The Best American Science and Nature Writing 2020

by Michio Kaku

  The AGNES suit is one of many instruments and appliances—​or “cool toys,” as they are more technically known—​that can be found in the AgeLab’s glass-walled halls and cubicled corridors, ready to entertain visiting writers, and to instruct visiting entrepreneurs. There is the driving simulator, specially fitted to track the driver’s eye movements as they flit back and forth from the dashboard to the horizon. (“With its new technologies, like navigation systems, the automotive industry is asking people to change fifty years of driving habits in ten minutes without instruction,” Coughlin says.) There is Paro, a robotic baby seal, from Japan, which bleats and moves its head, and is designed to act as a comfort to aging people, particularly Alzheimer’s patients struggling with the “sundown” moment at day’s end, when confusion and restlessness become acute. (“It’s a seal, rather than a dog or a cat, because people have great experiences with dogs and cats, and even Alzheimer’s patients can spot the eerie nonresemblance,” Coughlin says. “Having no experience of seals, we accept Paro as he is.”) There are mobile robotic nurses made for elderly care, and broad red upholstered chairs made for elderly rears. There are large research displays showing photographs of drivers, their faces embedded with sensors, and the varieties of “Glance Classification” that can, when analyzed, lead to “Crash Avoidance.” (“The ratio between confident decisions and correct confident decisions can be a story of life or death on the highway,” Coughlin explains.) And there are displays of word clouds associated with aging, showing the significant difference between the terms with which women imagine their post-career lives (Freedom, Time, Family) and those which men use (Retirement, Relax, Hobbies).

  * * *

  The work of the AgeLab is shaped by a paradox. Having been established to engineer and promote new products and services specially designed for the expanding market of the aged, the AgeLab swiftly discovered that engineering and promoting new products and services specially designed for the expanding market of the aged is a good way of going out of business. Old people will not buy anything that reminds them that they are old. They are a market that cannot be marketed to. In effect, to accept help in getting out of the suit is to accept that we’re in the suit for life. We would rather suffer because we’re old than accept that we’re old and suffer less.

  This paradox is, well, old. Heinz, back in the 1950s, tried marketing a line of “Senior Foods” that was, essentially, baby food for old people. It not only failed spectacularly but, as Coughlin puts it, poisoned an entire category. The most perverse of these failures is perhaps that of the PERS, or personal emergency response system, a category of device—​best known for the hysterically toned television ad in which an elderly woman calls out, “I’ve fallen and I can’t get up!”—​designed as a neck pendant that summons emergency services when pressed. It is simple and effective. “The problem is that no one wants one,” Coughlin says. “The entire penetration in the U.S. of the sixty-five-plus market is less than 4 percent. And a German study showed that, when subscribers fell and remained on the floor for longer than five minutes, they failed to use their devices to summon help 83 percent of the time.” In other words, many older people would sooner thrash on the floor in distress than press a button—​one that may summon assistance but whose real impact is to admit, I am old.

  “We buy products not just to do jobs but for what they say about us,” Coughlin summarizes. “Beige or light-blue bracelets or pendants say ‘Old Man Walking.’”

  The AgeLab has rediscovered the eternal truth that identity matters to us far more than utility. The most effective way of comforting the aged, the researchers there find, is through a kind of comical convergence of products designed by and supposedly for impatient millennials, which secretly better suit the needs of irascible boomers. The best hearing aids look the most like earbuds. The most effective PERS device is an iPhone or an Apple Watch app.

  Such unexpected convergences have happened in the past. Retirement villages came to be centered on golf courses, Coughlin maintains, not because oldsters necessarily like golf but because they like using golf carts. It’s the carts that supply greater mobility in and around the village. The golf comes with them. This process of “exaptation” has now accelerated. TaskRabbit and Uber and Rent the Runway—​services that provide immediate help for specific problems—​are especially valuable for an aging population.

  “The dominant paradigm is that older people don’t want new technology,” Coughlin says. “But take the microwave oven! It couldn’t have been better designed for people who live by themselves. It’s a perfect example of what I call ‘transcendent design’—​not made for older people, but ideal for them. We’re doing a lot of work in the on-demand economy, which was made for millennials but is working better for boomers. Meals are delivered—​these are amazing, assisted-living services that can come to anyone’s house. Older women in particular are saved from microdeficiencies in their diet. So, while the millennials want them for convenience, the boomers want them for care for their parents, or themselves.”

  Coughlin hates what he calls “the narrative,” according to which new tech appeals to newer people: “Startup money goes to youngsters because that’s what startup entrepreneurs are supposed to look like, and the products are designed for kids because that’s what startup products are meant to look like.” In his view—​detailed in his book The Longevity Economy—​the narrative, more than any rational calculation of profit, accounts for the technological gap. “There’s no reason for this enormous prejudice in favor of youthfulness in Silicon Valley and the tech industry,” he says. He also hates the misallocation of resources based on mere myths. “We have a belief that we send out our elderly to institutions. The fact of the matter is that less than 10 percent of the elderly go into nursing homes or assisted living. The senior-housing industry is building inventory meant for seniors, but 87 percent of retirement-age people want to stay in the same home where they have the three ‘M’s: marriage, mortgage, and memories. The problem is that they can’t. Not when the model is a two-story house with a bedroom and the bathroom upstairs. If we can solve the stairs problem, we won’t need new housing.”

