I want to introduce Dr. Jay Olshansky, a professor of epidemiology and biostatistics from the University of Illinois in Chicago. I appreciate that you could join us today.
Sure! Happy to be here.
Just a quick introduction if you don’t mind. Can you share a little bit about yourself and how you became interested in human aging, or as I ask a lot of persons, perhaps how human aging found you?
That’s actually an interesting story. I was a graduate student at the University of Chicago in the Ph.D. program in sociology with an interest in adolescent fertility. And my advisor suggested I take a course from a famous scientist by the name of Bernice Neugard in human development. And she knew of my interest in demography. She had just completed a book, that was funded by the National Academy of Sciences, on whether or not the U.S. Government should be funding research designed to slow biological aging in people. And she said “I want to know what you think. What happens if we succeed?” And so I picked up the book, I started reading it, and I couldn’t stop reading it. I then went to the library—she asked me if I were to write a paper on the topic, and I said “Sure.” She said “This would be the main paper for the course.”
And I wrote a paper that was like an inch thick! I swear I didn’t come out of the library for months. I became absolutely enthralled with it, I was consuming every article I could find, every book I could find, on the question of how long humans could live. And when I handed this to her she took one look at it, read it, and said “If you’d like, you can turn this into your Master’s Thesis because this is about as thorough of treatment of the field of aging and longevity as she had ever seen.” And I said “Sure.” And from that point on…this was 1979, I was hooked on aging and longevity and ever since then I’ve been consuming every single thing I could find on the topic and the issue of how long humans can live. And of course I’ve written extensively on the topic myself.
Yeah that question, how long can humans live, that was a question I was going to ask you because you study this quite a bit. You’ve written extensively. What is…how long can a human being live? We see a lot of experts out there and we read a lot of their works that suggest that there are persons out there that can live well to 150 or 500 or maybe those that have a history of living to, their families, to 70 or 80 that we could extend that 20 or 30 years. But what’s the reality?
Yes, I’m glad you asked the question that way. So, there’s a lot of hype in our field of aging about how long people can live. And let’s just deal with the facts for the moment. The fact is that no human has ever lived longer than 122.5. One woman by the name of Jeanne Calment. She died in 1997, she lived in southern France…no one has come close to 122 since then. In fact, very few people have made it past 115 since then. So when some of my colleagues ask the question “What’s the maximum humans can live?” It seems pretty obvious. It’s somewhere between 115 and 122. And it’s just not really possible for humans to live much beyond that. Now in terms of averages, life expectancy in 1900 was about 50, today it’s about 80 in most developed countries, maybe a little bit higher. That’s an average. A rough average. It’s a life table estimate of how long people born today can live.
And so, the question that one might ask is “How much higher can life expectancy go? How much higher can the average go?” Because I don’t think the maximum can really go much higher and even if it did, it’s one person that’s making it that far. It doesn’t have much meaning to the rest of us. And I said in an article, I published an article back in 1990, so this was 32 years ago, that the upper limit to human life expectancy was about 85. About 88 for women, about 82 for men, maybe a little bit higher. But we can’t really push it much higher than that. In order to get up to 85, by the way, you have to have a lot of people survive past 100, which is happening. So the answer is, for a population, about 85 to 88 somewhere. For individuals, I wouldn’t be surprised if somebody broke Jeanne Calmut’s record of 122. Maybe 125. Maybe 130 under extreme circumstances. But the human body wasn’t designed for long-term use. And so pushing out these bodies that far just doesn’t work. You get a failure of the neurons in the brain, the components of the body fail, the heart muscle, the cardiovascular system, loss of muscle mass, loss of bone density, these bodies just weren’t designed for long-term use.
When somebody asks me this question I usually turn around and say “How fast do you think we can run? What’s the fastest we can run a mile?” Just by way of illustration. So the current world record is 3 minutes, 43 seconds. And I will ask anyone who wants to learn about this issue of upper limits to human longevity “How much faster do you think we can run? Can we run a mile in one minute, instead of 3 minutes 43 seconds?” And everyone says “Oh, of course not.” And I say “Well why not? What’s stopping us?” And the answer that is most often given is that the human body is incapable of moving that fast no matter how hard we try. You can tell your legs to move faster but it doesn’t work. And it’s the same thing with human longevity. We can talk all we want about living to 150 or 250 or 500 or 1000, but the human body wasn’t designed to last that long and it’s not going to. So, yes, there is an upper limit to human longevity. And interestingly enough, this question of whether or not there’s an upper limit came up during testimony that I gave a week and a half ago in the U.S. Congress on human longevity and aging and whether or not we are going to have an aging intervention. They were asking…this is an important question! Because if there is no upper limit, then in theory we could just keep pushing out the envelope of survival. If there is an upper limit and we’re approaching it, that means that the focus should not be on living longer anymore, it should be on living healthier longer and that was the overall message that I was trying to get across.
