Dr Olshansky: ‘We might be living longer but there is a price to pay’

Longevity specialist Dr Stuart Jay Olshansky on why he’s bet against the human condition and the consequences of interfering with ageing

In the year 2000, a story appeared in a magazine called Scientific American that quoted a biology professor as saying a human being would one day reach 150 years old. Dr Stuart Jay Olshansky, who found the hypothesis utterly preposterous, called him up. “I said Steve [Steve Austad], come on, seriously, you don’t actually believe that do you?”
The world record was 122 at that point, and still is – Jeanne Calment, a French woman, died 122 years and 164 days old in 1997. “You’re talking about a quantum leap, light years of difference. Seriously, that’s not going to happen. He goes, ‘I think it’s possible.’ I said, ‘Well, you want to put some money down on that?’.”
They would each place a $150 (£115) bet on someone born that year living until 2150. If anyone managed it, Austad’s descendants would inherit whatever the $300 had appreciated to, and if no one did, then Olshanskys’ would.
By now, anyone who might be in the running to reach 150 years old – thanks to some extraordinary cocktail of genetics, lifestyle choices and precisely the right medical advances for their specific composition – will already have “accumulated 24 years worth of damage”.
“We don’t have an ageing intervention yet,” says Olshansky. “Steve was hoping one would come on in the next 10 years. Yeah, well, it didn’t happen.”
Olshansky, a professor of epidemiology and biostatistics at the University of Illinois in Chicago, invested the $300 – first in gold. “I bought it at like $600 an ounce and it went up to $2,000.” Then in Tesla, which “went up fivefold”. It’s now invested elsewhere. “The bottom line is, I think it’s going to be worth over a billion dollars.”
Of course, Olshansky, 70, and Austad won’t be around to see it. But the winner will be announced by the head of the National Academy of Sciences, and the money distributed to their descendants. “You’ll probably be able to buy a cup of coffee with it by then,” he jokes.
By 2000, Olshansky had already decided to die on this hill. He published a study in 1990 estimating that once 80 per cent of the population died between the ages of 65 and 95, we would have reached the limit of human life expectancy.
“We made a prediction that the rise in life expectancy must slow down. A lot of people disagreed with us. They said no, advances in medical technology will accelerate and it will drag life expectancy with it. We said the former will happen, the latter will not.”
Some 34 years on, he is as sure of his convictions as ever. Earlier this month, Olshansky re-examined his theory in new research released in the journal Nature Aging. He found that while average life expectancies have increased since 1990, the rate at which they are rising has slowed. On average, life expectancy increased by just six and a half years between 1990 and 2019 in the nine regions with the greatest lifespans (Hong Kong, Japan, South Korea, Australia, France, Italy, Switzerland, Sweden, and Spain). According to his findings, girls born recently in these areas have a 5.3 per cent chance of reaching 100, while boys have just a 1.7 per cent likelihood.
Despite medical advancements and improved public health, the legions of biohackers claiming to have slowed their own ageing and various billionaires’ unquenchable thirst for an elixir of life, it means that we are finally reaching the upper limits of how long a person can really live. In other words, Olshansky was right.
If the idea of betting against the human condition sounds morbid, you have misunderstood Olshansky’s motivation. “I want to see biohackers succeed in enabling us to live healthier longer, but when somebody makes a claim in advance that it works and they’re selling it to you? That’s when I have a problem. There is nothing that exists now that has been documented to work.”
The only way humans are going to live longer, Olshansky says, is if we discover a way to slow the ageing process. In finding new ways to combat disease, we have simply extended a person’s potential final act.
“In the 20th century, we manufactured an additional 30 years of life on average for populations,” he explains. “Back then, life expectancy was close to 50. Today, it’s closer to 80… We need to be enormously grateful for what public health and medicine has given us because most of us alive today over the age of 60 are living on time that was manufactured for us by medicine and public health.”
What it means, though, is that we have essentially been playing “a game of whack-a-mole” with fatal diseases, he says. We must address “the ageing of cells, tissues, organs and organ systems that accumulate damage just by living, by breathing, by eating, by oxidising”. He argues – as he always has – that if we don’t find a way to truly slow ageing, then no matter what biohackers might claim (with extreme diets and sleep regimes), human lifespans will plateau.
“The underlying biological process of ageing gets in the way of progress,” explains Olshansky, talking on a video call from the garden of his suburban home in Chicago, where he lives with his wife Sara. “So we can continue to manufacture more survival time, but the amount that we get is less and less.”
There is a relationship, he explains, between the basic process of ageing – “damage to cells and tissues” – and “the risk of ageing-related diseases”. Rather than simply treating one disease at a time as we do now, we need a drug that “influences multiple diseases at the same time” if we are to slow ageing.
