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Life expectancy by 2050 - how health care innovation will extend lifespan globally using next-generation tech including biotech and AI / Artificial Intelligence.

While our world was forced to battle COVID and remains threatened by other potential viral pandemics, future generations will treat ageing as a disease. The life of every reader of this web page has increased by an average of 15 minutes in the last hour – the pattern in many nations of the world over the last two decades, in people with reasonable education and wealth.

Take London, for example, where average life expectancy increased by a year between 2004–10, both for those at birth, and for those aged 65.  We have seen similar things in Japan and Germany. In many emerging nations, life expectancy is improving even faster. But what about the next 50‒100 years? 

* "How AI Will Change Your Life - A Futurist's Guide to a Super-Smart World" - Patrick Dixon's latest book on AI is published in September 2024 by Profile Books.  It contains 38 chapters on the impact of AI across different industries, government and our wider world, including future impact of AI on health care, AI in Pharma innovation, AI in genetics and biotech.

Ageing immortalists will grow rapidly in number

Expect Ageing Immortalists to grow in number: wealthy people obsessed with living forever. These are people who dream of being able to improve their own life expectancy by more than a year, with every year that passes.

Here is the truth about life expectancy, and why there has been collusion by governments and corporations to underplay the situation.

Every time you add a year to the expected life of an individual, you add over 3% to their pension deficit. So adding 5 years to projections can wipe out the entire reserves of many large corporations, or make government liabilities soar.

Slow down or reverse the ageing process

Scientists have already produced mice that live to the human equivalent of 160 years and earthworms that live to the equivalent of 500 years.

The gene activated in long-living worms is the same one often found in people who live until at least 100. Scientists at Harvard Medical School reversed the ageing process in mice by increasing levels of NAD protein. This protein restores communication between DNA in the nucleus of a cell and the DNA in the mitochondria.

As a result, the body tissue of a 6-year-old mouse was converted back to the age of a 2-year-old. It would be the equivalent of some of the tissues in a 60-year-old man or woman becoming as young as those in a 20-year-old.

Some animals do not age at all while others regenerate perfectly

We have identified types of rockfish and some whales that show no signs of normal ageing. Rougheye rockfish live to 200, while other rockfish live only to the age of 20, even though they are identical in every other way. Naked mole-rats can live in captivity for over 28 years, 9 times longer than similar-sized mice.

They show little sign of ageing and never develop cancer. The same for whales, where individual life expectancy can vary from 20 to over 200 years in the case of bowheads, depending on their genes. Aldabra giant tortoises live for up to 255 years, and ocean quahog clams can live for over 400 years.

We are also learning from animals that regenerate, such as lobsters, naked mole-rats and planarian worms, and learning from animals that regrow entire limbs, such as lizards.

And AI / Artificial Intelligence is giving us new ways to learn even faster about what makes us get old.

Nine mechanisms of ageing in almost every organism

Almost every group of cells, in every organism, in every corner of our planet, is ageing in similar ways. Insects, worms, frogs, fish, mice, tigers, elephants, monkeys and humans – it makes very little difference. You will find a mix of:

1. Telomere shortening – preventing cell division 

2. DNA damage - including cancer generation

3. Gene expression errors - epigenetics

4. Proteins become less functional or accumulate

5. Cells don’t die when they should – senescent cells

6. Energy production falls in mitochondria

7. Innefficient cell communication – insensitive to cytokines / hormones

8. Unbalanced metabolism / sensing nutrients

9. Stem cell exhaustion – less regeneration / renewal

Each of these nine mechanisms will become a target, in the search by scientists assisted by AI to discover the route to ‘negligible senescence’.

Touch one mechanism of ageing and you may impact 37 trillion cells in your body

Touch one mechanism, such as mitochondrial mutations, and you may improve the function of 37 trillion cells in a single human being.

Alteon 711 is an interesting compound that produced a permanent reduction in blood pressure levels in old mice and rats, as well as restoring elasticity of the skin.

Sadly, clinical trials found only a small effect on arteries and no effect on human skin, but we can expect many more such trials, targeting a fundamental part of the ageing process. Consider if Alteon 711 had worked in humans: demand for a drug that permanently cures high blood pressure and produces a face or body lift.

Gene mapping is showing us precisely which genes are the ones to slow down ageing, in the list of long-lived animals above. And AI / Artificial Intelligence is playing a vital role in understanding what these genes do, how they affect your future.

Genes tell cells to build proteins of a particular shape. So once we have found the right genes, pharma companies will make proteins as therapy, while biotech companies will try to activate the same genes instead.

