From lifespan to healthspan (1)

Transcript

it's a pleasure to be here I've been asked to talk about longevity and it's been great the last couple of days being around this meeting a couple thoughts have occurred to me one is this group seems awfully young to be all that excited about longevity but it seems pretty clear that CEOs of startups are probably aging more rapidly than the average person so maybe this is exactly the group that needs to hear about longevity the other thought I had is um you know really maybe it should be Tom Brady back up here given this talk um that guy was amazing and I think he clearly has figured out you know some approaches to reduce his biological aging compared to his chronological age and if if if you don't really know what biological aging is that's one of the things I hope to get across to you today

so I've spent really about the last 20 years as an academic doing research on the biology of aging and then about seven or eight months ago now left my academic position at the University of Washington for a startup in the longevity and health span space called optisan and I'll just going to tell you just a little bit about optisan during my talk but um my goal really throughout this whole my whole career has been both to understand the biological mechanisms of aging and to try to get that information to as many people as possible to help us live as long and as healthy as as we can and that's really sort of the underlying Mission um at optis ban so I want to start just with some level setting get everybody on the

same page about what I'm talking about I think it's useful to appreciate sort of how we got where we are um if you think about the approach of what I will call 20th century medicine to health it's very reactive and it's very disease oriented and while life expectancy is increased pretty dramatically in almost every developed Nation over the last 50 to 100 years it's a little bit less clear that Health span the period of Life spent in good health has increased and in fact I think you could make some pretty good arguments that Health span may actually be decreasing in the United States right now so what's clear is six span has increased we've done a really really good job at keeping sick people alive and obviously that's important at

the individual level but at the population level that creates some complications um if you look at the state of our Health Care system which I really would say is more of a reactive disease care system system it's really not sustainable so estimates suggest that about 50% of Americans have at least one chronic disease and age aging is the greatest risk factor for pretty much every major chronic disease and about 90% of healthc care dollars are spent on chronic disease and that number is increasing and I think it's safe to say that's not sustainable I don't know where it breaks if it's 92 94 96 but it can't get to 100 so we need a change and I I think this is the sort of situation

when a you know really entrenched system is ripe for disruption where there are lots of opportunities and I think there are going to be lots of opportunities in the health care space to actually improve the way that Healthcare is delivered I mentioned that you know traditional medicine 21st century medicine Primary Care is focused around individual diseases usually in isolation and it goes back before medicine that's true and pharmaceutical drug development it's true in biotechnology it's true in basic research we typically act ins trying to study individual diseases in isolation and we typically try to treat those diseases and the consequence is we do a pretty good job of treating those diseases and keep people alive with those diseases but one of the implications here is that we're maybe

missing sort of the thing that connects all of these diseases and I would argue it's pretty clear that that thing that connects all of these diseases and these are most of the major causes of death and disability in developed countries the thing that connects those things is aging and that there is a a biology of aging and that's something we can study and understand and if we can understand it well enough we can actually Target that biology in way in a way that should delay the onset and progression of many maybe all of these functional declines and diseases simultaneously and so this is where I hope and expect 21st century medicine will go and for the rest of my talk I'm going to hopefully um give you some reasons to be optimistic about that

but this is really the take-home message right there is a better way and I think targeting the biology of Aging has to be a part of that better way for healthcare going forward okay so the first point I want to make is that we've actually made a lot of progress in the field at understanding the biology of Aging in the last two decades this graphic here is a graphic uh called the Hallmarks of Aging some of you have probably heard of this the Hallmarks of Aging I'm not going to get into what they are happy to talk about that in the discussion period if people are interested but it's useful to understand that these Hallmarks of Aging are the bi biological mechanisms that underly the aging process and there are 12 of them and they seem to be the same across every animal so it's true in

people it's true in dogs it's true in cats it's true in mice it's true in cows look across the animal kingdom these are highly evolutionarily conserved mechanisms of aging and again the point I want to make is we understand this enough that we can actually give names to this we can study the biology in principle targeting any of these Hallmarks individually will have an impact on the biology of aging and I think the really cool thing is there's a network that underlies these Hallmarks and there are nodes in that Network that we can Target that seem to modulate the biology of Aging sort of overall um to again delay functional declines in diseases and that's really exciting so we have some interventions which we'll probably talk about so I'd say the biology of Aging is being solved but I do want to again set some realistic

