Olshansky S Jay
School of Public Health, University of Illinois at Chicago, Chicago, Illinois 60612.
Cold Spring Harb Perspect Med. 2016 Jan 8;6(2):a025940. doi: 10.1101/cshperspect.a025940.
The survival of large segments of human populations to advanced ages is a crowning achievement of improvements in public health and medicine. But, in the 21st century, our continued desire to extend life brings forth a unique dilemma. The risk of death from cardiovascular diseases and many forms of cancer have declined, but even if they continue to do so in the future, the resulting health benefits and enhanced longevities are likely to diminish. It is even possible that healthy life expectancy could decline in the future as major fatal diseases wane. The reason is that the longer we live, the greater is the influence of biological aging on the expression of fatal and disabling diseases. As long as the rates of aging of our bodies continues without amelioration, the progress we make on all major disease fronts must eventually face a point of diminishing returns. Research in the scientific study of aging has already showed that the aging of our bodies is inherently modifiable, and that a therapeutic intervention that slows aging in people is a plausible target for science and public health. Given the speed with which population aging is progressing and chronic fatal and disabling conditions are challenging health care costs across the globe, the case is now being made in the scientific literature that delayed aging could be one of the most efficient and promising ways to combat disease, extend healthy life, compress morbidity, and reduce health care costs. A consortium of scientists and nonprofit organizations has devised a plan to initiate an accelerated program of scientific research to develop, test for safety and efficacy, and then disseminate a therapeutic intervention to delay aging if proven to be safe and effective; this is referred to as the Longevity Dividend Initiative Consortium (LDIC). In this review, I articulate the case for the LDIC.
人类大部分人口活到高龄是公共卫生和医学进步的一项辉煌成就。但是,在21世纪,我们持续延长寿命的愿望带来了一个独特的困境。心血管疾病和多种癌症的死亡风险已经下降,但即便未来它们继续下降,由此带来的健康益处和寿命延长可能也会减少。随着主要致命疾病的减少,未来健康预期寿命甚至有可能下降。原因在于,我们活得越长,生物衰老对致命和致残疾病表现的影响就越大。只要我们身体的衰老速度持续不减,我们在所有主要疾病领域取得的进展最终必然会面临收益递减的问题。衰老科学研究已经表明,我们身体的衰老本质上是可以改变的,而且延缓人类衰老的治疗干预是科学和公共卫生的一个合理目标。鉴于人口老龄化的进展速度以及慢性致命和致残疾病对全球医疗保健成本构成的挑战,科学文献中目前正在提出这样的观点,即延缓衰老可能是对抗疾病、延长健康寿命、压缩发病期以及降低医疗保健成本的最有效和最有前景的方法之一。一个由科学家和非营利组织组成的联盟已经制定了一项计划,启动一个加速科研项目,以开发、测试安全性和有效性,然后在被证明安全有效后推广一种延缓衰老的治疗干预措施;这被称为长寿红利倡议联盟(LDIC)。在这篇综述中,我阐述了支持LDIC的理由。