  Coughlin says that having simple answers to two questions can determine whether you’re going to age well in place: “Who’s going to change the light bulb, and how are you going to get an ice-cream cone? Little tasks become sources of high friction. It’s not that you can’t climb the ladder to change the light bulb. But for the first time you are going to have someone yelling at you, ‘You’re going to fall and break your neck!’ That’s the problem of aging we have to tackle, not building more old people’s homes or senior villages.” It’s the failure of industry and engineering to address the actual problems of aging—​the problems summed up by the aggravations of the AGNES suit—​that makes Coughlin impatient with scientific speculations about extending life. “We’ve already extended life! What we need is not to put off death a little longer but to write a new narrative of aging as it could be.”

  * * *

  Aging has no point; it is the infuriating absence of a point. Having reproduced ourselves externally, we fall down on replicating ourselves internally. The processes of cellular replication that allow us to be boats rebuilt even as they cross the ocean cease acting efficiently, because they have no evolutionary reward for acting efficiently. They are like code monkeys in a failing tech business: they can mess up everything, absent-mindedly forget to code for the color of our hair or the elasticity of our skin, and no penalty is exacted for the failure. We’ve already made all the kids we are going to make.

  That, at least, is the classic explanation of why we age, proposed by the British Nobel laureate Peter Medawar, in the 1950s. Once we have passed reproductive age, the genes can get sloppy about copying, allowing mutations to accumulate, because natural selection no longer cares. And so things fall apart. The second law of thermodynamics gets us all in the end. The car or the Cuisinart works for a decade, breaks down,
and can’t be fixed; rust never sleeps, and we do.

  And yet some trees go on for centuries, collecting rings, growing older without really aging. Some species—​though those are often hard-to-track creatures, like Arctic sharks—​may live for centuries. Even if aging at some speed is ultimately inevitable, what happens when we age is far from self-evident.

  It may be that the real trick is not how much we age but how much we don’t. Human beings are outliers: we live much longer than other creatures of our size, defying the general truth that smaller animals live shorter lives than bigger ones. (Not that we should take too much pride in our defiance; another great defier is the naked mole rat, the world’s ugliest animal, which often lives for absurdly long periods and scarcely seems to age at all, although one might ask how anyone but another naked mole rat could tell.) Those extra thirty years of life, though won by advances in medicine and public health, are winnable because, given a little chance, we just go on. The big question of human aging then becomes not why we fall apart but why nature lets us hold together for so long.

  One evolutionary rationale is that there is something essential to human groups, with the slowly unfolding infancy of their young, in keeping the old folks around even when they can’t make more young folks. Old folks are repositories of extended cultural memory: it would seem to be advantageous to have a few senior citizens around who know what to do, so to speak, when winter comes. Evolutionary biologists tend to doubt whether nature cares about the fitness of groups, rather than the fitness of individuals, but the model of “kin selection”—​which gives weight to the fact that helping my relatives helps preserve my genes—​suggests that there might be evolutionary advantages in having grandmothers around to take care of kids and remember where the fish go every twenty years. (Then again, people who do have grandparents around to remind them what they’re doing wrong would probably suspect that killing off the oldsters early might actually make for more success, or at least more serenity.) People might not have a death sentence in their genes.

  * * *

  And so elsewhere in Cambridge, notably in certain genetic labs at Harvard, the chairs and seals and exaptated services of the AgeLab are regarded as mere Band-Aids on the problem to be solved. Here, there are whispers of undying yeast, tales of eternally young mice, rumors of rejuvenated dogs, and scientists who stubbornly insist that age is an illness to be treated like any other.

  Where fifty years ago it was taken for granted that the problem of age was a problem of the inevitable running down of everything, entropy working its worst, now many researchers are inclined to think that the problem is “epigenetic”: it’s a problem in reading the information—​the genetic code—​in the cells. To use a metaphor of the Harvard geneticist David Sinclair, the information in each cell is digital and perfectly stored; it’s the “readout,” the active expression of the information, that’s effectively analog, and subject to occlusion by the equivalent of dirt and scratches on the plastic surface of a CD. Clear those off, he says, and the younger you, still intact in the information layer, jumps out—​just as the younger Beatles jump out from a restored and remastered CD. (It would not be the first time in the history of science that the way we think about a phenomenon has been affected by the kinds of man-made models we’re acquainted with. When a telephone switchboard was our most impressive knowledge-bearing mechanism, people thought that the brain was like one; when Xerox copies, growing less legible as generation passed to generation, were familiar to everyone, the image of a cell ceasing to replicate itself effectively in that manner was self-evident.)

