We were lunching in God’s waiting room, which is what Bob Hope liked to call Palm Springs, when the subject of aging came up.
It was a good table for the subject, because if you were looking for two rational examples of healthy aging, you probably couldn’t do better than my mother, Betty, seventy-six, and her husband, Jerry, seventy-five. They’ve got it down: a simple, sensible diet with an occasional splurge, routine daily exercise, some yoga, lots of socializing, and lots of mental stimulation via travel, books, hobbies, and adult education. They’re the geriatric dream team—sensible, moderate, willing to try new things, and proactive when it comes to seeing their kids and grandkids. They’re not going to sit and ruminate over your not coming to see them. They’ll come to see you.
They are also huge and fairly discriminating consumers of health and medical information, and so it was with some relish that, one day over lunch not long ago, I told them about some new research I’d been reading on aging and health. “You see,” I said, dropping into PowerPoint mode, “the real issue isn’t life span, it’s health span. And what do we know about that? Well, we know that healthy aging is just that—and that what medicine should aim for is lengthening the health span, not the life span.”
They looked at me a little blankly and picked at their salads.
I went on. “And so, that’s led to kind of a new Holy Grail in aging research—the idea of rectangularization of morbidity.”
More blank stares. Forks now on plate. “… ‘cause, see, if you look at aging demographics, you see that the survival curve goes like this …”
I traced a downward-sloping line on the tablecloth with my finger.
“… with increasing sickness and disease as people get older. What we really want to do is make it square off, like this, at, say, age eighty-five.”
I traced a ninety-degree angle, downward.
“What does that mean?” my mom asked.
“Oh, simple,” I said. “It means that the goal of medical and aging research should be to get you to, say, eighty-two or eighty-five in good health, and then you drop off fast, say, in three to six months, without extended illness.”
There was a silence, and I knew I was in trouble.
“Oh,” my mother said, “I don’t go along with that at all….”
“Uh-uh,” said Jerry. “That’s not how we’re seeing it at all.”
“The way I see it, I’m going to live to one hundred and maybe more,” my mother said. “Why not? And a healthy hundred at that!” She picked up her fork and—nicely—stabbed an artichoke heart to death.
I stifled myself from pointing out that their gene pools did not augur well for such optimism, but, at this point, they owned the conversation. I wasn’t taking into consideration something they both seemed to know a lot about: antiaging medicine. They both had a “longevity doctor.” Their treatments included prescription “compounded” hormones, testosterone for him and progesterone cream for her. There were all kinds of things you could do to slow down the aging process.
“But, Ma,” I said, “you know that there’s no evidence that that stuff does any more or less for you than taking prescription hormones!”
“Ah! But there is! The difference is the cream is tailor-made for me! I get a blood test every month to make sure. And Gregory—I know you wrote a book about all this—but I am telling you it works! My skin hasn’t been like this for twenty years! And my energy level too. And I’m not even doing my yoga as much, so I know it’s the cream. It’s definitely making me feel younger. And frankly, Gregory, I don’t even think of aging the same way anymore. Aging, like that I mean, when you really think about it, it’s so unnatural!”
Driving home that day, I thought a lot about that last statement, the notion that aging was somehow unnatural. It was the kind of dimensional shift in perception that leads you to think that, once again, just like that “crazy Internet thing,” modern life has passed you by. Either that, or that everyone around you has gone totally off the grid.
After all, everyone knows that antiaging medicine is bogus, right? Certainly all the right-thinking folk think so. Even the somnolent FDA recently raided a bunch of pharmacies for selling antiaging compounds. The Gerontological Society of America—let’s call it Big G—sponsors seminars on antiaging quackery. A group of Big G researchers has even taken to issuing consensus edicts against antiaging medicine, often noting its more obvious frauds while impaling the whole notion as quackery. Some of these attacks are strangely personal, singling out bona fide researchers who differed from the establishment line as “rogues” and impaling others for being “celebrities.”
