Feature
Geroscience Comes of Age
July 22, 2022
Researchers on aging want people to not just live longer lives but healthier ones, free of debilitating diseases like Alzheimer's, cancer, heart disease, and type 2 diabetes. Understanding the biological mechanisms of aging that set the stage for these chronic diseases of aging has been Dr. Nir Barzilai's life's work. Barzilai, a professor in the department of medicine (endocrinology and geriatrics) and in the department of genetics, and director of Einstein's Institute for Aging Research, believes we can slow aging and extend healthy life.
Aging researchers — also known as geroscientists — are looking at why people slow down and get diseases as they age and whether the process can be prevented or even reversed. They want to know why some people live to 100 in bad health and others live to 100 and beyond in good health. Did the former get sick decades before the latter and are living sicker longer or is it something else? For a lot of centenarians, it is something else — their genetic makeup — that accounts for their long, healthy lives.
Through Einstein's Longevity Genes Project, now in its 20th year, Barzilai and his team have studied thousands of healthy older adults and their children to find out what is responsible for their long life. Several years ago, they identified variants in two genes associated with increased levels of high-density lipoproteins (the good cholesterol) in 750 individuals of Ashkenazi Jewish descent (aged 95 to 112) that protected them from many of the diseases of aging that occur much earlier in others without that protective gene variant.
Last month, Albert Einstein College of Medicine and the American Federation for Aging Research (AFAR), in collaboration with the Boston University College of Medicine, launched the SuperAgers Initiative, which will study 10,000 people aged 95 and older along with their family members to determine the biological and genetic underpinnings of exceptional longevity. Dr. Sofiya Milman, an associate professor in the department of medicine (endocrinology) and in the department of genetics, is leading the SuperAgers study at Einstein.
AFAR is also a partner with Einstein on its TAME (Targeting Aging with Metformin) study, a multicenter trial that will look at whether metformin, a common drug used to treat type 2 diabetes, and which has been shown to slow aging and the diseases of aging in animal studies, has similar effects in humans. If it does, this will offer the proof needed for an "aging indication" for treatment by the FDA, making it a recognized target for drug development. This would be a game-changer. Rather than treating diseases of aging individually, clinicians could treat them collectively by treating aging itself. It would change the FDA ethos of a one disease, one drug model treatment approach.
"Aging drives disease," says Barzilai. "Our research has shown that many with exceptional longevity (centenarians and super-centenarians) live 20 to 30 years longer and spend very little time sick at the end of their lives."
Aside from the personal benefits, extending healthy life would have an enormous economic impact. A recent study published in the journal Nature Aging, found that a slowdown in aging that increases life expectancy by one year is worth $38 trillion.
This is not part of an "anti-aging" movement. It's not about developing serums and potions and living forever but living longer in a healthier condition - combining lifespan and healthspan.
As Barzilai is wont to point out, "I am not an immortalist." He is more like an interventionist who is changing the face of aging - one centenarian at a time.