Geriatrics, Gerontology, and Engineering -- A Necessary Link

Every day, elderly people die as a result of phenomena in their bodies that you rarely, if ever, see in younger people (and that are interpreted as definitive signs of disease when they are).

At a meeting yesterday with a group of fellow longevity advocates, one issue that turned into a point of discussion was that of whether it is worth presenting longevity treatments as means to mitigate specific diseases, or whether doing so is simply a distraction from the fundamental issue of addressing aging itself (or whether it really matters).

Strictly speaking, there is potential for the realization of any one of the seven aspects of SENS to result in effective cures for various specific age-associated illnesses. For instance, if Lyso-SENS leads to treatments for deadly age-related storage diseases, people who might otherwise have died of these diseases will (obviously) still be alive -- meaning that they have an increased chance of living to enjoy the next advance in longevity treatments.

Addressing specific diseases associated with aging will certainly contribute toward more people being able to achieve escape velocity, however, just treating the specific diseases as they come up will by no means be enough to result in the kind of rejuvenation that will actually allow people to survive healthily for as long as they'd probably like to.

The changes associated with getting older don't start out problematic -- it is their accumulation and eventual spiral out of control that actually contributes toward obvious pathology. Effective longevity treatments must, in order to be worth applying, be able to address age-associated changes at a stage when they aren't necessarily causing actual, observable problems. However, the medical establishment isn't accustomed to thinking in this manner.

Geriatricians are devoted to the alleviation of pain and maintenance of healthy functioning (at least as much as possible) in the face of age-related pathology, but geriatric medicine has so far not exhibited sufficient interest in getting to the root causes of the pathologies being addressed prior to their becoming truly problematic.

On the other side of things, gerontology is interested in things like root causes and systemic differences between young and old bodies, however, the gerontological approach is more exploratory than action-oriented -- certainly, not action-oriented enough so as to prompt a focused and concerted effort to start saving people's lives in the near-enough future.

The engineering approach to addressing age-related decline and death is something of a new approach -- one that very well might be the needed "missing link" between geriatrics and gerontology. An engineering approach is one that focuses on appropriate maintenance of bodily systems, through repair and replacement of worn-out or disease-causing physical elements.

And if properly executed, an engineering approach encompasses both the acknowledgement that specific diseases do harm and kill people, and the acknowledgement that in order to stop people from dying, we need to address systemic changes in the body that both contribute to specific, known diseases and that result in what most people consider to be "normal aging".

The issue with focusing too heavily on the "specific disease" aspect of the equation is that the existing medical infrastructure doesn't treat the systemic failure that accompanies aging as a disease -- at least not in elderly people. Therefore if given the choice between funding an engineering approach to rejuvenation, or funding a study meant to address a particular pathology (such as hypertension), the particular pathology may get preferential treatment.

Meanwhile, people are still experiencing progressive systemic breakdown, which is making them weaker and more vulnerable to pathology and death. Clearly, a paradigm shift is in order.

Listing the specific diseases that an effective longevity treatment could address should be part of the overall explanation of what the goals of the healthy life extension effort are. This is probably also a reasonable way of getting the attention of the medical community -- after all, it doesn't seem conceivable that they wouldn't be interested in a potential means to resolve heart disease, Alzheimer's, or any other specific pathology.

But it is important to remember that by addressing the underlying phenomena associated with aging, the specific pathologies commonly found in elderly individuals will probably not appear -- not because specific, targeted cures for those diseases have necessarily been found (though they probably will be at some point) but because the body itself has been rejuvenated to a stronger, more resilient state.