Faculty Opinion: End the healthcare debate – slow the aging process

Judith CampisiThe good news is human life span and health span (years of healthy life) have risen remarkably during the last century in the US and other developed nations.  The bad news is many citizens of these nations will face years of chronic disability at the end of their lives.  Age is the largest single risk factor for developing chronic diseases such as stroke, heart failure, arthritis, diabetes, Alzheimer’s and Parkinson’s disease, bone and muscle frailty, eyesight and hearing loss, and even some forms of cancer.  These diseases bring crushing personal, societal and financial costs.

Constitutionality arguments aside, it is financial costs that lie at the heart of what seems to be our never-ending national health care debate.  As baby boomers reach age 65 during the next 2 decades – 10,000 a day, according to the Pew Research Center – the financial costs of caring for the chronically ill will dwarf our present budget deficit.  According to a report by the Robert Wood Johnson Foundation, treating chronic diseases already accounts for three-quarters of our health care budget -- and two-thirds of the increase in health care spending.  The cost of health care in the US could exceed $4 trillion by 2020, largely because treating chronic disease is lengthy and expensive.

How did we manage to extend life and health span so remarkably without an equally remarkable compression of the period of disability before death?  Biomedical research and medical practice have made great progress in understanding and treating specific diseases, including some chronic diseases of aging.  However, years gained by alleviating heart disease can result in years of suffering from Alzheimer’s disease or cancer; years gained by eliminating a cancer can leave years of suffering from stroke or arthritis, and so forth.  What we need are breakthroughs in treating the underlying cause of chronic disease: aging itself.

The possibility of postponing the onset -- and compressing the trajectory – of chronic diseases is not science fiction.  Research in animals shows that dietary and genetic interventions can slow aging.  These interventions not only prolong life span, but also prolong the period of functional life.  There are no guarantees these interventions can be translated to humans, and we certainly have not done it yet.  But, with so many aging baby boomers in the demographic pipeline, isn’t this a scientific bet worth making?

Alas, the promise of aging research will be hard to realize when the National Institutes of Health (NIH), with its annual $31.2 billion budget, (the House Republican budget aims to cut that figure to $29.5 million) allocates only about $160 million for research into the biology of aging.  This figure has barely changed in several years even though in 2008 a group of eminent scientists convinced the Senate committee that oversees the NIH budget to recommend increased funding for research in this area.  In their report, those scientists estimated a “Longevity Dividend”: a delay in the aging process of just 7 years would halve the incidence of incapacitating age-related disease and compress the costly period of disability prior to death.

At a time when people 65 or older will soon outnumber children under the age of 5, the looming health care crisis demands a change in the way we regard aging.  Not long ago, diseases such as polio, rubella and mumps were deemed inevitable scourges of childhood.  Those diseases were eradicated because we, as a society, made a concerted effort to eliminate them.  Now is the time to do the same for diseases of aging.  We cannot afford to not try to implement a longevity dividend.

Growing older should not doom us to years of debility, nor doom future generations to the burden of caring for the chronically ill.

Judith Campisi, PhD, is a Professor at the Buck Institute for Research on Aging and a Laureate of the Ipsen Foundation and winner of the Ipsen 2010 Longevity Prize.

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