Longevity Wiki - User contributions [en-GB]

Handbook:Handbook

2022-09-06T09:28:50Z

Jack: /* Available Roles and Projects for the Wiki */

== About the Handbook==
The Longevity Wiki Handbook is the 'source of truth' for the Wiki organisation. It currently contains our mission and strategy, the roles we are looking for, links to our communication platforms and some editing advice. Like the Wiki itself, it's all publicly accessible and transparent and will likely grow and change over time.
== Mission==
Longevity Wiki is an open-access project to create the go-to platform for the science of longevity. The wiki was borne from the need for high quality scientific content on aging and longevity to be freely available and accessible. The Wiki ultimately aims to cover the following topics in detail:

*Longevity drugs and the evidence supporting them
*Personal longevity strategies/advice
*Hallmarks of aging/biology of aging
*Animal models of aging
*Laboratories working in geroscience, and their focus
*Longevity biotech (companies, development pipeline)
*Biology of aging + diseases of aging connection

More information about us can be found on our [[About]] page.

==Strategy==
Instead of producing as much content as possible, we’re going to focus on creating 5 pillar articles written by experts on the topic. These articles will demonstrate the knowledge and quality of our initiative, and then we will build out the wiki from there. These are the pillar articles:

#'''Epigenetic reprogramming'''
#'''Aging and Neurodegeneration'''
#'''Rapamycin'''
#'''Biomarkers of healthspan'''
#'''COVID-19 and Aging'''

In conjunction with these articles, we are going to create a Glossary page of key terms in the longevity space, along with a short (2-3 sentence definition).

== Available Roles and Projects for the Wiki ==
Longevity Wiki is an open access, collaborative project and we invite all volunteers to contribute! The goal of the Wiki is to create a trusted, high quality platform of longevity science content.

This section lists the current projects we are working on, and how you can get involved. If you're interested, please complete our [https://forms.gle/P1huKGcDiPLnRAB17 Volunteer Survey Form] and we will follow up with you by email.

=== Marketing manager (paid role) ===
'''Minimum requirements: Bachelor's degree, and minimum 5 years' experience in marketing roles.'''

We are seeking an experienced marketing manager to assist in promoting the Wiki across social media platforms. This is a paid role, and remuneration will be provided in the form of cryptocurrency payments (Stablecoin).

The responsibilities of this role include the following:

* Oversee all marketing campaigns for Longevity Wiki
* Implement strategy for expanding the scope of the Wiki
* Promote the Wiki across multiple social media platforms
* Ensure the company is communicating the right messaging to attract prospective customers and retain existing ones
* Represent the marketing team to cross-functional groups i
* Updating senior leadership on the progress of marketing activities and reporting on the results of campaigns

===Pillar article writing===
'''Role: Senior content writer'''

'''Minimum requirements: Masters or PhD training, ideally in a relevant field to content being written'''

We are seeking those with strong scientific backgrounds to help our initial offering of 5 ‘pillar’ articles that will form the initial content on the Wiki.

These articles are designed to be long-form (1.5-2.5k words) articles summarizing the relevant literature as it pertains to aging biology. The style we are aiming for is similar to a literature review, but with a simplified writing style that is accessible to non-specialist readers.

An example is our article on [[Rapamycin]], however, the style and structure of the article may vary by topic.

The following topics have been selected:

*'''Epigenetic reprogramming'''
*'''Aging and Neurodegeneration'''
*'''Rapamycin'''
*'''Biomarkers of healthspan'''
*'''COVID-19 and Aging'''

===Glossary expansion===
'''Role: Junior content writer'''

'''Minimum requirements: High school level biology'''

We are building a glossary of relevant terminology to expand the scope of the Wiki. The glossary will be accessible from an article through the use of so called ‘hovercards’ which makes it possible to display the meaning of a difficult term without leaving the article page.

The list of glossary terms is being populated based on the pillar articles. A full list of glossary terms can be found here (ADD LINK).

To contribute to the glossary, simply choose a term that has not yet been defined, and write a concise, and scientifically accurate definition.

Some guidelines:

*All references should be cited using APA referencing

*All links to internal articles should be linked
*Definitions should be clear and comprehensible to non-specialist audiences
*Definitions can be up to 270 characters in length

An example of a glossary term (ADD LINK).

===Life extension tool database===
'''Role: Researcher'''

'''Minimum requirements: Undergraduate biology, ability to comprehend the longevity data and research'''

We are creating a ‘life extension tool’ that provides an up to date overview of the life extension achieved for different animals with different interventions.

A [https://zpl.io/bePZGJl sample of the tool] can be viewed on our design platform Zeplin.

In order to populate data for the tool, we require assistance in reviewing the literature to identify the lifespan extension associated with different drugs and species, and the original publication in which this was published.

Our current database: [https://docs.google.com/spreadsheets/d/14OLhV4WWSUGomEY-3zko1o8zHHrJwt5YipGbjxhracM/edit?usp=sharing Life Extension Tool Data].

===Software engineering support===
'''Role: Engineer'''

'''Minimum requirements: Interest in software engineering'''

As the wiki grows, we need to ensure that the automation and infrastructure develops. We are especially looking for people with the following abilities:

* AWS reliability engineering/DevOps (people to manage infrastructure and deploy apps)
* PHP
* Front-end development
* Technical product ownership
* A scrum master/iteration manager

===Marketing===
'''Role: Based on experience and performance'''

'''Minimum requirements: Past experience in marketing, splendid communicator and creative individual who is eager to learn'''

Our marketing department is expanding. If you are a creative individual who loves communicating, you could get a lot of significant responsibilities.

=== Graphic design ===
'''Role: Illustrator, data visualization'''

'''Minimum requirements: Experience with graphic design'''

We are looking for individuals with graphic design skills to help us create and re-work pictures, scientific diagrams and graphs to communicate information to non-technical audiences. You will work closely with our content writers to produce high-impact, engaging visuals to accompany the written content.

=== Other roles ===
'''Role: Translator'''

We are looking for individuals with language skills to translate articles into other languages to reach a broader audience - particularly languages spoken commonly around the world. This will be done with the assistance of tools such as [https://www.deepl.com/translator DeepL].

'''Role: UX specialist'''

We are seeking expertise in user experience (UX) to help us design an intuitive and engaging platform. The goal is to create a satisfying experience for our users. You will work with the Head of UX in this role.

== Our communication platforms ==
Besides this Handbook we use a few other platforms for communicating and sharing resources. We're committed to being an open-access platform, and as such, we share all information possible, such as meeting minutes.

Non-engineering tasks are organised in Trello for now, use [https://trello.com/invite/longevitywiki/46e20cd2037ee4cf6e326277218f8286 this invitation link] to get access to the organisation.

=== Discord Server ===
We mostly communicate via the [https://discord.gg/UDKmjcnjye Longevity Wiki Discord Server]. It serves as a day-to-day message board, as well as the host of our meetings. Meetings take place every week at 08:30 GMT.

=== Google Drive ===
Our [https://drive.google.com/drive/folders/19Ol2wcRd2IWUt_gOC5j5Ff7FjSzPVuBf Drive folder] is used for sharing many useful documents, such as draft ideas, spreadsheets, or useful non-wiki resources.

===Organisational monthly meetings===

* Organisanional task management: [https://trello.com/b/0u9pSclR/organisational Trello Board]
* [https://en.longevitywiki.org/wiki/Handbook:Meeting_Minutes Meeting minutes]

Monthly meeting on general organisational topics and as a synchronization between engineering and content writing.

==== Trello process ====
* Future ideas for clearly far in the future (months)
* Backlog for tasks to do soon (weeks)
* Todo for tasks agreed to be done next, or you want to work on next
* Once task is worked on -> Move to In Progress
* If you want someone to review -> Move to In Review
* If task is done -> Move to Done, can then be shared in the next weekly meeting and archived

=== Bi-weekly content writer meetings ===

* Organisanional task management: [https://trello.com/b/mfwbyEB6/content-creators Trello Board]
* [[Handbook:Content Writer Meetings|Meeting minutes]]

==== Agenda ====

* Introductions by new members (short, 1 min / person):
** Name & where you are based
** Background & interest in longevity
** What topics you want to contribute to
* Designate Meeting notes writer
* Content writer manager sharing process & technology updates
* Going through pillar articles updates (content, reviews, contributions)
* Round table: Unblocking writers - suggestions what to write on, asking for reviews etc.

==== Trello process ====
The process for tracking article progress with Trello cards is as follows:

* Unsassigned for article ideas
* Assigned when someone wants to write an article
* Once working on a draft: In progress
* When finished with a first draft: In Review (merged past columns)
* When reviewed by at least one other writer in the group: Completed

==== General remarks ====

* Articles are never really done, as science progresses, so if you want to add something meaningful - please do so and share your idea both on Trello and this meeting!
* Non-structured contributions: Just get started writing on topics that interest you - the Trello board is to synchronise your efforts with the team and share your work!

===Engineering Team===

*Source code: [https://github.com/longevitywiki Github]
*Task management: [https://longevitywiki.atlassian.net/jira/software/projects/LW/boards/1 Jira]
*Documentation & roadmap: [https://longevitywiki.atlassian.net/wiki/spaces/LW/overview Confluence]

==How to edit the Wiki==
All articles, no matter what categories they are tagged with, are found on the [[Special:AllPages|All Pages]] site.

===Let us know first===
If you want to edit the wiki, please [[Contact|contact us]] first, so we can help you get started.

===MediaWiki===
Longevity Wiki uses the [[mediawikiwiki:MediaWiki|MediaWiki]] platform - the same as Wikipedia. This is the software that makes it possible to store all content, edit articles, track changes and more.
[[File:Account menu.png|thumb|100x100px|The Account menu]]

===Create an account ===
If you want to edit the wiki, it's a good idea to create an account first. That way it's easier to keep track of your work and you get some extra functionality. To create an account, in the menu click the Account icon on the right (the 'little person') and click '''Create account''' and follow the instructions. Creating an account is not mandatory however for editing.
[[File:Contribute menu.png|thumb|198x198px|The Contribute menu]]

===Create a page===
To create a new article on the wiki, go to the menu and click '''Contribute''' and then '''Create new page'''. You will then be prompted to select a title for your article. After that, the Edit toolbar appears at the top and you can start writing. The Edit toolbar provides you with standard edit functions like making headings, bold text, insert links, insert images and much more.

[[File:Editor Options Menu.png|thumb|198x198px|Editor Options Menu]]

The articles are categorized into four kinds, each with an associated category that should be added by using the '''Categories''' Option in the menu within the editor. (See "Editor Options Menu")

*'''Pillar Articles:''' Described in the [[Handbook:Handbook#Strategy|Strategy]] section, need expert knowledge equivalent to having a post-grad (MSc, Ph.D., MD) in a related area, currently managed by the core group. (Category: Pillar Articles)
*'''Longevity Articles:''' All articles about longevity, traditional wiki development and open for everyone to contribute. Should be created as draft first and reviewed by others in the community. (Category: Longevity)
*'''Glossary:''' Key terms in the longevity space, along with a short 2-3 sentence definition, no draft necessary. (Category: Glossary)
*'''Drafts:''' Articles that haven't been reviewed yet and finalized to a certain stage. (Category: Drafts)
These articles are all shown on the website on the [[Articles]] page.

====Drafts====
When creating a new page, the [[Template:Draft-article|Draft Article banner template]] should be added to beginning of article via <nowiki>{{ Draft-article }}</nowiki> (without spaces), automatically adding a banner and the "Drafts" category.

Drafts will not be actively mantained, but the core team might ask authors sometimes if they are still working on the article. The process for now is simple: Write a draft, have others in the community review it, finalise it and remove the draft banner '''(Work in Progress)'''.

For the review process we encourage to use our Discord server and write comments with the comments feature of the editor; text that is written in the editor but not shown on the published page.

===Edit a page===
To edit an existing article, lookup the article, go to the menu and click '''Contribute''' and then (under 'This page...') click '''Edit'''. Then the Edit toolbar will open at the top, and you can start writing.
[[File:Text editor.png|none|thumb|732x732px|The '''Edit''' toolbar]]

===Images===
Often it's a good idea to include images in your article. Just make sure that if you use an image of someone else, you are not violating any copyright. In general, you are free to use images with a [https://creativecommons.org/ Creative Commons] license, but don't forget to use the right [https://creativecommons.org/use-remix/ attribution]. If you need help creating an image yourself, let us know in the Images channel on our [https://discord.gg/jBR5aRcpfV Discord Server], and we can help you create a unique and copyright-free image.

===Referencing===
For referencing to external sources (e.g. a journal article), Longevity Wiki uses the [[wikipedia:APA_style|APA referencing style]] - the same as Wikipedia. To create a reference, click '''Cite''' on the Edit toolbar. There are a few useful resources for creating citations, such as [https://zbib.org/ Zoterobib].

===Writing style===
The aim of the Wiki is to create '''comprehensive''', '''scientifically accurate''' and '''accessible''' content on longevity. The writing style we are aiming for is essentially the same as Wikipedia, in balancing technical and non-technical content. Here is our '''[[Writing tips for easy reading|writing guide]]''' to help you get started. More information on Wikipedia's writing style can be found in [[wikipedia:Wikipedia:Manual_of_Style|Wikipedia's Manual of Style]].

===Translating an existing article===
[[File:Source code view.png|thumb|199x199px|Select Source editing to copy an article with formatting and references]]
To translate an existing article, create a new page in the language version of the wiki you want to translate the article into. For more guidance, ask us in the multilingual-wiki channel on our [https://discord.gg/jBR5aRcpfV Discord Server].

To carry over formatting and references, copy the source code of the original article sections you want to translate into the new page using '''Source editing''' view in the toolbar.

Translate the article using our writing guide, aim to preserve the article's '''meaning''' and '''accuracy.''' The preferred translation tool for a first draft is [https://www.deepl.com/translator DeepL].

==Contact information==
See our [[Contact]] page.

Role: Lead Editor / Community Manager

2022-03-23T10:37:40Z

Jack:

'''Minimum requirements:''' Masters or PhD training, ideally in a relevant field to content being written

We are seeking those with strong scientific backgrounds to help our initial offering of 5 ‘pillar’ articles that will form the initial content on the Wiki.

These articles are designed to be long-form (1.5-2.5k words) articles summarizing the relevant literature as it pertains to aging biology. The style we are aiming for is similar to a literature review, but with a simplified writing style that is accessible to non-specialist readers.

An example is our article on [[Rapamycin]], however, the style and structure of the article may vary by topic.

The following topics have been selected:

* Epigenetic reprogramming
* Aging and Neurodegeneration
* Rapamycin
* Biomarkers of healthspan
* COVID-19 and Aging

10 hours/week

US$50/hour

community manager / content writer manager

exceptional communication, professionalism

strongly mission aligned

3 month contract, with possibility of extending to 6-12 months based on performance.

- build the community of dedicated content writers

- define new areas of

- reach out to academics in the field

- knowledge of the longevity space

Handbook:Meeting Minutes

2022-01-07T07:11:28Z

Jack:

== 05/01/2022 ==

=== 🧍 Attending ===

* Jack Harley
* Bogdan Dziewierz
* Stuart McWhinney
* Andreas Melhede

=== 📣 Updates ===

* '''Constitution'''
** Should create constitution with quora for meetings to formalize the structure. Necessary for setting up the charity.
* '''Content writer manager'''
** Still searching for content writer manager to run and manage content writers
* '''Creating a charitable organisation'''
** Significant paperwork involved
** Different legislations for each state - California might be a good location. Most organisations use services (lawyers).
** UK has a simpler process, but may not get tax benefits
** Looking for assistance in setting up charities
* '''FAQ page'''
** To continue updating the FAQ prior to posting on Reddit

{| class="wikitable"
|
===✅ Action Items===

* Finish the FAQ before posting on Reddit
*Continue Twitter activity
*Recruit content writer manager
|}
== 14/12/2021 ==

=== 🧍 Attending ===

* Jack Harley
* Marc Smeehuijzen
* Ben Wu
* Andreas Melhede

=== 📣 Updates ===

* '''FAQ article'''
** Discussed how it can be shared with various relevant organizations like Lifespan.Io and Longevity Technology

* '''Gitcoin Funding Round'''
** Focus on sharing it on our website in a more prominent way
** Discussed how the funding can be used
** Maybe using it to hire a full-time employee

* '''NFT Drop'''
** A NFT on Twitter, which is valued around $500k is being offered to one the Gitcoin Longevity projects
** This is being voted on, on Twitter
** Longevity Wiki isn't a part of this vote, but one of these 4 projects that are being voted on, wanted the whole funding to go to us.
** Discover the vote and the endorsements below:https://twitter.com/noun12LFG/status/1470056277397192711 https://twitter.com/DrugsInDaphnia

* '''Marketing for our launch'''
** Sharing the FAQ with relevant organizations for them to share with their supporters
** Sharing a Reddit post on our launch
** Sharing a Longevity Wiki social media post on all of our channels
** The more people who share the Wiki, the better. It's hard to predict virality. One individual can radically change things for us.
** It is preferred that we all share the launch with our followers on social media

* '''General comments and updates'''
** Andreas
*** Did a social media post on the Gitcoin Funding round
*** Wrote a social media post on our upcoming launch
*** Wrote a social media post on what we are working on up until our launch
*** Went through the FAQ, added a few things, and shared his comments
*** Have engaged and shared various studies and tweets through Longevity Wiki's social sites and by retweeting on his personal and on Immortalists Magazine's social site
** Jack
*** Is working on the FAQ article
** Ben
*** Has taken a look at the FAQ article and contributed to various segments

{| class="wikitable"
|
===✅ Action Items===

* Jack: Finish our FAQ/ introductory article to share at our launch
*Continue working on the pillar articles
*Finish as many articles as possible, before we launch tomorrow. Ben: Will assist Jack with writing the FAQ/introductory article
*Share as much on social media around our launch and the time after
*Reach out to relevant organizations such as Lifespan.Io and Longevity Technology to request for them to share our launch
|}
== 03/11/2021 ==

=== 🧍 Attending ===
*Jack Harley
*Marc Smeehuijzen
*Ben Wu
*Bogdan Dziewierz
*Max Schulz
*Andreas Melhede

=== 📣 Updates ===

* Discussed article drafts
** Maybe like MediaWiki handles drafts
** Keep the drafts where they are could also be a solution
** Wikipedia hides drafts, maybe we should do the same
** Having drafts under the heading "How to contribute"
*** Makes it easier for people to contribute
** We could link to another page that includes the drafts under the section "How to contribute"
* Link to the Handbook
** About us section could would make it easy to access the handbook as a drop-down menu.
** Few people will be interested in the handbook, so it should not be too prominent like adding it in top-menu.
** Making the handbook more prominent on the "How to contribute"
*** Write it as a heading or making it more prominent in some similar way
** Add the Handbook to the "Quick Start Guide"
** Merge the "Quick Start Guide" with the "How To Contribute" page
** Make it as easy to contribute as possible
** Make it easy for people to get started on the site
*** Adding an introductory article
*** Article for beginners to get started on
*** Adding a FAQ
**** To let people dive into the articles and understanding what longevity is all about
**** Define aging
**** Making it a much more accessible than most FAQ's out there
**** Make it somewhat introductory
*** Sharing an introductory article
**** For organizations, relevant homepages, etc. to share in anticipation of our launch
** General comments and updates
*** Marc:
**** Removed introduction article and added links to pillar article
**** On the about page he added a section about why we don't use Wikipedia
*** Jack
**** Created the "Quick Start Guide" to make it easier to contribute
*** Ben:
**** Done the reprogramming article
**** Working on the COVID article

{| class="wikitable"
|
===✅ Action Items===

* Jack: Work on FAQ and/or an introductory article to share in anticipation of our launch
* Continue working on the pillar articles
* Finish as many articles as possible, before we launch on December 15.
|}

== 20/10/2021 ==

=== 🧍 Attending ===
*Jack Harley
*Marc Smeehuijzen
*Ben Wu
*Bogdan Dziewierz

=== 📣 Updates ===

* Discussed Launch strategy with the following points
** Add Quick Start Guide under How to Contribute
*** Add quick video on how to contribute and what the wiki is
** Update Make Home Page
*** Add a message that everyone can contribute, but underline that content is reviewed
*** Add new sections to the homepage
**** Featured articles section with a list of Pillar articles
**** Most popular articles with a list of top 5 most read articles
**** Most recent articles with a list of 5 recently added / completed articles
** Update Articles page
*** Change category names or Make it flat again. It's confusing now to end-user because its not clear what Pillar, General, etc means.
** Update About us and Contact
*** Ma both pages less corporate-like. Remove titles, must read like grassroots movement, and not corporation.
*** On About Us explain to readers why we chosen not to simply edit Wikipedia pages on the topic?
** Complete and feature life extension tool on the homepage
** Change CAPTCHA to something more frictionless - maybe reCaptcha?
** Plan how to market the launch
*** Pregenerate marketing content for social media
*** Use personal social media to promote
*** Use Discord
*** Use influencer marketing? Who to target?
*** After marketing campaing look for spam and vandalism

* General comments and updates
** Marc:
*** Having 4 flavours of articles is confusing… Can we flatten it?
*** Can we hide drafts under separate page?
** Jack:
*** Meeting with healthylongevity.guide
**** Attempt to create commercial lognevity edu platform
**** Content behind Paywall
**** Vague promise for content editors to monetize
** Bogdan:
*** Trying to build an engineering team but that doesn’t work very well. I’ll focus my time to actual dev work instead for golive and return to the team-buliding exercise once we're live.
** Ben:
*** Completing Reprogramming article
*** Completing COVID

{| class="wikitable"
|
===✅ Action Items===

* Jack: Write launch marketing content for social media Write content for Quick Start Guide
* Marc: Update About us and Contact page and make them less corporate-like Add "Why not Wikipedia" section to About Us Design Featured / Recent / Popular blocks for the home page Flatten Articles page
* Bogdan: Change CAPTCHA system to reCAPTCHA to make it more frictionless Implement new changes to home page once they are desinged (i.e. Featured articles, etc) Complete Life Extension tool
*
|}
== 06/10/2021 ==

=== 🧍 Attending ===
*Jack Harley
*Marc Smeehuijzen
*Maximilian Schulz
*Ben Wu
*Andreas Melhede
*Stuart McWhinney

=== 📣 Updates ===
''Jack Harley''

* Aging and Neurodegeneration article is almost complete (Draft found here: [[Aging and Neurodegeneration]])
* Not many attendees at yesterday's content writer meeting. Unsure if it's because it wasn't announced beforehand via mail & Discord
** We should understand the value of the meetings
* We should think about how to create incentives to contribute: Intrestingly enough though, Wikipedia seems to work quite fine without "special incentives"
* It should be a goal of the project to have tight collaborations with the [https://www.reddit.com/r/longevity/ longevity subreddit] (where Ben is the moderator) such that new information and Q&A is also added to the Wiki by community members
* Max Schons sent his article ("Biomarkers of healthspan") to Jack as a google docs (should be added to the Wiki)
* It is not clear if the "pillar articles" or "general articles" will be more relevant to readers, we should measure this after lunch to direct our efforts
* We need to get the message accross that the Wiki is open access. We could add a banner at regular intervals to motivate more contributions
* We need a launch plan; who to contact, what channels to use. The main people for this should be Marc, Andreas and Ben
** '''Specific launch date that should be announced: 15th of December 2021!'''

''Marc Smeehuijzen''

* It is currently not clear to a general audience what "pillar articles" mean, it should be clearly described in the articles section

''Ben Wu''

* "Epigenetic reprogramming" article is almost complete
* EyeWiki can be a good reference for acknowledging authors which are shown at the top of an article ([https://eyewiki.org/Glaucoma_Drainage_Devices example])

''Max Schulz''

* We may consider thinking about a process to promote general articles to pillar articles that have an "expert reviewer"

''Stuart McWhinney''

* On Fandom, there is a sidebar with most popular articles and recent updates that helps users navigate the content

{| class="wikitable"
|
===✅ Action Items===

* Jack: Schedule launch discussion in 2 weeks on 20th of October
* Max: Follow-up with content writers for onboarding and checking up on their involvement
* Andreas: Brainstorm about incentives for writers on the Wiki
* Stuart: Finalizing Discord badges, checking w/Max with regards to content writers
* Marc: Add explanations to the article page to be clear about what pillar articles represent
* Marc: Look into how to show the main authors of an article (minimal author profile with background on top of page)
* Marc: Talk with Bogdan to showcase launch date on website
*
|}
== 15/09/2021 ==

=== 🧍 Attending===
*Jack Harley
*Bogdan Dziewierz
*Maximilian Schulz
*Ben Wu
*Andreas Melhede
*Stuart McWhinney

===📣 Updates===
'''Change in meeting cadence:''' From now on, cross organisational meeting will only be every first Wednesday of the month. Separate meetings for engineering and content writer tasks.

''Bogdan''

*Engineering team has divided tasks on Jira and is working on them

''Maximilian Schulz''

*Will change all seperate board invitations to organisation invitations: [https://trello.com/invite/longevitywiki/46e20cd2037ee4cf6e326277218f8286 Trello invite link]
*Content writer meetings set up again: [[Handbook:Content Writer Meetings]]
**Created doodle for upcoming content writer meetings: [https://doodle.com/poll/pp9uysigaw66ddes Doodle Link]
**Started reaching out to interested people in the past for 1:1 onboarding. Content writer onboarding checklist (initially created by Jack): [https://docs.google.com/document/d/15pdBEzUpfEakZ4A-lSRAyfitRRQCUkQ5jR1779P4Y8E/edit Google Docs] (moved in the future)
**Sharing the process updates in the Content Writer meeting minutes instead
** On vacation with limited internet access 20/09 - 03/10. Jack Harley will lead the next content writer meeting
**The drafting & review process is quite simplistic and won't work in the future, we are aware that we need to work on this
*There seem to be quite many people interested in the ethical aspects of longevity research (e.g. recently Robin Howlett, check the [https://docs.google.com/spreadsheets/d/1FDFYQhQVBdDdHEiGqY1pif0T7sd-suRwOK-0wl7AIXU/edit#gid=2043094641 Volunteer Survey responses]), however it's not part of the currently defined topics ([[Handbook:Handbook#Mission]]); Shall we add it? Does it fit to "wiki-style" content?
**Agreed that we distinguish between "Scientific" and "Philosophical/Ethical" articles on the topic
**No planned articles yet, can come from the community
**Consensus that there is a need for ethical articles that are objective to a Wiki standard (compared to more biased articles, e.g. from Lifespan.io)
*There are many lists on longevity managed by individuals, such as Karl Pfleger ([https://agingbiotech.info/diagnostics/ Diagnostics Example]) - I think it would make so much more sense to manage them in a community like Longevity Wiki, and also good to offer the primary source for these.
**Bogdan shared that he is already looking into the Semantic Wiki extension also as a data source for the life extension tool
*Not discussed in the meeting and followed up upon separately:
** Process for next organisational meeting should also include reviewing the Trello board
**Created public google calendar for LW Meetings, inviting everybody who manages meetings: [https://calendar.google.com/calendar/u/0?cid=NDA4YnV2MjhrNmk2aHU2ODhtZ29nZnBnbG9AZ3JvdXAuY2FsZW5kYXIuZ29vZ2xlLmNvbQ Calendar Link]
**It might make sense to look into the plugins Sam Voigt recommends such as the "Structured Discussions" Extension (see associated [https://trello.com/c/YQpe82tv/33-enable-discussion-forums-on-articles Trello Card])
''Stuart''

* It is currently difficult for newcomers to understand who to contact for what contributions, he along with Andreas Melhede will assign roles to the relevant people

{| class="wikitable"
|
===✅ Action Items===

* Bogdan: Meeting invitation is changed to first Wednesday of the month
*Max: Update Wiki to allow for "Philosophical Articles" as well
*Jack: Give Stuart admin access on Discord to assign roles
*
|}
==08/09/2021==
===🧍 Attending===
* Jack Harley
*Blake Delaney
* Marc Smeehuijzen
*Bogdan Dziewierz

===📣 Updates===
''Blake Delaney''

*Introduction: hedge fund manager, with programming, and bioscience background. Previously created a longevity wiki but did not gain traction at the time

* Wikipedia doesn't have the highest quality on longevity and cryonics topics as those with higher override capability often prevent a thorough review of the topic
*Media Wiki has the functionality for authors to be notified when their articles are updated - this can be applied to our project
*Created a 'Cryonics' page on the Wiki - should we keep it on the Wiki? Consensus was yes.
*Social funding could be used to raise funding for the Wiki
*Suggest he can fund AWS infrastructure
*Create a Lifespan.io project and pitch our organization to them to attract funding
*Crowdfunding on the Discord server
*Interested in joining the engineering team and will try to make it to this week's meeting
*Can support a member to create an application to register for a US charity
*There is significant work involved in maintaining charity status
*Alternatively, operate as an LLC and avoid most tax liability by spending as much as you earn
*Some US states have very minimal reporting requirements for LLCs.

''Marc''

*How should we provide feedback to each other's article?

*Discussion page makes sense for feedback to specific articles
* Benefit of our Wiki is that it allows for more speculative topics than Wikipedia, such as longevity science and cryonics

''Jack''

*Provided update on content writers meeting
*Block updates to 'Pillar' articles once completed to avoid vandalism
* Can keep the 'cryonics' page on the Wiki, though, pending reaching out to science and medical organizations for content writing

''Sharon Wong''

*Have a header that says, 'version active as of (date)' on multilingual pages to overcome the issue of translated articles requiring frequent updates
*Having issues uploading the image on the rapamycin article - @Bogdan to investigate
*Style and standardising translating terms into Chinese requires a standard glossary
*There is a need to stipulate the translation tool for those who are translating the wiki (e.g. DeepL)
*Need for the 'how to contribute' page on the Wiki Handbook to be updated with translation tasks.
*Higher bar for 'tax deductible status' in Australia. It's a good reason to avoid this for now, to avoid excessive paperwork.

''Bogdan''

*Will have to create 'drafts' namespace
*'Discussion' page associated with pages on the Wiki is currently active
*Discussion page can foster more discussion amongst non-Discord users of the Wiki
*Cryonics discussion brings up an interesting point - what is the included scope of the Wiki? Consensus was that anything 'life-span extending' related should be included. In particular topics that Wikipedia doesn't cover well.
*Updated the onboarding guide for new developers
*Life extension tool in-progress
*Sam Voigt has previously volunteered to pursue the pros and cons of registering as a non-for-profit - @Jack to get in touch
*UK may have a separate charity status to receive money if no goods or services (business-like activities)

==01/09/2021==

===🧍 Attending===

*Jack Harley
*Ben Wu
* Sharon Wong
*Marc Smeehuijzen
* Andreas Melhede

===📣 Updates===
''Jack Harley''

* Begun ''Aging and Neurodegeneration'' brainstorm and write-up. References and comments welcome.
*Collaborated with Max to create process for content writers (discussed below)
*Kindly ask all Wiki members to complete [https://docs.google.com/forms/d/e/1FAIpQLScnXVdwTutWe_xNt6wJMPoXu_v9QBLb1A7QrBXRXXBifUyESg/viewform?usp=send_form volunteer form] to help keep a record
*[https://agingpharma.org/ ARDD Conference] has begun - good opportunity for Wiki members to learn more about the field - videos should be uploaded to the website for free viewing in the coming weeks.
*Goal is to have 4 pillar articles - by Max, Jack, Ben and the Rapamycin articles - by the end of September 2021

''Sharon Wong''

* Noted that the translation for the Rapamycin article was updating while
*Found it difficult to quickly copy content and formatting to a new page - Bogdan may able to assist with this
*Noted that it's probably not worth translating references
*Recommended deepl.com as the 'gold standard' for translating of articles. Produces more simplistic sentence structures compared to Google Translate.

''Ben Wu''

*Summary of EARD conference - mentioned Tina Woods' talk on lobbying UK government to increase funding towards aging research, and recognising biology of aging as a critical healthcare mission. Also mentioned that emphasis on healthspan seems more effective in communication than emphasis on lifespan.

''Marc''

*Bi-weekly content writers meetings could be structured around a review process whereby writers provide helpful feedback on other writers' articles. Maybe writers with journalistic/editor experience know of an effective review process similar to how people work at a newspaper/magazine/journal.
*We should prevent information being copied across various parts of the website because this makes maintenance harder. E.g. the 'About us' information is now both on the About us page and in the Handbook. He suggests removing the 'About Us' content from the Handbook, and replace it with a link to the 'About us' page.
* The handbook contains much valuable information for contributors but is not that interesting for most wiki visitors who just visit the wiki for longevity related information. He suggests to show only some high level 'how to contribute' information on the 'How to contribute' page so we don't overwhelm visitors (basically just asking people to contact us if they want to help) and then add a prominent link to the Handbook for if they want to dive into all the details.<br />

Andreas Melhede:

*Discussed Discord Role Management on Discord with Stuart McWhinney.
** It is very close to finished and ready to be implemented on our server.

''Max Schulz:''

*Trello Board Set-up & Organization (Tasks on Wiki I would consider once further in development)
** Let's focus only on trello boards that are used, and archive others - I propose:
***Archiving ''Engineering'' and ''UX'' -> Moving to Jira
*** Merging ''Marketing'' & ''Operations Infrastructure'' into Organisational '''(Please move the tasks you find relevant and archive these)'''
***Using ''Organisational'' board to manage weekly core meetings
***Using ''Content creators'' board to manage (to be scheduled) bi-weekly content creators meeting
***Overall: Can we have one trello group/team with several boards instead of inviting separately for each board? (Should be possible with members instead of guests? [[https://trello.com/en/pricing Pricing Info] | [https://help.trello.com/article/1236-board-guests Board Guests Info]])
**''Organisational'' board (people need to be added):
*** Should be reviewed and kept up to date weekly
***Action items should be created as tasks, if applicable - I tried to add most of them, sometimes people have to be assigned again
***I propose even if task is technical (e.g. making handbook more prominent [https://trello.com/c/fOFtXUmy Trello card]) but relevant to the organisational meetings, it should also be tracked on Trello
***Proposed board usage:
****Future ideas for clearly far in the future (months)
****Backlog for tasks to do soon (weeks)
****Todo for tasks agreed to be done next, or you want to work on next
****Once task is worked on -> Move to In Progress
****If you want someone to review -> Move to In Review
****If task is done -> Move to Done, can then be shared in the next weekly meeting and archived
** Task hygiene we should agree on ([https://mnschulz.medium.com/managing-work-in-a-startup-e80a3d122620 Personal article]), examples:
***Meaningful task definitions
***Assigned doesn't necessarily mean the person does all the work, but takes (especially on the communication side) responsibility
** Side-remark: Tipp to see your cards - [https://help.trello.com/article/819-viewing-all-of-your-cards Trello Help]
*Content writer management:
** Low-hanging fruit for article organisation: Instead of just alphabetic ordering in [[Articles]], can we have groups of articles with the first "Category" as the ordering? (Or another mechanism in Mediawiki?) I think it would be important to separate "Pillar Articles", "General Articles" and "Glossary" already for the management of the articles
**Temporary content writer sheet: [https://docs.google.com/spreadsheets/d/1e9djbjXdMV7m4655yjIISHRoUpB_1mbJcv0O8Zwj1fg/edit#gid=0 link] - will be superseeded by volunteer survey responses (see below)
**Wrote update to content writers [https://docs.google.com/document/d/1FlD9sTf5fPGhBiWYHV9nhzr0ucO6n4CFfEzcdbtnfC0/edit (text link)] with doodle survey for first bi-weekly content meeting after summer (note: should have set a deadlien for doodle ...^^)
**''Content creators'' board:
*** Pillar article label added (also to introductory article, which can be vital as well)
***'''Process for bi-weekly meeting has to be figured out (round-table style?)'''
* Jack created the volunteer survey, ([https://docs.google.com/forms/d/1An8sOTXi_Hne3Elmp1sY1n-3fr6PXwf-bUgPBi8X6e0/edit edit link]) - [https://forms.gle/KHmveeaRSgamtr1D7 shareable link] | answers are linked to the [https://docs.google.com/spreadsheets/d/1FDFYQhQVBdDdHEiGqY1pif0T7sd-suRwOK-0wl7AIXU Google Sheet]
** Should be filled out by all team members so we have an overview.

==25/08/2021==

===🧍 Attending ===

*Jack Harley
* Bogdan Dziewierz
*Marc Smeehuijzen
*Ben Wu
*Andreas Melhede
*Heye Groß
*Max Schons
*Stuart

===📣 Updates===
*Considering scoring of new participants to determine level of understanding, also as filtering for determining what level they might contribute at
*Thinking about providing a list of articles/content etc for Wiki contributors to obtain a better overview of the field
* Database of interests of participants, time zones etc.
*Max Schons working on risk factors, subjective vs objective measures of health, various major disease
*Considering submitting core articles to professional proofreading agencies, or reaching out to undergrad/postgrad students
*Heye planning on engaging with EA community at conferences and talking about the Wiki
*Technical meeting bimonthly with Bogdan, Mac, Stuart
*Considering merging Max's medium article with Ben's intro article

{| class="wikitable"
|
===✅ Action Items===

* Continue working on core articles
*
|}

==18/08/2021 ==

===🧍 Attending===
*Jack Harley
*Bogdan Dziewierz
*Max Schulz
*Andreas Melhede
*Sam Voigt
*Marc Smeehujizen
*Heye Groß

===📣 Updates Roundtable===
Jack Harley

*India times article is being finalised, to be released next week or week after. New co-author [https://medicine.nus.edu.sg/bch/faculty/brian-kennedy/ Brian Kennedy] joined

*More contributors interested to join the project. There is a need for people to help with on-boarding new contributors

*Gave a talk in EA group in Melbourne. This was followed up with an invitation to the medical conference in Melbourne.

*Handbook work is progressing'''.''' We need to make it more prominent and visible in the menu.

''Bogdan Dziewierz''

*Custom namespace "Handbook" created on the Wiki
*Engineering iteration meeting needs to be scheduled. Created new #engineering channel in Discord to help with coordination of such activities.
* Slowly progressing on Life Extension tool

''Heye Groß''

*Will get more involved in Longevity Wiki over next weeks. More clear on working hours.
*Discussed whether Longevity is a topic that is / should be on the agenda for EA compared to other existential risks and how EA can be used as spread-the-word or funding platform for Longevity effectively.
*Open Philantropy: Donates to the most effective areas but have a pessimistic view of longevity research. We think their evaluation is limited because they haven’t done cost / benefits calculation of investing into geroscience. Can be low-hanging fruit for donations, provided cost / benefit calculation is done for them.

''Jack Harley''

*Let’s try to organise symposium or conference once we get funding. EA could be convinced to fund this initiative.

''Max Schulz''

*Meeting Organization in general: I also like the process of always having a pre-created meeting topics from participants file for the next meeting
**Every participant plan can add his points already (I personally like to do this), then the meeting owner already has an idea in advance what people want to talk about and how to potentially structure it (Jack Harley in this case?)
*Updated the about page with pillar articles and ongoing projects suggestion ([[Handbook:Handbook]]). Some open points on my side (see page)
**5 or 20 pillar articles to start with? Saw conflicting information
** Content should be merged with: [[About]], [[How to contribute]] (Especially "Other Roles")
**In the visual editor, there are quite some "paragraphs" that I can't delete, they don't show up in the source editor ...?
**Open calendar links for meetings would be good (also are there other meetings to know of...?)
*How do you currently navigate the articles on the wiki? For example, how do you find the handbook article? (Any ongoing efforts on the navigation side?)
*There are article drafts shared on Discord with Google Docs, we should encourage everybody to directly write to the Wiki so this work doesn't get lost (e.g. [https://docs.google.com/document/d/1gSJjEJbP_A1Qs_uewoWjkSFUhsyfN1IUNUYIVuxDb7E/edit link]) (The "core articles" that we want to work on should just be categorized accordingly IMHO)
**Similarly, with the glossary suggestion - better if it would be already added to the wiki instead: [https://docs.google.com/document/d/1q2dlsLK76bAXyU3ZPZ_eWn_oI3UFQEtie_8D2nRH5cQ/edit#heading=h.lhdrp4ijtcd2 google docs]
*What is the status of the vision and action plan? ([https://docs.google.com/presentation/d/1rlPZyncQGRW6koCunM23msQyVWEQ0CVyGMnMAUSaE8U/edit#slide=id.g655cbd83be_0_18 Google Slides])
*Idea to try get some funding from the upcoming Gitcoin round from VitaDAO? I know that the high quality articles would make the case stronger, on the other hand they explicitly want to also go for early projects and "open science": [https://docs.google.com/document/d/13rjnkgxCdQ63V1M69cE-moeY6ktRfo5XIF8E9nwaeIU/edit Quadratic Funding Round Document]
*Last week, the process of registering a non-profit was quickly discussed but it's not in the minutes (I don't remember what was discussed)

''Heye Groß / Jack Harley / Bogdan Dziewierz''

* There is need to think about what we need money for so that we can start participating in funding rounds / grants / etc.

