Learning from History

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The historical rise of human longevity is the result of a complex set of changes beginning several centuries ago. Prior to the 1930s, most of this decline was due to factors other than medical therapy (57), and is generally attributed to improvements in cFor example, a segment of ABC's 20/20 (broadcast on 16 January 1998) reported that this discovery would lead to the development of anti-aging drugs within 5 to 10 years, and one researcher interviewed on camera predicted healthy life spans of several hundred years. The finding itself was reported in Science magazine (54).

living conditions and public health. With the advent of antibacterial drugs in the 1930s and 1940s, medical treatment began to play an important role in these changes, and this role has expanded in recent decades, thanks to interventions in CVD and cancer, which have contributed to the rapid decline of old-age mortality.

It seems reasonable to expect that future mortality trends in wealthy nations will resemble past changes. Although the focus of our efforts will evolve, the net effect on death rates will probably be similar. For this reason, extrapolation is the preferred means of predicting the future of human mortality. This strategy rides the steady course of past mortality trends, whereas popular and scientific discussions of mortality often buck these historical trends, in either an optimistic or a pessimistic direction. History teaches us to be cautious. Pessimism about the continuation of mortality decline is not new, and earlier arguments about an imminent end to gains in human longevity have often been overturned, sometimes quite soon after they were put forth.c On the other hand, dubious claims about the road to immortality are probably as old as human culture itself, although they have not influenced official mortality forecasts as much as their more pessimistic counterparts.

Although imperfect, the appeal of extrapolation lies in the long-term stability of the historical mortality decline, which can be attributed to the complex character of the underlying process. This combination of stability and complexity should discourage us from believing that singular interventions or barriers will substantially alter the course of mortality decline in the future. In this situation, the burden of proof lies with those who predict sharp deviations from past trends. Such predictions should be based on theoretical results that are firmly established and widely accepted by the scientific community. Certainly, history can be overruled by a genuine consensus within the scientific community but not by unproven theories, intuition, or speculation.

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