The Problem with Focusing on Healthspan

There are numerous ways to go about advocacy for the cause of treating aging as medical condition, for the production of therapies to address the aging process. One might focus on talking about extended health, or the goal of greatly increased longevity, or the details of aging as a novel target for medicine, or discard aging as a topic in favor of the development of cures for common, well-recognized age-related diseases – something that can only be achieved through addressing the causes of aging, but many people are more receptive to treating age-related disease rather than treating aging, no matter that these must be one and the same in the end.

The advocates, researchers, and supporters in our small community are largely here because of the possibility of radical life extension and working rejuvenation therapies, especially those who were involved early on. The SENS rejuvenation research programs were initially supported because they are the most viable path forward towards the long-term goal of escaping the bounds of aging. SENS is the best of current plans for aging research because it aims to fundamentally change the human condition by bringing aging under control. Those who have over the years materially supported SENS to the greatest degree are also doing so precisely because the project aims high, not just because it is credible, but also because it isn’t just another group of aging researchers talking about small changes to the aging process.

Once engaging with the broader community of larger, more conservative funding bodies, and scientific institutions, and high net worth individuals, however, these are near entirely people who either do not subscribe to transhumanist views of what is possible to achieve through medical science in our lifetimes, or who are not willing to be seen to adopt that minority viewpoint, or to espouse any viewpoint significantly different from those of their peers. Even when it is correct. Even when it is useful. Even when it is the only practical way forward to address aging and age-related disease. This is politics in all its prosaic ugliness. So as advocacy for the treatment of aging as a medical condition has spread over the years, the message has been watered down. We go from the goals of radical life extension and rejuvenation to a focus on modest increases in healthspan with no mention of longevity.

There is a faction in our core community that believes we should go along with this, and dial back our public positions. Talk about healthspan and only healthspan, because it will pull in more supporters and more conservative funding. Or at least we can point to aging research institutions much larger than the SENS community, who only talk about healthspan, and seem to do quite well on the funding front – the Buck Institute is a good example. Why can’t we do that? If we did, the funds will still go to the same projects that are the foundation of rejuvenation therapies, stepping closer to an end to degenerative aging. Those projects will certainly do a good job of increasing healthspan: the only way to achieve radical life extension is to maintain youth, after all. Why care if goals are misaligned, if the funding sources think they are helping to achieve marginal, tiny gains in healthspan, because that is all they believe to be possible, and instead the result is large gains in both health and longevity?

I think that this argument misses the reality of what will happen in an environment where the rejuvenation research message is the same as that of people pushing supplements, trials of metformin, calorie restriction mimetics, boosted autophagy, cholesterol-lowering drugs, and so forth. When the greater conversation surrounding aging research is that it is a way to extend healthspan, and no-one talks about longevity, then the existing well-connected research groups that only work on slightly slowing aging will trample all over more radical groups like SENS researchers, by weight of numbers if nothing else. Those involved in research that aims to slightly slow aging can set a target of adding five years via some form of metabolic adjustment, and when it is achieved present the outcome as a great victory, task accomplished.

They will say that most people die by 90, with the unspoken assumption that this is set in stone. By adding five years of health, they can claim to have removed 20%-30% of the period of significant decline at the end of life, and isn’t that amazing progress? Armed with this message of compression of morbidity, such marginal strategies will continue to dominate the research community, just as they do today. Those of us who see further and want the implementation of rejuvenation to significantly extend both health and life, not just a slight slowing of the aging process, will continue to struggle to move the field of aging research beyond paltry efforts. So much of what goes on in the field today is near meaningless, a waste of effort when considered against what is possible to achieve through rejuvenation: additional decades and then centuries and longer of health and vigor.

The problem is that this field of research already spends near all of its time on marginal, unambitious goals. The problem is that the vast majority of advocacy and public engagement is focused on painting tiny gains as large gains, via the vision of compression of morbidity that talks only of healthspan. When longevity is not open to improvement, small increases in healthspan look large. But these increases are not large, vastly greater gains are possible, and this state of affairs must change. Creating that change requires that we distinguish ourselves and our message. All of the progress to date in establishing SENS rejuvenation research as an important part of the field has been achieved by distinguishing ourselves, by talking about greatly increased health and longevity and an end to aging, rather than hiding that view simply because some people would rather not engage with it. Further progress requires that we persuade more people to the goal of radical life extension, not that we make ourselves look just like the many other groups whose research strategies cannot possibly do more than add a couple of years to health or life span.

If you are running with the one viable, best, most effective way forward, then the worst thing you can do is to make your efforts, your plan for the future, look like the initiatives undertaken by everyone else. The point is to upend the world, revolutionize the research community, drag this field kicking and screaming into this 21st century of endless potential in biotechnology, to defeat aging and all of the death and suffering it creates completely and comprehensively. Aim high. Do what the others are not doing. Bring the world to your point of view. You can’t do that in camouflage, with the light under the bushel.

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