''Andres Melhede''

*Waiting for India article so that it can be used as a source for more content to be used on Social Media

{| class="wikitable"
|
===✅ Action Items===

*Jack: There is a need for volunteers to help with on-boarding new contributors

*Bogdan: We need to make it more prominent and visible in the menu
*Bogdan: How to contribute menu item needs to be replaced with Handbook
*Jack: We need to brainstorm and document what we need the funds for so that we can start participating in funding rounds / grants / etc.
*Jack: Let’s try to organise symposium or conference once we get funding.
*Max: Max to follow up with VitaDAO to find out if we can participate in their Gitcoin round.
|}

==11/08/2021 ==

===Purpose===
Regular weekly meeting

=== 🧍 Attending===

*Jack Harley, Co-Founder
*Bogdan Dziewierz, Co-founder & Head of Engineering
*Max Schons, Content Writer
*Max Schulz, Engineering Team Member and Organisational Consultant
*Ben Wu, Head of Content
*Andreas Melhede, Head of Marketing
*Sharon Wong, Content Translator

===📣 Updates Roundtable===

#Name: Max Schulz
##Discussed benefits of the ‘handbook-first’ approach, such as convenience in onboarding new volunteers to the organisation, and having a centralized knowledge base for strategy and roadmap documents. Brought up the need for a central landing page upon which organisational links are easily accessible.
##Discussed platforms for hosting the Handbook, such as Confluence.
#Name Bogdan
##Suggested using the Wiki itself as the ‘Handbook’, and Confluence for the engineering activities. The rest of the team agreed. Offered to create a namespace using MediaWiki for the handbook and landing page.
##Life extension tool is a work in progress.
#Name Jack
##Discussed the role of content writer manager, and suggested Max Schulz be introduced to this role.
## Once content writers are on board with the new content writing strategy, those with a biology background can be tasked with adding data to the life extension tool.
#‍Name Max Schons
##Outlined briefly the content strategy of creating a few high quality articles then seeking the endorsement of experts in the field, to attract more high quality contributors.
##Provided example of meeting minutes layouts in a handbook: <nowiki>https://github.com/mermaid-js/mermaid/releases</nowiki>
#Name Ben
##Provided update on the Times of India article, which will be published in the coming 1-2 weeks. The article will mention Longevity Wiki in the authors’ biographies section.
#Name Sharon
## Offered to review meeting minutes, and provided suggestions for the minutes - including key references and links at the beginning of the minutes.
#Name Andreas
##Provided updates on social media accounts.
##Did several edits and suggestions for the Aging Article for the Indian News Site.

{| class="wikitable"
|
===✅ Action Items===

*Bogdan to create namespace for Handbook, and Handbook landing page
*Jack follow up on Max’s organizational wiki suggestions
*Jack to follow up with Max Schulz regarding content writers management
* Jack to assign organizational document writing to other members
*Bogdan to organize an Engineering team spring meeting
*Jack to create and share a document of organizational processes
*Max Schulz to forward exemplary handbook to Jack
*Max Schons to continue working on Biomarkers of Healthspan article
* Ben Wu to continue working on Aging Epigenetics article
|}

== 04/08/2021==

===🧍 Attending===

*Jack Harley, Co-Founder
* Bogdan Dziewierz, Co-founder & Head of Engineering
*Marc Smeehuijzen, Head of UX
*Ben Wu, Head of Content
* Andreas Melhede, Head of Marketing

===📣 Updates Roundtable===

#Name: Bogdan
##Had the kick-off engineering meeting 30 July 2021 with Sam Voigt, Maximilian Schulz and Mark Whitlock. He setup Jira and Confluence. (These are popular project management tools in IT development). The engineering cards on Trello will be moved to Jira. For more details on this meeting, see the minutes on Confluence. (If you don’t have access to Confluence, ask Bogdan).
## Suggestion: split weekly meetings per department (so engineering, marketing, content, etc. all have their own weekly meeting instead of everybody in the same meeting).
##Suggestion: we could move the draft articles that we’re working on from Google Docs to the wiki itself. This way visitors can see the wiki is alive and check recent changes of the articles.
##Continue working on the Life Extension Tool and a glossary extension for the wiki, among other things. We might develop other tools in the future. Jack for instance suggested an interactive roadmap for longevity laboratories in the world.
# Name Ben
##There is a little delay in writing the India Times article on longevity. But it’s 90% done. He will see if we can get a famous professor as co author (e.g. David Sinclair). On Google Docs there’s a draft of the article and members of the team are welcome to provide feedback
# Name Jack
##Talked to Maximillian Schulz who made a number of interesting organizational suggestions for the wiki (see Jack’s email from 4 Aug. 2021). There is a need for organizational docs to be made transparently accessible on the Wiki, and we proposed this be in the form of pages on the Wiki categorized accordingly.
##New marketing expert is interested in joining the project, could work alongside Andreas
##Plan to reach out to expert in Rapamycin (Mikhail Blagosklonny) to seek a review/endorsement for this article on the Wiki.
##Looking for someone who can manage the content writers.
#‍Name Marc
##Updated the design for the Life Extension Tool. There are now two modes: 1. you can see per species what % life extension has been achieved per intervention and 2. you can see per intervention what % life extension has been achieved per species. The designs can be found on Zeplin. (If you don’t have access to Zeplin, please send Marc your email address so he can add you). He also posted some screenshots of the designs in the UX channel on our Discord server.
##Made English to Dutch translations of the interface elements of the wiki (document is on Google Drive).
#Name Andreas
##Made some social media posts on the 5 key articles that we’re working on.
##Engagement and sharing relevant content on the various social media platforms (especially focused on Twitter)

{| class="wikitable"
|
=== ✅ Action Items===

* Ben looks for famous professor as co author for India Times article
*Jack follow up on Maximillian’s organizational wiki suggestions
*Jack looks for someone to manage the content writers
*Jack to assign organizational document writing to other members
*Marc joins the engineering team and moves his Trello cards to Jira
|}

==29/07/2021==

===🧍 Attending===

* Jack Harley, Co-Founder
* Andreas Melhede, Head of Marketing
* Ben Wu, Head of Content

===🙌 Celebrate wins ===

*New software developer, Mark Whitlock, will join the IT team to help develop the technical side
*Database for the Life Extension Tool (the UX design for which can be viewed here) has been created

===💬 Discussion Topics ===

*Who are we trying to target with content? Discussed the need for content that appeals to the masses to fill a gap in content in this space. While we hope to create content that scientists will read, and for credibility most will likely stick with reading review articles so we should bear in mind our target audience of non-specialists.

===📣 Updates Roundtable ===

#Name: Jack
##A new contributor, Max Schultz, who has written blog posts about knowledge databases has provided a report on the state of the Wiki, offering avenues for expanding the Wiki. The notes for his meeting agenda with me are attached below this document.
##We have created an excel spreadsheet of data for the Life extension tool, and are encouraging contributors to help expand the data.
##Have created a new folder in the Google Drive called ‘Weekly Meetings’ wherein this Meeting Minutes and future minutes can be saved.
## Discussed the need to update content writers with a new approach of creating a glossary for pillar articles.
#Name Ben
##Joao Pedro’s database contains an extensive list of drugs and their life extension effects, which we can draw from for our own tool. <nowiki>https://genomics.senescence.info/drugs/browse.php</nowiki>

<nowiki>https://genomics.senescence.info/drugs/</nowiki>

We should aim to create a more user-friendly, and simplified version for our tool, focusing on ~20 key drugs that are most relevant to today’s life extension protocols.

#We should focus on data from the ITP (NIA’s Intervention Testing Program) as this is a rigorous and reliable test.

#Name Andreas
##Clarifying the target audience as primarily those who are non-specialists
##Clarified the style of social media posts, as evidence-based and reliable, as advised by Ben.

‍
{| class="wikitable"
|
===✅ Action Items===

*Jack meeting with Max Shulz to discuss further collaboration ideas
*Ben to add list of drugs of interest to lifespan extension tool database
*Ben to add relevant sources to the database for content writers - E.g. ITP
*Assign content writers / other team members with science background to assist with completing data for the life extension tool
*Andreas to create Discord channel for meeting minutes
*Communicate to content writers the new deliverables of expanding the glossary associated with the ‘pillar’ articles
|}

FAQ

2021-12-15T11:11:21Z

Jack: /* Will anti-aging drugs only be available to the rich? */

Longevity biotechnology is a new field of medical research and development that aims to extend healthy human lifespan and delay, prevent or reverse these diseases. This article provides an overview of the field through answering frequently asked questions.

== Why is aging a problem? ==
[[File:Aging graph.png|thumb|750x750px|The aging process results in the risk of age-related diseases increasing exponentially over time.]][[File:Gompertz-Makeham law of mortality.png|alt=Gompertz-Makeham law of mortality|thumb|257x257px|Gompertz-Makeham law of mortality<ref name=":0">En.wikipedia.org. 2021. ''Gompertz–Makeham law of mortality - Wikipedia''. [online] Available at: <<nowiki>https://en.wikipedia.org/wiki/Gompertz%E2%80%93Makeham_law_of_mortality</nowiki>> [Accessed 13 December 2021].</ref>]]Aging is the largest risk factor for the diseases that kill most people worldwide, including cancer, heart diseases and Alzheimer's disease.<ref name=":9" />

In the US in 2020, 9 of the 10 leading causes of death were strongly age-related.<ref name=":19">Ahmad, F. B., & Anderson, R. N. (2021). The leading causes of death in the US for 2020. ''JAMA'', ''325''(18), 1829-1830.https://jamanetwork.com/journals/jama/fullarticle/2778234</ref> Globally, approximately 70% of deaths annually are the result of aging.<ref name=":8" />

Aging also significantly affects quality of life, as deaths due to aging are usually preceded by many months of years of chronic illnesses such as cancer, type 2 diabetes and Alzheimer’s disease.

As a result of the aging process, the risk of an individual dying increases exponentially after the age of around 30 years old.<ref name=":0" /> This increase in mortality rate is known as the Gompertz-Makeham law of mortality.<ref name=":0" />
== How many people die from aging per day? ==
The aging process results in the deaths of 100,000 people per day; more than twice the sum of all other causes of death combined.<ref name=":8">Ritchie, H. and Roser, M., 2021. ''Causes of Death''. [online] Our World in Data. Available at: <<nowiki>https://ourworldindata.org/causes-of-death</nowiki>> [Accessed 13 December 2021].
</ref> This equates to over 37 million people dying per day of aging - a population the size of Canada. This is because aging results in the exponential increasing risk of age-related diseases such as cancer and type 2 diabetes. Aging also accounts for more than 30% of all disability-adjusted life years lost (DALYs); more than any other single cause.<ref>Vizhub.healthdata.org. 2021. ''GBD Compare | IHME Viz Hub''. [online] Available at: <<nowiki>https://vizhub.healthdata.org/gbd-compare/</nowiki>> [Accessed 13 December 2021].</ref>
[[File:Leading causes of death.png|center|thumb|713x713px|9 of the top 10 causes of death in the US in 2020 were strongly age-related.<ref name=":19" />]]

== Can healthy lifespan be extended? ==
[[File:Life extension mice.jpg|alt=Life extension mice|thumb|431x431px|Dietary manipulation, genetic manipulation, and drugs have been shown to increase the healthy lifespan of mice by up to 30%. <ref name=":1">de Magalhaes, J., 2021. ''DrugAge: Species Detail''. [online] Genomics.senescence.info. Available at: <<nowiki>https://genomics.senescence.info/drugs/species_details.php</nowiki>> [Accessed 14 December 2021].</ref>]]Clinical trials for longevity drugs in humans are in-progress, and there is not yet evidence that drugs can slow aging in humans. However, recent experimental breakthroughs over the last few decades have shown that in mice, worms and flies have demonstrated that healthy lifespan can be extended modified. Many clinical trials in humans today are testing whether these results can be replicated in humans.

In animal models, slowing the aging process in animals can be achieved via manipulation of diet, environment, genetics, epigenetics, or with drugs. In mice, over 100 drugs have been shown to extend healthy lifespan by up to 30%.<ref name=":1" />

The effect of longevity drugs on mice is often significant, delaying or eliminating the burden of age-related problems such as frailty, cataracts, cancer, and sarcopenia. For example, a new class of drugs called senolytics have been shown to extend lifespan in mice by over 30% whilst delaying age-related dysfunction.

== Which therapies may extend healthy lifespan? ==
Several drugs are known to extend healthy lifespan in animals. While there is no conclusive data that suggests these drugs would work the same in humans, many of these drugs are now being tested in clinical trials. [[File:Unity Mice.jpg|alt=Unity Mice|thumb|723x723px|Senolytic drugs eliminate senescent cells that accumulate with age, partially reversing multiple age-related diseases and extending the healthy lifespan of mice by up to 35%.<ref name=":16" /> ]]

=== Senolytics ===
Senolytics are drugs that remove senescent cells. These are cells which accumulate in the body with age and are linked with age-related diseases such as cancer.<ref>Xu, M., Pirtskhalava, T., Farr, J. N., Weigand, B. M., Palmer, A. K., Weivoda, M. M., ... & Kirkland, J. L. (2018). Senolytics improve physical function and increase lifespan in old age. ''Nature medicine'', ''24''(8), 1246-1256.</ref>
[[File:Metformin2.jpg|thumb|258x258px|Metformin extends lifespan in mice by 6%, and may extend lifespan in humans.<ref name=":13">Kulkarni, A. S., Gubbi, S., & Barzilai, N. (2020). Benefits of metformin in attenuating the hallmarks of aging. ''Cell metabolism'', ''32''(1), 15-30.</ref>]]
In mice, senolytics have been shown to increase the healthy lifespan by up to 35%.<ref name=":16">Baker, D. J., Childs, B. G., Durik, M., Wijers, M. E., Sieben, C. J., Zhong, J., ... & Van Deursen, J. M. (2016). Naturally occurring p16 Ink4a-positive cells shorten healthy lifespan. ''Nature'', ''530''(7589), 184-189.</ref> The first clinical trials of senolytics in humans began in 2020, and demonstrated benefits to functional measures suggesting these drugs may be effective in humans.

=== [[Metformin]] ===
Metformin is an approved drug for type 2 diabetes that extends lifespan in multiple species. In mice, Metformin extends lifespan by up to 6%.<ref>Anisimov, V. N., Berstein, L. M., Popovich, I. G., Zabezhinski, M. A., Egormin, P. A., Piskunova, T. S., Semenchenko, A. V., Tyndyk, M. L., Yurova, M. N., Kovalenko, I. G., & Poroshina, T. E. (2011). If started early in life, metformin treatment increases life span and postpones tumors in female SHR mice. ''Aging'', ''3''(2), 148–157. <nowiki>https://doi.org/10.18632/aging.100273</nowiki></ref> Metformin works by improving insulin sensitivity and may target several hallmarks of aging.<ref name=":13" /> Metformin is being tested as a longevity therapy in the largest clinical trial for a longevity therapy, the Targeting Aging with Metformin (TAME) trial in the US.<ref name=":14">''TAME - Targeting Aging with Metformin - American Federation for Aging Research''. (n.d.). American Federation for Aging Research. <nowiki>https://www.afar.org/tame-trial</nowiki></ref> This is a randomized clinical trial of 3000 elderly patients comparing metformin against a placebo for the onset of age-related diseases.<ref name=":14" />

=== [[Rapamycin]] ===
[[File:Rapamune .jpg|alt=Rapamune |thumb|253x253px|Rapamycin, also known as Rapamune© is being tested as a drug to extend healthy lifespan in humans. <ref name=":15" />]]
Rapamycin, also known as Rapamune©, is a drug used to prevent the rejection of organ transplants by the immune system. Rapamycin has been shown to extend lifespan by up to 26% when given at middle age, and 14% when given in late life.<ref name=":20">Harrison, D., Strong, R., Sharp, Z. ''et al.'' Rapamycin fed late in life extends lifespan in genetically heterogeneous mice. ''Nature'' 460, 392–395 (2009). <nowiki>https://doi.org/10.1038/nature08221</nowiki>
</ref><ref>Miller, R. A., Harrison, D. E., Astle, C. M., Fernandez, E., Flurkey, K., Han, M., Javors, M. A., Li, X., Nadon, N. L., Nelson, J. F., Pletcher, S., Salmon, A. B., Sharp, Z. D., Van Roekel, S., Winkleman, L., & Strong, R. (2014). Rapamycin-mediated lifespan increase in mice is dose and sex dependent and metabolically distinct from dietary restriction. ''Aging cell'', ''13''(3), 468–477. <nowiki>https://doi.org/10.1111/acel.12194</nowiki></ref>

Among the hundreds of interventions known to target aging, rapamycin is unique in its highly consistent and reproducible effect on healthy lifespan extension in mice.<ref name=":25">Johnson, S. C., Martin, G. M., Rabinovitch, P. S., & Kaeberlein, M. (2013). Preserving youth: does rapamycin deliver? ''Science translational medicine'', ''5''(211), 211fs40.</ref><ref>Kaeberlein, M. (2014). Rapamycin and aging: when, for how long, and how much? ''Journal of genetics and genomics'', ''41''(9), 459.</ref>

Rapamycin is being tested in a large-scale clinical trial called the Participatory Evaluation (of) Aging (With) Rapamycin (for) Longevity Study (PEARL). This is a randomized clinical trial aiming to enrol 1000 elderly patients comparing rapamycin against placebo for age-related outcomes.<ref name=":15">Clinicaltrials.gov. 2021. ''Participatory Evaluation (of) Aging (With) Rapamycin (for) Longevity Study - Full Text View - ClinicalTrials.gov''. [online] Available at: <<nowiki>https://clinicaltrials.gov/ct2/show/NCT04488601</nowiki>> [Accessed 14 December 2021].
</ref>

=== [[Epigenetic reprogramming]] ===
Epigenetic reprogramming is remodeling the epigenetic marks, such as methylation tags on the DNA, in cells. This technique was used in 2020 to restore vision to blind mice by fully regrowing the optic nerve.<ref>Lu, Y., Brommer, B., Tian, X. ''et al.'' Reprogramming to recover youthful epigenetic information and restore vision. ''Nature'' 588, 124–129 (2020). <nowiki>https://doi.org/10.1038/s41586-020-2975-4</nowiki></ref> The researchers at Harvard Medical School and believe this approach could one day be used to regenerate other tissues of the body as a longevity strategy.<ref>''Reversing The Aging Clock With Epigenetic Reprogramming''. (n.d.). Pubs - Bio-IT World. <nowiki>https://www.bio-itworld.com/news/2021/01/13/reversing-the-aging-clock-with-epigenetic-reprogramming</nowiki></ref>

In addition, over [https://www.lifespan.io/road-maps/the-rejuvenation-roadmap 50 other drugs] are being tested in human clinical trials for slowing aging.<ref name=":2">Lifespan.io. 2021. ''The Rejuvenation Roadmap | Lifespan.io''. [online] Available at: <<nowiki>https://www.lifespan.io/road-maps/the-rejuvenation-roadmap/</nowiki>> [Accessed 13 December 2021].</ref>

== What is the goal of longevity biotechnology? ==
[[File:Healthy lifespan extension.png|alt=Healthy lifespan extension|thumb|643x643px|Healthy lifespan extension involves early intervention to prevent or delay the decline associated with aging.<ref>''Longevity companies to watch in 2021 - Longevity.Technology''. (n.d.). Longevity.Technology. <nowiki>https://www.longevity.technology/longevity-companies-to-watch-in-2021/</nowiki></ref> ]]
Longevity biotechnology aims to slow or reverse the aging process to extend the healthy lifespan (‘healthspan’) of the population. Instead of treating diseases when they arise, one by one, longevity biotechnology aims to keep those who are already healthy, healthy by slowing the aging process. The aim is to thereby delay or prevent multiple diseases at once that are associated with aging.

The longevity biotechnology sector is rapidly growing, and there are currently over 170 private companies working on developing therapeutics to slow the aging process.<ref name=":4">Pfleger, K., 2021. ''Aging Companies''. [online] Agingbiotech.info. Available at: <<nowiki>https://agingbiotech.info/companies</nowiki>> [Accessed 13 December 2021].</ref> These companies are working on slowing or reversing the aging process by targeting one of more of the hallmarks of aging.

== Will healthy or unhealthy lifespan be extended? ==
[[File:Extending healthy lifespan.png|alt=Extending healthy lifespan|thumb|364x364px|Extending healthy versus unhealthy lifespan. <ref>''How to save Medicare: the anti-aging remedy''. (2012, March). <nowiki>https://www.researchgate.net/figure/From-longer-life-span-to-longer-health-span-and-life-span-From-A-to-B-Standard_fig1_230724035</nowiki>.</ref>]]
The stated goal of longevity biotechnology is to extend the healthy period of lifespan, before age-related diseases set in. This is in contrast to many of today's medical interventions, which extend life only after diseases (e.g. cancer, Alzheimer's) have reached a clinical level.

Age-related diseases are preceded by a long period of subclinical aging, i.e. aging that has not yet progressed far enough to produce clinical symptoms. By slowing, delaying or reversing the aging process, the hypothesis is that the healthy period of life can be extended.<ref name=":24" />

Studies in mice have demonstrated that life extending drugs such as rapamycin are capable of extending the healthy, rather than unhealthy period of life.<ref name=":20" />
== Should we treat specific diseases such as cancer, or aging? ==
[[File:Slowing aging versus curing cancer.jpg|alt=Slowing aging is potentially a more effective means of extending healthy lifespan than treating individual diseases due to the comorbid nature of age-related diseases. [6]|thumb|421x421px|Slowing aging is potentially a more effective means of extending healthy lifespan than treating individual diseases due to the comorbid nature of age-related diseases.<ref name=":18" /> ]]
Longevity biotechnology potentially offers a greater likelihood of extending healthy lifespan than attempting to find cures for the individual diseases of aging. This is because biological aging is associated with many of diseases of aging that develop as comorbidities i.e. at the same time. Even if a person survives one age-related disease such as cancer, another (e.g. diabetes, cardiovascular disease) is likely to kill the person if the underlying aging is not treated. This phenomenon is known as Taueber's paradox<ref name=":17">En.wikipedia.org. 2021. ''Taeuber Paradox - Wikipedia''. [online] Available at: <<nowiki>https://en.wikipedia.org/wiki/Taeuber_Paradox</nowiki>> [Accessed 14 December 2021].</ref>, and accounts for the much smaller projected increase in healthy lifespan associated with curing the diseases of aging, such as cancer (2-3 years), versus slowing aging itself (30+ years).<ref name=":18">Matt Kaeberlein, PhD, It is Time to Embrace 21st-Century Medicine, ''Public Policy & Aging Report'', Volume 29, Issue 4, 2019, Pages 111–115, <nowiki>https://doi.org/10.1093/ppar/prz022</nowiki></ref>
== What is biological aging? ==
There are two main types of 'age': chronological age - the number of years since birth, and biological age - a measure of the physical health of a person and their position in their lifespan. Biological age is more difficult to measure, but recent technologies are now available to estimate biological age. Over time, we age biologically. This occurs due to many processes in the body, which are generally categorised into 9 processes or 'hallmarks'.<ref name=":9" />
== What are the 9 Hallmarks of Aging? ==
[[File:Hallmarks of aging.jpg|alt=Hallmarks of aging|thumb|444x444px|The nine hallmarks of aging.<ref name=":9" />]]

The hallmarks of aging framework is considered to broadly represent key biological mechanisms of the biological aging process.<ref name=":9">López-Otín C, Blasco MA, Partridge L, Serrano M, Kroemer G. The hallmarks of aging. Cell. 2013 Jun 6;153(6):1194-217.</ref> Although there are various limitations of the hallmarks framework, it has become the central framework for understanding aging biology. The nine forms of cellular and molecular ‘damage’ that comprise the hallmarks of aging are<ref name=":9" />:

* Genomic instability
* Telomere attrition
* Epigenetic alterations
* Loss of proteostasis
* Deregulated nutrient-sensing
* Mitochondrial dysfunction
* Cellular senescence
* Stem cell exhaustion
* Altered intercellular communication

These are essentially the lowest common denominators of the aging process, on a cellular or subcellular level. All of the other changes associated with aging, such as greying hair, wrinkles, frailty and an increased risk of disease is thought to stem from these underlyig processes.<ref name=":9" />

== How does the aging cause disease? ==
The nine hallmarks of aging have been shown to play an integral role in the development of many age-related diseases such as neurodegenerative diseases and cancer:
=== [[Aging and Neurodegeneration|Neurodegenerative disease]] ===
[[File:Prevalence of neuro disorders.jpg|alt=Prevalence of neuro disorders|thumb|469x469px|The prevalence of neurodegenerative disorders increases exponentially with age, due to the biological aging process.<ref name=":12">Hou, Y., Dan, X., Babbar, M., Wei, Y., Hasselbalch, S. G., Croteau, D. L., & Bohr, V. A. (2019). Ageing as a risk factor for neurodegenerative disease. ''Nature reviews. Neurology'', ''15''(10), 565–581. <nowiki>https://doi.org/10.1038/s41582-019-0244-7</nowiki></ref> ]]
All of the hallmarks of aging are associated with an increased risk of neurodegenerative diseases, such as Parkinson's disease and Alzheimer's disease.<ref>Qiu, C., Kivipelto, M., & von Strauss, E. (2009). Epidemiology of Alzheimer's disease: occurrence, determinants, and strategies toward intervention. ''Dialogues in clinical neuroscience'', ''11''(2), 111.</ref> For example, several types of DNA damage are associated with neurodegeneration. The shortening of telomeres occurs as part of biological aging and causes cellular senescence, and is associated with neurodegeneration and neurodegenerative diseases including Alzheimer's disease and Parkinson's disease.<ref name=":12" /> Additionally, mitochondrial dysfunction, altered metabolism, stem cell exhaustion and loss of proteostasis are also involved in the development of neurodegenerative diseases.<ref name=":12" />
=== [[Aging and Cancer|Cancer]] ===
Several of the hallmarks of aging such as cellular senescence and alterations in the extracellular matrix are responsible for increasing the likelihood of tumorigenesis.<ref name=":5">Fane, M., & Weeraratna, A. T. (2020). How the ageing microenvironment influences tumour progression. ''Nature Reviews Cancer'', ''20''(2), 89-106.</ref> Other hallmarks of aging such as genomic instability, loss or proteostasis, altered intercellular communication (i.e. inflammation) and epigenetic alterations are also involved in tumorigenesis.<ref name=":5" />
== How is biological age measured? ==
[[File:Epigenetic clock.png|alt=Epigenetic clock|thumb|605x605px|The epigenetic clock measures biological age based on marks on the epigenome.<ref name=":6" /> ]]
Recent technologies have allow biological age to be measured. These include:

=== [[Epigenetic clock|Epigenetic clocks]] ===
The first generation of aging clocks are known as [[Epigenetic clock|epigenetic clocks or Horvath’s clock]].<ref name=":6">Horvath, S., & Raj, K. (2018). DNA methylation-based biomarkers and the epigenetic clock theory of ageing. ''Nature Reviews Genetics'', ''19''(6), 371-384.</ref> This clock is based on the finding that over time, the body accumulates methylation tags on the DNA in a pattern that can be predicted with machine learning. These changes to the epigenome are influenced by lifestyle, and can be used to measure biological age.<ref name=":6" /> Factors such as exercise frequency and a low BMI have been shown to reduce the rate of biological aging, whereas obesity and smoking can accelerate the rate of aging.<ref>Quach, A., Levine, M. E., Tanaka, T., Lu, A. T., Chen, B. H., Ferrucci, L., ... & Horvath, S. (2017). Epigenetic clock analysis of diet, exercise, education, and lifestyle factors. ''Aging (Albany NY)'', ''9''(2), 419.</ref><ref>Wu, X., Huang, Q., Javed, R., Zhong, J., Gao, H., & Liang, H. (2019). Effect of tobacco smoking on the epigenetic age of human respiratory organs. ''Clinical Epigenetics'', ''11''(1), 183. <nowiki>https://doi.org/10.1186/s13148-019-0777-z</nowiki>

[[Epigenetic clock#cite%20ref-12|↑]]</ref><ref>Horvath, S., Erhart, W., Brosch, M., Ammerpohl, O., von Schönfels, W., Ahrens, M., Heits, N., Bell, J. T., Tsai, P.-C., Spector, T. D., Deloukas, P., Siebert, R., Sipos, B., Becker, T., Röcken, C., Schafmayer, C., & Hampe, J. (2014). Obesity accelerates epigenetic aging of human liver. ''Proceedings of the National Academy of Sciences'', ''111''(43), 15538–15543. <nowiki>https://doi.org/10.1073/pnas.1412759111</nowiki>

[[Epigenetic clock#cite%20ref-13|↑]]</ref> The Horvath's clock has been used to accurately predict mortality risk.<ref>Fransquet, P. D., Wrigglesworth, J., Woods, R. L., Ernst, M. E., & Ryan, J. (2019). The epigenetic clock as a predictor of disease and mortality risk: a systematic review and meta-analysis. ''Clinical epigenetics'', ''11''(1), 1-17.</ref>

=== Multi-omic clocks ===
Multi-omic clocks are being developed that incorporate data from several sources, such as body imaging scans, blood tests, and fitness tests. These clocks are built using machine learning to estimate biological age. These aging clocks are being developed that combine multiple biological functional tests to create a unique aging signature, which can be monitored over time.<ref name=":21">Kudryashova, K. S., Burka, K., Kulaga, A. Y., Vorobyeva, N. S., & Kennedy, B. K. (2020). Aging Biomarkers: From Functional Tests to Multi‐Omics Approaches. ''Proteomics'', ''20''(5-6), 1900408.</ref>
[[File:Multiomic aging clock.jpg|alt=Multiomic clocks|center|thumb|542x542px|Multiomic clocks integrate various data sources to create a unique biological aging signature that can be tracked over time.<ref name=":21" /> ]]
== Which companies are trying to solve aging? ==
[[File:Calico Labs.png|alt=T|thumb|Calico Labs, a subsidiary of Google, is a billion-dollar company searching for treatments for aging.<ref name=":22" /> ]]
There are over [https://agingbiotech.info/companies 170 longevity biotechnology companies] trying to create therapies to slow or reverse the aging process.<ref name=":4" /> There are over [https://www.lifespan.io/road-maps/the-rejuvenation-roadmap/ 50 longevity drugs] currently in clinical trials in humans.<ref name=":2" />

Many of the longevity biotechnology companies are targeting specific hallmarks of aging. For example, [https://www.clearabiotech.com/#DiscoveryTimeline Cleara Biotech] are attempting to reduce cellular senescence by developing a drug that can eliminate senescent cells.<ref>Cleara Biotech. 2021. ''Cleara Biotech''. [online] Available at: <<nowiki>https://www.clearabiotech.com/#DiscoveryTimeline</nowiki>> [Accessed 15 December 2021].</ref>

Calico Labs is a Google-backed biotech company with the goal of combating aging and age-related diseases. In 2014, the company created a partnership with pharmaceutical giant AbbVie, which has since developed into a [https://www.cnbc.com/2018/06/26/alphabet-backed-calico-and-abbvie-chip-in-1-billion-to-cure-aging.html $2.5 billion venture] in the pursuit of improving “health, wellbeing and longevity.” <ref name=":22">2021. ''Google sister company and drug giant chip in another $1 billion to cure age-related diseases''. [online] Available at: <<nowiki>https://www.cnbc.com/2018/06/26/alphabet-backed-calico-and-abbvie-chip-in-1-billion-to-cure-aging.html</nowiki>> [Accessed 15 December 2021].</ref>

Since aging is not currently considered a disease by regulatory bodies such as the Food and Drug Administration (FDA), drug developers are currently focused on specific diseases of aging such as glaucoma and osteoarthritis.<ref>Clinicaltrialsarena.com. 2021. ''Unity's Phase II osteoarthritis study of UBX0101 misses primary goal''. [online] Available at: <<nowiki>https://www.clinicaltrialsarena.com/news/unity-ubx0101-osteoarthritis/</nowiki>> [Accessed 15 December 2021].</ref>

== Which billionaires are funding longevity biotechnology? ==
[[File:Jeff Bezos is funding longevity research.jpg|alt=Jeff Bezos is funding longevity research|thumb|Jeff Bezos is funding longevity research through financing Atlos Labs.<ref name=":7">MIT Technology Review. 2021. ''Meet Altos Labs, Silicon Valley’s latest wild bet on living forever''. [online] Available at: <<nowiki>https://www.technologyreview.com/2021/09/04/1034364/altos-labs-silicon-valleys-jeff-bezos-milner-bet-living-forever/</nowiki>> [Accessed 15 December 2021].</ref>]]
Several billionaires have funded companies or initiatives to slow or reverse human aging. These include:
* [[wikipedia:Jeff_Bezos|Jeff Bezos]], co-founder of Amazon, helped raise [https://www.technologyreview.com/2021/09/04/1034364/altos-labs-silicon-valleys-jeff-bezos-milner-bet-living-forever/ $270 million for new anti-aging drug company Altos Labs] in 2021.<ref name=":7" />
* [[wikipedia:Peter_Thiel|Peter Thiel]], co-founder of PayPal, was an [https://www.cnbc.com/2018/08/29/-jeff-bezos-is-backing-this-scientist-who-is-working-on-a-cure-for-aging.html early investor in Unity Biotechnology].<ref>CNBC. 2021. ''Why Jeff Bezos is backing this Silicon Valley scientist who is working on a cure for aging''. [online] Available at: <<nowiki>https://www.cnbc.com/2018/08/29/-jeff-bezos-is-backing-this-scientist-who-is-working-on-a-cure-for-aging.html</nowiki>> [Accessed 15 December 2021].</ref>
* [[wikipedia:Sergey_Brin|Sergey Brin]], co-founder of Google, donated [https://www.cnbc.com/2017/03/31/google-co-founders-and-silicon-valley-billionaires-try-to-live-forever.html $25 million for the National Academy of Medicine’s Grand Challenge in Health Longevity] to 'end aging forever'.<ref>Google’s co-founders and other Silicon Valley billionaires are trying to live forever. (2021). Retrieved 15 December 2021, from <nowiki>https://www.cnbc.com/2017/03/31/google-co-founders-and-silicon-valley-billionaires-try-to-live-forever.html</nowiki></ref>
* [[wikipedia:Larry_Page|Larry Page]], co-founder of Google, co-founded the [[wikipedia:Calico_(company)|billion-dollar aging research company Calico Labs.]]<ref>Contributors to Wikimedia projects. (2013, September 19). ''Calico (company) - Wikipedia''. Wikipedia, the free encyclopedia. <nowiki>https://en.wikipedia.org/wiki/Calico_(company)</nowiki>
</ref>
* [[wikipedia:Mike_Cannon-Brookes|Mike Cannon-Brookes]], billionaire cofounder of Australian software giant Atlassian, has invested [https://www.forbes.com/sites/samshead/2019/08/19/billionaire-backs-uk-startup-trying-to-extend-human-lifespans/ $10 million into longevity company Juvenescenc]e.<ref>Shead, S. (2019, August 19). ''Billionaire Backs U.K. Startup Trying To Extend Human Life Spans''. Forbes. <nowiki>https://www.forbes.com/sites/samshead/2019/08/19/billionaire-backs-uk-startup-trying-to-extend-human-lifespans/</nowiki></ref>
* [[wikipedia:Naveen_Jain|Naveen Jain]], billionaire entrepeneur who has raised [https://www.geekwire.com/2021/gut-health-startup-viome-raises-54m-develop-cancer-diagnostics-sell-microbiome-kits/ $54 million for his startup Viome].<ref>''Gut health startup Viome raises $54M to develop cancer diagnostics and sell microbiome kits''. (2021, November 10). Geekwire. <nowiki>https://www.geekwire.com/2021/gut-health-startup-viome-raises-54m-develop-cancer-diagnostics-sell-microbiome-kits/</nowiki></ref>
* [[wikipedia:Jim_Mellon|Jim Mellon]], who co-founded longevity company [https://www.juvlabs.com/people/co-founder/jim-mellon Juvenescence].<ref>''Jim Mellon - Chairman & Co-Founder''. (n.d.). Juvenescence - Science of Healthy Aging & Extended Lifespan. <nowiki>https://www.juvlabs.com/people/co-founder/jim-mellon</nowiki></ref>
* [[wikipedia:Larry_Ellison|Larry Ellison]], founder of Oracle, has spent [https://www.townandcountrymag.com/society/money-and-power/a9202324/science-of-longevity/ $430 million on longevity research].<ref>Tullis, P. (2017, March 30). ''Are You Rich Enough To Live Forever?'' Town & Country. <nowiki>https://www.townandcountrymag.com/society/money-and-power/a9202324/science-of-longevity/</nowiki></ref>
*Michael Greve, founder of Kizoo Technology, who has pledged [https://Longevity.Technology. https://www.longevity.technology/michael-greve-commits-e300m-for-rejuvenation-start-ups/ €300m to rejuvenation biotechnology companies.]<ref>''Michael Greve commits €300m for rejuvenation start-ups''. (2021, May 6). Longevity.Technology. <nowiki>https://www.longevity.technology/michael-greve-commits-e300m-for-rejuvenation-start-ups/</nowiki></ref>
* [[wikipedia:Yuri_Milner|Yuri Milner]], billionaire tech investor who has helped Altos Labs raise $270 million, with Jeff Bezos.<ref name=":7" />
* [https://wikitia.com/wiki/Richard_Heart Richard Heart], founder of the cryptocurrency Hex, who helped raise [https://www.express.co.uk/finance/city/1465354/pulsechain-cryptocurrency-srf-sens-research-foundation-airdrop-pulse-charity-longevity $25 million for the anti-aging research organisation SENS.]<ref>McGleenon, B. (2021, July 20). ''Pulsechain cryptocurrency raises 'mindblowing' $25M in five days for SENS longevity group''. Express.co.uk. <nowiki>https://www.express.co.uk/finance/city/1465354/pulsechain-cryptocurrency-srf-sens-research-foundation-airdrop-pulse-charity-longevity</nowiki></ref>
*[[wikipedia:Brian_Armstrong_(businessman)|Brian Armstrong]], CEO of CoinBase, who helped found and raise [https://www.dailymail.co.uk/sciencetech/article-10310475/Billionaire-launches-new-start-hopes-REVERSE-ageing-process.html $105 million for the epigenetic reprogramming startup NewLimit.]<ref>Liberatore, S. (2021, December 14). ''Billionaire launches new start-up to REVERSE the ageing process''. Mail Online. <nowiki>https://www.dailymail.co.uk/sciencetech/article-10310475/Billionaire-launches-new-start-hopes-REVERSE-ageing-process.html</nowiki></ref>
* [[wikipedia:Vitalik_Buterin|Vitalik Buterin]], founder of the cryptocurrency Ethereum, who donated $2.4 million to SENS.<ref>Foundation, S. R. (n.d.). ''SENS Research Foundation Receives $2.4 Million Ethereum Donation From Vitalik Buterin''. GlobeNewswire News Room. <nowiki>https://www.globenewswire.com/news-release/2018/02/02/1332410/0/en/SENS-Research-Foundation-Receives-2-4-Million-Ethereum-Donation-From-Vitalik-Buterin.html</nowiki></ref>

== How large will the longevity biotechnology field be? ==
Analysts from the Bank of America have predicted that the market size of longevity biotechnology will reach $600 billion by 2025.<ref>2021. ''Human lifespan could soon pass 100 years thanks to medical tech, says BofA''. [online] Available at: <<nowiki>https://www.cnbc.com/2019/05/08/techs-next-big-disruption-could-be-delaying-death.html</nowiki>> [Accessed 14 December 2021].</ref> Others have speculated that it is a trillion dollar industry owing to the immense savings associated with delaying or preventing chronic diseases.<ref>Colangelo, M., 2021. ''AI Will Drive The Multi-Trillion Dollar Longevity Economy''. [online] Forbes. Available at: <<nowiki>https://www.forbes.com/sites/cognitiveworld/2019/12/07/ai-will-drive-the-multi-trillion-dollar-longevity-economy/?sh=294766b74965</nowiki>> [Accessed 14 December 2021].</ref>
== Is age an important for risk factor for COVID-19 mortality? ==
[[File:Age is the -1 risk factor for COVID-19 mortality.jpg|alt=Age is the #1 risk factor for COVID-19 mortality - based on US CDC statistics|thumb|572x572px|The risk of dying from COVID-19 increases exponentially with age. [https://www.cdc.gov/coronavirus/2019-ncov/covid-data/investigations-discovery/hospitalization-death-by-age.html (US CDC statistics)]]]

