Forever Young

By Joel Garreau
 
Washington Post, October 13, 2002

William Haseltine, chairman of Human Genome Sciences in Rockville: "People my age will live into their 100s--and be healthy for most of that time." (Susan Biddle - The Washington Post/File Photo)

Just one generation ago, Jack Benny got laughs of recognition for perpetually claiming to be 39. At the time, 40 was over-the-hill. The idea of sexy 50-, 60-, 70- and 80-year-olds seemed a contradiction in terms.

How aging has changed. This is no longer the case, as has been demonstrated by Tina Turner, Susan Sarandon, Cheryl Tiegs, Isabella Rossellini, Glenn Close, Goldie Hawn, Diane Keaton, Farrah Fawcett, Cher, Charo, Barbra Streisand, Candice Bergen, Lauren Hutton, Cybill Shepherd, Catherine Deneuve, Blythe Danner, Faye Dunaway, Dolly Parton, Lynn Russell, Sophia Loren, Joan Collins, Jane Fonda, Raquel Welch, Stockard Channing, Kathleen Turner, Diane Sawyer, Tipper Gore, Shirley MacLaine and Lena Horne. Not to mention Sting, Peter Jennings, Bill Clinton, Vicente Fox, Junichiro Koizumi, Clint Eastwood, Robert Redford, Harry Belafonte, Chuck Yeager, Sonny Jurgensen, O.J. Simpson, Sean Connery, Clint Eastwood, Colin Powell, Kevin Costner, Oscar de la Renta, Ricardo Montalban, Tom Stoppard, Vernon Jordan, Warren Beatty, Harrison Ford and Paul Newman.

When feminist and one-time Playboy bunny Gloria Steinem turned 50 at a gala looking "younger, thinner and blonder than ever," as one partygoer put it, she famously insisted, "This is what 50 looks like." That was 18 years ago. Now we have grandparents in their eighties casually jet-setting off to the Great Wall of China, and dancing, prancing rock-and-roll stars in their sixties. Rock-and-roll stars in their sixties!

Remarkably, such pioneers of agelessness have accomplished all this using what some would call primitive means -- exercise and diet, for example, antibiotics and vaccines, makeup and plastic surgery.

Enough of that. Today, a whole new industry is booming that vows to slow, halt or actually reverse aging. The lure is not just achieving advanced years. It is doing so vigorously and even, dare we say it, youthfully. Americans are spending an estimated $6 billion this year on substances from ginkgo biloba to human growth hormone that claim to offer new powers. Some scientific skeptics think all this money literally is being peed away. They believe all those potions are passing through people's metabolisms producing nothing but expensive urine.

At the same time:

• Respected demographers calculate that half the American girls born today will live to be 100.

• The number of people older than 100 in America has been increasing by more than 7 percent per year since the '50s. The fastest-growing group of drivers in Florida is over 85.

• Dozens of start-up companies have been created in the last five years that are in the business of dramatically slowing aging. Some are staffed by distinguished scientists, including former members of the National Institute on Aging, part of the National Institutes of Health in Bethesda.

• Two anti-aging researchers have bet each other what will amount to millions on payoff that at least one person alive today will live to 150.

• Eminent technologists who believe science will evolve so fast in their lifetimes that they will energetically live a very long time, if not be effectively immortal, include William Haseltine, CEO of Human Genome Sciences in Rockville, who soon may be biotech's first billionaire; Ray Kurzweil, a member of the National Inventors Hall of Fame and winner of the National Medal of Technology; and Eric Drexler, a leading apostle of atomic-level manufacturing and author of "Engines of Creation."

The question is whether this all reflects the naive hopes of creaky baby boomers -- the first generation that will die with most of their own teeth -- or something like reality, in which case the baby boomers may be the last generation to die traditional old-age deaths. If the latter, how does such an enormous shift affect human nature itself?

Boom! They're Getting Old!

The growth curve in anti-aging companies looks like a hockey stick, rising dramatically in just the last few years. You ask -- what was the turning point? The growth in computer power? The access to information on the Internet? The sequencing of the human genome?

Anti-aging advocates look at you like you're from the planet Zircon.

"It's the aging of the baby boom," explains S. Mitchell Harman, president and director of the Kronos Longevity Research Institute and former chief of endocrinology at the National Institute on Aging. "They are not going gentle into that good night."

"Makes sense," says one now-menopausal '60s activist. "First we made the world safe for blacks and women. Now we're going to do it for all those people with their left-turn signals on for miles, who wear those funny hats."

The anti-aging industry continuum has, at its extremes, two camps. One consists of scientists who publish in prominent peer-reviewed journals who say there is absolutely nothing right now available for humans that will stop or reverse the aging process for you, period, full stop. Although of course they are working like crazy to change that. More about that in a moment.

