Today’s review involves another influential book by a prominent figure in the anti-aging field. This one is considerably more problematic than my review of David Sinclair’s book Lifespan. While Dr. Sinclair is somewhat controversial for his salesmanship and for claims and practices that aren’t always consistent with accepted scientific methods or evidence, he is still widely respected as a scientist and advocate for longevity research. Though I occasionally found myself gritting my teeth or rolling my eyes while reading Lifespan, I admired the quality of the writing and still found it an enjoyable and informative book. I found it much more difficult to read Ending Aging: The rejuvenation breakthroughs that could reverse human aging in our lifetime by Aubrey de Grey.
I must admit, some of the difficulty was personal. Dr. de Grey has a demonstrated history of sexually harassing women, and he appears entirely unrepentant for his inexcusable behavior. As a feminist and a man of about the same age as Dr. De Grey, I am both encouraged to see the fruits of the #MeToo movement in the growing intolerance for such behavior and infuriated that so many men still act this way. Such excuses as De Grey offers were unconvincing forty years ago, and they are absurd and delusional now.
I admit to some ambivalence about posting a review that draws attention to a such an individual. However, the aging field is a complex mix of sound science and pseudoscience, rational optimism and pure delusion, and, like most fields of human endeavor, admirable and unpleasant individuals. Part of the process of separating wheat from chaff is to look closely and critically at the most prominent ideas and arguments and, when necessary, at relevant characteristics of the individuals who promote them.
A major hurdle geroscience faces is the reputation of the field, which is inevitably dominated by the most visible figures rather than the most productive or wise. Dr. de Grey is unquestionably a highly visible figure promoting longevity, and I suspect ignoring him and his work is ultimately more enabling than looking at it directly and critically like that of other, less problematic individuals in the field.**
Apart from these considerations, most of the difficulty in reading Ending Aging, however, was purely due to the content and style. Where Sinclair is exuberantly optimistic and his tone is redolent of salesmanship, De Grey’s writing style is very much centered on himself and convincing the reader of the obvious truth of his insights. He also sees the battle against aging very much in martial terms, a war that would be easy to win were it not for the wrongheadedness of most everyone but him.
Most of us are in what he calls the “pro-aging trance,” mistakenly accepting aging as a natural feature of life to be approached with graceful acceptance rather than as a horrid disease to be cured. He characterizes this view as an understandable but inherently irrational psychological coping mechanism that we should be able to easily leave behind once we see, as he does, that aging is easily defeated.
This is a dominant theme running through the book. De Grey blames much of the lack of progress in retarding aging not on the inherent difficulty of the scientific task but on a lack of clear understanding of the problem and its importance. He frequently walks the reader through his thought processes in developing, and in his own mind confirming, theories that neatly wrap up all the complexities and loose ends about aging biology that other scientists struggle with.
Ending Aging shares a characteristic of many books written about alternative medicine in that it explains purported insights that the author has which promise to upend all previous thinking about a subject yet which somehow no one else has come across before. There is a dismissiveness towards objections or other points of view that obviates dealing with the substance and merits of those objections.
The central idea De Grey is proposing is that ending aging requires only a commitment, financial and intellectual, to his “engineering” approach. Instead of investigating the complexities of aging biology in order to prevent aging at its roots, or treating the negative impact of aging as it manifests clinically, he proposes interrupting the link between the core metabolic processes and the damage they cause. He suggests that the damage which aging creates, and which manifests as age-related disease, is due to a limited set of processes. Fixing each of these should be, in his view, relatively easy, so a few interventions should take care of pretty much all the harm caused by aging, leading to significant life extension.
After a clear discussion of the evolutionary roots of aging and an explication of De Grey’s core thesis and how it came to him, Ending Aging runs through each of the types of damage he believes form the majority of the effects of aging on health and discusses ideas for how these can be mitigated.
Many of these are subjects of intensive study in geroscience, including protein cross-linking, accumulation of senescent cells, mitochondrial dysfunction, loss of stem cells, and others. Most of the solutions he sees as forthcoming involve the use of processes or techniques already being developed, for these applications or for other purposes. He is unfailingly confident that each of these tools will be safe and effective and ready soon enough to make a huge impact on the health of most people alive today.
This confidence is a critical component of his approach to aging, which again is to characterize it as a war in which we must make intensive investments in a short time in order to definitively win. This war metaphor, and the promise of a clear victory, is used to support his call for funding, for alteration of the ethical and regulatory systems that he believes impede aging research, and for a change in the mindset of scientists, policymakers, and the public. It is also a major flaw of the book.
While many of us studying aging hope to bring about change in how the problem and routes to solutions are viewed, de Grey goes well beyond what most others in the field would advocate. For example, he calls for a “root-and-branch revision of laws and regulations governing clinical trials and approval of drugs.” He even goes so far as to suggest that because the effort to defeat aging is a war, we should view harm done to individuals in pursuit of this goal as an acceptable sacrifice. De Grey argues that the protections currently in place to minimize harm and even death during drug development go too far; losing more lives in faster, less careful drug development is ultimately worth it to save lives in the long run by defeating aging:
“People will die as a result…And people will be happy about this change, because they’ll know that it’s wartime, and the first priority—even justifying considerable loss of life in the short term—is to end the slaughter as soon as humanly possible.”
He employs the same logic in his “defense” of his sexual harassment of women, with the bizarre claim that it would be perfectly appropriate to suggest female associates sleep with potential doners to further the cause of fighting aging:
“It is at the same level of women in World War II sleeping with Nazis to get information. It is a war against aging here. You have to persuade people to give money. That is honestly who I am. I am the general.”
Many of the ideas and aging mechanisms discussed in Ending Aging are well-established and central to mainstream thinking in the field. The concept of an “engineering” approach to combating the effects of aging has some appeal, and it is worth continued exploration. Overall, however, the book represents a viewpoint inconsistent with the values and perspectives of many geroscientists and others working on the problem of aging.
The martial metaphors, the unqualified confidence and predictions of radical short-term progress, the reduction of hard scientific challenges to simple problems of faulty thinking, and the extremist views of how we should test longevity-promoting therapies seem to me unhelpful and counterproductive. This is the book of a zealot, and as such it isn’t a good representation of or introduction to the field of aging and longevity science.
**In the interest of transparency, I will also say that I work at a company headed by someone who has exposed de Grey’s harassment of her and other women. However, we have never discussed these events, and I have no information about it other than what is publicly available.