That’s very interesting. You know, you think about the forces that are out there today. CDC came out recently with post-Covid numbers, or during Covid, life expectancy has gone significantly down for those birth that are coming today. How does that factor into the equation? If you could make a prediction, what’s going to happen? We’ve got a lot of these social ails going on: crime, addiction, and at the same time you have these new diseases or viruses popping up.
Well, so I published a couple of articles on this topic. In 2005, my colleagues and I published an article in the New England Journal of Medicine predicting that life expectancy in the United States would drop due to obesity, diabetes, and a whole suite of related conditions. That’s exactly what happened, by the way. Even though a lot of people didn’t like the fact that we had made that prediction, that’s exactly what happened. We said this would be the first generation of children to live a shorter lifespan than their parents and it looks as though that may actually come true, unfortunately. So We’ve got a lot of major risk factors that exist in developed countries, including diabetes and and obesity that are going in the wrong direction.
When Covid hit, it was not unexpected. Look, we’ve had three infectious disease pandemics that occur just about every century. So it was only a matter of time before we were going to have another one and it wasn’t exactly unpredicted. We actually wrote a paper on this that we published in 1997, suggesting that we had better get ready. Something like this is coming. Now when it happens, of course, nobody really knows how it’s going to play out. Covid-19 hit and there were lots of unusual elements to it. I actually am reluctant to make predictions. I started to make predictions at the beginning of Covid-19, and realized that almost every prediction I would think of making was wrong.
And the fact is that we actually don’t really know what the severity or prevalence of Covid is. I don’t trust the data from the CDC at the moment that’s coming out. Part of the problem is that we don’t actually know how many people have had Covid. We don’t know how many people have actually died from Covid. We don’t know how many people are going to die from Covid. And we don’t know what new variants are going to come along and influence survival and mortality in the future. What I can tell you is in the 1918 influenza pandemic, H5N1, that hit, we had a pretty dramatic drop in life expectancy over a short time period just like Covid. And then there was a rebound that occurred a couple years later. So the question is, are we going to get a rebound now over the next year or so. And I would say it’s possible that this could happen. That we could get a natural immunity that eventually occurs. We might be seeing that now, with the death rate going down pretty dramatically. The Covid death rate is now close to or lower than influenza. Just so you know it’s about thirty to seventy thousand deaths per year in the United States alone. We seem to be comfortable living with that every year.
So now, it’s one of the reasons why the claim that the pandemic is over has been made. It’s because Covid has become our modern equivalent of influenza. Of course if you add it to influenza then you get sixty to a hundred and forty thousand deaths instead of thirty to seventy [thousand] occurring in a year. But I don’t know. We actually don’t know what the long-term consequences of Covid are going to be. I got Covid myself in April of this year for the first time. I had some rough days, but I’ve had the flu before and I’ve had a couple of rough days with that. What we don’t know is whether or not Covid is going to have a long-term impact on those of us that have been exposed. Is it possible that ten years from now we will all get lung cancer as a result? We don’t know. So the answer is, I don’t know. And I don’t feel comfortable projecting what the impact is going to be overall, but what I will say is that it’s probably not going to have that much of an impact overall on life expectancy.
Some have argued, by the way, that Covid culls the weaker members of the population that have multiple risk factors. Multiple conditions in their bodies all at once. It removes them from the population, leaving behind a more robust subgroup. It’s natural in action. But whether or not that plays out, I don’t know. And I don’t know if that’s actually going to happen. So the answer is the three words that I teach my students to use all the time when questions like this come up: I don’t know.