Age is the single most significant risk factor for COVID-19 mortality. The mortality rate from COVID-19 increases exponentially with age, such that the death rate for those aged over 80 years is over 1000 times higher than those below 30 years.<ref name=":29">[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7576244/ Santesmasses, D., Castro, J. P., Zenin, A. A., Shindyapina, A. V., Gerashchenko, M. V., Zhang, B., ... & Gladyshev, V. N. (2020). COVID‐19 is an emergent disease of aging. ''Aging cell'', ''19''(10), e13230.]</ref>

This increase in COVID-19 mortality with age is thought to be the result of a weakening of the immune system with age, known as immunosenescence.<ref>Bajaj, V., Gadi, N., Spihlman, A. P., Wu, S. C., Choi, C. H., & Moulton, V. R. (2021). Aging, immunity, and COVID-19: how age influences the host immune response to coronavirus infections?. ''Frontiers in Physiology'', ''11'', 1793.</ref>

The mortality rate doubling time for COVID-19 is close to the all-cause mortality rate doubling time.<ref name=":29" /> This has led several scientists to conclude that COVID-19 meets criteria for an age-related disease.<ref name=":29" /><ref>[[Promislow, D. E. (2020). A geroscience perspective on COVID-19 mortality. The Journals of Gerontology: Series A, 75(9), e30-e33.|Promislow, D. E. (2020). A geroscience perspective on COVID-19 mortality. ''The Journals of Gerontology: Series A'', ''75''(9), e30-e33.]]</ref><ref>Alberts, S. C., Archie, E. A., Gesquiere, L. R., Altmann, J., Vaupel, J. W., & Christensen, K. (2014). The male-female health-survival paradox: a comparative perspective on sex differences in aging and mortality. In ''Sociality, hierarchy, health: comparative biodemography: a collection of papers''. National Academies Press (US).</ref><ref name=":10">[[Sierra, F. (2020). Geroscience and the Coronavirus Pandemic: The Whack‐a‐Mole Approach is not Enough. Journal of the American Geriatrics Society, 68(5), 951.|Sierra, F. (2020). Geroscience and the Coronavirus Pandemic: The Whack‐a‐Mole Approach is not Enough. ''Journal of the American Geriatrics Society'', ''68''(5), 951.]]</ref><ref name=":11">[[Barzilai, N., Appleby, J. C., Austad, S. N., Cuervo, A. M., Kaeberlein, M., Gonzalez-Billault, C., ... & Sierra, F. (2020). Geroscience in the Age of COVID-19. Aging and disease, 11(4), 725.|Barzilai, N., Appleby, J. C., Austad, S. N., Cuervo, A. M., Kaeberlein, M., Gonzalez-Billault, C., ... & Sierra, F. (2020). Geroscience in the Age of COVID-19. ''Aging and disease'', ''11''(4), 725.]]</ref><ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7288963/</ref>

== How is aging biology research different to other fields of medical research? ==
Scientists studying the biology of aging believe that aging is a root cause of all the major diseases of aging, and that targeting aging directly would treat or reverse multiple diseases, simultaneously. This is known as the geroscience hypothesis, and has garnered traction in recent years.<ref name=":24">Austad, S. N. (2016). The geroscience hypothesis: is it possible to change the rate of aging?. In ''Advances in geroscience'' (pp. 1-36). Springer, Cham.</ref>

The approach of targeting aging directly differs from many fields in mainstream medical research such as cancer research, which seek to find cures for individual diseases. An argument in favour of targeting aging directly is that targeting single diseases leads to diminishing returns in healthy lifespan extension.<ref name=":18" /> Due to the many diseases that occur concurrently in older age, completely curing a single disease such as cancer would only add 2-3 healthy years of life on average, whereas slowing aging could add 30 or more healthy years.<ref name=":18" /> This is because another disease in line, e.g. Alzheimer's or lung disease, will subsequently result in death, a phenomenon known as the Taeuber Paradox.<ref name=":17" />
== Do all animals age in the same way? ==
[[File:Naked mole rat graph.png|alt=Naked mole rat graph|thumb|530x530px|The naked mole-rat does not follow the same increased risk of mortality due to aging that humans and other mammals do.<ref>Ruby, J. G., Smith, M., & Buffenstein, R. (2018). Naked mole-rat mortality rates defy Gompertzian laws by not increasing with age. ''elife'', ''7'', e31157.</ref> ]]
Many species, due to differences in their biology, age at different rates to humans. The jellyfish ''Turritopsis dohrnii'' can revert to earlier stages of its life cycle in response to stress, and can theoretically live forever - though eventually dies, usually due to predation.<ref>Bavestrello, Giorgio; Christian Sommer; Michele Sarà (1992). "Bi-directional conversion in Turritopsis nutricula (Hydrozoa)".</ref>

Among mammals, the naked mole rat is an exceptionally long lived organism that lives roughly ten times longer than similarly-sized rats.<ref name=":3">Ruby, J. G., Smith, M., & Buffenstein, R. (2018). Naked mole-rat mortality rates defy Gompertzian laws by not increasing with age. ''elife'', ''7'', e31157.</ref><ref>Buffenstein, R., Amoroso, V., Andziak, B., Avdieiev, S., Azpurua, J., Barker, A. J., ... & Smith, E. S. J. (2021). The naked truth: a comprehensive clarification and classification of current ‘myths’ in naked mole‐rat biology. ''Biological Reviews''.</ref> Unlike other organisms, such as humans, horses and mice, the mortality rate of the naked mole rat appears steady over time. This trend does not follow the exponential increase in mortality (Gompertz-Makeham law) that humans do.<ref name=":3" />

Scientists are now studying the naked mole rat to identify key patterns in their genetics, environmental traits, and metabolism that may be responsible for their longer lifespans.<ref>Kim, E. B., Fang, X., Fushan, A. A., Huang, Z., Lobanov, A. V., Han, L., ... & Gladyshev, V. N. (2011). Genome sequencing reveals insights into physiology and longevity of the naked mole rat. ''Nature'', ''479''(7372), 223-227.</ref>

[[File:Naked mole rat.jpg|alt=Naked mole rat|center|thumb|323x323px|The naked mole-rat is unusually long-lived relative to other mice and rats.<ref name=":3" /> ]]

== Is aging considered a disease? ==
Aging is not currently classified as a disease by regulatory bodies such as the Food and Drug Administration (FDA) in the United States. However, several scientists in the aging field have publicly stated their preference for aging to be considered a disease, including professor David Sinclair and professor Nir Barzilai.<ref>TEDx Talks. (2020, June 9). ''Ageing'' ''is'' ''a'' ''treatable'' ''disease'' ''|'' ''Nir'' ''Bazilai'' ''|'' ''TEDxBeaconStreetSalon'' [Video]. YouTube. <nowiki>https://www.youtube.com/watch?v=XN7rLbCBO1c</nowiki></ref>

== What are the economic benefits of extending healthy lifespan? ==
Extending the healthy human lifespan could have significant economic benefits gobally. An economic analysis from 2021 by researchers at the University of Oxford and Harvard University estimated the benefit of a drug that slows aging by 1 year as $38 trillion.<ref name=":23">Scott, A. J., Ellison, M., & Sinclair, D. A. (2021). The economic value of targeting aging. ''Nature Aging'', ''1''(7), 616-623.</ref> This is primarily because slowing aging reduces the incidence of age-related diseases such as cancer and Alzheimer’s disease, which require expensive treatment approaches. The study demonstrated a larger economic benefit of slowing aging than curing the individual diseases of aging. <ref name=":23" />
== Which scientists and institutions are trying to understand and reverse aging? ==
Over [https://whoswho.senescence.info/ 300 scientists are working on understanding the biology of aging] in leading institutions that include Harvard University, Stanford University, Yale University, and the University of Oxford.<ref>''Who's Who in Gerontology: Researchers and Companies Working on Aging''. (n.d.). Who's Who in Gerontology: Researchers and Companies Working on Aging. <nowiki>https://whoswho.senescence.info/</nowiki></ref> Some of the most well-known institutes and labs include:

=== The Buck Institute for Research on Aging ===
The Buck Institute for Research on Aging is one of the largest longevity research institutes with over 250 scientists. The research covers several areas including the mechanisms of aging, neurodegeneration, senescence, stem cells and regenerative medicine, cellular stress and disease, cancer associated with aging, and mitochondrial function.<ref>''Buck Institute''. (n.d.). BUCK. <nowiki>https://www.buckinstitute.org/</nowiki></ref>

=== Professor David Sinclair - Harvard Medical School ===
Professor Sinclair’s lab focuses on understanding and reversing aging. The lab focuses on a range of areas including DNA repair, mitochondrial dysfunction, and the interactions between epigenetic and genetic instability, and tissue reprogramming.<ref>''Welcome | The Sinclair Lab''. (n.d.). Welcome | The Sinclair Lab. <nowiki>https://sinclair.hms.harvard.edu/</nowiki></ref>

=== Professor Matt Kaeberlein - University of Washington ===
Professor Kaeberlein's lab focuses on biological mechanisms of aging in order to facilitate translational interventions that promote healthspan and improve quality of life. Kaeberlein is known for his work on the longevity drug rapamycin in organisms such as mice and dogs. He is Director of the Dog Aging Project, a multi-year initiative studying the genetic and environmental factors that influence health, with over 33,000 participating dogs.<ref>''Matt Kaeberlein, PhD | Faculty | Dept. of Laboratory Medicine & Pathology | UW Medicine''. (n.d.). Dept. of Laboratory Medicine & Pathology | UW Medicine. <nowiki>https://dlmp.uw.edu/faculty/kaeberlein</nowiki></ref>

=== Professor Brian Kennedy - National University of Singapore ===
Professor Kennedy’s lab focuses on understanding the biology of aging and translating research discoveries into new ways of delaying aging in humans. The lab has identified drugs that extend the healthy lifespan of worms and mice and are seeking to understand their mechanisms.<ref>''Brian Kennedy - Department of Biochemistry – School of Medicine, National University of Singapore''. (n.d.). Department of Biochemistry – School of Medicine, National University of Singapore. <nowiki>https://medicine.nus.edu.sg/bch/fa</nowiki></ref>

=== Associate Professor Lynne Cox - University of Oxford ===
Professor Cox’s lab study the molecular and cellular basis of aging to identify specific biochemical processes and pathways that change organisms age. The lab particularly cellular senescence, which underpins many age-related diseases including cancer and neurodegeneration.<ref>''Associate Prof Lynne Cox''. (n.d.). Home | Biochemistry. <nowiki>https://www.bioch.ox.ac.uk/research/cox</nowiki></ref>

== What books have been written on this topic? ==
Several books have been written on the topic of aging and longevity. These include:

* [https://www.amazon.com/Lifespan-Why-Age_and-Dont-Have/dp/1501191977 ''Lifespan: Why We Age And Why We Don't Have To'' - David Sinclair (2019)]

* [https://www.amazon.com/Ending-Aging-Rejuvenation-Breakthroughs-Lifetime/dp/0312367074 ''Ending Aging'' - Dr. Aubrey de Grey (2007)]

* [https://www.amazon.com/Ageless-Science-Getting-Older-Without/dp/0385544928 ''Ageless'' - Dr. Andrew Steele (2020)]

* [https://www.amazon.com.au/Age-Later-Health-Science-Longevity-ebook/dp/B0818MYCRR ''Age Later'' - Professor Nir Barzilai (2021)]

* [https://www.amazon.com.au/Science-Technology-Growing-Young-Breakthroughs/dp/1950665879 ''The Science and Technology of Growing Young'' - Sergey Young (2021)]

== Which anti-aging drugs are being tested in clinical trials today? ==
There are over 50 drugs being tested in human clinical trials for aging or age-related diseases.

The largest trial is the Targeting Aging with Metformin (TAME) trial, which began in 2020. The trial is being run in the United States with a cohort of 3000 older adults. The goal of the TAME trial is to determine whether diabetes drug metformin slows the aging process in older adults. The TAME trial is a $75 million trial run by the American Federation for Aging Research.<ref name=":14" />

Another large clinical trial is the Participitory Evaluation (of) Aging (with) Rapamycin (for) Longevity (PEARL) study. The goal of this study is to determine whether rapamycin, a drug currently approved for immunosuppression during organ transplants, slows biomarkers of aging in 1000 adults. The PEARL trial is being run by AgelessRx.<ref name=":15" />
== Is aging a natural process that should be accepted? ==
Although aging is a natural process in humans, it is the driving force of many diseases such as cancer and Alzheimer's disease - which as a society we have decided are worth trying to find cures for. In the past, these conditions, as well as atherosclerosis and even infectious diseases were once thought of as natural processes that could not be treated. However, nowadays it is understood that they are diseases that can be treated.

Atherosclerosis, the hardening of the arteries, was once viewed as a natural process that was simply a consequence of aging. However, when treatments such as statins were later developed to prevent atherosclerosis, the disease became widely regarded as a disease to be cured. Statins are now one one of the most widely prescribed drugs in the world, used in preventing heart diseases. The inventor of statins, Akira Endo, describes in his historical paper: “Serious research on the role of cholesterol in human atherosclerosis did not really get underway until the 1940s, due to a prevailing view that the disease was a simple consequence of aging and could not be prevented.”<ref>Endo A. (2010). A historical perspective on the discovery of statins. ''Proceedings of the Japan Academy. Series B, Physical and biological sciences'', ''86''(5), 484–493. <nowiki>https://doi.org/10.2183/pjab.86.484</nowiki></ref>

== Will anti-aging technology lead to overpopulation? ==
A common objection to the development of longevity technologies is that they may lead to an unsustainably large population size.

One study of a 2005 Swedish cohort of 9 million people modeled the effect of various anti-aging scenarios. The researchers showed that even with the most radical life-extension technology in which aging completely stopped after age 60, the population growth across 100 years was only 22%.<ref>Gavrilov, L. A., & Gavrilova, N. S. (2010). Demographic consequences of defeating aging. ''Rejuvenation research'', ''13''(2-3), 329-334.</ref>

Currently, the world’s population is 7.9 billion, and the WHO predicts the population will peak at 11 billion in 2100 before falling due to declining birth rates in many parts of the world. The fastest growing populations are in Africa and South-east Asia. However, several factors are thought to reduce birth rates over time, including increased access to contraceptives, female empowerment, increased education and increased employment. There is evidence that populations that move to a more advanced economy show a reduction in birth rates. This is expected to mitigate the increase in population size from longer lifespans.

== Will anti-aging drugs only be available to the rich? ==
It is unclear who will have first access to longevity drugs. Several researchers in the field have argued that several economic factors are likely to drive down the price of drugs that slow aging.

* The cost of many biotechnologies decreases substantially over time. For example, the first human genome cost $100 million to sequence, and is now available for a few hundred dollars.<ref>''The Cost of Sequencing a Human Genome''. (n.d.). Genome.gov. <nowiki>https://www.genome.gov/about-genomics/fact-sheets/Sequencing-Human-Genome-cost</nowiki></ref>

* The price of many lifesaving pharmaceuticals has fallen significantly in price once generic drugs were produced. For example, Lipitor, a statin used to prevent heart disease has fallen in price from $85 in 2011 to less than $5 today.

* Many companies in the longevity field have stated that equity of access is part of their core ethos, and many researchers are part of an international coalition called the Academy of Health & Lifespan research which aims to ensure that breakthroughs in aging research are accessible to all. <ref>''Academy for Health & Lifespan Research''. (n.d.). Academy for Health & Lifespan Research. <nowiki>https://www.ahlresearch.org/</nowiki></ref>

== References ==
<references />

FAQ

2021-12-15T11:08:31Z

Jack: /* Will anti-aging drugs only be available to the rich? */

Longevity biotechnology is a new field of medical research and development that aims to extend healthy human lifespan and delay, prevent or reverse these diseases. This article provides an overview of the field through answering frequently asked questions.

== Why is aging a problem? ==
[[File:Aging graph.png|thumb|750x750px|The aging process results in the risk of age-related diseases increasing exponentially over time.]][[File:Gompertz-Makeham law of mortality.png|alt=Gompertz-Makeham law of mortality|thumb|257x257px|Gompertz-Makeham law of mortality<ref name=":0">En.wikipedia.org. 2021. ''Gompertz–Makeham law of mortality - Wikipedia''. [online] Available at: <<nowiki>https://en.wikipedia.org/wiki/Gompertz%E2%80%93Makeham_law_of_mortality</nowiki>> [Accessed 13 December 2021].</ref>]]Aging is the largest risk factor for the diseases that kill most people worldwide, including cancer, heart diseases and Alzheimer's disease.<ref name=":9" />

In the US in 2020, 9 of the 10 leading causes of death were strongly age-related.<ref name=":19">Ahmad, F. B., & Anderson, R. N. (2021). The leading causes of death in the US for 2020. ''JAMA'', ''325''(18), 1829-1830.https://jamanetwork.com/journals/jama/fullarticle/2778234</ref> Globally, approximately 70% of deaths annually are the result of aging.<ref name=":8" />

Aging also significantly affects quality of life, as deaths due to aging are usually preceded by many months of years of chronic illnesses such as cancer, type 2 diabetes and Alzheimer’s disease.

As a result of the aging process, the risk of an individual dying increases exponentially after the age of around 30 years old.<ref name=":0" /> This increase in mortality rate is known as the Gompertz-Makeham law of mortality.<ref name=":0" />
== How many people die from aging per day? ==
The aging process results in the deaths of 100,000 people per day; more than twice the sum of all other causes of death combined.<ref name=":8">Ritchie, H. and Roser, M., 2021. ''Causes of Death''. [online] Our World in Data. Available at: <<nowiki>https://ourworldindata.org/causes-of-death</nowiki>> [Accessed 13 December 2021].
</ref> This equates to over 37 million people dying per day of aging - a population the size of Canada. This is because aging results in the exponential increasing risk of age-related diseases such as cancer and type 2 diabetes. Aging also accounts for more than 30% of all disability-adjusted life years lost (DALYs); more than any other single cause.<ref>Vizhub.healthdata.org. 2021. ''GBD Compare | IHME Viz Hub''. [online] Available at: <<nowiki>https://vizhub.healthdata.org/gbd-compare/</nowiki>> [Accessed 13 December 2021].</ref>
[[File:Leading causes of death.png|center|thumb|713x713px|9 of the top 10 causes of death in the US in 2020 were strongly age-related.<ref name=":19" />]]

== Can healthy lifespan be extended? ==
[[File:Life extension mice.jpg|alt=Life extension mice|thumb|431x431px|Dietary manipulation, genetic manipulation, and drugs have been shown to increase the healthy lifespan of mice by up to 30%. <ref name=":1">de Magalhaes, J., 2021. ''DrugAge: Species Detail''. [online] Genomics.senescence.info. Available at: <<nowiki>https://genomics.senescence.info/drugs/species_details.php</nowiki>> [Accessed 14 December 2021].</ref>]]Clinical trials for longevity drugs in humans are in-progress, and there is not yet evidence that drugs can slow aging in humans. However, recent experimental breakthroughs over the last few decades have shown that in mice, worms and flies have demonstrated that healthy lifespan can be extended modified. Many clinical trials in humans today are testing whether these results can be replicated in humans.

In animal models, slowing the aging process in animals can be achieved via manipulation of diet, environment, genetics, epigenetics, or with drugs. In mice, over 100 drugs have been shown to extend healthy lifespan by up to 30%.<ref name=":1" />

The effect of longevity drugs on mice is often significant, delaying or eliminating the burden of age-related problems such as frailty, cataracts, cancer, and sarcopenia. For example, a new class of drugs called senolytics have been shown to extend lifespan in mice by over 30% whilst delaying age-related dysfunction.

== Which therapies may extend healthy lifespan? ==
Several drugs are known to extend healthy lifespan in animals. While there is no conclusive data that suggests these drugs would work the same in humans, many of these drugs are now being tested in clinical trials. [[File:Unity Mice.jpg|alt=Unity Mice|thumb|723x723px|Senolytic drugs eliminate senescent cells that accumulate with age, partially reversing multiple age-related diseases and extending the healthy lifespan of mice by up to 35%.<ref name=":16" /> ]]

=== Senolytics ===
Senolytics are drugs that remove senescent cells. These are cells which accumulate in the body with age and are linked with age-related diseases such as cancer.<ref>Xu, M., Pirtskhalava, T., Farr, J. N., Weigand, B. M., Palmer, A. K., Weivoda, M. M., ... & Kirkland, J. L. (2018). Senolytics improve physical function and increase lifespan in old age. ''Nature medicine'', ''24''(8), 1246-1256.</ref>
[[File:Metformin2.jpg|thumb|258x258px|Metformin extends lifespan in mice by 6%, and may extend lifespan in humans.<ref name=":13">Kulkarni, A. S., Gubbi, S., & Barzilai, N. (2020). Benefits of metformin in attenuating the hallmarks of aging. ''Cell metabolism'', ''32''(1), 15-30.</ref>]]
In mice, senolytics have been shown to increase the healthy lifespan by up to 35%.<ref name=":16">Baker, D. J., Childs, B. G., Durik, M., Wijers, M. E., Sieben, C. J., Zhong, J., ... & Van Deursen, J. M. (2016). Naturally occurring p16 Ink4a-positive cells shorten healthy lifespan. ''Nature'', ''530''(7589), 184-189.</ref> The first clinical trials of senolytics in humans began in 2020, and demonstrated benefits to functional measures suggesting these drugs may be effective in humans.

=== [[Metformin]] ===
Metformin is an approved drug for type 2 diabetes that extends lifespan in multiple species. In mice, Metformin extends lifespan by up to 6%.<ref>Anisimov, V. N., Berstein, L. M., Popovich, I. G., Zabezhinski, M. A., Egormin, P. A., Piskunova, T. S., Semenchenko, A. V., Tyndyk, M. L., Yurova, M. N., Kovalenko, I. G., & Poroshina, T. E. (2011). If started early in life, metformin treatment increases life span and postpones tumors in female SHR mice. ''Aging'', ''3''(2), 148–157. <nowiki>https://doi.org/10.18632/aging.100273</nowiki></ref> Metformin works by improving insulin sensitivity and may target several hallmarks of aging.<ref name=":13" /> Metformin is being tested as a longevity therapy in the largest clinical trial for a longevity therapy, the Targeting Aging with Metformin (TAME) trial in the US.<ref name=":14">''TAME - Targeting Aging with Metformin - American Federation for Aging Research''. (n.d.). American Federation for Aging Research. <nowiki>https://www.afar.org/tame-trial</nowiki></ref> This is a randomized clinical trial of 3000 elderly patients comparing metformin against a placebo for the onset of age-related diseases.<ref name=":14" />

=== [[Rapamycin]] ===
[[File:Rapamune .jpg|alt=Rapamune |thumb|253x253px|Rapamycin, also known as Rapamune© is being tested as a drug to extend healthy lifespan in humans. <ref name=":15" />]]
Rapamycin, also known as Rapamune©, is a drug used to prevent the rejection of organ transplants by the immune system. Rapamycin has been shown to extend lifespan by up to 26% when given at middle age, and 14% when given in late life.<ref name=":20">Harrison, D., Strong, R., Sharp, Z. ''et al.'' Rapamycin fed late in life extends lifespan in genetically heterogeneous mice. ''Nature'' 460, 392–395 (2009). <nowiki>https://doi.org/10.1038/nature08221</nowiki>
</ref><ref>Miller, R. A., Harrison, D. E., Astle, C. M., Fernandez, E., Flurkey, K., Han, M., Javors, M. A., Li, X., Nadon, N. L., Nelson, J. F., Pletcher, S., Salmon, A. B., Sharp, Z. D., Van Roekel, S., Winkleman, L., & Strong, R. (2014). Rapamycin-mediated lifespan increase in mice is dose and sex dependent and metabolically distinct from dietary restriction. ''Aging cell'', ''13''(3), 468–477. <nowiki>https://doi.org/10.1111/acel.12194</nowiki></ref>

Among the hundreds of interventions known to target aging, rapamycin is unique in its highly consistent and reproducible effect on healthy lifespan extension in mice.<ref name=":25">Johnson, S. C., Martin, G. M., Rabinovitch, P. S., & Kaeberlein, M. (2013). Preserving youth: does rapamycin deliver? ''Science translational medicine'', ''5''(211), 211fs40.</ref> It is also the drug that exhibits the largest lifespan effect extension in multiple strains of mice, both when dosed in early life and at old age.<ref name=":25" /><ref>Kaeberlein, M. (2014). Rapamycin and aging: when, for how long, and how much? ''Journal of genetics and genomics'', ''41''(9), 459.</ref>

Rapamycin is being tested in a large-scale clinical trial called the Participatory Evaluation (of) Aging (With) Rapamycin (for) Longevity Study (PEARL). The is a randomized clinical trial aiming to enrol 1000 elderly patients comparing rapamycin against placebo for age-related outcomes.<ref name=":15">Clinicaltrials.gov. 2021. ''Participatory Evaluation (of) Aging (With) Rapamycin (for) Longevity Study - Full Text View - ClinicalTrials.gov''. [online] Available at: <<nowiki>https://clinicaltrials.gov/ct2/show/NCT04488601</nowiki>> [Accessed 14 December 2021].
</ref>

=== [[Epigenetic reprogramming]] ===
Epigenetic reprogramming is remodeling the epigenetic marks, such as methylation tags on the DNA, in cells. This technique was used in 2020 to restore vision to blind mice by fully regrowing the optic nerve.<ref>Lu, Y., Brommer, B., Tian, X. ''et al.'' Reprogramming to recover youthful epigenetic information and restore vision. ''Nature'' 588, 124–129 (2020). <nowiki>https://doi.org/10.1038/s41586-020-2975-4</nowiki></ref> The researchers at Harvard medical school and believe this approach could one day be used to regenerate other tissues of the body as a longevity strategy.<ref>''Reversing The Aging Clock With Epigenetic Reprogramming''. (n.d.). Pubs - Bio-IT World. <nowiki>https://www.bio-itworld.com/news/2021/01/13/reversing-the-aging-clock-with-epigenetic-reprogramming</nowiki></ref>

In addition, over [https://www.lifespan.io/road-maps/the-rejuvenation-roadmap 50 other drugs] are being tested in human clinical trials for slowing aging.<ref name=":2">Lifespan.io. 2021. ''The Rejuvenation Roadmap | Lifespan.io''. [online] Available at: <<nowiki>https://www.lifespan.io/road-maps/the-rejuvenation-roadmap/</nowiki>> [Accessed 13 December 2021].</ref>

== What is the goal of longevity biotechnology? ==
[[File:Healthy lifespan extension.png|alt=Healthy lifespan extension|thumb|643x643px|Healthy lifespan extension involves early intervention to prevent or delay the decline associated with aging.<ref>''Longevity companies to watch in 2021 - Longevity.Technology''. (n.d.). Longevity.Technology. <nowiki>https://www.longevity.technology/longevity-companies-to-watch-in-2021/</nowiki></ref> ]]
Longevity biotechnology aims to slow or reverse the aging process to extend the healthy lifespan (‘healthspan’) of the population. Instead of treating diseases when they arise, one by one, longevity biotechnology aims to keep those who are already healthy, healthy by slowing the aging process. The aim is to thereby delay or prevent multiple diseases at once that are associated with aging.

The longevity biotechnology sector is rapidly growing, and there are currently over 170 private companies working on developing therapeutics to slow the aging process.<ref name=":4">Pfleger, K., 2021. ''Aging Companies''. [online] Agingbiotech.info. Available at: <<nowiki>https://agingbiotech.info/companies</nowiki>> [Accessed 13 December 2021].</ref> These companies are working on slowing or reversing the aging process by targeting one of more of the hallmarks of aging.

== Will healthy or unhealthy lifespan be extended? ==
[[File:Extending healthy lifespan.png|alt=Extending healthy lifespan|thumb|364x364px|Extending healthy versus unhealthy lifespan. <ref>''How to save Medicare: the anti-aging remedy''. (2012, March). <nowiki>https://www.researchgate.net/figure/From-longer-life-span-to-longer-health-span-and-life-span-From-A-to-B-Standard_fig1_230724035</nowiki>.</ref>]]
The stated goal of longevity biotechnology is to extend the healthy period of lifespan, before age-related diseases set in. This is in contrast to many of today's medical interventions, which extend life only after diseases (e.g. cancer, Alzheimer's) have reached a clinical level.

Age-related diseases are preceded by a long period of subclinical aging, i.e. aging that has not yet progressed far enough to produce clinical symptoms. By slowing, delaying or reversing the aging process, the hypothesis is that the healthy period of life can be extended.<ref name=":24" />

Studies in mice have demonstrated that life extending drugs such as rapamycin are capable of extending the healthy, rather than unhealthy period of life.<ref name=":20" />
== Should we treat specific diseases such as cancer, or aging? ==
[[File:Slowing aging versus curing cancer.jpg|alt=Slowing aging is potentially a more effective means of extending healthy lifespan than treating individual diseases due to the comorbid nature of age-related diseases. [6]|thumb|421x421px|Slowing aging is potentially a more effective means of extending healthy lifespan than treating individual diseases due to the comorbid nature of age-related diseases.<ref name=":18" /> ]]
Longevity biotechnology potentially offers a greater likelihood of extending healthy lifespan than attempting to find cures for the individual diseases of aging. This is because biological aging is associated with many of diseases of aging that develop as comorbidities i.e. at the same time. Even if a person survives one age-related disease such as cancer, another (e.g. diabetes, cardiovascular disease) is likely to kill the person if the underlying aging is not treated. This phenomenon is known as Taueber's paradox<ref name=":17">En.wikipedia.org. 2021. ''Taeuber Paradox - Wikipedia''. [online] Available at: <<nowiki>https://en.wikipedia.org/wiki/Taeuber_Paradox</nowiki>> [Accessed 14 December 2021].</ref>, and accounts for the much smaller projected increase in healthy lifespan associated with curing the diseases of aging, such as cancer (2-3 years), versus slowing aging itself (30+ years).<ref name=":18">Matt Kaeberlein, PhD, It is Time to Embrace 21st-Century Medicine, ''Public Policy & Aging Report'', Volume 29, Issue 4, 2019, Pages 111–115, <nowiki>https://doi.org/10.1093/ppar/prz022</nowiki></ref>
== What is biological aging? ==
There are two main types of 'age': chronological age - the number of years since birth, and biological age - a measure of the physical health of a person and their position in their lifespan. Biological age is more difficult to measure, but recent technologies are now available to estimate biological age. Over time, we age biologically. This occurs due to many processes in the body, which are generally categorised into 9 processes or 'hallmarks'.<ref name=":9" />
== What are the 9 Hallmarks of Aging? ==
[[File:Hallmarks of aging.jpg|alt=Hallmarks of aging|thumb|444x444px|The nine hallmarks of aging.<ref name=":9" />]]

The hallmarks of aging framework is considered to broadly represent key biological mechanisms of the biological aging process.<ref name=":9">López-Otín C, Blasco MA, Partridge L, Serrano M, Kroemer G. The hallmarks of aging. Cell. 2013 Jun 6;153(6):1194-217.</ref> Although there are various limitations of the hallmarks framework, it has become the central framework for understanding aging biology. The nine forms of cellular and molecular ‘damage’ that comprise the hallmarks of aging are<ref name=":9" />:

* Genomic instability
* Telomere attrition
* Epigenetic alterations
* Loss of proteostasis
* Deregulated nutrient-sensing
* Mitochondrial dysfunction
* Cellular senescence
* Stem cell exhaustion
* Altered intercellular communication

These are essentially the lowest common denominators of the aging process, on a cellular or subcellular level. All of the other changes associated with aging, such as greying hair, wrinkles, frailty and an increased risk of disease is thought to stem from these underlyig processes.<ref name=":9" />

== How does the aging cause disease? ==
The nine hallmarks of aging have been shown to play an integral role in the development of many age-related diseases such as neurodegenerative diseases and cancer:
=== [[Aging and Neurodegeneration|Neurodegenerative disease]] ===
[[File:Prevalence of neuro disorders.jpg|alt=Prevalence of neuro disorders|thumb|469x469px|The prevalence of neurodegenerative disorders increases exponentially with age, due to the biological aging process.<ref name=":12">Hou, Y., Dan, X., Babbar, M., Wei, Y., Hasselbalch, S. G., Croteau, D. L., & Bohr, V. A. (2019). Ageing as a risk factor for neurodegenerative disease. ''Nature reviews. Neurology'', ''15''(10), 565–581. <nowiki>https://doi.org/10.1038/s41582-019-0244-7</nowiki></ref> ]]
All of the hallmarks of aging are associated with an increased risk of neurodegenerative diseases, such as Parkinson's disease and Alzheimer's disease.<ref>Qiu, C., Kivipelto, M., & von Strauss, E. (2009). Epidemiology of Alzheimer's disease: occurrence, determinants, and strategies toward intervention. ''Dialogues in clinical neuroscience'', ''11''(2), 111.</ref> For example, several types of DNA damage are associated with neurodegeneration. The shortening of telomeres occurs as part of biological aging and causes cellular senescence, and is associated with neurodegeneration and neurodegenerative diseases including Alzheimer's disease and Parkinson's disease.<ref name=":12" /> Additionally, mitochondrial dysfunction, altered metabolism, stem cell exhaustion and loss of proteostasis are also involved in the development of neurodegenerative diseases.<ref name=":12" />
=== [[Aging and Cancer|Cancer]] ===
Several of the hallmarks of aging such as cellular senescence and alterations in the extracellular matrix are responsible for increasing the likelihood of tumorigenesis.<ref name=":5">Fane, M., & Weeraratna, A. T. (2020). How the ageing microenvironment influences tumour progression. ''Nature Reviews Cancer'', ''20''(2), 89-106.</ref> Other hallmarks of aging such as genomic instability, loss or proteostasis, altered intercellular communication (i.e. inflammation) and epigenetic alterations are also involved in tumorigenesis.<ref name=":5" />
== How is biological age measured? ==
[[File:Epigenetic clock.png|alt=Epigenetic clock|thumb|605x605px|The epigenetic clock measures biological age based on marks on the epigenome.<ref name=":6" /> ]]
Recent technologies have allow biological age to be measured. These include:

=== [[Epigenetic clock|Epigenetic clocks]] ===
The first generation of aging clocks are known as [[Epigenetic clock|epigenetic clocks or Horvath’s clock]].<ref name=":6">Horvath, S., & Raj, K. (2018). DNA methylation-based biomarkers and the epigenetic clock theory of ageing. ''Nature Reviews Genetics'', ''19''(6), 371-384.</ref> This clock is based on the finding that over time, the body accumulates methylation tags on the DNA in a pattern that can be predicted with machine learning. These changes to the epigenome are influenced by lifestyle, and can be used to measure biological age.<ref name=":6" /> Factors such as exercise frequency and a low BMI have been shown to reduce the rate of biological aging, whereas obesity and smoking can accelerate the rate of aging.<ref>Quach, A., Levine, M. E., Tanaka, T., Lu, A. T., Chen, B. H., Ferrucci, L., ... & Horvath, S. (2017). Epigenetic clock analysis of diet, exercise, education, and lifestyle factors. ''Aging (Albany NY)'', ''9''(2), 419.</ref><ref>Wu, X., Huang, Q., Javed, R., Zhong, J., Gao, H., & Liang, H. (2019). Effect of tobacco smoking on the epigenetic age of human respiratory organs. ''Clinical Epigenetics'', ''11''(1), 183. <nowiki>https://doi.org/10.1186/s13148-019-0777-z</nowiki>

[[Epigenetic clock#cite%20ref-12|↑]]</ref><ref>Horvath, S., Erhart, W., Brosch, M., Ammerpohl, O., von Schönfels, W., Ahrens, M., Heits, N., Bell, J. T., Tsai, P.-C., Spector, T. D., Deloukas, P., Siebert, R., Sipos, B., Becker, T., Röcken, C., Schafmayer, C., & Hampe, J. (2014). Obesity accelerates epigenetic aging of human liver. ''Proceedings of the National Academy of Sciences'', ''111''(43), 15538–15543. <nowiki>https://doi.org/10.1073/pnas.1412759111</nowiki>

[[Epigenetic clock#cite%20ref-13|↑]]</ref> The Horvath's clock has been used to accurately predict mortality risk.<ref>Fransquet, P. D., Wrigglesworth, J., Woods, R. L., Ernst, M. E., & Ryan, J. (2019). The epigenetic clock as a predictor of disease and mortality risk: a systematic review and meta-analysis. ''Clinical epigenetics'', ''11''(1), 1-17.</ref>

=== Multi-omic clocks ===
Multi-omic clocks are being developed that incorporate data from several sources, such as body imaging scans, blood tests, and fitness tests. These clocks are built using machine learning to estimate biological age. These aging clocks are being developed that combine multiple biological functional tests to create a unique aging signature, which can be monitored over time.<ref name=":21">Kudryashova, K. S., Burka, K., Kulaga, A. Y., Vorobyeva, N. S., & Kennedy, B. K. (2020). Aging Biomarkers: From Functional Tests to Multi‐Omics Approaches. ''Proteomics'', ''20''(5-6), 1900408.</ref>
[[File:Multiomic aging clock.jpg|alt=Multiomic clocks|center|thumb|542x542px|Multiomic clocks integrate various data sources to create a unique biological aging signature that can be tracked over time.<ref name=":21" /> ]]
== Which companies are trying to solve aging? ==
[[File:Calico Labs.png|alt=T|thumb|Calico Labs, a subsidiary of Google, is a billion-dollar company searching for treatments for aging.<ref name=":22" /> ]]
There are over [https://agingbiotech.info/companies 170 longevity biotechnology companies] trying to create therapies to slow or reverse the aging process.<ref name=":4" /> There are over [https://www.lifespan.io/road-maps/the-rejuvenation-roadmap/ 50 longevity drugs] currently in clinical trials in humans.<ref name=":2" />

Many of the longevity biotechnology companies are targeting specific hallmarks of aging. For example, [https://www.clearabiotech.com/#DiscoveryTimeline Cleara Biotech] are attempting to reduce cellular senescence by developing a drug that can eliminate senescent cells.<ref>Cleara Biotech. 2021. ''Cleara Biotech''. [online] Available at: <<nowiki>https://www.clearabiotech.com/#DiscoveryTimeline</nowiki>> [Accessed 15 December 2021].</ref>

Calico Labs is a Google-backed biotech company with the goal of combating aging and age-related diseases. In 2014, the company created a partnership with pharmaceutical giant AbbVie, which has since developed into a [https://www.cnbc.com/2018/06/26/alphabet-backed-calico-and-abbvie-chip-in-1-billion-to-cure-aging.html $2.5 billion venture] in the pursuit of improving “health, wellbeing and longevity.” <ref name=":22">2021. ''Google sister company and drug giant chip in another $1 billion to cure age-related diseases''. [online] Available at: <<nowiki>https://www.cnbc.com/2018/06/26/alphabet-backed-calico-and-abbvie-chip-in-1-billion-to-cure-aging.html</nowiki>> [Accessed 15 December 2021].</ref>

Since aging is not currently considered a disease by regulatory bodies such as the Food and Drug Administration (FDA), drug developers are currently focused on specific diseases of aging such as glaucoma and osteoarthritis.<ref>Clinicaltrialsarena.com. 2021. ''Unity's Phase II osteoarthritis study of UBX0101 misses primary goal''. [online] Available at: <<nowiki>https://www.clinicaltrialsarena.com/news/unity-ubx0101-osteoarthritis/</nowiki>> [Accessed 15 December 2021].</ref>

