r/science Oct 16 '21 Silver 4 Helpful 7 Wholesome 7 Hugz 4 All-Seeing Upvote 1 Narwhal Salute 1 Wholesome Seal of Approval 1

Lifespan has increased dramatically, but those extra years are often wracked with disease — A new Mayo Clinic study seeks to answer whether regenerative medicine could slow the clock on age-related disorders to live a high-quality life in the final years Medicine

https://regenerativemedicineblog.mayoclinic.org/2021/10/07/a-regenerative-reset-for-aging/?utm_source=linkedin&utm_medium=sm&utm_content=post&utm_campaign=mayoclinic&mc_id=us&geo=national&placementsite=enterprise&cauid=105028&linkId=135475980
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u/Snackbot4000 Oct 16 '21

Sadly, I can really relate to this; my dad sailed through his 70's and into his early 80's with no problems at all. Somewhere after that he became frail, seemingly overnight, and now has health crises every few months as his health continues to decline.

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u/Imaginary_Trainer654 Oct 17 '21

I remember hearing a Ted Talk by a doctor that this is really how the human body should work. Be relatively healthy and capable until about 80-85, and then a host of problems. Thing is, modern medicine keeps us living but not really “alive” if that makes sense

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u/sanpompon Oct 17 '21

My grandmother finally passed away at 90. She had told us on several occasions that she wanted to die already. And, yeah, about 5 years ago is when she started to crater.

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u/obsessedcrf Oct 17 '21

There are more options than ever before for improving the quality of life in people with health issues. True, we have a long way to go but you shouldn't imply that modern medicine has made things worse in that regard.

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u/Jrook Oct 17 '21

My parents and aunts and uncles all look incredible compared to my grandparents at the same age. My grandmother has looked like the golden girls for nearly as long as the show itself

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u/cidiusgix Oct 17 '21

Damn my grandma too, I swear she looked the same from when my memory begins until she ended.

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u/Lou_Garoo Oct 16 '21

Both of my grandmothers died in their early 60's. As a child they seemed ancient to me, as an adult I see how young that was.

My own parents are in their mid-70s and other than some arthritis and high blood pressure they are pretty active and so much younger than my grandmothers ever were. I realize at this age anything can happen. The worst thing would be cognitive decline. My dad has always said that if that happens he is going off into the woods like an old cat.

We don't just have the ability to have longer lives, babyboomers have a more youthful outlook than their parents who seemed to age much more quickly. Better diagnostics mean we can catch things before they become fatal.

My husbands grandmother who is in her 90's seems content to live in the old age home she is in. She does not go anywhere. Not even really outside. To me that seems horrible, but she appears to be moderately happy. I wonder if your expectations change when you get older based on what you can do. Like an old dog is still happy to go for short walks and takes longer naps. Did I just compare my grandmother to an old dog? But we really aren't all that different I suppose.

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u/zrk03 Oct 16 '21

I just hope I'm in as good of condition as William Shatner when I hit 90.

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u/arunnnn Oct 16 '21

I remember seeing that one show a few years ago where he and others where traveling the world and it showed even on the trip they would all get up super early and be on the treadmill or something. It was eye opening, but also makes sense. Keep moving!

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u/Laladelic Oct 16 '21

Just, make, plenty, of pauses, you'll be fine.

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u/NabiscoLobstrosity Oct 17 '21

If you subtract the pauses, he's only 43 years old.

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u/sangjmoon Oct 16 '21

Looking in the mirror, I see a general deterioration over time similarly to that of my car which has more problems every year. Unless we develop medical technology similar to rebuilding a car, the older we get, the more things in our body will break down. Lifespan is a measure of survival. Although objectively measurable, what would probably be more useful is a measure for how well we live.

