Longevity leap: mind the healthspan gap

Abstract

Life expectancy has increased by three decades since the mid-twentieth century. Parallel healthspan expansion has however not followed, largely impeded by the pandemic of chronic diseases afflicting a growing older population. The lag in quality of life is a recognized challenge that calls for prioritization of disease-free longevity. Contemporary communal, clinical and research trends aspiring to extend the health horizon are here outlined in the context of an evolving epidemiology. A shared action integrating public and societal endeavors with emerging interventions that target age-related multimorbidity and frailty is needed. A multidimensional buildout of a curative perspective, boosted by modern anti-senescent and regenerative technology with augmented decision making, would require dedicated resources and cost-effective validation to responsibly bridge the healthspan-lifespan gap for a future of equitable global wellbeing.

Fig. 1. Global aging demographics.

A The world population continues to grow and has reached nearly 8 billion people (bars). A preeminent increase has occurred in those older than 70 years of age (blue line), outpacing those younger than 70 years of age (pink line). B While in 1950 a ‘youthful’ age distribution (green) typified all geographies, by 2020 a fourth of the globe had transitioned to an ‘aging’ structure (white). Forecasts for 2100 imply that over 80% percent of all territories/areas will exhibit an ‘aging’ or ‘advanced aging’ composition (orange). Percent of population ≥70 years of age is stratified and color-coded in <10% (green), 10–20% (white), and ≥20% (orage) strata.

Fig. 2. Healthspan-lifespan gap.

Lifespan is the total number of years lived by an individual. Healthspan is the number of disease-free years lived. Life expectancy and health-adjusted life expectancy are population-level measures of lifespan and healthspan, respectively. A gap of 9-year is deduced from comparing 2020 data for median probabilistic projection of life expectancy and health-adjusted life expectancy.

Fig. 3. Healthspan extending toolkit.

Healthspan extending strategies are comprehensive, relying on the unison of social, clinical and scientific programs. Societal initiatives include public health promotion and targeting of social determinants. Augmented decision making, harnessing multimodal datasets, has enhanced clinical management in the elderly. Breakthroughs in the anti-senescence and regenerative arsenal aim at curative solutions.

Fig. 4. An equitable healthcare horizon.

Healthy longevity mandates synchronized achievements at the individual, community, and global level. For each individual, holistic lifelong care must encompass validated healthspan expanding options. Freedom from disease and integration within the community must be ensured. Globally, in diverse populations, access to next-generation cures must be guaranteed to equitably reduce the healthspan-lifespan gap.