13 ms·

The economic value of targeting aging

150 points by deegles 5y ago

philipkglass 5y ago
A cure for aging only needs to get through human clinical trials for treating one aging-associated condition like osteoporosis. Once it has FDA approval for treating that one condition it can be prescribed off-label by a willing physician. If the osteoporosis treatment has unusual side effects of also making skin appear more youthful, improving short term memory, and increasing libido, then there will probably be a lot of off-label prescriptions written a few years later. So if you have a great way to cure aging but are worried that the FDA does not recognize aging as a condition, that's how you get the treatment to market.
- JumpCrisscross 5y ago
  > if you have a great way to cure aging but are worried that the FDA does not recognize aging as a condition, that's how you get the treatment to market If you have a cure for aging, I'm decently sure you can earn your ROI without respect to the FDA.
  - cwkoss 5y ago
    Yeah if you cure aging, fuck the FDA, sell it to billionaires for $1B/year until they are broke, then buy congress so you control the FDA
    - cwkoss 5y ago
      On second thought, you could certainly buy our mostly-geriatric congress with the cure directly, and probably sidestep a bunch of messy FEC regulations
- ska 5y ago
  If anyone actually comes up with an empirically verified treatment for aging (let alone a "cure"), market access or payment is not a problem they will face.
  - nostromo 5y ago
    David Sinclair is an expert on this and has said otherwise. Clinical trials are expensive. To fund them you need billions of dollars. Pharmas won’t fund research in anti-aging directly because it’s not considered a disease, can’t get FDA approval, and thus couldn’t be sold. So, yes, you need to find another route to approval, similar to metformin and rapamycin.
    - ska 5y ago
      Pharma companies won't fund research because they don't consider the risk-reward tradeoff worthwhile compared to other options for their resources. Off label use in endemic, and it does give a path to play with some things clinically; however if you formed a company around this idea and could have been demonstrated to do it, you'll be pulled off the market so fast it will make your head spin. What you are really talking about is about funding the research that wont work, in the hopes that eventually you hit on something that does. If you do hit on that and can rigorously demonstrate it, market access will not be a problem.
    - ALittleLight 5y ago
      One thing I've never understood, given that trials are so insanely expensive, is why healthcare companies with billions of dollars don't open up "offshore" research facilities to do trials in more lax jurisdictions. I've done none of the research, just imagining, but if you were to open up a compound in Somalia or somewhere, make the appropriate political contributions, would you really be bogged down with lots of red tape? Could you just experiment and iterate fast enough to develop convincing therapies cheaply and then bring them to mature markets?
      - beardyw 5y ago
        So, experiment on poor black people? I think you are on the wrong forum.
        ALittleLight 5y ago
        The necessary part is only that the prospective subjects aren't protected by strict regulatory regimes like in the United States. Somalia, as, essentially, a failed state, I assume, has lax medical regulations and is a possible candidate for experimentation. I think it's a bit racist for you to generalize my description of a poor and under regulated state, like Somalia, as being equal to "black people". Not all countries in Africa are like Somalia, you know. I suggest reading a bit more about Africa. I personally enjoy watching YouTube videos made by creators in different countries, African countries have a wide range. As Mark Twain said, "Travel is fatal to prejudice". Today, we can virtually "travel" with the click of a button. Not all black people are poor Somalis!
- bserge 5y ago
  > off-label by a willing physician Just great.
mkoubaa 5y ago
The average age of university presidents and members of Congress in the USA is in the 70s. At the risk of sounding callous can we fix our gerontoctratic system and then fix aging?
- blacktriangle 5y ago
  Honestly why is that a problem? Wouldn't one thing that we'd want the people with the most experience in higher level management positions. I don't think the problem with Congress is that members are in their 70s. The problem is that ideally they would have real jobs till their 60s THEN run for government. Instead they bum around various government roles till they get elected in their 30s and once they are there dig in like tics.
  - techbio 5y ago
    Self-fulfilling policy is the best policy. Also: "...like tic[-tac-toe]
    - sokoloff 5y ago
      If they intended the insect, "tick" is/was correct.
- jjallen 5y ago
  These sound like two separate problems. That is only 500 people you are talking about. What about the other 7.4B of u s? Also, they are the ones who are supposed to fix that problem.
- ben_w 5y ago
  I suspect gerontocracy would be a distinct without a difference after someone invents any real fountain-of-youth category of tech (mind uploading included), in much the same way that land ownership went from being a requirement for voting to merely one of many ways to hold wealth as the USA went from an agrarian to an industrial society. Big difference going from 50 to 70; proportionally less going from 600 to 700, even if the world isn’t changing in a way that makes recent experience count for more than ancient experience.
giantg2 5y ago
"the WTP at birth for the initial 1-year increase in remaining LE from 78.9 to 79.9 years via rectangularization is US$118,100, the WTP at age 60 for the first 1-year increase in remaining LE from 21.7 to 22.7 years through lifespan improvement is US$257,700." Who the fuck did they get to determine willingness? Most people don't have the money to spend. If it takes you years of extra work to pay for a one year life extension, why not just retire years earlier and enjoy that time? After all, you could still die from an accident after paying the sum at birth/60. It seems highly inappropriate to use a population based metric like life expectancy to have individuals decide if they want a one year increase (likely the individuals don't understand life expectancy as well as).
- ben_w 5y ago
  At a guess, old people have a house or something they can sell for that much.
  - giantg2 5y ago
    Given the massive gap between what people should have for retirement and the little they actually save, they probably need that money for necessities. That's what most people using reverse mortgages use it for today.
- maerF0x0 5y ago
  Back when I was _really_ into longevity stuff, aubrey de gret etc... I seem to recall that even if we removed all forms of aging people would have an expected lifespan of roughly 1000 years due to trauma death (eg: getting hit by a bus) . So that could serve as a rough rule of thumb for how to think about risk/reward on increasing health in later years. That is it generally has a good EROI for how safe (accident wise) our society actually is.
