for it!”

But what if I said this could possibly be accomplished by manipulating human longevity? ………..errrhhh… I hear the brakes screeching!

This last step will no doubt result in my losing many people who were, up till that stage of things, on board with the aspirations I was outlining.

So let’s see why people are likely to protest achieving these goals by manipulating longevity.

Is it the costs? Well, aging research is actually grossly under funded. As Jay Olshansky et. al. point out in this excellent paper, in 2006 the NIH was funded at $28 billion and yet less than 0.1% of that funding was spent on understanding the biology of aging and how it predisposes us to a vast array of costly diseases and disorders expressed at later ages. So we are spending billions pursuing each of (a) through (e) and yet very little on something that might accomplish all of these things at once (f). That doesn’t make sense does it?

Is it the time scale? Maybe people think retarding aging is something that would only happen, if ever, in the very distant future. "We shouldn’t waste our time pursuing interventions that will likely benefit people in 500 years when there are so many problems to deal with now" one might argue. Again, this response is not persuasive given that (1) aging research (despite being poorly funded) is rapidly progressing and the time scale for real tangible benefits- especially if we invested sufficient funds- is much smaller than most people would expect. Recall this post, the first anti-aging molecule is going to be tested in humans this year! So the science is much further along than most people realize.

And (2) given the magnitude of the benefits at stake in (f), our attitude towards the time scale issue needs to be consistent. Few people are willing to abandon cancer research or research into heart disease just because it might take some time to make serious headway on these diseases. Given that retarding aging could accomplish much more than eliminating any one disease could accomplish, it doesn’t make sense to single out the science of longevity for disparagement.

Is it the risk? Perhaps some believe that you could never safely apply an anti-aging intervention. Of course one must bear in mind that nothing in life is “risk free”. All the things in (a) – (e) have risks for us (indeed they kill millions every year). Would it be better to remain in the biological “status quo” of being intrinsically vulnerable to the diseases of aging versus pursuing an intervention that could reduce these risks (even if such an intervention had some risk of harm itself)? The devil is really in the details. I agree that how we could sensibly manage the risks in such a case is a challenging issue (especially if the intervention is to be pursued early in life), but it is not unprecedented. Vaccines, for example, have some risks associated with them yet their benefits far outweigh those risks. And the same applies for almost every medical intervention. So it is not rational to pick out the modulation of the aging process for special attention in this regard. [for more on my thoughts on this topic, see this article]

I recently read this excellent article by Richard Miller. He posits nine reasons for the current neglect of aging research. These range from scientific obstacles- like the time it takes to complete aging experiments in mammals- to political obstacles like the scarcity of lobbyists for basic aging research (compared to the lobbies for specific diseases like cancer or Alzheimer’s). One major obstacle that Miller specifically draws attention to as an impediment to manipulating longevity is what he calls “gerontologiphobia”. He describes this as follows:

There is an irrational public predisposition to regard research on specific late-life diseases as marvelous but to regard research on aging, and thus all late-life diseases together, as a public menace bound to produce a world filled with nonproductive, chronically disabled, unhappy senior citizens consuming more resources than they produce. No one who speaks in public about longevity research goes very far before encountering the widespread belief that research on extending the life span is unethical, because it will create a world with too many old people and not enough room for young folks.

Are you guilty of gerontologiphobia? This is a serious question we must all consider. For our attitudes towards aging and the science of longevity could stifle one of the most significant medical breakthroughs we could make this century. Retarding aging would significantly improve the health prospects of all persons who are susceptible to aging.