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u/[deleted] Oct 16 '21

“Life expectancy has increased by three decades” how much of this is down to the near elimination of infant mortality though? I mean three decades seems absurd

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u/Not_Legal_Advice_Pod Oct 16 '21 edited Oct 16 '21

It is true that infant mortality rates contribute significantly. But we all know, from our own elderly relatives, that generally what happens is that in their late 70s early 80s they have a "scare", or something that would have liked them off a hundred years ago, but got through it and are now having their lives saved at ever increasing frequency by ever increasing medical intervention until they require round the clock care.

Edit: just changed the first sentence to clarify that I agree a big portion comes from infant care.

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u/TheManInTheShack Oct 16 '21 Wholesome

100 years ago my dad would have died of a heart attack and my mom of heart failure. Instead, he got angioplasty and stents (along with statins) and mom got a pacemaker. They are both in descent physical shape for 85.

Unfortunately, they both have Alzheimer’s. Dad’s is simply his short term memory. He’s otherwise right as rain. Mom’s is short term memory though not as bad as dad, word retrieval and occasional confusion. In a way, they make up for each other. Mom remembers things that dad has forgotten and when she can’t retrieve a word, he usually knows which one she’s looking for and tells her.

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u/Alberiman Oct 16 '21

Alzheimers is a nightmare, the research into it is ongoing but i really hope someday we can find a cure for it

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u/TheManInTheShack Oct 16 '21

Me too. I was recently contacted about a third phase clinical trial for an Alzheimer’s treatment that they thought my dad would be a good candidate for but it involves brain surgery and he’s not willing to do that.

I found another one that is phase 2 but it involves daily injections and he’s at the very edge of age qualification.

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u/askingforafakefriend Oct 16 '21

Look up simufilam. It's just now starting phase 3. It's a daily pill.

And with one year phase 2 data it is showing COGS IMPROVEMENTS!!! not just slowing of the decline.

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u/TheManInTheShack Oct 16 '21

Wow! Thanks for the suggestion. I’ll look into it now!

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u/GRANDMA_FISTER Oct 16 '21

What does cogs improvement mean?

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u/askingforafakefriend Oct 16 '21 edited Oct 17 '21

It's a cognitive test administered in clinical trials to assess the decline in Alzheimer's patients. In all existing Alzheimer's trials, after a year the tested cognitive abilities go down. The issue is how far down. The highly controversial recently FDA approved drug from biogen at best arguably slightly decreased the decline in some aspects. Many scientists doubt there's any actual benefit.

In the one year data of the phase two trial of Simufilam, cognitive ability typically increased significantly which is absolutely unheard of in Alzheimer's research.

Disclaimer: because of certain risks in my family I follow Alzheimer's drug research closely and this is the first and only drug I've ever decided to invest in based on my read of the research. The stock has gone up in insane amount over the last year and became kind of a GameStop thing with investors longing and shorting and playing games. There was an allegation of fraud filed with the FDA with respect to biomarkers only (not disputing the cognitive improvements!) filed by a law firm which later had to admit that their clients alleging the fraud had all shorted the stock before they filed this. I mentioned this just to say that the company behind the stock is distracted with all kinds of GameStop Wall Street crap. But I would suggest anyone look into the actual data and veracity of anonymous claims... As well as the fact that the FDA has set up an SPA to work with them through phase 3 which all sounds great from the perspective of somebody hoping this moves forward with concrete data hopefully showing the same thing as phase 2!

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u/dreamingtodeath Oct 17 '21

it’ll be a couple days before i can dig into primary sources/journal articles, but i wanted to thank you for bringing this to my attention. a cursory glance at the published data has left me very impressed.

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u/NabiscoLobstrosity Oct 17 '21

I frequently wonder how much better off we'd be if, instead of increasing our notary budget massively at the start of the Bush administration (which they did before 9/11), they put those billions of dollars towards Alzheimer's and dementia research instead. If they even put 10% of those billions, it would be a huge difference.

Maybe we wouldn't have solved those problems by today, 20 years later, but we'd be a hell of a lot further along with it.

