Current State of Longevity Science in 2019

Since reading Aubrey de Grey’s book Ending Aging, and realizing that aging itself is a problem to be tackled. I’ve been thinking more about what one can do about aging.

As a result I ended up going to Aubrey’s Undoing Aging conference this year (2019), which gave me a better look at the cutting edge of research.

Based on what I learnt from the conference, and subsequent research, there appears to be 4 main types of interventions you can use to enhance healthspan and lifespan:

1. “Basic” healthy living steps – this is a kind of broad brush umbrella that covers everything from getting enough sleep, to fasting and calorie restriction. All things that you can do right now without purchasing any special supplements or therapies. For clarity, examples include, but are not limited to:

• Getting adequate sleep (in the region of 8 hours per night)
• Reducing stress – Either reducing external stress, or increasing internal methods of handling the stress (meditation, exercise)
• Time restricted feeding (reducing the time window in which you eat, and ideally lining it up with the circadian rhythm)
• Periodic fasting (occasional longer fasts)
• Eating a micronutrient rich diet – this often requires integrating a wide range of vegetables and other nutrient sources
• Exercising regularly, and in particular, moving regularly
• Not smoking or drinking, or at least not drinking to excess
• Avoiding sugary foods and drinks

2. Pathway Stimulating Drugs – There are a wide range of pathways that are associated with longer, healthier living. Some of these are influenced by genetics, others by fasting and exercise. It’s therefore possible to use drugs to target these, and either increase or decrease the expression of these pathways. Example drugs include metformin, rapamycin and resveratrol.

3. Function Boosting Therapies – These are essentially band-aids for bodily damage. They restore function temporarily without fixing the underlying isuse. Examples include hormone replacement therapy and NAD boosters. For example, testosterone replacement therapy restores testosterone levels to youthful levels, but doesn’t fix the reduced testosterone output. Likewise, NAD boosters restore NAD to youthful levels, but don’t fix the cellular dysfunction that causes the drop.

4. Damage Repair Therapies – These are the core focus for Aubrey de Grey and his organisation SENS. Essentially, as we age, we accumulate damage in a number of key areas (SENS target 7, the Hallmarks of Aging paper identifies 9). Because historically we pro-created way before this damage accumulation became dangerous, there has been less evolutionary pressure to evolve solutions. This means that to solve them, we will need to engineer our own solutions.

So in essence, my take on the above is…

1. “Basic” healthy living steps – these are the low hanging fruit that are crucial to eking out the most health/lifespan your genetics are capable of achieving. Not getting enough sleep, not exercising, consuming excess sugary foods – these kinds of things are almost guaranteed to shorten your health/lifespan. This is the easy (sometimes not so easy!) stuff to get right.

2. Fasting Mimetic Drugs – These compounds and the research into them is only going to improve. It’s very likely we get to a point where it becomes a standard protocol to use these to extend healthspan (and possibly lifespan). Current molecules to watch for include metformin, rapamycin and resveratrol. There are more in the works.

3. Function Boosting Therapies – In the interim whilst we’re working on damage repair technologies, it seems very plausible that (as with pathway stimulating drugs) these provide a useful function we can take advantage of.

If we combine the above 3 – we will *hopefully* live long (and healthy!) enough to see the fruits of research into category 4 (damage repair therapies). I think for many in the longevity space, that’s the long term strategy. Reduce damage as much as possible until the heavyweight therapies start making it to market.