Everything we talk about on The Optispan Podcast has geroscience at its root, so we decided to make an episode about it. Geroscience is the study of the mechanisms connecting biological aging with disease and disability. The term first appeared in the scientific literature around 2008, and its use has steadily increased since as researchers have discovered more about the aging process and its impact on our health. While it's clear that aging biology is at the root of the diseases and disabilities that most people get sick with and die from in their later years, it's been a challenge to get the field the traction and support that other fields enjoy, in part because we are used to a "disease care" model of waiting until people get sick and only then addressing their symptoms and/or curing their disease.

In this episode, Matt dives into the geroscience hypothesis and how it underpins the way we age, entrenched cultures in industries from drug development to insurance to regulation, and why he's excited to create a geroscience-inspired disruption in the medical and healthcare industries.

Check out the links below for further information and/or reading about some of the things we discussed in this podcast episode. Note that we do not necessarily endorse or agree with the content of these readings, but present them as supplementary material that may deepen your understanding of the topic after you listen to our podcast. This list is in no way exhaustive, but it’s a good start!

Hallmarks of aging: An expanding Universe

As Matt notes in the podcast, the Hallmarks of Aging are an easy way to think about the biological mechanisms that underlie aging and the functional declines and diseases that accompany aging. They are not a comprehensive list of everything that happens as we age, but they give a good starting point to understand the idea that several things change in our bodies with age. This paper proposes twelve hallmarks of aging and extends the work of the original 2013 paper outlining nine hallmarks of aging. The framework of “aging hallmarks”—that is, specific and identifiable molecular mechanisms or alterations that accompany the aging process—has provided a useful paradigm for understanding how certain biochemical changes form the essence of aging and of the disease and disability that accompanies it. However, we still don’t know a lot about the hierarchy of these hallmarks’ impact on the aging process or how they might interact with each other, and the evidence linking them to age-related disease is mostly correlative.

Major longevity gains termed unlikely

In 1990, researchers at the University of Chicago published their findings that the average American lifespan would only enjoy a three-year gain even if scientists came up with a magic pill to cure all cancers and heart disease. This article covers that research and also presents views about aging that are quite different from those of geroscience today. "Barring a reversal of human aging on a molecular level, the rapid increases in life expectancy are over,” the study’s lead author S. Jay Olshansky said. Of course, 21st century geroscience is trying to investigate exactly what Olshansky mentions: the molecular specifics of human aging and how we can target those molecular mechanisms to address the functional declines and diseases of later life.

The economic value of targeting aging

Published in 2021, this paper showed that a one-year increase in healthy life expectancy via targeting aging, as opposed to individual diseases, is worth $38 trillion in economic value. That number climbs to $367 trillion at 10 years of increased life expectancy. Those numbers might seem too big to be true, but they make more sense if we consider that delaying aging via a geroscience approach could potentially delay a huge number of age-related diseases, such as Alzheimer’s disease, as well as diseases whose risk is far greater with advanced age, such as COVID-19.

Is aging without illness possible?

This article presents perspectives from various prominent geroscience researchers about the history of the field, compounds that have shown promise thus far for targeting aging, and key barriers to progress. One important obstacle is hype. The idea of “antiaging therapies” is, according to University of Illinois Chicago Professor of Epidemiology and Biostatistics, “associated with an industry that is trying to sell products to the public to separate people from their money.” Overselling the promise of supplements, prescription medications, and other therapies is likely to increase skepticism about the geroscience and set the field back.

Fiscal Year 2024 Budget

The fiscal year 2024 budget of the National Institute on Aging (NIA), a division of the United States National Institutes of Health aimed at increasing healthy, active years of life in older adults, describes the NIA's research priorities. Several researchers in the geroscience field have expressed a wish for a greater proportion of the NIA budget to go toward studies of the biology of aging, rather than toward studies of individual diseases such as Alzheimer’s disease.