Goodbye mortals

Conquering the biggest killer of all: ageing

“There's no chance for us / It's all decided for us...Who wants to live forever…” – so the Queen song goes. Death is inevitable, right? Not in 2050. Scientists are confident that death will be a choice in as little as three decades’ time. Immortal? No, come on. We’re not vampires or superheroes or jellyfish (yet). We’ll be what the transhumanist movement calls ‘amortal’ – where the radical lengthening of your lifespan in good health will be a conscious choice.

No-one is going to force you to live for 200 years. Like everything in life, it’s up to you. You can choose to smoke and knowingly shorten your life. If you start to find life boring, you can choose to let it run its course. Or you might be the sort of person who wishes for 48 hours in every day. Someone who needs 500 years to cram in all the living you want to do. For you, there is only good news.

Either way, when you die, it will be a death on your time frame, not a death suffered. Long before 2050, you’ll start having regular checks on your ageing mechanism risk factors by your doctor. Depending on your stats, you’ll be prescribed various preventative treatments, from nanomedicine to automatically correct your blood pressure, to gene therapy slowing down greying hair or osteoporosis. There will be treatments for your senescent (old, inactive) cells or your autophagy (the process whereby your body gets rid of old, damaged proteins). Everything will be constantly monitored and adjusted to help you live happily and agelessly.

The hallmarks of ageing – dementia, Alzheimer’s, diminishing eyesight, cancer, heart disease – will now be managed effortlessly like you would arthritis or diabetes. ‘Brain pacemakers’ (brain stimulation implants) will be as ubiquitous as cardiac pacemakers. Currently they treat epilepsy and movement disorders like Parkinson’s; in 2051 you could get deep brain stimulation for depression, OCD, memory impairments, back pain and much more. Implants will come with AI technology that can observe brain function and make adjustments on the spot.

Rejuvenation therapies will be widely available – not just to the wealthy elite – as open-source technology is shared freely to anyone to adapt. You’ll no longer have to live with DNA you inherited from your parents. Genome editing will be so far advanced that you could prune away at any undesirable DNA cells or rewrite new ones. Gene splicing will add new genes into your body – for example, photoreceptor cells to restore vision in blind people. If an organ gives out, you will no longer have to wait months for a suitable donor – one could be 3D-printed for you. Suffering from dodgy dental work from decades back? No more scaring the grandkids with your false teeth. You can simply grow back the teeth you lost. Science fiction? Definitely not. Welcome to the age of amortality.

Solving the problem of ageing

Let’s face it – ageing is going to be solved very soon and likely by Silicon Valley. Longevity has become an obsession for tech titans who are throwing mountains of cash at the problem of lifespan extension. Jeff Bezos, Peter Thiel, Sergey Brin, Larry Ellison – they are all either funding longevity research or experimenting with anti-ageing interventions themselves (or both). If anything can be hacked, why not the process of ageing? It’s happening already and we’ll see exponential growth in this area over the next few decades.

But first, we must figure out exactly what causes ageing in our bodies. The first topic of study: the senescent or so-called ‘zombie cells’ in our bodies. These cells stick around forever, not really doing much, along with your other healthy cells. However, researchers now see that senescence plays a very important role. As we age, these damaged cells start to accumulate and cause havoc – changing your metabolism and stem cell function, kicking off the ageing process and accelerating conditions associated with it such as Alzheimer's disease. If we can destroy them, we can live longer.

In 2016, this was proven in an animal trial performed by Jan van Deursen, a molecular biologist at the Mayo Clinic. The study showed that if you purge senescent cells in a mouse born on the same day, from the same litter, and raised in the same conditions as its siblings, it will make him look younger and will delay the onset of mice-related ageing like cataracts and a bent spine.

Pharmaceutical companies and investors are working hard to find the compounds that can target senescent cells and are currently doing human trials with ‘senolytic’ drugs. One such company that is committed to producing anti-ageing medicine very soon is Unity Biotechnology (of which Van Deursen is a founder). This San Francisco start-up has attracted over $200 million from investors that include PayPal co-founder Peter Thiel and Amazon CEO Jeff Bezos. Unity’s tests currently focus on delivering localised therapy in ophthalmologic and neurologic diseases. Its stance is that when you view ageing through the lens of specific diseases, you will make someone more functional and therefore able to live longer.

