Aging, Disease, and Immortality

• Age-related disease
• Aging

Almost twenty years ago, I gave a talk at the National Institutes of Health and had the audacity to title it “Reversing Human Aging”. Looking up at a packed audience, I said the following:

When I’m done, anyone who leaves this room thinking we can reverse human aging is a fool. Likewise, anyone who leaves thinking we can’t reverse aging is a fool. If any of you have any sense, you’ll leave here saying that you don’t know if we can reverse aging or not, but you need to see the data.

A week ago, I ran into a new book [Adam Leith Gollner’s The Book Of Immortality], an expose of those pursuing immortality, as well as the cults and the “industry” generally. The gist of the book was that the world abounds with charlatans who think they can (or who want you to think they can) reverse aging and let you live forever.

Forever? The world has far too many con men and an unending supply of fools.

On the other hand, there is a universe of difference between the idea of reversing human aging (a scientific question) and the idea of immortality (a theological question). We may well be capable of reversing human aging – we can certainly do it in the lab, but we are incapable of immortality and not simple for technical reasons. Reverse aging, maybe. Immortality, no. You and I are going to die, although the when and the how remain, perhaps thankfully, a little unclear.

Reversing aging – and curing age-related diseases – however, is not the same as immortality.

Just because we may be able to reset the clock of biological aging does not mean that you can survive jumping off a cliff, dangerous driving, living in a war zone, starvation, or Hamlet’s “thousand natural shocks that flesh is heir to”. Nor will reversing aging make you any saner than Hamlet was. If we can reverse aging, it certainly won’t give you immortality. On the other hand, the good news is that you may avoid Alzheimer’s dementia, strokes, heart disease, osteoarthritis, and all the other diseases that undermine our lives and our spirits as we grow older. Preventing age-related disease is fair enough as a goal and, as it turns out, is probably feasible.

Even though reversing aging has nothing to do with immortality, preventing the diseases of aging and reversing the aging process are inextricably linked at the genetic level. To put it concretely, there is no way we can prevent your brain from aging (Alzheimer’s dementia) or your heart from aging (atherosclerosis and heart attacks) unless we can prevent the rest of you from aging at the same time. Which means that if we reverse aging – and extend your healthy lifespan – the only way we can do so is by ensuring that you won’t end up living in a nursing home with dementia, heart disease, bad hips, and shortness of breath.

Fair enough: none of us particularly yearned to live in a nursing home anyway.

Until now, all of the advances in human lifespan have merely kept us from dying young. The phenomenal increases in the mean lifespan were simply due to more people making it into middle and old age, and not due to our ability to alter aging itself in any way whatsoever. We have cut down on infant mortality, infections, trauma, starvation, and a host of diseases of the young and middle-aged, enabling most of us to live long enough to encounter the diseases of old age. Now, instead of dying of polio and childbirth, we die of vascular disease, cancer, and Alzheimer’s disease. Worse yet, current estimates suggest that even if we could treat only vascular disease and cancer as individual problems, we’d all end up with Alzheimer’s disease. We would, as it were, go from the frying pan into the fire.

But what if, instead of treating merely the outcomes of heart disease, we could prevent the epigenetic changes that underlie the aging process at the most basic level and thereby prevent all age-related diseases? What if we reset the aging process by resetting the pattern of gene expression that underlies those diseases? While you would still have infection, trauma, inherited disease, and all of the other “natural shocks” of our lives, we would no longer be forced to succumb to the diseases of aging. This is precisely what we would like to do. We won’t offer immortality or many other things, but we can prevent suffering, pain, and that loss of the human soul that is the final flow of the aging process.

We can try to give people back their lives.