Saturday, January 17, 2009

Aging, Chronic Disease and the "Black Plague"

Blogging has been light the past few weeks as I have been preparing two different talks on aging and aging research that I am giving this coming week.

The first talk will be tomorrow afternoon to Quill here in Kingston. Quill stands for "Queen's Institute for Lifelong Learning". I am really looking forward to getting feedback on this talk which is entitled "Slowing Human Aging: Ethical and Social Issues".

The main message of my talk is that there is both good news and bad news. And one has to be cautious concerning how one frames both of these things. The bad news, in terms of the projected number of human deaths caused by chronic disease (like heart disease, cancer, stroke, AD, etc.), is really bad. Indeed, chronic disease will cause an unprecedented number of deaths this century. This is due to two things: (1) there are more people in the world now than there ever has been before and (2) the world's populations are living to older ages, which makes them more vulnerable to heart disease, cancer, stroke, AD, etc.

So in conveying the current situation one wants to be accurate, and not merely "hype" the cause one is championing (which is something people often do with respect to other important problems, like climate change). OK, so here are the facts:

In the year 2005, approximately 55 million people died. Of that number, 35 million died of chronic disease. That number is twice the number of deaths due to infectious diseases (including HIV/AIDS, tuberculosis and malaria), maternal and perinatal conditions, and nutritional deficiencies. That is a staggering figure. Furthermore, between the years 2005-2015 WHO estimates that 220 million people will die from chronic disease, most of them (144 million deaths) in lower middle income countries like China and India. The diseases associated with aging are not, contrary to popular perception, only a problem for people living in the developed world. Indeed, being vulnerable to disability and frailty is a much greater disadvantage if one lives in a poor society with no decent health care or pension, as the link between income and "ability to work" is much more direct. So the chronic diseases associated with aging are a problem for all societies, not only the richest countries in the world.

One last point to make to illustrate the magnitude of the problem of chronic disease. It is estimated that between the mid-14th century and mid-17th century, the "Black Death" plague killed approximately 25 million people. This means that the current deaths caused by chronic disease in just one year outnumber the deaths caused by 3 centuries of the "Black Death" plague. This clearly illustrates why the imperative to combat chronic disease is one of the greatest imperatives ever facing humanity. And since aging is the major cause of these afflictions, one of the greatest moral imperatives facing humanity today is to tackle aging itself so that we can avoid the unprecedented rise in chronic disease that is expected to befall the world's populations this century.

OK, enough about the bad news. Now for the good news (this is abbreviated as I am pressed for time at the moment). Despite the herculean task facing us-- trying to prevent all the numerous diseases and afflictions that come with aging-- the good news is we don't have to find a cure for every single disease of aging in order to make serious headway in terms of extending our opportunity for health. The shortcut is to modify the rate of aging itself. This is not as outlandish as many might believe it to be. This video, for example, shows how far along the science really is. So does this and this.

What do we need to do?
(1) increase public funding for basic research on the biology of aging.
(2) shift our focus away from the exclusive focus on the proximate causes of disease to the ultimate (or evolutionary) cause of disease.
(3) encourage the kind of interdisciplinary research that will bring together epidemiologists, biodemographers, evolutionary biologists, doctors, etc. to better understand the role aging plays in the development of disease and the possible ways of promoting "healthy aging".
(4) dispel the public's misperception that retarding aging would be a bad thing (e.g. because it would destroy the earth or simply extend the length of time we live as frail) rather than one of the most important things humanity could achieve.

And finally (5) get the public behind evolution rather than holding onto the outdated ideas of our intellectually naive past. We also need to educate people to distinguish between the real science of aging research and quacks who are more than happy to sell products that have not been tested for safety and/or efficacy. And we need to educate people about the risks of aging, and the things they could do themselves *right now* to reduce their risks of morbidity and mortality (like these things).

IF we can decelerate the rate of molecular and cellular damage caused by aging, this would mean that the next generation would experience more healthy years. Nursing homes might become extinct. It would reduce strains on the health care system and society and individuals would reap enormous economic benefits. And these would be benefits that benefit all future generations. And I believe that that is a future worth fighting for!!