This article is from WeChat public account:Nature Natural Science Research (ID: Nature-Research), original author: Toren Finkel, FIG from Oriental head IC

This year, people over 65 years oldFor the first time in history, the population exceeded the population under the age of five. Like climate change, human aging is an irrefutable fact. However, there are considerable controversies about the possible consequences of this fact and its remedies. Recently, two books with very different perspectives have tried to propose some methods to deal with this “gray tsunami” (grey tsunami).

Related books

“Life: Why We Are Aging – and Why We Don’t Need It”

Author: David A. Sinclair and Matthew D. LaPlante

Publisher: Atria (2019)

“Old Age: Redefining Aging, Transforming Medicine, Reconstructing Life”

Author: Louise Aronson

Publisher: Bloomsbury (2019)

Geneticist David Sinclair and journalist Matthew LaPlante’s Lifetime (Lifespan) portrays a vision of a not too distant future It will be commonplace to live to be over 120 years old. In contrast, Doctor Louise Aronson’s “Span class=”text-remarks” label=”(Elderhood) focuses on current aging care that is often confusing and sometimes inhumane. scene. Both books attempt to explore the complexities of the upcoming demographic changes. Some countries will have to compromise with poorer, older people, such as the United States, which has used more than one-third of health care for people over the age of 65. But the solutions of the two authors are totally different. For Sinclair and LaPlante, the answer lies in understanding why we age and make the most of it; for Aronson, it is reassessing and positioningThe way we look at and treat the elderly.

When aging becomes a disease

Life is very interesting, and the rhythm is very fast. In the short time, he has reviewed the recent past and the near future – 90 years old will become the new 70 years old. Sinclair and LaPlante pass them in a series of interesting chapters (“Crazy Pianist” “Better Pills”) The superb narrative of weaving illustrates how we step by step to this critical turning point. The historical figures mentioned in the book include the Venetian Luigi Cornaro, who advocated heat limitation in the 16th century, and the “father of information theory,” Shannon (eg NAD+) and deacetylase , the two authors detail how we can change the trajectory of human aging. They predict that specific drugs will emerge, regulate these and other molecules associated with longevity pathways, or destroy harmful aging cells that accumulate with age and contribute to disease. Sinclair and LaPlante claim that some of these drugs may already be present; such as the widely used diabetes drug metformin and the immunomodulator rapamycin appear to mimic some beneficial behavioral strategies at the drug level – (respectively) is equivalent to hyperactivity and less eating.

Defining aging as a disease is at the heart of the approach proposed by the two authors. They believe that if we treat aging with a medical eye, just like treating heart disease or cancer, innovative therapies will appear faster. This view reflects the growing prevalence of “senior scientific assumptions” that suggest that basic biology therapies for aging will help slow or prevent chronic diseases that afflict older people, such as type 2 diabetes and dementia. Based on decades of research experience, Sinclair’s argument is that there is noUnchangeable biological principles limit how long we can live, or how high the quality of life is.

Sinclair and LaPlante examine the economics of extending life on a crowded and resource-limited planet, and the ethics of repairing the so-called natural order. But they also speculated on some unintended potential positive effects, such as you may be more responsible in managing your life when you know that you will see your grandson. If many generations live and work together, we may all become more understanding, or as Sinclair said, “more human.” This may become extraordinarily important in an era of uncertainty in all aspects of politics, the economy and the environment.

If you describe Life as a sprint to the aging future, Older (she will still come to diagnose this amazingly), taking care of the lessons of elderly parents And her insights into her aging process.

Many of her stories reveal the flaws of the US healthcare system. For example, readers will read Neeta, a patient who is weak, has mild dementia, and has a hip injury. After the operation, Neeta was transferred to an unsatisfactory nursing home where she became restless, took sedatives, contracted acne and quickly evolved into a hospice stage. Readers will also learn about Aronson’s own frustration. Once, the emergency department was extremely busy, and the doctor was blind. She had to personally perform a rectal examination of her father to prove that he did have internal bleeding.

essential stage

Intertwined with these very human stories is a rich social, cultural and historical perspective.

At the beginning of the book, Aronson described his encounter with Guy Micco, a doctor who taught at the University of California at Berkeley. Micco asked a classmate to write down “old” (“old”)The words “weakness” and “weakness” occupy a dominant position. In contrast, the term “span class=”text-remarks” label=”remarks”>(“elder”) leads to the words “respect,” “experience,” and “learning.” Words inside.

For Aronson, part of the problem is that we still insist on using a utilitarian, late 19th century vision to look at the body as a machine. From such an industrial perspective, “old” is no longer the high point of life experience. It is a loss of function, and the extension is the loss of intrinsic value.

Aronson sees life as a three-act scene: childhood, adulthood, and old age, which is subdivided into older, older, older, and older. Every scene is built on the previous scene and is essential. Aronson pointed out that only emphasizing the vicissitudes of the old age is like saying that youth is defined by acne. In fact, we may know ourselves better than ever before, and the overall satisfaction of life is higher.

Aronson’s point of view is different from that of Sinclair and LaPlante in anti-aging; she does not see it as a medical “treatment” of aging, but as a way to influence older people. Fight against “discriminatory views and policies”. In her view, the idea of ​​“treating” aging is itself age discrimination; it is not invoked at any other stage of life.

In fact, the most sinful thing in Aronson’s eyes is probably the medical system itself. She believes that this system disappoints both patients and doctors. The system lacks insight into subtle but vital differences in different life stages and focuses on “diseases and organs rather than people and life”. For example, she pointed out that many over-the-counter drugs have not been tested by older people, increasing the risk of prescribing.

She advocates a new paradigm: a rebalanced behavior in which technology plays a role, but the focus is on care. Unlike modern medicine, which is dominated by high-tech and algorithmic triumphs, her thoughts on true “personalized medicine” take care of the patient’s past experiences and current expectations. This comprehensive and humanized geriatric model is rare. We can only hope that relevant practices can be quickly adopted.

What conclusions should we draw? Is aging a disease that can be eliminated by science, or is it a natural third-acting scene threatened by over-medicalization? There is no doubt that the perception of this issue will be as diverse as the experience and disposition of people. However, from the aphorism of the 17th century philosopher Francis Bacon, it is not difficult to gain some wisdom: “OldYear is always 15 years older than my age.

The original text was published in The Book of Nature, September 10, 2019, under the title The Enlightenment of age.

Nature|doi:10.1038/d41586-019-02667-5

This article is from WeChat public account: Nature Nature Research (ID: Nature-Research) , original author: Toren Finkel