The longevity industry: why living forever comes at a cost

If it were possible, would you spend money on living forever? A number of Silicon Valley billionaires are pursuing more than technology products – they are also pursuing immortality.

Social media feeds are packed with influencers endorsing peptides, "functional" mushroom powders and other hacks – often lacking an evidence base – that supposedly extend lifespan. Some go further, saying they can reverse your "biological age".

The drive to live longer, appear younger or simply enjoy one’s "best life" has grown into a lucrative sector. Its offerings range from ice baths and saunas to cryotherapy chambers and red light therapy.

Yet much of the advertising and social media content is underpinned by commercial interests eager to serve people who fear growing old and dying.

Nobody lives forever

Evolution explains why humans do not live indefinitely. It selects genetic characteristics that support successful reproduction and adaptation, rather than traits that give an individual an unlimited lifespan.

Ancient Greek stories offered warnings about extending life. Characters who sought immortality generally discovered it carried a devastating price. Tithonus, for instance, received eternal life but not eternal youth, condemning him to perpetual ageing and deterioration.

Today’s longevity industry is supported by venture-capital firms, celebrity backers and pharmaceutical companies.

However, a substantial share of this investment goes towards services and products for which there is little, if any, evidence that they improve health or extend life.

In his highly publicised pursuit of life extension, US venture capitalist Bryan Johnson is reported to spend millions while undertaking continual medical tests in pursuit of the unattainable goal of never dying.

Johnson’s longevity programme involves an intensely controlled diet, hundreds of supplements each day, and rigid sleep and exercise schedules. He has also had transfusions of blood plasma from his own son.

We identify three significant and troubling issues with the longevity industry.

Profit before evidence

Innovation sits at the heart of the longevity industry and has drawn a wave of Silicon Valley investors hoping to "hack" ageing. However, robust evidence rarely supports these innovations.

For instance, full-body MRI is promoted as a means of finding cancer and other abnormalities at an early stage, before they become more difficult to treat. But there is no evidence that these scans produce better health outcomes. Medical colleges internationally do not advise full-body MRI for healthy people.

Such tests may produce "incidentalomas" – unforeseen findings that can trigger avoidable follow-up procedures, expense and anxiety.

The longevity industry presents itself as a disruptive alternative to conventional health care. Even so, it relies on the mainstream system to operate. Scans, blood tests and experimental therapies ultimately return to hospitals and clinics for follow-up appointments, specialist advice and interventions.

This creates further pressure on services that are already overstretched, both in costs and staffing, while arguably offering limited benefit to population health.

Test and you shall find

Although screening tests are widely popular with the public, experts have long cautioned that more tests do not necessarily mean better health.

Overdiagnosis is among the most obvious dangers: an abnormality or disease is identified even though it would never affect someone’s health during their life. The more testing is done, the more findings emerge – and much of what is found has no clinical relevance. This then forms a self-reinforcing cycle.

Unnecessary investigations may cause overdiagnosis and incidental findings, potentially setting off chains of additional needless tests or procedures.

Longevity isn't the same as prevention

Longevity marketers argue that their products and services belong to "preventive" medicine: detecting illness before it occurs and enabling people to remain healthier for longer.

Yet the longevity movement is profoundly different from the public-health concept of prevention.

Within mainstream medicine, prevention means straightforward measures supported by evidence. These include immunisations and cancer screening at the appropriate ages.

There is, however, no clear evidence that many of the extensive tests and treatments promoted by the longevity industry improve long-term outcomes for people who are otherwise healthy.

They are expensive, require substantial resources and can lead to yet more unwarranted testing.

Why this matters

By turning ageing into a medical problem, the longevity movement provides a classic case of disease mongering. It may also entrench ageism in everyday commerce by treating normal ageing as pathological instead of accepting it as part of life.

It could also draw resources and focus away from essential, basic public-health functions that can enhance quality of life for millions as we all age gracefully.

The excitement surrounding many unsupported longevity claims diverts attention from approaches already known to help: regular physical activity, nutritious food, good sleep, meaningful relationships and equitable access to evidence-based medical care.

Samuel Cornell, PhD Candidate in Public Health & Community Medicine, School of Population Health, UNSW Sydney; Brooke Nickel, NHMRC Emerging Leader Research Fellow, University of Sydney, and Sean Docking, Research Fellow, School of Public Health and Preventive Medicine, Monash University

This article is republished from The Conversation under a Creative Commons licence. Read the original article.