Yes, you can reformat it in that form if you prefer.
This is a gestalt impression based off my best impressions of the pace of ongoing research (significantly ramped up compared to where investment was 20 years ago), human neurology, synthetic organs and finally non-biological alternatives like cybernetic enhancement. I will emphasize that LEV != actual biological immortality, but it leads to at least a cure for aging if nothing else.
Aging, while complicated and likely multifactorial, doesn’t seem intractable to analysis or mitigation. We have independent research projects tackling individual aspects, but as I’ve stated, most of them are in stealth mode even if they’re well-funded, and solving any individual mechanism is insufficient because of how aging itself is an exponential process.
To help, I’m going to tackle the top causes of aging in the West-
Heart disease- This is highly amenable to outright replacement of the organ, be it with a cybernetic replacement or one grown in-vitro. Obesity, which contributes heavily to cardiovascular disease and morbidity, is already being tackled by the discovery of GLP-1 antagonists like semaglutide, and I fully expect that the obesity epidemic that is dragging down life expectancy in the West will be over well before then.
Cancer- Another reason for optimism, CAR-T therapy is incredibly promising, as are other targeted therapies. So are vaccines for diseases like HPV that themselves cause cancer (said vaccine already exists, I’m talking more generally).
Unintentional injuries- The world has grown grossly safer, and only will continue to do so, especially as things get more automated.
Respiratory diseases- Once again, reason for optimism that biological replacements will be cheap enough that we won’t have to rely on limited numbers of donors for transplants.
Stroke and cerebrovascular disease- I’ll discuss the brain separately, but while this is a harder subject to tackle, mitigating obesity helps immensely.
Alzheimers- Same disclaimer as above
Diabetes- Our insulin pumps and formulations only get better and cheaper, and many of the drawbacks of artificial insulin supplementation will vanish (our pancreas is currently better at quickly and responsively adjusting blood sugar levels by releasing insulin than we are). Once again, a target for outright replacement of the organ.
These are ranked in descending order.
The brain remains incredibly difficult to regenerate, so if we run into something intractable to the hypothetical capabilities 20 years hence, this will likely be the biggest hurdle. Even then, I’m cautiously optimistic we’ll figure something out, or reduce the incidence of dementia.
Beyond organic replacement, I’m bullish on gene therapy, most hereditary disease will be eliminated, and eventually somatic gene therapy will be able to work on the scale of the entire body, and I would be highly surprised if this wasn’t possible in 20 years.
I expect regenerative medicine to be widely available, beyond our current limited attempts at arresting the progression of illness or settling for replacements from human donors. There’s a grab bag of individual therapies like thymic replacement that I won’t get into.
As for the costs associated with this, I claim no particular expertise, but in general, most such treatments are amenable to economies of scale, and I don’t expect them to remain out of reach for long. Organ replacement will likely get a lot cheaper once they’re being vat grown, and I put a decent amount of probability that ~universally acceptable organs can be created by careful management of the expression of HLA antigens such that they’re unlikely to be rejected outright. Worst case, patient tissue such as pluripotent stem cells will be used to fill out inert scaffolding like we do today.
As a doctor, I can clearly see the premium people put on any additional extension of their lives when mortality is staring them in the face, and while price will likely be prohibitive for getting everyone on the globe to avail of such options, I expect even middle class Westerners with insurance to be able to keep up.
Like I said, this is a gestalt impression of a very broad field, and 70% isn’t an immense declaration of confidence. Besides, it’s mostly moot in the first place, we’re very likely certainly getting AGI of some form by 2043.
To further put numbers on it, I think that in a world where AI is arrested at a level not significantly higher than GPT-4, I, being under the age of 30, have a ~80% chance of making it to LEV in my lifespan, with an approximately 5% drop for every additional decade older you are at the present.
I, being under the age of 30, have a ~80% chance of making it to LEV in my lifespan, with an approximately 5% drop for every additional decade older you are at the present.
You, being a relatively wealthy person in a modernized country? Do you think you’ll be able to afford the LEV by that time, or only that some of the wealthiest people will?
I’m a doctor in India right now, and will likely be a doctor in the UK by then, assuming I’m not economically obsolete. And yes, I expect that if we do have therapies that help provide LEV, they will be affordable in my specific circumstances as well as most LW readers, if not globally. UK doctors are far poorer compared to the their US kin.
Most biological therapies are relatively amenable to economies of scale, and while there are others that might be too bespoke to manage the same, that won’t last indefinitely. I can’t imagine anything with as much demand as a therapy that is proven to delay aging nigh indefinitely, for an illustrative example look at what Ozempic and Co are achieving already, every pharma industry leader and their dog wants to get in on the action, and the prices will keep dropping for a good while.
It might even make economic sense for countries to subsidize the treatment (IIRC, it wouldn’t take much more for GLP-1 drugs to reach the point where they’re a net savings for insurers or governments in terms of reducing obesity related health expenditures). After all, aging is why we end up succumbing to so many diseases in our senescence, not the reverse.
Specifically, gene therapy will likely be the best bet for scaling, if a simple drug doesn’t come about (seems unlikely to me, I doubt there’s such low hanging fruit, even if the net result of LEV might rely on multiple different treatments in parallel with none achieving it by themself).
