Age is just a number….or is it?

There is no certainty in the world, they say, except taxes, and death. Yet, that has not stopped people from trying to escape both. There is no dearth of tax avoidance, fraud and related litigation - tax ‘advisory’ and law are fields brimming with activity and make for lucrative careers too! 

What about death though? There has indeed been a constant striving in medicine and science towards increasing lifespan. At the most fundamental level, there is much to cheer about. The last century has seen a significant increase in life expectancy due to a reduction in infant mortality, vaccines and antibiotics. This has helped tremendously by reducing the probability of death before old age. However, treating diseases related to old age and ‘senescence’ has proved far less tractable. Modern medicine has found ways to treat heart ailments once discovered - but cardiac diseases are still among the largest killers globally. Similarly, cancer has proved a holy grail, though many drugs have been able to ‘manage’ the disease better. 

Significantly, there is a large difference between lifespan and health-span. While a lot of research has focused on extending life itself, the same may not be said about health-span. The challenge before us to help people live healthier lives in their final years, rather than under constant medical care.

So what do we really know about ageing, and how it can be delayed? There are many theories and almost none of them have incontrovertible evidence to back them up. One of the most prominent theories is that ageing involves the process of damage to our DNA. This damage, it would seem, prevents the reproduction of healthy cells in the body and therefore causes ageing. One of the suspected methods of reducing DNA damage is caloric restriction - a lower intake of food and periodic starvation is believed to produce DNA repair and therefore a delay in ageing. This, of course, is easier said than done and the degree of caloric restriction that is needed to prevent or reverse ageing could well be severely inconvenient and unacceptable to humans.

Second, is the role of ‘senescent cells’ in the human body. This theory postulates that as we age, there are some cells in the human body that get stressed and decide to opt out of the cycle of cell division. Not only do they count themselves out, but also secrete a certain substance that accelerates the senescence of other cells in the human body, leading to ageing diseases such as osteoarthritis, cancer and atherosclerosis. As per some studies, each cell in the human body is limited to 50 cell division cycles. However, we now hear about a new class of drugs - senolytics, that are being tested for their ability to disrupt these senescent cells and prevent the ageing process.

One of the most popular explanations of ageing is oxidative stress. This is a process that causes damage to tissues through the accumulation of chemicals called ROS (Oxygen reactive species) in the body. There is a related issue called inflammation which is caused by oxidative stress. Many of our ageing related diseases including cancer are also suspected to be caused by chronic inflammation. What causes oxidative stress? While no one knows for sure, the usual suspects are pollutants, smoking, and high sugar-containing foods. On the other end of the spectrum are the anti-oxidants and foods with supposed anti-inflammatory properties - berries, turmeric and green tea to name some ‘super-foods’. Consumption of these are possibly linked to the reversal of oxidative stress and ageing.

The larger question is this - can humans manage ageing better, if not stall it completely? There are significant implications here - not just scientific, but also social (think demographics and polity) as well as economic (think healthcare costs, government finances and pension systems). As individuals - what perhaps matters most are the takeaways for healthy living - not just longer lifespans but longer health-spans. What started as a quest for immortality and the Elixir of life must get down to more mundane questions of diet, biology and lifestyle - the devil always lies in the details!

Of Life, Living & Jean-Baptiste Say

In many ways 2021 was a year defined by supply shortages. Whether it was life-saving vaccines at the beginning of the year, or more mundane things like coal, steel and semiconductor chips - supply chains around the world were caught unaware by a sudden surge in demand - led by re-openings and fiscal stimulus checks. In this backdrop, I found myself contemplating the relevance of a classic economic theory proposed by a certain Jean-Bapitste Say - and a rather controversial one at that.

Say argued that Supply creates its own demand. And while there have been many economists who have disagreed with what he had to say, his point was rather simple - that in order to be able to demand and purchase a good, an individual should first create something of value and offer it for exchange. 

Of course, one can puncture a few holes into this theory - First, modern economies use money as a medium of exchange rather than barter - so money supply can have its own effect on supply and demand for goods - e.g. tighter monetary conditions can cause individuals to hoard money rather than spending it on goods and services. Second, producing a good that is not of value (at any price) may not create any demand - e.g. a producer who manufactures a black & white CRT television today is unlikely to be compensated for his efforts - even though he/she may have been handsomely rewarded for the same good 50 years ago. But I do not intend to wade into this debate for now. 

What I find quite relevant about Say’s law today is its applicability to the process of innovation. What drives a significant amount of economic growth (and demand) around the world today is the act of creating new goods and services which did not exist previously. Supply of innovations creates demand for them. For instance, the act of inventing the smartphone has fostered a whole éco-system of component suppliers, app developers and online sellers. This has possibly created employment for millions around the world, and those individuals with their earnings have in turn created demand for new goods and services. 

Next, let’s take the world of pharmaceuticals and healthcare for example - there are lifesaving drugs today that did not exist a mere decade ago - treatments that help ameliorate (though not yet fully cure) cancer, manage diabetes and cardiac ailments. Within months of the outbreak of COVID, our scientists were ready with multiple vaccines and therapeutic drugs to fight the epidemic. There are nutritional supplements in existence today - for humans as well as animals - that money could not buy when our ancestors were around.

Look at the world of video games - an industry that did not even exist half a century ago is a thriving economic engine today and one that is growing increasingly sophisticated. You can now purchase in-game items with virtual currency, attend a concert within a game and create NFTs that sell for millions within a ‘metaverse’. I find this a fascinating corroboration of Say’s Law - supply creating demand where none existed.

This also creates a whole new dilemma for policymakers. Are we adequately measuring the cost of living and inflation? Most measures of inflation today capture prices of a fixed basket of goods over time. To be fair, this is perhaps the most scientific approach and one that captures what is relevant to the vast majority of citizens - basic necessities of life. But I would argue that a discretionary good of today may be a staple, a necessity of tomorrow. Try going a day or two without a smartphone and an internet connection and you will realise what I am talking about - connectivity is to our lives and times what electricity was to that of our parents. While policymakers may base their decisions on a basic cost of living, life has moved well beyond that. 

This also has massive implications for wealth and savings - what you deem a satisfactory nest egg today may prove grossly inadequate tomorrow. Who knows what fantastic new contraptions you may feel the need to purchase 30 years from today! It’s a brave new world indeed.