  - wpasc 5y ago
    If you don't mind me asking (off-topic), are you less into longevity stuff now? if yes, what made you less into it/possibly more skeptical of it?
seph-reed 5y ago
I know some really spry older (60-80) people. Good diet and exercise is what they have in common. It also helps with mental health (which we have an epidemic of in the US). By all means, this research should continue. But we do already have very good solutions to aging which are sorely overlooked.
- wpasc 5y ago
  The general Aubrey de Grey response to this observation is that yes, lifestyle improvements are great and diet/exercise are great for improving one's life. However, it ends up conferring only a few more years of life. Some evidence he provides is that even very healthy (by obesity metrics for example) countries only have a life expectancy a few years longer than "unhealthy" countries. I think he cites like Japan (with lower obesity rates) having a life expectancy of 6 years longer than US (high obesity rates). Not my observation so feel free to caveat me away, but I'm just regurgitating what some doctors who studying aging observe and perhaps I'm not remembering all the evidence they provide.
hardtke 5y ago
This reminds me of some articles that came out when the states sued the tobacco companies in the 1990s. Many asked why the US federal government did not sue as well, and the answer turned out to be that smoking is good for the federal government finances. It tends to kill people quickly (heart attack) just after they retire and start collecting social security.
fredliu 5y ago
Not surprised David Sinclair is one of the co-authors. Anti-aging is a fascinating new field. It's great that there's some discussion about economical aspects of "slow down aging" at a large scale.
mensetmanusman 5y ago
It’s obvious that healthy people that live shorter are better for the ‘economy’ but clearly humanity doesn’t live to optimize for the economy. If we did, we would be fighting obesity with 10x the seriousness of how we fight COVID.
- maerF0x0 5y ago
  basically anything that wasnt a long term compounding investment would be illegal... Obvious things like smoking and vaping, but maybe even time wasters like social media (you could be learning something...) Luckily human life is more than just economy (as expressed in GDP) optimization.
- deleted 5y ago
  [deleted]
- ohazi 5y ago
  There is no cohesive "humanity" with any sort of desire or ability to optimize for "the economy." Individuals optimize for their own (often short-term) economic benefit. That's it. The corporate overlords at ACME don't care about fighting obesity, because there are more than enough non-obese workers for them to exploit, and they don't want to cannibalize their highly profitable line of products that obese people need (i.e. insulin). Governments are composed of individuals, and the structures we have to hold these individuals accountable to their constituents are weak, so they still end up using their levers of power for their own gain, and for the gain of their corporate sponsors (also often short-term). Despite ~70 year lifespans, it seems that most of the population can't even be bothered to optimize for medium-term outcomes. This isn't going to change just because we invent a magic pill that lets you live youthfully till ~150. The problem isn't lifespan, the problem is that humanity is innately selfish and short-sighted. If this can't be fixed, we are completely fucked.
  - Ericson2314 5y ago
    > Individuals optimize for their own (often short-term) economic benefit. That's it. Don't go to too far with this sort of atomistic analysis. Large firms are better at enforcing coordination than "society at-large" or other groupings. The fact that at different scales the coordination is markedly different has a huge affect. We're not an "economy of households" as the orthodox macro might have one model.
dalbasal 5y ago
I only skimmed past the abstract (wolverine case is gold, lol) feel that such an analysis gets squirrely, both morally and technically. A few years back, there seemed to be a desire to justify cigarette taxes with a "it costs the state money when you get cancer" rationale. Some of the analysis seemed to indicate opposite results. Lung cancer, for example, tends to kill more quickly than age related diseases, saving on nursing home costs and palliative care. Everyone dies of something after all, and death is expensive as is aging. Either way, it seems kind of strange to place economic values on life itself. I mean isn't economic utility premised on life? In any case, it seems trivially true that economic measures will always correlate with either population size working age population size, depending on the model. I feel like these kinds of papers only exist to be cited in support of cheap rhetoric.
- t_serpico 5y ago
  "I feel like these kinds of papers only exist to be cited in support of cheap rhetoric." Agreed. The authors already made up their mind regarding the conclusion before writing the paper. This is an analysis that should be done by a group not involved in aging research so it's 'unbiased'.
- jjoonathan 5y ago
  Any action you take to preserve life has the side effect of putting an economic value on life. You invest some amount of effort into the action and the action has some amount of efficacy, so you can always divide the two to find a valuation. I agree that this exercise usually winds up as cheap rhetoric, but I'm not fully convinced it's the fault of the exercise. Refusing to calculate a value doesn't mean the value doesn't exist, it just means we are letting our instincts decide the value for us, and our instincts are prone to doing silly things like spending the wrong amount of attention on anti-terrorism vs heart disease.
  - dalbasal 5y ago
    This has a "trolley problem" feel to it. It's a contrived scenario that doesn't reflect real life. I'm not suggesting that all our decision making is good. Terrorism vs heart disease just don't really compete. A model of the world where everything competes with everything isn't a good one for decision making. Just like "don't build a particle collider until we have solved poverty" is not a workable approach. Terrorism & heart disease don't have the same consequences, socially, politically or geopolitically. We're not machines. Even in machines' decision making, such moral calculus doesn't really play. Self driving cars won't, and don't need to solve the trolley problem any more than we do. ..and don't underestimate our instincts. They may not be as "perfect" as legible reasoning, but they are far more complete.
deegles 5y ago