Others feel that larger trials should be done on ‘geroprotectors’ – the drugs that seem to slow down ageing altogether. The star here is metformin, the low-cost diabetes drug that may have already saved more people from cancer deaths than any drug in history. Comparing the results of diabetics taking metformin over twenty years versus those on other diabetes drugs, the results were astounding. Metformin takers were all-round healthier: they lived longer and had fewer cardiovascular events. They seem to suffer less from dementia and Alzheimer’s. But the biggest bonus was that they were 25-40% less likely to contract cancer than diabetics on other popular medications. Even when they did, they outlived those on other medication.

No wonder then, that Silicon Valley execs are popping metformin like candy – side effects be damned. Many scientists are pushing for the wonder drug to be approved for widespread use sooner rather than later. There is even data that shows it can significantly reduce the risk of death from COVID-19 in women.

The main issue is that the FDA doesn’t recognise ageing as a disease. That’s why the TAME Trial – Targeting Aging with Metformin – is so exciting. While focussing on the three main age-related chronic diseases (heart disease, cancer, and dementia), if the trial is successful it will be the first time that ageing is made an indication for treatment. We’ll only have those results by around 2027.

Looking much further ahead is the game plan of another longevity frontrunner, Calico Labs. Funded with billions of dollars by Google parent company Alphabet, Calico is on a mission to deeply understand the process of ageing with a very long-term view. For example, they are accurately mapping the genome of the naked mole-rat, which is able to live ten times longer than a mouse. If we can understand how the mole rat’s genes are organised for such a long life, maybe we can do the same for humans.

Analysing species with negligible senescence (biological ageing) is one of the most fascinating areas of research. Plants and animals in this category don’t show any decline in functional or reproductive capability, or rising death rates with age. On the almost mind-boggling side of the spectrum is the Great Basin Bristlecone pine that can live over 5000 years. Under the sea, the ocean quahog clam lives well over 500 years and Greenland sharks often celebrate their 400-year birthday. As for mammals, naked mole-rats have the longest lifespans relative to body size of any known, non-volant mammalian species.

Then there is of course the famous immortal jellyfish that can turn back time and defy death. Like many lobsters, sponges, corals and hydras, the Turritopsis dohrnii doesn’t degrade as it gets older, its fertility remains constant and it can regenerate after an injury and even reproduce asexually. Put an immortal jellyfish under stress and it won’t start comfort eating like us humans. If sick or old, attacked or under environmental stress, the jellyfish reverts to its polyp stage. (Basically, it’s like a butterfly moving back into a cocoon.) The jellyfish does this through a cell development process of transdifferentiation – changing the state of cells and transforming them into new types of cells.

How does this anti-ageing actually happen? It’s all down to the work of telomerase. This enzyme repairs long, repeating sections of DNA sequences at the ends of chromosomes, called telomeres. If we can figure out how our own human telomeres can be manipulated, it will, in the words of scientist Shin Kubota, be “mankind's most wonderful dream”. Mice bred with telomere lengthening have been proven to live longer, and molecular biologist Maria Blasco has developed a telomerase-based gene therapy for the treatment of different pathologies related to the shortening of telomeres – in other words, ageing.

Founder of the Singularity University, Ray Kurzweil, predicts that we’ll hit ‘longevity escape velocity” as soon as 2030. This is going to be a profound revolution – the point at which, for every year that you’re alive, science will be able to extend your life for more than a year. Biotechnology will take over from medicine and we’ll be able to seek and destroy cancerous cells and repair damaged organs. By the 2040s, we will be living agelessly and rejuvenation therapies will be affordable to everyone.

Centuries ago, death was simple. You died from an infected wound, childbirth or the flu. Today, thanks to much better nutrition, vaccines and cutting-edge medicine, life expectancy has doubled in wealthy nations. By 2050, the global population age 65 and older is projected to nearly triple, to 1.5 billion.

Ageing is the biggest pandemic we’ve ever had and the number one killer of the human race. Yet, there will always be people who’ll say just because we can extend life, does it mean we should? Is it ethical? In their book, La Muerte de la Muerte (The Death of Death), renowned futurists José Cordeiro and David Wood argue that if it’s moral to cure cancer, Parkinson’s and Alzheimer’s disease, curing ageing is the most ethical thing we could do. If anything, it’s something that should’ve happened much sooner already. If we’ve known for almost seventy years that cancer cells are immortal, why is there no cure for cancer yet?

The choice to live disease-free for longer is a good thing. Whatever we do, we can’t expect the world of 2050 to be anything like the world we know today. Adding another 20-40 years to our life expectancy will take a mind shift – a move away from the notion that the life of an elderly person is somehow less important or that one must disappear into non-existence after a certain age. There is nothing wrong with continuing to work and contribute to society (and the economy) well into your 80s and 90s. The cut-off point should be a deeply personal choice for each person – and certainly not determined by preventable diseases.