Blood or plasma from younger people

We are going to see many more centres offering blood or plasma as an anti-aging therapy, following research showing reverse in mental decline in mice transfused with blood proteins from younger mice.

The next stage will be to identify what the proteins are and manufacture them as a specific treatment.  The rejuvenation of old mice, with blood supplies joined to young mice, has been well known since the 1950s (parabiosis).

And we have also seen how brain cells in older human beings can be rejuvenated by transfusions from a much younger person.

So what molecules in human blood are making this difference, and how rapidly can we make and test them in clinical anti-aging trials.

AI / Artificial intelligence will help pharma scientists to answer these questions.

Using stem cells to grow new organs

Another way to keep people young is to repair old organs by injecting them with fresh stem cells. Bone marrow is the favourite source of stem cells, as techniques for bone marrow extraction are so well developed, for treatment of leukaemia.

Such treatments have already begun and will be routine for many conditions by 2025 in developed nations.

As I predicted in The Genetic Revolution (1995), despite many claims, there is no justification any longer for taking stem cells from embryos or foetuses.

We can get adult cells to revert to more primitive types, to repair just about any tissue we want. The source of such cells can be many tissues, including skin (to grow new retina) or blood (to repair brain or heart). When we use a person’s own cells, we don’t see rejection by their immune system, unless they already have an autoimmune disease.

Stem cells may form new functioning tissue in organs like the heart, but more likely is that they release cytokines which stimulate repair by other cells.

So we will also see research into the production of cytokines to be injected into damaged organs.  We can also expect to see new types of drugs which encourage large scale migration of stem cells from locations such as bone marrow, to repair damaged tissues.  

Expect other therapies which stimulate different types of brain cells to convert into new, fully functioning neurons to reverse local damage by stroke, Alzheimers and a host of other conditions.

Repair of brain or spinal cord

Cells from the olfactory bulb, high up inside the nose, will be used to repair the brain and spinal cord. The bulb is the organ that we use to smell, and is packed with brain stem cells. We have already seen successful repair of broken spinal cords in animals, and partial spine repairs in humans, with people regaining some sensation and movement.  

All nerves naturally regrow at around 2mm a day, but in the brain or spinal cord this growth is stopped by scarring and debris.

It is very likely that at some point in the next three decades someone with a newly cut spinal cord may recover complete sensation and movement - so long as treated early enough, and spinal cord either side of the wound is undamaged. We are already seeing some early success.

Head transplants – to get a new body

Such a breakthrough in spinal cord repair will open up the longer term possibility of head transplants, to enable someone to survive who would otherwise die very soon, using the body of someone who has died from severe brain injuries.

Short term head transplants have already been successfully carried out in rats, dogs and monkeys – and also carried out in China using a human corpse, as a technical test.

The procedure was well developed over two decades ago. Under anaesthetic, the ‘old’ head is cut off, and the new one stitched on, with careful connections of major arteries and veins as well as the windpipe and gullet.

During the process, the transplanted head needs to be cooled to protect the brain from damage during the short interruption in blood supply. In these animal studies, there was no attempt to reconnect the spinal cord or other nerves, nor was there any attempt to prevent the transplanted head from being rejected by the immune system, so the transplanted heads rapidly deteriorated after a few days.

However, the experiments continued for long enough for animals to wake up, and in one case a laboratory worker was bitten by a monkey after the operation was completed, which the researchers took as added proof that the mental processes of these reconstructed animals were intact.

Head transplants in animals or humans may seem grotesque, weird and unethical, but if someone is already completely paralysed from the neck down, and dying from something like combined total liver and heart failure, there is no practical reason why their head could not be transplanted today onto the healthy body of someone who is totally brain dead. It is just an extension of organ transplant technology.

And of course, once spinal repair techniques are perfected (and they will be), head transplants could allow an older person to jettison a worn out body and enjoy becoming a young adult again (from the neck down).

The astonishing truth about future life expectancy

Leaving aside such an exotic and controversial possibility, and only taking into account medical advances in the general ageing process that we considered earlier, we can see how human ageing could look rather different in the longer term.

More than 320,000 people are 100 years old or more, around the world. By 2050, that figure could be more than a million in Japan alone, with a further 4 million in America and 280,000 in the UK. But these modest figures assume very little innovation in health care.

Let me take you through a discussion I have had with hundreds of actuaries, whose job it is to predict life expectancy ‒ for banks, insurers, pension funds and government.