There are a lot of DIYers experimenting with senolytics and Rapamycin therapies for longevity. I expect that in the next 10 years or so evidence will be clear that at least some of these therapies work. It will be undeniable as more and more people start to hit their 80s, 90s, and beyond in very good health. I'm in my 30s so not in need yet but I'm keeping a close eye on the science. For example, this clinical trial [0] is studying the safety of various dosing schedules of Rapamycin, and a planned followup study will use the safest dose with a larger group and longer timeline. [0] https://www.lifespan.io/campaigns/pearl-participatory-evaluation-of-aging-with-rapamycin-for-longevity/ https://www.lifespan.io/campaigns/pearl-participatory-evalua... edit: fine, maybe more than 10 years but within my lifetime :)
- p1esk 5y ago
  the next 10 years or so evidence will be clear that at least some of these therapies work. I think you forgot an extra zero
  - deleted 5y ago
    [deleted]
- ska 5y ago
  > I expect that in the next 10 years or so evidence will be clear that at least some of these therapies work. It's an interesting area, and at least some empirically useful work is being done, but both the expectation and the timeline here seem pretty ambitious.
- bserge 5y ago
  They're not DIYers when using a prescription drug. Something inaccessible to the majority of the population. Can't wait for a time when trying to delay your death requires serious justification and approval from some asshole whose only authority comes from 5+ years of overpriced formal education.
  - ixacto 5y ago
    Sortof. But the assholes do know a bit about science, and are taking an arguably conservative view on pharmacological interventions in the treatment of aging to prevent possible problems. For example this trial: Targeting the Biology of Aging. Ushering a New Era of Interventions. The official web resource of the TAME Trial, managed by the American Federation for Aging Research. they are not saying that taking metformin slows aging, merely that it delays development of chronic illnesses. What we should be asking is if metformin is actually slowing down the biological aging process. https://www.afar.org/tame-trial https://www.afar.org/tame-trial
qntty 5y ago
Maybe conservatives worrying about death panels in 2008 weren't so crazy...
courtf 5y ago
The quest for immortality is popular, but it would mean the end of physical and cultural evolution. Seems as though this topic is gaining steam now, only as a large corpus of aging narcissists are finally grappling with the concept of death. It's another sign of the selfish immaturity ingrained into our culture.
- kiba 5y ago
  This is nonsense. We change everyday through forgetting and remembering and learning. Physical and cultural evolution don't stop. It's another sign of the selfish immaturity ingrained into our culture. Selfish immaturity? It seems that you yourself is a reflection of culture. One of our very first epic poems, the Epic of Gilgamesh basically railed against immortality and accepting one's fate.
  - courtf 5y ago
    > Physical and cultural evolution don't stop. If someone lives forever, they don't evolve physically. This is basic. To the degree we evolve culturally, most of our culture comes to us in our eponymous "formative years." Leaving those behind tends to result in comparatively little change in culture over the remaining course of our lives. > Selfish immaturity? It seems that you yourself is a reflection of culture. I rest my case. > One of our very first epic poems, the Epic of Gilgamesh basically railed against immortality and accepting one's fate. This was not a call to try and live forever, this is a call to live boldly, take risks and not to fear death. Striving for immortality is the absolute opposite, the coward's response to the challenge made in the poem.
    - sigstoat 5y ago
      > If someone lives forever, they don't evolve physically. you skipped some lessons in biology class; you're not doing any evolving over the course of _your_ life. regardless of how long or short it is.
      - courtf 5y ago
godelski 5y ago
I'm reminded of Nick Bostrom's story called "The Dragon Tyrant"[0][1] and David Foster Wallace's "This is Water"[2]. The dragon became so normal in our lives that we do not even question it, like a fish does not question what water is. That we've created a society around this how to deal with this inevitability. But at the end of the day if we could, killing the dragon would be more beneficial and reduce harm by a significant amount. I see several people in this thread complaining about the economic analysis here or how old people are messing up our world and thus we should fix those things first. For the former question, I see this analysis as adding ammunition to the debate, because many people that determine where we should fund base their decisions on economics. This paper isn't aimed at you, it is aimed at them (speak to your audience). For the latter, I question the premise. Culture has moved too fast that it cannot be purely explained by younger generations dictating the change. This also falls counter to old people controlling everything. So I don't buy the premise. The truth is that if people were living to a thousand years old that society would fundamentally change. Who we consider children and adults would fundamentally change. The truth is that we don't know what this society will look like until we open the box, and until the dust settles. We should be questioning if this is good or bad (we should challenge all ideas) but we need to recognize that this would be such a fundamental change in society that we have no real baseline for determining how we would change. My personal belief is that we do not go quiet into that dark night. There is a lot to fear, but often our fears are irrational. This would save billions of lives, and so I believe it is worth the risk and worth the hardship we will face as society transitions into this new paradigm. [0]https://nickbostrom.com/fable/dragon.html https://nickbostrom.com/fable/dragon.html [1](Animated by CGP Grey) https://www.youtube.com/watch?v=cZYNADOHhVY https://www.youtube.com/watch?v=cZYNADOHhVY [2] https://www.youtube.com/watch?v=eC7xzavzEKY https://www.youtube.com/watch?v=eC7xzavzEKY
- JumpCrisscross 5y ago
  > My personal belief is that we do not go quiet into that dark night I think many do. One of my takeaways from the pandemic is that there are people--intelligent, informed, unoppressed people--who will self select away from benefits. Even seemingly obvious ones. The fictional dystopias of the last century would have had an immortal elite keeping aging treatments from clamoring masses. I don't think that's how it would turn out. Many people--including leaders--would choose not to get the treatment. Still others would push their societies to ban treatments for everyone. I don't know how you model this. It's a different form of haves and have-nots than we're accustomed to. But it would undoubtedly feed into and ameliorate the concerns brought up in this thread.
The_rationalist 5y ago
I invite readers to look into SkQ1, thymalin and Epitalon
willwashburn 5y ago
It seems that their calculations use metformin. At what age should we start using it for health-span extension? I'm already using it to avoid glucose spikes, even though I'm not even prediabetic, but I'm curious if it's known how powerful is the health-span effect is younger humans.
- wincy 5y ago