Science hasn’t yet found a way to do it, though recent discoveries on the possible impact of GLP-1 drugs are intriguing. Researchers say the drugs, which belong to the same group of diabetes and weight-loss medications as Wegovy and Ozempic, are “interfering with the insulin signalling pathway”. That pathway “seems to be a gatekeeper that influences multiple diseases all at once”, says Olshansky. One side effect of these drugs, then, could be a “slowing down in the rate of ageing”. They may “lower the risk of diabetes, cardiovascular disease, cancer, and a broad range of other diseases and disorders”.
These days, we might be living longer, but we’re not necessarily living better. “We have to pay a price,” Olshansky adds. “And the price is the rise of heart disease, cancer, stroke, Alzheimer’s and other things that go wrong with ageing bodies. [We’re] sort of using them beyond their biological warranty period.”
Assisted dying is, in part, “a consequence” of these extended lives, he says. “We’ve now created people who are frail and disabled for very, very long time periods, some of whom are in severe pain. And alleviating that suffering is what this is all about.
We have “opened the door to extended survival” for those in places such as the UK and US, where “you have about 80 per cent of each birth cohort dying somewhere between the ages of 65 and 95 and about 14 per cent surviving beyond 95.
“But there is a price to pay, and assisted suicide is one of the consequences.”
Olshansky himself still has 10 years to go before he can legitimately claim the title of “super ager”, which he defines as someone over 80 who “remains cognitively intact and does extremely well”. He counts Joe Biden among them, and suspects that Donald Trump, 78, will eventually be considered one too. What about Biden’s recent performances on the world stage? “If you actually watched him, an hour later he was back to normal. His own doctor has indicated that there isn’t any problem with his cognitive functioning. I don’t see any reason to conclude that he’s not a super ager.”
Similarly, he continues, there is “no evidence” that Trump is facing “significant cognitive issues”. “People may not like what he says, but it’s not because of how old he is. There’s no evidence that he’s facing any kind of significant cognitive deficits.”
Olshansky, a father of two and grandfather of three, is a curious mix of realist and optimist. He is rigorous about his own health, having run marathons before giving them up in favour of a daily walk. He recently cut sugar out of his diet and now eats hardly any fried food, managing to bring his cholesterol down to a level that means he doesn’t require statins. “I’ve been able to lose enough body fat that I don’t need them any more, so I barely take anything. I do take a vitamin D because my natural vitamin D levels have gone down.”
He and his wife regularly see specialist doctors to get ahead of any possible health issues. “We monitor like crazy,” he says. “We like to pick things up early. I had skin cancer on the side of my head – I had it removed.”
He is excited by the research being carried out on delaying the ageing process but is sceptical about “anti-ageing quackery” peddled on the internet. I run him through the daily practice of Kayla Barnes-Lentz, a biohacker claiming to have reduced her biological age by a decade and planning to make it to 150, who shared her extreme routine with The Telegraph. “You might want to ask her why she thinks it’s going to make her live to 150,” responds an exasperated Olshansky.
“I mean, how did she make up that number? Why is she limiting herself to 150? Why not go for 500 while you’re at it.”
The global longevity market reached $2.7 million (£2 million) last year and is predicted to hit $4.1 million by 2031, according to one report by Insight Ace Analytic. What does Olshansky make of Bryan Johnson, the multi-millionaire who follows a “don’t die plan” and claims death is no longer a given, I wonder? He is intrigued by the way Johnson monitors his health but sceptical about the claims. “All of us should be monitoring ourselves very carefully… Investing in your own health is important, and it will work, in all likelihood, to extend your period of healthy life.
“The problem is, of course, that he’s claiming it won’t just make him healthier for longer, it’ll make him live longer, without one shred of evidence.”
In February, Olshansky attended an event in Honduras with Johnson. “He gave a presentation and he was talking about using growth hormones on himself. Apparently, he hadn’t read the literature on growth hormones because [they’re] known to be linked to brain cancer. It would be the last thing you would want to do.
“It’s a classic illustration of how some of these biohackers are willing to conduct experiments on their own bodies without knowing the actual science behind what they’re doing and what the potential dangers are.”
There is no silver bullet, Olshansky confirms, though he himself is in as good a position as anyone could hope to be. A genetic test revealed he has a gene called Fox03, which is “a genetic polymorphism associated with a higher probability of surviving beyond the ages of 90 and 100”. His father lived to 96 and only became ill eight days before he died. Olshansky is also doing what he can to stay healthy for as long as possible; I had assumed the buds in his ears were headphones, but in fact they’re hearing aids. His hearing is deteriorating at a normal rate, and there is “a direct link between hearing loss and dementia”.
Is there a North Star he is aiming for? “I don’t have a number, I just want to retain health for as long as possible.” Just so long as he doesn’t defy the odds and make it to 150 – his future descendants are counting on those Tesla billions.