Yes, you can reformat it in that form if you prefer.
This is a gestalt impression based off my best impressions of the pace of ongoing research (significantly ramped up compared to where investment was 20 years ago), human neurology, synthetic organs and finally non-biological alternatives like cybernetic enhancement. I will emphasize that LEV != actual biological immortality, but it leads to at least a cure for aging if nothing else.
Aging, while complicated and likely multifactorial, doesn’t seem intractable to analysis or mitigation. We have independent research projects tackling individual aspects, but as I’ve stated, most of them are in stealth mode even if they’re well-funded, and solving any individual mechanism is insufficient because of how aging itself is an exponential process.
To help, I’m going to tackle the top causes of aging in the West-
Heart disease- This is highly amenable to outright replacement of the organ, be it with a cybernetic replacement or one grown in-vitro. Obesity, which contributes heavily to cardiovascular disease and morbidity, is already being tackled by the discovery of GLP-1 antagonists like semaglutide, and I fully expect that the obesity epidemic that is dragging down life expectancy in the West will be over well before then.
Cancer- Another reason for optimism, CAR-T therapy is incredibly promising, as are other targeted therapies. So are vaccines for diseases like HPV that themselves cause cancer (said vaccine already exists, I’m talking more generally).
Unintentional injuries- The world has grown grossly safer, and only will continue to do so, especially as things get more automated.
Respiratory diseases- Once again, reason for optimism that biological replacements will be cheap enough that we won’t have to rely on limited numbers of donors for transplants.
Stroke and cerebrovascular disease- I’ll discuss the brain separately, but while this is a harder subject to tackle, mitigating obesity helps immensely.
Alzheimers- Same disclaimer as above
Diabetes- Our insulin pumps and formulations only get better and cheaper, and many of the drawbacks of artificial insulin supplementation will vanish (our pancreas is currently better at quickly and responsively adjusting blood sugar levels by releasing insulin than we are). Once again, a target for outright replacement of the organ.
These are ranked in descending order.
The brain remains incredibly difficult to regenerate, so if we run into something intractable to the hypothetical capabilities 20 years hence, this will likely be the biggest hurdle. Even then, I’m cautiously optimistic we’ll figure something out, or reduce the incidence of dementia.
Beyond organic replacement, I’m bullish on gene therapy, most hereditary disease will be eliminated, and eventually somatic gene therapy will be able to work on the scale of the entire body, and I would be highly surprised if this wasn’t possible in 20 years.
I expect regenerative medicine to be widely available, beyond our current limited attempts at arresting the progression of illness or settling for replacements from human donors. There’s a grab bag of individual therapies like thymic replacement that I won’t get into.
As for the costs associated with this, I claim no particular expertise, but in general, most such treatments are amenable to economies of scale, and I don’t expect them to remain out of reach for long. Organ replacement will likely get a lot cheaper once they’re being vat grown, and I put a decent amount of probability that ~universally acceptable organs can be created by careful management of the expression of HLA antigens such that they’re unlikely to be rejected outright. Worst case, patient tissue such as pluripotent stem cells will be used to fill out inert scaffolding like we do today.
As a doctor, I can clearly see the premium people put on any additional extension of their lives when mortality is staring them in the face, and while price will likely be prohibitive for getting everyone on the globe to avail of such options, I expect even middle class Westerners with insurance to be able to keep up.
Like I said, this is a gestalt impression of a very broad field, and 70% isn’t an immense declaration of confidence. Besides, it’s mostly moot in the first place, we’re very likely certainly getting AGI of some form by 2043.
To further put numbers on it, I think that in a world where AI is arrested at a level not significantly higher than GPT-4, I, being under the age of 30, have a ~80% chance of making it to LEV in my lifespan, with an approximately 5% drop for every additional decade older you are at the present.
You, being a relatively wealthy person in a modernized country? Do you think you’ll be able to afford the LEV by that time, or only that some of the wealthiest people will?
I’m a doctor in India right now, and will likely be a doctor in the UK by then, assuming I’m not economically obsolete. And yes, I expect that if we do have therapies that help provide LEV, they will be affordable in my specific circumstances as well as most LW readers, if not globally. UK doctors are far poorer compared to the their US kin.
Most biological therapies are relatively amenable to economies of scale, and while there are others that might be too bespoke to manage the same, that won’t last indefinitely. I can’t imagine anything with as much demand as a therapy that is proven to delay aging nigh indefinitely, for an illustrative example look at what Ozempic and Co are achieving already, every pharma industry leader and their dog wants to get in on the action, and the prices will keep dropping for a good while.
It might even make economic sense for countries to subsidize the treatment (IIRC, it wouldn’t take much more for GLP-1 drugs to reach the point where they’re a net savings for insurers or governments in terms of reducing obesity related health expenditures). After all, aging is why we end up succumbing to so many diseases in our senescence, not the reverse.
Specifically, gene therapy will likely be the best bet for scaling, if a simple drug doesn’t come about (seems unlikely to me, I doubt there’s such low hanging fruit, even if the net result of LEV might rely on multiple different treatments in parallel with none achieving it by themself).