Why Medical Age Reversal Is the Longevity Economy Wildcard

The world will change based on the ongoing demographic shift alone. But if medical age reversal becomes feasible and affordable? Buckle up.

The first person to live to 150 is alive today.

That statement has been kicked around for at least the last 20 years by various people with varying credentials who think we’ll medically reverse aging or radically extend life expectancy.

What’s truly remarkable about it is that in 2013, it was printed in large lettering on a billboard – paid for by Prudential, that insurance and investment services corporation you know all too well.

As I’ve mentioned previously, financial services is the one industry that’s not sleeping on the longevity economy. When your profitability depends on actuarial tables, you don’t pretend things aren’t happening in favor of status-quo catering to the youth market.

It’s important to distinguish between what’s projected to happen without medical breakthroughs and what can happen with them. While it’s currently projected that 100-year lifespans will become much more common in the future, that’s not dependent on what we’re about to explore.

In fact, it’s fair to say that all of the opportunities we’ve already explored in Longevity Gains will happen regardless of “science fiction” age reversal technology. The world will change significantly based on the ongoing demographic shift alone.

But if medical age reversal does become feasible and affordable?

Buckle up.

Is Aging a Disease?

At this point, aging is not considered to be a disease. That’s because it isn’t getting older  that kills you — it’s aging-associated diseases.

Examples of fatal aging-associated diseases are atherosclerosis and cardiovascular disease, cancer, type 2 diabetes, hypertension, and Alzheimer's disease. The likelihood of succumbing to these ailments increases exponentially with age.

That said, without the aging process, these diseases wouldn’t happen as a natural part of life. And that’s why Harvard’s David Sinclair says, “There is no reason we couldn’t live 200 years” if we can eliminate those age-related killers.

But that raises a question. If the degenerative process of aging gives rise to fatal afflictions in the first place, could it be fair to say that aging itself really is a disease?

There’s actually a robust debate about this in the medical community. It’s about how to define aging and whether a biological process that contributes to the risk of developing many diseases is itself a disease.

In its latest catalog of health conditions published in 2022, the World Health Organization almost equated old age with disease. Then the organization backed off from making the change that would characterize aging as pathological:

Crucially, the code associated with the diagnosis — a designation that is needed to register new drugs and therapies — included the word “pathological,” which could have been interpreted as suggesting that old age is a disease in itself.

Many researchers argue that linking old age more directly to disease allows new longevity treatments to obtain regulatory approval quicker. This then paves the way for a variety of drugs designed specifically to treat the aging process.

In other words, it’s the first step in defining aging as a treatable medical issue. The logic goes that if a condition is treatable, then it’s a disease. 

That’s how the massive multi-billion dollar anti-aging industry is already approaching the issue. Founders speak in terms of “medical rejuvenation,” or literally making us young again to increase both lifespan and healthspan.

“We think we can turn back the clock,” says Richard Klausner, organizer and chief scientist of Altos Labs, a new research company seeded with more than $3 billion to make this rejuvenation possible. Separately, additional billions are aimed at defeating cancer specifically, and we seem on the verge of a solution in the coming years.

This flurry of effort and optimism has a simple explanation. The Baby Boomers don’t want to die, and plenty of companies would love to get their hands on all that Boomer cash. It’s a perfect storm for getting some tough problems solved.

So while aging itself isn’t “officially” a disease, it is a gateway to disease and decline. The older you get, the more you accumulate senescent cells, which don’t reproduce or divide naturally and cause inflammation and tissue dysfunction. These so-called “zombie” cells release a variety of lethal substances that infect healthy cells — making you a frail and easy target for age-related illnesses.

One of the most promising approaches that’s been in the works since 2011 involves going after those senescent cells. Flush them out, and you also eliminate the age-related diseases that largely cause us to die – or at least that’s been the idea.

The most promising research into age reversal does, in fact, focus on the cellular level. But instead of “flushing out” senescent cells, the focus is on reprogramming them to replace information that goes missing as we age.

Medical Age Reversal Is Not Science Fiction

Yes, what we’re talking about is the ability to literally rewind aging. In other words, to reverse the age of our cells so that our bodies and brains revert to an earlier stage.

Cellular senescence specifically means that a cell has stopped multiplying and functioning properly but doesn’t die off and leave the body through apoptosis. This leads to general senescence – or aging – in the larger organism (that’s you).

There are two general theories of what causes cellular senescence. One theory is that a cell enters this dysfunctional state due to mutations, which would mean reversing the age of the cell and restoring the functionality would be practically impossible.

