Turn off Netflix and take the stairs: let’s aim for a healthy death instead of just living longer | Robin Mckie

PThe prospects for extending lifespan have made headlines in recent weeks. “Tantalizing drug makes mice live longer but preserves youthful appearance,” the Time announced. “Anti-aging drug is ‘holy grail’ in the fight against cancer,” claimed the Telegraph.

The agent of this is also not media worship – antibodies that block the action of the inflammatory substance IL-11 – the only anti-aging miracle cure to have been in the news in recent months. In March, researchers have announced that by balancing two types of immune cells, they had improved the ability of older mice to fight viral infections and thus live longer. This came on top of research from another group last year that revealed they had used injections of the drugs dasatinib and quercetin to rejuvenate the hearts of mice and make them less vulnerable.

It sounds very encouraging. Medical science is clearly making progress, and lab mice are living longer—although some caution is warranted. For starters, translating rodent experiments to humans is notoriously tricky. One example is the drug fialuridine, developed in the 1990s to treat people with hepatitis B. It worked well in mice (and rats, dogs, and primates), but in human trials it caused liver failure. Five people died as a result.

It remains to be seen how treatments that block the action of IL-11 will fare when the results of human trials are published, a point highlighted by Ilaria Bellantuono, professor of musculoskeletal ageing at the University of Sheffield. “The problem with all of these interventions is that we don’t have evidence in patients,” she argues. “Although trials are being conducted in the US, there are scientific hurdles that need to be overcome to use these interventions in patients, such as understanding who would benefit from the intervention. Every drug has side effects and there is a cost associated with them.”

In any case, simply pursuing the extension of human lifespan for its own sake is being challenged by a growing number of scientists who believe that we should be addressing health span, not life span, as the primary goal of aging research. In other words, we need to do much more than simply extend life span and instead pursue the specific goal of increasing the number of additional years we experience when we are independent, free from chronic disease, and wealthy enough to live fulfilling lives.

It’s a point that Susan Howlett, a professor of pharmacology and medicine at Dalhousie University in Nova Scotia, sums up. “Who wants to improve longevity if you’re in terrible shape and can’t enjoy your life? Eventually, something’s going to get you. We all know that. What we really have to fear is a long period of disability before that happens.”

It’s an approach to aging that’s perfectly summed up by the answer to the age-old question: “What’s the best way to die?” Getting shot at 85 by a jealous lover remains my favorite answer.

Or as Howlett puts it, we should aim for the simple goal of dying healthily. “You want to spend most of your old age in the best possible health. That should be our primary goal.” A glance at UK population statistics shows how important this approach is. Life expectancy is plateaued in the United Kingdom. However, the number of people who are living to a relatively old age has increased dramatically. In ten years’ time, there will be about 13 million people in the United Kingdom, people over 65 will make up more than a fifth of the country’s population.

This is a very different picture to that seen in Britain just a few decades ago, when those of pensionable age were a distinct minority. In 1950, for example, there were 5.3 million people over 65, a number that represents only 10.8% of the total population.

From this perspective it is clear that older people need to be fit and able to get the most out of their lives. Not only for their own good, but also to avoid becoming a burden to the relatively young rest of our society. This group is getting smaller as the population ages.

In short, we need to prepare for a society with a functioning population of elderly people. Think of it as a healthy campaign. The trick is of course to achieve this ambitious ambition.

The critical factor will be mental health, stresses Dr Richard Siow, director of ageing research at King’s College London. “We need to prepare for the onset of old age while we are still in middle age. We need to walk instead of taking the bus, use the stairs instead of the lift, avoid stress, adopt healthy sleep patterns and not watch Netflix until 3am, eat well and be careful about how we use social media.

“We need to enter old age with a healthy mindset, otherwise it will become oppressive for many people and they will sink into anxiety and depression. It doesn’t have to be that way, but we need to think about it now if we want people to enjoy their old age in a fulfilling way. That’s the real problem with old age that we are dealing with today.”