The far larger group at the other end is the one at which throngs of Americans are throwing money. It includes people with fewer credentials who are only too happy to sell you tonics for which they make enticing claims. Their products include everything from Vitamin E to shark cartilage, and from water about which they make startling assertions, to sand about which they make startling assertions, to light rays about which they make startling assertions.

The establishment scientists view the claims of the large group as at best unproven, and at worst, the work of "quacks, snake-oil salesmen and charlatans" in the finest traditions of goat gland and monkey testicle providers at the turn of the last century, as S. Jay Olshansky of the University of Illinois at Chicago puts it. He leads what has become known as the Gang of 51, a group of scientists who study aging that, in May, put out a report designed to be "an authoritative statement of what we know and do not know about intervening in human aging." In it they state flatly, "At present, there is no such thing as an anti-aging intervention."

Needless to say, those who believe they can offer such products -- and in whom many Americans are investing their faith -- beg to differ.

"Flat-Earthers" is how Ronald Klatz, 47, describes his detractors. Klatz is president of the American Academy of Anti-Aging Medicine, or A4M, an organization that boasts 11,500 practitioners in 65 countries whose official slogan is: "Aging is not inevitable! The war on aging has begun!"

"Remember 'Animal Story' by Orson Welles?" asks Klatz.

You mean "Animal Farm" by George Orwell?

"Maybe," he replies. "But it's four legs good, two legs bad."

He sees the science and medical establishments as out to get him.

"The guys in the bow ties and suspenders are right and anybody who says otherwise is wrong," he says sarcastically. He lists Science, Scientific American and the Journal of the American Medical Association as publications that "sandbagged anti-aging medicine without justification and without science. They rubber-stamped all those supposed scientists" from such noted institutions as the University of Chicago and the University of California San Francisco.

Klatz believes that within 10 years, we will begin to achieve "the technology necessary to accomplish mankind's oldest wish: practical immortality -- life-spans of 200 years and beyond," as he wrote in a recent article in the magazine the Futurist. "Humankind will evolve toward an Ageless Society, in which we all experience boundless physical and mental vitality."

Some scoff. "A life expectancy at birth of 100 years requires that almost every cause of death that exists today would have to be reduced dramatically or eliminated altogether," Olshansky and his co-author Bruce A. Carnes write in their book "The Quest for Immortality."

"How likely is that?" they ask.

Good question.

Die Old, Stay Pretty

The life of man in nature may or may not be nasty and brutish, but it is indeed short.

Over most of the course of human existence, average life expectancy hovered between 20 and 30 years. In part this is because so many infants died, but that does not obscure a bleak evolutionary fact: For hundreds of thousands of years, not long after we reproduced, we died. Even in Western Europe, life expectancy did not reach 40 until 1800 and 50 until 1900, note demographers James W. Vaupel and Bernard Jeune in "Exceptional Longevity: From Prehistory to the Present." In industrialized countries, female life expectancy is now above 80, slightly less for men. This represents close to a fourfold increase. Over the same period, your chance of living to 100 has increased from roughly 1 in 20 million to 1 in 50. The number of centenarians in the developed world has been increasing by more than 7 percent a year every year since the '50s, Vaupel says.

In the journal Science, Vaupel and his co-author, Jim Oeppen, noted "an astonishing fact." Since 1840 -- for 160 years -- life expectancy has been growing by a quarter of a year every year. "In 1840, the record for longest life expectancy was held by Swedish women, who lived on average a little more than 45 years," they noted. "Among nations today, the longest expectation of life -- almost 85 years -- is enjoyed by Japanese women." This steady march of increased life span has been so punctual, they note, that little humans have done collectively for so long has ever been more regular.

This stream of progress shows no sign of slowing down, much less stopping, they say. In the first half of the 20th century, we knocked back death among the young. Clean water, antibiotics and vaccines played enormous roles. In the second half, we improved survival after age 65. Incremental progress in fighting four big killers of the aged -- heart disease, some cancers, diabetes and stroke -- continues briskly. People now live long enough for Alzheimer's to be a big problem, so we're working on that, too.

The proverbial march of science has if anything accelerated. Ask yourself: Do you think the sequencing of the human genome, stem cells and cloning will have any effect on medicine? If so, you might find credible Vaupel's controversial projection that the average American girl born today will live to see 100.

This, of course, does little good if all we end up with is a vast cohort of geezers "drooling on their shoes," as Klatz puts it.

That's why the anti-aging industry is not particularly interested in gerontology -- patching up the old, hobbled and doddering. How more efficient would it be to interrupt the aging process in the first place, they reason.

For them, the object of the game is to die young.

As late as possible.

Faith and the Future

Just about every assertion about the future of aging is based on one faith-based system or another. People believe what they want to believe, with or without empirically established facts.

