We wanted to draw attention to an interesting paper that we saw today; this one argues that there are two broad Faustian bargains that people make while attempting to live longer. The first involves questionable products, and the second involves treating the symptoms of aging rather than the cause.
The First Faustian Bargain – Anti-aging
The first bargain is the promise made by the “anti-aging” industry, the supplement sellers who do not state outright but strongly imply that their elixirs could add years to your life. We have all seen the supplement blends with fancy names that often contain a mixture of compounds that we could obtain separately at far lower cost. These supplements are marketed as miracles, while their ingredients are only supported by mouse studies or sometimes not even that.
Such practices have cast a shade over the actual legitimate research being done in labs and have done much to harm public perception of the field. While there are indeed some supplements of demonstrable value, for each of these, there are a myriad of untested ones masquerading as being useful in the fight against aging. The bargain here is a gamble that such things might work when there is rarely any proof.
The modern practitioners of anti-aging medicine try and sell the public what appear to be genuine scientific interventions based on real science, before they’re proven to be safe and efficacious. This idea is best personified in an early twentieth century quote from Alan Valentine: “whenever science makes a discovery, the devil grabs it while the angels are debating the best way to use it.”
The truth is that whenever real scientific progress is being made, there are those willing to make money off the back of it, using a grain of scientific truth to legitimize them making a quick buck. When considering such matters, we should always remember that science is methodical, science is cautious and, above all, science is thorough before it makes far-reaching conclusions about the efficacy of an approach. If someone is telling you that something is an anti-aging miracle while there is little or no data to support it, then you should run a mile away.
The Second Faustian Bargain – Using an infectious disease model
The second bargain is that current medical approaches seek to deal with diseases as they manifest; almost like a game of whack-a-mole, one pops up and medicine hammers it down only for another to pop up elsewhere, and the cycle repeats with an ever-decreasing chance of success and a spiraling cost. The bargain here is receiving a small increase of lifespan in exchange for living that time in pain and suffering caused by diseases.
The application of an infectious disease model to chronic fatal and disabling diseases associated with aging is Mephistopheles latest “bargain.” The irony behind this new bargain (otherwise known as the current medical model of disease) is that the medical community advocating for disease eradication doesn’t even recognize the health consequences of success.
The ‘Longevity Dividend’
The paper goes on to discuss the concept of the ‘Longevity Dividend’, an approach that seeks to delay or slow the aging processes in order to prevent diseases and increase the period of healthy lifespan that we enjoy. This all sounds great on paper, but it is important when reading the piece to understand the position of the Longevity Dividend initiative a group with which the author has long been associated with. In broad terms, the Longevity Dividend initiative has the goal of increasing life expectancy moderately over the next decade or so by finding ways to slightly slow down the aging process. This is a pretty conservative view given the advances in technology we are now seeing.
Rather than a simple modest increase of life expectancy in the next 10-20 year period, there are other more ambitious and potentially superior possibilities on the table. We believe that the solution lies with rejuvenation biotechnology. The objective of rejuvenation biotechnology is to help us to maintain our health by keeping our body functionally younger, and thus to remain free from the diseases of aging by periodically repairing the damage that the aging processes do. These aging processes, known as the hallmarks of aging, lead to damage; that damage gradually reaches pathological levels, and then the familiar diseases of aging develop. This makes sense when you understand the relationship between aging and age-related diseases, as this infographic demonstrates.
To illustrate this point, the pyramid above shows how aging processes form the foundation of the diseases of aging. As we age, this pyramid grows higher and higher as more and more diseases begin to appear, leading to the ill health of old age and ultimately death as a result. Essentially, by targeting the individual aging processes, we can potentially delay, prevent or reverse a slew of age-related diseases in one fell swoop. This a far more palatable bargain than the current ones, which offer either an uncertain result from taking untested products or a small gain in lifespan in exchange for ill health.
What can we do now to improve things?
It might be a surprise that one of the reasons why we have this current situation is the relatively slow progress of fundamental and translational science due to poor funding. Snake oil salesmen and frauds monetize people’s desire to do something about aging and so continue to plague the field, preying on the unwary but well-meaning. If progress in the field was faster and more robust solutions could reach clinical trials sooner, this would likely do much to dislodge such hucksters and remove them from the marketplace once evidence-based therapies against aging start to become available.
Another reason is the poor transfer of information from academia to the public. This problem is especially due to publishers hiding scientific papers behind paywalls preventing the general public (and often decision makers) from benefitting from this knowledge. This leads to a very superficial public understanding of what the levels of scientific evidence are. Most people have no idea why the most reliable medical information that can be used for health decision making is presented in systemic reviews, meta-analysis, and randomised double-blind placebo-controlled clinical trials. However, only these studies have the lowest risk of bias, and their results are meant to be reproducible, demonstrating the safety and efficacy of the studied drug or therapy.
The author makes for a compelling argument that the two current options for attempting to live longer are both double-edged swords. While we certainly agree with the author that the current methods people use to try to live longer are Faustian bargains, we also believe science can do better than a modest increase of life expectancy in the next few decades.
In our view, the real way forward here is to develop true rejuvenation biotechnologies. This way, we can address not only the concern of longer life but also, most importantly, ensure that this extra time is spent in good health by eradicating age-related diseases at their root: the aging processes. Furthermore, one of the best ways to protect yourself from snake oil sellers is to check what types of publications their claims are based on. Remember, humans are not mice!
 Olshansky, J. (2017). Is Life Extension Today a Faustian Bargain?. Frontiers in Medicine, 4, 215.