Throughout human history children often struggled to make it to age five, due to infant mortality and childhood diseases. Undoubtedly the poor bore the brunt of infant mortality. However, the rich were not immune. Scientific American recently wrote about the mummy of the first-born son of an Austrian noble, who died at age 18 months. Although well fed, he apparently died of a vitamin D deficiency about 400 years ago.
According to an article in Wired Magazine your odds of making it into your 20s were roughly 50/50 for most of the time humans roamed the Earth. If you avoided infant mortality and childhood diseases, there were numerous other things that could kill you. The Black Death (Bubonic Plague) of 1347 to 1351 is thought to have killed from 75 million to as much as 200 million people worldwide.
Alexander the Great died at age 32 from malaria or typhoid fever. The famous composer Mozart died of an unknown illness at age 35. King Henry the 8th died at 55 of old age, but his poor health is thought to have stemmed from a jousting accident suffered years earlier. William the Conqueror died around age 59 from a ruptured intestine when his horse reared up in battle and drove the saddle’s pommel into his stomach.
Throughout history people have sought to slow aging and their inevitable demise. Spanish Conquistador Juan Ponce de León supposedly explored Florida in 1513 looking for the fountain of youth. He would have been 38 or 39 at the time and died only seven years later. Human lifespan would not begin its slow but steady rise for another three centuries after Ponce de León.
Over the past century or so medical science began reducing death from diseases. In many cases it was public health measures that reduced mortality, not medicine. Indeed, the greatest public health achievements of the 20th Century that reduced mortality are not what most people would expect. These include safer foods, safer drinking water, vaccination, family planning leading to healthier mothers and babies and safer workplaces, to name a few.
As medical science increased longevity, people began dying of new diseases. Cancer, for instance, is mostly a disease of old age. Then there is old age itself. As people no longer were at great risk from dying of diseases caught in their youth, they succumbed to diseases of old age and old age itself.
According to Wired Magazine:
Aging is now responsible for over two-thirds of deaths globally—more than 100,000 people every day. This is because, counterintuitive though it may sound, the chief risk factor for most of the modern world’s leading killers is the aging process itself: Cancer, heart disease, dementia, and many more health problems become radically more common as we get older. We all know that factors such as smoking, lack of exercise, and poor diet can increase the risk of chronic diseases, but these are relatively minor compared to aging. For instance, having high blood pressure doubles your risk of having a heart attack; being 80 rather than 40 years old multiplies your risk by ten. As the global population ages, the magnitude of death and suffering caused by aging will only increase.
Some researchers wonder why there aren’t drugs to treat aging itself, not just drugs to treat the symptoms of aging.
Scientists now have a good handle on what causes us to age, biologically speaking: The so-called “hallmarks” of the aging process range from damage to our DNA—the instruction manual within each of our cells—to proteins that misbehave because of alterations to their chemical structure. Most excitingly, we now have ideas of how to treat them.
The first true anti-aging medicine will very likely target a specific age-related disease driven by a particular hallmark, rather than aging writ large. But the success of a drug targeting an aspect of aging in clinical trials will allow us to consider this loftier goal in the not-too-distant future.
One problem is that the U.S. Food and Drug Administration does not consider aging to be a disease. Thus, the bar for approval is higher than for diseases due to aging.
The Food and Drug Administration (FDA) considers aging to be a natural process. This makes it difficult to get FDA approval for drugs that seek to slow or reverse the biological process of aging. Instead, drugs intended to target aging must target a disease that often results from the aging process in order to demonstrate efficacy and gain approval.
There is some interest in the diabetes drug, Metformin as an anti-aging drug. It doesn’t make you younger, just supposedly less likely to come down with diseases of old age. This from Harvard.
If you have diabetes and need metformin to help lower your blood sugar, its other potential health benefits are a wonderful — not harmful — side effect. And if you don’t have diabetes? Well, its role in preventing or treating diseases, and possibly even slowing aging and extending life expectancy, is much less clear.
While the research so far is promising, we need more compelling evidence before endorsing its widespread use for people without diabetes. But, for clinical researchers hoping to repurpose an old medicine as a new wonder drug, metformin would seem like a great place to start.
If drugs were developed that seemingly slowed the biological aging process they would probably be expensive. They would likely have to be taken continually similar to drugs for chronic conditions. Health insurance would likely not cover them if they were not approved to treat a specific disease. The liberal media would lament how horrible it is that life-extending drugs are not free and why not force health insurance to cover them. If covered by health insurance, the prices would become really, really expensive.
A background on clinical trials targeting aging can be found here.