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u/hary627 Oct 16 '21

My gran had a fall about 10 years ago, now suffers from short term memory loss. Can remember basically nothing new. My grandad took care of her, kept her right and made sure she remembered stuff. Then he passed from bowel cancer. Now my gran is in a care home and needs 24 hour care that was a struggle to get her into. She broke her foot at one point and kept trying to walk on it because she didn't remember she broke it or why she was in hospital. Memory loss sucks

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u/FellowTraveler69 Oct 16 '21

I hate to say it, but both parents with alzheimers, it isn't looking too good for you when you get to that age.

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u/angryarugula Oct 16 '21

No time like the present to invest in Alzheimer's research!

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u/mrs_shrew Oct 16 '21

I think that's the whole point, what quality of life can you expect at 85 years? That's still a really old age to die, and dementia is expected really. My gran had it from around 86 ish, and she died at 93, but those last few years were effectively pointless because she never went anyway and never remembered anything. So what's the point of being a living corpse?

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u/TheManInTheShack Oct 16 '21

It depends. Look at William Shatner. He’s 90 and clearly in great shape both physically and mentally. My in laws are in their early 80s and are both in great shape physically and mentally.

I think the problem for many people is that they stop working at these things as they get older and the saying “use it or lose it” appears to be more true than not.

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u/thelizardkin Oct 16 '21

The first marathon my dad ran, he was beaten by a woman in her 90s.

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u/bixtuelista Oct 16 '21

I am so glad Bezos didn't kill Captain Kirk.

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u/TheManInTheShack Oct 16 '21

Well there are a lot of contributing factors. My parents both retired at 55. Was that because their brains already no longer wanted to be challenged? Is that an indicator? My father’s father was clear as a bell until the day he died at 95.

I’m doing everything I can think of to avoid their fate. For years I’ve taken part in an online study of my short term memory. If it starts to fail, I’ll see that in the study results. I’m now older than my parents were when they retired and have no plans to do that myself any time soon. Even if I did, I have lots of plans that would keep me busy with intellectual challenges. My primary hobby is music. I write and record original songs. I’m writing a book. I’m teaching myself another spoken language. I don’t drink or smoke (I never have). I exercise a lot and I keep my weight in the normal BMI range. There’s little more I can do so hopefully it will be enough.

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u/FellowTraveler69 Oct 16 '21

Well, sounds like you got a plan. I wish you nothing but the best than.

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u/TheDumbAsk Oct 16 '21

Ya, now we can basically Darth Vader everyone. Should measure it as qol expectancy now.

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u/get_it_together1 PhD | Biomedical Engineering | Nanomaterials Oct 16 '21

They are starting to use qol-adjusted years when evaluating interventions like chemotherapy. Six more months of life that requires six months of intensive chemo is maybe not so worth it. I don’t know how rigorous this is, I heard about it from a clinician and it shows up in a book on aging and death called Being Mortal.

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u/Zidane62 Oct 16 '21

Another thing about qol is that my mother just passed from covid. A breakthrough case. The doctors told us they could keep her alive if they surgically put a breathing tube into their throat and that’s how she’d live the rest of her life. We said screw that and let her pass peacefully

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u/Cultjam Oct 16 '21

I’m so sorry for your loss.

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u/KawaiiCoupon Oct 16 '21

It’s a hard decision because it’s not like dying with cancer without treatment is some kind of serene experience where you feel okay and then you die in your sleep one night (for a lot of people anyway).

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u/Rabid-Ginger Oct 16 '21

Which is onw of many reasons why medically-assisted suicide should be a legal option.

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u/KawaiiCoupon Oct 16 '21

I’m all for it.

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u/get_it_together1 PhD | Biomedical Engineering | Nanomaterials Oct 16 '21

The treatment doesn’t make you feel better, sometimes it makes you feel even worse. It stops the cancer from growing but you have all your cancer symptoms plus chemo symptoms, then you stop treatment and the cancer keeps growing and you still have chemo side effects. The decision in this case is between palliative care and aggressive chemo.

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u/TurkeyBold Oct 16 '21

If we Darth Vadered everyone, infant mortality would go up wouldn't it?

