Robert Butler MD died this week of leukemia at the age of 83, full of projects and brimming with new constructs for future research. I was a junior at SUNY Buffalo when I read "Why Survive? Being Old in America.” What I found striking about the book what Butler’s ability to deconstruct aging as a product of disease, not of getting old, which he argued was society’s convenient way of not investing time and money into understanding the biological processes that characterized “getting old.”
Butler’s contribution to science and society has been two-fold. Through his establishment of the National Institute on Aging he developed a focused program of biomedical research and epidemiological studies to establish precisely which diseases had the most impact as we age and provided clinicians and academic scientists tools for preventing the onset of conditions once considered a natural part of getting old. This change in clinical practice, bolstered by the research Butler supported has done more to improve life expectancy and increase well-being in the United States than anything else we have done.
Second, Butler has combined this push for science-based prevention with a sustained search for molecular markers of ‘aging’, or more accurately, of the molecular factors that contribute to cellular breakdown and wear and tear. And recently, genetic analysis has shown that “extreme longevity is associated with a select group of genetic markers.” Yet people who live long lives also have similar levels of a large set of disease-associated genetic risk factors as people do not, including risk factors for Alzheimer's, diabetes, and cardiovascular disease. The question is now what are those factors that make longer life possible and how do they regulate other diseases.
These and other issues are being studied now because Robert Butler made aging his life’s purpose. Irving Kristol observed: You have to know one big thing and stick with it. The leaders who had one very big idea and one very big commitment. This permitted them to create something. Those are the ones who leave a legacy.
Robert Butler leaves many big legacies. Our nation, our world is better and living longer and healthier as a result.
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