This past year has been one in which I have received multiple medical diagnoses, none are life-ending but they are chronic, debilitating and typical in the elderly. Per this Hippocrates quotation: Old people have fewer diseases than the young, but their diseases never leave them.

Ever resourceful, scientists have approached the issue of degenerative aging in two completely different ways: One, to shorten the time of elder disability (ie compress the amount of time spent in disease), and two, to get rid of old age entirely, replacing it with immortality.

Compressed morbidity: Die at your “normal” age, but live healthy until then

The 1950s were a time when life expectancy AND birth rates increased dramatically. There were fears that over-population would consume our resources and guarantee long lives of chronic illness.  Imagine living to 120 with 50 years of dementia, diabetes, heart failure and pulmonary issues! How frightening that idea is!

A still popular counter-argument was made by Dr. James Fries in a 1980 New England Journal of Medicine publication that the maximum age of death was unlikely to rise much above 83, and that science should endeavor to “compress morbidity” though lifestyle changes.

Compressed morbidity, according to Dr. Fries, was achievable with healthy lifestyle. He particularly examined smoking, obesity and exercise as his variables. I encourage you to read his 1980 paper; it clearly reflects the restless mind which led him to create databases, computer programming, health assessment questionnaires and more to prove his point. Kudos go to him for his persistence and impact, and his conclusions are still generally accepted. You can read his honors and obituary here, noting the irony that he died of a stroke and senility at age of 83 after a lifetime of living healthily.

Immortality

Today, millions are being poured into anti-aging research by Calico (a Google company), Jeff Bezos, and Mark Zuckerberg. The study of anti-aging has reached the molecular level. According to a 2021 MIT Technology review “with the addition of just four proteins, now known as Yamanaka factors, cells can be instructed to revert to a primitive state with the properties of embryonic stem cells. By 2016, Izpisúa Belmonte’s lab had applied these factors to entire living mice, achieving signs of age reversal and leading him to term reprogramming a potential “elixir of life.”…The results of such mouse experiments, while tantalizing, were also frightening. Depending on how much reprogramming occurred, some mice developed ugly embryonic tumors called teratomas.”

Meanwhile, Google’s Calico is  targeting diseases commonly linked with aging in its anti-aging research –always with the potential to extend the overall human healthspan. They are currently working with Abbvie on the development of medications to treat ALS and a rare “vanishing white matter” neurologic genetic disease.

In 2024, it’s hard to argue against the basic common sense of healthy lifestyle, but as Dr. Fries’s own death proved, it will not prolong your life or save you from degenerative diseases. On the other hand, immortality holds very little appeal for most of us. Granted that the anti-aging research may generate treatments for a variety of disabling illnesses, Emily Dickinson wrote “To think that we must forever live and never cease to be. It seems as if Death which all so dread because it launches us upon an unknown world would be a relief to so endless a state of existence.”