That’s a good answer! You talk about…going back, I heard a very interesting interview on the radio the other morning. A local station out of Oklahoma City. One of the physicians out of OU Health Science Center was talking about risk factors and Covid, but he said a more interesting group are the ones… are the persons and humans in the population that have not had Covid whatsoever. Are those the ones you are talking about that come out of the pandemic, or a state like this, that are stronger? That have, you know, their genes pass on now, and are we going to… is that a…
No, it’s not really an issue. Think of it this way: the people that are dying from it for the most part are older. They’ve already passed their genes on to the next generation. So it’s too late, natural selection is not operating through Covid. So no, that’s not going to happen. But you’re right, there are subgroups of the population that appear to be either unaffected by Covid or they’re not getting it for reason that we don’t know. Although I’m skeptical of that. It’s entirely possible, perhaps likely, that thought they didn’t get it actually did get it and had no symptoms. Now, that in and of itself is interesting. Why is it that some people can be exposed to Covid and have no symptoms at all. They’re asymptomatic. That was one of the unusual elements of Covid to begin with, was the asymptomatic element to it. Almost no one that gets flu is asymptomatic. When you have the flu, you know it. So Covid is a different animal.
And why some people are not influenced by it is of great interest. And we’ll eventually discover what it is among subgroups of the population but I don’t think that that subgroup is necessarily healthier. They may be less susceptible to Covid and more susceptible to something else. It’s just something unique about them. Why is it that some people have long-term health effects associated with Covid and others have no long-term health effects associated with Covid? Why do some people get brain fog and others do not? These all represent subtle differences among subgroups of the population that are playing itself out in realtime for us, but I don’t think that this is evolution in action influencing gene frequencies.
Remember, if you look at the death rate for Covid it parallels the death rate for total mortality almost identically. In humans almost all deaths occur between the ages of 65 and 95, and everyone who is 65 to 95, almost everyone, has already passed their genes on to the next generation. It is not natural in action.
Yeah, good to clarify. A lot of times students get confused by it and kind of misled by some of the things they see and read. You talk about, in your work, a term called longevity dividend. Can you explain this concept a little bit, and share a little bit about what it means and what really are the dividends or benefits of living a long life?
Well, so think of it this way. If, in fact, there is an upper limit to human longevity, and we’ve approached it or reached it, then why are we trying to make ourselves live longer? What you’re doing, what we are doing to ourselves, by attacking one disease at a time, which I refer to by the way as a game of whack-a-mole, once you get people that live to very old ages you get all these diseases that accumulate in all their bodies. And you reduce one through medical technology or surgery or prevention or whatever, and two or three crop up right afterwards. So it’s a big game of whack-a-mole that we’ve created in public health. And so if indeed there’s an upper limit and we’re approaching it, then the focus of modern medicine and public health shouldn’t be on trying to push the limits out further. It should be on trying to compress the frailty and disability that occurs later in life into a shorter duration of time near the end.
And that’s what the longevity dividend is all about. It’s basically suggesting, stop trying to make us live longer and start trying to make us trying to live healthier for a longer time period. And that’s where the benefit comes in. That’s where the dividend is. The dividend is an extension of the period of healthy life. And will we live longer as a result of interventions that eventually yield an extension of healthspan? Yeah, probably. I don’t know by how much. No one really knows, in spite of the fact that some of my colleagues like to claim that we’re going to live to 150 or 200. They’re all made-up numbers. I’m not a big fan of making up numbers in the world of science, but unfortunately in the field of aging it’s a pretty common event. So the longevity dividend is nothing more than an argument that instead of attacking one disease at a time as it arises, which is called competing risk, so the game of whack-a-mole. But in epidemiology it’s competing risks: one disease replacing another. We should really be focusing in on trying to address the underlying risk factor for almost everything that goes wrong with us as we get older, which is the biological process of aging itself. And not necessarily the specific risk factors for diseases one at a time. And so the longevity dividend is an effort to slow aging, which is the primary risk factor for things that go wrong. And the result, we think, will be a compression of morbidity and disability and the extension of the period of healthy life.
Now the other part of your question is, what’s the benefit of growing old? Now, this is a wonderful question to ask young students and I’ve actually asked this of my young students all of whom are in their early 20’s. They’re all graduate students. Some are in their mid 20’s, maybe late 20’s, and I will ask them “Is there anything good that happens when you get older?” I get such a kick out of their answers, because almost universally they say no. It’s all bad. Everything that happens when you get older is bad. They see it in their parents, their grandparents, they start to complain about their aches and pains. They get these diseases, they can’t run as fast, they can’t think as fast, at least according to these younger folks. That’s what they think is actually happening. They don’t realize that there’s a whole suite of benefits that are associated with growing older. Especially with growing older healthy, with mind and body intact.