  If glucose spikes are bad for you, why not just exclude all foods with a glycemic index? That’s what I’ve done and find my mental health and energy levels have improved substantially.
nostromo 5y ago
I used metformin for a bit, but stopped because it was found to hinder muscle growth. I decided for the time being I’d rather look and feel good and not be a fragile waif in the hopes of living a bit longer. I came to similar conclusions about calorie restriction. These schemes tend to slow or restrict growth and energy levels, which is a real side effect we should be discussing more. Rapamycin seems promising though. It appears you can cycle on and off it and get most of the anti-aging benefits, while limiting the effects of blocking protein synthesis.
- kiba 5y ago
  I used metformin for a bit, but stopped because it was found to hinder muscle growth. I decided for the time being I’d rather look and feel good and not be a fragile waif in the hopes of living a bit longer. I heard the effect was effectively not much, so you should be OK exercising. Just that your muscle gain will be a little bit less. This is just what I heard from other people though, so take it with a grain of salt. Even if hinder muscle growth by 50%, I might still take it. I came to similar conclusions about calorie restriction. These schemes tend to slow or restrict growth and energy levels, which is a real side effect we should be discussing more. I doubt calorie restriction actually works for us. I find intermittent fasting easy.
im3w1l 5y ago
Personally I believe that the fundamental driver of aging is dna damage. The direct issue is cancer, but the indirect consequence is that the body slows down cellular reproduction to counteract said cancer. This means slower healing of any injuries, and lower vigor. Thus I see any aging treatment that doesn't fix dna damage as fundamentally a blind alley. And conversely if someone manages to fix dna damage, then the rest should just be some small details.
ben7799 5y ago
This article seems to be about the economic value gained by reduced health care or something. If you actually extended lifespans by a significant margin (say to 200 years) there would be other knock on effects that would completely derail the global economy & markets. This study doesn't seem to think about how those things could actually negatively impact economics. Eventually if you're intelligent and you're trying to self-fund your retirement you build up assets that are growing at a sufficient rate that you can live off the growth without touching your principal. Once you hit that, work becomes unnecessary. If everyone goes from retiring for 20-30 years to suddenly possibly retiring for 120-140 years things get all kinds of strange things happening, the percentage of the population working would diminish. But then that would negatively impact companies due to increasing difficulty in finding workers, which would negatively impact markets, which would then feedback into ruining the investments allowing all these retirees to live off investments & savings. The current system couldn't work without room to greatly expand the population of living people to ensure growth of the workforce. I have seen these ideas explored in Science Fiction occasionally, but not many other places. There is another aspect as well, if you lived 200 years, what if you ended up having multiple successive families? Raise a family, your kids grow up, then you raise another family 50 years later?
- JumpCrisscross 5y ago
  > If you actually extended lifespans by a significant margin (say to 200 years) there would be other knock on effects that would completely derail the global economy & markets Re-structure? Sure. De-rail? No. One could imagine our current low-interest rate environment (interest rates and time horizons are fundamentally linked) as a first step towards that world. You're highlighting a problem of retirement savings running out and the labor pool diminishing. These problems offer an obvious solution.
  - ben7799 5y ago
    Retirees running out of money because the economy is crashing doesn't really match up with "they'll just go back to work". People might stop having kids too, then there will be no new workers entering the work force eventually if lifespan was extended indefinitely.
rad_gruchalski 5y ago
Okay, but what do we do when there is 30 or 40 billion of us?
- ALittleLight 5y ago
  Invest in space travel and colonization.
- _carbyau_ 5y ago
  Population control. Episode 3, Season 2, "Love, Death & Robots" covers a very similar scenario with Black Mirror-like horror... Effectively, having "unapproved" children results in the children being executed, the parents gaoled for criminal/mental health issues.
justinboogaard 5y ago
Glad they draw attention to the difference between “healthy years” and “just more years”. From our work at GoGo (GoGoGrandparent.com) our clients specifically value more time in the community they grew old in. As you age the trip to church every Sunday becomes what you live for, and taking that away so you can live more years in a retrofitted apartment building isn’t worth it to a lot of people.
nootropicat 5y ago
I don't expect any noticeable progress as long as medical regulations assume that people already live forever. Avoidance of risk is an absolute priority, even though under current technology level everybody is certain to die. Collective insanity helped by entrenched interest of big pharma corporations. The only way this changes is if against all odds diy biohacking scene arrives and outright breaks the law by doing human experiments. I got interested a few years ago and concluded until dna synthesis becomes cheap and more reliable for longer sequences it's a pipe dream. That would require a fundamentally new technology (enzymatic dna synthesis?) as current tech is just marginally improved 1970s tech.
MarkMc 5y ago
Thereputic Plasma Exchange (ie. exchanging blood plasma with saline and albumin) seems a very promising treatment for aging. [1] [2] "These findings are exciting not only because they represent a scientific advance in understanding aging, but also because they herald the first real anti-aging product that could come to market. Therapeutic plasma exchange is FDA-approved (not for aging, but for a bunch of other conditions). I imagine there remain prohibitions on advertising that it can add years to your life, but it is safe, and a doctor can prescribe it off label. It’s also cheap. An automated plasmapheresis machine—which lets you do treatment after treatment—can be bought online for under $3,000. That is less than the cost of a single transfusion of young blood sold by the startup Ambrosia. How long until someone opens a clinic offering plasma dilution? I bet someone tries it in 2021. If it works, people will get over the weirdness, and it could be commonplace by 2030." [3] [1] https://www.aging-us.com/article/103418/text#fulltext https://www.aging-us.com/article/103418/text#fulltext [2] https://link.springer.com/article/10.1007/s11357-020-00297-8 https://link.springer.com/article/10.1007/s11357-020-00297-8 [3] https://elidourado.com/blog/notes-on-technology-2020s/ https://elidourado.com/blog/notes-on-technology-2020s/

