Anna Dixon, Chief Executive, Centre for Ageing Better
Is ageing a disease? And if so, is there a cure? These are not new questions, but they are being asked more and more frequently. This is part of a broader, and necessary, conversation about our longer lives and how to make the most of them. But the hunt for a ‘cure for ageing’ risks distracting us from the more everyday – but no less miraculous – things we can do to improve later life for everyone.
Ill-health and disability are not inevitable consequences of growing older, and chronological age often tells us very little about someone’s health or fitness. The factors that affect our health as we age are complex, including genetics, lifestyle, and environmental factors. From around the age of 30, a process called ‘senescence’ begins, which is the biological process of ageing: our organs and cells begin to wear out. This happens to all of us, but not at the same rate. Part of this process is the shortening of telomeres – the end sections of our DNA. This shortening is one of the biological pathways towards disease, and telomere length is a predictor of overall mortality. But this process isn’t entirely outside our control. Factors like pollution, smoking, poor diet, alcohol, stress and poor sleep quality are all associated with telomere shortening.
Some recent studies have suggested that the effects of senescence can be reversed through medical intervention – and not surprisingly, this possibility has become the focus for a great deal of investment and research. Some innovations promise to lengthen our lives by slowing the ageing process itself, rather than fighting individual diseases. The hunt for a ‘cure’ for ageing has been spurred on by the recent inclusion of ‘old age’ as a condition in the World Health Organisation’s International Classification of Diseases – meaning it can be legitimately treated by doctors (and reimbursed by health insurers). As a result, medicines designed to slow the process of ageing could be used in clinical care – potentially providing a huge boost to the profits of the companies producing them.
What are the implications? On the one hand, these new drug therapies could revolutionise the way we treat ill-health in later life. But there is a risk of medicalising ageing, at huge cost to the NHS, meanwhile losing focus on the crucial issues across the life course that affect how we age. Instead of chasing a miracle cure, we must recognise that many of the answers to a good, healthy later life are right in front of us.
This means investing in prevention, tackling risk factors like smoking and alcohol, and ensuring there is sufficient resource to help people with chronic conditions manage them effectively. It means designing communities that encourage walking and cycling, and enable people to stay active throughout their lives. And it means making sure our homes and workplaces support our wellbeing as we get older, rather than putting our health at risk. New research this week suggested that leading a healthy lifestyle could give women an extra ten years of good health – seven for men. If we’re searching for ways to shorten the amount of time we spend in ill health in old age, our everyday lives should be the first place we look to make change.
New treatments that make a positive difference to people’s quality of life are always to be welcomed. But whether or not these treatments emerge, there are urgent steps we must take now to improve health at all ages, reduce the massive health inequalities that exist today, and ensure that we’re all able to age well. We must not risk being distracted by the possibility of a miracle cure and missing our chance to give everyone a good later life.