Health Health

We'll all be a fair deal older in 2030, that's for sure. But just how far will we have advanced medical science? The breadth and thrust of modern day medical research is increasing our remaining life expectancy at one fifth of the rate at which we live - but that pace is picking up. What is plausible for 2030? Some thoughts from Advanced Nano:

Achieving three times or more progress in longevity from 2007 to 2030 versus 1984 to 2007 seems very achievable. This will be from public health improvements, disease cures or treatments, lifestyle improvements (from behavior or with medical assistance) and success from direct progress against the processes of aging. This would mean going from a life extension increase of 0.1 to 0.2 years each year to 0.5 years.

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I believe that the Strategies for Engineered Negligible Senescence (SENS) is a good plan. SENS could help contibute to a far greater increase in life expectancy. However, SENS success is dependent on both successful science and development and on the funding that it receives.

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The future can arrive earlier for you if make the lifestyle adjustments now. You can give yourself a very good chance to live to 90 and the possibility of 100+ with lifestyle and pro-active medical tests and treatments. For the really big gains, help by donating to the SENS project.

Some folk in the systems biology field project a 10 to 20 year increase in life expectancy over the next 20 years. The Longevity Dividend folk are aiming for 7 years over a similar timeframe, and the actuaries are debating models that fall within these ranges. Aubrey de Grey, of course, makes the case that indefinite healthy life span in mice, maintained through repair technologies, has a good chance of success 20 years after large-scale funding is initiated for such a project.

Those in the know agree that more healthy life is possible and plausible, but disagree on how much and how exactly it will be attained. Certainly it will require support and understanding, regardless of the methodology that wins out in the end; science develops to the degree that people desire technology to achieve their ends, and are therefore willing to fund research.

Technorati tags: life extension

Early adopters are a form of investor - they provide much needed funds and validation for the continued development of new technologies, taking risks on the comparatively poor first commercial versions. In doing so, these folk play an important role in turning the wheel of progress. Stephen Gordon says it well:

Aubrey de Grey has a related theory about the development of life extension therapy. When asked if these treatments would only be available to the rich, Aubrey has responded that, yes, initially only the rich will be able to afford life extension treatments. But these early expensive therapies wouldn't be very effective anyway.

Later, de Grey argues, the price of these therapies will go down as their effectiveness goes up. There will be some mid-point where moderately money will buy moderately effectively treatments. Ultimately we'll have very inexpensive treatments that everyone can afford that will also be very effective.

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I think this movement from "expensive/relatively ineffective" to "cheap/effective" will happen fast with life extension. Once the world sees these therapies as something more than fantasy, we'll pour incredible resources into their development and dissemination. And since technological development is accelerating, progress will be faster by then.

I have been an early adopter several times in the past. Being human (and subject to temptation) I'll probably be first-in-line to buy some cool, marginally-useful gadget again. It might even happen that I'll feel compelled by the risks of age or diminished capacity to shell out big money for life extension version 1.0.

If so, the whipper-snappers who'll benefit later can toast me.

All new technologies - medical technologies included - are hard to produce, comparatively poor in quality and expensive. That is no more than simple economics; creating the new is difficult. Difficult is expensive. Expensive requires investment, and investments in early development must be seen to be recouped within the timeframe of comfort for the investors, or they will not be made in the first place.

Technologies become easily manufactured, of high quality and cheap very quickly if they take off in adoption - commercial revenue opens the door to greater investment in development, expansion of infrastructure for commercialization, and the onset of competition that drives quality up and cost down. The early adoption contingent help to make that process more rapid, and by their actions - and willingness to risk resouces on the new new things in this world - make it more likely that future research and technological development will be funded.

Technorati tags: economics, life extension

You might recall some of the pioneers of the field of systems biology (pioneers of defining what the term "systems biology" means, even) see it as a pillar of the next generation of medicine, enabling new technology that will add ten to twenty years to our life expectancy:

It takes five years for people to get anything. The first few times they hear it, they can think of a thousand reasons why it's wrong. Then, after they've heard it a few more times, it starts to sound more logical. If you're a missionary, you've got to be patient with your congregation. We are at the very beginning stages of thinking about this. ... You see what drives the change? Technology. If we invent the technologies that enable this, everything else gets dragged right along. That is one of the fundamental rules of civilization. I think it will make medicine less costly, infinitely more efficient. I think within 20 to 25 years, we'll be living productively 10 to 20 years longer.

The latest issue of The Scientist takes a nuts and bolts, what have you done for me today view of systems biology:

Selling Systems Biology

. From early discovery to market, the vast majority of promising pharmaceutical compounds end in failure. Some of these stories end with a whimper or, in the case of something like Vioxx, with a bang.

Enter systems biology. The field has as many definitions as it has practitioners, but Current Genomics puts it simply: "The goal of systems biology is to describe and quantitatively model complete biological systems."