150 points by deegles 5y ago

A cure for aging only needs to get through human clinical trials for treating one aging-associated condition like osteoporosis. Once it has FDA approval for treating that one condition it can be prescribed off-label by a willing physician. If the osteoporosis treatment has unusual side effects of also making skin appear more youthful, improving short term memory, and increasing libido, then there will probably be a lot of off-label prescriptions written a few years later. So if you have a great way to cure aging but are worried that the FDA does not recognize aging as a condition, that's how you get the treatment to market.

JumpCrisscross 5y ago
> if you have a great way to cure aging but are worried that the FDA does not recognize aging as a condition, that's how you get the treatment to market If you have a cure for aging, I'm decently sure you can earn your ROI without respect to the FDA.
- cwkoss 5y ago
  Yeah if you cure aging, fuck the FDA, sell it to billionaires for $1B/year until they are broke, then buy congress so you control the FDA
  - cwkoss 5y ago
    On second thought, you could certainly buy our mostly-geriatric congress with the cure directly, and probably sidestep a bunch of messy FEC regulations
ska 5y ago
If anyone actually comes up with an empirically verified treatment for aging (let alone a "cure"), market access or payment is not a problem they will face.
- nostromo 5y ago
  David Sinclair is an expert on this and has said otherwise. Clinical trials are expensive. To fund them you need billions of dollars. Pharmas won’t fund research in anti-aging directly because it’s not considered a disease, can’t get FDA approval, and thus couldn’t be sold. So, yes, you need to find another route to approval, similar to metformin and rapamycin.
  - ska 5y ago
    Pharma companies won't fund research because they don't consider the risk-reward tradeoff worthwhile compared to other options for their resources. Off label use in endemic, and it does give a path to play with some things clinically; however if you formed a company around this idea and could have been demonstrated to do it, you'll be pulled off the market so fast it will make your head spin. What you are really talking about is about funding the research that wont work, in the hopes that eventually you hit on something that does. If you do hit on that and can rigorously demonstrate it, market access will not be a problem.
  - ALittleLight 5y ago
    One thing I've never understood, given that trials are so insanely expensive, is why healthcare companies with billions of dollars don't open up "offshore" research facilities to do trials in more lax jurisdictions. I've done none of the research, just imagining, but if you were to open up a compound in Somalia or somewhere, make the appropriate political contributions, would you really be bogged down with lots of red tape? Could you just experiment and iterate fast enough to develop convincing therapies cheaply and then bring them to mature markets?
    - beardyw 5y ago
      So, experiment on poor black people? I think you are on the wrong forum.
      - ALittleLight 5y ago
        The necessary part is only that the prospective subjects aren't protected by strict regulatory regimes like in the United States. Somalia, as, essentially, a failed state, I assume, has lax medical regulations and is a possible candidate for experimentation. I think it's a bit racist for you to generalize my description of a poor and under regulated state, like Somalia, as being equal to "black people". Not all countries in Africa are like Somalia, you know. I suggest reading a bit more about Africa. I personally enjoy watching YouTube videos made by creators in different countries, African countries have a wide range. As Mark Twain said, "Travel is fatal to prejudice". Today, we can virtually "travel" with the click of a button. Not all black people are poor Somalis!
bserge 5y ago
> off-label by a willing physician Just great.

mkoubaa 5y ago

The average age of university presidents and members of Congress in the USA is in the 70s. At the risk of sounding callous can we fix our gerontoctratic system and then fix aging?

blacktriangle 5y ago
Honestly why is that a problem? Wouldn't one thing that we'd want the people with the most experience in higher level management positions. I don't think the problem with Congress is that members are in their 70s. The problem is that ideally they would have real jobs till their 60s THEN run for government. Instead they bum around various government roles till they get elected in their 30s and once they are there dig in like tics.
- techbio 5y ago
  Self-fulfilling policy is the best policy. Also: "...like tic[-tac-toe]
  - sokoloff 5y ago
    If they intended the insect, "tick" is/was correct.
jjallen 5y ago
These sound like two separate problems. That is only 500 people you are talking about. What about the other 7.4B of u s? Also, they are the ones who are supposed to fix that problem.
ben_w 5y ago
I suspect gerontocracy would be a distinct without a difference after someone invents any real fountain-of-youth category of tech (mind uploading included), in much the same way that land ownership went from being a requirement for voting to merely one of many ways to hold wealth as the USA went from an agrarian to an industrial society. Big difference going from 50 to 70; proportionally less going from 600 to 700, even if the world isn’t changing in a way that makes recent experience count for more than ancient experience.

giantg2 5y ago

"the WTP at birth for the initial 1-year increase in remaining LE from 78.9 to 79.9 years via rectangularization is US$118,100, the WTP at age 60 for the first 1-year increase in remaining LE from 21.7 to 22.7 years through lifespan improvement is US$257,700." Who the fuck did they get to determine willingness? Most people don't have the money to spend. If it takes you years of extra work to pay for a one year life extension, why not just retire years earlier and enjoy that time? After all, you could still die from an accident after paying the sum at birth/60. It seems highly inappropriate to use a population based metric like life expectancy to have individuals decide if they want a one year increase (likely the individuals don't understand life expectancy as well as).

ben_w 5y ago
At a guess, old people have a house or something they can sell for that much.
- giantg2 5y ago
  Given the massive gap between what people should have for retirement and the little they actually save, they probably need that money for necessities. That's what most people using reverse mortgages use it for today.
maerF0x0 5y ago
Back when I was _really_ into longevity stuff, aubrey de gret etc... I seem to recall that even if we removed all forms of aging people would have an expected lifespan of roughly 1000 years due to trauma death (eg: getting hit by a bus) . So that could serve as a rough rule of thumb for how to think about risk/reward on increasing health in later years. That is it generally has a good EROI for how safe (accident wise) our society actually is.
- wpasc 5y ago
  If you don't mind me asking (off-topic), are you less into longevity stuff now? if yes, what made you less into it/possibly more skeptical of it?

