Reinventing Aging: An Update on the Longevity Dividend
Olshansky, S. Jay, Aging Today
In 2006, my colleagues and I coined the phrase "the Longevity Dividend" to describe the economic and health benefits that would accrue to individuals and societies if we extend healthy life by slowing the biological processes of aging. This idea was distinctive because we would extend healthy life by shifting our emphasis from disease management to delayed aging. We were not the first to suggest this.
Implications of Extended Life
Clive McKay and colleagues first raised the issue in the mid-50s in the Bulletin of the New York Academy of Medicine (32:2, 1956), and Bernie Strehler coined the term "gerontogeny" in 1975 in "Implications of Aging Research for Society" (from the Proceedings of the 58th Annual Meeting of the Federation of American Societies for Experimental Biology) to describe the development of interventions to extend healthy life. The first formal discussion of delayed aging among scientists appeared in Extending the Human Life Span: Social Policy and Social Ethics, published by Dr. Bernice Neugarten and colleagues in 1977 (Arlington, VA: National Science Foundation). That book was a product of a three-year project on the future of aging funded by the National Science Foundation, culminating in a conference in 1976.
Conference participants were asked to discuss these questions: should the science of biogerontology be devoted to improving older people's quality of life? Or should it extend the lifespan of the human species? If lifespan is extended, what would be its deleterious and beneficial effects on society? How much money should be allocated to research addressed directly to extending the human lifespan? What social and ethical implications would follow from a "magic elixir" that would extend active life expectancy by 15 to 20 years?
At the conference it was noted that the longevity revolution in the 20th century brought decades of healthy life, and contributed substantially to our nation's economic growth. But all was not rosy. Conference participants were acutely aware that extended lives came at a price- rapid increases in chronic fatal and disabling diseases. Some scientists there argued we should not pursue life extension as a national goal because the result would be an increase in the number and proportion of people requiring acute nursing care.
Gerontological Society president George Sacher expressed concern that extending life without extending health would result in a disproportionate number of years of disease and disability for the 10 percent of the population living the longest. But most conference participants agreed with James Goddard (former Commissioner of the U.S. Food and Drug Administration), who argued that healthy life extension should be a national goal requiring political support and strong vested interests.
Although the National Institute on Aging (NIA) was formed just before the Neugarten conference, the focus of modern medicine (and the majority of the NIA budgets since its beginning) has been centered on the disease model rather than the delayed-aging model. Advice from Neugarten conference participants to escalate the attack on aging, as well as to battle against major diseases, was not followed.
Re-Inventing the Argument
Four factors led my colleagues and I, in 2006, to reformulate the idea of targeting delayed aging: rapid increases in life expectancy since the late 70s; accelerated population aging; and rapid increases in chronic fatal and disabling diseases. These three occurred rapidly in developed nations, and developing nations are catching up. The fourth factor was the most important- recent advances in biogerontology suggested that it is plausible to delay aging. (For a summary of this line of reasoning, see asaging.org/blog/delayaging)further-reading.)
The Neugarten conference participants had predicted the dramatic increases of chronic fatal and disabling diseases that accompanied our longer lives. Cancer, heart disease, stroke, Alzheimer's disease, arthritis, sensory impairments and many other familiar maladies now common among older people are, in large measure, a product of the privilege of living long enough to experience them. …