expectations because if any of you sort of have perus the sort of longevity Community you may be misled into thinking that we're close to solving aging or we're close to of this thing called Longevity Escape velosophy or immortality for billionaires that's not true so anybody who says that you can immediately ignore those people because they don't know what they're talking about or they are lying to you it's one of those two things I would actually say and I know this upsets people in the field when I do this a little bit we're kind of closer to where Humanity was and our understanding of the uh face of the Earth in 500 BC so this is a map of the know and World in 500 BC there's this sort of vaguely Europe shaped thing there's a Asia that doesn't look at all like Asia an oversized Libya and if you

sail too far you fall off the edge right so there's two things I want to say about this um actually we probably understand aging a little bit better than this but maybe not a lot two things I want to say about this though um one is there's a lot more to learn than we already know and two and this is important this map was pretty darn useful in 500 BC right people Ed this map to trade to make money to move around to explore the unknown and so I think we know enough about the biology of Aging that it's useful today but there's a lot more to learn and and we really also need to be focusing on what we don't know um okay so I do want to take just a second to talk about biological age in case that's not clear to everybody what I mean when I say

biological age as opposed to chronological age chronological age passage of Time how old you are no ambiguity very easy to understand biological age is sort of the the change in the function physiologically of your cells and tissues and organs um due to the biology of Aging the mechanisms the Hallmarks of aging and one way to really appreciate this I think everybody can get is you just think about dogs right we all learn from sort of an early age that one human year is about seven dog years now obviously that's not true for Chronological time what we're referring to is biological aging rate dogs age about seven times faster than people do but it's not linear and so this is a graphic um showing one measure of

biological age called epigenetic age if any of you have heard of these biological age tests that are available to Consumers they're measuring epigenetic age that's only one piece of biological aging but if you measure the epigenetic age of dogs compared to humans what you see is it's a nonlinear relationship so and this is true if you go to your vet and you see the chart that they have up there of dog years and human years also nonlinear just like this dogs are aging maybe 15 times faster than people biologically when they're young until they reach sexual maturation and then it kind of tails off and it's maybe like 3 years to one year later in life so we can actually start to measure biological age in meaningful ways that reflect what we see visually or or what we see in terms of functional

changes or disease measures and one of the things that I started about 10 years ago is a large study of Aging in pet dogs living with their owners called the dog aging project if any of you are dog people I'd encourage you to consider joining the dog aging project it's a nonprofit purely academic project really trying to understand the mechanisms of Aging in pet dogs with the goal of extending Health span and lifespan in pet dogs and learning about the biology of aging and people we've got about almost 50,000 people and dogs in the study now we also have one clinical trial of a drug called rapamycin it's really the first clinical trial for the biology of Aging with lifespan as the Endo in a healthy population to really test does rapy slow aging increase

lifespan improve health Span in pet dogs that's called Triad test of Ramy and aging dogs okay so now I'm going to shift gears and talk a little bit more about where we're at in terms of human uh longevity and health span and maybe some of the things we can do now so my new company opto span which I'm not raising money for so I'm not going to not going to pit you guys on optis span um but our goal is really you know I it's ambitious uh our goal is really to help people achieve their Optimal Health span so Optimal Health span op topan Optimal Health spans for everyone and do that by creating tools that that will enable doctors nurse practitioners providers to bring this sort of care to as many people as possible and one of

the things I want to illustrate so that orange piece there is the curve I showed you originally right six span has extended in in America um I actually think today we've got a pretty good opportunity to what we call Square the curve to make it so that health is pretty good pretty far out until towards the end of life and that's really what the green shading is showing this recapturing the Lost decade is what we call it helping people maintain their health for as long as possible obviously this is an idealized curve right I'm not realistically saying we're going to get everybody out to 80 years and then they're all going to die the next day but I think we can get closer to that and it's probably not as hard as a lot of people think so some of it's obvious right lifestyle is important like it or

