Most people accept that the ageing of body and mind is unavoidable. According to biomedical gerontologist Aubrey de Grey, however, not believing that we can win the struggle against ageing is the reason why life expectancy has not increased substantially. If we believe in this struggle and invest resources in this belief, we may be able to develop therapies in a mere 20 years that can keep people physically and mentally young as long as they live.
The human body is like a car. When a car runs, it slowly but surely wears out. The early faults are small and innocuous, and the car is built to withstand a specific amount of damage. But in time, accumulating so many minor faults causes the car to suddenly stop working properly. According to Aubrey de Grey, a British biomedical gerontologist, this applies similarly to the human body.
“There are cars driving around today that are literally 100 years old. Think about why those cars have lasted so long and why they are still working as well as they did when they were built. It is not because they were designed to last that long. That is the critical thing to pay attention to here. It is not because they were designed to last 100 years,” explained Aubrey de Grey, Chief Science Officer of the Strategies for Engineered Negligible Senescence (SENS) Research Foundation, at the Heartland Festival 2017 held at Egeskov Slot in Denmark.
According to Aubrey de Grey, the reason why some cars surpass their manufacturers’ maximum life expectancy and survive 100 years anyway and the key to humans living well past our maximum life expectancy is maintenance.
“The human body is set up to tolerate a whole bunch of damage, but not an infinite amount, and the human body does do damage to itself, starting from before we are born, because of the side-effects of the many things the body has to do throughout life to keep us alive. We can go in and periodically repair the damage. That’s what preventive maintenance is. You repair damage before there is so much that the doors fall off.”
Is Alzheimer’s really a disease?
Of course, doors do not break or fail among humans. Other things do. Based on the last 60 years of research in aging Aubrey de Grey and his SENS Research Foundation have identified seven types of damage that should be regularly repaired to get people to live longer and especially avoid the many disorders that accompany ageing. The problem is that we often define these conditions as diseases when they are actually wear and tear.
The 7 types of damages that according to Aubrey de Grey needs maintenance.
1. Cell loss and tissue atrophy. Every day cells are damaged. Some are repaired, but others are destroyed. Over time tissues like the brain becomes compromised.
2. Cancerous cells. Damage accumulate in our genes as we age causing abnormal gene expression and potentially cancer.
3. Mitochondrial mutations. Mitochondria are the cells “power plants,” converting nutrients into energy that powers reactions in the cell. Mitochondria generate toxic waste products, which can damage cellular structures.
4. Death-Resistant Cells. Our cells have built-in programming that sometimes veers them away from their normal fate. The number of these cells rises over time, until they reach levels that are harmful.
5. Extracellular matrix stiffening. Structural features of the body, such as the elasticity of the artery wall, are built out of proteins laid down early in our life. But occasionally molecules in the fluids in which these tissues are bathed will react with these proteins, impairing the proteins ability to move.
6. Extracellular aggregates. Extracellular junk is accumulations of malformed proteins that no longer serve their function, but instead impair cell or tissue function by their presence. The most well-known form of extracellular junk is beta-amyloid that forms plaques in the brains of patients with Alzheimer's disease,
7. Intracellular aggreagtes. Cells have a variety of systems for breaking down and recycling unwanted materials. However, sometimes these constituents are so badly fused together that the body can't tear them apart.
“All infections are in fact diseases. But is Alzheimer’s disease really a disease? Think about it. It is not like an infection at all. It is a side-effect of being alive. It is a consequence of having too much of a certain type of damage in the brain.”
According to Aubrey de Grey, although external factors presumably help to trigger the onset of Alzheimer’s disease, cancer and other conditions that we characterize as diseases, these disorders should instead be characterized as the result of damage that naturally accompanies life as a human being. Aubrey de Grey says that this misunderstanding is the reason why research into ageing is generally heading in the wrong direction.
“Metabolism – the word biologists use for all the things the body has to do to keep us alive – creates damage through life. Like in a car, that damage is initially harmless, but once it has accumulated to certain levels, it causes these things that we don’t want. The ill health of old age. We usually call this pathology. But that is really just the application of ageing to living organisms.”
Current strategies not working
To combat ageing, we must thus break the link between metabolism and pathology – or, as Aubrey de Grey calls it, the link between “being alive or dead”. However, the strategies for achieving this vary greatly. Biologists who study ageing try to examine whether the damage metabolism causes can be avoided. However, this is an extremely complicated task. Geriatrics studies medicine that can prevent old people from becoming ill, regardless of how much damage metabolism has caused to their bodies.
“Once you think about what ageing is – as this three-word summary: metabolism causing damage causing pathology – it is easy to see that geriatric medicine will never work. Metabolism is continuing progressively to create more and more damage. And the damage is more and more powerful at creating pathology. So, it’s pretty much a matter of definition that any attempt to attack the pathologies directly – any geriatric medicine – is going to become progressively more ineffective.”
Aubrey de Grey therefore believes that throwing so much money at geriatrics is a mistake. The money should instead be used to develop therapies for maintaining the human body. This is the strategy of Aubrey de Grey’s SENS Research Foundation, which has developed a research programme and a potential clinical product to treat each challenge based on the seven types of damage (see box). The research has not yet led to any specific products, but Aubrey de Grey is optimistic.
It is going rather well, and within the next 20 years or so, we have a very good chance of developing these maintenance therapies to a point where they actually work decisively. In other words, where we can genuinely eliminate people needing to get sick when they get old. We can keep people truly youthful both physically and mentally however long they live.
Ethical duty to act
Only time will tell whether Aubrey de Grey is mad or a genius. He previously asserted that the first person to live 1000 years has already been born. This spurred some of his critics to start a debate on the overpopulation to which such a steep increase in life expectancy would inevitably contribute.
“It is absolutely crazy to think that way. Because it means we are just going to carry on getting sick and dying just the way our parents, grandparents and great-great-great-grandparents did. And I’d rather not do that. I’d rather stay healthy. I’d rather stay in the same condition I am now – however long I live.”
In addition, Aubrey de Grey also believes that the existence of new knowledge and technologies ethically obligates us not to give up but instead do even more to avoid our descendants having to suffer the same disorders of old age that we increasingly do.
“They are probably not going to be very happy that we didn’t take the trouble to invent the therapies that could have stopped that from happening. And I do not want to be responsible for condemning an entire population to an unnecessarily painful and an unnecessarily early death – just because I thought that it would be better for them.”
Aubrey de Grey is Chief Science Officer of the SENS Research Foundation and Adjunct Professor at the Moscow Institute of Physics and Technology. He is Editor-in-Chief of the journal Rejuvenation Research, author of The Mitochondrial Free Radical Theory of Aging (1999) and co-author of Ending Aging: the Rejuvenation Breakthroughs that Could Reverse Human Aging in Our Lifetime (2007). The Novo Nordisk Foundation supported Future Talks at Heartland Festival 2017, where Aubrey de Grey gave the talk “The first human to live to be 1000 years has already been born”.