== Which billionaires are funding longevity biotechnology? ==
[[File:Jeff Bezos is funding longevity research.jpg|alt=Jeff Bezos is funding longevity research|thumb|Jeff Bezos is funding longevity research through financing Atlos Labs.<ref name=":7">MIT Technology Review. 2021. ''Meet Altos Labs, Silicon Valley’s latest wild bet on living forever''. [online] Available at: <<nowiki>https://www.technologyreview.com/2021/09/04/1034364/altos-labs-silicon-valleys-jeff-bezos-milner-bet-living-forever/</nowiki>> [Accessed 15 December 2021].</ref>]]
Several billionaires have funded companies or initiatives to slow or reverse human aging. These include:
* [[wikipedia:Jeff_Bezos|Jeff Bezos]], co-founder of Amazon, helped raise [https://www.technologyreview.com/2021/09/04/1034364/altos-labs-silicon-valleys-jeff-bezos-milner-bet-living-forever/ $270 million for new anti-aging drug company Altos Labs] in 2021.<ref name=":7" />
* [[wikipedia:Peter_Thiel|Peter Thiel]], co-founder of PayPal, was an [https://www.cnbc.com/2018/08/29/-jeff-bezos-is-backing-this-scientist-who-is-working-on-a-cure-for-aging.html early investor in Unity Biotechnology].<ref>CNBC. 2021. ''Why Jeff Bezos is backing this Silicon Valley scientist who is working on a cure for aging''. [online] Available at: <<nowiki>https://www.cnbc.com/2018/08/29/-jeff-bezos-is-backing-this-scientist-who-is-working-on-a-cure-for-aging.html</nowiki>> [Accessed 15 December 2021].</ref>
* [[wikipedia:Sergey_Brin|Sergey Brin]], co-founder of Google, donated [https://www.cnbc.com/2017/03/31/google-co-founders-and-silicon-valley-billionaires-try-to-live-forever.html $25 million for the National Academy of Medicine’s Grand Challenge in Health Longevity] to 'end aging forever'.<ref>Google’s co-founders and other Silicon Valley billionaires are trying to live forever. (2021). Retrieved 15 December 2021, from <nowiki>https://www.cnbc.com/2017/03/31/google-co-founders-and-silicon-valley-billionaires-try-to-live-forever.html</nowiki></ref>
* [[wikipedia:Larry_Page|Larry Page]], co-founder of Google, co-founded the [[wikipedia:Calico_(company)|billion-dollar aging research company Calico Labs.]]<ref>Contributors to Wikimedia projects. (2013, September 19). ''Calico (company) - Wikipedia''. Wikipedia, the free encyclopedia. <nowiki>https://en.wikipedia.org/wiki/Calico_(company)</nowiki>
</ref>
* [[wikipedia:Mike_Cannon-Brookes|Mike Cannon-Brookes]], billionaire cofounder of Australian software giant Atlassian, has invested [https://www.forbes.com/sites/samshead/2019/08/19/billionaire-backs-uk-startup-trying-to-extend-human-lifespans/ $10 million into longevity company Juvenescenc]e.<ref>Shead, S. (2019, August 19). ''Billionaire Backs U.K. Startup Trying To Extend Human Life Spans''. Forbes. <nowiki>https://www.forbes.com/sites/samshead/2019/08/19/billionaire-backs-uk-startup-trying-to-extend-human-lifespans/</nowiki></ref>
* [[wikipedia:Naveen_Jain|Naveen Jain]], billionaire entrepeneur who has raised [https://www.geekwire.com/2021/gut-health-startup-viome-raises-54m-develop-cancer-diagnostics-sell-microbiome-kits/ $54 million for his startup Viome].<ref>''Gut health startup Viome raises $54M to develop cancer diagnostics and sell microbiome kits''. (2021, November 10). Geekwire. <nowiki>https://www.geekwire.com/2021/gut-health-startup-viome-raises-54m-develop-cancer-diagnostics-sell-microbiome-kits/</nowiki></ref>
* [[wikipedia:Jim_Mellon|Jim Mellon]], who co-founded longevity company [https://www.juvlabs.com/people/co-founder/jim-mellon Juvenescence].<ref>''Jim Mellon - Chairman & Co-Founder''. (n.d.). Juvenescence - Science of Healthy Aging & Extended Lifespan. <nowiki>https://www.juvlabs.com/people/co-founder/jim-mellon</nowiki></ref>
* [[wikipedia:Larry_Ellison|Larry Ellison]], founder of Oracle, has spent [https://www.townandcountrymag.com/society/money-and-power/a9202324/science-of-longevity/ $430 million on longevity research].<ref>Tullis, P. (2017, March 30). ''Are You Rich Enough To Live Forever?'' Town & Country. <nowiki>https://www.townandcountrymag.com/society/money-and-power/a9202324/science-of-longevity/</nowiki></ref>
*Michael Greve, founder of Kizoo Technology, who has pledged [https://Longevity.Technology. https://www.longevity.technology/michael-greve-commits-e300m-for-rejuvenation-start-ups/ €300m to rejuvenation biotechnology companies.]<ref>''Michael Greve commits €300m for rejuvenation start-ups''. (2021, May 6). Longevity.Technology. <nowiki>https://www.longevity.technology/michael-greve-commits-e300m-for-rejuvenation-start-ups/</nowiki></ref>
* [[wikipedia:Yuri_Milner|Yuri Milner]], billionaire tech investor who has helped Altos Labs raise $270 million, with Jeff Bezos.<ref name=":7" />
* [https://wikitia.com/wiki/Richard_Heart Richard Heart], founder of the cryptocurrency Hex, who helped raise [https://www.express.co.uk/finance/city/1465354/pulsechain-cryptocurrency-srf-sens-research-foundation-airdrop-pulse-charity-longevity $25 million for the anti-aging research organisation SENS.]<ref>McGleenon, B. (2021, July 20). ''Pulsechain cryptocurrency raises 'mindblowing' $25M in five days for SENS longevity group''. Express.co.uk. <nowiki>https://www.express.co.uk/finance/city/1465354/pulsechain-cryptocurrency-srf-sens-research-foundation-airdrop-pulse-charity-longevity</nowiki></ref>
*[[wikipedia:Brian_Armstrong_(businessman)|Brian Armstrong]], CEO of CoinBase, who helped found and raise [https://www.dailymail.co.uk/sciencetech/article-10310475/Billionaire-launches-new-start-hopes-REVERSE-ageing-process.html $105 million for the epigenetic reprogramming startup NewLimit.]<ref>Liberatore, S. (2021, December 14). ''Billionaire launches new start-up to REVERSE the ageing process''. Mail Online. <nowiki>https://www.dailymail.co.uk/sciencetech/article-10310475/Billionaire-launches-new-start-hopes-REVERSE-ageing-process.html</nowiki></ref>
* [[wikipedia:Vitalik_Buterin|Vitalik Buterin]], founder of the cryptocurrency Ethereum, who donated $2.4 million to SENS.<ref>Foundation, S. R. (n.d.). ''SENS Research Foundation Receives $2.4 Million Ethereum Donation From Vitalik Buterin''. GlobeNewswire News Room. <nowiki>https://www.globenewswire.com/news-release/2018/02/02/1332410/0/en/SENS-Research-Foundation-Receives-2-4-Million-Ethereum-Donation-From-Vitalik-Buterin.html</nowiki></ref>

== How large will the longevity biotechnology field be? ==
Analysts from the Bank of America have predicted that the market size of longevity biotechnology will reach $600 billion by 2025.<ref>2021. ''Human lifespan could soon pass 100 years thanks to medical tech, says BofA''. [online] Available at: <<nowiki>https://www.cnbc.com/2019/05/08/techs-next-big-disruption-could-be-delaying-death.html</nowiki>> [Accessed 14 December 2021].</ref> Others have speculated that it is a trillion dollar industry owing to the immense savings associated with delaying or preventing chronic diseases.<ref>Colangelo, M., 2021. ''AI Will Drive The Multi-Trillion Dollar Longevity Economy''. [online] Forbes. Available at: <<nowiki>https://www.forbes.com/sites/cognitiveworld/2019/12/07/ai-will-drive-the-multi-trillion-dollar-longevity-economy/?sh=294766b74965</nowiki>> [Accessed 14 December 2021].</ref>
== Is age an important for risk factor for COVID-19 mortality? ==
[[File:Age is the -1 risk factor for COVID-19 mortality.jpg|alt=Age is the #1 risk factor for COVID-19 mortality - based on US CDC statistics|thumb|572x572px|The risk of dying from COVID-19 increases exponentially with age. [https://www.cdc.gov/coronavirus/2019-ncov/covid-data/investigations-discovery/hospitalization-death-by-age.html (US CDC statistics)]]]

Age is the single most significant risk factor for COVID-19 mortality. The mortality rate from COVID-19 increases exponentially with age, such that the death rate for those aged over 80 years is over 1000 times higher than those below 30 years.<ref name=":29">[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7576244/ Santesmasses, D., Castro, J. P., Zenin, A. A., Shindyapina, A. V., Gerashchenko, M. V., Zhang, B., ... & Gladyshev, V. N. (2020). COVID‐19 is an emergent disease of aging. ''Aging cell'', ''19''(10), e13230.]</ref>

This increase in COVID-19 mortality with age is thought to be the result of a weakening of the immune system with age, known as immunosenescence.<ref>Bajaj, V., Gadi, N., Spihlman, A. P., Wu, S. C., Choi, C. H., & Moulton, V. R. (2021). Aging, immunity, and COVID-19: how age influences the host immune response to coronavirus infections?. ''Frontiers in Physiology'', ''11'', 1793.</ref>

The mortality rate doubling time for COVID-19 is close to the all-cause mortality rate doubling time.<ref name=":29" /> This has led several scientists to conclude that COVID-19 meets criteria for an age-related disease.<ref name=":29" /><ref>[[Promislow, D. E. (2020). A geroscience perspective on COVID-19 mortality. The Journals of Gerontology: Series A, 75(9), e30-e33.|Promislow, D. E. (2020). A geroscience perspective on COVID-19 mortality. ''The Journals of Gerontology: Series A'', ''75''(9), e30-e33.]]</ref><ref>Alberts, S. C., Archie, E. A., Gesquiere, L. R., Altmann, J., Vaupel, J. W., & Christensen, K. (2014). The male-female health-survival paradox: a comparative perspective on sex differences in aging and mortality. In ''Sociality, hierarchy, health: comparative biodemography: a collection of papers''. National Academies Press (US).</ref><ref name=":10">[[Sierra, F. (2020). Geroscience and the Coronavirus Pandemic: The Whack‐a‐Mole Approach is not Enough. Journal of the American Geriatrics Society, 68(5), 951.|Sierra, F. (2020). Geroscience and the Coronavirus Pandemic: The Whack‐a‐Mole Approach is not Enough. ''Journal of the American Geriatrics Society'', ''68''(5), 951.]]</ref><ref name=":11">[[Barzilai, N., Appleby, J. C., Austad, S. N., Cuervo, A. M., Kaeberlein, M., Gonzalez-Billault, C., ... & Sierra, F. (2020). Geroscience in the Age of COVID-19. Aging and disease, 11(4), 725.|Barzilai, N., Appleby, J. C., Austad, S. N., Cuervo, A. M., Kaeberlein, M., Gonzalez-Billault, C., ... & Sierra, F. (2020). Geroscience in the Age of COVID-19. ''Aging and disease'', ''11''(4), 725.]]</ref><ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7288963/</ref>

== How is aging biology research different to other fields of medical research? ==
Scientists studying the biology of aging believe that aging is a root cause of all the major diseases of aging, and that targeting aging directly would treat or reverse multiple diseases, simultaneously. This is known as the geroscience hypothesis, and has garnered traction in recent years.<ref name=":24">Austad, S. N. (2016). The geroscience hypothesis: is it possible to change the rate of aging?. In ''Advances in geroscience'' (pp. 1-36). Springer, Cham.</ref>

The approach of targeting aging directly differs from many fields in mainstream medical research such as cancer research, which seek to find cures for individual diseases. An argument in favour of targeting aging directly is that targeting single diseases leads to diminishing returns in healthy lifespan extension.<ref name=":18" /> Due to the many diseases that occur concurrently in older age, completely curing a single disease such as cancer would only add 2-3 healthy years of life on average, whereas slowing aging could add 30 or more healthy years.<ref name=":18" /> This is because another disease in line, e.g. Alzheimer's or lung disease, will subsequently result in death, a phenomenon known as the Taeuber Paradox.<ref name=":17" />
== Do all animals age in the same way? ==
[[File:Naked mole rat graph.png|alt=Naked mole rat graph|thumb|530x530px|The naked mole-rat does not follow the same increased risk of mortality due to aging that humans and other mammals do.<ref>Ruby, J. G., Smith, M., & Buffenstein, R. (2018). Naked mole-rat mortality rates defy Gompertzian laws by not increasing with age. ''elife'', ''7'', e31157.</ref> ]]
Many species, due to differences in their biology, age at different rates to humans. The jellyfish ''Turritopsis dohrnii'' can revert to earlier stages of its life cycle in response to stress, and can theoretically live forever - though eventually dies, usually due to predation.<ref>Bavestrello, Giorgio; Christian Sommer; Michele Sarà (1992). "Bi-directional conversion in Turritopsis nutricula (Hydrozoa)".</ref>

Among mammals, the naked mole rat is an exceptionally long lived organism that lives roughly ten times longer than similarly-sized rats.<ref name=":3">Ruby, J. G., Smith, M., & Buffenstein, R. (2018). Naked mole-rat mortality rates defy Gompertzian laws by not increasing with age. ''elife'', ''7'', e31157.</ref><ref>Buffenstein, R., Amoroso, V., Andziak, B., Avdieiev, S., Azpurua, J., Barker, A. J., ... & Smith, E. S. J. (2021). The naked truth: a comprehensive clarification and classification of current ‘myths’ in naked mole‐rat biology. ''Biological Reviews''.</ref> Unlike other organisms, such as humans, horses and mice, the mortality rate of the naked mole rat appears steady over time. This trend does not follow the exponential increase in mortality (Gompertz-Makeham law) that humans do.<ref name=":3" />

Scientists are now studying the naked mole rat to identify key patterns in their genetics, environmental traits, and metabolism that may be responsible for their longer lifespans.<ref>Kim, E. B., Fang, X., Fushan, A. A., Huang, Z., Lobanov, A. V., Han, L., ... & Gladyshev, V. N. (2011). Genome sequencing reveals insights into physiology and longevity of the naked mole rat. ''Nature'', ''479''(7372), 223-227.</ref>

[[File:Naked mole rat.jpg|alt=Naked mole rat|center|thumb|323x323px|The naked mole-rat is unusually long-lived relative to other mice and rats.<ref name=":3" /> ]]

== Is aging considered a disease? ==
Aging is not currently classified as a disease by regulatory bodies such as the Food and Drug Administration (FDA) in the United States. However, several scientists in the aging field have publicly stated their preference for aging to be considered a disease, including professor David Sinclair and professor Nir Barzilai.<ref>TEDx Talks. (2020, June 9). ''Ageing'' ''is'' ''a'' ''treatable'' ''disease'' ''|'' ''Nir'' ''Bazilai'' ''|'' ''TEDxBeaconStreetSalon'' [Video]. YouTube. <nowiki>https://www.youtube.com/watch?v=XN7rLbCBO1c</nowiki></ref>

== What are the economic benefits of extending healthy lifespan? ==
Extending the healthy human lifespan could have significant economic benefits gobally. An economic analysis from 2021 by researchers at the University of Oxford and Harvard University estimated the benefit of a drug that slows aging by 1 year as $38 trillion.<ref name=":23">Scott, A. J., Ellison, M., & Sinclair, D. A. (2021). The economic value of targeting aging. ''Nature Aging'', ''1''(7), 616-623.</ref> This is primarily because slowing aging reduces the incidence of age-related diseases such as cancer and Alzheimer’s disease, which require expensive treatment approaches. The study demonstrated a larger economic benefit of slowing aging than curing the individual diseases of aging. <ref name=":23" />
== Which scientists and institutions are trying to understand and reverse aging? ==
Over [https://whoswho.senescence.info/ 300 scientists are working on understanding the biology of aging] in leading institutions that include Harvard University, Stanford University, Yale University, and the University of Oxford.<ref>''Who's Who in Gerontology: Researchers and Companies Working on Aging''. (n.d.). Who's Who in Gerontology: Researchers and Companies Working on Aging. <nowiki>https://whoswho.senescence.info/</nowiki></ref> Some of the most well-known institutes and labs include:

=== The Buck Institute for Research on Aging ===
The Buck Institute for Research on Aging is one of the largest longevity research institutes with over 250 scientists. The research covers several areas including the mechanisms of aging, neurodegeneration, senescence, stem cells and regenerative medicine, cellular stress and disease, cancer associated with aging, and mitochondrial function.<ref>''Buck Institute''. (n.d.). BUCK. <nowiki>https://www.buckinstitute.org/</nowiki></ref>

=== Professor David Sinclair - Harvard Medical School ===
Professor Sinclair’s lab focuses on understanding and reversing aging. The lab focuses on a range of areas including DNA repair, mitochondrial dysfunction, and the interactions between epigenetic and genetic instability, and tissue reprogramming.<ref>''Welcome | The Sinclair Lab''. (n.d.). Welcome | The Sinclair Lab. <nowiki>https://sinclair.hms.harvard.edu/</nowiki></ref>

=== Professor Matt Kaeberlein - University of Washington ===
Professor Kaeberlein's lab focuses on biological mechanisms of aging in order to facilitate translational interventions that promote healthspan and improve quality of life. Kaeberlein is known for his work on the longevity drug rapamycin in organisms such as mice and dogs. He is Director of the Dog Aging Project, a multi-year initiative studying the genetic and environmental factors that influence health, with over 33,000 participating dogs.<ref>''Matt Kaeberlein, PhD | Faculty | Dept. of Laboratory Medicine & Pathology | UW Medicine''. (n.d.). Dept. of Laboratory Medicine & Pathology | UW Medicine. <nowiki>https://dlmp.uw.edu/faculty/kaeberlein</nowiki></ref>

=== Professor Brian Kennedy - National University of Singapore ===
Professor Kennedy’s lab focuses on understanding the biology of aging and translating research discoveries into new ways of delaying aging in humans. The lab has identified drugs that extend the healthy lifespan of worms and mice and are seeking to understand their mechanisms.<ref>''Brian Kennedy - Department of Biochemistry – School of Medicine, National University of Singapore''. (n.d.). Department of Biochemistry – School of Medicine, National University of Singapore. <nowiki>https://medicine.nus.edu.sg/bch/fa</nowiki></ref>

=== Associate Professor Lynne Cox - University of Oxford ===
Professor Cox’s lab study the molecular and cellular basis of aging to identify specific biochemical processes and pathways that change organisms age. The lab particularly cellular senescence, which underpins many age-related diseases including cancer and neurodegeneration.<ref>''Associate Prof Lynne Cox''. (n.d.). Home | Biochemistry. <nowiki>https://www.bioch.ox.ac.uk/research/cox</nowiki></ref>

== What books have been written on this topic? ==
Several books have been written on the topic of aging and longevity. These include:

* [https://www.amazon.com/Lifespan-Why-Age_and-Dont-Have/dp/1501191977 ''Lifespan: Why We Age And Why We Don't Have To'' - David Sinclair (2019)]

* [https://www.amazon.com/Ending-Aging-Rejuvenation-Breakthroughs-Lifetime/dp/0312367074 ''Ending Aging'' - Dr. Aubrey de Grey (2007)]

* [https://www.amazon.com/Ageless-Science-Getting-Older-Without/dp/0385544928 ''Ageless'' - Dr. Andrew Steele (2020)]

* [https://www.amazon.com.au/Age-Later-Health-Science-Longevity-ebook/dp/B0818MYCRR ''Age Later'' - Professor Nir Barzilai (2021)]

* [https://www.amazon.com.au/Science-Technology-Growing-Young-Breakthroughs/dp/1950665879 ''The Science and Technology of Growing Young'' - Sergey Young (2021)]

== Which anti-aging drugs are being tested in clinical trials today? ==
There are over 50 drugs being tested in human clinical trials for aging or age-related diseases.

The largest trial is the Targeting Aging with Metformin (TAME) trial, which began in 2020. The trial is being run in the United States with a cohort of 3000 older adults. The goal of the TAME trial is to determine whether diabetes drug metformin slows the aging process in older adults. The TAME trial is a $75 million trial run by the American Federation for Aging Research.<ref name=":14" />

Another large clinical trial is the Participitory Evaluation (of) Aging (with) Rapamycin (for) Longevity (PEARL) study. The goal of this study is to determine whether rapamycin, a drug currently approved for immunosuppression during organ transplants, slows biomarkers of aging in 1000 adults. The PEARL trial is being run by AgelessRx.<ref name=":15" />
== Is aging a natural process that should be accepted? ==
Although aging is a natural process in humans, it is the driving force of many diseases such as cancer and Alzheimer's disease - which as a society we have decided are worth trying to find cures for. In the past, these conditions, as well as atherosclerosis and even infectious diseases were once thought of as natural processes that could not be treated. However, nowadays it is understood that they are diseases that can be treated.

Atherosclerosis, the hardening of the arteries, was once viewed as a natural process that was simply a consequence of aging. However, when treatments such as statins were later developed to prevent atherosclerosis, the disease became widely regarded as a disease to be cured. Statins are now one one of the most widely prescribed drugs in the world, used in preventing heart diseases. The inventor of statins, Akira Endo, describes in his historical paper: “Serious research on the role of cholesterol in human atherosclerosis did not really get underway until the 1940s, due to a prevailing view that the disease was a simple consequence of aging and could not be prevented.”<ref>Endo A. (2010). A historical perspective on the discovery of statins. ''Proceedings of the Japan Academy. Series B, Physical and biological sciences'', ''86''(5), 484–493. <nowiki>https://doi.org/10.2183/pjab.86.484</nowiki></ref>

== Will anti-aging technology lead to overpopulation? ==
A common objection to the development of longevity technologies is that they may lead to an unsustainably large population size.

One study of a 2005 Swedish cohort of 9 million people modeled the effect of various anti-aging scenarios. The researchers showed that even with the most radical life-extension technology in which aging completely stopped after age 60, the population growth across 100 years was only 22%.<ref>Gavrilov, L. A., & Gavrilova, N. S. (2010). Demographic consequences of defeating aging. ''Rejuvenation research'', ''13''(2-3), 329-334.</ref>

Currently, the world’s population is 7.9 billion, and the WHO predicts the population will peak at 11 billion in 2100 before falling due to declining birth rates in many parts of the world. The fastest growing populations are in Africa and South-east Asia. However, several factors are thought to reduce birth rates over time, including increased access to contraceptives, female empowerment, increased education and increased employment. There is evidence that populations that move to a more advanced economy show a reduction in birth rates. This is expected to mitigate the increase in population size from longer lifespans.

== Will anti-aging drugs only be available to the rich? ==
It is unclear who will have first access to longevity drugs. Several researchers in the field have argued that several economic factors are likely to drive down the price of drugs that slow aging.

* The cost of many biotechnologies decreases substantially over time. For example, the first human genome cost $100 million to sequence, and is now available for a few hundred dollars.<ref>''The Cost of Sequencing a Human Genome''. (n.d.). Genome.gov. <nowiki>https://www.genome.gov/about-genomics/fact-sheets/Sequencing-Human-Genome-cost</nowiki></ref>

* The price of many lifesaving pharmaceuticals has fallen significantly in price once generic drugs were produced. For example, Lipitor, a statin used to prevent heart disease has fallen in price from $85 in 2011 to less than $5 today.

* Many companies in the longevity field have stated that equity of access is part of their core ethos, and many researchers are signatories to the

== References ==
<references />

FAQ

2021-12-15T11:03:51Z

Jack: /* Do all animals age in the same way? */

Longevity biotechnology is a new field of medical research and development that aims to extend healthy human lifespan and delay, prevent or reverse these diseases. This article provides an overview of the field through answering frequently asked questions.

== Why is aging a problem? ==
[[File:Aging graph.png|thumb|750x750px|The aging process results in the risk of age-related diseases increasing exponentially over time.]][[File:Gompertz-Makeham law of mortality.png|alt=Gompertz-Makeham law of mortality|thumb|257x257px|Gompertz-Makeham law of mortality<ref name=":0">En.wikipedia.org. 2021. ''Gompertz–Makeham law of mortality - Wikipedia''. [online] Available at: <<nowiki>https://en.wikipedia.org/wiki/Gompertz%E2%80%93Makeham_law_of_mortality</nowiki>> [Accessed 13 December 2021].</ref>]]Aging is the largest risk factor for the diseases that kill most people worldwide, including cancer, heart diseases and Alzheimer's disease.<ref name=":9" />

In the US in 2020, 9 of the 10 leading causes of death were strongly age-related.<ref name=":19">Ahmad, F. B., & Anderson, R. N. (2021). The leading causes of death in the US for 2020. ''JAMA'', ''325''(18), 1829-1830.https://jamanetwork.com/journals/jama/fullarticle/2778234</ref> Globally, approximately 70% of deaths annually are the result of aging.<ref name=":8" />

Aging also significantly affects quality of life, as deaths due to aging are usually preceded by many months of years of chronic illnesses such as cancer, type 2 diabetes and Alzheimer’s disease.

As a result of the aging process, the risk of an individual dying increases exponentially after the age of around 30 years old.<ref name=":0" /> This increase in mortality rate is known as the Gompertz-Makeham law of mortality.<ref name=":0" />
== How many people die from aging per day? ==
The aging process results in the deaths of 100,000 people per day; more than twice the sum of all other causes of death combined.<ref name=":8">Ritchie, H. and Roser, M., 2021. ''Causes of Death''. [online] Our World in Data. Available at: <<nowiki>https://ourworldindata.org/causes-of-death</nowiki>> [Accessed 13 December 2021].
</ref> This equates to over 37 million people dying per day of aging - a population the size of Canada. This is because aging results in the exponential increasing risk of age-related diseases such as cancer and type 2 diabetes. Aging also accounts for more than 30% of all disability-adjusted life years lost (DALYs); more than any other single cause.<ref>Vizhub.healthdata.org. 2021. ''GBD Compare | IHME Viz Hub''. [online] Available at: <<nowiki>https://vizhub.healthdata.org/gbd-compare/</nowiki>> [Accessed 13 December 2021].</ref>
[[File:Leading causes of death.png|center|thumb|713x713px|9 of the top 10 causes of death in the US in 2020 were strongly age-related.<ref name=":19" />]]

== Can healthy lifespan be extended? ==
[[File:Life extension mice.jpg|alt=Life extension mice|thumb|431x431px|Dietary manipulation, genetic manipulation, and drugs have been shown to increase the healthy lifespan of mice by up to 30%. <ref name=":1">de Magalhaes, J., 2021. ''DrugAge: Species Detail''. [online] Genomics.senescence.info. Available at: <<nowiki>https://genomics.senescence.info/drugs/species_details.php</nowiki>> [Accessed 14 December 2021].</ref>]]Clinical trials for longevity drugs in humans are in-progress, and there is not yet evidence that drugs can slow aging in humans. However, recent experimental breakthroughs over the last few decades have shown that in mice, worms and flies have demonstrated that healthy lifespan can be extended modified. Many clinical trials in humans today are testing whether these results can be replicated in humans.

In animal models, slowing the aging process in animals can be achieved via manipulation of diet, environment, genetics, epigenetics, or with drugs. In mice, over 100 drugs have been shown to extend healthy lifespan by up to 30%.<ref name=":1" />

The effect of longevity drugs on mice is often significant, delaying or eliminating the burden of age-related problems such as frailty, cataracts, cancer, and sarcopenia. For example, a new class of drugs called senolytics have been shown to extend lifespan in mice by over 30% whilst delaying age-related dysfunction.

== Which therapies may extend healthy lifespan? ==
Several drugs are known to extend healthy lifespan in animals. While there is no conclusive data that suggests these drugs would work the same in humans, many of these drugs are now being tested in clinical trials. [[File:Unity Mice.jpg|alt=Unity Mice|thumb|723x723px|Senolytic drugs eliminate senescent cells that accumulate with age, partially reversing multiple age-related diseases and extending the healthy lifespan of mice by up to 35%.<ref name=":16" /> ]]

=== Senolytics ===
Senolytics are drugs that remove senescent cells. These are cells which accumulate in the body with age and are linked with age-related diseases such as cancer.<ref>Xu, M., Pirtskhalava, T., Farr, J. N., Weigand, B. M., Palmer, A. K., Weivoda, M. M., ... & Kirkland, J. L. (2018). Senolytics improve physical function and increase lifespan in old age. ''Nature medicine'', ''24''(8), 1246-1256.</ref>
[[File:Metformin2.jpg|thumb|258x258px|Metformin extends lifespan in mice by 6%, and may extend lifespan in humans.<ref name=":13">Kulkarni, A. S., Gubbi, S., & Barzilai, N. (2020). Benefits of metformin in attenuating the hallmarks of aging. ''Cell metabolism'', ''32''(1), 15-30.</ref>]]
In mice, senolytics have been shown to increase the healthy lifespan by up to 35%.<ref name=":16">Baker, D. J., Childs, B. G., Durik, M., Wijers, M. E., Sieben, C. J., Zhong, J., ... & Van Deursen, J. M. (2016). Naturally occurring p16 Ink4a-positive cells shorten healthy lifespan. ''Nature'', ''530''(7589), 184-189.</ref> The first clinical trials of senolytics in humans began in 2020, and demonstrated benefits to functional measures suggesting these drugs may be effective in humans.

=== [[Metformin]] ===
Metformin is an approved drug for type 2 diabetes that extends lifespan in multiple species. In mice, Metformin extends lifespan by up to 6%.<ref>Anisimov, V. N., Berstein, L. M., Popovich, I. G., Zabezhinski, M. A., Egormin, P. A., Piskunova, T. S., Semenchenko, A. V., Tyndyk, M. L., Yurova, M. N., Kovalenko, I. G., & Poroshina, T. E. (2011). If started early in life, metformin treatment increases life span and postpones tumors in female SHR mice. ''Aging'', ''3''(2), 148–157. <nowiki>https://doi.org/10.18632/aging.100273</nowiki></ref> Metformin works by improving insulin sensitivity and may target several hallmarks of aging.<ref name=":13" /> Metformin is being tested as a longevity therapy in the largest clinical trial for a longevity therapy, the Targeting Aging with Metformin (TAME) trial in the US.<ref name=":14">''TAME - Targeting Aging with Metformin - American Federation for Aging Research''. (n.d.). American Federation for Aging Research. <nowiki>https://www.afar.org/tame-trial</nowiki></ref> This is a randomized clinical trial of 3000 elderly patients comparing metformin against a placebo for the onset of age-related diseases.<ref name=":14" />

=== [[Rapamycin]] ===
[[File:Rapamune .jpg|alt=Rapamune |thumb|253x253px|Rapamycin, also known as Rapamune© is being tested as a drug to extend healthy lifespan in humans. <ref name=":15" />]]
Rapamycin, also known as Rapamune©, is a drug used to prevent the rejection of organ transplants by the immune system. Rapamycin has been shown to extend lifespan by up to 26% when given at middle age, and 14% when given in late life.<ref name=":20">Harrison, D., Strong, R., Sharp, Z. ''et al.'' Rapamycin fed late in life extends lifespan in genetically heterogeneous mice. ''Nature'' 460, 392–395 (2009). <nowiki>https://doi.org/10.1038/nature08221</nowiki>
</ref><ref>Miller, R. A., Harrison, D. E., Astle, C. M., Fernandez, E., Flurkey, K., Han, M., Javors, M. A., Li, X., Nadon, N. L., Nelson, J. F., Pletcher, S., Salmon, A. B., Sharp, Z. D., Van Roekel, S., Winkleman, L., & Strong, R. (2014). Rapamycin-mediated lifespan increase in mice is dose and sex dependent and metabolically distinct from dietary restriction. ''Aging cell'', ''13''(3), 468–477. <nowiki>https://doi.org/10.1111/acel.12194</nowiki></ref>

Among the hundreds of interventions known to target aging, rapamycin is unique in its highly consistent and reproducible effect on healthy lifespan extension in mice.<ref>Johnson, S. C., Martin, G. M., Rabinovitch, P. S., & Kaeberlein, M. (2013). Preserving youth: does rapamycin deliver?. ''Science translational medicine'', ''5''(211), 211fs40.</ref> It is also the drug that exhibits the largest lifespan effect extension in multiple strains of mice, both when dosed in early life and at old age.<ref>Johnson, S. C., Martin, G. M., Rabinovitch, P. S., & Kaeberlein, M. (2013). Preserving youth: does rapamycin deliver?. ''Science translational medicine'', ''5''(211), 211fs40.</ref><ref>Kaeberlein, M. (2014). Rapamycin and aging: when, for how long, and how much? ''Journal of genetics and genomics'', ''41''(9), 459.</ref>

Rapamycin is currently being tested in a large-scale clinical trial called the Participatory Evaluation (of) Aging (With) Rapamycin (for) Longevity Study (PEARL). The study is a randomized clinical trial of 1000 elderly patients comparing rapamycin against placebo for age-related outcomes.<ref name=":15">Clinicaltrials.gov. 2021. ''Participatory Evaluation (of) Aging (With) Rapamycin (for) Longevity Study - Full Text View - ClinicalTrials.gov''. [online] Available at: <<nowiki>https://clinicaltrials.gov/ct2/show/NCT04488601</nowiki>> [Accessed 14 December 2021].
</ref>

=== [[Epigenetic reprogramming]] ===
Epigenetic reprogramming is remodeling the epigenetic marks, such as methylation tags on the DNA, in cells. This technique was used in 2020 to restore vision to blind mice by fully regrowing the optic nerve.<ref>Lu, Y., Brommer, B., Tian, X. ''et al.'' Reprogramming to recover youthful epigenetic information and restore vision. ''Nature'' 588, 124–129 (2020). <nowiki>https://doi.org/10.1038/s41586-020-2975-4</nowiki></ref> The researchers at Harvard medical school and believe this approach could one day be used to regenerate other tissues of the body as a longevity strategy.<ref>''Reversing The Aging Clock With Epigenetic Reprogramming''. (n.d.). Pubs - Bio-IT World. <nowiki>https://www.bio-itworld.com/news/2021/01/13/reversing-the-aging-clock-with-epigenetic-reprogramming</nowiki></ref>

In addition, over [https://www.lifespan.io/road-maps/the-rejuvenation-roadmap 50 other drugs] are being tested in human clinical trials for slowing aging.<ref name=":2">Lifespan.io. 2021. ''The Rejuvenation Roadmap | Lifespan.io''. [online] Available at: <<nowiki>https://www.lifespan.io/road-maps/the-rejuvenation-roadmap/</nowiki>> [Accessed 13 December 2021].</ref>

== What is the goal of longevity biotechnology? ==
[[File:Healthy lifespan extension.png|alt=Healthy lifespan extension|thumb|643x643px|Healthy lifespan extension involves early intervention to prevent or delay the decline associated with aging.<ref>''Longevity companies to watch in 2021 - Longevity.Technology''. (n.d.). Longevity.Technology. <nowiki>https://www.longevity.technology/longevity-companies-to-watch-in-2021/</nowiki></ref> ]]
Longevity biotechnology aims to slow or reverse the aging process to extend the healthy lifespan (‘healthspan’) of the population. Instead of treating diseases when they arise, one by one, longevity biotechnology aims to keep those who are already healthy, healthy by slowing the aging process. The aim is to thereby delay or prevent multiple diseases at once that are associated with aging.

The longevity biotechnology sector is rapidly growing, and there are currently over 170 private companies working on developing therapeutics to slow the aging process.<ref name=":4">Pfleger, K., 2021. ''Aging Companies''. [online] Agingbiotech.info. Available at: <<nowiki>https://agingbiotech.info/companies</nowiki>> [Accessed 13 December 2021].</ref> These companies are working on slowing or reversing the aging process by targeting one of more of the hallmarks of aging.

== Will healthy or unhealthy lifespan be extended? ==
[[File:Extending healthy lifespan.png|alt=Extending healthy lifespan|thumb|364x364px|Extending healthy versus unhealthy lifespan. <ref>''How to save Medicare: the anti-aging remedy''. (2012, March). <nowiki>https://www.researchgate.net/figure/From-longer-life-span-to-longer-health-span-and-life-span-From-A-to-B-Standard_fig1_230724035</nowiki>.</ref>]]
The stated goal of longevity biotechnology is to extend the healthy period of lifespan, before age-related diseases set in. This is in contrast to many of today's medical interventions, which extend life only after diseases (e.g. cancer, Alzheimer's) have reached a clinical level.

