Ageing: a treatable disease?
The older you get, the higher your risk of a gory array of diseases. Currently, these diseases are researched and treated separately. But David Gems, Deputy Director of the Institute of Healthy Ageing at UCL, asks why not concentrate on treating the underlying cause? The process of ageing.
Though most diseases today are caused by it, ageing is mostly an unsolved mystery. David Gems’ lab takes a simple animal, the worm Caenorhabditis elegans, and studies it to help understand the biology of ageing. With this comes hope of unraveling the undoubtedly more complex puzzle of human ageing and possibly even treating it and its associated diseases, such as cardiovascular disease and cancer.
Researchers at the University of Arkansas have achieved a ten-fold life extension in C. elegans. When I ask David Gems if this can be applied to humans, he immediately quashes my hopes of living for an extra 1000 years: “translated to humans, is a ten-fold increase an extra few months as it would be in C.elegans, or actually a ten-fold increase?” I get the feeling it’s closer to the former.
The improvements in lifespan seen in the lab are not fully understood, but have sparked some ideas on why ageing leads to increased risk of illness. Theories range from an accumulation of molecular damage, to the immune system’s decline overtime leaving us vulnerable. What Gems says scientists have definitely learnt from C. elegans, however, is that “ageing is not set in stone. There is a plasticity in human beings that we can intervene in.”
Treatment would target senescence, the deterioration of biological function that leads to the whole range of age-related diseases and ensures everyone’s death one way or another. Lab research suggests that physical decline can be delayed, not halted. Gems hopes that a life-span increase of 5, 10 or even 20 years is possible, stressing that treatment should extend the healthy part of life and not the time spent on your deathbed.
Gems argues that we are already treating ageing: sunblock prevents molecular damage by UV rays and dietary restriction is proven to increase lifespan in mammals. An aim of ageing research is to develop drugs to replicate these effects. A pill might be taken from “midlife onwards. This pill would theoretically slow ageing with minimal side effects. Its predicted impact would be to reduce the incidence of ageing-related diseases at all ages – although not to remove them altogether.”
Not everyone welcomes this route to longer life. Ageing is seen to represent the culmination of wisdom, the passage of time and the seemingly eternal natural rule that everything must end. Gems describes the resulting “dual standard” from this emotional association: ageing treatment is seen as dangerous, but disease treatment is a perfectly acceptable thing. This is despite the fact they both lead to a modest increase in lifespan and a healthier life.
Gems thinks “one of the great fallacies is the separation of ageing from the rest of medicine. I think ageing is a disease, and conceptually follows the same basic ethical rules.” He describes how medical students are not taught the biology of ageing, despite the fact that ageing is one of the main challenges they will face as doctors: “the medical establishment has a lot of hostility against the treatment of ageing, but it’s ill-informed.”
Some fear that demand could cause other problems. On an individual basis it is hard to refuse, but societally it could lead to a massive rise in overpopulation and other health risks that come with it. But there is an ethical cry for ageing treatment now. Gems hopes that “if we can prepare for it socially, politically and institutionally, and if we keep birth rates low, we should be able to ensure long, healthier, happier lives for our children and for our children’s children”.