Innovating aging: promises and pitfalls on the road to life extension

Abstract

One of the main benefits of the dramatic technological progress over the last two centuries is the enormous increase in human life expectancy, which has now reached record highs. After conquering most childhood diseases and a fair fraction of the diseases that plague adulthood, medical technology is now mainly preoccupied by age-related disorders. Further progress is dependent on circumventing the traditional medical focus on individual diseases and instead targeting aging as a whole as the ultimate cause of the health problems that affect humankind at old age. In principle, a major effort to control the gradual accumulation of molecular and cellular damage - considered by many as the ultimate cause of intrinsic aging - may rapidly lead to interventions for regenerating aged and worn-out tissues and organs. While considered impossible by many, there really is no reason to reject this as scientifically implausible. However, as we posit, it is not only scientific progress that is currently a limiting factor, but societal factors that hinder and may ultimately prevent further progress in testing and adopting the many possible interventions to cure aging.

Fig. 1

As in other developed nations, in the US, median age at death (left) has increased dramatically, but now appears to level off. Simultaneously, death rates (right) have fallen increasingly fast for both sexes, although very recently there has been no further decline for women. Source: Actuarial Study No. 120. Life Tables for the United States Social Security Area 1900–2100. (Felicitie C. Bell, Michael L. Miller)

Fig. 2

New drug approvals by the US Food and Drug Administration versus R$D expenditures from 1963 to 2008. From ref. .

Fig. 3

NIH funding from fiscal 1994 to fiscal 2012. The dotted line and asterisks show the addition of ARRA funds in fiscal 2009 and 2010. From: The National Institutes of Health (NIH): Organization, Funding, and Congressional Issues. Judith A. Johnson, Pamela W. Smith. Congressional Research Service 7–5700 www.crs.gov R41705.