seph-reed 5y ago

I know some really spry older (60-80) people. Good diet and exercise is what they have in common. It also helps with mental health (which we have an epidemic of in the US). By all means, this research should continue. But we do already have very good solutions to aging which are sorely overlooked.

wpasc 5y ago
The general Aubrey de Grey response to this observation is that yes, lifestyle improvements are great and diet/exercise are great for improving one's life. However, it ends up conferring only a few more years of life. Some evidence he provides is that even very healthy (by obesity metrics for example) countries only have a life expectancy a few years longer than "unhealthy" countries. I think he cites like Japan (with lower obesity rates) having a life expectancy of 6 years longer than US (high obesity rates). Not my observation so feel free to caveat me away, but I'm just regurgitating what some doctors who studying aging observe and perhaps I'm not remembering all the evidence they provide.

hardtke 5y ago

This reminds me of some articles that came out when the states sued the tobacco companies in the 1990s. Many asked why the US federal government did not sue as well, and the answer turned out to be that smoking is good for the federal government finances. It tends to kill people quickly (heart attack) just after they retire and start collecting social security.

fredliu 5y ago

Not surprised David Sinclair is one of the co-authors. Anti-aging is a fascinating new field. It's great that there's some discussion about economical aspects of "slow down aging" at a large scale.

mensetmanusman 5y ago

It’s obvious that healthy people that live shorter are better for the ‘economy’ but clearly humanity doesn’t live to optimize for the economy. If we did, we would be fighting obesity with 10x the seriousness of how we fight COVID.

maerF0x0 5y ago
basically anything that wasnt a long term compounding investment would be illegal... Obvious things like smoking and vaping, but maybe even time wasters like social media (you could be learning something...) Luckily human life is more than just economy (as expressed in GDP) optimization.
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ohazi 5y ago
There is no cohesive "humanity" with any sort of desire or ability to optimize for "the economy." Individuals optimize for their own (often short-term) economic benefit. That's it. The corporate overlords at ACME don't care about fighting obesity, because there are more than enough non-obese workers for them to exploit, and they don't want to cannibalize their highly profitable line of products that obese people need (i.e. insulin). Governments are composed of individuals, and the structures we have to hold these individuals accountable to their constituents are weak, so they still end up using their levers of power for their own gain, and for the gain of their corporate sponsors (also often short-term). Despite ~70 year lifespans, it seems that most of the population can't even be bothered to optimize for medium-term outcomes. This isn't going to change just because we invent a magic pill that lets you live youthfully till ~150. The problem isn't lifespan, the problem is that humanity is innately selfish and short-sighted. If this can't be fixed, we are completely fucked.
- Ericson2314 5y ago
  > Individuals optimize for their own (often short-term) economic benefit. That's it. Don't go to too far with this sort of atomistic analysis. Large firms are better at enforcing coordination than "society at-large" or other groupings. The fact that at different scales the coordination is markedly different has a huge affect. We're not an "economy of households" as the orthodox macro might have one model.

dalbasal 5y ago

I only skimmed past the abstract (wolverine case is gold, lol) feel that such an analysis gets squirrely, both morally and technically. A few years back, there seemed to be a desire to justify cigarette taxes with a "it costs the state money when you get cancer" rationale. Some of the analysis seemed to indicate opposite results. Lung cancer, for example, tends to kill more quickly than age related diseases, saving on nursing home costs and palliative care. Everyone dies of something after all, and death is expensive as is aging. Either way, it seems kind of strange to place economic values on life itself. I mean isn't economic utility premised on life? In any case, it seems trivially true that economic measures will always correlate with either population size working age population size, depending on the model. I feel like these kinds of papers only exist to be cited in support of cheap rhetoric.

t_serpico 5y ago
"I feel like these kinds of papers only exist to be cited in support of cheap rhetoric." Agreed. The authors already made up their mind regarding the conclusion before writing the paper. This is an analysis that should be done by a group not involved in aging research so it's 'unbiased'.
jjoonathan 5y ago
Any action you take to preserve life has the side effect of putting an economic value on life. You invest some amount of effort into the action and the action has some amount of efficacy, so you can always divide the two to find a valuation. I agree that this exercise usually winds up as cheap rhetoric, but I'm not fully convinced it's the fault of the exercise. Refusing to calculate a value doesn't mean the value doesn't exist, it just means we are letting our instincts decide the value for us, and our instincts are prone to doing silly things like spending the wrong amount of attention on anti-terrorism vs heart disease.
- dalbasal 5y ago
  This has a "trolley problem" feel to it. It's a contrived scenario that doesn't reflect real life. I'm not suggesting that all our decision making is good. Terrorism vs heart disease just don't really compete. A model of the world where everything competes with everything isn't a good one for decision making. Just like "don't build a particle collider until we have solved poverty" is not a workable approach. Terrorism & heart disease don't have the same consequences, socially, politically or geopolitically. We're not machines. Even in machines' decision making, such moral calculus doesn't really play. Self driving cars won't, and don't need to solve the trolley problem any more than we do. ..and don't underestimate our instincts. They may not be as "perfect" as legible reasoning, but they are far more complete.

