Who Wants To Live Forever?

Who wants to live forever? I don’t. I’m interested in a healthy last 15-20 years rather than being enfeebled or suffering from dementia-related conditions. However, on my last day, I might want to withdraw the statement, but that will depend on my circumstances. Rationally, I don’t want to live forever, but I want to enjoy my years as a fully functioning human as far as possible.

If You’re Under Forty, Scroll On

Younger people are already scrolling onward; who wants to consider mortality? But if you’re forty or over, spend five minutes and read this. We are fortunate that advanced healthcare and relatively high living standards lead to longer lifespans. Look at the graph below: you are going to live longer. In the next 40 years, there will be another 8.6 million people over 65 in the UK, and people over 85 will number over 5 million, or 7% of the population. And guess who will have a disproportionate amount of disposable wealth? Yes, you.

We all want to enjoy these extra years as healthy, vibrant beings. Building that foundation starts now.

How Can I Help Myself?

The Japanese island of Okinawa is one of five ‘blue zones’ in the world, where an unusually high number of centenarians live. This New York Times bestseller by Dr Bradley Willcox explains why it’s believed this phenomenon occurs on the island.

• A highly plant-focused diet is a key element of the Okinawa lifestyle, as is the habit of hara hachi bu – eating until you are 80% full. Alcohol consumption is moderate, and smoking is also lower.
• Having an ikigai is essential; it’s something I have written about and also had tattooed on my left calf muscle. Have a reason to get out of bed each day; your reason, not society’s reason.
• Staying engaged mentally is crucial. Abandoning lifelong habits can quickly lead to decline. When someone says to me, ‘Why don’t you retire and play golf?’ my answer tends to be ‘If you ever see me with a golf club, break it over my head.’ In Okinawa, no word for retirement exists. Damned right; I already plan what to do after my current job.
• Join a social programme. This has been measured in many dimensions across the world. Single men die sooner than married men. Lonely people with a limited social life are prone to a lower life expectancy due to disease. Be around people and engage.
• Stress less and refine your relationship with time. Okinawans tend to start in a relaxed fashion but always finish the task. As importantly, their mindset makes them markedly stress-resistant. These characteristics are in a small way genetic but primarily related to tragedy and pain dealt with in their generation.
• Meditation and spirituality is the final element. Not necessarily organised religion, but sometimes practices such as meditation, being in nature, or seeking spiritual energy.

Am I An Okinawan?

I stack up better than I thought, to my surprise. True, some of the positive characteristics have emerged only in recent years. But better to have emerged late than never.

I haven’t drunk for five years and have never smoked. I won’t pretend to be a vegan, and I definitely cannot eat to 80% full when that 20% of emptiness is becoming me onto the rocks of gluttony. Yet my diet is healthy in terms of no processed foods and making sensible choices. Except for ice cream, but what the hell? I will give myself 8 out of 10 on the Okinawa scale, leaving myself that 20% of headspace to grow into.

Ikigai is a straight ten (cut Strictly Come Dancing scorecards waved aloft.) My ikigai is modifying now I’m in the fourth quarter, but there has always been one. Looking at myself in the mirror, I can be assured without an ikigai, and I most certainly wouldn’t have made it this far. Who wants to live forever? Not me, but for the years I live, I must have my ikigai.

Mentally engaged is a high score. I’m always curious. If I’m not being curious, I quickly become restless at a cellular level.

Being social arrived with me late in life. I married Mish ten years ago and that ushered in a new and very positive life for me. I met a cycling community, which has been a blessing. Both of these, together with my recovery from depression, has made me social in other dimensions of my life. I will speak to people in the street instead of hurrying past, head down, as I used to.

Spirituality has occupied a larger space of my being in recent years. Not in an ‘I’m getting old, I had better take out a God and Son spiritual insurance policy’ way. I don’t believe there is an afterlife. I don’t believe there is a God. God is simply an imaginary friend to help humans deal with our anxieties about mortality.

About That Mental Engagement

I’m constantly engaged and curious, whether in work or existing activities, but also seeking new learning in esoteric areas. It gives me vigour and makes me feel like I’m on a journey that never ends.

Coffee is a small example. During the COVID lockdown, I wanted to learn how to make ‘proper’ coffee, and before long, I had explored various methods and coffee beans from around the world. I now have a high-end coffee setup and can make an espresso to match anyone’s.