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u/NostalgiaSchmaltz Oct 16 '21

Yeah, my grandfather is like this. He's almost 80 and pretty much cannot function on his own. Can't walk on his own, can't get up from his chair on his own, can't even go to the bathroom or bathe himself on his own. Requires nearly 24/7 care. Seems like a pretty awful way to live if you ask me.

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u/[deleted] Oct 16 '21

That’s a very good point, and accurate

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u/No_Slide_402 Oct 16 '21

All you need to know about humans is that we find it humane to put down animals that are in pain when they can no longer have a decent quality of life but in humane to do to people.

It can’t be both. It’s one of the other but humans are fucked up.

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u/Shutterstormphoto Oct 16 '21

Don’t forget we also have a ton of things like osha and the fda making sure we don’t die at work and don’t die from snake oil or poorly prepped food. Health safety is actually enforced, and restaurants are heavily inspected and so on. Cars have seatbelts, which reduced crash deaths by 50%. Trains have crossing guards at just about every crossing. Medicine is better than it’s ever been. Mandatory vaccines as well have eliminated polio, and nearly eliminated measles mumps and rubella. Better sewage treatment, better water supplies, etc.

A lot of work (and science) has gone into keeping us alive longer.

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u/_Z_E_R_O Oct 16 '21

Women not dying in childbirth by itself is a huge average lifespan bump.

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u/NabiscoLobstrosity Oct 17 '21

Modern sanitation plays a huge role. I expect it's probably the single most important factor.

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u/Five_Decades Oct 16 '21

I once read a book about medicine that discusses life expectancy growing by about three decades in the 20th century.

of those 30 years, about 25 were due to public health measures. clean water, sanitation, vaccinations, food safety, osha standards, safety features on cars, better nutrition, etc.

42 months was due to hospitals and surgery.

18 months was due to primary care and pharmaceuticals.

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u/syricc Oct 16 '21

Yup, I remember being taught this in medical school (don't recall what the exact numbers were, but this sounds about right). All the advances made in medical care are responsible for only a few years increase in life expectancy, and the quality of life of those years can be questionable. Public health and sanitation are far more important at a population scale

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u/brberg Oct 16 '21 edited Oct 16 '21

About half. Globally, remaining life expectancy at age 10 has increased by 15 years since 1950.

Note that the OP also gives a global statistic. By 1950, the effect of infant mortality on overall life expectancy at birth in wealthy countries was fairly minimal. The increase in life expectancy at age 10 in wealthy countries has been a bit more moderate, about 10-12 years.

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u/ControlAgent13 Oct 16 '21

I mean three decades seems absurd

Your right that child mortality figures into that. But I just read a book on ancient Rome. The author says the average life expectancy for men was 26 and women was 24 (lower due to death in child birth).

He further goes on to say that you could live to old age in ancient Rome - 1 in 10 would make it to 60, of those, 1 in 10 would make it to 70 and 1 in 10 of those would make it to 80.

Now look around today, we have lots of 60+ year olds - heck they are elected to run the county...

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u/urnbabyurn Oct 16 '21

Be nice to use median and not mean age.

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u/SonOfTK421 Oct 16 '21

Depends on how far back they measure. In 1921 life expectancy for men in the US was 60 years, and today it’s 78.8. That’s not much different than globally, except a little to the high end, so they must be going back a ways further than 100 years.

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u/StoicOptom Oct 16 '21 edited Oct 16 '21

Original paper - Longevity leap: mind the healthspan gap

Abstract

Life expectancy has increased by three decades since the mid-twentieth century. Parallel healthspan expansion has however not followed, largely impeded by the pandemic of chronic diseases afflicting a growing older population. The lag in quality of life is a recognized challenge that calls for prioritization of disease-free longevity. Contemporary communal, clinical and research trends aspiring to extend the health horizon are here outlined in the context of an evolving epidemiology. A shared action integrating public and societal endeavors with emerging interventions that target age-related multimorbidity and frailty is needed. A multidimensional buildout of a curative perspective, boosted by modern anti-senescent and regenerative technology with augmented decision making, would require dedicated resources and cost-effective validation to responsibly bridge the healthspan-lifespan gap for a future of equitable global wellbeing.

