2022 year end reflection on aging science and where we're headed

In 2022, I started earnestly working in biomedicine after over a decade in tech and startups. As the year nears a close, I wanted to reflect on my work and the general outlook for aging science.

Is aging science the right focus? My big goal is that humanity achieves significant lifespan and healthspan extension by 2063. I decided to direct my professional energy to this, while maintaining a high quality of life otherwise. To be clear, It does not mean sacrificing today's life for some future life. Overall, I still think this is a great goal. By 2050, 1.3 billion people will be over 65 years old [1] and likely starting to suffer from age-related decline and disease. It would be great personally, for my family and friends, and for billions of people around the world to have more healthy years.

Is the goal realistic? At a high-level, yes. We know that biology figured out how to reproduce young cells and organisms from old cells via reproduction. There are "negligibly senescent" creatures like the hydra, ocean quahog, Galapagos tortoise, and naked mole rat. I've been inspired again and again by new discoveries this year. Increasingly, it seems that cellular reprogramming can reduce the functional age of cells and tissues without causing cancer. Cellular reprogramming on its own could be one of the defining technologies for the 21st century. The advances in machine learning have been stunning, from AlphaFold to Chat-GPT. These will increasingly be applied to biomedical discovery. Of critical importance, there is no shortage of funding for this work in the foreseeable future. The aging population, which happens to hold most of societal wealth, will continue to invest more and more money into biomedicine, which will attract new talent and ideas, and encourage faster progress. There will be millions and millions of brilliant people around the world working on aging science.

What should the next decade look like for aging science? We still haven't proven the fundamental science. There are increasingly powerful theories of aging (e.g. Sinclair's "information theory"), but we still have open questions of what drives aging. Cellular reprogramming is incredibly exciting, but it still needs to be proven to safely extend long-term lifespan in other organisms, let alone humans. Priority #1, in my view, is to progress fundamental aging science as quickly as possible, including cellular reprogramming. Priority #2 should be bringing discoveries from the last few decades to drugs that can moderately extend healthspan and lifespan. Senolytics are compelling for moderate life extension, but we don't yet have proven drugs. Young blood plasma is surprisingly powerful, yet we don't have safe therapies. Rapamycin, metformin, and new diet and exercise interventions are all currently in clinical trials. We need interventions like these to start hitting the market in the next decade, which will extend healthspan and build momentum for the field. Priority #3 should be exploring new, risky ideas for aging science, beyond the current mainstream. How do other organisms achieve negligible senescence? How can advances in machine learning and large-language models reveal insights into aging?

I'm thrilled to be working in this field in an actual paying job. The learning curve is steep. I hope to contribute by my own efforts in science. I also hope to inspire others to switch their careers into aging science.


References:

[1] United Nations Department of Economic Social Affairs. World population prospects 2019: highlights. New York: United Nations Department of Economic Social Affairs; 2019.