“20 years from now you’d give anything to be this exact age, exactly this healthy, in this exact moment.Richard Webster
Take a second to enjoy it.”
As I get older, I am increasingly interested in the subject of ageing, both professionally and personally. I recently read the book Lifespan by David Sinclair which covers some of the new science behind why we age.
Put simply, Sinclair argues that the way we look at age-related diseases is fundamentally wrong. As a result, he believes we still don’t have a true understanding of the biology of ageing, and therefore don’t have the tools to truly slow its impact on our bodies.
Today, we categorise illness into diseases like cancer, heart disease or Parkinson’s. We give them individual diagnoses and offer different treatments and cures based on the diagnosis given. But by viewing all these diseases as entirely separate from one another, Sinclair believes that we are avoiding getting to the root of the problem – ageing.
By failing to define ageing as a disease itself, we are missing out on understanding how it really functions, and crucially, how we can slow it down and maintain not only a good lifespan but a great health span.
Scientists have identified cells called senescent cells as at the heart of the anti-ageing question. These are effectively old or run-down cells that have reached the end of their lives or have been damaged beyond repair. In our youth, our immune system can clear them out by itself, but as we get older our body does this less effectively, leading them to accumulate and damage other cells. And the presence of a high number of senescent cells have been linked to age related diseases such as diabetes.
There are currently over 20 different clinical trials of drugs that combat senescent cells (known as senolytics), targeting several different age-related conditions from Alzheimer’s to Osteoarthritis and beyond. Whilst more data is needed, the hope is that senolytics could be the key to slowing down not just progression of specific diseases but ageing more generally.
Senomorphics are another class of drugs being looked at. These instead of killing senescent cells, make them less aggressive. Metformin viewed by many as the ‘wonder drug’ is a medication used to treat diabetes and pre-diabetes as early as the late 1950’s. Metformin appears to have strong senomprphic properties and I think ongoing studies will confirm it as an anti-ageing medication. GLP-1 receptor agonists know to many as the weight loss injection Ozempic are often used in substitution or alongside metformin and may have a long-term place in anti-ageing.
Rapamycin is a potent anti-tumour drug used in kidney transplantation. It targets a protein know as mTOR which causes cell growth. Studies in mice have shown sleep affects the activity of mTOR. Blocking this can result in cell growth inhibition and the use of this has therefore been implicated in diseases such as cancer and dementia. From an anti-ageing perspective, it also mops up damaged cell parts which in turn promotes cell longevity. More studies are currently being undertaken, especially as no immunosuppressive drug can be free from side effects itself.
It’s not so simple – senescent cells don’t all have the same characteristics, and because they also hold some positive characteristics such as helping would healing and tissue generation, we simply can’t kill them all off. But if we can find the right number of senescent cells needed to heal and regenerate tissue whilst still delaying the onset of age-related conditions, we may be on the way to being able to see ageing as something that cannot just be slowed down but cured.
Until then, there have been a number of studies which suggest that there are day-to-day changes that we can make to reduce the accumulation of bad senescent cells, from increase in exercise to sleeping well to calorie restriction.
We all want to know more about the impacts of ageing and what we can do to slow down its effects.
I am living my best life here, come and see it.
Dr Sophia Khalique