Age-related diseases are preceded by a long period of subclinical aging, i.e. aging that has not yet progressed far enough to produce clinical symptoms. By slowing, delaying or reversing the aging process, the hypothesis is that the healthy period of life can be extended.<ref name=":24" />

Studies in mice have demonstrated that life extending drugs such as rapamycin are capable of extending the healthy, rather than unhealthy period of life.<ref name=":20" />
== Should we treat specific diseases such as cancer, or aging? ==
[[File:Slowing aging versus curing cancer.jpg|alt=Slowing aging is potentially a more effective means of extending healthy lifespan than treating individual diseases due to the comorbid nature of age-related diseases. [6]|thumb|421x421px|Slowing aging is potentially a more effective means of extending healthy lifespan than treating individual diseases due to the comorbid nature of age-related diseases.<ref name=":18" /> ]]
Longevity biotechnology potentially offers a greater likelihood of extending healthy lifespan than attempting to find cures for the individual diseases of aging. This is because biological aging is associated with many of diseases of aging that develop as comorbidities i.e. at the same time. Even if a person survives one age-related disease such as cancer, another (e.g. diabetes, cardiovascular disease) is likely to kill the person if the underlying aging is not treated. This phenomenon is known as Taueber's paradox<ref name=":17">En.wikipedia.org. 2021. ''Taeuber Paradox - Wikipedia''. [online] Available at: <<nowiki>https://en.wikipedia.org/wiki/Taeuber_Paradox</nowiki>> [Accessed 14 December 2021].</ref>, and accounts for the much smaller projected increase in healthy lifespan associated with curing the diseases of aging, such as cancer (2-3 years), versus slowing aging itself (30+ years).<ref name=":18">Matt Kaeberlein, PhD, It is Time to Embrace 21st-Century Medicine, ''Public Policy & Aging Report'', Volume 29, Issue 4, 2019, Pages 111–115, <nowiki>https://doi.org/10.1093/ppar/prz022</nowiki></ref>
== What is biological aging? ==
There are two main types of 'age': chronological age - the number of years since birth, and biological age - a measure of the physical health of a person and their position in their lifespan. Biological age is more difficult to measure, but recent technologies are now available to estimate biological age. Over time, we age biologically. This occurs due to many processes in the body, which are generally categorised into 9 processes or 'hallmarks'.<ref name=":9" />
== What are the 9 Hallmarks of Aging? ==
[[File:Hallmarks of aging.jpg|alt=Hallmarks of aging|thumb|444x444px|The nine hallmarks of aging.<ref name=":9" />]]

The hallmarks of aging framework is considered to broadly represent key biological mechanisms of the biological aging process.<ref name=":9">López-Otín C, Blasco MA, Partridge L, Serrano M, Kroemer G. The hallmarks of aging. Cell. 2013 Jun 6;153(6):1194-217.</ref> Although there are various limitations of the hallmarks framework, it has become the central framework for understanding aging biology. The nine forms of cellular and molecular ‘damage’ that comprise the hallmarks of aging are<ref name=":9" />:

* Genomic instability
* Telomere attrition
* Epigenetic alterations
* Loss of proteostasis
* Deregulated nutrient-sensing
* Mitochondrial dysfunction
* Cellular senescence
* Stem cell exhaustion
* Altered intercellular communication

These are essentially the lowest common denominators of the aging process, on a cellular or subcellular level. All of the other changes associated with aging, such as greying hair, wrinkles, frailty and an increased risk of disease is thought to stem from these underlyig processes.<ref name=":9" />

== How does the aging cause disease? ==
The nine hallmarks of aging have been shown to play an integral role in the development of many age-related diseases such as neurodegenerative diseases and cancer:
=== [[Aging and Neurodegeneration|Neurodegenerative disease]] ===
[[File:Prevalence of neuro disorders.jpg|alt=Prevalence of neuro disorders|thumb|469x469px|The prevalence of neurodegenerative disorders increases exponentially with age, due to the biological aging process.<ref name=":12">Hou, Y., Dan, X., Babbar, M., Wei, Y., Hasselbalch, S. G., Croteau, D. L., & Bohr, V. A. (2019). Ageing as a risk factor for neurodegenerative disease. ''Nature reviews. Neurology'', ''15''(10), 565–581. <nowiki>https://doi.org/10.1038/s41582-019-0244-7</nowiki></ref> ]]
All of the hallmarks of aging are associated with an increased risk of neurodegenerative diseases, such as Parkinson's disease and Alzheimer's disease.<ref>Qiu, C., Kivipelto, M., & von Strauss, E. (2009). Epidemiology of Alzheimer's disease: occurrence, determinants, and strategies toward intervention. ''Dialogues in clinical neuroscience'', ''11''(2), 111.</ref> For example, several types of DNA damage are associated with neurodegeneration. The shortening of telomeres occurs as part of biological aging and causes cellular senescence, and is associated with neurodegeneration and neurodegenerative diseases including Alzheimer's disease and Parkinson's disease.<ref name=":12" /> Additionally, mitochondrial dysfunction, altered metabolism, stem cell exhaustion and loss of proteostasis are also involved in the development of neurodegenerative diseases.<ref name=":12" />
=== [[Aging and Cancer|Cancer]] ===
Several of the hallmarks of aging such as cellular senescence and alterations in the extracellular matrix are responsible for increasing the likelihood of tumorigenesis.<ref name=":5">Fane, M., & Weeraratna, A. T. (2020). How the ageing microenvironment influences tumour progression. ''Nature Reviews Cancer'', ''20''(2), 89-106.</ref> Other hallmarks of aging such as genomic instability, loss or proteostasis, altered intercellular communication (i.e. inflammation) and epigenetic alterations are also involved in tumorigenesis.<ref name=":5" />
== How is biological age measured? ==
[[File:Epigenetic clock.png|alt=Epigenetic clock|thumb|605x605px|The epigenetic clock measures biological age based on marks on the epigenome.<ref name=":6" /> ]]
Recent technologies have allow biological age to be measured. These include:

=== [[Epigenetic clock|Epigenetic clocks]] ===
The first generation of aging clocks are known as [[Epigenetic clock|epigenetic clocks or Horvath’s clock]].<ref name=":6">Horvath, S., & Raj, K. (2018). DNA methylation-based biomarkers and the epigenetic clock theory of ageing. ''Nature Reviews Genetics'', ''19''(6), 371-384.</ref> This clock is based on the finding that over time, the body accumulates methylation tags on the DNA in a pattern that can be predicted with machine learning. These changes to the epigenome are influenced by lifestyle, and can be used to measure biological age.<ref name=":6" /> Factors such as exercise frequency and a low BMI have been shown to reduce the rate of biological aging, whereas obesity and smoking can accelerate the rate of aging.<ref>Quach, A., Levine, M. E., Tanaka, T., Lu, A. T., Chen, B. H., Ferrucci, L., ... & Horvath, S. (2017). Epigenetic clock analysis of diet, exercise, education, and lifestyle factors. ''Aging (Albany NY)'', ''9''(2), 419.</ref><ref>Wu, X., Huang, Q., Javed, R., Zhong, J., Gao, H., & Liang, H. (2019). Effect of tobacco smoking on the epigenetic age of human respiratory organs. ''Clinical Epigenetics'', ''11''(1), 183. <nowiki>https://doi.org/10.1186/s13148-019-0777-z</nowiki>

[[Epigenetic clock#cite%20ref-12|↑]]</ref><ref>Horvath, S., Erhart, W., Brosch, M., Ammerpohl, O., von Schönfels, W., Ahrens, M., Heits, N., Bell, J. T., Tsai, P.-C., Spector, T. D., Deloukas, P., Siebert, R., Sipos, B., Becker, T., Röcken, C., Schafmayer, C., & Hampe, J. (2014). Obesity accelerates epigenetic aging of human liver. ''Proceedings of the National Academy of Sciences'', ''111''(43), 15538–15543. <nowiki>https://doi.org/10.1073/pnas.1412759111</nowiki>

[[Epigenetic clock#cite%20ref-13|↑]]</ref> The Horvath's clock has been used to accurately predict mortality risk.<ref>Fransquet, P. D., Wrigglesworth, J., Woods, R. L., Ernst, M. E., & Ryan, J. (2019). The epigenetic clock as a predictor of disease and mortality risk: a systematic review and meta-analysis. ''Clinical epigenetics'', ''11''(1), 1-17.</ref>

=== Multi-omic clocks ===
Multi-omic clocks are being developed that incorporate data from several sources, such as body imaging scans, blood tests, and fitness tests. These clocks are built using machine learning to estimate biological age. These aging clocks are being developed that combine multiple biological functional tests to create a unique aging signature, which can be monitored over time.<ref name=":21">Kudryashova, K. S., Burka, K., Kulaga, A. Y., Vorobyeva, N. S., & Kennedy, B. K. (2020). Aging Biomarkers: From Functional Tests to Multi‐Omics Approaches. ''Proteomics'', ''20''(5-6), 1900408.</ref>
[[File:Multiomic aging clock.jpg|alt=Multiomic clocks|center|thumb|542x542px|Multiomic clocks integrate various data sources to create a unique biological aging signature that can be tracked over time.<ref name=":21" /> ]]
== Which companies are trying to solve aging? ==
[[File:Calico Labs.png|alt=T|thumb|Calico Labs, a subsidiary of Google, is a billion-dollar company searching for treatments for aging.<ref name=":22" /> ]]
There are over [https://agingbiotech.info/companies 170 longevity biotechnology companies] trying to create therapies to slow or reverse the aging process.<ref name=":4" /> There are over [https://www.lifespan.io/road-maps/the-rejuvenation-roadmap/ 50 longevity drugs] currently in clinical trials in humans.<ref name=":2" />

Many of the longevity biotechnology companies are targeting specific hallmarks of aging. For example, [https://www.clearabiotech.com/#DiscoveryTimeline Cleara Biotech] are attempting to reduce cellular senescence by developing a drug that can eliminate senescent cells.<ref>Cleara Biotech. 2021. ''Cleara Biotech''. [online] Available at: <<nowiki>https://www.clearabiotech.com/#DiscoveryTimeline</nowiki>> [Accessed 15 December 2021].</ref>

Calico Labs is a Google-backed biotech company with the goal of combating aging and age-related diseases. In 2014, the company created a partnership with pharmaceutical giant AbbVie, which has since developed into a [https://www.cnbc.com/2018/06/26/alphabet-backed-calico-and-abbvie-chip-in-1-billion-to-cure-aging.html $2.5 billion venture] in the pursuit of improving “health, wellbeing and longevity.” <ref name=":22">2021. ''Google sister company and drug giant chip in another $1 billion to cure age-related diseases''. [online] Available at: <<nowiki>https://www.cnbc.com/2018/06/26/alphabet-backed-calico-and-abbvie-chip-in-1-billion-to-cure-aging.html</nowiki>> [Accessed 15 December 2021].</ref>

Since aging is not currently considered a disease by regulatory bodies such as the Food and Drug Administration (FDA), drug developers are currently focused on specific diseases of aging such as glaucoma and osteoarthritis.<ref>Clinicaltrialsarena.com. 2021. ''Unity's Phase II osteoarthritis study of UBX0101 misses primary goal''. [online] Available at: <<nowiki>https://www.clinicaltrialsarena.com/news/unity-ubx0101-osteoarthritis/</nowiki>> [Accessed 15 December 2021].</ref>

== Which billionaires are funding longevity biotechnology? ==
[[File:Jeff Bezos is funding longevity research.jpg|alt=Jeff Bezos is funding longevity research|thumb|Jeff Bezos is funding longevity research through financing Atlos Labs.<ref name=":7">MIT Technology Review. 2021. ''Meet Altos Labs, Silicon Valley’s latest wild bet on living forever''. [online] Available at: <<nowiki>https://www.technologyreview.com/2021/09/04/1034364/altos-labs-silicon-valleys-jeff-bezos-milner-bet-living-forever/</nowiki>> [Accessed 15 December 2021].</ref>]]
Several billionaires have funded companies or initiatives to slow or reverse human aging. These include:
* [[wikipedia:Jeff_Bezos|Jeff Bezos]], co-founder of Amazon, helped raise [https://www.technologyreview.com/2021/09/04/1034364/altos-labs-silicon-valleys-jeff-bezos-milner-bet-living-forever/ $270 million for new anti-aging drug company Altos Labs] in 2021.<ref name=":7" />
* [[wikipedia:Peter_Thiel|Peter Thiel]], co-founder of PayPal, was an [https://www.cnbc.com/2018/08/29/-jeff-bezos-is-backing-this-scientist-who-is-working-on-a-cure-for-aging.html early investor in Unity Biotechnology].<ref>CNBC. 2021. ''Why Jeff Bezos is backing this Silicon Valley scientist who is working on a cure for aging''. [online] Available at: <<nowiki>https://www.cnbc.com/2018/08/29/-jeff-bezos-is-backing-this-scientist-who-is-working-on-a-cure-for-aging.html</nowiki>> [Accessed 15 December 2021].</ref>
* [[wikipedia:Sergey_Brin|Sergey Brin]], co-founder of Google, donated [https://www.cnbc.com/2017/03/31/google-co-founders-and-silicon-valley-billionaires-try-to-live-forever.html $25 million for the National Academy of Medicine’s Grand Challenge in Health Longevity] to 'end aging forever'.<ref>Google’s co-founders and other Silicon Valley billionaires are trying to live forever. (2021). Retrieved 15 December 2021, from <nowiki>https://www.cnbc.com/2017/03/31/google-co-founders-and-silicon-valley-billionaires-try-to-live-forever.html</nowiki></ref>
* [[wikipedia:Larry_Page|Larry Page]], co-founder of Google, co-founded the [[wikipedia:Calico_(company)|billion-dollar aging research company Calico Labs.]]<ref>Contributors to Wikimedia projects. (2013, September 19). ''Calico (company) - Wikipedia''. Wikipedia, the free encyclopedia. <nowiki>https://en.wikipedia.org/wiki/Calico_(company)</nowiki>
</ref>
* [[wikipedia:Mike_Cannon-Brookes|Mike Cannon-Brookes]], billionaire cofounder of Australian software giant Atlassian, has invested [https://www.forbes.com/sites/samshead/2019/08/19/billionaire-backs-uk-startup-trying-to-extend-human-lifespans/ $10 million into longevity company Juvenescenc]e.<ref>Shead, S. (2019, August 19). ''Billionaire Backs U.K. Startup Trying To Extend Human Life Spans''. Forbes. <nowiki>https://www.forbes.com/sites/samshead/2019/08/19/billionaire-backs-uk-startup-trying-to-extend-human-lifespans/</nowiki></ref>
* [[wikipedia:Naveen_Jain|Naveen Jain]], billionaire entrepeneur who has raised [https://www.geekwire.com/2021/gut-health-startup-viome-raises-54m-develop-cancer-diagnostics-sell-microbiome-kits/ $54 million for his startup Viome].<ref>''Gut health startup Viome raises $54M to develop cancer diagnostics and sell microbiome kits''. (2021, November 10). Geekwire. <nowiki>https://www.geekwire.com/2021/gut-health-startup-viome-raises-54m-develop-cancer-diagnostics-sell-microbiome-kits/</nowiki></ref>
* [[wikipedia:Jim_Mellon|Jim Mellon]], who co-founded longevity company [https://www.juvlabs.com/people/co-founder/jim-mellon Juvenescence].<ref>''Jim Mellon - Chairman & Co-Founder''. (n.d.). Juvenescence - Science of Healthy Aging & Extended Lifespan. <nowiki>https://www.juvlabs.com/people/co-founder/jim-mellon</nowiki></ref>
* [[wikipedia:Larry_Ellison|Larry Ellison]], founder of Oracle, has spent [https://www.townandcountrymag.com/society/money-and-power/a9202324/science-of-longevity/ $430 million on longevity research].<ref>Tullis, P. (2017, March 30). ''Are You Rich Enough To Live Forever?'' Town & Country. <nowiki>https://www.townandcountrymag.com/society/money-and-power/a9202324/science-of-longevity/</nowiki></ref>
*Michael Greve, founder of Kizoo Technology, who has pledged [https://Longevity.Technology. https://www.longevity.technology/michael-greve-commits-e300m-for-rejuvenation-start-ups/ €300m to rejuvenation biotechnology companies.]<ref>''Michael Greve commits €300m for rejuvenation start-ups''. (2021, May 6). Longevity.Technology. <nowiki>https://www.longevity.technology/michael-greve-commits-e300m-for-rejuvenation-start-ups/</nowiki></ref>
* [[wikipedia:Yuri_Milner|Yuri Milner]], billionaire tech investor who has helped Altos Labs raise $270 million, with Jeff Bezos.<ref name=":7" />
* [https://wikitia.com/wiki/Richard_Heart Richard Heart], founder of the cryptocurrency Hex, who helped raise [https://www.express.co.uk/finance/city/1465354/pulsechain-cryptocurrency-srf-sens-research-foundation-airdrop-pulse-charity-longevity $25 million for the anti-aging research organisation SENS.]<ref>McGleenon, B. (2021, July 20). ''Pulsechain cryptocurrency raises 'mindblowing' $25M in five days for SENS longevity group''. Express.co.uk. <nowiki>https://www.express.co.uk/finance/city/1465354/pulsechain-cryptocurrency-srf-sens-research-foundation-airdrop-pulse-charity-longevity</nowiki></ref>
*[[wikipedia:Brian_Armstrong_(businessman)|Brian Armstrong]], CEO of CoinBase, who helped found and raise [https://www.dailymail.co.uk/sciencetech/article-10310475/Billionaire-launches-new-start-hopes-REVERSE-ageing-process.html $105 million for the epigenetic reprogramming startup NewLimit.]<ref>Liberatore, S. (2021, December 14). ''Billionaire launches new start-up to REVERSE the ageing process''. Mail Online. <nowiki>https://www.dailymail.co.uk/sciencetech/article-10310475/Billionaire-launches-new-start-hopes-REVERSE-ageing-process.html</nowiki></ref>
* [[wikipedia:Vitalik_Buterin|Vitalik Buterin]], founder of the cryptocurrency Ethereum, who donated $2.4 million to SENS.<ref>Foundation, S. R. (n.d.). ''SENS Research Foundation Receives $2.4 Million Ethereum Donation From Vitalik Buterin''. GlobeNewswire News Room. <nowiki>https://www.globenewswire.com/news-release/2018/02/02/1332410/0/en/SENS-Research-Foundation-Receives-2-4-Million-Ethereum-Donation-From-Vitalik-Buterin.html</nowiki></ref>

== How large will the longevity biotechnology field be? ==
Analysts from the Bank of America have predicted that the market size of longevity biotechnology will reach $600 billion by 2025.<ref>2021. ''Human lifespan could soon pass 100 years thanks to medical tech, says BofA''. [online] Available at: <<nowiki>https://www.cnbc.com/2019/05/08/techs-next-big-disruption-could-be-delaying-death.html</nowiki>> [Accessed 14 December 2021].</ref> Others have speculated that it is a trillion dollar industry owing to the immense savings associated with delaying or preventing chronic diseases.<ref>Colangelo, M., 2021. ''AI Will Drive The Multi-Trillion Dollar Longevity Economy''. [online] Forbes. Available at: <<nowiki>https://www.forbes.com/sites/cognitiveworld/2019/12/07/ai-will-drive-the-multi-trillion-dollar-longevity-economy/?sh=294766b74965</nowiki>> [Accessed 14 December 2021].</ref>
== Is age an important for risk factor for COVID-19 mortality? ==
[[File:Age is the -1 risk factor for COVID-19 mortality.jpg|alt=Age is the #1 risk factor for COVID-19 mortality - based on US CDC statistics|thumb|572x572px|The risk of dying from COVID-19 increases exponentially with age. [https://www.cdc.gov/coronavirus/2019-ncov/covid-data/investigations-discovery/hospitalization-death-by-age.html (US CDC statistics)]]]

Age is the single most significant risk factor for COVID-19 mortality. The mortality rate from COVID-19 increases exponentially with age, such that the death rate for those aged over 80 years is over 1000 times higher than those below 30 years.<ref name=":29">[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7576244/ Santesmasses, D., Castro, J. P., Zenin, A. A., Shindyapina, A. V., Gerashchenko, M. V., Zhang, B., ... & Gladyshev, V. N. (2020). COVID‐19 is an emergent disease of aging. ''Aging cell'', ''19''(10), e13230.]</ref>

This increase in COVID-19 mortality with age is thought to be the result of a weakening of the immune system with age, known as immunosenescence.<ref>Bajaj, V., Gadi, N., Spihlman, A. P., Wu, S. C., Choi, C. H., & Moulton, V. R. (2021). Aging, immunity, and COVID-19: how age influences the host immune response to coronavirus infections?. ''Frontiers in Physiology'', ''11'', 1793.</ref>

The mortality rate doubling time for COVID-19 is close to the all-cause mortality rate doubling time.<ref name=":29" /> This has led several scientists to conclude that COVID-19 meets criteria for an age-related disease.<ref name=":29" /><ref>[[Promislow, D. E. (2020). A geroscience perspective on COVID-19 mortality. The Journals of Gerontology: Series A, 75(9), e30-e33.|Promislow, D. E. (2020). A geroscience perspective on COVID-19 mortality. ''The Journals of Gerontology: Series A'', ''75''(9), e30-e33.]]</ref><ref>Alberts, S. C., Archie, E. A., Gesquiere, L. R., Altmann, J., Vaupel, J. W., & Christensen, K. (2014). The male-female health-survival paradox: a comparative perspective on sex differences in aging and mortality. In ''Sociality, hierarchy, health: comparative biodemography: a collection of papers''. National Academies Press (US).</ref><ref name=":10">[[Sierra, F. (2020). Geroscience and the Coronavirus Pandemic: The Whack‐a‐Mole Approach is not Enough. Journal of the American Geriatrics Society, 68(5), 951.|Sierra, F. (2020). Geroscience and the Coronavirus Pandemic: The Whack‐a‐Mole Approach is not Enough. ''Journal of the American Geriatrics Society'', ''68''(5), 951.]]</ref><ref name=":11">[[Barzilai, N., Appleby, J. C., Austad, S. N., Cuervo, A. M., Kaeberlein, M., Gonzalez-Billault, C., ... & Sierra, F. (2020). Geroscience in the Age of COVID-19. Aging and disease, 11(4), 725.|Barzilai, N., Appleby, J. C., Austad, S. N., Cuervo, A. M., Kaeberlein, M., Gonzalez-Billault, C., ... & Sierra, F. (2020). Geroscience in the Age of COVID-19. ''Aging and disease'', ''11''(4), 725.]]</ref><ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7288963/</ref>

== How is aging biology research different to other fields of medical research? ==
Scientists studying the biology of aging believe that aging is a root cause of all the major diseases of aging, and that targeting aging directly would treat or reverse multiple diseases, simultaneously. This is known as the geroscience hypothesis, and has garnered traction in recent years.<ref name=":24">Austad, S. N. (2016). The geroscience hypothesis: is it possible to change the rate of aging?. In ''Advances in geroscience'' (pp. 1-36). Springer, Cham.</ref>

The approach of targeting aging directly differs from many fields in mainstream medical research such as cancer research, which seek to find cures for individual diseases. An argument in favour of targeting aging directly is that targeting single diseases leads to diminishing returns in healthy lifespan extension.<ref name=":18" /> Due to the many diseases that occur concurrently in older age, completely curing a single disease such as cancer would only add 2-3 healthy years of life on average, whereas slowing aging could add 30 or more healthy years.<ref name=":18" /> This is because another disease in line, e.g. Alzheimer's or lung disease, will subsequently result in death, a phenomenon known as the Taeuber Paradox.<ref name=":17" />
== Do all animals age in the same way? ==
[[File:Naked mole rat graph.png|alt=Naked mole rat graph|thumb|530x530px|The naked mole-rat does not follow the same increased risk of mortality due to aging that humans and other mammals do.<ref>Ruby, J. G., Smith, M., & Buffenstein, R. (2018). Naked mole-rat mortality rates defy Gompertzian laws by not increasing with age. ''elife'', ''7'', e31157.</ref> ]]
Many species, due to differences in their biology, age at different rates to humans. The jellyfish ''Turritopsis dohrnii'' can revert to earlier stages of its life cycle in response to stress, and can theoretically live forever - though eventually dies, usually due to predation.<ref>Bavestrello, Giorgio; Christian Sommer; Michele Sarà (1992). "Bi-directional conversion in Turritopsis nutricula (Hydrozoa)".</ref>

Among mammals, the naked mole rat is an exceptionally long lived organism that lives roughly ten times longer than similarly-sized rats.<ref name=":3">Ruby, J. G., Smith, M., & Buffenstein, R. (2018). Naked mole-rat mortality rates defy Gompertzian laws by not increasing with age. ''elife'', ''7'', e31157.</ref><ref>Buffenstein, R., Amoroso, V., Andziak, B., Avdieiev, S., Azpurua, J., Barker, A. J., ... & Smith, E. S. J. (2021). The naked truth: a comprehensive clarification and classification of current ‘myths’ in naked mole‐rat biology. ''Biological Reviews''.</ref> Unlike other organisms, such as humans, horses and mice, the mortality rate of the naked mole rat appears steady over time. This trend does not follow the exponential increase in mortality (Gompertz-Makeham law) that humans do.<ref name=":3" />

Scientists are now studying the naked mole rat to identify key patterns in their genetics, environmental traits, and metabolism that may be responsible for their longer lifespans.<ref>Kim, E. B., Fang, X., Fushan, A. A., Huang, Z., Lobanov, A. V., Han, L., ... & Gladyshev, V. N. (2011). Genome sequencing reveals insights into physiology and longevity of the naked mole rat. ''Nature'', ''479''(7372), 223-227.</ref>

[[File:Naked mole rat.jpg|alt=Naked mole rat|center|thumb|323x323px|The naked mole-rat is unusually long-lived relative to other mice and rats.<ref name=":3" /> ]]

== Is aging considered a disease? ==
Aging is not currently classified as a disease by regulatory bodies such as the Food and Drug Administration (FDA) in the United States. However, several scientists in the aging field have publicly stated their preference for aging to be considered a disease, including professor David Sinclair and professor Nir Barzilai.<ref>TEDx Talks. (2020, June 9). ''Ageing'' ''is'' ''a'' ''treatable'' ''disease'' ''|'' ''Nir'' ''Bazilai'' ''|'' ''TEDxBeaconStreetSalon'' [Video]. YouTube. <nowiki>https://www.youtube.com/watch?v=XN7rLbCBO1c</nowiki></ref>

== What are the economic benefits of extending healthy lifespan? ==
Extending the healthy human lifespan could have significant economic benefits gobally. An economic analysis from 2021 by researchers at the University of Oxford and Harvard University estimated the benefit of a drug that slows aging by 1 year as $38 trillion.<ref name=":23">Scott, A. J., Ellison, M., & Sinclair, D. A. (2021). The economic value of targeting aging. ''Nature Aging'', ''1''(7), 616-623.</ref> This is primarily because slowing aging reduces the incidence of age-related diseases such as cancer and Alzheimer’s disease, which require expensive treatment approaches. The study demonstrated a larger economic benefit of slowing aging than curing the individual diseases of aging. <ref name=":23" />
== Which scientists and institutions are trying to understand and reverse aging? ==
Over [https://whoswho.senescence.info/ 300 scientists are working on understanding the biology of aging] in leading institutions that include Harvard University, Stanford University, Yale University, and the University of Oxford.<ref>''Who's Who in Gerontology: Researchers and Companies Working on Aging''. (n.d.). Who's Who in Gerontology: Researchers and Companies Working on Aging. <nowiki>https://whoswho.senescence.info/</nowiki></ref> Some of the most well-known institutes and labs include:

=== The Buck Institute for Research on Aging ===
The Buck Institute for Research on Aging is one of the largest longevity research institutes with over 250 scientists. The research covers several areas including the mechanisms of aging, neurodegeneration, senescence, stem cells and regenerative medicine, cellular stress and disease, cancer associated with aging, and mitochondrial function.<ref>''Buck Institute''. (n.d.). BUCK. <nowiki>https://www.buckinstitute.org/</nowiki></ref>

=== Professor David Sinclair - Harvard Medical School ===
Professor Sinclair’s lab focuses on understanding and reversing aging. The lab focuses on a range of areas including DNA repair, mitochondrial dysfunction, and the interactions between epigenetic and genetic instability, and tissue reprogramming.<ref>''Welcome | The Sinclair Lab''. (n.d.). Welcome | The Sinclair Lab. <nowiki>https://sinclair.hms.harvard.edu/</nowiki></ref>

=== Professor Matt Kaeberlein - University of Washington ===
Professor Kaeberlein's lab focuses on biological mechanisms of aging in order to facilitate translational interventions that promote healthspan and improve quality of life. Kaeberlein is known for his work on the longevity drug rapamycin in organisms such as mice and dogs. He is Director of the Dog Aging Project, a multi-year initiative studying the genetic and environmental factors that influence health, with over 33,000 participating dogs.<ref>''Matt Kaeberlein, PhD | Faculty | Dept. of Laboratory Medicine & Pathology | UW Medicine''. (n.d.). Dept. of Laboratory Medicine & Pathology | UW Medicine. <nowiki>https://dlmp.uw.edu/faculty/kaeberlein</nowiki></ref>

=== Professor Brian Kennedy - National University of Singapore ===
Professor Kennedy’s lab focuses on understanding the biology of aging and translating research discoveries into new ways of delaying aging in humans. The lab has identified drugs that extend the healthy lifespan of worms and mice and are seeking to understand their mechanisms.<ref>''Brian Kennedy - Department of Biochemistry – School of Medicine, National University of Singapore''. (n.d.). Department of Biochemistry – School of Medicine, National University of Singapore. <nowiki>https://medicine.nus.edu.sg/bch/fa</nowiki></ref>

=== Associate Professor Lynne Cox - University of Oxford ===
Professor Cox’s lab study the molecular and cellular basis of aging to identify specific biochemical processes and pathways that change organisms age. The lab particularly cellular senescence, which underpins many age-related diseases including cancer and neurodegeneration.<ref>''Associate Prof Lynne Cox''. (n.d.). Home | Biochemistry. <nowiki>https://www.bioch.ox.ac.uk/research/cox</nowiki></ref>

== What books have been written on this topic? ==
Several books have been written on the topic of aging and longevity. These include:

* [https://www.amazon.com/Lifespan-Why-Age_and-Dont-Have/dp/1501191977 ''Lifespan: Why We Age And Why We Don't Have To'' - David Sinclair (2019)]

* [https://www.amazon.com/Ending-Aging-Rejuvenation-Breakthroughs-Lifetime/dp/0312367074 ''Ending Aging'' - Dr. Aubrey de Grey (2007)]

* [https://www.amazon.com/Ageless-Science-Getting-Older-Without/dp/0385544928 ''Ageless'' - Dr. Andrew Steele (2020)]

* [https://www.amazon.com.au/Age-Later-Health-Science-Longevity-ebook/dp/B0818MYCRR ''Age Later'' - Professor Nir Barzilai (2021)]

* [https://www.amazon.com.au/Science-Technology-Growing-Young-Breakthroughs/dp/1950665879 ''The Science and Technology of Growing Young'' - Sergey Young (2021)]

== Which anti-aging drugs are being tested in clinical trials today? ==
There are over 50 drugs being tested in human clinical trials for aging or age-related diseases.

The largest trial is the Targeting Aging with Metformin (TAME) trial, which began in 2020. The trial is being run in the United States with a cohort of 3000 older adults. The goal of the TAME trial is to determine whether diabetes drug metformin slows the aging process in older adults. The TAME trial is a $75 million trial run by the American Federation for Aging Research.<ref name=":14" />

Another large clinical trial is the Participitory Evaluation (of) Aging (with) Rapamycin (for) Longevity (PEARL) study. The goal of this study is to determine whether rapamycin, a drug currently approved for immunosuppression during organ transplants, slows biomarkers of aging in 1000 adults. The PEARL trial is being run by AgelessRx.<ref name=":15" />
== Is aging a natural process that should be accepted? ==
Although aging is a natural process in humans, it is the driving force of many diseases such as cancer and Alzheimer's disease - which as a society we have decided are worth trying to find cures for. In the past, these conditions, as well as atherosclerosis and even infectious diseases were once thought of as natural processes that could not be treated. However, nowadays it is understood that they are diseases that can be treated.

Atherosclerosis, the hardening of the arteries, was once viewed as a natural process that was simply a consequence of aging. However, when treatments such as statins were later developed to prevent atherosclerosis, the disease became widely regarded as a disease to be cured. Statins are now one one of the most widely prescribed drugs in the world, used in preventing heart diseases. The inventor of statins, Akira Endo, describes in his historical paper: “Serious research on the role of cholesterol in human atherosclerosis did not really get underway until the 1940s, due to a prevailing view that the disease was a simple consequence of aging and could not be prevented.”<ref>Endo A. (2010). A historical perspective on the discovery of statins. ''Proceedings of the Japan Academy. Series B, Physical and biological sciences'', ''86''(5), 484–493. <nowiki>https://doi.org/10.2183/pjab.86.484</nowiki></ref>

== Will anti-aging technology lead to overpopulation? ==
A common objection to the development of longevity technologies is that they may lead to an unsustainably large population size.

One study of a 2005 Swedish cohort of 9 million people modeled the effect of various anti-aging scenarios. The researchers showed that even with the most radical life-extension technology in which aging completely stopped after age 60, the population growth across 100 years was only 22%.<ref>Gavrilov, L. A., & Gavrilova, N. S. (2010). Demographic consequences of defeating aging. ''Rejuvenation research'', ''13''(2-3), 329-334.</ref>

Currently, the world’s population is 7.9 billion, and the WHO predicts the population will peak at 11 billion in 2100 before falling due to declining birth rates in many parts of the world. The fastest growing populations are in Africa and South-east Asia. However, several factors are thought to reduce birth rates over time, including increased access to contraceptives, female empowerment, increased education and increased employment. There is evidence that populations that move to a more advanced economy show a reduction in birth rates. This is expected to mitigate the increase in population size from longer lifespans.

== Will anti-aging drugs only be available to the rich? ==
It is unclear who will have first access to longevity drugs. Several researchers in the field have argued that several economic factors are likely to drive down the price of drugs that slow aging.

* The cost of many biotechnologies decreases substantially over time. For example, the first human genome cost $100 million to sequence, and is now available for a few hundred dollars.

* The price of many lifesaving pharmaceuticals has fallen significantly in price once generic drugs were produced. For example, Lipitor, a statin used to prevent heart disease has fallen in price from $85 in 2011 to less than $5 today.

* Many companies in the longevity field have stated that equity of access is part of their core ethos, and many researchers are signatories to the

== References ==
<references />

FAQ

2021-12-15T11:00:05Z

Jack: /* Why is aging a problem? */

Longevity biotechnology is a new field of medical research and development that aims to extend healthy human lifespan and delay, prevent or reverse these diseases. This article provides an overview of the field through answering frequently asked questions.

== Why is aging a problem? ==
[[File:Aging graph.png|thumb|750x750px|The aging process results in the risk of age-related diseases increasing exponentially over time.]][[File:Gompertz-Makeham law of mortality.png|alt=Gompertz-Makeham law of mortality|thumb|257x257px|Gompertz-Makeham law of mortality<ref name=":0">En.wikipedia.org. 2021. ''Gompertz–Makeham law of mortality - Wikipedia''. [online] Available at: <<nowiki>https://en.wikipedia.org/wiki/Gompertz%E2%80%93Makeham_law_of_mortality</nowiki>> [Accessed 13 December 2021].</ref>]]Aging is the largest risk factor for the diseases that kill most people worldwide, including cancer, heart diseases and Alzheimer's disease.<ref name=":9" />

In the US in 2020, 9 of the 10 leading causes of death were strongly age-related.<ref name=":19">Ahmad, F. B., & Anderson, R. N. (2021). The leading causes of death in the US for 2020. ''JAMA'', ''325''(18), 1829-1830.https://jamanetwork.com/journals/jama/fullarticle/2778234</ref> Globally, approximately 70% of deaths annually are the result of aging.<ref name=":8" />

Aging also significantly affects quality of life, as deaths due to aging are usually preceded by many months of years of chronic illnesses such as cancer, type 2 diabetes and Alzheimer’s disease.

As a result of the aging process, the risk of an individual dying increases exponentially after the age of around 30 years old.<ref name=":0" /> This increase in mortality rate is known as the Gompertz-Makeham law of mortality.<ref name=":0" />
== How many people die from aging per day? ==
The aging process results in the deaths of 100,000 people per day; more than twice the sum of all other causes of death combined.<ref name=":8">Ritchie, H. and Roser, M., 2021. ''Causes of Death''. [online] Our World in Data. Available at: <<nowiki>https://ourworldindata.org/causes-of-death</nowiki>> [Accessed 13 December 2021].
</ref> This equates to over 37 million people dying per day of aging - a population the size of Canada. This is because aging results in the exponential increasing risk of age-related diseases such as cancer and type 2 diabetes. Aging also accounts for more than 30% of all disability-adjusted life years lost (DALYs); more than any other single cause.<ref>Vizhub.healthdata.org. 2021. ''GBD Compare | IHME Viz Hub''. [online] Available at: <<nowiki>https://vizhub.healthdata.org/gbd-compare/</nowiki>> [Accessed 13 December 2021].</ref>
[[File:Leading causes of death.png|center|thumb|713x713px|9 of the top 10 causes of death in the US in 2020 were strongly age-related.<ref name=":19" />]]

== Can healthy lifespan be extended? ==
[[File:Life extension mice.jpg|alt=Life extension mice|thumb|431x431px|Dietary manipulation, genetic manipulation, and drugs have been shown to increase the healthy lifespan of mice by up to 30%. <ref name=":1">de Magalhaes, J., 2021. ''DrugAge: Species Detail''. [online] Genomics.senescence.info. Available at: <<nowiki>https://genomics.senescence.info/drugs/species_details.php</nowiki>> [Accessed 14 December 2021].</ref>]]Clinical trials for longevity drugs in humans are in-progress, and there is not yet evidence that drugs can slow aging in humans. However, recent experimental breakthroughs over the last few decades have shown that in mice, worms and flies have demonstrated that healthy lifespan can be extended modified. Many clinical trials in humans today are testing whether these results can be replicated in humans.

In animal models, slowing the aging process in animals can be achieved via manipulation of diet, environment, genetics, epigenetics, or with drugs. In mice, over 100 drugs have been shown to extend healthy lifespan by up to 30%.<ref name=":1" />

The effect of longevity drugs on mice is often significant, delaying or eliminating the burden of age-related problems such as frailty, cataracts, cancer, and sarcopenia. For example, a new class of drugs called senolytics have been shown to extend lifespan in mice by over 30% whilst delaying age-related dysfunction.

== Which therapies may extend healthy lifespan? ==
Several drugs are known to extend healthy lifespan in animals. While there is no conclusive data that suggests these drugs would work the same in humans, many of these drugs are now being tested in clinical trials. [[File:Unity Mice.jpg|alt=Unity Mice|thumb|723x723px|Senolytic drugs eliminate senescent cells that accumulate with age, partially reversing multiple age-related diseases and extending the healthy lifespan of mice by up to 35%.<ref name=":16" /> ]]

=== Senolytics ===
Senolytics are drugs that remove senescent cells. These are cells which accumulate in the body with age and are linked with age-related diseases such as cancer.<ref>Xu, M., Pirtskhalava, T., Farr, J. N., Weigand, B. M., Palmer, A. K., Weivoda, M. M., ... & Kirkland, J. L. (2018). Senolytics improve physical function and increase lifespan in old age. ''Nature medicine'', ''24''(8), 1246-1256.</ref>
[[File:Metformin2.jpg|thumb|258x258px|Metformin extends lifespan in mice by 6%, and may extend lifespan in humans.<ref name=":13">Kulkarni, A. S., Gubbi, S., & Barzilai, N. (2020). Benefits of metformin in attenuating the hallmarks of aging. ''Cell metabolism'', ''32''(1), 15-30.</ref>]]
In mice, senolytics have been shown to increase the healthy lifespan by up to 35%.<ref name=":16">Baker, D. J., Childs, B. G., Durik, M., Wijers, M. E., Sieben, C. J., Zhong, J., ... & Van Deursen, J. M. (2016). Naturally occurring p16 Ink4a-positive cells shorten healthy lifespan. ''Nature'', ''530''(7589), 184-189.</ref> The first clinical trials of senolytics in humans began in 2020, and demonstrated benefits to functional measures suggesting these drugs may be effective in humans.

=== [[Metformin]] ===
Metformin is an approved drug for type 2 diabetes that extends lifespan in multiple species. In mice, Metformin extends lifespan by up to 6%.<ref>Anisimov, V. N., Berstein, L. M., Popovich, I. G., Zabezhinski, M. A., Egormin, P. A., Piskunova, T. S., Semenchenko, A. V., Tyndyk, M. L., Yurova, M. N., Kovalenko, I. G., & Poroshina, T. E. (2011). If started early in life, metformin treatment increases life span and postpones tumors in female SHR mice. ''Aging'', ''3''(2), 148–157. <nowiki>https://doi.org/10.18632/aging.100273</nowiki></ref> Metformin works by improving insulin sensitivity and may target several hallmarks of aging.<ref name=":13" /> Metformin is being tested as a longevity therapy in the largest clinical trial for a longevity therapy, the Targeting Aging with Metformin (TAME) trial in the US.<ref name=":14">''TAME - Targeting Aging with Metformin - American Federation for Aging Research''. (n.d.). American Federation for Aging Research. <nowiki>https://www.afar.org/tame-trial</nowiki></ref> This is a randomized clinical trial of 3000 elderly patients comparing metformin against a placebo for the onset of age-related diseases.<ref name=":14" />

=== [[Rapamycin]] ===
[[File:Rapamune .jpg|alt=Rapamune |thumb|253x253px|Rapamycin, also known as Rapamune© is being tested as a drug to extend healthy lifespan in humans. <ref name=":15" />]]
Rapamycin, also known as Rapamune©, is a drug used to prevent the rejection of organ transplants by the immune system. Rapamycin has been shown to extend lifespan by up to 26% when given at middle age, and 14% when given in late life.<ref name=":20">Harrison, D., Strong, R., Sharp, Z. ''et al.'' Rapamycin fed late in life extends lifespan in genetically heterogeneous mice. ''Nature'' 460, 392–395 (2009). <nowiki>https://doi.org/10.1038/nature08221</nowiki>
</ref><ref>Miller, R. A., Harrison, D. E., Astle, C. M., Fernandez, E., Flurkey, K., Han, M., Javors, M. A., Li, X., Nadon, N. L., Nelson, J. F., Pletcher, S., Salmon, A. B., Sharp, Z. D., Van Roekel, S., Winkleman, L., & Strong, R. (2014). Rapamycin-mediated lifespan increase in mice is dose and sex dependent and metabolically distinct from dietary restriction. ''Aging cell'', ''13''(3), 468–477. <nowiki>https://doi.org/10.1111/acel.12194</nowiki></ref> Rapamycin is currently being tested in a large-scale clinical trial called the Participatory Evaluation (of) Aging (With) Rapamycin (for) Longevity Study (PEARL). The study is a randomized clinical trial of 1000 elderly patients comparing rapamycin against placebo for age-related outcomes.<ref name=":15">Clinicaltrials.gov. 2021. ''Participatory Evaluation (of) Aging (With) Rapamycin (for) Longevity Study - Full Text View - ClinicalTrials.gov''. [online] Available at: <<nowiki>https://clinicaltrials.gov/ct2/show/NCT04488601</nowiki>> [Accessed 14 December 2021].
</ref>

=== [[Epigenetic reprogramming]] ===
Epigenetic reprogramming is remodeling the epigenetic marks, such as methylation tags on the DNA, in cells. This technique was used in 2020 to restore vision to blind mice by fully regrowing the optic nerve.<ref>Lu, Y., Brommer, B., Tian, X. ''et al.'' Reprogramming to recover youthful epigenetic information and restore vision. ''Nature'' 588, 124–129 (2020). <nowiki>https://doi.org/10.1038/s41586-020-2975-4</nowiki></ref> The researchers at Harvard medical school and believe this approach could one day be used to regenerate other tissues of the body as a longevity strategy.<ref>''Reversing The Aging Clock With Epigenetic Reprogramming''. (n.d.). Pubs - Bio-IT World. <nowiki>https://www.bio-itworld.com/news/2021/01/13/reversing-the-aging-clock-with-epigenetic-reprogramming</nowiki></ref>

In addition, over [https://www.lifespan.io/road-maps/the-rejuvenation-roadmap 50 other drugs] are being tested in human clinical trials for slowing aging.<ref name=":2">Lifespan.io. 2021. ''The Rejuvenation Roadmap | Lifespan.io''. [online] Available at: <<nowiki>https://www.lifespan.io/road-maps/the-rejuvenation-roadmap/</nowiki>> [Accessed 13 December 2021].</ref>

== What is the goal of longevity biotechnology? ==
[[File:Healthy lifespan extension.png|alt=Healthy lifespan extension|thumb|643x643px|Healthy lifespan extension involves early intervention to prevent or delay the decline associated with aging.<ref>''Longevity companies to watch in 2021 - Longevity.Technology''. (n.d.). Longevity.Technology. <nowiki>https://www.longevity.technology/longevity-companies-to-watch-in-2021/</nowiki></ref> ]]
Longevity biotechnology aims to slow or reverse the aging process to extend the healthy lifespan (‘healthspan’) of the population. Instead of treating diseases when they arise, one by one, longevity biotechnology aims to keep those who are already healthy, healthy by slowing the aging process. The aim is to thereby delay or prevent multiple diseases at once that are associated with aging.

