Research Perspective Volume 11, Issue 19 pp 8048—8067

Rapamycin for longevity: opinion article

Figure 3. Effects of standard and anti-aging medicine on health- and life-span. (A) The relationship between health- and life-span. Aging is a sum of all age-related diseases, pre-diseases and pre-pre-diseases. Before overt age-related diseases become apparent, there is a seemingly healthy period of aging (so-called healthy aging). Starting from adulthood, pre-pre-diseases progress towards pre-diseases and then towards overt diseases. Unless treated with modern standard medical practice, the diseased stage is relatively brief. From (A) to (B) Standard medical treatment is usually started when overt diseases are diagnosed. Standard medicine extends life span mostly by preventing death from diseases, thus extending “unhealthy” phase of life, especially terminal stages of diseases, characterized by organ damage, failure and loss of functions. Standard medicine extends lifespan. From (B) to (C) Anti-aging medicine is most effective at the stage of pre-diseases and initial stages of diseases, characterized by increased functions before complications and organ damage occur. In terminal stages of deadly diseases, anti-aging therapy may not be useful. Thus, anti-aging medicine increases both health span and life span. Anti-aging medicine and standard medicine are additive when aging becomes unhealthy. The schema is simplified because, in reality, age-related diseases start at different ages (presbyopia vs sarcopenia), progress at different paces (atherosclerosis vs cancer), and most are not lethal, and some are well treated (cataract). Therefore, healthspan is an abstraction.