Ageing of populations

World population is growing but not as rapidly as was the case in the past. Growth rates are high in some areas but are coming down in several other places. Demographers have calculated what they call the "replacement age" at 2.1 children per woman. The rate has fallen well below that average in the US, Western Europe and Russia which means that populations in these places have begun to decline. In Africa and several parts of South Asia – in particular in Pakistan – on the other hand, the replacement rates are well above that level. Decline in the rate of fertility brings about aging, which is the case in most of the West. However, aging causes enormous economic problems. Young people are needed to empower the economy while the cost of health care increases as populations age.

Low replacement rate is not the only demographic change that poses problems that need to be managed. The other are scientific advances that are keeping people alive for longer periods than has been the case normally. In 2023, Wyss-Coray and his team of researchers working at Stanford University were able to calculate the rate of aging of eleven major organs, using proteins in the blood known as biomarkers. And this past July, researchers in Sweden announced that they had developed a simple blood test that could detect Alzheimer's disease with as much as 90 per cent accuracy. Alzheimer's is a major cause of death in aging societies.

This type of ongoing research has laid down a new foundation on which they can build with the promise of detecting, treating, and even halting emerging diseases such as heart ailments, cognitive decline and several forms of cancer before they seriously attack the body. Such advances in health sciences, which not too long ago, were the subject of science-fiction are now within sight. The obvious result of this would be to prolong life. Today the maximum human life span is somewhere between 115 and 120 years. Frenchwoman Jeanne Clement is believed to be the oldest person who ever lived who died in 1997 at the age of 122. Data are not readily available in the northern areas of Pakistan, such as Hunza. But it is well known that lives are long in these areas.

Researchers who are studying aging are not just focused on longevity but also on making it possible to live long and healthy lives. "We are not looking to have people live forever, but to have them lead healthy lives for as long as they live," says Thomas Rando, director of University of California, Los Angeles, UCLA, Broad Steam Cell Center. In their research they are studying the field of superagers – people over the age of 80 years – whose memory is as good as those in their 50s and 60s.

"On average, individuals experience cognitive decline with each successive decade from the 30s and 40s," says neuro-scientist Emily Rogalski, director of the University of Chicago Healthy Aging and Alzheimer Research Care Center, the HAARC, who first defined the term super-ager. According to her, the biggest risk factor for chronic diseases such as heart problems, type 2 diabetes, cancers, osteoarthritis – even hearing loss – is simply getting old. If we slow the rate of aging, we can also delay, and perhaps prevent, the onset of disease, allowing people to live longer and healthier.

"We have identified some dials we can tweak that allow us to change the rate of ageing," says Eric Verdin, president of the Buck Institute for research on Aging. "The hypothesis is not fully proven yet, but the evidence is pretty strong. The aging field is transforming medicine." AARP, the Washington-based agency, that represents old and retired Americans, devoted its recent bulletin to "superagers" and focused on some of the recent medical advances to prolong life and keep it healthy. "This new way of looking at disease has triggered a tectonic shift in science of aging, a field of research referred to by a different name: geroscience. The goal of geroscience is to extend physical health and cognition and make being a super ager, the rule rather than the exception," wrote Jeanne Dorin McDowell, the author of the AARP study. "We may be just a few years away – perhaps even a few months – from medical breakthroughs that will change the way time impacts our bodies, our minds and our lives," she wrote. Researchers working in the area of aging believe that mankind has already arrived at the stage where live spans in the 90s and 100s would be the norm.

The research on aging is receiving a lot of attention in the US. Over the next 30 years, the number of centenarians in the country is projected to quadruple to roughly 422,000 by 2054, according to the US Census Bureau, while the population over 65 may reach 82 million in the next 25 years. "At last half of these individuals over 65 will have two or more diseases; a quarter of them will have three or more diseases by age 70," says biochemist Laura Niederhofer, director of the Institution on the Biology and Aging and Metabolism at the University of Minnesota. "We need a radical new approach." Some researchers working in the field of aging and looking at the new information that is arriving almost daily believe that radical new approach towards managing old age have already arrived.

Advances in screening technology, together with targeted therapies, may usher in "a new era in the detection and treatment of cancer," says Ronald DePinho, cancer biologist and the Harry Graves Burkhart III distinguished university chair and past president of the University of Texas MD Anderson Cancer Research Center. The Texas-based institution is one of the premier cancer treatment centres in the US. Because of the advances made in this other cancer in situations, a person diagnosed with pancreatic cancer – which today has a five-year survival rate averaging just 13 years – a combination of targeted therapy, immunology drugs, activating the immune system, and a personalised mRNA vaccine which triggers cancer-specific treatments could lead to doubling or tripling five-year survival. One notable example of the success of this approach is former US president Jimmy Carter who has just celebrated his 100th birthday. Carter was treated by these technologies.

Human beings – in fact all living beings – are a collection of organs and not everyone's organs are aging at the same rate. And that opens up a wide world of opportunities to detect, treat and reverse disease. There are hundreds of Pakistani Americans working in these areas. They should be called upon to help develop medical institutions in what was once their home country to take advantage of these developments.