Aging: Raising the Stokes of Healthfulness

Excerpted from
Inevitable Surprises
By Peter Schwartz

How old is that stranger across the room who appears to be 40? These days he or she might well be 50, 55, or even 60. A few years from now it may be hard to distinguish a 40-year-old from a wealthy 80- or even 90-year-old individual. The physical deterioration of aging is about to be dramatically slowed down, and in some ways even reversed.

As members of the baby-boom generation-those born between 1948 and 1962-become elders, they will tend to be far more noticeably younger looking, younger feeling, healthier, and more active than any of their predecessors. People will be vigorous and alert long past the boundary of what was once considered old age. Elders in the future-including many of the people reading this book-will work, travel, read, enjoy a full sexual life, remain athletic, and possibly even raise young children in their sixties, seventies, eighties, and nineties, with far fewer of the infirmities of aging than people at similar ages today.

The reasons for this are technological. The development of new instruments, the mapping of the human genome, the increasing research into nanotechnology, and the evolution of biogenetic and pharmacological research in general have all combined to accelerate each other. As any investor in biotech companies knows, biomedical research often fails to pan out; thus, we can't assume that any research under way in laboratories will be inevitably successful. For example: In 2002 a genetically engineered compound called imatinib mesylate, which is sold as the prescription leukemia drug Gleevec by the Swiss pharmaceutical company Novartis, turned 10 percent of patients' hair from gray back to their original hair color in a set of French field trials. Novartis immediately announced publicly that they were not researching Gleevec as an antiaging medicine. But they (or others) have a very great incentive to isolate the hair-color-restoring factor and produce it for the public. My own hair, which is now gray, was once a strong natural red. Will I get that pigment back in five years or so? It's hard to imagine that I could.

But you might have said the same, fifteen years ago, if you'd asked if I could have the eyesight of a 7-year-old again. Or you might have argued that drugs to boost memory would always be placebos. Yet in 2002 a company called Memory Pharmaceuticals, cofounded by Nobel laureate (in medicine) Eric Kandel, announced six new drugs for the treatment of severe memory illnesses like Alzheimer's disease and dementia. These drugs, some of which stimulate enzymes that affect neuron effectiveness in various parts of the brain linked to memory, are also likely to improve short-term memory functioning for the broader aging population. Skin quality, bone strength, hearing, muscle tone, resistance to disease, and sexual potency-all have already been shown to be enhanceable through drugs, laser treatments, or other means. The drugs and treatments that enhance them will become increasingly sophisticated, powerful, and popular. At the same time almost all the degenerative diseases of aging-arthritis, osteoporosis, and various autoimmune diseases-will have been eliminated.

In his Red Mars/Green Mars/Blue Mars trilogy, science fiction writer Kim Stanley Robinson posited that "whole-body" treatments to reverse cellular aging could emerge by the end of the twenty-first century. In fact, the first such treatments for aging have already been administered, with mice as subjects. These research efforts use genetically engineered viruses to bind new genes into a cell's DNA.

Much is unknown about this: Can the treatment be applied to human beings? What will be the side effects? And how successful will it be? But this is only one avenue of research, and within the next twenty years such announcements will proliferate. We will see more drugs, both internal and external, aimed at stopping cell decay through genetic intervention. Cyborg implants-machine augmentation of human physiological capability-will move out of the realm of catastrophic surgery and prosthetics, and prolong our everyday quality of life. Cochlear implants to deal with hearing loss are becoming common. Growing new glands to replace defective ones may be the next generation implant. Human habitats will become more and more oriented toward the reinforcement of longevity; research into cloning will ultimately yield cloned cells or implants that rejuvenate our existing physical selves.

Each of these innovations, in itself, will have relatively small effect. Some will fail. Others, while technically successful, will simply represent too much effort or expense for too little payoff (like Rogaine, which never found the vast market of bald men predicted for it). Still others wall make a major difference in fighting particular diseases (Alzheimer's, heart disease, and strokes are three likely candidates) but may only represent small breakthroughs in preventing aging. The significant surprise will come from putting them together. They will all reinforce one another's effects, and the healthy way of life that becomes increasingly possible for more people will accelerate the rejuvenation effect.

What I've described so far is inevitable; the treatments exist today in some form, or are so numerous and well developed that it would take a miracle-or a very strong political movement-to stop them. And while such a political movement is possible, emerging out of religious and social concerns, everything we have seen so far suggests that protests would focus on very narrow issues, such as cloning, which would only partially defer the inevitability of the prevention of aging.

But there are also some uncertainties. The most significant has to do with the efficacy of the treatments themselves. Will they make aging reversible, so that 70-year-olds find themselves looking and feeling more like 30-year-olds? Or will they only be useful for those who are already youthful, allowing 30-year-olds to retain their physical presence while their parents are stuck with the physicality of 60? We also don't know how expensive such treatments will be. They may be rare and limited to a very few, or as commonplace as aspirin, affecting billions of people around the world.

Finally, it's not clear how widespread this trend will be geographically. We don't know, for example, how many political systems will be willing or able to pay the immense costs of developing rejuvenation treatments through national health services in the countries that have them. Already some countries with advanced medical facilities are becoming known as rejuvenation resorts, drawing a growing crowd of people who go there to be made younger. One of the surprising early indicators is the degree to which anti-aging treatments, as they are coming to be called, are popular in the developing world. Unilever executives, marketing the drug Retin-A (Vitamin A) as an ingredient in wrinkle cream, were initially surprised to discover high demand not just in the industrialized world, but in China, India, and Africa.

Even at a minimum, however, we're about to experience a dramatic boom in the capacity to lead productive and full lives after age 60. Many of the readers of this book will live to be 120; many of them will stay fairly youthful until at least age 100. You will look like 40- or 50-year-olds: you will be able to practice athletics, work, read, travel, and enjoy sex. You will lead full lives, even physical lives, unbound (as people have rarely been unbound before) by the infirmities of aging.

This, in turn, will fundamentally change the political and economic institutions around you.