But something has bothered others in the fields of aging and medicine about this consensus. When you looked a little harder, you saw that some of the bigger names had refused to sign on. It was too soon to take such a censoring position, they said. Younger scientists viewed it as a generational affront. As a graduate student named Adam Spong, a cell biology researcher at Southern Illinois University Medical School, told me, “Their whole thing is just so, so … postmodern in that 1970s way. I mean, you cannot talk about aging as a disease, because that would be ageist. You cannot talk about something objectively factual—that it is better, physiologically, to be young than be old—without supposedly causing stigma or victimizing the elderly. To me it all stinks of some weird, self-defeating orthodoxy, call it political correctness, if you want.”
In fact, the more one looks at antiaging, or longevity, science and medicine, the more one sees that there is no real consensus about it at all, and that myriad enterprises, both public and private, are forging onward into a brave new pro-longevist world. Consider, for example, that:
Stanford University professor Shripad Tuljapurkar, an expert in population mathematics, projects that anti-aging advances in developed countries could increase life expectancy by a year for each year of the decades 2010 to 2030.
The National Institute on Aging, the country’s federally funded arbiter of gerontology, is now underwriting a long-term, wide-ranging program to test life-span-extending compounds on mice at three leading research institutions. Although designed to debunk commercial claims, the early results have already identified three compounds that extend maximum life span in mice—a huge surprise to the dedicated skeptics running the trials.
Another NIA study, the first on humans, showed that thickening of the carotid artery, a key sign of aging and a risk factor for stroke, was dramatically reduced in practitioners of caloric restriction.
When the noted RAND Corporation asked the nation’s leading gerontologists, cardiologists, and geriatricians about the possibility of a major life-span-extending compound, many were surprisingly bullish, with a number predicting a 50 percent chance of such a compound in the next ten years.
The cofounder of PayPal, Peter Thiel, one of the financial world’s shrewdest investors, has put $3.5 million into a project to do nothing less than “end aging.”
The pharmaceuticals giant Glaxo recently paid $750 million for the development rights to resveratrol, a compound that seems, among other things, to slow the underlying aging process in some lab animals
The head of Rice University’s prestigious environmental engineering department, considered one of the best in the world, is now leading an experiment that will use soil bacteria to target and destroy human arterial plaque, essentially creating a way, in the words of one researcher, to “end arterial aging as we know it.”
The NIH is funding trials in pig-to-primate organ transplantation, hoping to push the science closer to usefulness before current demographic trends worsen and organ demand outstrips supply even more dramatically than at present.
Aging Americans are no longer waiting for breakthrough science or Big Pharma. A soaring number of prescriptions going out the pharmacy door these days is for a hormone-based product, most of them used for antiaging purposes. Instructively, it is almost always paid for in cash.
I come to this remarkable and fast-moving world with my own biases and prejudices. Like most people, I want antiaging medicine to work, especially since men in my lineage don’t tend to live very long. There are loved ones all around me whom I’d like to enjoy a lot longer. And, surprise: I think the bodily and mental degradation that comes with advanced years is cruel, capricious, and unrelenting, and the attempts to maintain one’s dignity in the face of it are too often clownish, pitiful and, ultimately, ineffective. A recent concussion—which resulted in a form of accelerated brain aging and for which I sought treatment in antiaging medicine after conventional medicine failed—drove that point home in a personal way. A jock would say that I’ve got skin in the game.
The more I looked, the more it seemed to me that, over the next fifty years, science, medicine, and technology will transform aging—and the way we think about it. This change will come in ways small and large, its evolution gradual but inexorable, fueled by both self-experimentation and publicly funded trials. Much of it will take place in terra incognita; aging may become easier and more comfortable, but more expensive and even a little riskier, too.
So where does antiaging, or longevity, science come from, what does it tell us, how does it connect (or not) with traditional medicine and medical science, and how will we think of our own bodies as a result? Those are the questions this book will try to answer. To start, we must first go to Tucson, Arizona.