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January 6, 2023

'There's never enough time': A doctor's perspective on aging

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    For many people, aging may have a "clear arc," but there is a growing interest in longevity science, which aims to "slow the clock" and help people extend their lifespans, writes Daniela Lamas, a pulmonary and critical care physician at Brigham and Women's Hospital, in the New York Times.

    What does it mean to age?

    According to Lamas, doctors often start their patient conversations by talking about age since it allows them "to focus on the most likely diagnoses and to develop a mental image of the patient before we enter a room."

    Doctors may also use age to "frame the patient's story and in effect to grade its degree of tragedy," Lamas writes. For example, a college student who is dying from respiratory failure after the flu will be considered differently and potentially receive different clinical interventions than someone in their 80s.

    "This used to make sense to me," Lamas writes. "A human life span has a clear arc that ends naturally somewhere around the ‌‌eighth or ‌‌even ninth decade."

    "Throughout my 20s and much of my 30s, the years melted one into another, and I barely noted their passing," Lamas writes. However, as she watched her parents age and grew older herself, she found herself "thinking differently about age and its meaning in medicine."

    "We are at a unique time in this country when it comes to aging," she writes. "Our president recently turned 80, and the Senate is, on average, the oldest in history. People regularly survive medical diagnoses that would have meant an early death in years past."

    Because of this, there has been a growing interesting in the field of anti-aging, which seeks to extend not only a person's lifespan but their "health span"—or how long they can have a good quality of life and be healthy and active.

    Even as a critical care physician who routinely works with patients who are dying, "I am captivated by the promise of longevity medicine," Lamas writes.

    Is aging a disease that can be treated?

    According to Lamas, longevity researchers argue that aging is a disease and that certain conditions, such as cancer, heart disease, and dementia, are merely its symptoms. Over time, researchers hope to better understand aging and potentially even treat it.

    "I find myself drawn in by images of aging mice racing longer, the promise within the science," Lamas writes. "What if the arc of aging that I have come to expect while working in the hospital is not inevitable?"

    Already, some longevity companies are offering a blood test that will estimate a person's genetic age based on the impurities in their DNA and the length of their telomeres, which shorten over time. Although it is not clear whether a younger genetic age will lead to a longer or better life, there is still a chance that it could be beneficial.

    However, "[s]imply being able to entertain this reality, and even more so thinking that it is in any way within our control, is a privilege," she writes. Currently, the wealthiest individuals live an average of almost 10 disability-free years longer than the poorest.

    Already, Lamas sees this firsthand in her work at the hospital with patients who have been "punished by illness, by decades of chronic stress, by factors that are within and outside our control." These experiences can physiologically age patients, making them seem much older than their chronological ages.

    Although some part of Lamas is tempted to find out more about her own aging, she is also not sure that she actually wants to have the information at all. "Perhaps it would worry me; perhaps it would offer me false reassurance," she writes

    "Either way, … I am aware that even if we can slow the clock, there is never enough time," Lamas writes. (Lamas, New York Times, 1/4)

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