Ideally, systems biology incorporates what Lauffenburger calls the four M's: measurement, mining, modeling, and manipulation. Firstly, scientists catalogue de novo response pathways in order to connect cell-surface receptors with gene expression, or piece together a network from published literature. Next, they pick apart the interaction and cross-regulation of the pathways. All this is captured electronically and integrated into a computer model, which is validated in the lab. If successful, this approach could form the foundation for a rational, hypothesis-based method of identifying new drug targets and biomarkers, while minimizing side effects. The hunt for compounds is a needle-in-a-haystack problem. Systems biology, supporters say, could be our magnet.

Of course, it is hugely hyped; it seems that most new new things in medicine go through the stage of initial hype, collapse of the hype, and then meaningful progress and broad growth of new applications in the years that follow. Expectations always seem to be both too narrow and ahead of reality for the first decade or so - look at the history of gene therapy, for example.

Pharma's 10,000 Losses

If only it were so simple. It would be, if systems biology were able to "describe and quantitatively model complete biological systems," as Current Genomics so optimistically put it. But that's currently an impossible dream. To illustrate, the full description of just a single pathway in yeast that triggers the first step toward sexual reproduction is taking up the entire activities of a whole research institute, the Molecular Sciences Institute

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In the case of systems biology, what's irritating is that the unfulfilled hype and the subsequent disdain has obscured the fact that systems biology can be valuable and is finding a place in drug discovery.

There's a far broader future for systems biology than propping up the dry old drug pipeline mode of medical research - the here and now viewpoint is deliberately limited.

We don't presently have access to the computational capacity and complexity management tools to map processes any faster than speeds measured in man-years. That is rapidly changing, however. In a near future when the computation power to simulate an entire body, cell by cell - and molecule by molecule not so long after that - is next to free, and most research takes place in simulation, systems biology is a lynchpin and design manual.

Technorati tags: life extension, medical research

We won't defeat aging in any reasonable timeframe by peeling out named conditions one by one - or tens by tens - and tackling each in turn. There is just too much there:

The dividing line between solemnly named condition and mysterious process of aging is utterly arbitrary; the "normal aging process" only really exists if you want to define it into existence. When you say "normal aging," you are applying a name to a collection of changes, damage, diseases and medical conditions, some of which have their own well-worn taxonomy, and some of which don't.

A recent piece at EurekAlert! makes a similar point, one I wish was made more often:

A broad study of adults ages 65 and older has found that half of them have one or more conditions that can affect their ability to participate in activities of daily living, such as bathing and dressing on their own. ... people with geriatric conditions had about the same level of dependency when performing activities of daily living as older patients with chronic diseases, including heart disease, chronic lung disease, diabetes, cancer, musculoskeletal conditions, stroke and psychiatric problems.

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“The focus in medicine has long been on diseases, and how to diagnose and treat them. But that focus often isn’t helpful in regard to older adults; they tend to have one or more of these geriatric conditions, which are not considered diseases and can be missed by physicians."

Degeneration is degeneration, whether or not it has a fancy name and well-established research and patient advocacy communities. The overwhelming focus on naming and patching late-stage conditions - the results of years or decades of chained failures and wear in the overlapping systems of the body - is unfortunate, to say the least.

Dr. Westphal and Mr. Sinclair stress that they are not working to 'cure' aging, a condition that, so far at least, is common to all humanity and that most physicians do not consider a disease. 'Curing aging is not an endpoint the federal drug agency would recognize,' Dr. Westphal says dryly. Instead, both men say, they are working to ameliorate the diseases of aging.

It leads the medical community away from the rational path forward, which is to seek the simplest root causes and intervene at that point. Prevent rather than patch; repair the known forms of age-related cellular and molecular damage at the early stages without needing to understand the ever more complex chains of consequence and failure.

The scientific community and those who fund it could be doing so much more than they are at present to eliminate age-related suffering and death. That must change.

Technorati tags: aging, life extension

The California Dept. of Managed Health Care has fined Kaiser Foundation Health Plan $3 million.

The department said the fine is for Kaiser not adequately providing oversight of quality assurance programs intended to address patient complaints and physician peer review cases at its 29 medical centers in California.

The DMHC started an investigation in August 2006 after issues were identified during an investigation into Kaiser's San Francisco Medical Center kidney transplant facility, and after several complaints were received by the DMHC's HMO help center.

The department found that Kaiser did not meet state requirements in two ways. It lacked adequate health plan oversight of quality assurance programs, and it was inconsistent in its handling of quality of care cases referred for peer review.

But the plan could not verify whether serious problems were being addressed now, according to the department.

"State law requires health plans to have processes in place to hear member concerns and act upon them in a timely manner," said Cindy Ehnes, director of the DMHC, in a prepared statement.

In its own prepared statement, Kaiser said it has "a long history of evaluating and improving quality assurance processes, and monitors performance through data tracking and reporting to the highest level of management."

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