Darwinian Anti-Aging Medicine

Two new movements vie for the attention of mainstream medicine: anti-aging medicine and Darwinian medicine. Each is based on the rejection of one of the major assumptions of medical practice and medical research. Anti-aging medicine rejects the basic assumption of conventional medicine that the deterioration accompanying increasing chronologic age is an unchangeable absolute.1 Instead, anti-aging is based firmly on the hope that medical research will discover practical means to intervene in human aging processes, not just individual degenerative diseases, so that the limits of the healthy human life span can be progressively increased. Darwinian medicine rejects the assumption that the scientific foundations of medicine are to be found in the swatch of biologic disciplines ranging from biochemistry to organismal physiology, and no further.2 Proponents of Darwinian medicine argue that numerous concrete benefits can be obtained from reforming, or at least expanding, medicine so that it takes into account the many insights derivable from such fields as population genetics, molecular evolution, quantitative genetics, evolutionary ecology, and the like. These two new perspectives on medicine intersect in a small field that I call "Darwinian anti-aging medicine." Defining this approach to medicine is the concern of the present article. Darwinian anti-aging medicine is based on 1946 and 1952 essays.5'6 The latter of these a rad cal premise, that aging is caused by works,6 "An Unsolved Problem of Biology," an inevitable fall in the force of natural selecachieved some fame, and may be regarded as the tion acting on survival over the course of adultopening salvo of the evolutionary attack on the hood in organisms that properly have adults, problem of aging. Unfortunately, Medawar's arsuch as humans. This original intuition is preguments were often either sketchy or erroneous, sent in works by Fisher3 and Haldane4, but it Hamilton7 and Charlesworth8 supplied the cornachieved its first full articulation in Medawar's plete work-up that Medawar had not: a matheDepartment of Ecology and Evolutionary Biology, University of California, Irvine, CA 92697-2525.