Improved life expectancy across the developed and most of the developing world is one of the main triumphs of medicine. But although the expected lifetime of an individual is slowly increasing in most countries, the maximum lifespan isn’t.
Unlike most other metrics of human achievement, the age of the oldest person alive seems to oscillate around a hundred and ten or a hundred and fifteen years without any sign of there being an underlying positive trend.
As the population of most countries becomes older, medical interventions will increasingly come to focus on those ailments that seem to be inherent to aging itself. The recent reduction in mortality rates from cardiovascular diseases is an example of this, as well as the reduced lethality, although not the incidence, of most types of cancer. Medicine advances in great part by switching from treatment to prevention, for example with vaccination and contemporary protocols controlling blood pressure and lipids. But the constellation of diseases associated with the late stages of aging seems to be unavoidable.
If this situation continues, it can be expected that the treatment of age-related diseases will constitute an even larger sector of the practice and business of healthcare.
However, there are reasons to think that this might not be the case. The last years have seen a growing body of research concerning the molecular mechanisms of aging. Although there is still no well-understood explanation of aging at the molecular level, the body of data is quickly growing, and unlike previous attempts at understanding aging, we can for the first time analyze genetic and biochemical mechanisms in a very direct fashion. There are currently no thoroughly tested anti-aging treatments for humans, but it’s important to note that complex organisms, including mice, have had their maximum lifespans prolonged by 30% or more by a multitude of artificial procedures. It’s not a stretch of the imagination to think that at least one of those procedures could open the door to similar interventions for humans.
This possibility casts a shadow of uncertainty over the long-term shape of the medical industry. The need for certain kinds of medical services is often influenced by developments in other areas, and the demand structure has changed much during the last decades. Potential discoveries in the molecular mechanisms of aging could shift it even more, and in ways that are not easily to discern. The care of older adults with declining cognitive capabilities, for example, could either become a huge market or shrink until it disappears, depending on our understanding of brain function. The same can be observed about many of the “obvious” tendencies in healthcare that shape current long-term investment. Our societies are aging, yes, but it would be unwise to be too certain about what this will entail, specially for healthcare providers.
Demography, it has been told by observers of history, is destiny. This might be the case, but science and technology are always rewriting the meaning of it.
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