Most people do not want to live forever. It would be very boring. I would explore everything,” said Shekhar Biswas, a data scientist from Berlin. He speaks for most of the people I interviewed one afternoon on Berlin’s Alexanderplatz – no one said they were interested in eternal life. (Also read: Loss of neurons makes Alzheimer’s patients sleepy: Study)
But what Biswas and many others will care about, I learned, is a long life—perhaps until age 100. When he should die, Biswas said, he wants it to happen without the burden of any agonizing illness and disease at the end of years.
Most researchers have concluded that nothing will stop death. But there can be ways to make life last longer, and the dying process shorter.
Gerontologists vs. charlatans
There are horizons in the world of aging science, according to Dr. Nir Barzilai, who heads the Institute for Research on Aging at Albert Einstein College of Medicine in New York.
“One of them is the people who fight aging,” he said, “like the people selling multivitamins promising to extend life through cellular renewal.” “They’re usually charlatans. They tell you to take this drug and you’ll live forever. If you die, no one will sue them. Then there’s gerontology. These are the scientists who work in the biology of aging, who know the things that are the goal, and they are very legitimate.”
Barzilai, of course, is an aging scientist. He’s been following a group of 750 centenarians (people who lived to the age of 100) for years. He recently announced plans to expand his study to include 10,000 people.
The new study is not backed by government grants but by a 26-year-old Bitcoin millionaire named James Fekl. This unconventional flow of financing may seem unusual. But as you begin to understand the logic behind aging research, the puzzle begins to fit together.
Healthspan, not Omar
First things first: geologists will tell you that they are not interested in longevity – the number of years you live – but rather a “healthy period,” the number of years in which you are healthy and able to live a normal life without complications or setbacks from illness or disease.
Scientists estimate that more than 50% of deaths worldwide are due to diseases caused by aging – such as Alzheimer’s disease, cardiovascular disease, cancer, type 2 diabetes and high blood pressure. This number is increasing in industrialized countries where access to modern medicine and healthcare means that people live long enough to contract age-related diseases and do not die from diseases such as malaria and dengue fever at a young age.
They say that if scientists like Barzilai could find a drug to help prolong people’s health, death would be faster and less painful.
James Kirkland, professor of medicine at the Mayo Clinic and president of the American Federation for Research on Aging, said they’re looking to find a way to prevent something called “multiplicity of deaths” at the end of life.
If you watched an elderly family member die, you probably know what this is. It begins with a diagnosis of cancer or dementia and is followed by a host of other problems. Problems such as arthritis, cataracts, forgetfulness and osteoporosis come together during the final years of a person’s life, making life seem like a daily battle.
It doesn’t have to be this way, Kirkland says. Instead, he said, dying might feel more like “going out and running five miles and then not getting up the next morning.”
This concept is called Compressive Mortality – Reducing the number of years or months a person goes through the dying process.
Imprinting vs Imprinting
Barzilai has been following centenarians for more than 20 years now, and is looking to see if they can provide some clues on how to live to reach 100 years old. Besides living long, healthy lives, he noted, these people often experienced a “stressed mortality,” dying over the course of a few weeks rather than years.
Is it something they eat, somewhere they live? Are they non-smokers or vegetarians? Are there certain things these elderly people do or have done during their lives that allow them to live long?
Barzilai found the answer is no.
“60% of the men smoked, 30% of the women. More than 50% of them are overweight or obese and don’t exercise. Only 2% were vegetarians. They’re not special,” he said.
A healthy lifestyle plays a role in longevity, so don’t stop eating your vegetables. But Barzilai’s research means that the elixir of youth will likely come in the form of a drug capable of targeting specific “longevity genes.”
“It’s 80% genetic and 20% environmental,” he said. The question, then, is, what do those who die at the age of eighty not have?
Centenarians don’t have complete genes or even clear genetic mutations that protect them from diseases like Alzheimer’s — they develop these diseases much later than non-centenarians, Brazily said.
