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Roula Khalaf, editor of the FT, picks her favorite stories in this weekly newsletter.
Do you want to become immortal? Me neither. Silicon Valley titans who long to “escape death” leave me cold. But most of us would like to stay young longer – preferably without Botox. A series of breakthroughs suggest that the science of aging is now at a tipping point.
Our perception of age is already changing. People who, in their youth, crowded concert halls to hear the Beatles sing: “Do you still need me?” . When I am 64?” Do you think today that old age begins at 74 years old? According to a large German study, people who are middle-aged or older today have an increased perception of “old” compared to previous generations.
This reflects increasing life expectancy, particularly for the wealthier half of the population in rich countries. The big prize now is to make the last decade better for everyone, rich and poor. Few of us would want to live forever even if it were offered; But we would give much to avoid a cruel descent into the twilight zone of debilitating frailty.
Since interviewing scientists for a book about aging, I’ve been regularly asked for advice about what substances I should take, even off-label. Everyone wants a shortcut for longevity. American men in top jobs are particularly interested in experimenting with products, including supplements, that are available in the United States rather than Europe. I take one of these myself, with no visible results – but then they wouldn’t be visible. Given the amount of snake oil in this market, it is safer to wait for officially licensed products. But that’s the big question now: Will regulators agree to consider aging a “treatable” condition?
While conventional medicine treats one disease at a time, scientists have been making discoveries since the 1990s that suggest we could target the biology that underlies aging itself. They have created worms and mice that live longer and stay alive longer by targeting specific genes. Cynthia Kenyon, the biologist who discovered that partially deactivating a single gene can double the lifespan of roundworms, described to me the awe she felt as she watched the modified worms wriggling and wriggling almost to the point of death skipped the prolonged tumbling stage she observed in her normal worm friends.
A steady stream of discoveries is driving the emerging field of geroscience. Many are focused on stemming the decline in the body’s ability to repair DNA. Some molecular biologists are working on NAD (nicotinamide adenine dinucleotide), an enzyme central to metabolism that declines with age. Others, like Australian-American David Sinclair, believe epigenetic noise is a major cause of aging and confuses signals in the body. Sinclair and colleagues at Life Biosciences have partially restored vision in mice and monkeys.
Some teams are experimenting with drugs that are already prescribed to people. Rapamycin, an immunosuppressant used in human transplants, has been shown to significantly extend the life of mice, even very old ones. It appears to work by suppressing the mTOR complex, a set of genes that regulate metabolism. Meanwhile, a study is examining whether metformin, commonly prescribed for type 2 diabetes, could delay the development of other chronic diseases. For example, studies have found a link between metformin and delaying cancer, but the cause has not yet been proven, nor has metformin been tested in healthy, non-diabetic older people.
The attitude of treating only one disease at a time is accompanied by a licensing process for new drugs and therapies that only approves them for certain diseases. For example, statins are prescribed for heart disease; Insulin for diabetes. But even if we managed to eliminate one of the big killers – cancer, heart disease, stroke – it would only give us a few extra years of life because something else would harm us instead. The falling death rates from heart attacks are a great success, but there will also be more victims of dementia in the future, because age 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 signal that it can be “treated.” Since metformin is a generic drug and therefore does not provide sufficient profits to pharmaceutical companies, it finds it difficult to raise enough funds for clinical trials.
The tipping point could come from dogs, not people. The wonderfully named Dog Aging Project, which has sequenced the genomes of more than 7,000 pets provided by enthusiastic owners, is conducting a clinical trial to find out whether rapamycin extends the longevity and health of our furry friends can. Last year, Loyal, a veterinary medicine company, announced that it had met the FDA’s “reasonable expectation of effectiveness” test for a drug it was developing to extend the lives of dogs.
While these ideas are being advanced by clinical trials, protocols and safety testing, there is a reliable, time-tested way to reduce the risk of certain age-related diseases: exercise. Other than occasional injury, it has no serious side effects. Every scientist I’ve ever interviewed says that aerobic exercise and strength training are essential to staying healthy, regardless of what additional medications we take.
It may seem selfish for the West to try to extend life expectancy, particularly of domestic animals, while tuberculosis and malaria are still rampant in much 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 being healthier and more active over the past few decades is a liberating thought in itself.