Life, the Universe, and Everything

Book review: Deep Utopia: Life and Meaning in a Solved World, by Nick Bostrom.

Bostrom’s previous book, Superintelligence, triggered expressions of concern. In his latest work, he describes his hopes for the distant future, presumably to limit the risk that fear of AI will lead to a The Butlerian Jihad-like scenario.

While Bostrom is relatively cautious about endorsing specific features of a utopia, he clearly expresses his dissatisfaction with the current state of the world. For instance, in a footnoted rant about preserving nature, he writes:

Imagine that some technologically advanced civilization arrived on Earth … Imagine they said: “The most important thing is to preserve the ecosystem in its natural splendor. In particular, the predator populations must be preserved: the psychopath killers, the fascist goons, the despotic death squads … What a tragedy if this rich natural diversity were replaced with a monoculture of healthy, happy, well-fed people living in peace and harmony.” … this would be appallingly callous.

The book begins as if addressing a broad audience, then drifts into philosophy that seems obscure, leading me to wonder if it’s intended as a parody of aimless academic philosophy.

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Book review: Outlive: The Science and Art of Longevity, by Peter Attia.

This year’s book on aging focuses mostly on healthspan rather than lifespan, in an effort to combat the tendency of people in the developed world to have a wasted decade around age 80.

Attia calls his approach Medicine 3.0. He wants people to pay a lot more attention to their lifestyle starting a couple of decades before problems such as diabetes and Alzheimer’s create obvious impacts.

He complains about Medicine 2.0 (i.e. mainstream medicine) treating disease as a binary phenomenon. There’s lots of evidence suggesting that age-related diseases develop slowly over periods of more than a decade.

He’s not aiming to cure aging. He aims to enjoy life until age 100 or 120.

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BioVie Inc recently reported some unusual results from a clinical trial for Alzheimer’s.

They report some mildly encouraging cognitive improvements, but it’s only 3 months into the trial and there’s no placebo group, so it’s easy to imagine they’re just seeing a placebo effect (Annovis’ results show a clear placebo effect, presumably influencing the measurement rather than the actual health).

What interested me is this:

Reduces Horvath DNA Methylation SkinBlood Clock by 3.3 years after 3 months of treatment.

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I previously sounded vaguely optimistic about the Baze blood test technology. They shut down their blood test service this spring, “for the foreseeable future”. Their web site suggests that they plan to resume it someday. I don’t have much hope that they’ll resume selling it.

Shortly after I posted about Baze, they stopped reporting numbers for magnesium, vitamin D, and vitamin B12. I.e. they only told me results such as “low”, “optimal”, “normal”, etc. This was apparently was due to FDA regulations, although I’m unclear why.

I’d like to believe that Baze is working on getting permission to report results the way that companies such as Life Extension report a wide variety of tests that are conducted via LabCorp.

At roughly the same time, Thorne Research announced study results of a device that sounds very similar to the Baze device (maybe a bit more reliable?).

Thorne is partly a supplement company, but also already has enough of a focus on testing that I don’t expect it to use tests primarily for selling vitamins, the way Baze did.

I’m debating whether to invest in Thorne.

Book review: What We Owe the Future, by William MacAskill.

WWOTF is a mostly good book that can’t quite decide whether it’s part of an activist movement, or aimed at a small niche of philosophy.

MacAskill wants to move us closer to utilitarianism, particularly in the sense of evaluating the effects of our actions on people who live in the distant future. Future people are real, and we have some sort of obligation to them.

WWOTF describes humanity’s current behavior as reckless, like an imprudent teenager. MacAskill almost killed himself as a teen, by taking a poorly thought out risk. Humanity is taking similar thoughtless risks.

MacAskill carefully avoids endorsing the aspect of utilitarianism that says everyone must be valued equally. That saves him from a number of conclusions that make utilitarianism unpopular. E.g. it allows him to be uncertain about how much to care about animal welfare. It allows him to ignore the difficult arguments about the morally correct discount rate.

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The US, and to a lesser extent much of the developed world, has concentrated interest groups (e.g. big pharma), which have incentives to increase medical spending. The main check on pro-expense interest groups used to be patients’ desire to spend less of their money. We’ve carefully eliminated that incentive for most patients. That leaves us with a situation in which spending increases to absorb much of the increase in disposable income.

I originally started writing this post in reaction to Aduhelm’s conspicuously bloated price. But it now seems that the system has enough sanity to avoid major waste there.

I’m also interested in the situation with statins. There’s reasonably good evidence that they saves the lives of a small fraction of people who take statins, but also some reason to doubt that cholesterol best describes what problem they fix (I don’t have a good link for these doubts. Here are some mediocre ones: 1, 2, 3).

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New Dementia Trial Results

There’s a new clinical trial result showing that Bredesen’s approach is able to at least partially cure common forms of Alzheimer-like dementia. (Press release here). It has not received as much attention as it deserves.

The 9 month study seemed a bit less impressive than what I’d hoped for, but the outcomes still support the claim that common forms of dementia are partly curable.

Out of 25 patients, 21 or 19 improved their cognition compared to the start of the trial, depending on which measure I look at, and 2 or 3 declined.

Side effects included occasional improvements in hypertension and diabetes, enough to allow patients to stop taking medications for those conditions.

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