Online Features Columnist Catherine Hefner discusses the ever-ageing population, and whether science can provide a ‘cure’ for ageing.
Last week, I mentioned the fact that our population is ageing at an alarming rate. According to the WHO (World Health Organisation), by 2050, the proportion of the world’s over 60s will have doubled from 11 per cent to 22 per cent of the global population. In this time, the proportion of over 80s will have quadrupled. An already dwindling workforce will be called upon to care for the massive rise in the number of elderly patients. We’ll be facing a huge amount of economic and social change in our communities. For these reasons the WHO dubs ageing as one of the greatest challenges of our generation.
So if we want to do something about ageing to prepare ourselves for this, what do we think needs to happen? Do we simply want to modify and enhance care of the elderly? Or should we be investigating a ‘cure’ for ageing? One of the main issues we’re facing is that we don’t actually understand ageing all that well. At the moment we’ve got a quite a few theories flying around, both biological and non-biological. So I thought I’d include just a couple of the ones that I’ve found really interesting. Prepare thyselves, things are about to get sciency…
Gerontologist Aubrey de Grey defines ageing as the accumulation of damage to the body over time. It’s a process that begins before we’re born, and is only harmful at the point where the amount of damage is too great for the body to deal with. Ageing is truly a side effect of living, in that metabolism will inevitably lead to pathology.
Aubrey has identified 7 types of major damage that contribute to diseases and disabilities of old age, from a molecular to a cellular to an organ level. He’s confident that this list is comprehensive, noting that despite huge advances in medical science it’s been the same list for thirty years! And from this list, Aubrey believes that regenerative medicine is the key to finding a ‘cure’ for ageing. Rather than preventing damage in the first place, regenerative medicine would provide a way to repair the damage already caused. You’d think this would be the trickier way of combating ageing, but apparently not! For each of the 7 types of major damage in ageing De Grey has identified generic therapies that could be used to treat all of them and therefore, in theory, treat all the diseases and disabilities of old age.
There’s other recent research indicating that another way of combating ageing could involve a class of enzymes called sirtuins. Scientists believe sirtuins may influence a huge range of cellular processes such as inflammation, apoptosis (programmed cell death) and the transcription of genetic information; interestingly, all of which are processes involved in Aubrey de Grey’s 7 types of ageing.
Through studies with yeast cells, Harvard professor David Sinclair found that sirtuins are involved in turning genes off. To rehash some GCSE biology knowledge, every cell in your body contains a copy of all of your genes. In each cell, some genes will be turned on and some will be turned off. Sinclair found that as more genes became switched on in yeast cells, they began to age and eventually died. But this genetic change is not irreversible!
Genes can be turned off just as easily as they were turned on. So in theory, if we found a way of enhancing the action of sirtuins, we could turn these genes off again and prevent this cascade of ageing. There’s a drug called resveratrol which does precisely that – it increases the activity of sirtuins so they can turn genes off at a faster rate. The effects of resveratrol are still being researched, so it’s not available as a drug yet. But you’ll find it naturally in berries, peanuts, red grapes and red wine (although it’ll take you about 100 glasses of red wine a day to get a decent amount of resveratrol…your liver may not thank you).
The whole concept of ageing research opens up a bunch of ethical questions. Isn’t it natural to age? Won’t increasing our life span simply exacerbate the problem of our ageing population? Well, Aubrey de Grey is adamant that it would in fact be unethical to avoid this research and make the decision on behalf of future generations.
Ageing is our biggest killer – over two thirds of the world’s deaths are caused by ageing, a figure that rises to 90% of deaths in industrialised areas. However it’s not just the deaths that we have to consider but also the suffering involved with ageing. Sinclair notes that the rate of ageing is decreasing – we’ve worked out ways of keeping our organs healthy, but not our brains. So a large proportion of the elderly are now living with well-functioning bodies, but a deteriorating brain.
To bring up some more scary WHO estimates, last year there were an estimated 44.4 million dementia sufferers worldwide, a figure which is set to rise to 135.5 million with current trends. And obviously, it’s a hugely expensive problem for our healthcare. For this reason, Sinclair believes the best direction for research should not be simply looking at age-related diseases but at ageing as a whole – combating the root of the problem. That’s not to say the aim is for everyone to live to 500 as many stories in the media imply, but simply for people to live healthily for longer.
But what are we doing about caring for today’s elderly? Technology is stepping in with a host of helpful care aids. Amongst the panic buttons and cords that you see in nursing homes today, we could soon be looking at fibre optic carpets that can sense when someone’s fallen and even track the gait of the patient to predict the likelihood of a fall. As trivial as that sounds, falling accounts for over 50% of hospital admissions for over 65s. This is part of a phenomenon known as “telehealth” or “telecare” technologies. Aside from sensing where a patient is in their home – whether they’re sitting or standing or lying in bed, telehealth could involve monitoring blood pressure and glucose levels and transmitting them to a health care centre.
And it’s not just in physical health that technology is advancing. Japanese technology has also brought us “Paro”, an interactive, robotic seal designed to combat loneliness and act as a comforter to elderly patients. It responds to light, temperature, posture and auditory stimuli which allows it to interact with people and the environment.
Sound a little creepy? Sherry Turkle, once one of the foremost advocates for this kind of technology, felt “profoundly depressed” when she witnessed people reacting to this robot. She described it as finding herself “at the cold-hard centre of the perfect storm. We expect more from technology and less from each other”. Strong words. However, as robotics researchers have pointed out, it’s not really today’s elderly we should be asking about developing this technology for but for today’s youth – the first generation of the computer age. So I guess the real question is how we’d feel about the prospect of using these technologies some day.
Aubrey de Grey says ageing is an inevitable side effect of being alive. But is it inevitable in the way that we know it now? I’d imagine by 2050, many of us students will be approaching retirement age. It’s the decisions we’re making about the research of today that will affect how our lives look when we’re the ones being looked after. Personally, I might be giving that robotic seal a miss…
Catherine Heffner, Online Features Columnistbookmark me