And I’ve had this discussion with them, I said “Is there anything good that happens when you get older?” And they go “Yeah, no. Nothing.” And I’m going “Well, I mean don’t you think it’s possible that as people get older, they maybe they grow wiser? Maybe they grow smarter? Maybe they acquire knowledge and experience?” “Oh yeah, I guess that does happen.” You know, do they acquire more wealth, are they more comfortable in their own skin, are they psychologically more stable? “Yeah, I guess.” You go through one after another, and suddenly they realize “Yeah, I guess all of those things that we want, we don’t get until we get old.” Right? So they want that emotional stability, they want to be better off financially, they want to be smarter, they want to be wiser, yeah well guess what? You gotta wait. You have to live life to get up there, to experience the benefits of old age.
So as long as older age is accompanied by health, then it’s a wonderful benefit. My friend and colleague Linda Fried from Columbia University refers to healthy older individuals as the last rising natural resource that exists on the planet. And so we need to take advantage of this natural resource and help older individuals continue to contribute to society in important and meaningful ways because healthy older people are extraordinarily valuable in our world. We need to nurture them as much as possible. And keep in mind, these younger people that you’re asking the question of are eventually going to make it out to these older ages. So the benefits that we’re pursuing now are eventually going to benefit them.
Invest now and the dividends come later, and the benefits come later, especially in terms of one’s health. Well, another question for you involves your career and your research. Is there one discovery or one finding that you have made in you work that was just…you didn’t expect it. It just kind of…may have been something serendipitous, it may have been something that you just didn’t expect and as you continued to investigate it, it just kind of came all together. Is there something in your career, when you think about the totality of your career, that’s one discovery or one thing that’s really kind of shifted your thinking or maybe even moved the field in new directions?
So this is a really interesting question. I would have to say that the most important event that happened was a meeting that I attended way back in 1988 that was run by George Martin, from the University of Washington, on aging. And at the time, we were talking about how long humans can live and the question that kept coming up was this one: how long can we live? And at the meeting it occurred to me that we were asking this question the wrong way. Instead of asking “How long can we live?” I would reverse-engineer this question and say “Well, how long… how much would death rates have to decline in order to achieve these higher numbers that we were talking about?” Which no one had really bothered to look at. And so I went home and did the calculations and I couldn’t believe what I saw, which was the numbers were huge. The percentage declines in the death rates in order to get life expectancy up higher were much greater than I thought. And so I went to a friend of mine, Bruce Carnes, who was also at Argonne National Laboratory where I worked at the time, and I showed it to him. He did similar work but with animals on survival and I said “Is this right?” And he goes “Yeah, sure looks right to me.” The calculation was not complicated, so we did it over and over and over and over again and eventually came to the conclusion that this was right.
So we eventually published this as a lead article in Science, the title of which was “In search of Methuselah: estimating the upper limits to human longevity.” where we came to the conclusion that life expectancy could rise to about 85 to 88 and then after that can’t really rise much further. Not because we can’t reduce death rates—we can— but because the metric of life expectancy is an insensitive one. And that article really, it was completely unexpected. And interestingly enough that was a purely mathematical demographic argument about upper limits to human longevity. But I quickly realized that there was another related question. And that is, why is there a limit like that? Why can’t we live to 120, 150, and higher? And that led me to the field of evolutionary biology. And my friend was a biologist, Bruce Carnes, and he started introducing me to the world of evolutionary biology and I came across articles that were written by famous evolutionary biologists in the middle part of the 20th Century. I had already been familiar with the actuarial work that was done by Benjamin Gompers in 1825 predicting mortality rates for humans. And as it turned out, the work that was done by the evolutionary biologists in the middle part of the 20th century provided an explanation for why Gompers observed what he observed in 1825.
And that combination of evolutionary biology and demography in the actuarial sciences led my friend and I, Bruce Carnes, to develop the modern concept of biodemography. That’s where the modern concept of biodemography came from. It came from Bruce and I in an article that we published in the early 1990’s with funding from the Social Security Administration. And as it turns out the field of biodemography has taken off as a discipline ever since then. Interestingly enough there have been some people that have claimed that they were the creators of the field of biodemography and my friend Bruce and I laugh at that because the interesting thing was, I first presented the concept at a meeting run by the Social Security Administration in 1992, and the one person who claimed he discovered it was at that meeting. His name was [???] by the way who died recently, interestingly enough. And he said, at the meeting, “Oh yeah, nothing will ever come of biodemography.” And a couple years later he claimed that he was the father of the field. So my friend Bruce and I were laughing at this. We’re going “Seriously, how can somebody actually get away with that?”