The competing theory is that aging results from cells losing critical instructions they need to continue functioning and that it’s possible to “reboot” the cell by restoring the missing epigenetic information. This is what the aforementioned David Sinclair, professor of genetics and co-director of the Paul F. Glenn Center for Biology of Aging Research at Harvard Medical School, calls the Information Theory of Aging:

It’s similar to the way software programs operate off hardware, but sometimes become corrupt and need a reboot, says Sinclair. ‘If the cause of aging was because a cell became full of mutations, then age reversal would not be possible,’ he says. ‘But by showing that we can reverse the aging process, that shows that the system is intact, that there is a backup copy and the software needs to be rebooted.’

After 13 years of research, Sinclair provided evidence that Information Theory is correct and cellular aging can, in fact, be reversed. A study published in January of 2023 in the journal Cell reveals that Sinclair and his team have both sped up and reversed the aging process in mice — not just in individual cells, but for the whole animal:

In the Cell paper, Sinclair and his team report that not only can they age mice on an accelerated timeline, but they can also reverse the effects of that aging and restore some of the biological signs of youthfulness to the animals.

That could mean that a host of age-related diseases, including terminal ailments such as heart disease and Alzheimer’s, could be treated by reversing the aging process that leads to them in the first place.

Okay, so that’s in mice. But experiments often start there because we’re more genetically similar to mice than you might think. And in this case, the necessary cellular functions of both mice and humans are the same when it comes to this particular procedure.

From there, Sinclair and his team have moved to testing on larger non-human primates and also with human neurons, skin, and fibroblast cells. Sinclair says that eye diseases will be the first condition used to test this aging reversal in people since the gene therapy can be injected directly into the eye area.

This research seems incredibly promising, but don’t expect this method for reversing cellular aging to be available immediately. The main concern is side effects from the treatment on humans, such as cancerous mutations. One ray of hope in that specific case is that the researchers have already encountered this problem with mice and solved it. 

Even with cancer presumably accounted for, it will take years to develop a true age-reversal medical process through human trials. But we may be looking at a simple issue of timing, as  Sinclair’s says:

Now, when I see an older person, I don’t look at them as old, I just look at them as someone whose system needs to be rebooted. It’s no longer a question of if rejuvenation is possible, but a question of when.

That’s the essence of this particular approach to longevity science, and while there are many others, cellular age reversal seems the most feasible and revolutionary. For more detail on the history of the research and the process itself, here are two solid guides:

Scientists Have Reached a Key Milestone in Learning How to Reverse Aging (Time)

Has First Person to Live to be 150 Been Born? (Harvard Gazette interview with David Sinclair)

Stay Healthy Long Enough to Stay Healthy

When it comes to who will benefit from age reversal treatments, it’s a matter of who’s around when the remedy becomes available at a mass scale. If that takes 20 years, the Baby Boomers will largely miss out, but Generation X could become the first generation to live significantly longer and be much healthier in their later years.

Whether aging can be truly reversed in a decade or two isn’t really the point. That’s because in the process of trying to solve the hard problem with the billions of dollars invested in the effort, new treatments that reduce or eliminate the age-related diseases themselves will extend healthspans to the point that we’ve got more time for comprehensive solutions.

Even highly-funded longevity startups like Altos Labs talk in terms of increased healthspan, not total lifespan. The goal is to extend healthy lives, not just tack on additional years.

You may be nonetheless thinking that if true age reversal treatments are decades away, what’s the point of factoring it in now? In a word – hope.

The most valuable prospects in the longevity economy are those who actively extend their healthspans the old-fashioned way – through exercise, nutrition, and sleep. While these people are motivated by health itself, it certainly doesn’t hurt for them to have hope that if they make it long enough, novel treatments may help them survive (and thrive) a lot longer.

And for those who are not as naturally motivated to take care of themselves, this glimmer of hope is even more powerful. Instead of weary resignation that accelerates the downsides of aging, more people may respond with positive changes in behavior if they see a possible reward beyond the immediate health benefits.

You don’t have to be in the health and wellness space to craft messages around advances in age-reversal technology. In addition to dispelling misconceptions and ageist stereotypes, your job is to motivate older people to live life to the fullest.

Plus, people can’t make sound decisions about work, retirement, and what they want to do with the rest of their lives without properly understanding the massive efforts to reverse the inevitable deadly effects of aging. In this case, cutting-edge longevity science may be an integral aspect of your marketing strategy.