Bruce Ames of the University of California at Berkeley is a great man in bioscience. His scholarly articles are among the most cited of the 20th century. If you want to discover whether a substance will cause genetic mutation, what you want is the "Ames Test."

Nonetheless, he's got something he wants to sell you. It is an anti-aging "nutraceutical" that is for sale over the Internet. It's called Juvenon and consists of two antioxidants. He says he doesn't make any money on it; the proceeds all go to a foundation. Nonetheless, the claims he and others make for it are arresting. Memory and energy levels in lab animals increase significantly, he reported in the Proceedings of the National Academy of Sciences.

In his Berkeley living room with its marvelous view of the Golden Gate Bridge, over a glass of sea-dark wine, he loves to say Juvenon makes his aging lab rats "dance the macarena."

"This is great stuff. I'm beginning to remember the '60s," reports Stewart Brand, the onetime counterculture icon who created the Whole Earth Catalog.

The trouble is nobody knows if it really works on humans. Ames says he is selling the stuff to raise the money that only now will allow him to begin the double-blind clinical human trials that are the scientific gold standard.

There are no biomarkers that reliably predict remaining years of life, says Huber Warner, director of the Biology of Aging program of the National Institute on Aging. There is as yet no way to look at your cells and quantify whether they are biologically older or younger than anybody else's. So the only way to determine for sure whether any intervention works is to try it and wait for the control group to drop dead.

In humans, this can take 20 years or more, inconveniently enough. That's why there are so many people who are taking leaps of faith, playing the odds. Their need is more urgent than that.

One very prominent anti-aging researcher says off the record that he takes saw palmetto for his prostate symptoms, even though he acknowledges there is no conclusive evidence that it works. Recent studies of ephedra, Saint-John's-wort, ginkgo biloba and kava have called into question those substances' effectiveness or safety. Scientists are consumed by memories of fen-phen and female hormonal treatment, which turned out to have unexpected consequences. Nonetheless, we are conducting this vast "uncontrolled experiment," as Warner puts it, gobbling down potions and hoping for the best. "Which would you rather be?" one researcher asks. "In the experimental group or the control group?"

The closest thing to classic scientific rationalism you'll find is in the work of people like George S. Roth. He wants to add 30-plus healthy years to your life by convincing your cells they're starving half to death. Roth is a senior guest scientist in the nutritional and molecular physiology section of the National Institute on Aging. He has a company in Baltimore called GeroTech full of retired NIA scientists. They and others are working on "caloric restriction mimetics."

If you semi-starve a healthy organism, it turns out, its life span will increase by 40 percent. This is the only proven method of altering the rate of aging. Works on nematodes, fruit flies, mice, dogs, rats and spiders. Critters react by channeling their energy from reproduction to maintenance.

There is this slight problem. Semi-starved lab rats are mean. "Oh, God, do they bite," notes one researcher. That's why it's hard to get humans into test trials. "Do you live longer or does it just feel that way?" another researcher jokes.

Roth and other researchers have a more cheerful thought. What if you could safely fool the cells into switching into starvation mode while allowing the humans to eat normally? Roth hopes he's only a few years away from bringing such a nutraceutical, available without prescription, to a health food store near you. If so, it could be a big deal.

Geriatrics researchers are up to their lab rats in work on memory, impotence, menopause, baldness, wrinkles, obesity, deafness, eyesight loss, muscle loss, bone loss, joint deterioration, cholesterol buildup and general aches and pains -- not to mention breast cancer, prostate cancer, colon cancer and Alzheimer's. Some of their results could produce the next Viagra -- especially the memory drugs.

But these relatively conventional research directions, while promising, are not the sort of thing that fires up visions of godlike immortality.

For that you want the revolution described by the National Science Foundation and the Department of Commerce in a July report. It points to the four rapidly evolving and intertwining "GRIN" technologies -- genomics, robotics, information and nano-engineering. Together they hold the potential of "a tremendous improvement in human abilities, societal outcomes and quality of life," the report says.

"The human body will be more durable, healthy, energetic, easier to repair, and resistant to many kinds of stress, biological threat, and [the] aging process," the report states.

That's why the inventor and author Ray Kurzweil, 54, is personally eating very few carbohydrates and fats, taking more than a hundred supplements and trying not to be too big of a nag to others his age. But he almost can't help himself.

"If I look at my kids -- kids in their teens, twenties or even thirties -- unless they have unusual problems, a decade or two from now they will be young and the revolutions will be in full force. They don't have to do a lot to benefit from really radical life extensions," Kurzweil says. "The oblivious generation is my own. The vast majority are going to get sick and die in the old-fashioned way. They don't have to do that. They're right on the cusp."

Like many others he sees biotechnologies within the decade that will, for example, allow us to regrow our tissues and organs, prevent hardening of the arteries and cure diabetes. Beyond 10 years he sees technologies that will allow us to supplement our red and white blood cells with little robotic devices that are hundreds of times faster. "Our biological systems are really very inefficient, not optimally engineered," he says. A well-designed blood system, he says, will allow you to "run an Olympic sprint for 16 minutes without taking a breath."

