Brace Yourselves… The Senile Tsunami is Coming

Global demographic aging is no joke. The world is rapidly getting old and sick as we have fewer children and the elderly live longer (but not better or with more vitality).

This crisis is also known as the Silver Tsunami, and the most economically, socially, and emotionally catastrophic component of this trend is what I call the “Senile Tsunami” — the rising tide of neurodegenerative disease, particularly Alzheimer’s dementia.

dementia

Source: Alzheimer’s Disease International, World Alzheimer Report 2010, accessed on July 11, 2012.

According to the World Health Organization, the number of people suffering with dementia will triple by 2050. We have 35 million afflicted today and it will reach 115 million only three decades from now. That number ties Mexico as the 10th largest country in the world. And each one of those patients will require an additional caregiver to look after them. This is an enormous economic shock to an already troubled global workforce.

Demographic Aging
The Senile Tsunami is a bigger problem than global climate change, which has politicians and the public running around hysterically. Indeed, it is a problem — especially for agriculture and rainfall patterns. But at least we have a clear roadmap to solving the problem: dramatically cut greenhouse gas emission, plant trees and grow algae to sequester CO2, and transition rapidly to a fossil-fuel free global economy.

Of course the fossil fuel (“energy”) industry is one of the largest and most powerful lobby groups in the world, so there has been considerable resistance to pursuing this plan. Alas, we have a critical path and it is technologically feasible today with renewable energy, carbon capping regulations, and sequestration.

And even if we don’t act, climate change will be a major economic disruption (lost beachfront property, destruction of property by natural disasters, lost revenue from agriculture, etc.) but we can adapt.

We cannot adapt to our mortality and increasing decrepitude, nor that we have more people extracting money from the public purse for increasingly expensive medical care and fewer working-age people paying into the system (“dependency ratio”).

Dealing with the demographic crisis is not so clear

One option, like the Japanese do, is voluntary suicide by the elderly (to reduce the financial burden on their family should they become ill). This is related to hospice and assisted suicide. That’s not a great option, but often the best option an individual has. But it’s not likely to work for the entire population.

Plus, I want to live a long life and you probably do too. You may think that in 50 or 60 years you’ll be ready to go. But I bet if I asked you, as an 80 year old in decent health: are you ready to die tomorrow? You would respond with a resolute “No.” You still have family, friends, and goals. So longevity itself is desirable (even if a Black Hole instantly wiping out humanity in an could be a desirable utilitarian outcome if you ask Schopenhauer).

The other option is to extend healthy lifespan, and even rejuvenate the aged.

This has been demonstrated in animals many times already. Caloric restriction, geroprotective nutraceuticals, gene editing, and more recently the ablation of senescent (damaged, old) cells can rejuvenate aged mice by 27%.

We are pursuing the elixir of life, the goal of Gilgamesh, the Philosopher’s Stone, and all the rest. I don’t believe biological immortality is achievable — but the goal of all medicine has been to prolong healthy life. So let’s get serious about it and stop consigning the elderly to 20 years of chronic degenerative disease at the end of life. This is a form of torture, and it’s avoidable today.

Let’s get serious about aging. We need a Manhattan Project for aging — a coordinated effort with clear milestones motivated by an understanding that this global biological force is a greater threat than any foreign enemy. We need an engineering approach, and a lot more funding. The rate of progress is not intrinsic to the arrow of time — it’s directly proportional to societal investment and the talent of those working on the problem.

“It seems reasonable to suppose that the discovery of a technique that can, in a laboratory animal, diminish to near zero the incidence of neoplasia, cardiovascular illnesses, and diabetic changes would prompt a substantial public commitment to working out the mechanism of the intervention and developing analogues that work well in humans.

Reasonable but wrong: such an intervention has been clearly established for decades, and yet its investigation receives such a small proportion of governmental research funding that it cannot be seen in a pie chart.” – Richard Miller, PhD, geroscientist

Extending Life: Scientific Prospects and Political Obstacles by Richard Miller (2002).

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