Eternal youth has attracted the minds of people - I'm not afraid to say - for thousands of years. But let's imagine that we finally get to this goal. What will happen next? In the 1850s, life expectancy in many parts of the world was only 40 years. Today that number is already confidently reaching 78. The latest medical research teases us with the promise of further extension of human life. What will be the consequences if medicine gets its way? How will society change?
The first thought that comes to mind when trying to answer this question is a gloomy, overpopulated future in which decisive measures are being taken to combat overpopulation and, in fact, a population struggling for scarce resources. The need for strict population control is not pure fantasy: until recently, China had a one-child policy due to its rapidly growing population in the 1970s.
It may seem that a longer-lived society will lead to an increase in population, but the reality is the opposite. Population growth is determined to a greater extent by the birth rate and mortality rate, when the former exceed the latter. "In the short term, falling mortality leads to an increase in population," says Jane Falkingham, professor and director of the Population Center at the University of Southampton. "In the longer term, fertility is the engine, not mortality."
Recent clinical trials in mice have shown that diabetic animals who took the drug metmorphine, first introduced in 1957, live longer than non-diabetics who did not. It has been suggested that metmorphine may protect against underlying aging and not just type 2 diabetes.
However, there are several possible pharmaceutical therapies that can not only protect against aging but actually reverse the effects of aging itself.
The almost vampiric practice of older people receiving blood transfusions from young donors has been found to have some medical validity. This fascination with the potentially life-giving properties of blood was first taken up by the German doctor Andreas Libavius in 1615 when he tried to connect the arteries of a young man and an old man.
Libavius was confident that he had succeeded, and the results of experiments in 2005 showed that the idea was promising. Older mice became healthier with younger blood, and younger mice infused with the blood of older mice got sick. However, the risks associated with blood transfusions, such as lung injury and infections, should not be ignored.
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And yet, treatments are being developed that are less controversial and often prove effective in laboratory tests.
Mice that had older cells removed - those that can no longer divide to create new cells - with Foxo4-DRI injections lived longer. This compound significantly interferes with the normal process that causes cells to stop dividing. These mice are now 30 months old, the equivalent of 100 human years, and remain active, proving that the effect is not temporary.
“If you target the so-called bad senescent cells, which are not needed because they become old and irreparably damaged, health can be prolonged and even restored to some extent,” explains Peter de Keyser of the Department of Molecular Genetics at Erasmus University Medical Center. "By targeting these cells, you can not only delay aging, but reverse it to some extent."
Meanwhile, Calico, a division of Google's parent company, Alphabet, intends to apply cutting-edge technology to understand the biology that drives life expectancy and use that knowledge for interventions that will help people lead longer, healthier lives.
So, what would be the consequences if all of these methods succeed in drastically extending life? One of the possible problems for people living longer will be that this will not solve the problem of overpopulation and the growing population in general, which have exacerbated in the 21st century.
In 2015, the number of births to mothers in England and Wales averaged about 1.8 mole rats. As societies become more educated and health improves, families will have a biological imperative to have many children to compensate for the problems of survival with excess populations. In addition, the average age of women giving birth has increased to 30.3 years, and the number of women who do not want children is growing. “Many countries have moved on to these targets,” says Sarah Harper, professor of gerontology at the University of Oxford.
There is also an ethical conundrum that, if the treatment of aging becomes available to all, heightens the danger of a two-tiered society of those who have access to treatment and who do not. We already live in a society of serious social inequalities. “A child born in the slums of Nairobi has far fewer life paths than a child born in Kensington (London),” says Falkingham.
If the treatment for aging is spread evenly, we will face an increase in the elderly population.
The oldest living person who ever made the list was Jeanne Kalmant, who lived to be 122 years old (from 1875 to 1997). Since healthcare has improved steadily since then, it is surprising that this record has not yet been broken. However, it seems that we are genetically predisposed to death after reaching a certain age. “In 2016, there was an article that argued that we couldn't live longer than 120 years,” de Keyser says.
Others think differently. Aubrey De Gray, a professor at the SENS Foundation, believes that human life expectancy can reach up to 1000 years. But very few agree with him.
Many seniors struggle with diseases such as cancer, heart problems, dementia and others. Much of current medical research is not about living longer, but about living healthier longer and delaying ailments. “It’s much better to put all our resources on ensuring that everyone has a long and healthy life,” Harper says.
Anti-aging treatments can address the physical aspects of aging, but they do not address the mental and neurological elements such as Alzheimer's and senile dementia, that is, dementia. At the same time, the number of reported cases of dementia is decreasing. One theory is that just as we keep our bodies active, our bodies are slower and degrade, so there is an argument that if we can keep our mental activity active, we will get rid of dementia, Harper said.
Another aspect affecting a long and healthy life is that our chronological age becomes meaningless in determining our lives. We see 40-year-old women giving birth for the first time, and we see 40-year-old women who become grandmothers. Despite their common age, their lives are completely different.
Even though we are living longer, our 20s and 30s remain demographically dense because we still have children and begin our careers during these years. “By extending life expectancy, we are not changing our biological time,” says Falkingham. "Women still give birth at 20-30 years old."
Anti-aging treatments are also expensive. Even if the Foxo4-DRI treatment is approved for use in humans, it will cost in the order of several thousand euros for 10 mg. What about blood transfusions? Everything is limited here. Not many people from the population, as a percentage, become blood donors. And they certainly will not want to donate blood so that someone else will cancel their old age.
The lack of supply also increases opportunities for the black market, where young people are forced or bribed to donate their blood, as well as unlicensed dealers selling counterfeit blood plasma or not suitable for transfusion. Don't forget that the healthcare industry has become a lucrative sector for organized crime. The distribution of counterfeit pharmaceutical products on the Internet is especially dangerous.
We will need incredible advances in our understanding of human science in order to completely prevent aging in people and also to maintain their quality of life at a good level. The ethical, cultural and sociological issues of eradicating aging will have to be thoroughly discussed.
“Part of being human is that our life is not endless and we divide it into chunks,” concludes Harper. "It is much better to invest all our resources in ensuring that everyone has long and healthy life paths, instead of a few people living a little longer than others."
Ilya Khel
