How much is a longer life worth?

We all know a few bores who talk endlessly about the state of their “body battery”, the people who believe they can “hack health” by monitoring their sleep, blood sugar and oxygen levels along with other obscure markers all day. Nobel Laureate Venki Ramakrishnan describes this as “the general psychological obsession of the worried well”. In other words, people generally fear ageing and death—and in a society that rarely wants to confront hard questions, collecting and analysing data probably gives a sense of control to those who can afford to “solve” everything with money and data. While a knowledge and understanding of biology can help people live better—hack health, if you will—can one really live forever? And do we really want to?

Ramakrishnan is an authority on the subject, having shared the 2009 Chemistry Nobel with Thomas A Steitz and Ada Yonath for work on ribosomes, structures in the cell that help create proteins. A few months ago, he released the book Why We Die: The New Quest for Ageing and the Science of Immortality, which examines the latest breakthroughs and research in ageing and biology.

Though humans have long pondered the philosophical and religious ideas of death and immortality, it’s only in the last 50 years or so—as life expectancy and overall prosperity has risen—that scientists of all stripes have started examining questions of mortality and ageing. Funding much of this research are billionaires who aren’t just content with leaving behind a legacy but want to defy death and cure disease. Some governments, too, have recognised the challenges of ageing and are backing research.

Also read: Healthy ageing: A three-step plan to live longer

“The broad spectrum in the middle want to tackle ageing directly to compress morbidity so that humans might live healthy lives into old age,” Ramakrishnan writes. For a better, longer, healthier life, Ramakrishnan (who is 72) makes a case for greater flexibility in work and retirement ages, better housing and city design and more social contact for the elderly, rather than leaving them on the edges, especially as the challenges of a greying society are already becoming evident. Excerpts from an interview with Ramakrishnan.

Is living longer one of the pressing concerns of our age, considering the many other problems in the world?

It is not mainly about living longer. All societies are facing a situation where people are living longer and also having fewer children. This means that a larger fraction of the population will consist of older people. It is important to find ways of ensuring that as people age, they remain healthy, independent and productive.

Ageing hasn’t always been one of your primary areas of research. Why did you choose to write about ageing?

Actually, the process of protein synthesis and its control is essential to normal function, and its loss of regulation plays a central role in many of the causes of ageing. So, it is not really far from my own area of research.

While humans have wondered about mortality ever since we became aware of it, it is only in the last few decades that we have made progress in understanding the biological causes of ageing, which is a first step to begin to tackle some of the effects of ageing.

At the same time, because there is now a large amount of money going into ageing research, and there is natural anxiety about ageing and death, there is also a lot of hype and some dubious practices. As someone close to the field but not directly in it, and with no vested interest in it, I wanted to take an objective look at what we know and what the prospects are.

Could the millions going into anti-ageing-related research be funnelled towards helping people live better now?

Ageing is a slow accumulation of damage to our molecules and cells with time. This damage occurs all the time and we have elaborate mechanisms to repair the damage, but as we age, these repair mechanisms themselves are affected and we cannot keep up with the general deterioration of function. This manifests itself in many ways…

Much of ageing research is precisely directed at improving the quality of life in old age. One of the biggest risk factors for many diseases such as heart disease, cancer, diabetes and neurodegenerative diseases is, in fact, age. So the thinking is that if we can tackle some of underlying causes of ageing or at least its effects, we can simultaneously prevent some of these diseases. Radical life extension is the fantasy of only some of the extreme segments of the longevity research community. …

Preventing ageing of the brain is a huge challenge that will require some big breakthroughs. However, even if older people are not as creative and imaginative later in life, they can serve a very useful purpose in society, so it is really important to tackle the disabilities of old age and ensure healthy aging.

Is the desire for longevity a function of prosperity? Or more simply: Do you need lots of money to live forever?

We all have a deep instinctive desire not to age or die, whether we are rich or poor. However, there is a huge economic disparity in longevity. Even in rich countries, the poor live about 10-20 years shorter lives and spend less of their lives in good health. I doubt that “living forever” will be possible but certainly having money significantly increases the chances of living a longer and healthier life.

You conclude by saying that sleep, diet and exercise are crucial to living a long and healthy life. Does that mean sophisticated interventions aren’t really necessary?

People are constantly given all sorts of advice, but without understanding its scientific basis, it is hard to know what advice works and what doesn’t. The point about this trio of interventions is that we now understand the underlying biological basis for WHY they work. In fact, the point of my book is to help readers understand the biology of ageing so they will have a frame of reference to evaluate any future advice and also separate hype and nonsense from real findings.

Currently, the trio of sleep, diet and exercise work better than any anti-ageing medicine on the market. But the same trio can also reduce blood pressure and cholesterol. However, despite my best efforts to keep them under control naturally, I eventually had to go on blood pressure medication and statins. Similarly, the hope of much ageing research is to be able to help beyond what we can accomplish naturally to keep us healthy.

If we all lived to 120-150, wouldn’t the world be a terribly boring place?

I personally think that the world would be better off and more interesting if we have more frequent generational turnover rather than a more stagnant world where the same people hang around for a very long time and are only slowly replaced.

Life extension advocates would argue that we now live twice as long on average as we did a hundred years ago, and we are all better off for it, but this is misleading.

Much of that gain was by combating infant mortality and diseases but they were not inevitable: even in those days, there were people who lived very long lives. So this movement towards life extension is fundamentally different because it seeks to change something that is both universal and naturally inevitable.

However, I think while the radical life-extension advocates generate much of the noise and hype—many of them are prominent and wealthy—they are a minority of the anti-ageing research community.

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