The longevity biotechnology sector is rapidly growing, and there are currently over 170 private companies working on developing therapeutics to slow the aging process.<ref name=":4">Pfleger, K., 2021. ''Aging Companies''. [online] Agingbiotech.info. Available at: <<nowiki>https://agingbiotech.info/companies</nowiki>> [Accessed 13 December 2021].</ref> These companies are working on slowing or reversing the aging process by targeting one of more of the hallmarks of aging.

== Will healthy or unhealthy lifespan be extended? ==
[[File:Extending healthy lifespan.png|alt=Extending healthy lifespan|thumb|364x364px|Extending healthy versus unhealthy lifespan. <ref>''How to save Medicare: the anti-aging remedy''. (2012, March). <nowiki>https://www.researchgate.net/figure/From-longer-life-span-to-longer-health-span-and-life-span-From-A-to-B-Standard_fig1_230724035</nowiki>.</ref>]]
The stated goal of longevity biotechnology is to extend the healthy period of lifespan, before age-related diseases set in. This is in contrast to many of today's medical interventions, which extend life only after diseases (e.g. cancer, Alzheimer's) have reached a clinical level.

Age-related diseases are preceded by a long period of subclinical aging, i.e. aging that has not yet progressed far enough to produce clinical symptoms. By slowing, delaying or reversing the aging process, the hypothesis is that the healthy period of life can be extended.<ref name=":24" />

Studies in mice have demonstrated that life extending drugs such as rapamycin are capable of extending the healthy, rather than unhealthy period of life.<ref name=":20" />
== Should we treat specific diseases such as cancer, or aging? ==
[[File:Slowing aging versus curing cancer.jpg|alt=Slowing aging is potentially a more effective means of extending healthy lifespan than treating individual diseases due to the comorbid nature of age-related diseases. [6]|thumb|421x421px|Slowing aging is potentially a more effective means of extending healthy lifespan than treating individual diseases due to the comorbid nature of age-related diseases.<ref name=":18" /> ]]
Longevity biotechnology potentially offers a greater likelihood of extending healthy lifespan than attempting to find cures for the individual diseases of aging. This is because biological aging is associated with many of diseases of aging that develop as comorbidities i.e. at the same time. Even if a person survives one age-related disease such as cancer, another (e.g. diabetes, cardiovascular disease) is likely to kill the person if the underlying aging is not treated. This phenomenon is known as Taueber's paradox<ref name=":17">En.wikipedia.org. 2021. ''Taeuber Paradox - Wikipedia''. [online] Available at: <<nowiki>https://en.wikipedia.org/wiki/Taeuber_Paradox</nowiki>> [Accessed 14 December 2021].</ref>, and accounts for the much smaller projected increase in healthy lifespan associated with curing the diseases of aging, such as cancer (2-3 years), versus slowing aging itself (30+ years).<ref name=":18">Matt Kaeberlein, PhD, It is Time to Embrace 21st-Century Medicine, ''Public Policy & Aging Report'', Volume 29, Issue 4, 2019, Pages 111–115, <nowiki>https://doi.org/10.1093/ppar/prz022</nowiki></ref>
== What is biological aging? ==
There are two main types of 'age': chronological age - the number of years since birth, and biological age - a measure of the physical health of a person and their position in their lifespan. Biological age is more difficult to measure, but recent technologies are now available to estimate biological age. Over time, we age biologically. This occurs due to many processes in the body, which are generally categorised into 9 processes or 'hallmarks'.<ref name=":9" />
== What are the 9 Hallmarks of Aging? ==
[[File:Hallmarks of aging.jpg|alt=Hallmarks of aging|thumb|444x444px|The nine hallmarks of aging.<ref name=":9" />]]

The hallmarks of aging framework is considered to broadly represent key biological mechanisms of the biological aging process.<ref name=":9">López-Otín C, Blasco MA, Partridge L, Serrano M, Kroemer G. The hallmarks of aging. Cell. 2013 Jun 6;153(6):1194-217.</ref> Although there are various limitations of the hallmarks framework, it has become the central framework for understanding aging biology. The nine forms of cellular and molecular ‘damage’ that comprise the hallmarks of aging are<ref name=":9" />:

* Genomic instability
* Telomere attrition
* Epigenetic alterations
* Loss of proteostasis
* Deregulated nutrient-sensing
* Mitochondrial dysfunction
* Cellular senescence
* Stem cell exhaustion
* Altered intercellular communication

These are essentially the lowest common denominators of the aging process, on a cellular or subcellular level. All of the other changes associated with aging, such as greying hair, wrinkles, frailty and an increased risk of disease is thought to stem from these underlyig processes.<ref name=":9" />

== How does the aging cause disease? ==
The nine hallmarks of aging have been shown to play an integral role in the development of many age-related diseases such as neurodegenerative diseases and cancer:
=== [[Aging and Neurodegeneration|Neurodegenerative disease]] ===
[[File:Prevalence of neuro disorders.jpg|alt=Prevalence of neuro disorders|thumb|469x469px|The prevalence of neurodegenerative disorders increases exponentially with age, due to the biological aging process.<ref name=":12">Hou, Y., Dan, X., Babbar, M., Wei, Y., Hasselbalch, S. G., Croteau, D. L., & Bohr, V. A. (2019). Ageing as a risk factor for neurodegenerative disease. ''Nature reviews. Neurology'', ''15''(10), 565–581. <nowiki>https://doi.org/10.1038/s41582-019-0244-7</nowiki></ref> ]]
All of the hallmarks of aging are associated with an increased risk of neurodegenerative diseases, such as Parkinson's disease and Alzheimer's disease.<ref>Qiu, C., Kivipelto, M., & von Strauss, E. (2009). Epidemiology of Alzheimer's disease: occurrence, determinants, and strategies toward intervention. ''Dialogues in clinical neuroscience'', ''11''(2), 111.</ref> For example, several types of DNA damage are associated with neurodegeneration. The shortening of telomeres occurs as part of biological aging and causes cellular senescence, and is associated with neurodegeneration and neurodegenerative diseases including Alzheimer's disease and Parkinson's disease.<ref name=":12" /> Additionally, mitochondrial dysfunction, altered metabolism, stem cell exhaustion and loss of proteostasis are also involved in the development of neurodegenerative diseases.<ref name=":12" />
=== [[Aging and Cancer|Cancer]] ===
Several of the hallmarks of aging such as cellular senescence and alterations in the extracellular matrix are responsible for increasing the likelihood of tumorigenesis.<ref name=":5">Fane, M., & Weeraratna, A. T. (2020). How the ageing microenvironment influences tumour progression. ''Nature Reviews Cancer'', ''20''(2), 89-106.</ref> Other hallmarks of aging such as genomic instability, loss or proteostasis, altered intercellular communication (i.e. inflammation) and epigenetic alterations are also involved in tumorigenesis.<ref name=":5" />
== How is biological age measured? ==
[[File:Epigenetic clock.png|alt=Epigenetic clock|thumb|605x605px|The epigenetic clock measures biological age based on marks on the epigenome.<ref name=":6" /> ]]
Recent technologies have allow biological age to be measured. These include:

=== [[Epigenetic clock|Epigenetic clocks]] ===
The first generation of aging clocks are known as [[Epigenetic clock|epigenetic clocks or Horvath’s clock]].<ref name=":6">Horvath, S., & Raj, K. (2018). DNA methylation-based biomarkers and the epigenetic clock theory of ageing. ''Nature Reviews Genetics'', ''19''(6), 371-384.</ref> This clock is based on the finding that over time, the body accumulates methylation tags on the DNA in a pattern that can be predicted with machine learning. These changes to the epigenome are influenced by lifestyle, and can be used to measure biological age.<ref name=":6" /> Factors such as exercise frequency and a low BMI have been shown to reduce the rate of biological aging, whereas obesity and smoking can accelerate the rate of aging.<ref>Quach, A., Levine, M. E., Tanaka, T., Lu, A. T., Chen, B. H., Ferrucci, L., ... & Horvath, S. (2017). Epigenetic clock analysis of diet, exercise, education, and lifestyle factors. ''Aging (Albany NY)'', ''9''(2), 419.</ref><ref>Wu, X., Huang, Q., Javed, R., Zhong, J., Gao, H., & Liang, H. (2019). Effect of tobacco smoking on the epigenetic age of human respiratory organs. ''Clinical Epigenetics'', ''11''(1), 183. <nowiki>https://doi.org/10.1186/s13148-019-0777-z</nowiki>

[[Epigenetic clock#cite%20ref-12|↑]]</ref><ref>Horvath, S., Erhart, W., Brosch, M., Ammerpohl, O., von Schönfels, W., Ahrens, M., Heits, N., Bell, J. T., Tsai, P.-C., Spector, T. D., Deloukas, P., Siebert, R., Sipos, B., Becker, T., Röcken, C., Schafmayer, C., & Hampe, J. (2014). Obesity accelerates epigenetic aging of human liver. ''Proceedings of the National Academy of Sciences'', ''111''(43), 15538–15543. <nowiki>https://doi.org/10.1073/pnas.1412759111</nowiki>

[[Epigenetic clock#cite%20ref-13|↑]]</ref> The Horvath's clock has been used to accurately predict mortality risk.<ref>Fransquet, P. D., Wrigglesworth, J., Woods, R. L., Ernst, M. E., & Ryan, J. (2019). The epigenetic clock as a predictor of disease and mortality risk: a systematic review and meta-analysis. ''Clinical epigenetics'', ''11''(1), 1-17.</ref>

=== Multi-omic clocks ===
Multi-omic clocks are being developed that incorporate data from several sources, such as body imaging scans, blood tests, and fitness tests. These clocks are built using machine learning to estimate biological age. These aging clocks are being developed that combine multiple biological functional tests to create a unique aging signature, which can be monitored over time.<ref name=":21">Kudryashova, K. S., Burka, K., Kulaga, A. Y., Vorobyeva, N. S., & Kennedy, B. K. (2020). Aging Biomarkers: From Functional Tests to Multi‐Omics Approaches. ''Proteomics'', ''20''(5-6), 1900408.</ref>
[[File:Multiomic aging clock.jpg|alt=Multiomic clocks|center|thumb|542x542px|Multiomic clocks integrate various data sources to create a unique biological aging signature that can be tracked over time.<ref name=":21" /> ]]
== Which companies are trying to solve aging? ==
[[File:Calico Labs.png|alt=T|thumb|Calico Labs, a subsidiary of Google, is a billion-dollar company searching for treatments for aging.<ref name=":22" /> ]]
There are over [https://agingbiotech.info/companies 170 longevity biotechnology companies] trying to create therapies to slow or reverse the aging process.<ref name=":4" /> There are over [https://www.lifespan.io/road-maps/the-rejuvenation-roadmap/ 50 longevity drugs] currently in clinical trials in humans.<ref name=":2" />

Many of the longevity biotechnology companies are targeting specific hallmarks of aging. For example, [https://www.clearabiotech.com/#DiscoveryTimeline Cleara Biotech] are attempting to reduce cellular senescence by developing a drug that can eliminate senescent cells.<ref>Cleara Biotech. 2021. ''Cleara Biotech''. [online] Available at: <<nowiki>https://www.clearabiotech.com/#DiscoveryTimeline</nowiki>> [Accessed 15 December 2021].</ref>

Calico Labs is a Google-backed biotech company with the goal of combating aging and age-related diseases. In 2014, the company created a partnership with pharmaceutical giant AbbVie, which has since developed into a [https://www.cnbc.com/2018/06/26/alphabet-backed-calico-and-abbvie-chip-in-1-billion-to-cure-aging.html $2.5 billion venture] in the pursuit of improving “health, wellbeing and longevity.” <ref name=":22">2021. ''Google sister company and drug giant chip in another $1 billion to cure age-related diseases''. [online] Available at: <<nowiki>https://www.cnbc.com/2018/06/26/alphabet-backed-calico-and-abbvie-chip-in-1-billion-to-cure-aging.html</nowiki>> [Accessed 15 December 2021].</ref>

Since aging is not currently considered a disease by regulatory bodies such as the Food and Drug Administration (FDA), drug developers are currently focused on specific diseases of aging such as glaucoma and osteoarthritis.<ref>Clinicaltrialsarena.com. 2021. ''Unity's Phase II osteoarthritis study of UBX0101 misses primary goal''. [online] Available at: <<nowiki>https://www.clinicaltrialsarena.com/news/unity-ubx0101-osteoarthritis/</nowiki>> [Accessed 15 December 2021].</ref>

== Which billionaires are funding longevity biotechnology? ==
[[File:Jeff Bezos is funding longevity research.jpg|alt=Jeff Bezos is funding longevity research|thumb|Jeff Bezos is funding longevity research through financing Atlos Labs.<ref name=":7">MIT Technology Review. 2021. ''Meet Altos Labs, Silicon Valley’s latest wild bet on living forever''. [online] Available at: <<nowiki>https://www.technologyreview.com/2021/09/04/1034364/altos-labs-silicon-valleys-jeff-bezos-milner-bet-living-forever/</nowiki>> [Accessed 15 December 2021].</ref>]]
Several billionaires have funded companies or initiatives to slow or reverse human aging. These include:
* [[wikipedia:Jeff_Bezos|Jeff Bezos]], co-founder of Amazon, helped raise [https://www.technologyreview.com/2021/09/04/1034364/altos-labs-silicon-valleys-jeff-bezos-milner-bet-living-forever/ $270 million for new anti-aging drug company Altos Labs] in 2021.<ref name=":7" />
* [[wikipedia:Peter_Thiel|Peter Thiel]], co-founder of PayPal, was an [https://www.cnbc.com/2018/08/29/-jeff-bezos-is-backing-this-scientist-who-is-working-on-a-cure-for-aging.html early investor in Unity Biotechnology].<ref>CNBC. 2021. ''Why Jeff Bezos is backing this Silicon Valley scientist who is working on a cure for aging''. [online] Available at: <<nowiki>https://www.cnbc.com/2018/08/29/-jeff-bezos-is-backing-this-scientist-who-is-working-on-a-cure-for-aging.html</nowiki>> [Accessed 15 December 2021].</ref>
* [[wikipedia:Sergey_Brin|Sergey Brin]], co-founder of Google, donated [https://www.cnbc.com/2017/03/31/google-co-founders-and-silicon-valley-billionaires-try-to-live-forever.html $25 million for the National Academy of Medicine’s Grand Challenge in Health Longevity] to 'end aging forever'.<ref>Google’s co-founders and other Silicon Valley billionaires are trying to live forever. (2021). Retrieved 15 December 2021, from <nowiki>https://www.cnbc.com/2017/03/31/google-co-founders-and-silicon-valley-billionaires-try-to-live-forever.html</nowiki></ref>
* [[wikipedia:Larry_Page|Larry Page]], co-founder of Google, co-founded the [[wikipedia:Calico_(company)|billion-dollar aging research company Calico Labs.]]<ref>Contributors to Wikimedia projects. (2013, September 19). ''Calico (company) - Wikipedia''. Wikipedia, the free encyclopedia. <nowiki>https://en.wikipedia.org/wiki/Calico_(company)</nowiki>
</ref>
* [[wikipedia:Mike_Cannon-Brookes|Mike Cannon-Brookes]], billionaire cofounder of Australian software giant Atlassian, has invested [https://www.forbes.com/sites/samshead/2019/08/19/billionaire-backs-uk-startup-trying-to-extend-human-lifespans/ $10 million into longevity company Juvenescenc]e.<ref>Shead, S. (2019, August 19). ''Billionaire Backs U.K. Startup Trying To Extend Human Life Spans''. Forbes. <nowiki>https://www.forbes.com/sites/samshead/2019/08/19/billionaire-backs-uk-startup-trying-to-extend-human-lifespans/</nowiki></ref>
* [[wikipedia:Naveen_Jain|Naveen Jain]], billionaire entrepeneur who has raised [https://www.geekwire.com/2021/gut-health-startup-viome-raises-54m-develop-cancer-diagnostics-sell-microbiome-kits/ $54 million for his startup Viome].<ref>''Gut health startup Viome raises $54M to develop cancer diagnostics and sell microbiome kits''. (2021, November 10). Geekwire. <nowiki>https://www.geekwire.com/2021/gut-health-startup-viome-raises-54m-develop-cancer-diagnostics-sell-microbiome-kits/</nowiki></ref>
* [[wikipedia:Jim_Mellon|Jim Mellon]], who co-founded longevity company [https://www.juvlabs.com/people/co-founder/jim-mellon Juvenescence].<ref>''Jim Mellon - Chairman & Co-Founder''. (n.d.). Juvenescence - Science of Healthy Aging & Extended Lifespan. <nowiki>https://www.juvlabs.com/people/co-founder/jim-mellon</nowiki></ref>
* [[wikipedia:Larry_Ellison|Larry Ellison]], founder of Oracle, has spent [https://www.townandcountrymag.com/society/money-and-power/a9202324/science-of-longevity/ $430 million on longevity research].<ref>Tullis, P. (2017, March 30). ''Are You Rich Enough To Live Forever?'' Town & Country. <nowiki>https://www.townandcountrymag.com/society/money-and-power/a9202324/science-of-longevity/</nowiki></ref>
*Michael Greve, founder of Kizoo Technology, who has pledged [https://Longevity.Technology. https://www.longevity.technology/michael-greve-commits-e300m-for-rejuvenation-start-ups/ €300m to rejuvenation biotechnology companies.]<ref>''Michael Greve commits €300m for rejuvenation start-ups''. (2021, May 6). Longevity.Technology. <nowiki>https://www.longevity.technology/michael-greve-commits-e300m-for-rejuvenation-start-ups/</nowiki></ref>
* [[wikipedia:Yuri_Milner|Yuri Milner]], billionaire tech investor who has helped Altos Labs raise $270 million, with Jeff Bezos.<ref name=":7" />
* [https://wikitia.com/wiki/Richard_Heart Richard Heart], founder of the cryptocurrency Hex, who helped raise [https://www.express.co.uk/finance/city/1465354/pulsechain-cryptocurrency-srf-sens-research-foundation-airdrop-pulse-charity-longevity $25 million for the anti-aging research organisation SENS.]<ref>McGleenon, B. (2021, July 20). ''Pulsechain cryptocurrency raises 'mindblowing' $25M in five days for SENS longevity group''. Express.co.uk. <nowiki>https://www.express.co.uk/finance/city/1465354/pulsechain-cryptocurrency-srf-sens-research-foundation-airdrop-pulse-charity-longevity</nowiki></ref>
*[[wikipedia:Brian_Armstrong_(businessman)|Brian Armstrong]], CEO of CoinBase, who helped found and raise [https://www.dailymail.co.uk/sciencetech/article-10310475/Billionaire-launches-new-start-hopes-REVERSE-ageing-process.html $105 million for the epigenetic reprogramming startup NewLimit.]<ref>Liberatore, S. (2021, December 14). ''Billionaire launches new start-up to REVERSE the ageing process''. Mail Online. <nowiki>https://www.dailymail.co.uk/sciencetech/article-10310475/Billionaire-launches-new-start-hopes-REVERSE-ageing-process.html</nowiki></ref>
* [[wikipedia:Vitalik_Buterin|Vitalik Buterin]], founder of the cryptocurrency Ethereum, who donated $2.4 million to SENS.<ref>Foundation, S. R. (n.d.). ''SENS Research Foundation Receives $2.4 Million Ethereum Donation From Vitalik Buterin''. GlobeNewswire News Room. <nowiki>https://www.globenewswire.com/news-release/2018/02/02/1332410/0/en/SENS-Research-Foundation-Receives-2-4-Million-Ethereum-Donation-From-Vitalik-Buterin.html</nowiki></ref>

== How large will the longevity biotechnology field be? ==
Analysts from the Bank of America have predicted that the market size of longevity biotechnology will reach $600 billion by 2025.<ref>2021. ''Human lifespan could soon pass 100 years thanks to medical tech, says BofA''. [online] Available at: <<nowiki>https://www.cnbc.com/2019/05/08/techs-next-big-disruption-could-be-delaying-death.html</nowiki>> [Accessed 14 December 2021].</ref> Others have speculated that it is a trillion dollar industry owing to the immense savings associated with delaying or preventing chronic diseases.<ref>Colangelo, M., 2021. ''AI Will Drive The Multi-Trillion Dollar Longevity Economy''. [online] Forbes. Available at: <<nowiki>https://www.forbes.com/sites/cognitiveworld/2019/12/07/ai-will-drive-the-multi-trillion-dollar-longevity-economy/?sh=294766b74965</nowiki>> [Accessed 14 December 2021].</ref>
== Is age an important for risk factor for COVID-19 mortality? ==
[[File:Age is the -1 risk factor for COVID-19 mortality.jpg|alt=Age is the #1 risk factor for COVID-19 mortality - based on US CDC statistics|thumb|572x572px|The risk of dying from COVID-19 increases exponentially with age. [https://www.cdc.gov/coronavirus/2019-ncov/covid-data/investigations-discovery/hospitalization-death-by-age.html (US CDC statistics)]]]

Age is the single most significant risk factor for COVID-19 mortality. The mortality rate from COVID-19 increases exponentially with age, such that the death rate for those aged over 80 years is over 1000 times higher than those below 30 years.<ref name=":29">[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7576244/ Santesmasses, D., Castro, J. P., Zenin, A. A., Shindyapina, A. V., Gerashchenko, M. V., Zhang, B., ... & Gladyshev, V. N. (2020). COVID‐19 is an emergent disease of aging. ''Aging cell'', ''19''(10), e13230.]</ref>

This increase in COVID-19 mortality with age is thought to be the result of a weakening of the immune system with age, known as immunosenescence.<ref>Bajaj, V., Gadi, N., Spihlman, A. P., Wu, S. C., Choi, C. H., & Moulton, V. R. (2021). Aging, immunity, and COVID-19: how age influences the host immune response to coronavirus infections?. ''Frontiers in Physiology'', ''11'', 1793.</ref>

The mortality rate doubling time for COVID-19 is close to the all-cause mortality rate doubling time.<ref name=":29" /> This has led several scientists to conclude that COVID-19 meets criteria for an age-related disease.<ref name=":29" /><ref>[[Promislow, D. E. (2020). A geroscience perspective on COVID-19 mortality. The Journals of Gerontology: Series A, 75(9), e30-e33.|Promislow, D. E. (2020). A geroscience perspective on COVID-19 mortality. ''The Journals of Gerontology: Series A'', ''75''(9), e30-e33.]]</ref><ref>Alberts, S. C., Archie, E. A., Gesquiere, L. R., Altmann, J., Vaupel, J. W., & Christensen, K. (2014). The male-female health-survival paradox: a comparative perspective on sex differences in aging and mortality. In ''Sociality, hierarchy, health: comparative biodemography: a collection of papers''. National Academies Press (US).</ref><ref name=":10">[[Sierra, F. (2020). Geroscience and the Coronavirus Pandemic: The Whack‐a‐Mole Approach is not Enough. Journal of the American Geriatrics Society, 68(5), 951.|Sierra, F. (2020). Geroscience and the Coronavirus Pandemic: The Whack‐a‐Mole Approach is not Enough. ''Journal of the American Geriatrics Society'', ''68''(5), 951.]]</ref><ref name=":11">[[Barzilai, N., Appleby, J. C., Austad, S. N., Cuervo, A. M., Kaeberlein, M., Gonzalez-Billault, C., ... & Sierra, F. (2020). Geroscience in the Age of COVID-19. Aging and disease, 11(4), 725.|Barzilai, N., Appleby, J. C., Austad, S. N., Cuervo, A. M., Kaeberlein, M., Gonzalez-Billault, C., ... & Sierra, F. (2020). Geroscience in the Age of COVID-19. ''Aging and disease'', ''11''(4), 725.]]</ref><ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7288963/</ref>

== How is aging biology research different to other fields of medical research? ==
Scientists studying the biology of aging believe that aging is a root cause of all the major diseases of aging, and that targeting aging directly would treat or reverse multiple diseases, simultaneously. This is known as the geroscience hypothesis, and has garnered traction in recent years.<ref name=":24">Austad, S. N. (2016). The geroscience hypothesis: is it possible to change the rate of aging?. In ''Advances in geroscience'' (pp. 1-36). Springer, Cham.</ref>

The approach of targeting aging directly differs from many fields in mainstream medical research such as cancer research, which seek to find cures for individual diseases. An argument in favour of targeting aging directly is that targeting single diseases leads to diminishing returns in healthy lifespan extension.<ref name=":18" /> Due to the many diseases that occur concurrently in older age, completely curing a single disease such as cancer would only add 2-3 healthy years of life on average, whereas slowing aging could add 30 or more healthy years.<ref name=":18" /> This is because another disease in line, e.g. Alzheimer's or lung disease, will subsequently result in death, a phenomenon known as the Taeuber Paradox.<ref name=":17" />
== Do all animals age in the same way? ==
[[File:Naked mole rat graph.png|alt=Naked mole rat graph|thumb|530x530px|The naked mole-rat does not follow the same increased risk of mortality due to aging that humans and other mammals do. ]]
Many species, due to differences in their biology, age at different rates to humans. The jellyfish ''Turritopsis dohrnii'' can revert to earlier stages of its life cycle in response to stress, and can theoretically live forever - though eventually dies, usually due to predation.

Among mammals, the naked mole rat is an exceptionally long lived organism that lives roughly ten times longer than similarly-sized rats.<ref name=":3">Ruby, J. G., Smith, M., & Buffenstein, R. (2018). Naked mole-rat mortality rates defy Gompertzian laws by not increasing with age. ''elife'', ''7'', e31157.</ref><ref>Buffenstein, R., Amoroso, V., Andziak, B., Avdieiev, S., Azpurua, J., Barker, A. J., ... & Smith, E. S. J. (2021). The naked truth: a comprehensive clarification and classification of current ‘myths’ in naked mole‐rat biology. ''Biological Reviews''.</ref> Unlike other organisms, such as humans, horses and mice, the mortality rate of the naked mole rat appears steady over time. This trend does not follow the exponential increase in mortality (Gompertz-Makeham law) that humans do.<ref name=":3" />

Scientists are now studying the naked mole rat to identify key patterns in their genetics, environmental traits, and metabolism that may be responsible for their longer lifespans.<ref>Kim, E. B., Fang, X., Fushan, A. A., Huang, Z., Lobanov, A. V., Han, L., ... & Gladyshev, V. N. (2011). Genome sequencing reveals insights into physiology and longevity of the naked mole rat. ''Nature'', ''479''(7372), 223-227.</ref>

[[File:Naked mole rat.jpg|alt=Naked mole rat|center|thumb|323x323px|The naked mole rat is unusually long-lived relative to other mice and rats. ]]

== Is aging considered a disease? ==
Aging is not currently classified as a disease by regulatory bodies such as the Food and Drug Administration (FDA) in the United States. However, several scientists in the aging field have publicly stated their preference for aging to be considered a disease, including professor David Sinclair and professor Nir Barzilai.<ref>TEDx Talks. (2020, June 9). ''Ageing'' ''is'' ''a'' ''treatable'' ''disease'' ''|'' ''Nir'' ''Bazilai'' ''|'' ''TEDxBeaconStreetSalon'' [Video]. YouTube. <nowiki>https://www.youtube.com/watch?v=XN7rLbCBO1c</nowiki></ref>

== What are the economic benefits of extending healthy lifespan? ==
Extending the healthy human lifespan could have significant economic benefits gobally. An economic analysis from 2021 by researchers at the University of Oxford and Harvard University estimated the benefit of a drug that slows aging by 1 year as $38 trillion.<ref name=":23">Scott, A. J., Ellison, M., & Sinclair, D. A. (2021). The economic value of targeting aging. ''Nature Aging'', ''1''(7), 616-623.</ref> This is primarily because slowing aging reduces the incidence of age-related diseases such as cancer and Alzheimer’s disease, which require expensive treatment approaches. The study demonstrated a larger economic benefit of slowing aging than curing the individual diseases of aging. <ref name=":23" />
== Which scientists and institutions are trying to understand and reverse aging? ==
Over [https://whoswho.senescence.info/ 300 scientists are working on understanding the biology of aging] in leading institutions that include Harvard University, Stanford University, Yale University, and the University of Oxford.<ref>''Who's Who in Gerontology: Researchers and Companies Working on Aging''. (n.d.). Who's Who in Gerontology: Researchers and Companies Working on Aging. <nowiki>https://whoswho.senescence.info/</nowiki></ref> Some of the most well-known institutes and labs include:

=== The Buck Institute for Research on Aging ===
The Buck Institute for Research on Aging is one of the largest longevity research institutes with over 250 scientists. The research covers several areas including the mechanisms of aging, neurodegeneration, senescence, stem cells and regenerative medicine, cellular stress and disease, cancer associated with aging, and mitochondrial function.<ref>''Buck Institute''. (n.d.). BUCK. <nowiki>https://www.buckinstitute.org/</nowiki></ref>

=== Professor David Sinclair - Harvard Medical School ===
Professor Sinclair’s lab focuses on understanding and reversing aging. The lab focuses on a range of areas including DNA repair, mitochondrial dysfunction, and the interactions between epigenetic and genetic instability, and tissue reprogramming.<ref>''Welcome | The Sinclair Lab''. (n.d.). Welcome | The Sinclair Lab. <nowiki>https://sinclair.hms.harvard.edu/</nowiki></ref>

=== Professor Matt Kaeberlein - University of Washington ===
Professor Kaeberlein's lab focuses on biological mechanisms of aging in order to facilitate translational interventions that promote healthspan and improve quality of life. Kaeberlein is known for his work on the longevity drug rapamycin in organisms such as mice and dogs. He is Director of the Dog Aging Project, a multi-year initiative studying the genetic and environmental factors that influence health, with over 33,000 participating dogs.<ref>''Matt Kaeberlein, PhD | Faculty | Dept. of Laboratory Medicine & Pathology | UW Medicine''. (n.d.). Dept. of Laboratory Medicine & Pathology | UW Medicine. <nowiki>https://dlmp.uw.edu/faculty/kaeberlein</nowiki></ref>

=== Professor Brian Kennedy - National University of Singapore ===
Professor Kennedy’s lab focuses on understanding the biology of aging and translating research discoveries into new ways of delaying aging in humans. The lab has identified drugs that extend the healthy lifespan of worms and mice and are seeking to understand their mechanisms.<ref>''Brian Kennedy - Department of Biochemistry – School of Medicine, National University of Singapore''. (n.d.). Department of Biochemistry – School of Medicine, National University of Singapore. <nowiki>https://medicine.nus.edu.sg/bch/fa</nowiki></ref>

=== Associate Professor Lynne Cox - University of Oxford ===
Professor Cox’s lab study the molecular and cellular basis of aging to identify specific biochemical processes and pathways that change organisms age. The lab particularly cellular senescence, which underpins many age-related diseases including cancer and neurodegeneration.<ref>''Associate Prof Lynne Cox''. (n.d.). Home | Biochemistry. <nowiki>https://www.bioch.ox.ac.uk/research/cox</nowiki></ref>

== What books have been written on this topic? ==
Several books have been written on the topic of aging and longevity. These include:

* [https://www.amazon.com/Lifespan-Why-Age_and-Dont-Have/dp/1501191977 ''Lifespan: Why We Age And Why We Don't Have To'' - David Sinclair (2019)]

* [https://www.amazon.com/Ending-Aging-Rejuvenation-Breakthroughs-Lifetime/dp/0312367074 ''Ending Aging'' - Dr. Aubrey de Grey (2007)]

* [https://www.amazon.com/Ageless-Science-Getting-Older-Without/dp/0385544928 ''Ageless'' - Dr. Andrew Steele (2020)]

* [https://www.amazon.com.au/Age-Later-Health-Science-Longevity-ebook/dp/B0818MYCRR ''Age Later'' - Professor Nir Barzilai (2021)]

* [https://www.amazon.com.au/Science-Technology-Growing-Young-Breakthroughs/dp/1950665879 ''The Science and Technology of Growing Young'' - Sergey Young (2021)]

== Which anti-aging drugs are being tested in clinical trials today? ==
There are over 50 drugs being tested in human clinical trials for aging or age-related diseases.

The largest trial is the Targeting Aging with Metformin (TAME) trial, which began in 2020. The trial is being run in the United States with a cohort of 3000 older adults. The goal of the TAME trial is to determine whether diabetes drug metformin slows the aging process in older adults. The TAME trial is a $75 million trial run by the American Federation for Aging Research.<ref name=":14" />

Another large clinical trial is the Participitory Evaluation (of) Aging (with) Rapamycin (for) Longevity (PEARL) study. The goal of this study is to determine whether rapamycin, a drug currently approved for immunosuppression during organ transplants, slows biomarkers of aging in 1000 adults. The PEARL trial is being run by AgelessRx.<ref name=":15" />
== Is aging a natural process that should be accepted? ==
Although aging is a natural process in humans, it is the driving force of many diseases such as cancer and Alzheimer's disease - which as a society we have decided are worth trying to find cures for. In the past, these conditions, as well as atherosclerosis and even infectious diseases were once thought of as natural processes that could not be treated. However, nowadays it is understood that they are diseases that can be treated.

Atherosclerosis, the hardening of the arteries, was once viewed as a natural process that was simply a consequence of aging. However, when treatments such as statins were later developed to prevent atherosclerosis, the disease became widely regarded as a disease to be cured. Statins are now one one of the most widely prescribed drugs in the world, used in preventing heart diseases. The inventor of statins, Akira Endo, describes in his historical paper: “Serious research on the role of cholesterol in human atherosclerosis did not really get underway until the 1940s, due to a prevailing view that the disease was a simple consequence of aging and could not be prevented.”<ref>Endo A. (2010). A historical perspective on the discovery of statins. ''Proceedings of the Japan Academy. Series B, Physical and biological sciences'', ''86''(5), 484–493. <nowiki>https://doi.org/10.2183/pjab.86.484</nowiki></ref>

== Will anti-aging technology lead to overpopulation? ==
A common objection to the development of longevity technologies is that they may lead to an unsustainably large population size.

One study of a 2005 Swedish cohort of 9 million people modeled the effect of various anti-aging scenarios. The researchers showed that even with the most radical life-extension technology in which aging completely stopped after age 60, the population growth across 100 years was only 22%.<ref>Gavrilov, L. A., & Gavrilova, N. S. (2010). Demographic consequences of defeating aging. ''Rejuvenation research'', ''13''(2-3), 329-334.</ref>

Currently, the world’s population is 7.9 billion, and the WHO predicts the population will peak at 11 billion in 2100 before falling due to declining birth rates in many parts of the world. The fastest growing populations are in Africa and South-east Asia. However, several factors are thought to reduce birth rates over time, including increased access to contraceptives, female empowerment, increased education and increased employment. There is evidence that populations that move to a more advanced economy show a reduction in birth rates. This is expected to mitigate the increase in population size from longer lifespans.

== Will anti-aging drugs only be available to the rich? ==
It is unclear who will have first access to longevity drugs. Several researchers in the field have argued that several economic factors are likely to drive down the price of drugs that slow aging.

* The cost of many biotechnologies decreases substantially over time. For example, the first human genome cost $100 million to sequence, and is now available for a few hundred dollars.

* The price of many lifesaving pharmaceuticals has fallen significantly in price once generic drugs were produced. For example, Lipitor, a statin used to prevent heart disease has fallen in price from $85 in 2011 to less than $5 today.

* Many companies in the longevity field have stated that equity of access is part of their core ethos, and many researchers are signatories to the

== References ==
<references />

FAQ

2021-12-15T10:46:33Z

Jack: /* Will anti-aging drugs only be available to the rich? */

Longevity biotechnology is a new field of medical research and development that aims to extend healthy human lifespan and delay, prevent or reverse these diseases. This article provides an overview of the field, answering common questions.

== Why is aging a problem? ==
[[File:Aging graph.png|thumb|750x750px|The aging process results in the risk of age-related diseases increasing exponentially over time.]][[File:Gompertz-Makeham law of mortality.png|alt=Gompertz-Makeham law of mortality|thumb|257x257px|Gompertz-Makeham law of mortality<ref name=":0">En.wikipedia.org. 2021. ''Gompertz–Makeham law of mortality - Wikipedia''. [online] Available at: <<nowiki>https://en.wikipedia.org/wiki/Gompertz%E2%80%93Makeham_law_of_mortality</nowiki>> [Accessed 13 December 2021].</ref>]]Aging is the largest risk factor for the diseases that kill most people worldwide, including cancer, heart diseases and Alzheimer's disease.

In the US in 2020, 9 of the 10 leading causes of death were strongly age-related.<ref name=":19">Ahmad, F. B., & Anderson, R. N. (2021). The leading causes of death in the US for 2020. ''JAMA'', ''325''(18), 1829-1830.https://jamanetwork.com/journals/jama/fullarticle/2778234</ref> Globally, approximately 70% of deaths annually are the result of aging.<ref name=":8" />

Aging also significantly affects quality of life, as deaths due to aging are usually preceded by many months of years of chronic illnesses such as cancer, type 2 diabetes and Alzheimer’s disease.

As a result of the aging process, the risk of an individual dying increases exponentially after the age of around 30 years old.<ref name=":0" /> This increase in mortality rate is known as the Gompertz-Makeham law of mortality.<ref name=":0" />
== How many people die from aging per day? ==
The aging process results in the deaths of 100,000 people per day; more than twice the sum of all other causes of death combined.<ref name=":8">Ritchie, H. and Roser, M., 2021. ''Causes of Death''. [online] Our World in Data. Available at: <<nowiki>https://ourworldindata.org/causes-of-death</nowiki>> [Accessed 13 December 2021].
</ref> This equates to over 37 million people dying per day of aging - a population the size of Canada. This is because aging results in the exponential increasing risk of age-related diseases such as cancer and type 2 diabetes. Aging also accounts for more than 30% of all disability-adjusted life years lost (DALYs); more than any other single cause.<ref>Vizhub.healthdata.org. 2021. ''GBD Compare | IHME Viz Hub''. [online] Available at: <<nowiki>https://vizhub.healthdata.org/gbd-compare/</nowiki>> [Accessed 13 December 2021].</ref>
[[File:Leading causes of death.png|center|thumb|713x713px|9 of the top 10 causes of death in the US in 2020 were strongly age-related.<ref name=":19" />]]

== Can healthy lifespan be extended? ==
[[File:Life extension mice.jpg|alt=Life extension mice|thumb|431x431px|Dietary manipulation, genetic manipulation, and drugs have been shown to increase the healthy lifespan of mice by up to 30%. <ref name=":1">de Magalhaes, J., 2021. ''DrugAge: Species Detail''. [online] Genomics.senescence.info. Available at: <<nowiki>https://genomics.senescence.info/drugs/species_details.php</nowiki>> [Accessed 14 December 2021].</ref>]]Clinical trials for longevity drugs in humans are in-progress, and there is not yet evidence that drugs can slow aging in humans. However, recent experimental breakthroughs over the last few decades have shown that in mice, worms and flies have demonstrated that healthy lifespan can be extended modified. Many clinical trials in humans today are testing whether these results can be replicated in humans.

In animal models, slowing the aging process in animals can be achieved via manipulation of diet, environment, genetics, epigenetics, or with drugs. In mice, over 100 drugs have been shown to extend healthy lifespan by up to 30%.<ref name=":1" />

The effect of longevity drugs on mice is often significant, delaying or eliminating the burden of age-related problems such as frailty, cataracts, cancer, and sarcopenia. For example, a new class of drugs called senolytics have been shown to extend lifespan in mice by over 30% whilst delaying age-related dysfunction.

