Preventing age-related disease is one of the great challenges of our time
When we think about aging today, most of what comes to mind are negatives, and ageism appears to be spreading around the globe.
It’s a myth that ageism is a Western phenomenon and that Eastern cultures hold their elders in greater esteem. In fact, recent research found the opposite. Negative attitudes towards older age in fact peak in East Asia (Japan and China in particular), driven by recent demographic changes that pull on the social fabric and create tensions with traditional beliefs. A similar development can be observed in the greying countries of Western Europe.
And yet, this demographic trend is unlikely to be reversed, but instead will start to affect a growing number of regions worldwide as life expectancies increase. While the US is still – in relative terms – demographically youthful, thanks largely to immigration, life expectancies for Americans have risen by over 30 years since the beginning of the 20th century. The trend is expected to continue, even in the highly unlikely case that medicine and longevity science will not see any major breakthroughs in the foreseeable future.
On a global level, people aged 65 or older will very soon outnumber children under five for the first time in recorded history. It is therefore a matter of urgency that these demographic shifts are addressed.
One of the key issues is that not only life expectancies, but also age-related, chronic and degenerative diseases are on the rise. Our old live longer, but are also more likely than ever to suffer from years if not decades of ill health, which reduces their ability to contribute to their families, communities and societies.
Encouragingly though, there is mounting evidence that people can theoretically remain healthy, independent and productive well into old age. Prevention of chronic and degenerative disease is what it all comes down to. Now the problem is that these types of disease tend to not only become more common but also more likely to accumulate as we get older.
Calculations show that even if a person was able to completely eliminate the chance of contracting a specific disease (say cardiovascular diseases or cancer), they would be unlikely to win more than three to five years of good health, since the next disease would be just around the corner. An on-going long-term study at Newcastle University shows that at the age of 85 we tend to have four to five health conditions on average.
So what can we do?
Firstly, there is a need for a new class of drugs. While the evidence above suggests that it would be most efficient to look at disease prevention from a holistic angle, pharma companies today still largely focus on the treatment of specific conditions in a siloed disease-by-disease approach. The key barrier to researching and releasing a more all-encompassing “health insurance” drug is that “aging” is not considered a medical indication by regulatory agencies. Therefore, a drug aimed at treating aging (meaning the process that triggers senescence and the development of degenerative disease) could currently not be sold, even if it existed.
The first step is therefore to define “aging” as an indication, so pharma companies have an incentive to target it with new or even existing drugs (e.g. evidence exists that Metformin, a common diabetes drug, or Rapamycin, a drug treating organ transplant rejection, both have “anti-aging” effects).
Secondly, we need to make existing solutions more accessible. The current state of affairs is not all bleak and there has in fact been good progress in understanding what keeps us healthy for longer. From engaging in regular exercise to following a healthy diet to taking supplements like resveratrol – or on the more cutting edge side of things – Elysium Health’s Basis (which imitates the effects of calorie restriction and has been proven to reverse cellular aging in mice).
However, not only is the field of healthy aging today prone to quackery, it is also elitist. Basis’ Elysium Health costs fifty dollars per month and, in order to work, needs to be taken continuously – a proud investment that most average Americans couldn’t or wouldn’t want to afford.
But the key barrier to aging healthfully is not only income but education. Today, the best-educated Americans not only live an average of 10-14 years longer than the least educated, they also stay healthier. This is not because reading Kant prevents cancer, but because education is a proxy for other relevant criteria: A college educated person is less likely to smoke and more likely to eat well and exercise.
The challenge here is not necessarily to get more people to university, but to provide better information and communicate it more efficiently, e.g. by repositioning the idea of healthy living in order to make it feel less complex, less of a luxury and less of a compromise. No need to say that it also wouldn’t hurt if more affordable products – from healthy foods and beverages to health trackers – and services – from healthcare to gym classes – were available.
And finally, we need to actively target ageism. Ageism is not only a result of increased age-related illness, research suggests that it can also act as a cause: In cultures where old age is thought of as signifying low status, older people tend to feel less healthy. Experiencing prejudice can lead to stress and depression, which in turn are risk factors for heart disease and dementia as well as numerous other chronic illnesses. This means that ageism and illness create a vicious cycle. A cycle that can be broken and maybe reversed.
Brands have a strong role to play here. There is a need to rethink the way that older adults are portrayed and marketed to, moving away from dominant, unhelpful discourses towards a new, positive definition of later life stages. A definition that doesn’t rely on tired stereotypes or comparisons to the young (e.g. presenting a healthful, active elder as “beating the odds” or “chasing youth”) in order to not just celebrate but, most importantly, normalize notions of achievement, contribution and dynamism in connection with older age.
Health through the Culture Lens is a weekly series exploring important cultural currents in health and pharma
Image source: The Dreslyn x Land of Women
- Article by Katalin Kleemann