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Longevity

Is Radical Human Lifespan Extension Possible This Century?

Posted on 17 October 2024

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Recently, a paper was published that has caused a lot of discussion and some controversy among prominent scientists studying human ageing. The article features Jay Olshansky as a well-known author, a renowned researcher who predicted in 1990 that life expectancy gains would slow down even if medical advances accelerated. 

The paper is called ‘Implausibility of radical life extension in humans in the twenty-first century’, and was picked up by many prominent news outlets. It has been frustrating (though not surprising) to see reports from some less scientifically focussed media completely misunderstanding the message of the study. While there’s no excuse for poor journalism, the title of the paper may be partly to blame, as it seems to assert that getting humans to live much longer than they currently do is ‘implausible’ this century. The reality of what they are suggesting is a bit more nuanced. Let’s take a look at what the researchers actually did.

A Recent History Of Lifespan Extension

Life expectancy skyrocketed over the course of the previous century, mostly due to radical reductions in infant mortality. What changed? Mainly improvements in sanitation and other technologies sparing us from early death due to infectious diseases. This greatly improved our chances of living into old age. As medical advances continued, treatments for diseases of old age improved as well. Overall, we gained about 3 years of life expectancy per decade during the 20th century. 

Just before the turn of the century, some scientists hypothesised that this radical increase in lifespan was not sustainable and that we were fast approaching a ‘hard limit’ on human lifespan. Others were hopeful that medical breakthroughs would allow life expectancy to continue to increase at the same rate. 

Now a quarter of our way into this century, the authors of this study wanted to take stock of our situation and determine which of these hypotheses is best supported by the data. 

Losing Momentum

Focussing on data from Australia, France, Italy, Japan, South Korea, Spain, Sweden, Switzerland, Hong Kong and the United States, the trend was clear. Annual life expectancy gains have been decelerating since 1990 (the researchers only used data up until 2019, so the Covid pandemic didn’t play a role in this). Only Hong Kong and South Korea maintained the 3 year per decade increase in life expectancy that characterised most of the 20th century, and Hong Kong only maintained that level of life expectancy gain during the years 1990-2000. Every other country gained less than 2 years of life expectancy during the previous decade. The United States was an outlier, with life expectancy gains stalling almost entirely during the previous decade.

A graph showing data from the Human Mortality Database, showing how life expectancy at birth increased each year on average for the last three decades. Life expectancy at birth is the average lifespan a newborn can be expected to live if age-specific mortality rates don’t change.
Implausibility of radical life extension in humans in the twenty-first century

So, life expectancy is still increasing, but not to the extent it was during the 1900s, and it seems to be slowing down.

A World Of Centenarians?

The authors then asked what percentage of people born today could expect to live for 100 years or more. The answer: not that many. They estimate around 5.1% of women and 1.8% of men overall. The highest regional estimate was for Hong Kong: 12.8% for women and 4.4% for men. In other words, we are a long way from a world in which most people can expect to live to 100.

Expected percentage of people (male and female) born in the last three decades who will reach the age of 100.
Implausibility of radical life extension in humans in the twenty-first century

Diminishing Returns For Our Efforts

The authors then asked another interesting question: by how much would we need to reduce mortality in order to raise our life expectancy by one year? They found that the required level of mortality reduction has been increasing. To raise life expectancy from 88 to 89 in women and from 82 to 83 in men would require cutting mortality rates from all causes by 20.3% and 9.5% respectively.

This is largely because reductions in mortality are increasingly coming from older age groups. Saving a child who then goes on to live until they are 70 is going to have a much greater effect on life expectancy than saving a 70 year-old who will live another 10 years. The researchers go on to estimate what would be required to reach a life expectancy at birth of 110 years, with reference to current mortality rates in Japan. They estimate that mortality from all causes would need to be be 88% lower than the 2019 mortality rate for 109 year-old Japanese people, and this mortality rate would need to be sustained until age 150 (this is illustrated in the figure below). Assuming mortality throughout life followed the same pattern, it would entail about a quarter of the population living longer than Jeanne Calment, thought to be the oldest human to have lived (122 years old at death). This reduction is so drastic that it would require all major causes of death that exist today to be eliminated.

A comparison of death rates throughout life in a life table cohort (typically 100,000 people) for Japanese women in 2019 (blue), and what death rates would need to look like for the same population to have a life expectancy at birth of 110.
Implausibility of radical life extension in humans in the twenty-first century

The Take Home Message, And Some Optimism

This research clearly shows that it is getting harder and harder to raise human life expectancy, and that if the current trend continues, gains in life expectancy this century will not match those of the previous century. This is a bleak outlook that most scientists agree with. However, this study is an analysis of what has happened based on existing population data, and what needs to happen if we are to change course. The authors are very clear that further medical advances that slow down the biology of ageing could still result in radical lifespan extension this century. They are not claiming the existence of a brick wall for life expectancy, merely that we are unlikely to raise the average and upper limit of human lifespan without medical breakthroughs. In fact, the last paragraph contains this rather upbeat statement:

Given rapid advances now occurring in geroscience42, there is reason to be optimistic that a second longevity revolution is approaching in the form of modern efforts to slow biological aging, offering humanity a second chance at altering the course of human survival.

Implausibility of radical life extension in humans in the twenty-first century

This is a crucial point that some journalists appear to have missed. A common misinterpretation of this study has been that we should give up trying to live longer because it’s futile, and should focus on treating age-related diseases instead. Yet if anything, this study supports the idea that our current focus on treating age-related diseases after they have occurred is yielding diminishing returns. To turn this situation around, we need breakthroughs that will do for age related diseases what vaccines and sanitation did for infectious diseases: prevention. The best way to prevent age related diseases is to target ageing itself. Aubrey De Grey, prominent advocate for longevity research and co-founder of the SENS Research Foundation, summarises many people’s frustration with the paper:

This is yet another appalling example of a fundamental disconnect between the content of an article about future progress against ageing and its title. The article provides, as have innumerable others for decades, solid evidence that both mean and maximum human longevity will only ever rise by more than a further decade if there are fundamental breakthroughs in medicine against ageing. But the title declares that such breakthroughs are ‘implausible.’ No basis for such an assertion is given.

-Aubrey De Grey, quote source: Lifespan.io


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    References

    Implausibility of radical life extension in humans in the twenty-first century https://doi.org/10.1038/s43587-024-

    Title image by Jannes Jacobs

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