Some of them have genes that block the action of growth hormones, Barzilay said. Through his research on centenarians, he looks to identify the genes or genetic mutations that appear to influence aging. Once these pathways are identified, drugs can be developed and tested to target them.
Barzilay is already testing how metformin, the diabetes drug, works to stop some of the effects of aging in the body. This is just one of the many drugs that are being tested to see if they can counteract aging; Matt Kaeberlin, a biologist at the University of Washington, is conducting an experiment to see if rapamycin affects dog aging, hoping to later test it in humans.
Aging cannot be attributed to a single process that occurs in the body. It’s a combination of many different processes, and each drug is looking to treat different forms of it.
The only thing that causes the body to age is something called cellular aging. The cells in our bodies are constantly going through a process called cell division. But scientists have found that this process is disrupted over time, causing some cells to stop dividing. Although these cells die, they do not leave the body and instead accumulate, causing health problems such as infections.
Kirkland’s work is to develop drugs that kill unnecessary senescent cells in our bodies. The drugs Barzilai and Kaeberline try to prevent senescent cells from causing problems such as inflammation, but don’t completely turn off the cells.
Kirkland said it will likely be at least a decade before we know if these drugs work to halt negative aging processes. But once he finds the right solution, he’s convinced that it will be transformative.
“If some of these things actually work, it would be like the discovery of antibiotics,” Kirkland said. “It’s going to be that big, because these basic aging processes are the root causes that contribute to everything.”
Fekl, a supporter of Barzilai’s study, wasn’t the only one interested in aging research. Russian-Israeli billionaire Yuri Milner backed by Altos Labs, a California-based biotech startup focused on aging research that pays its scientists $1m in salaries, started early this year with a mission to “reverse disease to transform medicine.”
It’s not the billionaire’s first backed attempt to unlock the secret of eternal youth. Alphabet’s parent company Calico Labs was launched in 2013, but the company has so far been silent about its research and development.
Altos Labs is looking at many different solutions for long life, some of which include processes being trialled by teams like Barzilai, Kirkland and Kaeberlein. But they are also looking at more empirical sciences – the kind that may not be able to receive support through traditional academic scholarships because they are so new.
Barzilai said that although Altos is a company, it is not an anti-aging charlatan. They’ve enlisted some of the best scientists in the field of anti-aging research – including Nobel Prize winners – to research another potential solution to increasing healthy period, called cell reprogramming.
The idea behind cell reprogramming, sometimes called cell regeneration, is relatively easy to understand. The old cells will turn into new cells free from the defects they were born with, cells that have not been affected by things like smoking or drinking beer, for example.
The science behind it is based on the discoveries made by cloning Dolly the sheep. One of the biggest scientific advances that occurred based on this research was Shinya Yamanaka’s discovery that four proteins can restore cells to their original state. He was awarded the Nobel Prize in 2012 for research that has been applied to several disciplines.
Scientists at Altos are looking to see if they can apply it to the aging process.
Scientists are cautious but optimistic
There are many drawbacks to this research, one of the most important being the cell’s loss of identity once it has been replicated. And we likely won’t see any results for a long time — even once researchers find an effective method, it will take years to test it on animals and people, and even longer for any potential drug to go through clinical trials to reach the general use market.
Kirkland says the drugs being investigated by Barzilai, Kirkland, Kaeberlein and others will also need some time, but they could hit the market in the coming decades if they pass clinical trials.
This is great then. Scientists caution not to stir up any kind of excitement around the drugs. Much could fall apart in clinical trials; Of the dozens currently underway, Kirkland said, most will fail. But they are optimistic that when the right treatment comes along, it can have a huge impact.
“I think most of us think this is coming,” Kaeberlin said. “I don’t know if it will take 10 years, 20 years, 30 years, but it happens and it will change things.”
Edited by: Ashutosh Pandey