Live long and prosper. If they will let you.

Longer lives, society, and freedom.

Longer, healthier lives:  A disaster for humanity?  To hear some people talk, yes.

Harvard aging researcher David Sinclair has managed to regulate the aging process in mice, making young mice old and old mice young.  And numerous researchers elsewhere are working on finding ways to turn back the clock. 

This has created a good deal of excitement.  We’ve seen these waves of antiaging enthusiasm before:  There was a flurry of interest in the first decade of this century, with news stories, conferences, and so on.  That enthusiasm mostly involved activating the SIRT-1 gene, which is also activated by caloric restriction.

You can buy supplements, like resveratrol or quercetin, that show some evidence of slowing the aging process by activating that gene, or by killing senescent cells.  Drugs like rapamycin and metformin have shown promise as well.  And diet and exercise do enough good that if they were available in pill form, everyone would be gobbling them.

But while pumping the brakes on the process of getting older and frailer is a good thing, being able to actually stop – or better yet reverse – the process is better still.  If I had the chance, I’d be happy to knock a few decades off of my biological age.  (Ideally, I think I’d be physically 25 and cosmetically about 40.)

But does this mean we’re looking at something like immortality?  Well, not really.

Even a complete conquest of aging wouldn’t mean eternal life.  Accidents, disease, even death by violence will still ensure that your time on Earth – or wherever you’re living in a century or two – eventually comes to an end.   Still an end to, or even a dramatic delaying of, the process of decay and decline would be nice.  As Robert Heinlein observed in the 1950s, you spend the first 25 years of your life getting established, then the next couple of decades striving to get ahead, and then by age 50 your reward for all that is that your middle is thickening, your breath is shortening, and your aches and pains are accumulating as the Grim Reaper waits around the corner.

Sinclair doesn’t talk about immortality, but he did opine in a recent interview that the first person who will live to 150 is alive now.  And in fact, with good luck, people reading this essay might live that long.  More importantly, they might live that long in good health.

Aging researchers talk about lifespan, but they also talk about “health span” – the years when people are able to get around, feel good, and enjoy life.  Right now centenarians are the fastest growing age cohort in some nations, but they’re generally pretty frail by comparison to middle-aged adults.   An intervention that just extended old age would be economically ruinous, and really not much fun for the beneficiaries.  (Like Jonathan Swift’s Struldbrugs, who lived very long lives but aged all the while, with unfortunate results.) 

I once saw Jay Leno putting down diet and exercise on this ground.  Diet and exercise add years to your life, he said.  What they don’t tell you is that those years are in your eighties, when what you actually want are more years in your twenties.

That’s funny, but it’s not really true even for diet and exercise.  People who take care of themselves generally look and feel a lot better in their later years than people who don’t.  And while modern medicine has been accused, with some justice, of keeping people alive and sickly for longer, in fact it does more than that.  Many of the diseases and dysfunctions of aging are treatable now, and people in their 50s, considered old a century ago, can seem quite young today, and people in their 70s and 80s do much better too.  It used to be that when folks died at seventy, everyone figured they’d had their threescore and ten.  Now people say “so young!”

In fact, the transition to longer, healthier lives has been underway for a while.  In his superb book The Escape from Hunger and Premature Death, 1700-2100, Robert Fogel lays out the dramatic improvements in health and life expectancy over the past couple of centuries:

The life expectancy of the [British] lower classes increased from 41 years at birth in 1875 to about 74 years today, while the life expectancy of the elite increased from 58 years at birth to about 78 years.  Indeed, there was more than twice as much increase in life expectancies during the last century as there was during the previous 200,000 years.  If anything sets the twentieth century apart from the past, it is this huge increase in the longevity of the lower classes. . . .

One factor arguing in support of the optimists’ [lifespan] projections is the increasing span of years that individuals have free of chronic conditions.  For those who reached age 65 during the first decade of the twentieth century, the average age of onset of chronic disabilities was about 51.  By the 1990s, however, the average age of onset of chronic conditions was more than 10 years later.  Moreover, these disabilities are now generally milder, and many effective interventions to reduce the impact of chronic conditions are available.

So people are not only living longer, they’re healthier in old age.  Imagine that we increased “healthspan” so that people aged 100 would be roughly as healthy and active as people of 70 are today.  Would that be a good thing, or a bad thing?

