WEALTH

MICRO
Local knowledge
PLUGGING THE
LEAKS OF TIME
To fend off the rising cost of aging, societies
need to lend greater support to geroscience’s
struggle against age-related diseases
DAVID STIPP
The author of The Youth
Pill and winner of the
American Aging
Association’s 2014
Excellence in Journalism
Award, David Stipp has
written about science,
medicine, the
environment and biotech
since 1982. He led
Fortune’s science and
medical coverage from
1995 to 2005 as a senior
writer, and from 1982 to
1995 covered science and
medicine as a staff
reporter at the Wall
Street Journal
By David Stipp
You might call it Murphy’s law of aging:
anything that can go wrong inside you
will do so if you live long enough. Yet
no one experiences the full force of the law, of
course, since one malady is often enough to
lead to the system’s breakdown.
Still, the law’s effects are increasingly
familiar as ever more of us reach the
biodegrading time of life. In fact, noncommunicable
diseases now pose a greater
health burden, in terms of healthy life years
lost, than communicable diseases in most
countries outside of Africa.
Unfortunately, the conventional strategy
in medicine, treating one disease at a time,
isn’t meeting this challenge very well. One
reason is that the ills of aging tend to be
intractable and progressive, and by the time
symptoms appear, they have often caused
irreversible damage. Treatments frequently
yield little gain despite racking up large
medical bills. And even if one ailment can be
held at bay, Murphy’s law guarantees that it
won’t be long before others strike.
Worse, diseases such as macular
degeneration, heart failure, strokes, arthritis
and Alzheimer’s disease often leave their
victims in a costly, disabled state long before
they die. As a New England Journal of Medicine
article on global health trends put it, “What
ails most [elderly] persons is not necessarily
what kills them.” Disability caused by noncommunicable
diseases now accounts for
more than 40% of lost healthy years in the US,
Europe and other parts of the developed world,
according to the World Health Organization.
This burden is increasing rapidly. By 2050, 21%
of the world’s population, about 2 billion
people, will be 60 or older, more than triple the
number in 2000, according to the UN report
World Population Ageing: 1950–2050. Today, the
oldest nation, Japan, has a median age of 46; by
mid-century, half of the people in a number of
countries, including Spain, Italy, South Korea
and Japan, are expected to be over 50.
Meanwhile, older populations in less developed
regions will have quadrupled. In China, an
estimated 437 million people will be 60
or older.
ONE DISEASE AT A TIME DOES NOT WORK
Ominously, life expectancy gains in the US are
already adding more years of disabling disease
than healthy years to people’s lives, says Dana
Goldman, a University of Southern California
health economist. That’s not surprising in
light of the study he coauthored in 2013:
Substantial Health and Economic Returns From
Delayed Aging May Warrant a New Focus For
Medical Research. The study showed that the
one-disease-at-a-time strategy is likely to face
diminishing returns – that is, smaller gains in
longevity – even if in coming years it greatly
reduces the incidence of the two leading
causes of death in the developed world, heart
disease and cancer.
Indeed, the strategy increasingly resembles
the little Dutch boy of popular legend: instead
of saving the day by plugging a dike leak
with his finger, he’s overwhelmed as one
leak after another springs out. That’s Murphy’s
law at work.
36 • Allianz