Consider this: In the year 1902, if it had been somehow possible to gather together everyone in America who had reached the age of 85 or older, that population would have scarcely made up a single Zip Code in today's Sun Belt. Today, the numbers of people age 85 and above, about 5 million Americans, will increase four-fold with the aging of the Baby Boom. People aged 100 or more - currently some 70,000 - will increase 10 times before we are halfway through this century. This demographic tsunami will affect every institution and every community, and will touch all of us personally.

What happened between then and now was the tempestuous 20th Century. One of the most profound changes wrought by the last hundred years has been a nearly 50% increase in average life expectancy, driven in large measure by the advent of new medical technologies and scientific breakthroughs. We have transformed the duration and quality of human life for people in the industrialized world because of what we have learned from scientific research and what we've been able to apply in better health and care for people as they age. As maturity and mortality flavor the thoughts of many, the public is increasingly aware of new ideas and new technologies emerging from the life sciences.

The diseases of aging

A century ago the leading causes of death in the U.S. were tuberculosis, diphtheria and influenza. Thanks to discoveries of antibiotics, vaccines and improved public health measures those top three killers are no longer major threats to Americans. More recent developments in HIV therapy, clot-buster drugs, angioplasty, along with new understanding of the importance of diet and exercise, have made significant inroads against today's top killer diseases: heart attacks, cancer and stroke.

Chronic age-related diseases that gradually disable over long periods of time are emerging as the leading health challenge of the 21st Century. This is quite a new event in human history. Literature from the Bible onward does not record, until fairly recently, instances of older people dying after long, lingering illnesses. But in the new century, Alzheimer's and Parkinson's diseases, type II diabetes, vision and hearing loss, bone and joint diseases, incontinence, depression and other maladies of the old could approach epidemic proportions. These diseases deprive older people of their cherished independence, rob the quality of longer lives, and threaten all of us with mounting bills for national health care.

The number of Americans with age-related diseases is skyrocketing. Of the over 65 population, 80% have at least one chronic disease. The nation's rate of Alzheimer's alone will quadruple over the next 50 years, when 1 in every 45 people may be seriously disabled due to the disease. Therefore, research that will yield breakthroughs in treating age-related diseases must continue, indeed it must accelerate.

The biology of aging

Aging begins at birth. In order to scientifically secure a life full of vigor and independence, we not only need to avoid the diseases and conditions of old age, but also have better scientific understanding of the aging process itself.

The field of aging research on the molecular and cellular biology of aging is rapidly advancing and new discoveries abound. Consider the following breakthroughs:

• Researchers studying aging in nematodes (roundworms) have found that by altering certain genes, they can substantially extend the normal life of these tiny organisms. This exciting research may lead to the discovery of the genetic and biologic secrets to longevity in humans.
• Scientific research into teleomeres, the tails at the ends of every chromosome that keep them intact, may hold the answer to understanding cell replication and cellular aging. These repetitive DNA sequences that appear to help regulate cellular replication have led researchers to learn more about telomere structure and function as a possible "clock of aging." For instance, we now know that women have slightly longer length teleomeres than men, possibly accounting for their extended lifespan.
• Studies of mammalian diets strictly controlled for calories currently underway at the University of Wisconsin, University of Maryland, University of California at San Francisco, and the NIH are showing promising results in extending their lifetime by 30 to 40 percent. These results, described as "stunning" by gerontologists, have raised hope that further studies of caloric restriction will uncover the mechanisms responsible for disease in old age.
• Scientists are working to determine what "longevity genes" are and how they work. There may be a group of genes in each species that can extend life beyond what is presently considered the maximum life span. These longevity-enabling genes could open the gateway to understanding the roots of biological aging in humans and provide revolutionary cures in treating age related diseases.

The more we probe the mysteries of human life at the levels of cells and genes, proteins and growth factors, the more we will discover how to improve vastly the health of older Americans.

Human beings legitimately yearn for more of the good years of life; governments, whether they recognize it or not, need to aspire to more productive and vital lives for their citizens at every age. Most importantly, the wellsprings of scientific knowledge capable of constructing new dimensions of life, health and longevity, are waiting to be tapped in the 21st Century.

Keep in mind that only with a national commitment to basic biomedical, clinical and behavioral research will we meet humane goals of longer, healthier and more independent lives. The objective of longevity science is not to engineer people who live 200 years or more. It is to add to the good years of life, to strengthen our physical and mental capacities for full functioning, and to allow us to age with health, vitality, and to contribute to our families, our communities, and our unique individual life goals.