Can we live forever? Tom Kirkwood joins the debate

Tom Kirkwood, associate dean at the Institute for Ageing, professor emeritus at the University of Newcastle and professor at the University of Manchester since 1993, studied at the universities of Cambridge and Oxford.

The so-called "longevity prophet" began studying ageing in 1974, first at the National Institute for Biological Standards and Control and then at the National Institute for Medical Research. He is the author of more than a hundred scientific articles on the subject and has managed to make a place among the best thanks to the theory of "disposable soma".

He is currently a member of numerous scientific committees and the editorial board of eight international journals specializing in the life sciences and medicine. He also serves as president of the British Society for Research into Ageing and head of the Research Advisory Council of the Medical Charity Research into Ageing. It is important not to forget his role as advisor to the Committee of Science and Technology of the House of Lords.

1. How close are we to immortality?

I think it will be a long time before it is possible for someone to live forever, and we still do not know if this is really possible. Ageing is an extremely complex process. We are beginning to learn how it works and we can be very optimistic that this knowledge will help us improve the "health period", the period of time during which we can enjoy reasonable health, but it is still early. We must remember that we have been working on challenges such as eliminating cancer for much longer; and despite some significant advances on the cancer front, we would like to achieve much more.

2. From your own perspective: do you study ageing as a pathology?

Ageing is a normal biological process, but it has the distinctive property that makes us more vulnerable to diseases of many types. Therefore, it is a bit hybrid, as it is normal but also a source of pathologies. The old arguments about whether ageing is normal or a disease are not particularly useful. Ageing is driven by the accumulation of damage to our cells and organs, which is also related to diseases of age. Therefore, there is a great overlap. Once we understand the basic mechanisms of ageing itself, we will gain valuable knowledge about the many diseases that can affect us in later life.

3. What kind of interventions can we do in our own cells?

Mainly, we could design interventions that could slow down or prevent part of the damage that is at the heart of ageing. For a long time it was expected that the addition of antioxidants could reduce the oxidative damage that seems to be part of ageing. But in reality the evidence of a successful intervention through antioxidants is not as strong. Other interventions are currently being tested, some of which show interesting results in short-lived animals such as mice and fruit flies. An intervention that seems to work is exercise. This is funny because exercise really stresses the cells and causes them damage. However, it also stimulates the maintenance and repair systems of the cell, so the final result is an improvement.

4. Is there no programmed obsolescence in people?

It is one of the oldest and most common ideas about ageing, either to make room for our offspring or to help allow for evolutionary change. In reality, however, it is very difficult to see how programmed obsolescence could have evolved. In nature, the vast majority of animals die young, so there is no need for such obsolescence and it is very difficult that it has evolved as a benefit itself. In our body, almost all cellular processes seem to consist in helping the body to survive, not in killing it. The reason why we get older is not because we are programmed for death but because there was never an evolutionary force strong enough to allow us to live forever.

5. Procreation or longevity, is this the question?

The secret to understanding ageing seems to be that life always implies concessions of one kind or another. We have developed highly complex structures such as the brain, but that complexity makes it more difficult to repair and renew this organ. One of the main sources of compensation refers to the energy that sustains everything the body needs to do in life. If we allocate more energy to growth and reproduction, then there is less for maintenance and repair. Then, under the pressure of natural selection, our evolution forced a compromise: we invested enough in maintenance to keep the body in good shape while it can reasonably be expected to survive the many dangers of the natural environment. But invest more than this, and thus create the potential for the body to last longer, would cost because it would reduce the resources for growth and reproduction. The idea that there is a compromising relationship between procreation and longevity lies at the heart of the disposable soma theory.

6. What role does technology play in these scientific advances? Do both sectors advance at the same time?

Technology and biology are advancing at the same time. Technology brings new capabilities in fundamental science, for example, through advances in the generation of images that allow studying ageing with a type of detail that was never possible before. Beyond biology, technology is helping to create new possibilities to adapt to the physical changes caused by ageing, for example, through new types of assistive devices.

7. Is there a feminization of ageing?

Ageing affects women and men in generally similar ways but also has important differences. The mortality rate of men is higher in all ages than in women, so there is no doubt that, in biological terms, women are the most robust sex. As people live longer, the difference in survival rates indicates that this increases in most women. Interestingly, however, despite their better survival rates, it also happens that women experience more diseases and disabilities in old age, a phenomenon that is sometimes called the paradox of survival and disability.

