S. Jay Olshansky, a professor in the School of Public Health at the University of Illinois at Chicago, thinks there’s a revolution coming in the way we age. But rather than a planet full of 150 year olds, we’re going to see lots of very healthy 80 year olds. The key to this outcome, he says, is slowing down the thing most associated with these diseases: aging itself.
You’re a proponent of slowing aging rather than extending lifespan. Why is that?
Lifespan extension has never really been a goal of aging science nor should it. The reason is that extending lifespan without extending health would be a harmful intervention [in the course of human life]. The last thing you ever want to do is extend the period of frailty and disability and make people unhealthy for a longer time period. So lifespan extension in and of itself should not be the goal of medicine, nor should it be the goal of public health, nor should it be the goal of aging science.
If scientists are successful in slowing aging, how would that change the way we think of older people?
First of all, I don't think we need any of that to change our view of older people. My colleagues and I who have been involved in the World Economic Forum have written an entire book on how we should reconsider our views of older people based on what we see today: Many older people who are highly productive, major contributors to every aspect of society. Our concepts of aging really should be blurring because there are plenty of people who make it to older ages who aren't really any different in many ways than people who are decades younger. So first and foremost we just need to recognize the value of people making it to older age. Now if we succeed in decelerating aging, and extending the period of healthy life, then our concepts of what “old” is will become even more blurred than they are today. Remember, the goal of much of this work is to essentially have it take 60 years to become a 40 year old, or 70 years to become a 50 year old, and so on. So our concepts of aging and the aged will change dramatically. We won't look at somebody who is 70, 80 or 90 in the same light as we do today, as someone who's approaching death, but as somebody who's right in the middle of the prime of their life.
Would a 70 year old who has aged as much as today’s 50 year olds actually look like a 50 year old?
We know from aging science now that people who age more slowly look younger. So yes, in fact, we're talking about every conceivable aspect of the aging process occurring more slowly. Somebody who's older in the future will look like someone who's younger today. Actually, I'm pretty sure this has already happened. If you look at photographs of people who on average are 60 years old today, and you compare them to photographs of people who were 60 years old 100 years ago, there's a dramatic difference. People look much younger today at just about every age relative to decades ago.
And that's just because they're healthier?
Some people are healthier, yes. They've spent decades exercising and eating right, and avoiding the things that make us age more rapidly, like smoking and obesity. Those who are able to avoid these things do seem to grow biologically at a slower rate, and they show it.
What kind of approach do we take currently for dealing with aging?
The approach that we take now is one disease at a time, as if they're all independent of each other. That's how we go after them. That's how we treat them. Those of us in aging science are suggesting a systemic approach focused on aging itself, which would make perfect sense now given the speed at which the demographics are changing.
Tell me about that change.
Demographically, there's going to be a rather dramatic shift that occurs over the next 20 years in which every country across the globe will become an aged population very rapidly. The number of people that are making it to older ages is about to change in ways that we've never seen before. From that point forward, humanity will be much older than it ever was, and so the prevalence alone of older people requires that we take a new approach to diseases and disorders that are expressed at later ages.
What are the risks of focusing on treating one disease at a time?
The Faustian trade of the 20th century was, we got 30 years of additional life, but in return we got heart disease, cancer, stroke, Alzheimer's and sensory impairments. The question is: What Faustian trade are we making now, as we go after heart disease, cancer, stroke and Alzheimer’s? We reduce the risk of these diseases, but because death is a zero sum game, something must rise. The question is: What is it that's going to rise?
Looking forward, what's required to make the necessary advances?
We need to dramatically accelerate research in the field. Right now, there's very little work going on, relatively speaking, in aging science. Most work is focused on diseases. The National Institutes of Health could appropriately be called the National Institutes on Diseases. We need to accelerate funding for this research and we're running out of time. The demographics are changing very rapidly. The potential health and economic impacts are huge. We published an article last year in Health Affairs that illustrated the health and economic benefits of decelerated aging. There's no question everyone would benefit. There's no question countries would benefit. If you're thinking about primary prevention, you should be thinking about aging science.
Interview By Jordan G. Teicher