not that's a fact I think preventative Diagnostics is a place where almost everybody is falling down I would guess that probably almost nobody in this room has done the preventative Diagnostics that will optimally prepare you for your future health your future healthspan trajectory I would also say there's a place for these generation one geroscience interventions and we may talk more about that in the discussion period things like rap ayon potentially that can really help to get us that last little increment of of Health span but I think this is doable and I'm very excited to to be in a space and have the opportunity to um to to hopefully help make this a reality then I think the interesting question is can we do better can we actually through studying the

biology of Aging push lifespan out closer to something which is close to what we think right now without intervention is the species maximum about 120 years um and this is getting to where we would now have to go off that map that I showed you right the map of KN and biology of Aging to get out to this this this area um I think it's possible I don't know how hard it's going to be another company which we spun out of my lab when I was at the University of Washington called Aura biomedical that's actually what they're working on so this is a technology to explore the unknown and Aura has a technology um that I think can can can measure longevity interventions uh at about two to three orders of magnitude

faster than what's currently possible in the rest of the field so Ora started this thing called the million molecule Challenge and the idea there is to test a million interventions for their effect on longevity to really try to explore the dark matter and figure out what don't we know about the biology of Aging so if you're interested there's a video on YouTube if you just look up million molecule challenge I'm sure you can find it this is a community project where anybody in the community can help participate to create this open access data set which I think really has the opportunity to change the landscape um in the field okay so then the last slide what should you do now right this is probably what everybody's most uh most interested in and we can dive a little bit deeper um I think the most important

thing obviously should be you've got to invest in your health like it's your most important asset almost nobody does this but if you really sit back and think about it if you don't have your health nothing else in life is as good so I would suggest that this is something that that every even if you're even if you're in your 20s you should probably start thinking about this and if you're in your 40s or 50s you really should start thinking about this um so rule number one don't die okay necessary but not sufficient if you want to maximize Health span um but when we get beyond that right you know first of all how do you not die okay risky behaviors are obvious this again I think is where some of the preventative diagnos sticks come into play and they're not super expensive you don't need this super

complicated you know protocol with 50 different supplements um I think there's a relatively small number of things that you can do to get you most of the way there but if you're sick if you've got a problem you want to know about it as early as possible and part of that is preventative Diagnostics also part of it is knowing your genetics what are you at highest risk for okay genetics can't tell you everything environment is super important obviously but there's no reason not to have that information um here's the hard one how do you find a good doc so again most docs haven't picked up on this yet most docs are still in the reactive disease care mode I don't have a great answer for you other than to say one of the things we're doing at optisan is collecting a network or creating a network of doctors

nurse practitioners who want to do this kind of medicine and and then as we create that Network we can actually help them know what to do what are the right protocols Diagnostics how do you interpret the data and then also point point people to those individuals um I think that for now looking for a doc that's preventative care rather than repair shop makes a lot of sense a doc who at least has started thinking about this space I wish I could give you a a name I know at least one person is out there and want you want to ask me who can I go to I I'm sorry I don't have that for you yet but we'll get there um I said lifestyle matters obviously everybody's got their pillars um our pillars at optis spam we have four of them eat move sleep connect I think

that's pretty obvious what we're talking about but again happy to dive into that if people want to last thing I'd say is again this is part of investing in your health money is important but actually taking some time to educate yourself is important as well there is a lot of noise in this field unfortunately there are a lot of people out there looking to make a buck being dishonest and so I would say you need to be a little bit you need to be a lot skeptical um and you need to do your own research and and unfortunately there aren't a ton of credible voices that I can point you towards I hope I'm one I try to be um we will be creating a YouTube channel an opto span YouTube channel if you're interested where we're going to try to actually take a sober realistic look at

the space and inform people uh among the sort of most popular influencers out there I would say Peter AA is the one person I would point you to who's very credible in this space very realistic unfortunately there aren't a lot more so I think you've got to do some some digging on your own and try to line up you know where does this seem real where does it seem like it might not be real um and just be aware again be a little bit skeptical I think I'm sort of surprised how often people really smart people listen to some guy talking about his protocol who has no experience in this space and they're like oh yeah that guy's got it no you really need to be skeptical when you look at a lot of the noise that's out there so I'll stop

talking uh and I'm happy I think we'll have a chance to take some questions so hopefully that's been useful and uh thank you for your attention