8. Will it be necessary for the birth rate to increase in a future society dominated by people older than 85?

Many countries see a decrease in the birth rate at the same time that the death rates in old age decrease. This means that the relationship between the elderly and young people is increasing fast enough. In the scenario where older people are fragile and dependent, there is concern that there will not be enough young people to maintain the necessary functions of society. One solution might be to try to increase the birth rate, but this would also boost the overall population growth even faster. The alternative is to try to maintain good health for longer and, therefore, reduce dependence on the elderly.

9. Do we live more and more, but also better?

One of the big questions about our societies is whether the gains in life expectancy correspond to the gains in health expectation. It would be good if all the additional years we are acquiring were years of good health instead of years of illness and disability. So far, the image is not entirely clear and there is a variation from one country to another. It seems that the extra years are neither good nor bad. This is something that must be measured and understood very carefully in the years to come.

10. Will this form of ageing of the future be homogeneous? This means that, we, as a society, will have the same opportunities for a quality longevity in the future or will it increase inequalities?

Unfortunately, we know that there are many inequalities in societies around the world. Within each country, there seems to always be a "social gradient" in health. The most affluent people, those of the most important socioeconomic groups, live longer and get sick and become disabled later than less accommodated people. The reasons for this social gradient are complex and should be better understood. If the life expectancy and health of those belonging to the lowest socioeconomic groups could be equated to the levels of the better-off, there could be very important improvements in the health and quality of life in the population and reductions in the level of high dependency cost. And, of course, there would be greater justice.

11. Do we really want to live longer?

The question of whether we really want to live longer depends to a large extent on what the additional years of this life would be like. Many younger people, observing the diseases of older people, say they would rather die than achieve that status. However, older people, despite having an illness, generally qualify their health and quality of life as good. In general, people do not want to die unless they suffer so much that life is painful. So, we are not always consistent with what we think we want.

12. Do you really think that it is possible that in 20 years we will witness "the death of death"?

In my opinion, the "death of death" currently resides in the realm of fiction and fantasy. It is an idea that has always had a great fascination and that is now driven by the important advances that are being made in the understanding of the science of ageing. However, it is important that we do not allow fantasy to dominate the important ageing agendas of 21st century life. It is a truly remarkable achievement that during the nineteenth and twentieth centuries the average life doubled. Now we face the challenge of how to build a world in which this immense success can be combined with a new capacity to make the most of our longer lives. I do not completely rule out the possibility that one day we can afford to live much longer, perhaps even indefinitely. I have written precisely about this scenario in a work of exploratory fiction, at the end of my book 'The End of Ageing', but even in this scenario there would still be death.

13. What advice would you give young researchers?

A career in research is a wonderful opportunity, but it is always difficult, so my first advice is that you should be prepared for a roller coaster ride, hopefully with stimulating maxims but also with some very discouraging minimums. Interesting and important questions are always difficult, so determination is needed to find the right answers. Most successes, such as publication of documents and winning grants, depend on peer review and this can be brutal. Nobody has an easy trip. If your work is really original, often reviewers may not appreciate it at first. The important ingredients for success are commitment, creativity, integrity and maybe a bit of good luck.

14. For institutions to devote more resources to research, it is important that society also requires it. Are the messages, both scientific and social, that reach citizens through media communication adequate?

It is good to see the growing commitment to communicate the content and the importance of research. Most researchers are supported by money that ultimately comes from the public. Therefore, not only is it good to get involved in communication because it can be fun, but there is also a moral imperative to do so. In general, the quality of communication is good and improving, but there is a tension between the need for the means to tell a story that can "sell" and the fact that much research is done, either in relatively modest steps or that will take time to show a real change. The subject of ageing is especially interesting and challenging. People have complex feelings about ageing and death, which cover the entire range of negativity and denial of savage over-optimism. Social attitudes towards ageing must still absorb the changes that are taking place not only through research but also more generally. There is a very important role for scientific communication to contribute to this necessary evolution.

15. Do researchers adequately evaluate the importance of non-specialized media in society's perception of their work and, in general, on ageing?

Sometimes it happens that researchers, who are deep specialists in their own areas, may find it difficult to explain the nature of what they do through non-specialized means. But it is really important to do it, and it is good that many organizations offer some kind of media training to their staff. It is also important, perhaps especially with a topic such as ageing, that affects the lives of all, that researchers are open to learn about ageing itself. It is one thing to know, for example, the genetics and molecular biology of ageing in a model organism, and something quite different is to know about the experiences and knowledge that people get as they move towards old age. Thus, exchanges must work in both directions.