The pursuit of longevity is an ancient quest, but it’s having a moment right now.

Amazon founder Jeff Bezos and OpenAI CEO Sam Altman have invested in longevity start-ups. The Saudi royal family launched the non-profit foundation Hevolution in 2021, to spur scientific research on ageing.

Infosys co-founder Kris Gopalakrishnan has donated ₹675 crore so that the Indian Institute of Science (IISc) could set up a Centre for Brain Research. Its mission is to conduct long-term research into age-related cognitive diseases and help improve quality of life for the elderly. Last week, IISc launched a separate Longevity India Initiative that aims to research the process of ageing and develop enhanced treatments for age-related conditions.

The journal Nature even launched a title dedicated to research in this field, Nature Aging, in 2021.

Meanwhile, books such as Outlive (2023) by Bill Gifford and Dr Peter Attia, on the art and science of longevity, are bestsellers. Netflix released a docuseries last year titled Live to 100, which chronicles the lifestyles and diets of people in regions with outlier lifespans.

Huberman Lab, a podcast about health, the brain, wellness and yes, longevity, hosted by American neuroscientist Dr Andrew Huberman since 2021, has earned him over 5 million subscribers on YouTube alone.

India is seeing an uptick in anti-ageing start-ups and research too. Some of these have turned up on Shark Tank India. Others include the likes of Amura Health, which was launched in 2017, has been honing customised anti-ageing programmes, and is now roping in artificial intelligence (AI) to help.

This is a dramatic shift for a niche that has traditionally been considered an esoteric corner of the medical and bio-tech industries.

There is now, simply, far greater reason to hope. And more reason to experiment. Because longevity, so far the result of advances in mainstream medicine, will now come from new directions.

As things stand, the average human lifespan has more than doubled, from about 32 in 1900 to 71 today, driven by improvements in health care, nutrition and sanitation.

Through it all, the maximum lifespan hasn’t changed much in centuries. The oldest a human has ever been known to live to is 122. The number of super-centenarians, or people over 110, remains very small (some estimates put this population at about 200 worldwide).

But, between our deep understanding of how genes function, and AI’s ability to assist with analysis, advanced modelling and in silico trials, there is a real chance that humans born today could routinely live to 120.

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Before we get into how we aim to live longer, perhaps we should spend a minute or two on why.

Well, to quote Edmund Hillary, one key reason is “because it’s there”. Or, to quote an entirely different generation: You Only Live Once. The quest to live longer, maybe even “forever”, is another horizon to cross; like landing on the Moon was, or travelling to Mars is now.

But, for even the most enthusiastic advocates of longevity, lifespan isn’t the only goal. Healthspan is almost as crucial. Because the universal blessing “May you live long” is only one side of the coin. Perhaps a more cherished wish is the one succinctly encapsulated by Star Trek: “Live long and prosper.”

This gap, between living long and living with health and vitality intact, has been commercially exploited since the days of mythical heroes riding to perilous lands in search of an elixir. Later, it would seek to be bridged by quacks collectively called snake-oil salesmen. (The original snake oil, incidentally, is an ancient Chinese palliative, made with oil from a water snake, that does ease inflammation. The term was hijacked in the 19th century, by shysters in the US with no water snakes at hand, looking to make a quick buck).

Well, the salesmen knew their solutions couldn’t work.

We now have solutions that can.

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So, what will that take? Ageing is, of course, a complex process based on the interplay of individual genes, environmental factors, lifestyle habits and time. Advances hinge on how comprehensively we can decode — and then control — how the degeneration caused by this interplay unfolds at the cellular level.

Can we slow it down, even reverse it?

Can our ability to micro-measure parameters of health become part of the solution too?

Bryan Johnson, an entrepreneur and venture capitalist-turned-“body hacker”, claims his body only ages about 8.5 months every year. His experiments on himself involve a gruelling exercise regimen, the constant monitoring of vital signs, and the ingestion of about 100 supplements daily. It’s a maintenance plan that costs him, by his account, $2 million dollars a year.

There is no way to know yet, with certainty, that his methods are working, or that such a protocol would be effective in others. But in both its high price tag and its incessant examination of minutiae, his regimen is an indication of what such bio-hacking-based longevity could involve, at least in the short term.

For the longer term, more conventional, institutional research is occurring in labs around the world. The Spanish biochemist Carlos Lopez-Otin and his colleagues at University of Oviedo have been working to identify biomarkers of ageing, in research that has greatly increased our understanding of the process.

Perhaps the most promising developments come from the field of epigenetic reprogramming, which hinges on the idea that cells can be engineered, modified or otherwise trained to age differently.

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What does it look like, the effort to keep a cell “young”?

At Harvard Medical School, a team led by geroscientist David Sinclair has proposed the Information Theory of Aging (IToA). Our cells can replenish and repair themselves but over multiple repair cycles, errors accumulate, leading to a gradual loss of the “information” called epigenetic data. This is inherently what causes ageing, they posit, in a study published in Nature Aging in December.

This is a novel reframing of ageing, as a sort of “software” glitch in the cell, one that could be fixed by rebooting and restoring the epigenetic data. What would such a data backup system look like? How would it interact with the cell in a living human body and brain? These are the questions now being explored through trials in mice and monkeys.

Existing gene therapies are based on Japanese stem cell researcher Shinya Yamanaka’s pioneering work on reprogramming mature cells into young, stem cells (for which he won the 2012 Nobel Prize in Medicine, alongside British developmental biologist John Gurdon).

So far, epigenetic reprogramming has been shown to extend the lifespans of mice by 30%. It has also been shown to restore vision in both mice and monkeys. But, the therapy is complex to administer and, in some scenarios, can trigger cancer. So, alternative mechanisms of delivering these therapies are being explored.

AI has a role here, in speeding up research efforts and helping to identify or even design promising molecules for safer delivery of therapies.

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Interestingly, new protocols may be rolled out for animals before they are rolled out for humans, which could well mean that pet longevity is achieved first.

As treatments and therapies for humans begin to take shape on the horizon, meanwhile, existing health and medical systems have some catching up to do.

The US Food and Drug Administration, for instance, does not recognise ageing as a disease. That means that insurance cannot currently cover the costs of anti-ageing treatments. Government funding lags behind private capital, with implications for who will control the eventual technology, and how it will be priced.

It is also worth considering how extended lifespans will alter societies and economies. On the material level, what will our cities need to look like? How will healthcare need to evolve? But also, how do we manage the extra time?

Everything on Earth revolves around the fact that our time here is brief. Extending the average lifespan has already altered how we work and live, how nations budget, how economies grow and shrink. Age caps have had to be instituted in politics and in boardrooms. Tensions can be expected to intensify between seniors nearing 100 and people 70 and 80 years younger, pushing for greater change in an already fast-changing world.

Alongside advances in the science of longevity, then, we will need to start reimagining our societies too.

Meanwhile, for those looking to be early adopters, there is a personal longevity programmme currently available that is simple, relatively inexpensive and easily customisable. It will also be a key component in any protocols to come.

Here’s the big reveal: The key to a good, long life will include eating well, sleeping well, managing stress, and getting plenty of exercise. There is, so far, simply no way around that.

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