Chronic diseases like cancer, heart disease and diabetes often arise in our 60s, leading to decades of decline and multiple illnesses treated one after another. But what if we could push back these diseases by targeting aging itself? Longevity science aims to do just that by understanding and influencing the biological underpinnings of aging.

The goal is to extend healthspans - the number of years we remain healthy and free of chronic disease. This could mean enjoying extra years of vigor and compressing sick years into a shorter period later in life.

Treating Aging to Prevent Disease

Today's medical system focuses on diagnosing and managing diseases after they occur. But many researchers believe age is the root cause behind conditions like cancer, diabetes, and Alzheimer's.

"Our health care system has evolved to focus on individual diseases, usually from the perspective of waiting until people are sick and then trying to treat or cure their disease," says Matt Kaeberlein, a professor of pathology at the University of Washington.

This reactive approach is akin to fixing plane damage mid-flight instead of preemptive maintenance on the ground, says Kaeberlein. Longevity science aims to be more proactive by understanding and influencing the biology of aging itself.

Promising Longevity Interventions

Lifestyle choices like exercise and diet can significantly impact how long we stay healthy. But researchers are also exploring medical interventions like drugs and therapies to extend healthspans.

Rapamycin

This compound discovered on Easter Island inhibits the protein mTOR involved in cell growth and metabolism. Studies in animals show rapamycin prolongs lifespan and improves immune function. Early research suggests it may also enhance immune response in older humans.

By suppressing cellular senescence - when cells stop dividing but don't die - rapamycin may reduce chronic inflammation behind age-related diseases. Human trials are underway to further test these benefits.

Senolytics

Instead of suppressing senescent "zombie cells", these drugs seek and destroy them. Animal studies suggest senolytics could treat conditions like osteoarthritis, kidney dysfunction, and cardiovascular disease. Human trials for specific age-related disorders are now beginning.

Metformin

This common diabetes drug may have anti-aging effects. People with diabetes taking metformin lived longer than non-diabetics not on it. The large TAME trial is now testing if metformin can extend healthspan and delay dementia, cancer, and heart disease in seniors.

Growth Differentiation Factor 11

GDF11 is a circulating protein that declines with age. Raising levels in mice reverses cardiac hypertrophy and improves exercise endurance. One startup is advancing GDF11 into human trials to boost muscle and cardiac function.

Developing Tests and Biomarkers

Unlike disease, aging progresses slowly over decades, making clinical trials long and costly. Researchers are searching for biomarkers - biological indicators of aging that change more rapidly and can track treatment effectiveness.

Examples include epigenetic changes to DNA such as methylation, or levels of "zombie cells" and inflammatory factors in the blood. These early measures could indicate if an anti-aging drug is working before waiting years to see if it prevents disease.

Finding reliable biomarkers of aging will be crucial to testing interventions efficiently. But they must correlate closely with clinical outcomes.

Learning From 'Super Agers'

While average life expectancy hovers around 80, some individuals live vigorously past 100. Understanding the biology of these "super agers" could yield insights to help others achieve longevity.

One startup analyzes long-lived individuals using AI to identify protective molecular signatures. They then look for drugs that could replicate these effects, such as a compound now in trials to prevent muscle loss from aging.

Studying centenarians and the genetics of longevity may uncover natural mechanisms that drugs could mimic to extend healthspans for more of the population.

Aging as Disease?

Currently aging is not defined as a medical condition. For anti-aging therapies to be approved, aging itself may need to be classified as a treatable process. The TAME metformin trial could help establish aging as a druggable target.

But preventing disease in otherwise healthy people presents ethical considerations around safety and risk. The FDA has strict criteria for disease definitions.

There are also concerns that longevity treatments could exacerbate healthcare inequalities if only accessible to the wealthy. Policymakers and medical ethics boards are increasingly discussing these complex issues.

Potential Impact on Health and Society

Delaying chronic illness could greatly increase both lifespan and healthspan for many. But it raises questions around social support systems if people live decades longer.

Radical longevity may require rethinking retirement timelines and elderly care. But being healthier longer could also reduce healthcare costs from chronic age-related disease.

Longevity science is still early but advancing rapidly. While unlikely to enable immortality, treatments that compress sick years and extend healthy lifespans seem plausible in the coming decades.

Does Longevity Research Raise False Hopes?

Longevity science holds promise to extend healthspans and prevent diseases of aging. But some criticize it as hyperbolic hype that will fail to deliver. Others argue longevity treatments will only be accessible to the rich, exacerbating inequality.

In truth, it's still early days. Lifestyle choices like diet and exercise remain the most proven longevity boosters. But research into compounds like metformin and senolytics continues to uncover new mechanisms and pathways. Turning these insights into widely accessible treatments could take decades.

Current projections likely overstate near-term potential. But dismissing longevity science risks ignoring real opportunities to alleviate vast human suffering. With rigorous science and equitable policies, longevity research could yield therapies that give millions extra years of healthy life.

Will Longevity Science Lead to Overpopulation?

One objection is life extension will cause overpopulation. But future effects are debatable. For instance, raising average lifespan from 80 to 90 may not increase total population if birth rates decline.

And lifespan gains don’t necessarily require radical 150+ year longevity - just compressing late-life morbidity could deliver huge benefits. Japan's declining birth rate but growing ranks of healthy elderly challenges assumptions about aging populations.

Forecasts depend heavily on future cultural norms. We can’t reliably extrapolate before longevity treatments exist. But we know enhancing healthspan to cure diseases benefits humanity. With thoughtful policies, gains in longevity can be a positive for individuals and society.

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