I wanted some decent kitchen knives, so I bought some. Then they weren’t sharp enough, so I researched knife sharpening, and now all my knives can cut through a sheet of paper. I wanted to make sushi, and Mish bought me a specialist Takeshi Saji knife called a Takohiki for my birthday, to do the job correctly.

A friend suggested that I have obsessive-compulsive disorder. I beg to differ. If I find something interesting, I will explore it until I am the best I can be. People can work a lifetime in the two areas above – coffee growing and making and knife manufacture. Their life isn’t trivial. What they do is art. So I must do that justice and learn as much as possible. I don’t want to live forever, but I want to remain curious until it’s time to punch the clock.

What About Exercise?

The Okinawa list doesn’t mention exercise. Yet it’s well known that exercise significantly contributes to mental and physical wellbeing, and longevity. Indeed, my good physical condition for my age was a significant factor in my promising recovery from my serious cycling exercise.

I could run wild with references to underpin the argument on the power of exercise, but I will limit the list. Harvard Medical School cite that even small amounts of exercise improve longevity. PubMed concisely summarises the benefits of exercise for older adults, including cardiovascular health, fracture risk, and functional ability.

Exercise has been a powerful tool for improving my mental health. See here a link to resources on exercise and mental health, including risk reduction for anxiety, depression, dementia, and cognitive decline.

Exercise is a non-negotiable part of my life. Recent events have shown some of the benefits of that. Not only my recovery from a serious accident but my vast improvement in mental health over the last two years and the positive results from my annual medical check last month.

I’ll reference Peter Attia at the end of this blog, but he states that the most potent anti-ageing drug is exercise and outlines his Centenarian Decathlon in his new book. The body of robust scientific proof of the anti-ageing properties of exercise grows monthly.

Imagine an Okinawan marathon-running family. What number would they put on the longevity scoreboard?

Leading Edge Or Bleeding Edge?

In keeping with my curious nature, I’ve closely examined Rapamycin, the immunomodulator and anti-inflammatory drug. It has delivered anti-ageing properties in mice. I’m not a mouse which raises the ‘So what?’ question. A solid and growing body of evidence shows potentially positive benefits in humans, with little risk – i.e., at the aspirin level of risk – when used at low dosages.

There is an extended paper on the pros and cons of Rapamycin here. For my taste, it is a little on the bold side. But the data on the low-risk levels is aligned with the broader body of published papers on the subject. A more approachable New York Times article is accessible here.

What’s the snag with Rapamycin? I guess you don’t know it doesn’t work until too late. When a life-shortening disease strikes, it’s too late to say, “Doh, the Rapamycin was a waste of time.”

On balance, it’s worth an experiment. Limited and controllable side effects while on a low-dose, periodised regime balanced against some potentially life-changing upsides seem a fair bet. Once again, my stance is firmly ‘Who wants to live forever?’ to see if there are potential quality of life benefits.

As with coffee machines and sharp knives, some experimentation with Rapamycin is in keeping with my nature. I thought this was an incisive summary by Dr Matt Kaeberlein –

“I would argue we should be willing to tolerate some level of risk if the payoff is 20 to 30 percent increase in healthy longevity,” he said. “If we don’t do anything, we know what the outcome is going to be. You’re going to get sick, and you’re going to die.”

_{Dogs Test Drug Aimed at Humans’ Biggest Killer: Age. Amy Harmon, New York Times, 16 May, 2016.}

I started taking Rapamycin for a month before my recent accident. Side effects were minor to the point of possibly being coincidental. Having spent 12 days in the hospital and then home recovery with a rich cocktail of opioids and NSAIDs in me, I thought it best to back off temporarily. But I’m up for continuing.

Who Wants To Live Forever?

I conclude where I opened, addressing the question, ‘Who wants to live forever?” Not me. I want to live another fifteen or twenty years of high-quality life. Infirmity is not a state I aspire to. Dementia or other severe diseases of cognition are not for me. And I definitely will not take up golf. I want to be physically active, and I want to keep developing my ikigai. I want to follow the habits of the people of Okinawa. That sounds like a decent plan. It sounds like a lot of fun too.

It should apply to you too. Don’t wait. Build the physical and mental foundations now. Be fit, healthy, social, and curious. If you want to learn more, I can recommend the new book by Peter Attia, which draws together a lot of current thinking and data in the longevity sphere. If you don’t have time for a book, here’s a concise review of the book.

My closing thoughts. Don’t delay. Exercise is key. As is a positive mental outlook.