This paper draws attention to our global aging populations, and discsusses the critical importance of advancing regenerative medicine and aging biology research. The authors highlight how COVID-19 was a stark reminder of the vulnerability of our older adults to disease.

The SARS-CoV-2 viral outbreak and the ensuing COVID19 pandemic have tragically reminded us of the indispensable value of health, and unequaled impact amongst vulnerable populations. The successful development of safe and effective vaccines, within a record timeframe, symbolizes the remarkable capabilities of modern science. In contrast to acute harm, however, a gradually progressing danger tends to be under-recognized per analogy to the ‘boiling frog’ metaphor. The insidious accumulation of chronic disease and frailty must engender disruptive innovation.

The authors identify the physiological decline associated with aging (e.g. immunosenescence) as a root cause of vulnerability that society should focus on for healthcare strategy.

Targeting the root cause at latent stages offers the prospect of implementing proactive, prophylactic actions. Beyond constraining disease symptomatology, disease-free outcome would require achieving enhanced intrinsic resilience against health-compromising stressors. Growing regenerative options offer opportunities to boost innate healing, and address aging-associated decline.

Currently, there is insufficient emphasis in preventive medicine as a strategy to address the healthcare challenges of an aging population - targeting the biology of aging is one such way to prevent the pandemic of chronic diseases associated with aging, such as Alzheimer's, cancer, and heart disease.

See /r/longevity for more on this research

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u/octaw Oct 16 '21

Is fasting a good way to clear cellular senescence?

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u/AnUberLlama Oct 16 '21

Fasting and blocking insulin/IGF1 signaling has demonstrated lifespan extension in non-human models (with correlational studies in humans supporting these data), but fasting itself hasn't been borne out as a senolytic intervention (similar story for insulin signaling, but it's early days). What might be more likely is that both fasting and attenuation of insulin/IGF1 signaling can exert a senomorphic effect, likely mediated through mTORC1/2. This effect is likely anti-inflammatory (reduced IL-1a, among others), and may decrease the incidence of paracrine senescence, leading to a slower emergence of "aged" tissues.

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u/bixtuelista Oct 16 '21

One thing that totally frys me is that so much resources are thrown at people when they become "patients" at the end of life.. the last 10 yrs, 2 years, 6 months, whatever. It's medicare, so there's an infinite pile of money even for poor people. There is medical/dental care that could be done --all thru life-- that would (in my opinion) vastly improve quality of life. Most of the people who I would consider middle class I know wind up with dentures, sometimes after very prolonged tooth loss. I'll probably keep most of my teeth, in large part because my family and I have been able to afford regular dentistry. But at end of life, the medical system may send the government a $500k bill for heroic measures. I'd rather people had access to good care throughout life.

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u/tnakonom Grad Student | Physiology | Reproductive Endocrinology Oct 16 '21

This is why there’s a huge push in the health sciences to increase healthspan, not lifespan. When the age researchers on my campus speak about their research it’s something they identify as a huge priority right off the bat.

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u/GeococcyxSonorense Oct 16 '21 edited Oct 16 '21

Not a lot of discussion about how a lifelong healthy diet and regular exercise affect the quality of life over the age of, say, 65. I mean, yeah if you live on an American diet of unhealthy food and are sedentary, your final years will be about chronic disease and frailty. Diabetes, heart disease, HTN, and low bone density are all largely the consequence of lifestyle.

Sure, research into this is useful and important, but it's a hell of a lot easier to make good dietary decision and be active. A lot easier than tryna find a pill or a shot that does the same thing.

EDIT: okay so NOW there's a lot of discussion about it. Seems I was not the only one thinking about this.

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u/brianstormIRL Oct 16 '21

It doesnt even have to be a lifetime of a healthy lifestyle. Just start looking after yourself as you enter your 40s and 50s and you will have a dramatically better quality of life as you get older.