== Which therapies may extend healthy lifespan? ==
Several drugs are known to extend healthy lifespan in animals. While there is no conclusive data that suggests these drugs would work the same in humans, many of these drugs are now being tested in clinical trials. [[File:Unity Mice.jpg|alt=Unity Mice|thumb|723x723px|Senolytic drugs eliminate senescent cells that accumulate with age, partially reversing multiple age-related diseases and extending the healthy lifespan of mice by up to 35%.<ref name=":16" /> ]]

=== Senolytics ===
Senolytics are drugs that remove senescent cells. These are cells which accumulate in the body with age and are linked with age-related diseases such as cancer.<ref>Xu, M., Pirtskhalava, T., Farr, J. N., Weigand, B. M., Palmer, A. K., Weivoda, M. M., ... & Kirkland, J. L. (2018). Senolytics improve physical function and increase lifespan in old age. ''Nature medicine'', ''24''(8), 1246-1256.</ref>
[[File:Metformin2.jpg|thumb|258x258px|Metformin extends lifespan in mice by 6%, and may extend lifespan in humans.<ref name=":13">Kulkarni, A. S., Gubbi, S., & Barzilai, N. (2020). Benefits of metformin in attenuating the hallmarks of aging. ''Cell metabolism'', ''32''(1), 15-30.</ref>]]
In mice, senolytics have been shown to increase the healthy lifespan by up to 35%.<ref name=":16">Baker, D. J., Childs, B. G., Durik, M., Wijers, M. E., Sieben, C. J., Zhong, J., ... & Van Deursen, J. M. (2016). Naturally occurring p16 Ink4a-positive cells shorten healthy lifespan. ''Nature'', ''530''(7589), 184-189.</ref> The first clinical trials of senolytics in humans began in 2020, and demonstrated benefits to functional measures suggesting these drugs may be effective in humans.

=== [[Metformin]] ===
Metformin is an approved drug for type 2 diabetes that extends lifespan in multiple species. In mice, Metformin extends lifespan by up to 6%.<ref>Anisimov, V. N., Berstein, L. M., Popovich, I. G., Zabezhinski, M. A., Egormin, P. A., Piskunova, T. S., Semenchenko, A. V., Tyndyk, M. L., Yurova, M. N., Kovalenko, I. G., & Poroshina, T. E. (2011). If started early in life, metformin treatment increases life span and postpones tumors in female SHR mice. ''Aging'', ''3''(2), 148–157. <nowiki>https://doi.org/10.18632/aging.100273</nowiki></ref> Metformin works by improving insulin sensitivity and may target several hallmarks of aging.<ref name=":13" /> Metformin is being tested as a longevity therapy in the largest clinical trial for a longevity therapy, the Targeting Aging with Metformin (TAME) trial in the US.<ref name=":14">''TAME - Targeting Aging with Metformin - American Federation for Aging Research''. (n.d.). American Federation for Aging Research. <nowiki>https://www.afar.org/tame-trial</nowiki></ref> This is a randomized clinical trial of 3000 elderly patients comparing metformin against a placebo for the onset of age-related diseases.<ref name=":14" />

=== [[Rapamycin]] ===
[[File:Rapamune .jpg|alt=Rapamune |thumb|253x253px|Rapamycin, also known as Rapamune© is being tested as a drug to extend healthy lifespan in humans. <ref name=":15" />]]
Rapamycin, also known as Rapamune©, is a drug used to prevent the rejection of organ transplants by the immune system. Rapamycin has been shown to extend lifespan by up to 26% when given at middle age, and 14% when given in late life.<ref name=":20">Harrison, D., Strong, R., Sharp, Z. ''et al.'' Rapamycin fed late in life extends lifespan in genetically heterogeneous mice. ''Nature'' 460, 392–395 (2009). <nowiki>https://doi.org/10.1038/nature08221</nowiki>
</ref><ref>Miller, R. A., Harrison, D. E., Astle, C. M., Fernandez, E., Flurkey, K., Han, M., Javors, M. A., Li, X., Nadon, N. L., Nelson, J. F., Pletcher, S., Salmon, A. B., Sharp, Z. D., Van Roekel, S., Winkleman, L., & Strong, R. (2014). Rapamycin-mediated lifespan increase in mice is dose and sex dependent and metabolically distinct from dietary restriction. ''Aging cell'', ''13''(3), 468–477. <nowiki>https://doi.org/10.1111/acel.12194</nowiki></ref> Rapamycin is currently being tested in a large-scale clinical trial called the Participatory Evaluation (of) Aging (With) Rapamycin (for) Longevity Study (PEARL). The study is a randomized clinical trial of 1000 elderly patients comparing rapamycin against placebo for age-related outcomes.<ref name=":15">Clinicaltrials.gov. 2021. ''Participatory Evaluation (of) Aging (With) Rapamycin (for) Longevity Study - Full Text View - ClinicalTrials.gov''. [online] Available at: <<nowiki>https://clinicaltrials.gov/ct2/show/NCT04488601</nowiki>> [Accessed 14 December 2021].
</ref>

=== [[Epigenetic reprogramming]] ===
Epigenetic reprogramming is remodeling the epigenetic marks, such as methylation tags on the DNA, in cells. This technique was used in 2020 to restore vision to blind mice by fully regrowing the optic nerve.<ref>Lu, Y., Brommer, B., Tian, X. ''et al.'' Reprogramming to recover youthful epigenetic information and restore vision. ''Nature'' 588, 124–129 (2020). <nowiki>https://doi.org/10.1038/s41586-020-2975-4</nowiki></ref> The researchers at Harvard medical school and believe this approach could one day be used to regenerate other tissues of the body as a longevity strategy.<ref>''Reversing The Aging Clock With Epigenetic Reprogramming''. (n.d.). Pubs - Bio-IT World. <nowiki>https://www.bio-itworld.com/news/2021/01/13/reversing-the-aging-clock-with-epigenetic-reprogramming</nowiki></ref>

In addition, over [https://www.lifespan.io/road-maps/the-rejuvenation-roadmap 50 other drugs] are being tested in human clinical trials for slowing aging.<ref name=":2">Lifespan.io. 2021. ''The Rejuvenation Roadmap | Lifespan.io''. [online] Available at: <<nowiki>https://www.lifespan.io/road-maps/the-rejuvenation-roadmap/</nowiki>> [Accessed 13 December 2021].</ref>

== What is the goal of longevity biotechnology? ==
[[File:Healthy lifespan extension.png|alt=Healthy lifespan extension|thumb|643x643px|Healthy lifespan extension involves early intervention to prevent or delay the decline associated with aging.<ref>''Longevity companies to watch in 2021 - Longevity.Technology''. (n.d.). Longevity.Technology. <nowiki>https://www.longevity.technology/longevity-companies-to-watch-in-2021/</nowiki></ref> ]]
Longevity biotechnology aims to slow or reverse the aging process to extend the healthy lifespan (‘healthspan’) of the population. Instead of treating diseases when they arise, one by one, longevity biotechnology aims to keep those who are already healthy, healthy by slowing the aging process. The aim is to thereby delay or prevent multiple diseases at once that are associated with aging.

The longevity biotechnology sector is rapidly growing, and there are currently over 170 private companies working on developing therapeutics to slow the aging process.<ref name=":4">Pfleger, K., 2021. ''Aging Companies''. [online] Agingbiotech.info. Available at: <<nowiki>https://agingbiotech.info/companies</nowiki>> [Accessed 13 December 2021].</ref> These companies are working on slowing or reversing the aging process by targeting one of more of the hallmarks of aging.

== Will healthy or unhealthy lifespan be extended? ==
[[File:Extending healthy lifespan.png|alt=Extending healthy lifespan|thumb|364x364px|Extending healthy versus unhealthy lifespan. <ref>''How to save Medicare: the anti-aging remedy''. (2012, March). <nowiki>https://www.researchgate.net/figure/From-longer-life-span-to-longer-health-span-and-life-span-From-A-to-B-Standard_fig1_230724035</nowiki>.</ref>]]
The stated goal of longevity biotechnology is to extend the healthy period of lifespan, before age-related diseases set in. This is in contrast to many of today's medical interventions, which extend life only after diseases (e.g. cancer, Alzheimer's) have reached a clinical level.

Age-related diseases are preceded by a long period of subclinical aging, i.e. aging that has not yet progressed far enough to produce clinical symptoms. By slowing, delaying or reversing the aging process, the healthy period of life can be extended.

Studies in mice have demonstrated that life extending drugs such as rapamycin are capable of extending the healthy, rather than unhealthy period of life.<ref name=":20" />
== Should we treat specific diseases such as cancer, or aging? ==
[[File:Slowing aging versus curing cancer.jpg|alt=Slowing aging is potentially a more effective means of extending healthy lifespan than treating individual diseases due to the comorbid nature of age-related diseases. [6]|thumb|421x421px|Slowing aging is potentially a more effective means of extending healthy lifespan than treating individual diseases due to the comorbid nature of age-related diseases.<ref name=":18" /> ]]
Longevity biotechnology potentially offers a greater likelihood of extending healthy lifespan than attempting to find cures for the individual diseases of aging. This is because biological aging is associated with many of diseases of aging that develop as comorbidities i.e. at the same time. Even if a person survives one age-related disease such as cancer, another (e.g. diabetes, cardiovascular disease) is likely to kill the person if the underlying aging is not treated. This phenomenon is known as Taueber's paradox<ref name=":17">En.wikipedia.org. 2021. ''Taeuber Paradox - Wikipedia''. [online] Available at: <<nowiki>https://en.wikipedia.org/wiki/Taeuber_Paradox</nowiki>> [Accessed 14 December 2021].</ref>, and accounts for the much smaller projected increase in healthy lifespan associated with curing the diseases of aging, such as cancer (2-3 years), versus slowing aging itself (30+ years).<ref name=":18">Matt Kaeberlein, PhD, It is Time to Embrace 21st-Century Medicine, ''Public Policy & Aging Report'', Volume 29, Issue 4, 2019, Pages 111–115, <nowiki>https://doi.org/10.1093/ppar/prz022</nowiki></ref>
== What is biological aging? ==
There are two main types of 'age': chronological age - the number of years since birth, and biological age - a measure of the physical health of a person and their position in their lifespan. Biological age is more difficult to measure, but recent technologies are now available to estimate biological age. Over time, we age biologically. This occurs due to many processes in the body, which are generally categorised into 9 processes or 'hallmarks'.
== What are the 9 Hallmarks of Aging? ==
[[File:Hallmarks of aging.jpg|alt=Hallmarks of aging|thumb|444x444px|The nine hallmarks of aging.<ref name=":9" />]]

The hallmarks of aging framework is considered to broadly represent key biological mechanisms of the biological aging process.<ref name=":9">López-Otín C, Blasco MA, Partridge L, Serrano M, Kroemer G. The hallmarks of aging. Cell. 2013 Jun 6;153(6):1194-217.</ref> Although there are various limitations of the hallmarks framework, it has become the central framework for understanding aging biology. The nine forms of cellular and molecular ‘damage’ that comprise the hallmarks of aging are<ref name=":9" />:

* Genomic instability
* Telomere attrition
* Epigenetic alterations
* Loss of proteostasis
* Deregulated nutrient-sensing
* Mitochondrial dysfunction
* Cellular senescence
* Stem cell exhaustion
* Altered intercellular communication

These are essentially the lowest common denominators of the aging process, on a cellular or subcellular level. All of the other changes associated with aging, such as greying hair, wrinkles, frailty and an increased risk of disease is thought to stem from these underlyig processes.<ref name=":9" />

== How does the aging cause disease? ==
The nine hallmarks of aging have been shown to play an integral role in the development of many age-related diseases such as neurodegenerative diseases and cancer:
=== [[Aging and Neurodegeneration|Neurodegenerative disease]] ===
[[File:Prevalence of neuro disorders.jpg|alt=Prevalence of neuro disorders|thumb|469x469px|The prevalence of neurodegenerative disorders increases exponentially with age, due to the biological aging process.<ref name=":12">Hou, Y., Dan, X., Babbar, M., Wei, Y., Hasselbalch, S. G., Croteau, D. L., & Bohr, V. A. (2019). Ageing as a risk factor for neurodegenerative disease. ''Nature reviews. Neurology'', ''15''(10), 565–581. <nowiki>https://doi.org/10.1038/s41582-019-0244-7</nowiki></ref> ]]
All of the hallmarks of aging are associated with an increased risk of neurodegenerative diseases, such as Parkinson's disease and Alzheimer's disease.<ref>Qiu, C., Kivipelto, M., & von Strauss, E. (2009). Epidemiology of Alzheimer's disease: occurrence, determinants, and strategies toward intervention. ''Dialogues in clinical neuroscience'', ''11''(2), 111.</ref> For example, several types of DNA damage are associated with neurodegeneration. The shortening of telomeres occurs as part of biological aging and causes cellular senescence, and is associated with neurodegeneration and neurodegenerative diseases including Alzheimer's disease and Parkinson's disease.<ref name=":12" /> Additionally, mitochondrial dysfunction, altered metabolism, stem cell exhaustion and loss of proteostasis are also involved in the development of neurodegenerative diseases.<ref name=":12" />
=== [[Aging and Cancer|Cancer]] ===
Several of the hallmarks of aging such as cellular senescence and alterations in the extracellular matrix are responsible for increasing the likelihood of tumorigenesis.<ref name=":5">Fane, M., & Weeraratna, A. T. (2020). How the ageing microenvironment influences tumour progression. ''Nature Reviews Cancer'', ''20''(2), 89-106.</ref> Other hallmarks of aging such as genomic instability, loss or proteostasis, altered intercellular communication (i.e. inflammation) and epigenetic alterations are also involved in tumorigenesis.<ref name=":5" />
== How is biological age measured? ==
[[File:Epigenetic clock.png|alt=Epigenetic clock|thumb|605x605px|The epigenetic clock measures biological age based on marks on the epigenome.<ref name=":6" /> ]]
Recent technologies have allow biological age to be measured. These include:

=== [[Epigenetic clock|Epigenetic clocks]] ===
The first generation of aging clocks are known as [[Epigenetic clock|epigenetic clocks or Horvath’s clock]].<ref name=":6">Horvath, S., & Raj, K. (2018). DNA methylation-based biomarkers and the epigenetic clock theory of ageing. ''Nature Reviews Genetics'', ''19''(6), 371-384.</ref> This clock is based on the finding that over time, the body accumulates methylation tags on the DNA in a pattern that can be predicted with machine learning. These changes to the epigenome are influenced by lifestyle, and can be used to measure biological age.<ref name=":6" /> Factors such as exercise frequency and a low BMI have been shown to reduce the rate of biological aging, whereas obesity and smoking can accelerate the rate of aging.<ref>Quach, A., Levine, M. E., Tanaka, T., Lu, A. T., Chen, B. H., Ferrucci, L., ... & Horvath, S. (2017). Epigenetic clock analysis of diet, exercise, education, and lifestyle factors. ''Aging (Albany NY)'', ''9''(2), 419.</ref><ref>Wu, X., Huang, Q., Javed, R., Zhong, J., Gao, H., & Liang, H. (2019). Effect of tobacco smoking on the epigenetic age of human respiratory organs. ''Clinical Epigenetics'', ''11''(1), 183. <nowiki>https://doi.org/10.1186/s13148-019-0777-z</nowiki>

[[Epigenetic clock#cite%20ref-12|↑]]</ref><ref>Horvath, S., Erhart, W., Brosch, M., Ammerpohl, O., von Schönfels, W., Ahrens, M., Heits, N., Bell, J. T., Tsai, P.-C., Spector, T. D., Deloukas, P., Siebert, R., Sipos, B., Becker, T., Röcken, C., Schafmayer, C., & Hampe, J. (2014). Obesity accelerates epigenetic aging of human liver. ''Proceedings of the National Academy of Sciences'', ''111''(43), 15538–15543. <nowiki>https://doi.org/10.1073/pnas.1412759111</nowiki>

[[Epigenetic clock#cite%20ref-13|↑]]</ref> The Horvath's clock has been used to accurately predict mortality risk.<ref>Fransquet, P. D., Wrigglesworth, J., Woods, R. L., Ernst, M. E., & Ryan, J. (2019). The epigenetic clock as a predictor of disease and mortality risk: a systematic review and meta-analysis. ''Clinical epigenetics'', ''11''(1), 1-17.</ref>

=== Multi-omic clocks ===
Multi-omic clocks are being developed that incorporate data from several sources, such as body imaging scans, blood tests, and fitness tests. These clocks are built using machine learning to estimate biological age. These aging clocks are being developed that combine multiple biological functional tests to create a unique aging signature, which can be monitored over time.<ref name=":21">Kudryashova, K. S., Burka, K., Kulaga, A. Y., Vorobyeva, N. S., & Kennedy, B. K. (2020). Aging Biomarkers: From Functional Tests to Multi‐Omics Approaches. ''Proteomics'', ''20''(5-6), 1900408.</ref>
[[File:Multiomic aging clock.jpg|alt=Multiomic clocks|center|thumb|542x542px|Multiomic clocks integrate various data sources to create a unique biological aging signature that can be tracked over time.<ref name=":21" /> ]]
== Which companies are trying to solve aging? ==
[[File:Calico Labs.png|alt=T|thumb|Calico Labs, a subsidiary of Google, is a billion-dollar company searching for treatments for aging.<ref name=":22" /> ]]
There are over [https://agingbiotech.info/companies 170 longevity biotechnology companies] trying to create therapies to slow or reverse the aging process.<ref name=":4" /> There are over [https://www.lifespan.io/road-maps/the-rejuvenation-roadmap/ 50 longevity drugs] currently in clinical trials in humans.<ref name=":2" />

Many of the longevity biotechnology companies are targeting specific hallmarks of aging. For example, [https://www.clearabiotech.com/#DiscoveryTimeline Cleara Biotech] are attempting to reduce cellular senescence by developing a drug that can eliminate senescent cells.<ref>Cleara Biotech. 2021. ''Cleara Biotech''. [online] Available at: <<nowiki>https://www.clearabiotech.com/#DiscoveryTimeline</nowiki>> [Accessed 15 December 2021].</ref>

Calico Labs is a Google-backed biotech company with the goal of combating aging and age-related diseases. In 2014, the company created a partnership with pharmaceutical giant AbbVie, which has since developed into a [https://www.cnbc.com/2018/06/26/alphabet-backed-calico-and-abbvie-chip-in-1-billion-to-cure-aging.html $2.5 billion venture] in the pursuit of improving “health, wellbeing and longevity.” <ref name=":22">2021. ''Google sister company and drug giant chip in another $1 billion to cure age-related diseases''. [online] Available at: <<nowiki>https://www.cnbc.com/2018/06/26/alphabet-backed-calico-and-abbvie-chip-in-1-billion-to-cure-aging.html</nowiki>> [Accessed 15 December 2021].</ref>

Since aging is not currently considered a disease by regulatory bodies such as the Food and Drug Administration (FDA), drug developers are currently focused on specific diseases of aging such as glaucoma and osteoarthritis.<ref>Clinicaltrialsarena.com. 2021. ''Unity's Phase II osteoarthritis study of UBX0101 misses primary goal''. [online] Available at: <<nowiki>https://www.clinicaltrialsarena.com/news/unity-ubx0101-osteoarthritis/</nowiki>> [Accessed 15 December 2021].</ref>

== Which billionaires are funding longevity biotechnology? ==
[[File:Jeff Bezos is funding longevity research.jpg|alt=Jeff Bezos is funding longevity research|thumb|Jeff Bezos is funding longevity research through financing Atlos Labs.<ref name=":7">MIT Technology Review. 2021. ''Meet Altos Labs, Silicon Valley’s latest wild bet on living forever''. [online] Available at: <<nowiki>https://www.technologyreview.com/2021/09/04/1034364/altos-labs-silicon-valleys-jeff-bezos-milner-bet-living-forever/</nowiki>> [Accessed 15 December 2021].</ref>]]
Several billionaires have funded companies or initiatives to slow or reverse human aging. These include:
* [[wikipedia:Jeff_Bezos|Jeff Bezos]], co-founder of Amazon, helped raise [https://www.technologyreview.com/2021/09/04/1034364/altos-labs-silicon-valleys-jeff-bezos-milner-bet-living-forever/ $270 million for new anti-aging drug company Altos Labs] in 2021.<ref name=":7" />
* [[wikipedia:Peter_Thiel|Peter Thiel]], co-founder of PayPal, was an [https://www.cnbc.com/2018/08/29/-jeff-bezos-is-backing-this-scientist-who-is-working-on-a-cure-for-aging.html early investor in Unity Biotechnology].<ref>CNBC. 2021. ''Why Jeff Bezos is backing this Silicon Valley scientist who is working on a cure for aging''. [online] Available at: <<nowiki>https://www.cnbc.com/2018/08/29/-jeff-bezos-is-backing-this-scientist-who-is-working-on-a-cure-for-aging.html</nowiki>> [Accessed 15 December 2021].</ref>
* [[wikipedia:Sergey_Brin|Sergey Brin]], co-founder of Google, donated [https://www.cnbc.com/2017/03/31/google-co-founders-and-silicon-valley-billionaires-try-to-live-forever.html $25 million for the National Academy of Medicine’s Grand Challenge in Health Longevity] to 'end aging forever'.<ref>Google’s co-founders and other Silicon Valley billionaires are trying to live forever. (2021). Retrieved 15 December 2021, from <nowiki>https://www.cnbc.com/2017/03/31/google-co-founders-and-silicon-valley-billionaires-try-to-live-forever.html</nowiki></ref>
* [[wikipedia:Larry_Page|Larry Page]], co-founder of Google, co-founded the [[wikipedia:Calico_(company)|billion-dollar aging research company Calico Labs.]]<ref>Contributors to Wikimedia projects. (2013, September 19). ''Calico (company) - Wikipedia''. Wikipedia, the free encyclopedia. <nowiki>https://en.wikipedia.org/wiki/Calico_(company)</nowiki>
</ref>
* [[wikipedia:Mike_Cannon-Brookes|Mike Cannon-Brookes]], billionaire cofounder of Australian software giant Atlassian, has invested [https://www.forbes.com/sites/samshead/2019/08/19/billionaire-backs-uk-startup-trying-to-extend-human-lifespans/ $10 million into longevity company Juvenescenc]e.<ref>Shead, S. (2019, August 19). ''Billionaire Backs U.K. Startup Trying To Extend Human Life Spans''. Forbes. <nowiki>https://www.forbes.com/sites/samshead/2019/08/19/billionaire-backs-uk-startup-trying-to-extend-human-lifespans/</nowiki></ref>
* [[wikipedia:Naveen_Jain|Naveen Jain]], billionaire entrepeneur who has raised [https://www.geekwire.com/2021/gut-health-startup-viome-raises-54m-develop-cancer-diagnostics-sell-microbiome-kits/ $54 million for his startup Viome].<ref>''Gut health startup Viome raises $54M to develop cancer diagnostics and sell microbiome kits''. (2021, November 10). Geekwire. <nowiki>https://www.geekwire.com/2021/gut-health-startup-viome-raises-54m-develop-cancer-diagnostics-sell-microbiome-kits/</nowiki></ref>
* [[wikipedia:Jim_Mellon|Jim Mellon]], who co-founded longevity company [https://www.juvlabs.com/people/co-founder/jim-mellon Juvenescence].<ref>''Jim Mellon - Chairman & Co-Founder''. (n.d.). Juvenescence - Science of Healthy Aging & Extended Lifespan. <nowiki>https://www.juvlabs.com/people/co-founder/jim-mellon</nowiki></ref>
* [[wikipedia:Larry_Ellison|Larry Ellison]], founder of Oracle, has spent [https://www.townandcountrymag.com/society/money-and-power/a9202324/science-of-longevity/ $430 million on longevity research].<ref>Tullis, P. (2017, March 30). ''Are You Rich Enough To Live Forever?'' Town & Country. <nowiki>https://www.townandcountrymag.com/society/money-and-power/a9202324/science-of-longevity/</nowiki></ref>
*Michael Greve, founder of Kizoo Technology, who has pledged [https://Longevity.Technology. https://www.longevity.technology/michael-greve-commits-e300m-for-rejuvenation-start-ups/ €300m to rejuvenation biotechnology companies.]<ref>''Michael Greve commits €300m for rejuvenation start-ups''. (2021, May 6). Longevity.Technology. <nowiki>https://www.longevity.technology/michael-greve-commits-e300m-for-rejuvenation-start-ups/</nowiki></ref>
* [[wikipedia:Yuri_Milner|Yuri Milner]], billionaire tech investor who has helped Altos Labs raise $270 million, with Jeff Bezos.<ref name=":7" />
* [https://wikitia.com/wiki/Richard_Heart Richard Heart], founder of the cryptocurrency Hex, who helped raise [https://www.express.co.uk/finance/city/1465354/pulsechain-cryptocurrency-srf-sens-research-foundation-airdrop-pulse-charity-longevity $25 million for the anti-aging research organisation SENS.]<ref>McGleenon, B. (2021, July 20). ''Pulsechain cryptocurrency raises 'mindblowing' $25M in five days for SENS longevity group''. Express.co.uk. <nowiki>https://www.express.co.uk/finance/city/1465354/pulsechain-cryptocurrency-srf-sens-research-foundation-airdrop-pulse-charity-longevity</nowiki></ref>
*[[wikipedia:Brian_Armstrong_(businessman)|Brian Armstrong]], CEO of CoinBase, who helped found and raise [https://www.dailymail.co.uk/sciencetech/article-10310475/Billionaire-launches-new-start-hopes-REVERSE-ageing-process.html $105 million for the epigenetic reprogramming startup NewLimit.]<ref>Liberatore, S. (2021, December 14). ''Billionaire launches new start-up to REVERSE the ageing process''. Mail Online. <nowiki>https://www.dailymail.co.uk/sciencetech/article-10310475/Billionaire-launches-new-start-hopes-REVERSE-ageing-process.html</nowiki></ref>
* [[wikipedia:Vitalik_Buterin|Vitalik Buterin]], founder of the cryptocurrency Ethereum, who donated $2.4 million to SENS.<ref>Foundation, S. R. (n.d.). ''SENS Research Foundation Receives $2.4 Million Ethereum Donation From Vitalik Buterin''. GlobeNewswire News Room. <nowiki>https://www.globenewswire.com/news-release/2018/02/02/1332410/0/en/SENS-Research-Foundation-Receives-2-4-Million-Ethereum-Donation-From-Vitalik-Buterin.html</nowiki></ref>

== How large will the longevity biotechnology field be? ==
Analysts from the Bank of America have predicted that the market size of longevity biotechnology will reach $600 billion by 2025.<ref>2021. ''Human lifespan could soon pass 100 years thanks to medical tech, says BofA''. [online] Available at: <<nowiki>https://www.cnbc.com/2019/05/08/techs-next-big-disruption-could-be-delaying-death.html</nowiki>> [Accessed 14 December 2021].</ref> Others have speculated that it is a trillion dollar industry owing to the immense savings associated with delaying or preventing chronic diseases.<ref>Colangelo, M., 2021. ''AI Will Drive The Multi-Trillion Dollar Longevity Economy''. [online] Forbes. Available at: <<nowiki>https://www.forbes.com/sites/cognitiveworld/2019/12/07/ai-will-drive-the-multi-trillion-dollar-longevity-economy/?sh=294766b74965</nowiki>> [Accessed 14 December 2021].</ref>
== Is age an important for risk factor for COVID-19 mortality? ==
[[File:Age is the -1 risk factor for COVID-19 mortality.jpg|alt=Age is the #1 risk factor for COVID-19 mortality - based on US CDC statistics|thumb|572x572px|The risk of dying from COVID-19 increases exponentially with age. [https://www.cdc.gov/coronavirus/2019-ncov/covid-data/investigations-discovery/hospitalization-death-by-age.html (US CDC statistics)]]]

Age is the single most significant risk factor for COVID-19 mortality. The mortality rate from COVID-19 increases exponentially with age, such that the death rate for those aged over 80 years is over 1000 times higher than those below 30 years.<ref name=":29">[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7576244/ Santesmasses, D., Castro, J. P., Zenin, A. A., Shindyapina, A. V., Gerashchenko, M. V., Zhang, B., ... & Gladyshev, V. N. (2020). COVID‐19 is an emergent disease of aging. ''Aging cell'', ''19''(10), e13230.]</ref>

This increase in COVID-19 mortality with age is thought to be the result of a weakening of the immune system with age, known as immunosenescence.<ref>Bajaj, V., Gadi, N., Spihlman, A. P., Wu, S. C., Choi, C. H., & Moulton, V. R. (2021). Aging, immunity, and COVID-19: how age influences the host immune response to coronavirus infections?. ''Frontiers in Physiology'', ''11'', 1793.</ref>

The mortality rate doubling time for COVID-19 is close to the all-cause mortality rate doubling time.<ref name=":29" /> This has led several scientists to conclude that COVID-19 meets criteria for an age-related disease.<ref name=":29" /><ref>[[Promislow, D. E. (2020). A geroscience perspective on COVID-19 mortality. The Journals of Gerontology: Series A, 75(9), e30-e33.|Promislow, D. E. (2020). A geroscience perspective on COVID-19 mortality. ''The Journals of Gerontology: Series A'', ''75''(9), e30-e33.]]</ref><ref>Alberts, S. C., Archie, E. A., Gesquiere, L. R., Altmann, J., Vaupel, J. W., & Christensen, K. (2014). The male-female health-survival paradox: a comparative perspective on sex differences in aging and mortality. In ''Sociality, hierarchy, health: comparative biodemography: a collection of papers''. National Academies Press (US).</ref><ref name=":10">[[Sierra, F. (2020). Geroscience and the Coronavirus Pandemic: The Whack‐a‐Mole Approach is not Enough. Journal of the American Geriatrics Society, 68(5), 951.|Sierra, F. (2020). Geroscience and the Coronavirus Pandemic: The Whack‐a‐Mole Approach is not Enough. ''Journal of the American Geriatrics Society'', ''68''(5), 951.]]</ref><ref name=":11">[[Barzilai, N., Appleby, J. C., Austad, S. N., Cuervo, A. M., Kaeberlein, M., Gonzalez-Billault, C., ... & Sierra, F. (2020). Geroscience in the Age of COVID-19. Aging and disease, 11(4), 725.|Barzilai, N., Appleby, J. C., Austad, S. N., Cuervo, A. M., Kaeberlein, M., Gonzalez-Billault, C., ... & Sierra, F. (2020). Geroscience in the Age of COVID-19. ''Aging and disease'', ''11''(4), 725.]]</ref><ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7288963/</ref>

== How is aging biology research different to other fields of medical research? ==
Scientists studying the biology of aging believe that aging is a root cause of all the major diseases of aging, and that targeting aging directly would treat or reverse multiple diseases, simultaneously. This is known as the geroscience hypothesis, and has garnered traction in recent years.<ref>Austad, S. N. (2016). The geroscience hypothesis: is it possible to change the rate of aging?. In ''Advances in geroscience'' (pp. 1-36). Springer, Cham.</ref>

The approach of targeting aging directly differs from many fields in mainstream medical research such as cancer research, which seek to find cures for individual diseases. An argument in favour of targeting aging directly is that targeting single diseases leads to diminishing returns in healthy lifespan extension.<ref name=":18" /> Due to the many diseases that occur concurrently in older age, completely curing a single disease such as cancer would only add 2-3 healthy years of life on average, whereas slowing aging could add 30 or more healthy years.<ref name=":18" /> This is because another disease in line, e.g. Alzheimer's or lung disease, will subsequently result in death, a phenomenon known as the Taeuber Paradox.<ref name=":17" />
== Do all animals age in the same way? ==
[[File:Naked mole rat graph.png|alt=Naked mole rat graph|thumb|530x530px|The naked mole-rat does not follow the same increased risk of mortality due to aging that humans and other mammals do. ]]
Many species, due to differences in their biology, age at different rates to humans. The jellyfish ''Turritopsis dohrnii'' can revert to earlier stages of its life cycle in response to stress, and can theoretically live forever - though eventually dies, usually due to predation.

Among mammals, the naked mole rat is an exceptionally long lived organism that lives roughly ten times longer than similarly-sized rats.<ref name=":3">Ruby, J. G., Smith, M., & Buffenstein, R. (2018). Naked mole-rat mortality rates defy Gompertzian laws by not increasing with age. ''elife'', ''7'', e31157.</ref><ref>Buffenstein, R., Amoroso, V., Andziak, B., Avdieiev, S., Azpurua, J., Barker, A. J., ... & Smith, E. S. J. (2021). The naked truth: a comprehensive clarification and classification of current ‘myths’ in naked mole‐rat biology. ''Biological Reviews''.</ref> Unlike other organisms, such as humans, horses and mice, the mortality rate of the naked mole rat appears steady over time. This trend does not follow the exponential increase in mortality (Gompertz-Makeham law) that humans do.<ref name=":3" />

Scientists are now studying the naked mole rat to identify key patterns in their genetics, environmental traits, and metabolism that may be responsible for their longer lifespans.<ref>Kim, E. B., Fang, X., Fushan, A. A., Huang, Z., Lobanov, A. V., Han, L., ... & Gladyshev, V. N. (2011). Genome sequencing reveals insights into physiology and longevity of the naked mole rat. ''Nature'', ''479''(7372), 223-227.</ref>

[[File:Naked mole rat.jpg|alt=Naked mole rat|center|thumb|323x323px|The naked mole rat is unusually long-lived relative to other mice and rats. ]]

== Is aging considered a disease? ==
Aging is not currently classified as a disease by regulatory bodies such as the Food and Drug Administration (FDA) in the United States. However, several scientists in the aging field have publicly stated their preference for aging to be considered a disease, including professor David Sinclair and professor Nir Barzilai.

== What are the economic benefits of extending healthy lifespan? ==
Extending the healthy human lifespan could have significant economic benefits gobally. An economic analysis from 2021 by researchers at the University of Oxford and Harvard University estimated the benefit of a drug that slows aging by 1 year as $38 trillion.<ref name=":23">Scott, A. J., Ellison, M., & Sinclair, D. A. (2021). The economic value of targeting aging. ''Nature Aging'', ''1''(7), 616-623.</ref> This is primarily because slowing aging reduces the incidence of age-related diseases such as cancer and Alzheimer’s disease, which require expensive treatment approaches. The study demonstrated a larger economic benefit of slowing aging than curing the individual diseases of aging. <ref name=":23" />
== Which scientists and institutions are trying to understand and reverse aging? ==
Over [https://whoswho.senescence.info/ 300 scientists are working on understanding the biology of aging] in leading institutions that include Harvard University, Stanford University, Yale University, and the University of Oxford.<ref>''Who's Who in Gerontology: Researchers and Companies Working on Aging''. (n.d.). Who's Who in Gerontology: Researchers and Companies Working on Aging. <nowiki>https://whoswho.senescence.info/</nowiki></ref> Some of the most well-known institutes and labs include:

=== The Buck Institute for Research on Aging ===
The Buck Institute for Research on Aging is one of the largest longevity research institutes with over 250 scientists. The research covers several areas including the mechanisms of aging, neurodegeneration, senescence, stem cells and regenerative medicine, cellular stress and disease, cancer associated with aging, and mitochondrial function.<ref>''Buck Institute''. (n.d.). BUCK. <nowiki>https://www.buckinstitute.org/</nowiki></ref>

=== Professor David Sinclair - Harvard Medical School ===
Professor Sinclair’s lab focuses on understanding and reversing aging. The lab focuses on a range of areas including DNA repair, mitochondrial dysfunction, and the interactions between epigenetic and genetic instability, and tissue reprogramming.<ref>''Welcome | The Sinclair Lab''. (n.d.). Welcome | The Sinclair Lab. <nowiki>https://sinclair.hms.harvard.edu/</nowiki></ref>

=== Professor Matt Kaeberlein - University of Washington ===
Professor Kaeberlein's lab focuses on biological mechanisms of aging in order to facilitate translational interventions that promote healthspan and improve quality of life. Kaeberlein is known for his work on the longevity drug rapamycin in organisms such as mice and dogs. He is Director of the Dog Aging Project, a multi-year initiative studying the genetic and environmental factors that influence health, with over 33,000 participating dogs.<ref>''Matt Kaeberlein, PhD | Faculty | Dept. of Laboratory Medicine & Pathology | UW Medicine''. (n.d.). Dept. of Laboratory Medicine & Pathology | UW Medicine. <nowiki>https://dlmp.uw.edu/faculty/kaeberlein</nowiki></ref>

=== Professor Brian Kennedy - National University of Singapore ===
Professor Kennedy’s lab focuses on understanding the biology of aging and translating research discoveries into new ways of delaying aging in humans. The lab has identified drugs that extend the healthy lifespan of worms and mice and are seeking to understand their mechanisms.<ref>''Brian Kennedy - Department of Biochemistry – School of Medicine, National University of Singapore''. (n.d.). Department of Biochemistry – School of Medicine, National University of Singapore. <nowiki>https://medicine.nus.edu.sg/bch/fa</nowiki></ref>

=== Associate Professor Lynne Cox - University of Oxford ===
Professor Cox’s lab study the molecular and cellular basis of aging to identify specific biochemical processes and pathways that change organisms age. The lab particularly cellular senescence, which underpins many age-related diseases including cancer and neurodegeneration.<ref>''Associate Prof Lynne Cox''. (n.d.). Home | Biochemistry. <nowiki>https://www.bioch.ox.ac.uk/research/cox</nowiki></ref>

== What books have been written on this topic? ==
Several books have been written on the topic of aging and longevity. These include:

* [https://www.amazon.com/Lifespan-Why-Age_and-Dont-Have/dp/1501191977 ''Lifespan: Why We Age And Why We Don't Have To'' - David Sinclair (2019)]

* [https://www.amazon.com/Ending-Aging-Rejuvenation-Breakthroughs-Lifetime/dp/0312367074 ''Ending Aging'' - Dr. Aubrey de Grey (2007)]

* [https://www.amazon.com/Ageless-Science-Getting-Older-Without/dp/0385544928 ''Ageless'' - Dr. Andrew Steele (2020)]

* [https://www.amazon.com.au/Age-Later-Health-Science-Longevity-ebook/dp/B0818MYCRR ''Age Later'' - Professor Nir Barzilai (2021)]

* [https://www.amazon.com.au/Science-Technology-Growing-Young-Breakthroughs/dp/1950665879 ''The Science and Technology of Growing Young'' - Sergey Young (2021)]

== Which anti-aging drugs are being tested in clinical trials today? ==
There are over 50 drugs being tested in human clinical trials for aging or age-related diseases.

The largest trial is the Targeting Aging with Metformin (TAME) trial, which began in 2020. The trial is being run in the United States with a cohort of 3000 older adults. The goal of the TAME trial is to determine whether diabetes drug metformin slows the aging process in older adults. The TAME trial is a $75 million trial run by the American Federation for Aging Research.<ref name=":14" />

Another large clinical trial is the Participitory Evaluation (of) Aging (with) Rapamycin (for) Longevity (PEARL) study. The goal of this study is to determine whether rapamycin, a drug currently approved for immunosuppression during organ transplants, slows biomarkers of aging in 1000 adults. The PEARL trial is being run by AgelessRx.<ref name=":15" />
== Is aging a natural process that should be accepted? ==
Although aging is a natural process in humans, it is the driving force of many diseases such as cancer and Alzheimer's disease - which as a society we have decided are worth trying to find cures for. In the past, these conditions, as well as atherosclerosis and even infectious diseases were once thought of as natural processes that could not be treated. However, nowadays it is understood that they are diseases that can be treated.

Atherosclerosis, the hardening of the arteries, was once viewed as a natural process that was simply a consequence of aging. However, when treatments such as statins were later developed to prevent atherosclerosis, the disease became widely regarded as a disease to be cured. Statins are now one one of the most widely prescribed drugs in the world, used in preventing heart diseases. The inventor of statins, Akira Endo, describes in his historical paper: “Serious research on the role of cholesterol in human atherosclerosis did not really get underway until the 1940s, due to a prevailing view that the disease was a simple consequence of aging and could not be prevented.”<ref>Endo A. (2010). A historical perspective on the discovery of statins. ''Proceedings of the Japan Academy. Series B, Physical and biological sciences'', ''86''(5), 484–493. <nowiki>https://doi.org/10.2183/pjab.86.484</nowiki></ref>

== Will anti-aging technology lead to overpopulation? ==
A common objection to the development of longevity technologies is that they may lead to an unsustainably large population size.

