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There has been a quiet revolution regarding the science of aging. Most of the medical advances ranging from public health, sanitation, and drugs have been geared towards giving a person a longer lifespan. We use vaccines to prevent life-threatening diseases; we have regular trash pick up to prevent cholera and other deadly sanitation-related diseases; we make sure our water supply is clean; we have countless drugs and surgical procedures; we have life-saving diagnostic tools like mammograms and sonograms. All of this effort to help stave off death has been working, and people today enjoy a longer life span than they did fifty years ago. However, with the largest population in the US and abroad, the Baby Boomers, entering old age, a new way of approaching health and research is happening, and that is called health span (also spelled healthspan). Health span is not the length of your years alive. It is the length of your years without having any chronic disease or age-based frailty like not being able to tie your shoes (which is a test given to seniors). Shifting the focus from lifespan to health span has some profound implications, and it's important to note that the research towards health span is ramping up and will most likely play an increasing role in how we view aging and practice medical interventions. “Prior to 2000, only 14 papers were indexed on PubMed with ‘healthspan’ or ‘health span’ in the title or abstract. By mid-2018, that number has grown to more than 900.” (How Healthy is the Healthspan Concept? By Matt Kaeberlein, ncbi.nlm.nih.gov)
The most significant change in research through the lens of health span versus life span is not focusing on any one specific disease like lung cancer or Type 2 diabetes; rather it is investigating the biological process of aging and tackling the mechanisms that make an aging person vulnerable to age-related chronic diseases. The leading causes of death (all primarily age-related): heart disease, lung cancer, COPD, stroke, lower respiratory infections, Alzheimer’s disease, type 2 diabetes, colorectal cancers, breast cancer, and prostate cancer. Before, most if not all research and medical interventions have been towards treating these major killers to stave off death. Health span research is about preventing these and giving people longer years without any chronic disease versus longer years with chronic illness. The World Health Organization has developed a way to put a number of the average healthy life expectancy or health span which they call HALE. The 2015 estimate was 67.3 years old. That means currently we live around 20% of our lives unhealthy. (Healthspan Is More Important Than Lifespan, So Why Don’t More People Know About It? By Tim Peterson, Assistant Professor, Department of Medicine, Washington University in St. Louis, May 30, 2017, publichealth.wustl.edu)
Of course, the first thing one thinks when they hear about health span versus life span is that it’s going to be another Jedi mind trick to get the population on the prevention train and of course that is part of it. I must confess if not drinking alcohol or using tobacco products, and getting eight hours of sleep a night, keeping stress down, meditating daily, exercising regularly, eating healthy, having tons of healthy relationships, and perhaps finding the pot of gold at the end of the rainbow was super easy and doable everyone would be doing it. The truth is, being human is a very complex endeavor and being bad just comes with the territory. However, what is interesting is that lifestyle is only one aspect to the research behind health span. “Four broad groups that cause the diseases and deterioration of old age: chronic inflammation; cell dysfunction, changes in stem cells that make them fail to regenerate tissue, and cellular senescence, the accumulation in tissue of aging cells that accompanies disease.” (How Long Can People Live? By Nicholas Bakalar, Nov. 19, 2018, nytimes.com) Essentially, all of the chronic diseases like various cancers and heart disease have a collection of root causes, and instead of tackling breast cancer or type 2 diabetes, the logic of health span is to tackle the age-related causes that make a person develop those conditions. Besides lifestyle, fatty acids, energy ‘efficiencies’ such as glucose and oxygen, and antioxidants such as NAD+, stem cell therapies, caloric restriction, very experimental drugs such as rapamycin and metformin, social, intellectual, and physical activities are all currently being researched and have produced some positive results in staving off aging. (Healthspan Is More Important Than Lifespan, So Why Don’t More People Know About It? By Tim Peterson, Assistant Professor, Department of Medicine, Washington University in St. Louis, May 30, 2017, publichealth.wustl.edu)
Staving off aging—ultimately that is what the new health span movement is. Instead of researching ways to fight age onset chronic disease researchers are looking for ways to fight off the aging process itself. So, the average age a person does finally succumb to a chronic disease shifts to perhaps 80 years old versus the current average health span of 67 years. In reviewing some of the research aimed at tackling the actual aging process, there have been some exciting discoveries. It does look like an upstream approach in tackling chronic disease and giving people longer healthy years is something people right now can utilize. After reading some of the scientific papers, I must confess it does encourage me to work harder on lifestyle too. It is an exciting and fascinating area of research and has profound implications regarding the quality of life.
Jennifer Barnick is a painter and writer. She studied painting at the San Francisco Art Institute. She founded Twenty-two Twenty-eight. “One of the most exciting aspects of Twenty-two Twenty-eight is building a channel for artists and writers to share their work with the world.”
Check out Jennifer’s book. You can read the first short story for free on Amazon here.