We are on the verge of a breakthrough in anti-ageing remedies. Stretched out before us is a blissful vista where our newly youthful selves frolic in perpetual prime. The only cloud dampening our spirits is the knowledge that we have been standing on this verge for at least 5,000 years already — which is, frankly, playing havoc with my arthritis.
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As Easter celebrations remind us, the dream of defeating ageing and death is an ancient one — as too is the belief that victory is imminent. St Paul thought that the resurrection of Jesus presaged an all-out raising of the dead within his lifetime. Long before that, medical papyri show that the ancient Egyptians were working on an elixir of eternal youth (mummification was merely Plan B). Detailed records reveal that the first emperor of China, having unified that great land in 221BC, focused all its resources on achieving immortality.
Some might be tempted to see a great gulf between the magical thinking of ancient times and the methods of modern science. But this would be a mistake. For one, those civilisations were based on immense technical accomplishments in fields from metallurgy to medicine; their subjects had good reason to believe they were on the verge of further breakthroughs. Second, modern science is also replete with wild claims and false elixirs. In the 19th century, the Harvard professor Charles-Édouard Brown-Séquard lauded the rejuvenating effects of injecting oneself with crushed animal testes; while the effects were entirely make-believe, his claims nonetheless helped launch endocrinology, the study of hormones. In the latter part of the 20th century, the double Nobel Prize-winning scientist Linus Pauling claimed that megadoses of vitamin C were a cure-all, briefly giving false hope to thousands.
So could the 21st century be different? Three eminent academics argue that it might. Indeed, scientists do not come much more eminent than Sir Venki Ramakrishnan, a professor at my university, Cambridge, who won the 2009 Nobel Prize in Chemistry for his work on ribosomes, the tiny parts of cells that make proteins. His new book, Why We Die , is a wonderfully readable introduction to anti-ageing research, spicing up the science with vivid analogies and potted biographies of the real people behind the discoveries.
Similarly, How We Age by Coleen T Murphy, director of Princeton University’s Paul F Glenn Laboratories for Aging Research, provides a lucid and detailed overview of the field for a more advanced readership. And The Longevity Imperative by Andrew J Scott, a professor of economics at London Business School, is a compelling examination of the socio-economic consequences of humans living longer lives.
All three authors lay out why this time might indeed be different. The field of gerontology (the study of ageing) has now emerged from its association with crackpots and ruined reputations to become a boom area. To a large extent, this is because it has been put on a much firmer foundation by many real breakthroughs in genetics and molecular biology during the past half century. As a consequence, anti-ageing research is now increasingly well funded ($5.2bn went into geroscience companies in 2022, according to Scott), with cash-rich start-ups poaching top university talent in a way that mirrors the AI boom of the past decade.
What gives most hope to optimists is the fact that it is now possible to reliably extend the lifespans of a whole range of “model organisms” in the lab. Both Murphy and Ramakrishnan provide fascinating accounts of the importance of work with yeast, fruit flies and mice. These species’ short life cycles — 40-50 days in the case of fruit flies — allow experiments that would simply not be possible with humans. Much of Murphy’s own research has been with the tiny nematode worm C elegans , which possesses only 959 cells (by comparison, we have more than 50 trillion). She explains how the discovery in 1993 that a mutation in a single gene could double the worm’s lifespan gave new hope — and credibility — to anti-ageing research.
Since then, one intervention in particular has been shown repeatedly to work across species: caloric restriction (CR), which can slow ageing and the onset of age-related diseases by 10 to 30 per cent in flies, mice and even monkeys. About as much fun as its belt-tightening name suggests, CR involves consuming only two-thirds of the usual calorie intake. Despite reported side effects that range from crankiness and brain fog to impotence and infertility, many humans are trying it out.
