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Roula Khalaf, editor-in-chief of the FT, selects her favorite stories in this weekly newsletter.
Want to become immortal? Me neither. Silicon Valley titans who covet “escape speed from death” leave me cold. But most of us would like to stay younger for longer – preferably without Botox. A series of breakthroughs suggests that the science of aging is now at an inflection point.
Already, our perception of old age is changing. The people who filled concert halls in their youth to hear the Beatles sing “Will You Still Need Me?” . . When I’m 64? Old age is now believed to begin at age 74. Middle-aged and older people today have a higher idea of “old” than previous generations, according to a large German study.
This reflects increasing life expectancy, particularly for the wealthier half of the population in rich countries. The big challenge now is to improve the last decade for everyone – rich and poor. Few of us want to live forever, even if it were offered; but we would give much to avoid a dark descent into the twilight zone of crippling fragility.
Since I interviewed scientists for a book on aging, I have been regularly asked for my opinion on substances to take, including those “off-label”. Everyone wants a shortcut to longevity. American men in high-power jobs are particularly eager to experiment with products, including supplements, available in the United States and not in Europe. I take one myself, with no visible results, but then they wouldn’t be visible. Given the amount of snake oil in this market, it’s safer to wait for officially licensed products. But now the big question is: will regulators agree to consider aging as a “treatable” disease?
While conventional medicine treats one disease at a time, scientists have made discoveries since the 1990s that suggest we could target the biology that causes aging itself. They created worms and mice that live longer and stay vibrant longer, by targeting particular genes. Cynthia Kenyon, the biologist who discovered that partially disabling a single gene could double the lifespan of roundworms, described to me the fear she felt watching the engineered worms writhe almost to death , skipping the prolonged dodder stage she observed in their normal worm friends.
A constant stream of discoveries drives the emerging field of geroscience. Many are working to stem the decline in the body’s ability to repair DNA. Some molecular biologists work on NAD (nicotinamide adenine dinucleotide), an enzyme central to metabolism that declines with age. Others, like Australian-American David Sinclair, believe that epigenetic noise is a major cause of aging, confusing signals in the body. Sinclair and his colleagues at Life Biosciences have partially restored sight to mice and monkeys.
Some teams are experimenting with drugs already prescribed to humans. Rapamycin, an immunosuppressant used in human transplant operations, has been shown to significantly extend the lives of mice, including very old ones. It appears to work by suppressing the mTOR complex, a set of genes that regulate metabolism. Meanwhile, a trial aims to determine whether metformin, commonly prescribed for type 2 diabetes, could delay the development of other chronic diseases. Studies have found a correlation between metformin and delaying cancer, for example, but causation is not yet proven nor has metformin been tested in healthy, non-diabetic older adults. .
The mentality of treating one disease at a time comes with a licensing process for new drugs and therapies that only approves them for specific conditions. Statins are prescribed for heart disease, for example; insulin for diabetes. But even if we managed to eliminate one of the leading causes of death – cancer, heart disease, stroke – it would only give us a few extra years of life, because something else would kill us instead . Falling death rates from heart attacks, while a great success, provide more future dementia victims because aging makes us vulnerable.
One goal of the metformin trial is to persuade the U.S. Food and Drug Administration to approve aging as an “indication,” to mean it can be “treated.” It has struggled to raise enough funds for clinical trials because metformin is a generic drug and therefore does not offer sufficient profits to pharmaceutical companies.
The turning point may come from dogs, not humans. The wonderfully named Dog Aging Project, which has sequenced the genomes of more than 7,000 pets provided by doting owners, is conducting a clinical trial to see if rapamycin can extend the longevity and health of our four-legged friends. Last year, Loyal, a veterinary medicine company, announced that it had met the FDA’s “reasonable expectation of effectiveness” test for a drug it is developing to extend the lives of dogs.
While these ideas advance through clinical trials, protocols and safety testing, there is a long-proven, reliable way to reduce the risk of certain age-related diseases: exercise. Apart from occasional injuries, it does not cause any serious side effects. Every scientist I’ve interviewed says that aerobic exercise and strength training are prerequisites for staying healthy, regardless of any additional medications we might take.
It may seem selfish for the West to seek to extend lifespans, especially those of pets, when tuberculosis and malaria still plague large parts of the world. But if we could reduce morbidity, it could also change the way we think. We fear old age long before we enter it. The possibility of living healthier, more active decades is a liberating thought in itself.
