Jay Olshansky has seen the problem, and it is us—a population that is becoming older and sicker and is creating an economic burden for future generations. Olshansky, a professor of epidemiology at the University of Illinois at the Chicago School of Public Health, is a thought leader on aging and longevity. He and his colleagues have projected current health trends 50 years forward. They estimate that as life span continues to increase, so will the numbers of disabled elderly, nearing 30 million in the U.S. by 2060. By that time, according to government economists, Medicare coffers will have been depleted for decades, drained dry by the cost of caring for people with the chronic diseases of aging.
But Olshansky also envisions a solution in exceptional men and women like Jimmy Carter, Judi Dench, Desmond Tutu, Madeline Albright and Warren Buffett who have continued to make enormous contributions to their fields well into their eighth and ninth decades. His goal is to see that productive elders become the rule rather than the exception within the next 50 years. The key is to find the mechanism that keeps exceptional people healthy and productive over a long lifetime and to transfer it to everyone.
If you could scale up one remarkable health care idea, what would it be?
"Slowing the biological processes of aging in people is not only a plausible target for science and public health communities; it is a necessity in a rapidly aging world where an insatiable desire for longer life drives our health care system. A consortium of scientists and nonprofit organizations has devised a new innovative plan to combat disease, extend healthy life and reduce health care costs by accelerating research on the development and dissemination of a therapeutic intervention to delay aging."
- S. Jay Olshansky, Ph.D., Professor of Epidemiology,
University of Illinois at Chicago School of Public Health
and leading thinker on aging and longevity
To unearth this mechanism, the U.S. and other developed nations need to retool their approach to medical research, Olshansky contends. “What we get with the current disease-specific approaches are more effective interventions for heart disease and cancer that may increase life span, but they will also result in a growing population of the sick and frail elderly.”
A quick scan of the 19 organizations composing the National Institutes of Health illustrates how firmly the disease-specific concept is entrenched. Nearly all, like the National Cancer Institute and the National Heart, Lung and Blood Institute, are named for specific disorders or organ systems, largely because researchers depend on disease constituencies to lobby for funding. Even the National Institute on Aging devotes around 50 percent of its research to a single disorder, Alzheimer’s disease.
The problem with this approach, Olshansky says, is that at least half of seniors have more than one chronic medical condition. Eliminating heart disease, for example, may add a year or two to seniors’ lives, but it still leaves them vulnerable to cancer and Alzheimer’s. “What we need is a single approach that will have multiple effects. We shouldn’t be talking about how we can extend life, but how we can extend health. We shouldn’t pursue any intervention that doesn’t extend physical and mental health along with age.”
His research bears this out. In October 2013 Olshansky and his colleagues published a study based on the Future Elderly Model—a simulation of the future health and economic contributions of men and women in their early 50s. The researchers found that the current approach would produce a 3.2-year gain in longevity by 2060. However, breakthroughs in either cancer research or heart disease alone wouldn’t result in a marked advantage over the status-quo projection simply because most people have not just one, but several, degenerative diseases. In contrast, delaying aging—the most significant risk factor for all degenerative diseases—could yield a bonus of 2.2 (mostly healthy) years.
The model projects an economic bonus of $7.1 trillion over 50 years, resulting from a steady increase in the percentage of nondisabled elderly over that period. It also assumes that people will be working longer and spending more, along with an increase in the age of eligibility for Social Security and Medicare benefits.
For almost a decade, Olshansky and colleagues have been urging scientists and policy makers to refocus efforts toward reaping this “longevity dividend.” Their intent isn’t to divert funds from research on specific diseases but to convince scientists to focus on attacking risk factors—inflammation, stress and obesity—are also associated with aging, identifying and attacking the molecular and cellular processes responsible for them will not only slow the aging process, it will delay the onset of degenerative diseases caused by age. While we can’t slow down time, we can slow down the aging process, and thus the medical conditions that accompany it. Above all, Olshansky believes that slowing aging itself will help us lead healthier lives, longer.
The research community is getting their message. The United States Senate Special Committee on Aging recently hosted a roundtable on forging collaboration between National Institutes of Health research “silos”—organizational barriers to cross-disciplinary cooperation. The NIH GeroScience Interest Group is mounting similar projects. And, in the private sector, Google has launched Calico, an enterprise directed at extending life span, and has hired top pharmaceutical and biotechnology experts to spearhead the search for a drug to retard aging.Olshansky has optimistic expectations for such research: “I’m hoping for a therapeutic intervention that can be performed in youth or middle age, so that in a few decades we will see people taking 60 years to turn 40.”