Most research programs that purportedly aim to extend human life by intervening in the aging process do not in fact have a good expectation of producing meaningful results. They typically involve searching the existing drug catalog for ways to alter the operation of metabolism so as to, for example, recapture some of the effects of calorie restriction, as lowering calorie intake is well proven to improve health and slow aging. This has turned out to be expensive, time-consuming, and challenging. So far very little of practical use has been achieved on this front after fifteen years of focus involving hundreds of scientists, at a cost of billions of dollars. Expense and difficulty are not the primary objection, however: it comes with the territory at the cutting edge of the life sciences. The primary objection to this branch of research is that even if these researchers achieved a perfect replication of calorie restriction, and so far they aren't close to achieving even a fraction of this goal, that wouldn't extend human life by more than a couple of years.

If all that the research community could do was this, then so be it. We would have to resign ourselves. But it isn't: much greater goals in extended health life span are possible with the same expenditure of time and funding, given a different research strategy. It is particularly frustrating to see this continued focus on slightly slowing aging at great cost when there is, in fact, a much better path forward. That better path consists of the research strategies described in the SENS vision for rejuvenation biotechnology, a package of approaches to aging and its causes drawn from the work of researchers across the breadth of the field. In short, the research community has a good catalog of the forms of cell and tissue damage that distinguish old tissue from young tissue, has had that catalog in a fairly complete state for more than two decades, and there exist detailed plans for treatments capable of repairing the damage. Repairing the damage that causes aging will be no more expensive and challenging than trying to alter metabolism to slow aging, but it has the possibility to create rejuvenation, to extend healthy life span indefinitely when the repair is comprehensive enough. Some of the technologies needed to create repair therapies to treat aging have been demonstrated in the laboratory, and a few are even at the stage of startup companies building treatments.

These days there is a lot of agitation for greater progress and greater investment in efforts to find drug candidates to alter metabolism in ways that may modestrly slow aging: calorie restriction mimetics, autophagy enhancers, exercise mimetics. This coincides nicely with the scientific urge to completely map the large blank regions in the grand map of human biochemistry. It is a huge project. But as Aubrey de Grey of the SENS Research Foundation points out below in a quite clear outline of his view of the field, metabolic adjustment to slightly slow aging is the wrong focus. The majority of the research community is forging ahead on a path that will produce only very small gains in lifespan and health, while ignoring what is known of how to repair the causes of aging completely. While there is certainly progress towards both repair therapies and persuading more of the research community to support that path to rejuvenation therapies, it is taking far too long and far too much effort to turn this ship. There is optimism in some quarters, but I fear that this process will remain slow and painful even after the first of the portfolio of SENS rejuvenation therapies, such as senescent cell clearance, are robustly demonstrated in human studies, as they have been mice. The inertia of large, heavily regulated research and development communities is a hard thing to wrestle with.

Future Trends in Aging Research