deegles 5y ago

There are a lot of DIYers experimenting with senolytics and Rapamycin therapies for longevity. I expect that in the next 10 years or so evidence will be clear that at least some of these therapies work. It will be undeniable as more and more people start to hit their 80s, 90s, and beyond in very good health. I'm in my 30s so not in need yet but I'm keeping a close eye on the science. For example, this clinical trial [0] is studying the safety of various dosing schedules of Rapamycin, and a planned followup study will use the safest dose with a larger group and longer timeline. [0] https://www.lifespan.io/campaigns/pearl-participatory-evaluation-of-aging-with-rapamycin-for-longevity/ https://www.lifespan.io/campaigns/pearl-participatory-evalua... edit: fine, maybe more than 10 years but within my lifetime :)

p1esk 5y ago
the next 10 years or so evidence will be clear that at least some of these therapies work. I think you forgot an extra zero
- deleted 5y ago
  [deleted]
ska 5y ago
> I expect that in the next 10 years or so evidence will be clear that at least some of these therapies work. It's an interesting area, and at least some empirically useful work is being done, but both the expectation and the timeline here seem pretty ambitious.
bserge 5y ago
They're not DIYers when using a prescription drug. Something inaccessible to the majority of the population. Can't wait for a time when trying to delay your death requires serious justification and approval from some asshole whose only authority comes from 5+ years of overpriced formal education.
- ixacto 5y ago
  Sortof. But the assholes do know a bit about science, and are taking an arguably conservative view on pharmacological interventions in the treatment of aging to prevent possible problems. For example this trial: Targeting the Biology of Aging. Ushering a New Era of Interventions. The official web resource of the TAME Trial, managed by the American Federation for Aging Research. they are not saying that taking metformin slows aging, merely that it delays development of chronic illnesses. What we should be asking is if metformin is actually slowing down the biological aging process. https://www.afar.org/tame-trial https://www.afar.org/tame-trial

qntty 5y ago

Maybe conservatives worrying about death panels in 2008 weren't so crazy...

courtf 5y ago

The quest for immortality is popular, but it would mean the end of physical and cultural evolution. Seems as though this topic is gaining steam now, only as a large corpus of aging narcissists are finally grappling with the concept of death. It's another sign of the selfish immaturity ingrained into our culture.

kiba 5y ago
This is nonsense. We change everyday through forgetting and remembering and learning. Physical and cultural evolution don't stop. It's another sign of the selfish immaturity ingrained into our culture. Selfish immaturity? It seems that you yourself is a reflection of culture. One of our very first epic poems, the Epic of Gilgamesh basically railed against immortality and accepting one's fate.
- courtf 5y ago
  > Physical and cultural evolution don't stop. If someone lives forever, they don't evolve physically. This is basic. To the degree we evolve culturally, most of our culture comes to us in our eponymous "formative years." Leaving those behind tends to result in comparatively little change in culture over the remaining course of our lives. > Selfish immaturity? It seems that you yourself is a reflection of culture. I rest my case. > One of our very first epic poems, the Epic of Gilgamesh basically railed against immortality and accepting one's fate. This was not a call to try and live forever, this is a call to live boldly, take risks and not to fear death. Striving for immortality is the absolute opposite, the coward's response to the challenge made in the poem.
  - sigstoat 5y ago
    > If someone lives forever, they don't evolve physically. you skipped some lessons in biology class; you're not doing any evolving over the course of _your_ life. regardless of how long or short it is.
    - courtf 5y ago

godelski 5y ago

I'm reminded of Nick Bostrom's story called "The Dragon Tyrant"[0][1] and David Foster Wallace's "This is Water"[2]. The dragon became so normal in our lives that we do not even question it, like a fish does not question what water is. That we've created a society around this how to deal with this inevitability. But at the end of the day if we could, killing the dragon would be more beneficial and reduce harm by a significant amount. I see several people in this thread complaining about the economic analysis here or how old people are messing up our world and thus we should fix those things first. For the former question, I see this analysis as adding ammunition to the debate, because many people that determine where we should fund base their decisions on economics. This paper isn't aimed at you, it is aimed at them (speak to your audience). For the latter, I question the premise. Culture has moved too fast that it cannot be purely explained by younger generations dictating the change. This also falls counter to old people controlling everything. So I don't buy the premise. The truth is that if people were living to a thousand years old that society would fundamentally change. Who we consider children and adults would fundamentally change. The truth is that we don't know what this society will look like until we open the box, and until the dust settles. We should be questioning if this is good or bad (we should challenge all ideas) but we need to recognize that this would be such a fundamental change in society that we have no real baseline for determining how we would change. My personal belief is that we do not go quiet into that dark night. There is a lot to fear, but often our fears are irrational. This would save billions of lives, and so I believe it is worth the risk and worth the hardship we will face as society transitions into this new paradigm. [0]https://nickbostrom.com/fable/dragon.html https://nickbostrom.com/fable/dragon.html [1](Animated by CGP Grey) https://www.youtube.com/watch?v=cZYNADOHhVY https://www.youtube.com/watch?v=cZYNADOHhVY [2] https://www.youtube.com/watch?v=eC7xzavzEKY https://www.youtube.com/watch?v=eC7xzavzEKY

JumpCrisscross 5y ago
> My personal belief is that we do not go quiet into that dark night I think many do. One of my takeaways from the pandemic is that there are people--intelligent, informed, unoppressed people--who will self select away from benefits. Even seemingly obvious ones. The fictional dystopias of the last century would have had an immortal elite keeping aging treatments from clamoring masses. I don't think that's how it would turn out. Many people--including leaders--would choose not to get the treatment. Still others would push their societies to ban treatments for everyone. I don't know how you model this. It's a different form of haves and have-nots than we're accustomed to. But it would undoubtedly feed into and ameliorate the concerns brought up in this thread.