He also sees us replacing our gastrointestinal system with an engineered one that would allow us to eat as much of anything as we want, for sociability and pleasure, while our new gut "intelligently extracts nutrients from food" and trashes the rest. "Our whole GI system is pretty stupid. It stores too much fat," he says.

This long view has "definitely had a profound perspective on my life," says Kurzweil. "There's always risks, but I really envision living through this century and beyond, and it does give me a sense of the possibilities. I am not looking to slow down 10 years from now and be happy if I make it to 80. It's liberating. I envision doing things and being different kinds of people that the normal model of human wouldn't allow." Ultimately he envisions us expanding our brains through "intimate interaction with nonbiological intelligence," i.e., computers.

But to get there, you've got to take care of yourself now, he insists.

William Haseltine, who is almost 58, agrees. The founder of Human Genome Sciences Inc. thinks it perfectly plausible that "people my age will live into their 100s -- and healthy for most of that time." He bases that just on existing technologies that lower cholesterol levels, strengthen bones, control high blood pressure and offer surgeons terrific images of what's going on inside the body.

Haseltine is resolutely cautious about what bioscience will be able to do. He talks a great deal about what we don't know about stem cells. Breakthroughs "happen much slower than people think, even when they are extremely well funded," he says.

Nonetheless, given current technology, he expects people now in their fifties to live a decade or two longer than they expect -- perhaps "to 110 or 120 in reasonably good health." He points to tissue engineering in which you create bladders and blood vessels and cartilage outside the body for eventual implant. "People are trying to grow pieces of new lung, new kidney. The textbook 'Tissue Engineering' is now in its second edition," he notes. He also points to mechanical helpers. "Look at what Cheney's got. He's basically got a defibrillator implanted. They didn't do that 10 years ago."

Asked how all this is affecting his life personally, Haseltine says he's taking very good care of his body. And oh yes: "I like compound interest."

More seriously, he says the prospect of very long life "allows you to embark on longer-range projects." He has taken on a 10-to-20-year program to learn more history. Haseltine is going back to translations of some of the original Roman and Greek texts -- Horace, Virgil, Ovid. He also is scheduling trips to see art by Giotto and Donatello. "I've always been interested in art and history. But with more time to see things, you might as well learn," he says.

Eric Drexler, 47, the Silicon Valley nanotech pioneer, is more optimistic than either Kurzweil or Haseltine. He wears a medallion around his neck that asks the finder, in case of Drexler's death, to "Call now for instructions/ Push 50,000 U heparin by IV and do CPR while cooling with ice to 10C/ Keep PH 7.5/ No embalming/ No autopsy." For Drexler plans to come back.

He and others believe that robots smaller than a human cell will soon work like Pac-Man. Inject a few million of them into your bloodstream, and they'll gobble up fat cells, cancer cells, what have you.

That's why he wants to make it through the next decade or two until the new technologies kick in. If for some reason he happens to croak prematurely, he wants to get frozen right next to Ted Williams so that when the right technology arrives, he can be thawed and have a nanotech workover.

Does he think this will make him immortal?

"Depends on what you mean by immortal," he says, sitting at Silicon Valley's Original House of Pancakes in Los Altos, Calif., letting his ham and eggs get cold. "There is such a thing as proton decay."

Pause.

He's talking about the eventual collapse of subatomic particles in untold eons.

Okay, what about merely geological time? Hundreds of thousands of years?

"Oh yeah." He smiles. "That. For sure."

Forever Is a Long Time

As technology evolves ever faster, the distance between science and science fiction shrinks. This makes estimating the impact on culture and values a challenge. What happens in a world that can be increasingly young and vital and robust and busy at the same time that it is increasingly very, very old? What happens to Social Security? How many careers do you have? How many marriages do you have? How many children do you have?

While formidable, these calculations are relatively straightforward. To really imagine richly the complexity of such a world, one perhaps needs the sensibilities of a novelist.

Will the new young people who are only in their twenties ever be able to compete with the old young? Especially if the old young have seen their compound-interest money grow startlingly?

In ancient lore, Gilgamesh built the walls around the city of Uruk as a monument that would make him immortal. If we did not fear death, would we lose our will to achieve? Would you put all of life forever before you? "What's the rush? I'll get to that when I'm 100." If you did not have to seek your immortality in children, would you have them?

If life stretches out for a very long time, do you avoid risks? Or do you court them? Is there a growth market in recreational life-risking? Will more people emulate George Bush, the elder, by parachuting out of airplanes at the age of 72?

If immortality is at hand, do we need religion?

If death is never imminent, is love as intense? Do Romeo and Juliet inhabit the world only of the very biologically young?