Although stories revolving around long life and eternal youth have always been told throughout human history, most of us accept aging as a completely natural process. But if it is possible for some species, such as a certain type of jellyfish, to be biologically “immortal”, why not humans? As our understanding of biological processes improve, scientists have started to take on aging from a whole different viewpoint.

The Seven Revolutions in Healthcare That Will Impact Your Life – Part 5

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How long can we live?

Only the gods can never age, the gods can never die. All else in the world almighty Time obliterates, crushes all to nothing.

– Oedipus at Colonus

Before we discuss potential lifespans of the future, let’s first take a look at what has happened in the past century. The 20^th century saw an unprecedented acceleration and growth of life expectancy. The world average life expectancy rose from 45.6 years in 1900 to 77.8 years in 2000. This means that our average longevity increased by 3.22 years every decade during the past century.  But this trend is slowing down. In the UK, from 2009 to 2019, male life expectancy only rose by 1.5 years, and female by 1.1 years. In the US, life expectancy plateaued at 78.9 years in 2014, dropped slightly for three consecutive years, and remained at below 79 years until 2020. Ironically, this deceleration trend has been accompanied by record spending increases in the healthcare sector.

Another trend in aging is the separation of lifespan and healthspan. Healthspan is the period of lifespan free from any chronic, age-related diseases. In 2019, noncommunicable, chronic diseases contributed to seven of the world’s top ten causes of death. Cardiovascular disease, cancer, chronic obstructive pulmonary disease, Alzheimer’s disease, and type 2 diabetes, all age-related diseases, are leading causes of frailty and disability among the older population.

There is no single answer yet to how long we can live.

Biomedical gerontologist Aubrey de Grey is well known for his rather radical theory of. He believes that at some point in the future, scientific progress will advance faster than the human body ages, potentially extending our life expectancy indefinitely.

Other scientists have looked to statistic modeling to predict the trajectory of life expectancy. A recent study based on longitudinal monitoring and analysis of human blood markers concluded that the upper limit of the human lifespan is between 120 and 150 years.

The question of lifespan and its potential limits is expected to be debated for a long time to come. However, despite different answers to this question, more and more scientists are coming to the understanding that aging is a fundamental biological process among the elderly. The key to all age-related diseases may lie in aging itself.

Why do we age?

One of the oldest theories about aging is the wear-and-tear theory. This theory argued that the human body will inevitably break down with use over the years, similar to a mechanical system.

Although the wear-and-tear theory fits with our observation, we know now that the human body is a biological system that is equipped with damage-repairing ability. In some studies, scientists have found that the aging process can be partially or completely reversed.

Scientists are only now beginning to understand the deeper underlying mechanisms at the cellular level. now involves many very different ideas and approaches. The development of “The Nine Hallmarks of Aging” established a model that presents all the different factors that play a role in aging.

In the 1970s, Elizabeth Blackburn discovered telomeres, the DNA sequences located at the end of all our chromosomes. During aging processes, the telomeres shorten, which also limits the number of times our cells can divide. Telomere attrition became one of the first hallmarks of aging to be identified. Other hallmarks are genomic instability, epigenetic alterations, loss of proteostasis, deregulated nutrient-sensing, mitochondrial dysfunction, cellular senescence, stem cell exhaustion, and altered intercellular communication. If one of the hallmarks is aggravated, aging will accelerate; if it is ameliorated, aging will be prevented. The nine hallmarks of aging also showed us which areas anti-aging treatment should target.

What can we do about aging?

For many people, remaining healthy into older age is more important than having a longer life. Both for individuals and for society at large, the best outcome would be if the progressive disability of later life could be compressed into a shorter period. This goal, however, will be difficult to achieve if we treat age-related diseases separately. Aging not only affects nearly all our organs, but it is also the single most important risk factor for cancer, heart disease, diabetes, and Alzheimer’s disease. If we try to combat age-related diseases individually, we will only be replacing one problem with another one. The reasonable solution should be to prevent, delay, or reverse aging itself.

“If you live long enough, you will get cancer.” – Professor Robert Weinberg, a pioneer in cancer research

Anti-aging medicine is still in its infancy. Many medical treatments targeting aging are still being tested on animals, which means we will likely not see any age-targeted treatment before the next decade. However, a few lifestyle-related approaches are already showing promising results in small-size human trials. Among these approaches are intermittent fasting and high-intensity interval training. Some supplements, such as NAD+ booster, resveratrol, and most recently spermidine, also are considered to be effective in preventing aging processes by bringing about rejuvenation on the cellular level. Last but not least, personal factors such as having a purpose in life, feeling healthy and satisfied, or becoming socially connected also play a role in healthy aging. The above actionable approaches are explained in detail in the .

The future of healthy aging

Time waits for no one. For anti-aging interventions, sooner is better than later. identified 150 companies that are working on anti-aging solutions. Most of the therapies are still in the pre-clinical stage. About 28 of them are currently being tested in human trials, including some of the existing drugs that were initially designed for other conditions, such as metformin and rapamycin. The re-purposed drugs could become some of the first available anti-aging treatments.

Anti-aging medicine is benefiting very much from the application of artificial intelligence (AI), machine learning, data analysis, and progress in genomic research. AI-assisted drug discovery has been implemented by a few start-ups. There are also some anti-aging start-ups that combine digital markers, biomarkers, and genetic markers to monitor the aging process and provide lifestyle recommendations.

Whether aging can be stopped or reversed is a question that will likely be debated for the foreseeable future. But there should be no doubt that even a few years’ delay in the aging process will have huge impacts on individuals and society.

The opinion on aging from some scientists is reflected in a tweet from the renowned biologist and professor of genetics, David Sinclair, “there is no biological law that says we must age.”

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[1] Life expectancy (from birth) in the United Kingdom from 1765 to 2020*. Statista. June 2019. https://www.statista.com/statistics/1040159/life-expectancy-united-kingdom-all-time/

[2] Christensen J., US life expectancy is still on the decline. Here’s why. CNN. November 26, 2019. https://edition.cnn.com/2019/11/26/health/us-life-expectancy-decline-study/index.html

[3] World Health Organization. The top 10 causes of death. 2020.  https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death

[4] Findlay C., Extreme longevity: Why Aubrey de Grey believes we may live to age 1,000. Supertrends. September 16, 2020. https://www.supertrends.com/extreme-longevity-why-we-may-live-to-age-1000/

[5] Pyrkov, T.V., Avchaciov, K., Tarkhov, A.E. et al. Longitudinal analysis of blood markers reveals progressive loss of resilience and predicts human lifespan limit. Nat Commun 12, 2765 (2021). https://doi.org/10.1038/s41467-021-23014-1

[6] López-Otín, C., Blasco, M.A., Partridge, L., et al. The Hallmarks of Aging, Cell, 2013, Volume 153, Issue 6, Pages 1194-1217, https://doi.org/10.1016/j.cell.2013.05.039.

[7] Supertrends in Anti-Aging, Supertrends, last updated 22 June 2021, https://www.supertrends.com/solutions/dynamic-reports/supertrends-in-anti-aging/

[8] Lents N., Why Everyone Will Eventually Get Cancer. Psychology Today. May 22, 2018. https://www.psychologytoday.com/us/blog/beastly-behavior/201805/why-everyone-will-eventually-get-cancer