The_rationalist 5y ago

I invite readers to look into SkQ1, thymalin and Epitalon

willwashburn 5y ago

It seems that their calculations use metformin. At what age should we start using it for health-span extension? I'm already using it to avoid glucose spikes, even though I'm not even prediabetic, but I'm curious if it's known how powerful is the health-span effect is younger humans.

wincy 5y ago
If glucose spikes are bad for you, why not just exclude all foods with a glycemic index? That’s what I’ve done and find my mental health and energy levels have improved substantially.

nostromo 5y ago

I used metformin for a bit, but stopped because it was found to hinder muscle growth. I decided for the time being I’d rather look and feel good and not be a fragile waif in the hopes of living a bit longer. I came to similar conclusions about calorie restriction. These schemes tend to slow or restrict growth and energy levels, which is a real side effect we should be discussing more. Rapamycin seems promising though. It appears you can cycle on and off it and get most of the anti-aging benefits, while limiting the effects of blocking protein synthesis.

kiba 5y ago
I used metformin for a bit, but stopped because it was found to hinder muscle growth. I decided for the time being I’d rather look and feel good and not be a fragile waif in the hopes of living a bit longer. I heard the effect was effectively not much, so you should be OK exercising. Just that your muscle gain will be a little bit less. This is just what I heard from other people though, so take it with a grain of salt. Even if hinder muscle growth by 50%, I might still take it. I came to similar conclusions about calorie restriction. These schemes tend to slow or restrict growth and energy levels, which is a real side effect we should be discussing more. I doubt calorie restriction actually works for us. I find intermittent fasting easy.

im3w1l 5y ago

Personally I believe that the fundamental driver of aging is dna damage. The direct issue is cancer, but the indirect consequence is that the body slows down cellular reproduction to counteract said cancer. This means slower healing of any injuries, and lower vigor. Thus I see any aging treatment that doesn't fix dna damage as fundamentally a blind alley. And conversely if someone manages to fix dna damage, then the rest should just be some small details.

ben7799 5y ago

This article seems to be about the economic value gained by reduced health care or something. If you actually extended lifespans by a significant margin (say to 200 years) there would be other knock on effects that would completely derail the global economy & markets. This study doesn't seem to think about how those things could actually negatively impact economics. Eventually if you're intelligent and you're trying to self-fund your retirement you build up assets that are growing at a sufficient rate that you can live off the growth without touching your principal. Once you hit that, work becomes unnecessary. If everyone goes from retiring for 20-30 years to suddenly possibly retiring for 120-140 years things get all kinds of strange things happening, the percentage of the population working would diminish. But then that would negatively impact companies due to increasing difficulty in finding workers, which would negatively impact markets, which would then feedback into ruining the investments allowing all these retirees to live off investments & savings. The current system couldn't work without room to greatly expand the population of living people to ensure growth of the workforce. I have seen these ideas explored in Science Fiction occasionally, but not many other places. There is another aspect as well, if you lived 200 years, what if you ended up having multiple successive families? Raise a family, your kids grow up, then you raise another family 50 years later?

JumpCrisscross 5y ago
> If you actually extended lifespans by a significant margin (say to 200 years) there would be other knock on effects that would completely derail the global economy & markets Re-structure? Sure. De-rail? No. One could imagine our current low-interest rate environment (interest rates and time horizons are fundamentally linked) as a first step towards that world. You're highlighting a problem of retirement savings running out and the labor pool diminishing. These problems offer an obvious solution.
- ben7799 5y ago
  Retirees running out of money because the economy is crashing doesn't really match up with "they'll just go back to work". People might stop having kids too, then there will be no new workers entering the work force eventually if lifespan was extended indefinitely.

rad_gruchalski 5y ago

Okay, but what do we do when there is 30 or 40 billion of us?

ALittleLight 5y ago
Invest in space travel and colonization.
_carbyau_ 5y ago
Population control. Episode 3, Season 2, "Love, Death & Robots" covers a very similar scenario with Black Mirror-like horror... Effectively, having "unapproved" children results in the children being executed, the parents gaoled for criminal/mental health issues.

justinboogaard 5y ago

Glad they draw attention to the difference between “healthy years” and “just more years”. From our work at GoGo (GoGoGrandparent.com) our clients specifically value more time in the community they grew old in. As you age the trip to church every Sunday becomes what you live for, and taking that away so you can live more years in a retrofitted apartment building isn’t worth it to a lot of people.

nootropicat 5y ago

I don't expect any noticeable progress as long as medical regulations assume that people already live forever. Avoidance of risk is an absolute priority, even though under current technology level everybody is certain to die. Collective insanity helped by entrenched interest of big pharma corporations. The only way this changes is if against all odds diy biohacking scene arrives and outright breaks the law by doing human experiments. I got interested a few years ago and concluded until dna synthesis becomes cheap and more reliable for longer sequences it's a pipe dream. That would require a fundamentally new technology (enzymatic dna synthesis?) as current tech is just marginally improved 1970s tech.

MarkMc 5y ago

Thereputic Plasma Exchange (ie. exchanging blood plasma with saline and albumin) seems a very promising treatment for aging. [1] [2] "These findings are exciting not only because they represent a scientific advance in understanding aging, but also because they herald the first real anti-aging product that could come to market. Therapeutic plasma exchange is FDA-approved (not for aging, but for a bunch of other conditions). I imagine there remain prohibitions on advertising that it can add years to your life, but it is safe, and a doctor can prescribe it off label. It’s also cheap. An automated plasmapheresis machine—which lets you do treatment after treatment—can be bought online for under $3,000. That is less than the cost of a single transfusion of young blood sold by the startup Ambrosia. How long until someone opens a clinic offering plasma dilution? I bet someone tries it in 2021. If it works, people will get over the weirdness, and it could be commonplace by 2030." [3] [1] https://www.aging-us.com/article/103418/text#fulltext https://www.aging-us.com/article/103418/text#fulltext [2] https://link.springer.com/article/10.1007/s11357-020-00297-8 https://link.springer.com/article/10.1007/s11357-020-00297-8 [3] https://elidourado.com/blog/notes-on-technology-2020s/ https://elidourado.com/blog/notes-on-technology-2020s/