My grandmother is a guide to your future

Let us start with my own grandmother. She was born in 1905, retired officially in 1970 at 65, but continued to enjoy working part-time as a physician until she was 82, playing bridge most afternoons and also playing golf twice a week. She died a decade later.

Even if we were to say that each generation can only expect an additional 5 years of life, that would mean the same grandmother today would retire at 75, then work part-time as a physician until her 92nd birthday, with over a decade of full retirement ahead, before she died at the grand age of 102. Indeed, one of my cousins has just died at the age of 103, with all her mental faculties intact.

The real future of a 40-year-old today

Now let us look at a more recent generation. Let us suppose that a woman called Jane is 40 years old and is now reading this book. If she was from Western Europe, Japan or North America, government figures would give her an average life expectancy forecast of 82, or 42 more years.

However, the fact that she is reading this book gives her an extra 5, because it means she is in an upper socio-economic group: well-educated, middle class. So on average she would still be alive at the age of 87.

But as we have seen, to keep pace with endless small corrections made over the last 20 years, we need to add 2.5 years in every decade. So on that basis alone, without even considering any major advances, it is perfectly logical to add a further decade over the next 45 years. That would give an average life of 97 years for our example.

However, if you look at the rapidly growing pace of medical research and innovation in medical technology, it is reasonable to assume that knowledge and capability in health care will continue to double every 24 months.

That means we will know 10 times as much as today in a decade, 100 times as much by the end of the following decade, 1000 times as much by the end of the third decade and so on. Therefore, we are bound to see several major advances in health care over the next 30 years and these must surely add at least 5 more years to Jane’s life during that period, which takes her to an average life expectancy of 103.

The most spectacular medical advances that Jane will witness between now and the age of 103 will of course be in her final two decades, because of this relentless acceleration of health-related science.

During that 20-year period there will almost certainly be more medical advances than in the whole of human history before that point, many times over.

It is hard to fully comprehend the scale of health advances over the next 63 years. To help us, look back 63 years for a moment, and consider what life was like in the mid 1950s. 

So it is perfectly reasonable to add a further 5 years to Jane’s average life expectancy to allow for what new medical advances are likely to offer her by the mid 2080s. That would mean a ‘true’ life expectancy for Jane of at least 107 years. And because this is only an average, it means some of her generation will still be alive at the age of 120, while a few may see the dawn of the 22nd century.

Social meltdown or a welcome transition?

We can see now why most actuarial experts believe that commonly quoted figures for life expectancy are completely misleading, and a dangerous basis on which to project the future of societies..

This will be one of the world’s greatest social adjustments, and will affect every aspect of every nation, the solvency of every pension fund, and the balance sheet of every large corporation.

It will also affect your own average life expectancy of course, if are in reasonable health now. Most people are out of step with their own biological clocks. And they have underestimated the costs of funding their retirement.

Some forecasters have made dire warnings about social meltdown, with countries crippled by tens of millions of ancient people, who have no money left, but need constant care.

While there is an element of truth in this, it is also true that, as in the example above, most older people will enjoy very extended working lives, biologically much younger than those at the same age a decade or two ago, and will also enjoy extended retirement.

Now having said all the above, in some nations there has been a recent small fall in life expectancy, so what is going on?  

The trouble is that many different factors are in play at the same time, in different parts of the population. T

ake, for example, the effects of anti-smoking campaigns on the one hand and the rise in obesity on the other.  Both are due to lifestyle choices, and the balance can shift a major trend.  But the underlying trend points to long term, step by step improvements in treatments, cure rates and new ways to help people survive longer.

Health messages will start to backfire

When it comes to health messages, we will see a kind of double-think. On the one hand obsession with ageing and with staying healthy forever, and on the other increasing apathy about personal health. 

So, for example, we will find 80-year-olds who decide to enjoy all kinds of risky activities for the first time in their lives – who have no wish whatsoever to live to a very old age in a very frail state, in dire circumstances, and are more than happy to ‘go out with a bang’. Expect more headlines like that of the woman who celebrated her 100th birthday in the UK by going skydiving. More eating, drinking and smoking – ‘Who cares. Life is for living. When life is short, eat dessert now.’

First Life and Second Life

By 2040, childhood, youth and young adulthood will be defined as up to 30 years old, because of delays in settling down to have children, and longer education or training.

First Life will be defined as 30 to 65 years ‒ what people used to consider their normal working lives.

Second Life will be defined as 65 to 100 years – an identical length of adulthood. A period of many surprises, new skills, new jobs, new purposes and patterns of life. Old age will be those over 100.

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