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u/TurkeyPits Oct 16 '21

Or start looking after yourself as soon as you’re past childhood, and then it’s gotta be way easy to keep looking after yourself in your middle life

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u/BaconComposter Oct 16 '21

My kids work out.

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u/zion1886 Oct 16 '21

You don’t see many obese 70 year olds. I’m sure there are plenty of studies indicating obesity as a huge predictor for mortality.

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u/Raetro_live Oct 17 '21

Sorry but I gotta disagree with the saying...I mean sorta.

The saying implies that obese people die out before 70, at least a majority. But the reason is because all the obese people are stuck in their homes. They're wheelchair bound, frail so they can't move themselves, slow, and fat. So they're alive...but they basically sit in their retirement home rooms and do nothing but exist.

So you don't see them but they are still alive.

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u/Distinct_Ad_4495 Oct 16 '21

True. I've seen healthy people go down pretty hard though around the 70-80 range. Things just stop doing what they're supposed to. Like normal cell activity just breaks down.

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u/Penny_Farmer Oct 17 '21

My greatest fear is cognitive decline. I plan on doing everything I can to exercise and eat well into my later years. But will that be enough to stave off dementia and Alzheimer’s? Who knows.

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u/BeowulfShaeffer Oct 16 '21

If there’s any one thing I’m most bitter about in this life it’s that humanity has not made this kind of research the very highest priority. Like a global space race or Manhattan project. We likely have immortality almost in our grasp but no, let’s have anti-intellectualism and vast militaries instead.

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u/NabiscoLobstrosity Oct 17 '21

I posted earlier in the thread - I wonder where we'd be today if 10% of the military budget increase during the Bush years (not even the war expenses, just the permanent budget changes) went to Alzheimer's and dementia research instead.

Hell, I can name a $20 billion waste off the top of my head: the USS Zumwalt. It's a navy cruiser that was built around a gun, for which there is no ammo (and will never be ammo). As a result they took the gun off; so now it's an attack cruiser without any actual weapon whatsoever. Also, it's more stable upside down than right-way up. Most of the project has been cancelled; but they still spent $20 billion on it, to produce 2 boats (out of an original plan of 20). They'll be used as training boats - a role usually reserved for old, retired ships that have little military use in the modern world.

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u/march20rulez Oct 16 '21

I get what you're saying but...let's not do immortality. The idea of the top 1% living forever is...unpleasant

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u/kaminaowner2 Oct 16 '21

I heard a few years ago that in my lifetime I’ll see the switch form modern medicine trying to keep you alive to it trying to keep me young. It was explained to me that up till now we’ve basically been just fixing problems as we go, but if we slowed or even stoped aging those problems won’t exist anyway. I hope this happens because even if I only get 80 years I’d prefer to feel like a 20-30 year old through them

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u/former_twitcher Oct 16 '21

Whatever happened to stem cells being the saviour for all sorts of problems? That was like two decades ago and absolutely nothing has popped up on my radar about this since. Was it an absolutely waste of time after all the hoopla?

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u/itWasForetold Oct 16 '21

https://www.nature.com/articles/ncb0710-627#:~:text=Former%20President%20Clinton%20signed%20a,US%20Congress%20every%20year%20since.

Maybe you read two decades ago about how the religious fought super hard to stop stem cell research and it worked?

Although not illegal, it’s sparsely funded here. Not elsewhere, but the US does historically tend to lead for research simply due to funding.

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u/Benjaminx23 Oct 16 '21

It amazes me how far science has come in a few decades

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u/rottenanon Oct 16 '21 edited Oct 18 '21

That's like my dream, healthy as long as I'm alive. I don't want extra years, but healthy years of whatever is left!

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u/ListenToGeorgeCarlin Oct 17 '21

I’ll put this out there. David Sinclair, a geneticist out of Harvard, has an interesting book on the science of aging and the new emerging tech/medicines being developed to combat it.

Lifespan is the book.