I’d regard it as good.  Obviously good for the people who enjoy longer, healthier lives.  Also good for society.  If we lived in the Malthusian nightmare that people expected the 21^st Century to be in the 1970s, post Paul Ehrlich and Soylent Green, maybe it would be different.  But our big problem now is a shortage of people.  Birth rates are plummeting everywhere, with the prospect of many countries facing an enormous burden of supporting a glut of old-age pensioners with much smaller workforces.

Pension realities will force the extension of retirement dates anyway, but how much better would it be to extend retirement dates for decades not so much out of financial exigency but because people don’t need to retire?

When Otto von Bismarck (somewhat cynically) set the German retirement age at 70, later reduced to 65, he chose that age because most workers wouldn’t live that long, but most thought they would.  People expected retirement to mean a few years of dignified leisure on the part of workers who were nearly used up, before the inevitable decline and death.  Now retirement can last decades.  Can we afford that if people live to 150?  (We can’t even afford it for much longer if they don’t).

If people live decades longer in good health, retirement ages should be pushed back, or retirement should be treated more like disability – you’re too old to work when you’re too old to work, not when you hit an arbitrary age.

One argument often offered against people living longer is that the old will clog the career paths of younger people, staying in their jobs longer while people stagnate waiting for a promotion that comes only after their own vitality is largely extinguished.  (We can call that the “King Charles III effect.”)

But people have been living longer for a century, and that century has been the most dynamic and creative period in human history.  And in American society, at least, turnover has accelerated as individuals live longer. CEOs and university presidents don’t stay in office for decades anymore, and second and third careers (often following voluntary and involuntary retirements) are common now.  As a professor, I see an increasing number of what we call “re-entry” students, some of them in their sixties and seventies.

The only place where we see people hanging on forever is in Congress and the federal bureaucracy, where people like Mitch McConnell, Nancy Pelosi, and Dianne Feinstein – not to mention our current President, or Anthony Fauci – hang on for decades past their sell-by date.  Rather than sentencing the entire populace to die earlier, some sort of term limits or mandatory retirement ages for those institutions would seem like a better solution.  (Looking globally, we see intense gerontocracies mostly at the top of communist run countries like China and the old Soviet Union, and in the United States federal government.  Coincidence?)

Nor are older people necessarily less creative.  The average age of a successful startup founder is 45,contrary to the popular notion that successful startups are founded by college-aged whiz kids.  Many scientists do top work in their later years – Freeman Dyson continued to do important work into his nineties, in a life that stretched from 1923 to 2020. 

At any rate, we might be better off with birth rates well above replacement, and a pyramided age structure.  But we don’t have those anymore, and nobody knows how to get back to them.  That being the case, getting more productive years out of the people we have would seem to be good for society.

But not everyone agrees.  The last time this subject came up for national debate, the Chair of the White House Bioethics Council, Leon Kass, wrote:

Is it really true that longer life for individuals is an unqualified good? . . .  If the human life span were increased even by only twenty years, would the pleasures of life increase proportionately?  Would professional tennis players really enjoy playing 25 percent more games of tennis?  Would the Don Juans of our world feel better for having seduced 1250 women instead of 1000?  Having experienced the joys and tribulations of raising a family until the last had left for college, how many parents would like to extend the experience by another ten years?

Now I would say the answer to these questions is yes.  (Though I’m not sure about Kass’s math here:  Only 250 more women in twenty more years?  That’s little more than one per month, which suggests Don Juan is slowing down in his old age.)  And the joy of hanging out with one’s grown children shouldn’t be understated, and in fact should be extended as long as possible in my opinion.

And at any rate, as noted above, we’ve basically done the experiment.  Life, and health, has been extended by about 20 years, and people seem happy with it.  And judging by the ads for life-enhancing pharmaceuticals like Viagra and Cialis, they’re eager to stay, um, active in their later years.  It’s possible that there’s a point of diminishing returns for longer lifespans somewhere out there, but there’s not much reason to think that we’re anywhere near that part of the curve yet.

If we’re left to doing what people want, I expect technology for lengthening people’s life- and health spans (and especially the latter) to sell, and be sold, quite vigorously.  But of course, the experience of the last few years suggests that politically motivated “public health” and social engineering regulations might squash it.  What the people want is, with increasing frequency, precisely the thing that our governing class wishes to deny them. 

Live long, and prosper.  If they will let you.

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