The race is now on to uncover exactly why caloric restriction promotes longevity, in the hope that the effects can be replicated without needing to live in a state of grouchy semi-starvation. One compound in particular is showing promise in mimicking CR: rapamycin, named after Rapa Nui (Easter Island), where it was first found. Ramakrishnan tells the extraordinary story of scientific serendipity, curiosity and perseverance that led to the discovery of this small but powerful molecule, a product of soil bacteria that was first developed for its antifungal properties. Rapamycin seems to flick the same protein switches as caloric restriction, but without the depressing diet.
However, rapamycin is also an immunosuppressant, meaning that its long-term use could increase the risk of infection. This is a perfect example of the immense complexity of biological systems, and the countless trade-offs our bodies must make every day. Ramakrishnan and Murphy are both expert guides to this complexity, making clear how much we still don’t know, as well as what we do.
These surveys of the state of the art give the impression that breakthroughs for human longevity are not inevitable. But they’re also not impossible, given our increasing understanding of the underlying mechanisms of ageing. Average life expectancy has already topped 80 in many countries — which means half the population are living beyond that. In other words, longer lives are already a reality, and much longer lives are a distinct possibility. In The Longevity Imperative , an important and timely book, Scott argues that we need to take all this a lot more seriously.
The imperative, as Scott sees it, is to reshape our world so that as many people as possible can enjoy the benefits of longer lives. He is keen to shift the narrative away from that of “the ageing society”, with its connotations of ever more decrepit seniors dependent on a dwindling number of put-upon young workers. This narrative encourages already rampant ageism, he argues, based on medical models that define ageing only in terms of decline, and economic models that dismiss older people as unproductive burdens. Instead, he advocates for a “longevity society” that celebrates, and plans for, the fact that unprecedented numbers of people can expect to live for close to a century.
Realising this utopia requires people not only to live longer, but to stay healthy for longer. However, currently, the proportion of life we spend in poor health is staying steady as lifespans extend, or even increasing — which means that the absolute number of years suffering from age-related disease is going up.
The irony is that we already know what helps to preserve health: regular exercise, avoiding stress, eating well (plants and olive oil instead of beer and burgers), quitting smoking, staying sociable and so on. These measures aren’t as sexy as popping a pill that resets our inner clock, but they are proven to work, with no ill side effects.
In what might be a sign of things to come, Murphy describes an experiment from 2009 in Albert Lea, Minnesota — the Blue Zones Project — aimed at helping people make just such healthy choices, including walking instead of driving and eating more veg. She notes that the city has reported millions of dollars in savings in healthcare costs, mostly arising from reduced smoking and obesity. The project has now been rolled out in other locations.
This illustrates one of Scott’s key points: the economic dividend of longer, healthier lives is potentially enormous, with lower health and care costs and greater productivity. He estimates a boost of 3-4 per cent of gross domestic product every year. But to achieve this we will need to make changes. For a start, the retirement age will either have to go up or be abandoned altogether. Longer lives mean either longer working lives, or spreading one’s lifetime earnings more thinly. Scott clearly favours the former, supported by investment in adult education and retraining, career breaks and jobs redesigned to suit older workers.
Still, a longer life of hard grind is not on everyone’s wish list. Ramakrishnan cites a Pew Research Center study that found over half of Americans thought slowing ageing would be bad. Many people have mixed feelings about the prospect of endless days ahead. Which brings us back to the Easter weekend. As we unwrap chocolate eggs in an ancient ritual of hope and renewal, are we really ready for what we wish for?
Why We Die: The New Science of Ageing and the Quest for Immortality by Venki Ramakrishnan Hodder Press £25/ William Morrow, $32.50, 320 pages
How We Age: The Science of Longevity by Coleen T Murphy Princeton University Press £30/$35, 464 pages
The Longevity Imperative: Building a Better Society for Healthier, Longer Lives by Andrew J Scott Basic Books £25/ $32, 336 pages
Stephen Cave, director of the Institute for Technology and Humanity at the University of Cambridge, is author with John Martin Fischer of ‘Should You Choose to Live Forever? A Debate’
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