So, biodemography was an outgrowth of the combination of evolutionary biology and genetics and demographic actuarial sciences. And then, ultimately, this led to my favorite article that I’ve ever published which combined all of this stuff together into one place. It was an article that we published in Scientific American entitled “If humans were built to last?” where we basically, Bruce Carnes and I, and Bob Butler, the founding director of the National Institute on Aging, wrote this paper and we basically said “Yeah, this human body wasn’t really intended for long-term use. And there’s lots of things that go wrong with it. But if we could re-engineer …if we were the engineers, and we could engineer this body to last longer, what might it look like?” And that was the byproduct, that was the product of that particular article. It was my favorite article I’ve ever published. We basically explained what goes wrong, why there’s limits, and we have to live with the body design that we have which limits how long humans are capable of living. That’s a long-winded answer but it’s a really important question, I think, and I was happy to answer it.
Yeah that’s interesting, what would be your ultimate dream car if you could build it.
Yeah I mean, some people were born with a Yugo body and some people were born with a Mercedes body, and we know what that mortality distribution looks like. The ones with the Mercedes bodies inherited Fox3 genes which are associated with exceptional longevity. They’ve got the right genetic polymorphism for Apoee. We know what the components are that contribute to exceptional longevity. We’re beginning to learn what those elements are. And that’s what’s fascinating about the field of aging, figuring out what in us contributes to longer life in some and shorter life in others.
Yeah. Well a final question for you is, this course that I’m teaching is really, the focus is on, we call it Successful Aging for lack of a better term. Just to kind of get the students to understand the biopsychosocial type of components that go into living well, living long, whatever it may be. Rowe and Khan kind of coined this term, Successful Aging, but I’m asking everyone to give their take on that. How do you define successful aging?
You know, it’s an interesting dilemma because there’s such genetic diversity in a population. It’s inevitable that some people are going to die early. And, for those folks that are going to die early, the goal is to live as healthy for as long as possible. That applies whether you can live to 30 or 50 or 70 or 100. So to me, the concept of healthy aging or successful aging, is unique to you as an individual. I don’t define it as the observed health and longevity of one person, Jeanne Calmone, who made it to 122, because we can’t all live to 122 just like we can’t all run a 4-minute mile. So the question is for your body, for your body design, for what you inherited, what’s the maximum healthy lifespan you can achieve?
And that’s going to be heavily influenced by how you live your life. Just think of it as how hard you press the accelerator on your car. How you drive that car. Well, how we drive these bodies influences how healthy they are along the way. And when we exercise and eat right that’s like an oil lube and a filter for your car, it’s an oil lube and a filter for your body. It makes the body operate more efficiently for a longer time period. You don’t have to do it, but it works. And so the concept of successful aging, to me, varies from one person to another. I don’t use a single individual or a single group of individuals as the basis for determining what success is. It should be unique to you. But it’s basically maximizing your healthspan regardless of how long you live. Or how long you’re capable of living.
And that’s my takeaway, that’s my concept, of successful aging. It varies from one person to another. Just because if some at 50 doesn’t mean they haven’t successfully aged. They have successfully aged up to their biological maximum. When somebody lives to 100 but spends the last 30 years frail and disabled, and not living well, one can determine or conclude that maybe that wasn’t a case of successful aging. Now let me step back on that question for a second because some of my colleagues, I think appropriately so, have said “Look Jay, just because somebody is frail and somebody’s disabled doesn’t mean that they haven’t successfully aged.” And they may very well be happy. Perfectly happy with their lives even though they are experiencing some level of frailty and disability. So be careful how you define success, and I actually agree with that view. So, while I would like to see as many people survive as healthy as possible for as long as possible, it’s not necessary to achieve successful aging. There are people that can make it out and live ten years frail and disabled and be perfectly happy with their lives. And maybe the concept of successful aging needs to be defined more by happiness than by health. And I’m inclined to buy in to that argument.
Well I appreciate your time today, taking time to answer a few questions and I appreciate your contributions.
collectively and socially shared experiences with those born at or around the same birth year.
Goals and preferences in the later half of life that are elective and time specific versus those that evolve from loss-based experiences