  We don’t have to micromanage the repair, the Harvard molecular biologist George Church observes: “If we think epigenetically, we can see that we can make the cells industriously do the repair themselves.” Already a legendary figure for devising genomic-sequencing techniques—​it must help that he’s a scientific eminence who has the aura of one, with a grand Darwinian beard and a slow-spoken orotundity—​Church gained further attention for his experiments in trying to resurrect extinct species, particularly the woolly mammoth. (One of his standard jokes is that the fifth floor of his lab is off limits to visitors, because that is where the mammoths and the Neanderthals live.) He is also among a group of engineer-entrepreneurs who are trying not to make better products for aging people but to make fewer aging people to sell products to. Perhaps aging is not a condition to be managed but a mistake to be fixed. Sinclair, for one, has successfully extended the life of yeast, and says that he is moving on to human trials. He is an evangelist for the advantages of what he calls “hormesis”—​the practice of inducing metabolic stress by short intense exercise or intermittent fasting. “Every day, try to be hungry and out of breath” is his neatly epigenetic epigram.

  Anti-aging research, in its “translational,” or applied, form, seems to be proceeding along two main fronts: through “small molecules,” meaning mostly dietary supplements that are intended to rev up the right proteins; and, perhaps more dramatically, through genetic engineering. Typically, genetic engineering involves adding or otherwise manipulating genes in a population of animals, often mice, perhaps by rejiggering a mouse’s genome in embryo and then using it to breed a genetically altered strain. In mice studies, genetic modifications that cause the rodents to make greater amounts of a single protein, sirtuin 6, have resulted in longer life spans (although some scientists think that the intervention merely helped male mice to live as long as female mice).

  Church and Noah Davidsohn, a former postdoc in his lab, have engaged in a secretive but much talked-about venture to make old dogs new. They have conducted gene therapy on beagles with the Tufts veterinary school, and are currently advertising for Cavalier King Charles spaniels, which are highly prone to an incurable age-related heart condition, mitral-valve disease; almost all of them develop it by the age of ten. Using a genetically modified virus, Church and Davidsohn’s team will insert a piece of DNA into a dog’s liver cells and get them to produce a protein meant to stop the heart disease from progressing. But the team has larger ambitions. It has been identifying other targets for gene-based interventions, studying a database of aging-related genes: genes that are overexpressed or underexpressed—​that make too much or too little of a particular protein—​as we grow old. In the CD replay of life, these are the notes that get muffled or amplified, and Davidsohn and Church want to restore them to their proper volume.

  Many problems cling to this work, not least that there are surprisingly few “biomarkers” of increased longevity. One researcher makes a comparison with cancer research: we know a patient’s cancer has been successfully treated when the cancer cells go away, but how do you know if you’ve made people live longer except by waiting decades and seeing when they die? Ideally, we’d find something that could be measured in a blood test, say, and was reliably correlated with someone’s life span.

  Church is optimistic about the genetic-engineering approach. “We know it can work,” he says, “because we’ve already had success reprogramming embryonic stem cells: you can take a really old cell and turn that back into a young cell. We’re doing it now. Most of the work was done in mice, where we’ve extended the life of mice by a factor of two. It isn’t seen as impressive, because it’s mice, but now we’re working on dogs. There are about nine different pathways that we’ve identified for cell rejuvenation, one of which eliminates senescent cells”—​moldering cells that have stopped dividing and tend to spark inflammation, serving as a perpetual irritant to their neighbors.

  “We’re already in clinical trials with dogs,” Church says. “If all goes well, we should have that accomplished within two years, and be overlapping that with human clinical trials within the next five years. My guess is that dog trials will go well. Based on the mouse trials, we’re hoping that the effects are general and independent of species—​we’re using the same gene therapy in mice and dogs and humans.”

  Church is aware that the Food and Drug Administration, amo
ng other regulatory bodies, may not be crazy about weird new therapies that address what we customarily take to be a natural process. “Our emphasis is on reversal rather than longevity, in part because it’s easier to get permission from the FDA for reversal of diseases than for prolongation of life,” he says. “Longevity isn’t our aim—​we’re just aiming at the reversal of age-related diseases.” Noah Davidsohn enthusiastically seconds this: “We want to make people live better, not necessarily longer, though obviously longer is part of better.” But Church makes it plain that these are adjoining concerns. “How old can people grow?” he says. “Well, if our approach is truly effective, there is no upper limit. But our goal isn’t eternal life. The goal is youthful wellness rather than an extended long period of age-related decline. You know, one of the striking things is that many supercentenarians”—​people who live productively past a hundred years—​“live a youthful life, and then they die very quickly. They’re here, living well, and then they’re not. It’s not a bad picture.”

  There are many skeptics among scientists who wonder how much, or how soon, this kind of work will really affect aging. Church gets shares for serving on the advisory board of Elysium Health, which markets an anti-aging supplement called Basis, and though the literature is careful to say that, “rather than endorsing a specific product, this network of scientists, clinicians and health professionals advises the Elysium team on product identification and development,” how one distinguishes between advising on the product and endorsing the product seems to many a bit mystical. Others may recall the enthusiasm, in the early twentieth century, for implanting monkey glands in people, a procedure that was held out as a scientific solution to the problem of aging. (W. B. Yeats had a related procedure.) The fountain of youth is always splashing away somewhere.