In 1900, the number of Americans who lived past the age of 65 amounted to a mere 3.1 million people. By 2010, more than 40 million graced the nation. Baby boomers were watching more and more of their parents being kept alive by statins, beta-blockers, blood thinners, and diabetes medications, but still they watched them slowly deteriorate, shuttling in and out of hospitals, joining the ever expanding ranks of assisted living facilities. If living longer only meant passing your last years doddering around nursing homes with a drool cup awaiting the arrival of the Great Beyond, who wanted that?
Meanwhile, the cost of keeping the elderly alive was rising by the day. A generation earlier, these souls would have long ago passed away. Yet here they were, collecting Social Security and Medicare, enriching the pharmaceutical industry, and creating more patients for the world’s hospitals than ever. In 2010 the National Institutes of Health (NIH) projected that by 2020, the cost of cancer care in the United States would top $157 billion a year—and the disease struck down the elderly far more than anyone else. The same went for treatments of old standbys like heart disease and arthritis, plus the latest new killer: dementia. Bodies were lasting longer, but brains were blinking out. Thirty-five million people had been diagnosed with some form of dementia around the world, and if the situation didn’t change, the experts at the World Health Organization projected the caseload would triple to 115 million by 2050. The bill? Six hundred four billion dollars a year: one percent of the entire world’s GDP.5
Not that anyone for a moment preferred a quick death over these treatments. But how long could this go on? Many experts simply assumed this was the tattered world in which most of the aged would live. Gerontologists meditated on how the thinning ranks of the young could possibly handle the economic sinkholes boomers would create as they became the next generation to fall to pieces—not just in the United States, but also throughout western Europe and Japan, and the other so-called advanced nations. In Japan, businesses were now delivering more diapers to the elderly than to infants and toddlers!
Policymakers perceived a supreme irony: Long life was creating an epidemic of new diseases. And baby boomers were not pleased with the results. They knew all too well how the body breaks down, and gerontologists could run the numbers for them in excruciating detail. Maximum lung capacity drops 40 percent between the ages of 20 and 80. At age 40, the eyes have difficulty seeing up close; heart rate drops 25 percent by age 75; half of a 30-year-old man’s muscle mass disappears by the time he is 60; spinal disks are habitually crunched, bulged, or ruptured; bones weaken and veins twist. Arthritis and osteoporosis set in like some biological cat burglar. At 70, memory and reaction time begin to sputter. And this happens in people who are in reasonably good shape!
Yet—and this was the strange thing—this only seemed to add to the boomer mentality. All things were possible, right? So maybe there was some way to stop aging and maintain youth. Hadn’t all the medical advances of the past century proved just that again and again? In the baby boomer’s mind, if you were sick, you simply went to the doctor and were taken care of. It had always been that way. A shot, an antibiotic, a pill, a knee replacement, an MRI—some drug or treatment; there was always a solution, or at least that was the expectation. For boomers, invincibility was a birthright, and under no circumstances was the status quo acceptable.
Nevertheless, aging itself—the true molecular underpinnings of it—refused to knuckle under. Only now were some mainstream researchers beginning to grapple with its complexities. Truthfully, no one really knew what aging was. A disease? A series of diseases? Just the natural order of things, impossible to change, like it was impossible to travel faster than the speed of light?
Back in 1961, American anatomist Leonard Hayflick had found that if you put fresh human fetal cells into a petri dish and let them divide, they would hit their limit at 40 to 60 divisions, then give up the ghost. It was called the Hayflick limit, and it reinforced the idea that dying was a natural—and unstoppable—process.
In 2013, scientists from 10 top universities and institutes around the world published a paper entitled “The Hallmarks of Aging” in the scientific journal Cell. It outlined in yet more detail the many captivating ways the body deteriorates: genomic instability and mitochondrial dysfunction, stem cell exhaustion, and cellular aging. The free radical theory of aging explained how rogue oxygen cells insistently damage DNA like little bombs; the telomere theory held that each time a cell divides, its life span grows shorter until it can no longer be replicated; and the DNA repair theory said we simply lose our ability to effectively restore our cells as we age. Some scientists thought maybe marauding retrotransposons—scoundrel snippets of replicating genes—bogged down our DNA, or the cross talk between each of our own cells and the mitochondria within them became increasingly garbled. Any, or all, of these could be the source of our collective and inevitable doom.
Nor did researchers think aging was simply a matter of a body’s cells breaking down like an old machine. Yes, the brutal hammering that life inflicts on DNA in every body every second—upwards of 10,000 insults a day, per cell (that’s ten thousand hundred trillion hits a day)—takes its toll at the hands of common culprits like radiation from sunlight, chemicals in food and water, mental and emotional stress, and the work of dealing with rogue oxygen molecules (those itinerant free radicals). But that was only the half of it. Usually evolution’s marvelously maximized molecular systems repaired this damage, and the human body continued to function just fine. But with age, the repair mechanisms themselves start to break down—and that accelerates the sabotage.
You could think of the whole arrangement as a recipe. Researchers had known for a long time that DNA doesn’t simply hold the instructions for replicating a cell; it also acts as the operating manual for the cell itself, in the way a recipe tells a chef how to combine all the right ingredients at just the right time and in just the right way to make a fabulous soufflé. When we’re young, the recipe works fine. But imagine a recipe whose key instructions slowly become blotted out with dabs of butter, or some misplaced relish. Or imagine the words disappearing to the point where the cook starts guessing at, or eliminating, the recipe’s instructions. Then the soufflé might not work so well.
Thus it is with living and dying—or at least, that’s what many researchers think. The more smudged and ragged the DNA, the more proteins and ribosomes and enzymes cease to do what they once did so well in their youth—the more death stalks us. The instructions DNA sends—for building muscle and collagen, or white blood cells, heart cells, or sheathing for nerves—begin to unravel; as a result, proteins stop folding the way they should. After a while, individual cells become so compromised that they no longer function properly, at which point still more unraveling occurs.
In some cases, the cell concludes that it’s doing more damage than good and commits hara-kiri—something biologists call apoptosis. One theory is that a cell’s decision to kill itself is evolution’s way of reducing cancer, which happens when cells go sideways and begin dividing uncontrollably. Apoptosis is a fine evolutionary fix that removes damaged cells in the short term, like the weekly trash pickup when you are young. But in the course of life, even the trash system starts to break down and fails to show up, leaving even more dead and damaged cells behind.
Scientists had also learned that not all damaged cells repair themselves or commit suicide. Some simply become “senescent”—useless, but alive enough that they aren’t scooped up and removed as dead. They serve no other purpose except to cause trouble, a little like the zombies of The Walking Dead. And over time, they accumulate. Unlike cells that kill themselves, senescent cells can lead to cancer, which is one theory that explains why cancer increases with age. And if they don’t cause cancer, then their misfiring DNA can produce proteins and enzymes the body doesn’t need or want: loose cannons that begin ransacking the body’s good cells, burdening an already battered body as it ages. In the end, hearing and eyes falter, major organs—including the brain—fail, strength diminishes, the heart stops, and we die.
Clearly, where aging was concerned, there was no shortage of Need. The market and the desire for a long and healthy life were immense. But was there anybody out there with the Will to actually do something about our inevitable and universal demise?
As it turned out, there was.