One study of a 2005 Swedish cohort of 9 million people modeled the effect of various anti-aging scenarios. The researchers showed that even with the most radical life-extension technology in which aging completely stopped after age 60, the population growth across 100 years was only 22%.

Currently, the world’s population is 7.9 billion, and the WHO predicts the population will peak at 11 billion in 2100 before falling due to declining birth rates in many parts of the world.

The fastest growing populations are in Africa and South-east Asia. However, several factors are thought to reduce birth rates over time, including increased access to contraceptives, female empowerment, increased education and increased employment. There is evidence that populations that move to a more advanced economy show a reduction in birth rates.

== Will anti-aging drugs only be available to the rich? ==
It is unclear who will have first access to longevity drugs. Several researchers in the field have argued that several economic factors are likely to drive down the price of drugs that slow aging.

* The cost of many biotechnologies decreases substantially over time. For example, the first human genome cost $100 million to sequence, and is now available for a few hundred dollars.

* The price of many lifesaving pharmaceuticals has fallen significantly in price once generic drugs were produced. For example, Lipitor, a statin used to prevent heart disease has fallen in price from $85 in 2011 to less than $5 today.

* Many companies in the longevity field have stated that equity of access is part of their core ethos, and many researchers are signatories to the

== References ==
<references />

FAQ

2021-12-15T09:37:14Z

Jack: /* Is aging an important for risk factor for COVID-19 mortality? */

Longevity biotechnology is a new field of medical research and development that aims to extend healthy human lifespan and delay, prevent or reverse these diseases. This article provides an overview of the field, answering common questions.

== Why is aging a problem? ==
[[File:Aging graph.png|thumb|750x750px|The aging process results in the risk of age-related diseases increasing exponentially over time.]][[File:Gompertz-Makeham law of mortality.png|alt=Gompertz-Makeham law of mortality|thumb|257x257px|Gompertz-Makeham law of mortality<ref name=":0">En.wikipedia.org. 2021. ''Gompertz–Makeham law of mortality - Wikipedia''. [online] Available at: <<nowiki>https://en.wikipedia.org/wiki/Gompertz%E2%80%93Makeham_law_of_mortality</nowiki>> [Accessed 13 December 2021].</ref>]]Aging is the largest risk factor for the diseases that kill most people worldwide, including cancer, heart diseases and Alzheimer's disease.

In the US in 2020, 9 of the 10 leading causes of death were strongly age-related.<ref>Ahmad, F. B., & Anderson, R. N. (2021). The leading causes of death in the US for 2020. ''JAMA'', ''325''(18), 1829-1830.https://jamanetwork.com/journals/jama/fullarticle/2778234</ref> Globally, approximately 70% of deaths annually are the result of aging.<ref name=":8" />

Aging also significantly affects quality of life, as deaths due to aging are usually preceded by many months of years of chronic illnesses such as cancer, type 2 diabetes and Alzheimer’s disease.

As a result of the aging process, the risk of an individual dying increases exponentially after the age of around 30 years old.<ref name=":0" /> This increase in mortality rate is known as the Gompertz-Makeham law of mortality.<ref name=":0" />
== How many people die from aging per day? ==
The aging process results in the deaths of 100,000 people per day; more than twice the sum of all other causes of death combined.<ref name=":8">Ritchie, H. and Roser, M., 2021. ''Causes of Death''. [online] Our World in Data. Available at: <<nowiki>https://ourworldindata.org/causes-of-death</nowiki>> [Accessed 13 December 2021].
</ref> This equates to over 37 million people dying per day of aging - a population the size of Canada. This is because aging results in the exponential increasing risk of age-related diseases such as cancer and type 2 diabetes. Aging also accounts for more than 30% of all disability-adjusted life years lost (DALYs); more than any other single cause.<ref>Vizhub.healthdata.org. 2021. ''GBD Compare | IHME Viz Hub''. [online] Available at: <<nowiki>https://vizhub.healthdata.org/gbd-compare/</nowiki>> [Accessed 13 December 2021].</ref>
[[File:Leading causes of death.png|center|thumb|713x713px|9 of the top 10 causes of death in the US in 2020 were strongly age-related]]

== Can healthy lifespan be extended? ==
[[File:Life extension mice.jpg|alt=Life extension mice|thumb|431x431px|Dietary manipulation, genetic manipulation, and drugs have been shown to increase the healthy lifespan of mice by up to 30%. <ref name=":1">de Magalhaes, J., 2021. ''DrugAge: Species Detail''. [online] Genomics.senescence.info. Available at: <<nowiki>https://genomics.senescence.info/drugs/species_details.php</nowiki>> [Accessed 14 December 2021].</ref>]]Clinical trials for longevity drugs in humans are in-progress, and there is not yet evidence that drugs can slow aging in humans. However, recent experimental breakthroughs over the last few decades have shown that in mice, worms and flies have demonstrated that healthy lifespan can be extended modified. Many clinical trials in humans today are testing whether these results can be replicated in humans.

In animal models, slowing the aging process in animals can be achieved via manipulation of diet, environment, genetics, epigenetics, or with drugs. In mice, over 100 drugs have been shown to extend healthy lifespan by up to 30%.<ref name=":1" />

The effect of longevity drugs on mice is often significant, delaying or eliminating the burden of age-related problems such as frailty, cataracts, cancer, and sarcopenia. For example, a new class of drugs called senolytics have been shown to extend lifespan in mice by over 30% whilst delaying age-related dysfunction.

== Which therapies may extend healthy lifespan? ==
Several drugs are known to extend healthy lifespan in animals. While there is no conclusive data that suggests these drugs would work the same in humans, many of these drugs are now being tested in clinical trials. [[File:Unity Mice.jpg|alt=Unity Mice|thumb|723x723px|Senolytic drugs eliminate senescent cells that accumulate with age, partially reversing multiple age-related diseases and extending the healthy lifespan of mice by up to 35%.<ref name=":16" /> ]]

=== Senolytics ===
Senolytics are drugs that remove senescent cells. These are cells which accumulate in the body with age and are linked with age-related diseases such as cancer.<ref>Xu, M., Pirtskhalava, T., Farr, J. N., Weigand, B. M., Palmer, A. K., Weivoda, M. M., ... & Kirkland, J. L. (2018). Senolytics improve physical function and increase lifespan in old age. ''Nature medicine'', ''24''(8), 1246-1256.</ref>
[[File:Metformin2.jpg|thumb|258x258px|Metformin extends lifespan in mice by 6%, and may extend lifespan in humans.<ref name=":13">Kulkarni, A. S., Gubbi, S., & Barzilai, N. (2020). Benefits of metformin in attenuating the hallmarks of aging. ''Cell metabolism'', ''32''(1), 15-30.</ref>]]
In mice, senolytics have been shown to increase the healthy lifespan by up to 35%.<ref name=":16">Baker, D. J., Childs, B. G., Durik, M., Wijers, M. E., Sieben, C. J., Zhong, J., ... & Van Deursen, J. M. (2016). Naturally occurring p16 Ink4a-positive cells shorten healthy lifespan. ''Nature'', ''530''(7589), 184-189.</ref> The first clinical trials of senolytics in humans began in 2020, and demonstrated benefits to functional measures suggesting these drugs may be effective in humans.

=== [[Metformin]] ===
Metformin is an approved drug for type 2 diabetes that extends lifespan in multiple species. In mice, Metformin extends lifespan by up to 6%.<ref>Anisimov, V. N., Berstein, L. M., Popovich, I. G., Zabezhinski, M. A., Egormin, P. A., Piskunova, T. S., Semenchenko, A. V., Tyndyk, M. L., Yurova, M. N., Kovalenko, I. G., & Poroshina, T. E. (2011). If started early in life, metformin treatment increases life span and postpones tumors in female SHR mice. ''Aging'', ''3''(2), 148–157. <nowiki>https://doi.org/10.18632/aging.100273</nowiki></ref> Metformin works by improving insulin sensitivity and may target several hallmarks of aging.<ref name=":13" /> Metformin is being tested as a longevity therapy in the largest clinical trial for a longevity therapy, the Targeting Aging with Metformin (TAME) trial in the US.<ref name=":14">''TAME - Targeting Aging with Metformin - American Federation for Aging Research''. (n.d.). American Federation for Aging Research. <nowiki>https://www.afar.org/tame-trial</nowiki></ref> This is a randomized clinical trial of 3000 elderly patients comparing metformin against a placebo for the onset of age-related diseases.<ref name=":14" />

=== [[Rapamycin]] ===
[[File:Rapamune .jpg|alt=Rapamune |thumb|253x253px|Rapamycin, also known as Rapamune© is being tested as a drug to extend healthy lifespan in humans. <ref name=":15" />]]
Rapamycin, also known as Rapamune©, is a drug used to prevent the rejection of organ transplants by the immune system. Rapamycin has been shown to extend lifespan by up to 26% when given at middle age, and 14% when given in late life.<ref>Harrison, D., Strong, R., Sharp, Z. ''et al.'' Rapamycin fed late in life extends lifespan in genetically heterogeneous mice. ''Nature'' 460, 392–395 (2009). <nowiki>https://doi.org/10.1038/nature08221</nowiki>
</ref><ref>Miller, R. A., Harrison, D. E., Astle, C. M., Fernandez, E., Flurkey, K., Han, M., Javors, M. A., Li, X., Nadon, N. L., Nelson, J. F., Pletcher, S., Salmon, A. B., Sharp, Z. D., Van Roekel, S., Winkleman, L., & Strong, R. (2014). Rapamycin-mediated lifespan increase in mice is dose and sex dependent and metabolically distinct from dietary restriction. ''Aging cell'', ''13''(3), 468–477. <nowiki>https://doi.org/10.1111/acel.12194</nowiki></ref> Rapamycin is currently being tested in a large-scale clinical trial called the Participatory Evaluation (of) Aging (With) Rapamycin (for) Longevity Study (PEARL). The study is a randomized clinical trial of 1000 elderly patients comparing rapamycin against placebo for age-related outcomes.<ref name=":15">Clinicaltrials.gov. 2021. ''Participatory Evaluation (of) Aging (With) Rapamycin (for) Longevity Study - Full Text View - ClinicalTrials.gov''. [online] Available at: <<nowiki>https://clinicaltrials.gov/ct2/show/NCT04488601</nowiki>> [Accessed 14 December 2021].
</ref>

=== [[Epigenetic reprogramming]] ===
Epigenetic reprogramming is remodeling the epigenetic marks, such as methylation tags on the DNA, in cells. This technique was used in 2020 to restore vision to blind mice by fully regrowing the optic nerve.<ref>Lu, Y., Brommer, B., Tian, X. ''et al.'' Reprogramming to recover youthful epigenetic information and restore vision. ''Nature'' 588, 124–129 (2020). <nowiki>https://doi.org/10.1038/s41586-020-2975-4</nowiki></ref> The researchers at Harvard medical school and believe this approach could one day be used to regenerate other tissues of the body as a longevity strategy.<ref>''Reversing The Aging Clock With Epigenetic Reprogramming''. (n.d.). Pubs - Bio-IT World. <nowiki>https://www.bio-itworld.com/news/2021/01/13/reversing-the-aging-clock-with-epigenetic-reprogramming</nowiki></ref>

In addition, over [https://www.lifespan.io/road-maps/the-rejuvenation-roadmap 50 other drugs] are being tested in human clinical trials for slowing aging.<ref name=":2">Lifespan.io. 2021. ''The Rejuvenation Roadmap | Lifespan.io''. [online] Available at: <<nowiki>https://www.lifespan.io/road-maps/the-rejuvenation-roadmap/</nowiki>> [Accessed 13 December 2021].</ref>

== What is the goal of longevity biotechnology? ==
[[File:Healthy lifespan extension.png|alt=Healthy lifespan extension|thumb|643x643px|Healthy lifespan extension]]
Longevity biotechnology aims to slow or reverse the aging process to extend the healthy lifespan (‘healthspan’) of the population. Instead of treating diseases when they arise, one by one, longevity biotechnology aims to keep those who are already healthy, healthy by slowing the aging process. The aim is to thereby delay or prevent multiple diseases at once that are associated with aging.

The longevity biotechnology sector is rapidly growing, and there are currently over 170 private companies working on developing therapeutics to slow the aging process.<ref name=":4">Pfleger, K., 2021. ''Aging Companies''. [online] Agingbiotech.info. Available at: <<nowiki>https://agingbiotech.info/companies</nowiki>> [Accessed 13 December 2021].</ref> These companies are working on slowing or reversing the aging process by targeting one of more of the hallmarks of aging.

== Will healthy or unhealthy lifespan be extended? ==
[[File:Extending healthy lifespan.png|alt=Extending healthy lifespan|thumb|364x364px|Extending healthy lifespan]]
The stated goal of longevity biotechnology is to extend the healthy period of lifespan, before age-related diseases set in. This is in contrast to many of today's medical interventions, which extend life only after diseases (e.g. cancer, Alzheimer's) have reached a clinical level.

Age-related diseases are preceded by a long period of subclinical aging, i.e. aging that has not yet progressed far enough to produce clinical symptoms. By slowing, delaying or reversing the aging process, the healthy period of life can be extended.

Studies in mice have demonstrated that life extending drugs such as rapamycin are capable of extending the healthy, rather than unhealthy period of life.
== Should we treat specific diseases such as cancer, or aging? ==
[[File:Slowing aging versus curing cancer.jpg|alt=Slowing aging is potentially a more effective means of extending healthy lifespan than treating individual diseases due to the comorbid nature of age-related diseases. [6]|thumb|421x421px|Slowing aging is potentially a more effective means of extending healthy lifespan than treating individual diseases due to the comorbid nature of age-related diseases. ]]
Longevity biotechnology potentially offers a greater likelihood of extending healthy lifespan than attempting to find cures for the individual diseases of aging. This is because biological aging is associated with many of diseases of aging that develop as comorbidities i.e. at the same time. Even if a person survives one age-related disease such as cancer, another (e.g. diabetes, cardiovascular disease) is likely to kill the person if the underlying aging is not treated. This phenomenon is known as Taueber's paradox<ref name=":17">En.wikipedia.org. 2021. ''Taeuber Paradox - Wikipedia''. [online] Available at: <<nowiki>https://en.wikipedia.org/wiki/Taeuber_Paradox</nowiki>> [Accessed 14 December 2021].</ref>, and accounts for the much smaller projected increase in healthy lifespan associated with curing the diseases of aging, such as cancer (2-3 years), versus slowing aging itself (30+ years).<ref name=":18">Matt Kaeberlein, PhD, It is Time to Embrace 21st-Century Medicine, ''Public Policy & Aging Report'', Volume 29, Issue 4, 2019, Pages 111–115, <nowiki>https://doi.org/10.1093/ppar/prz022</nowiki></ref>
== What is biological aging? ==
There are two main types of 'age': chronological age - the number of years since birth, and biological age - a measure of the physical health of a person and their position in their lifespan. Biological age is more difficult to measure, but recent technologies are now available to estimate biological age. Over time, we age biologically. This occurs due to many processes in the body, which are generally categorised into 9 processes or 'hallmarks'.
== What are the 9 Hallmarks of Aging? ==
[[File:Hallmarks of aging.jpg|alt=Hallmarks of aging|thumb|444x444px|Hallmarks of aging]]

The hallmarks of aging framework is considered to broadly represent key biological mechanisms of the biological aging process.<ref name=":9">López-Otín C, Blasco MA, Partridge L, Serrano M, Kroemer G. The hallmarks of aging. Cell. 2013 Jun 6;153(6):1194-217.</ref> Although there are various limitations of the hallmarks framework, it has become the central framework for understanding aging biology. The nine forms of cellular and molecular ‘damage’ that comprise the hallmarks of aging are<ref name=":9" />:

* Genomic instability
* Telomere attrition
* Epigenetic alterations
* Loss of proteostasis
* Deregulated nutrient-sensing
* Mitochondrial dysfunction
* Cellular senescence
* Stem cell exhaustion
* Altered intercellular communication

These are essentially the lowest common denominators of the aging process, on a cellular or subcellular level. All of the other changes associated with aging, such as greying hair, wrinkles, frailty and an increased risk of disease is thought to stem from these underlyig processes.<ref name=":9" />

== How does the aging cause disease? ==
The nine hallmarks of aging have been shown to play an integral role in the development of many age-related diseases such as neurodegenerative diseases and cancer:
=== [[Aging and Neurodegeneration|Neurodegenerative disease]] ===
[[File:Prevalence of neuro disorders.jpg|alt=Prevalence of neuro disorders|thumb|469x469px|The prevalence of neurodegenerative disorders increases exponentially with age, due to the biological aging process.<ref name=":12">Hou, Y., Dan, X., Babbar, M., Wei, Y., Hasselbalch, S. G., Croteau, D. L., & Bohr, V. A. (2019). Ageing as a risk factor for neurodegenerative disease. ''Nature reviews. Neurology'', ''15''(10), 565–581. <nowiki>https://doi.org/10.1038/s41582-019-0244-7</nowiki></ref> ]]
All of the hallmarks of aging are associated with an increased risk of neurodegenerative diseases, such as Parkinson's disease and Alzheimer's disease.<ref>Qiu, C., Kivipelto, M., & von Strauss, E. (2009). Epidemiology of Alzheimer's disease: occurrence, determinants, and strategies toward intervention. ''Dialogues in clinical neuroscience'', ''11''(2), 111.</ref> For example, several types of DNA damage are associated with neurodegeneration. The shortening of telomeres occurs as part of biological aging and causes cellular senescence, and is associated with neurodegeneration and neurodegenerative diseases including Alzheimer's disease and Parkinson's disease.<ref name=":12" /> Additionally, mitochondrial dysfunction, altered metabolism, stem cell exhaustion and loss of proteostasis are also involved in the development of neurodegenerative diseases.<ref name=":12" />
=== [[Aging and Cancer|Cancer]] ===
Several of the hallmarks of aging such as cellular senescence and alterations in the extracellular matrix are responsible for increasing the likelihood of tumorigenesis.<ref name=":5">Fane, M., & Weeraratna, A. T. (2020). How the ageing microenvironment influences tumour progression. ''Nature Reviews Cancer'', ''20''(2), 89-106.</ref> Other hallmarks of aging such as genomic instability, loss or proteostasis, altered intercellular communication (i.e. inflammation) and epigenetic alterations are also involved in tumorigenesis.<ref name=":5" />
== How is biological age measured? ==
[[File:Epigenetic clock.png|alt=Epigenetic clock|thumb|605x605px|Epigenetic clock is the first aging clock. ]]
Recent technologies have allow biological age to be measured. These include:

=== [[Epigenetic clock|Epigenetic clocks]] ===
The first generation of aging clocks are known as [[Epigenetic clock|epigenetic clocks or Horvath’s clock]].<ref name=":6">Horvath, S., & Raj, K. (2018). DNA methylation-based biomarkers and the epigenetic clock theory of ageing. ''Nature Reviews Genetics'', ''19''(6), 371-384.</ref> This clock is based on the finding that over time, the body accumulates methylation tags on the DNA in a pattern that can be predicted with machine learning. These changes to the epigenome are influenced by lifestyle, and can be used to measure biological age.<ref name=":6" /> Factors such as exercise frequency and a low BMI have been shown to reduce the rate of biological aging, whereas obesity and smoking can accelerate the rate of aging.<ref>Quach, A., Levine, M. E., Tanaka, T., Lu, A. T., Chen, B. H., Ferrucci, L., ... & Horvath, S. (2017). Epigenetic clock analysis of diet, exercise, education, and lifestyle factors. ''Aging (Albany NY)'', ''9''(2), 419.</ref><ref>Wu, X., Huang, Q., Javed, R., Zhong, J., Gao, H., & Liang, H. (2019). Effect of tobacco smoking on the epigenetic age of human respiratory organs. ''Clinical Epigenetics'', ''11''(1), 183. <nowiki>https://doi.org/10.1186/s13148-019-0777-z</nowiki>

[[Epigenetic clock#cite%20ref-12|↑]]</ref><ref>Horvath, S., Erhart, W., Brosch, M., Ammerpohl, O., von Schönfels, W., Ahrens, M., Heits, N., Bell, J. T., Tsai, P.-C., Spector, T. D., Deloukas, P., Siebert, R., Sipos, B., Becker, T., Röcken, C., Schafmayer, C., & Hampe, J. (2014). Obesity accelerates epigenetic aging of human liver. ''Proceedings of the National Academy of Sciences'', ''111''(43), 15538–15543. <nowiki>https://doi.org/10.1073/pnas.1412759111</nowiki>

[[Epigenetic clock#cite%20ref-13|↑]]</ref> The Horvath's clock has been used to accurately predict mortality risk.<ref>Fransquet, P. D., Wrigglesworth, J., Woods, R. L., Ernst, M. E., & Ryan, J. (2019). The epigenetic clock as a predictor of disease and mortality risk: a systematic review and meta-analysis. ''Clinical epigenetics'', ''11''(1), 1-17.</ref>

=== Multi-omic clocks ===
Multi-omic clocks are being developed that incorporate data from several sources, such as body imaging scans, blood tests, and fitness tests. These clocks are built using machine learning to estimate biological age. These aging clocks are being developed that combine multiple biological functional tests to create a unique aging signature, which can be monitored over time.<ref>Kudryashova, K. S., Burka, K., Kulaga, A. Y., Vorobyeva, N. S., & Kennedy, B. K. (2020). Aging Biomarkers: From Functional Tests to Multi‐Omics Approaches. ''Proteomics'', ''20''(5-6), 1900408.</ref>
[[File:Multiomic aging clock.jpg|alt=Multiomic clocks|center|thumb|542x542px|Multiomic clocks integrate various data sources to create a unique biological aging signature that can be tracked over time. ]]
== Which companies are trying to solve aging? ==
[[File:Calico Labs.png|alt=T|thumb|Calico Labs, a subsidiary of Google, is a billion-dollar company searching for treatments for aging. ]]
There are over [https://agingbiotech.info/companies 170 longevity biotechnology companies] trying to create therapies to slow or reverse the aging process.<ref name=":4" /> There are over [https://www.lifespan.io/road-maps/the-rejuvenation-roadmap/ 50 longevity drugs] currently in clinical trials in humans.<ref name=":2" />

Many of the longevity biotechnology companies are targeting specific hallmarks of aging. For example, [https://www.clearabiotech.com/#DiscoveryTimeline Cleara Biotech] are attempting to reduce cellular senescence by developing a drug that can eliminate senescent cells.<ref>Cleara Biotech. 2021. ''Cleara Biotech''. [online] Available at: <<nowiki>https://www.clearabiotech.com/#DiscoveryTimeline</nowiki>> [Accessed 15 December 2021].</ref>

Calico Labs is a Google-backed biotech company with the goal of combating aging and age-related diseases. In 2014, the company created a partnership with pharmaceutical giant AbbVie, which has since developed into a [https://www.cnbc.com/2018/06/26/alphabet-backed-calico-and-abbvie-chip-in-1-billion-to-cure-aging.html $2.5 billion venture] in the pursuit of improving “health, wellbeing and longevity.” <ref>2021. ''Google sister company and drug giant chip in another $1 billion to cure age-related diseases''. [online] Available at: <<nowiki>https://www.cnbc.com/2018/06/26/alphabet-backed-calico-and-abbvie-chip-in-1-billion-to-cure-aging.html</nowiki>> [Accessed 15 December 2021].</ref>

Since aging is not currently considered a disease by regulatory bodies such as the Food and Drug Administration (FDA), drug developers are currently focused on specific diseases of aging such as glaucoma and osteoarthritis.<ref>Clinicaltrialsarena.com. 2021. ''Unity's Phase II osteoarthritis study of UBX0101 misses primary goal''. [online] Available at: <<nowiki>https://www.clinicaltrialsarena.com/news/unity-ubx0101-osteoarthritis/</nowiki>> [Accessed 15 December 2021].</ref>

== Which billionaires are funding longevity biotechnology? ==
[[File:Jeff Bezos is funding longevity research.jpg|alt=Jeff Bezos is funding longevity research|thumb|Jeff Bezos is funding longevity research through financing Atlos Labs.<ref name=":7">MIT Technology Review. 2021. ''Meet Altos Labs, Silicon Valley’s latest wild bet on living forever''. [online] Available at: <<nowiki>https://www.technologyreview.com/2021/09/04/1034364/altos-labs-silicon-valleys-jeff-bezos-milner-bet-living-forever/</nowiki>> [Accessed 15 December 2021].</ref>]]
Several billionaires have funded companies or initiatives to slow or reverse human aging. These include:
* [[wikipedia:Jeff_Bezos|Jeff Bezos]], co-founder of Amazon, helped raise [https://www.technologyreview.com/2021/09/04/1034364/altos-labs-silicon-valleys-jeff-bezos-milner-bet-living-forever/ $270 million for new anti-aging drug company Altos Labs] in 2021.<ref name=":7" />
* [[wikipedia:Peter_Thiel|Peter Thiel]], co-founder of PayPal, was an [https://www.cnbc.com/2018/08/29/-jeff-bezos-is-backing-this-scientist-who-is-working-on-a-cure-for-aging.html early investor in Unity Biotechnology].<ref>CNBC. 2021. ''Why Jeff Bezos is backing this Silicon Valley scientist who is working on a cure for aging''. [online] Available at: <<nowiki>https://www.cnbc.com/2018/08/29/-jeff-bezos-is-backing-this-scientist-who-is-working-on-a-cure-for-aging.html</nowiki>> [Accessed 15 December 2021].</ref>
* [[wikipedia:Sergey_Brin|Sergey Brin]], co-founder of Google, donated [https://www.cnbc.com/2017/03/31/google-co-founders-and-silicon-valley-billionaires-try-to-live-forever.html $25 million for the National Academy of Medicine’s Grand Challenge in Health Longevity] to 'end aging forever'.<ref>Google’s co-founders and other Silicon Valley billionaires are trying to live forever. (2021). Retrieved 15 December 2021, from <nowiki>https://www.cnbc.com/2017/03/31/google-co-founders-and-silicon-valley-billionaires-try-to-live-forever.html</nowiki></ref>
* [[wikipedia:Larry_Page|Larry Page]], co-founder of Google, co-founded the [[wikipedia:Calico_(company)|billion-dollar aging research company Calico Labs.]]<ref>Contributors to Wikimedia projects. (2013, September 19). ''Calico (company) - Wikipedia''. Wikipedia, the free encyclopedia. <nowiki>https://en.wikipedia.org/wiki/Calico_(company)</nowiki>
</ref>
* [[wikipedia:Mike_Cannon-Brookes|Mike Cannon-Brookes]], billionaire cofounder of Australian software giant Atlassian, has invested [https://www.forbes.com/sites/samshead/2019/08/19/billionaire-backs-uk-startup-trying-to-extend-human-lifespans/ $10 million into longevity company Juvenescenc]e.<ref>Shead, S. (2019, August 19). ''Billionaire Backs U.K. Startup Trying To Extend Human Life Spans''. Forbes. <nowiki>https://www.forbes.com/sites/samshead/2019/08/19/billionaire-backs-uk-startup-trying-to-extend-human-lifespans/</nowiki></ref>
* [[wikipedia:Naveen_Jain|Naveen Jain]], billionaire entrepeneur who has raised [https://www.geekwire.com/2021/gut-health-startup-viome-raises-54m-develop-cancer-diagnostics-sell-microbiome-kits/ $54 million for his startup Viome].<ref>''Gut health startup Viome raises $54M to develop cancer diagnostics and sell microbiome kits''. (2021, November 10). Geekwire. <nowiki>https://www.geekwire.com/2021/gut-health-startup-viome-raises-54m-develop-cancer-diagnostics-sell-microbiome-kits/</nowiki></ref>
* [[wikipedia:Jim_Mellon|Jim Mellon]], who co-founded longevity company [https://www.juvlabs.com/people/co-founder/jim-mellon Juvenescence].<ref>''Jim Mellon - Chairman & Co-Founder''. (n.d.). Juvenescence - Science of Healthy Aging & Extended Lifespan. <nowiki>https://www.juvlabs.com/people/co-founder/jim-mellon</nowiki></ref>
* [[wikipedia:Larry_Ellison|Larry Ellison]], founder of Oracle, has spent [https://www.townandcountrymag.com/society/money-and-power/a9202324/science-of-longevity/ $430 million on longevity research].<ref>Tullis, P. (2017, March 30). ''Are You Rich Enough To Live Forever?'' Town & Country. <nowiki>https://www.townandcountrymag.com/society/money-and-power/a9202324/science-of-longevity/</nowiki></ref>
*Michael Greve, founder of Kizoo Technology, who has pledged [https://Longevity.Technology. https://www.longevity.technology/michael-greve-commits-e300m-for-rejuvenation-start-ups/ €300m to rejuvenation biotechnology companies.]<ref>''Michael Greve commits €300m for rejuvenation start-ups''. (2021, May 6). Longevity.Technology. <nowiki>https://www.longevity.technology/michael-greve-commits-e300m-for-rejuvenation-start-ups/</nowiki></ref>
* [[wikipedia:Yuri_Milner|Yuri Milner]], billionaire tech investor who has helped Altos Labs raise $270 million, with Jeff Bezos.<ref name=":7" />
* [https://wikitia.com/wiki/Richard_Heart Richard Heart], founder of the cryptocurrency Hex, who helped raise [https://www.express.co.uk/finance/city/1465354/pulsechain-cryptocurrency-srf-sens-research-foundation-airdrop-pulse-charity-longevity $25 million for the anti-aging research organisation SENS.]<ref>McGleenon, B. (2021, July 20). ''Pulsechain cryptocurrency raises 'mindblowing' $25M in five days for SENS longevity group''. Express.co.uk. <nowiki>https://www.express.co.uk/finance/city/1465354/pulsechain-cryptocurrency-srf-sens-research-foundation-airdrop-pulse-charity-longevity</nowiki></ref>
*[[wikipedia:Brian_Armstrong_(businessman)|Brian Armstrong]], CEO of CoinBase, who helped found and raise [https://www.dailymail.co.uk/sciencetech/article-10310475/Billionaire-launches-new-start-hopes-REVERSE-ageing-process.html $105 million for the epigenetic reprogramming startup NewLimit.]<ref>Liberatore, S. (2021, December 14). ''Billionaire launches new start-up to REVERSE the ageing process''. Mail Online. <nowiki>https://www.dailymail.co.uk/sciencetech/article-10310475/Billionaire-launches-new-start-hopes-REVERSE-ageing-process.html</nowiki></ref>
* [[wikipedia:Vitalik_Buterin|Vitalik Buterin]], founder of the cryptocurrency Ethereum, who donated $2.4 million to SENS.<ref>Foundation, S. R. (n.d.). ''SENS Research Foundation Receives $2.4 Million Ethereum Donation From Vitalik Buterin''. GlobeNewswire News Room. <nowiki>https://www.globenewswire.com/news-release/2018/02/02/1332410/0/en/SENS-Research-Foundation-Receives-2-4-Million-Ethereum-Donation-From-Vitalik-Buterin.html</nowiki></ref>

== How large will the longevity biotechnology field be? ==
Analysts from the Bank of America have predicted that the market size of longevity biotechnology will reach $600 billion by 2025.<ref>2021. ''Human lifespan could soon pass 100 years thanks to medical tech, says BofA''. [online] Available at: <<nowiki>https://www.cnbc.com/2019/05/08/techs-next-big-disruption-could-be-delaying-death.html</nowiki>> [Accessed 14 December 2021].</ref> Others have speculated that it is a trillion dollar industry owing to the immense savings associated with delaying or preventing chronic diseases.<ref>Colangelo, M., 2021. ''AI Will Drive The Multi-Trillion Dollar Longevity Economy''. [online] Forbes. Available at: <<nowiki>https://www.forbes.com/sites/cognitiveworld/2019/12/07/ai-will-drive-the-multi-trillion-dollar-longevity-economy/?sh=294766b74965</nowiki>> [Accessed 14 December 2021].</ref>
== Is age an important for risk factor for COVID-19 mortality? ==
[[File:Age is the -1 risk factor for COVID-19 mortality.jpg|alt=Age is the #1 risk factor for COVID-19 mortality - based on US CDC statistics|thumb|572x572px|The risk of dying from COVID-19 increases exponentially with age. [https://www.cdc.gov/coronavirus/2019-ncov/covid-data/investigations-discovery/hospitalization-death-by-age.html (US CDC statistics)]]]

Age is the single most significant risk factor for COVID-19 mortality. The mortality rate from COVID-19 increases exponentially with age, such that the death rate for those aged over 80 years is over 1000 times higher than those below 30 years.<ref name=":29">[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7576244/ Santesmasses, D., Castro, J. P., Zenin, A. A., Shindyapina, A. V., Gerashchenko, M. V., Zhang, B., ... & Gladyshev, V. N. (2020). COVID‐19 is an emergent disease of aging. ''Aging cell'', ''19''(10), e13230.]</ref>

This increase in COVID-19 mortality with age is thought to be the result of a weakening of the immune system with age, known as immunosenescence.<ref>Bajaj, V., Gadi, N., Spihlman, A. P., Wu, S. C., Choi, C. H., & Moulton, V. R. (2021). Aging, immunity, and COVID-19: how age influences the host immune response to coronavirus infections?. ''Frontiers in Physiology'', ''11'', 1793.</ref>

The mortality rate doubling time for COVID-19 is close to the all-cause mortality rate doubling time.<ref name=":29" /> This has led several scientists to conclude that COVID-19 meets criteria for an age-related disease.<ref name=":29" /><ref>[[Promislow, D. E. (2020). A geroscience perspective on COVID-19 mortality. The Journals of Gerontology: Series A, 75(9), e30-e33.|Promislow, D. E. (2020). A geroscience perspective on COVID-19 mortality. ''The Journals of Gerontology: Series A'', ''75''(9), e30-e33.]]</ref><ref>Alberts, S. C., Archie, E. A., Gesquiere, L. R., Altmann, J., Vaupel, J. W., & Christensen, K. (2014). The male-female health-survival paradox: a comparative perspective on sex differences in aging and mortality. In ''Sociality, hierarchy, health: comparative biodemography: a collection of papers''. National Academies Press (US).</ref><ref name=":10">[[Sierra, F. (2020). Geroscience and the Coronavirus Pandemic: The Whack‐a‐Mole Approach is not Enough. Journal of the American Geriatrics Society, 68(5), 951.|Sierra, F. (2020). Geroscience and the Coronavirus Pandemic: The Whack‐a‐Mole Approach is not Enough. ''Journal of the American Geriatrics Society'', ''68''(5), 951.]]</ref><ref name=":11">[[Barzilai, N., Appleby, J. C., Austad, S. N., Cuervo, A. M., Kaeberlein, M., Gonzalez-Billault, C., ... & Sierra, F. (2020). Geroscience in the Age of COVID-19. Aging and disease, 11(4), 725.|Barzilai, N., Appleby, J. C., Austad, S. N., Cuervo, A. M., Kaeberlein, M., Gonzalez-Billault, C., ... & Sierra, F. (2020). Geroscience in the Age of COVID-19. ''Aging and disease'', ''11''(4), 725.]]</ref><ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7288963/</ref>

== How is aging biology research different to other fields of medical research? ==
Scientists studying the biology of aging believe that aging is a root cause of all the major diseases of aging, and that targeting aging directly would treat or reverse multiple diseases, simultaneously. This is known as the geroscience hypothesis, and has garnered traction in recent years.<ref>Austad, S. N. (2016). The geroscience hypothesis: is it possible to change the rate of aging?. In ''Advances in geroscience'' (pp. 1-36). Springer, Cham.</ref>

The approach of targeting aging directly differs from many fields in mainstream medical research such as cancer research, which seek to find cures for individual diseases. An argument in favour of targeting aging directly is that targeting single diseases leads to diminishing returns in healthy lifespan extension.<ref name=":18" /> Due to the many diseases that occur concurrently in older age, completely curing a single disease such as cancer would only add 2-3 healthy years of life on average, whereas slowing aging could add 30 or more healthy years.<ref name=":18" /> This is because another disease in line, e.g. Alzheimer's or lung disease, will subsequently result in death, a phenomenon known as the Taeuber Paradox.<ref name=":17" />
== Do all animals age in the same way? ==
[[File:Naked mole rat graph.png|alt=Naked mole rat graph|thumb|530x530px|The naked mole-rat does not follow the same increased risk of mortality due to aging that humans and other mammals do. ]]
Many species, due to differences in their biology, age at different rates to humans. The jellyfish ''Turritopsis dohrnii'' can revert to earlier stages of its life cycle in response to stress, and can theoretically live forever - though eventually dies, usually due to predation.

Among mammals, the naked mole rat is an exceptionally long lived organism that lives roughly ten times longer than similarly-sized rats.<ref name=":3">Ruby, J. G., Smith, M., & Buffenstein, R. (2018). Naked mole-rat mortality rates defy Gompertzian laws by not increasing with age. ''elife'', ''7'', e31157.</ref><ref>Buffenstein, R., Amoroso, V., Andziak, B., Avdieiev, S., Azpurua, J., Barker, A. J., ... & Smith, E. S. J. (2021). The naked truth: a comprehensive clarification and classification of current ‘myths’ in naked mole‐rat biology. ''Biological Reviews''.</ref> Unlike other organisms, such as humans, horses and mice, the mortality rate of the naked mole rat appears steady over time. This trend does not follow the exponential increase in mortality (Gompertz-Makeham law) that humans do.<ref name=":3" />

Scientists are now studying the naked mole rat to identify key patterns in their genetics, environmental traits, and metabolism that may be responsible for their longer lifespans.

[[File:Naked mole rat.jpg|alt=Naked mole rat|center|thumb|323x323px|The naked mole rat is unusually long-lived relative to other mice and rats. ]]

== Is aging considered a disease? ==
Aging is not currently classified as a disease by regulatory bodies such as the Food and Drug Administration (FDA) in the United States. However, several scientists in the aging field have publicly stated their preference for aging to be considered a disease, including professor David Sinclair and professor Nir Barzilai.

== What are the economic benefits of extending healthy lifespan? ==
Extending the healthy human lifespan could have significant economic benefits gobally. An economic analysis from 2021 by researchers at the University of Oxford and Harvard University estimated the benefit of a drug that slows aging by 1 year as $38 trillion. This is primarily because slowing aging reduces the incidence of age-related diseases such as cancer and Alzheimer’s disease, which require expensive treatment approaches. The study demonstrated a larger economic benefit of slowing aging than curing the individual diseases of aging.
== Which anti-aging drugs are being tested in clinical trials today? ==
There are over 50 drugs being tested in human clinical trials for aging or age-related diseases.

The largest trial is the Targeting Aging with Metformin (TAME) trial, which began in 2020. The trial is being run in the United States with a cohort of 3000 older adults. The goal of the TAME trial is to determine whether diabetes drug metformin slows the aging process in older adults. The TAME trial is a $75 million trial run by the American Federation for Aging Research.

Another large clinical trial is the Participitory Evluation of Rapamycin (PEARL) study. The goal of this study is to determine whether rapamycin, a drug currently approved for immunosuppression during organ transplants, slows biomarkers of aging in 1000 adults. The PEARL trial is being run by AgelessRx.
== Is aging a natural process that should be accepted? ==
Although aging is a natural process in humans, it is the driving force of many diseases such as cancer and Alzheimer's disease - which as a society we have decided are worth trying to find cures for. In the past, these conditions, as well as atherosclerosis and even infectious diseases were once thought of as natural processes that could not be treated. However, nowadays it is understood that they are diseases that can be treated.

Atherosclerosis, the hardening of the arteries, was once viewed as a natural process that was simply a consequence of aging. However, when treatments such as statins were later developed to prevent atherosclerosis, the disease became widely regarded as a disease to be cured. Statins are now one one of the most widely prescribed drugs in the world, used in preventing heart diseases. The inventor of statins, Akira Endo, describes in his historical paper: “Serious research on the role of cholesterol in human atherosclerosis did not really get underway until the 1940s, due to a prevailing view that the disease was a simple consequence of aging and could not be prevented.”<ref>Endo A. (2010). A historical perspective on the discovery of statins. ''Proceedings of the Japan Academy. Series B, Physical and biological sciences'', ''86''(5), 484–493. <nowiki>https://doi.org/10.2183/pjab.86.484</nowiki></ref>

== Will anti-aging technology lead to overpopulation? ==
A common objection to the development of longevity technologies is that they may lead to an unsustainably large population size.

One study of a 2005 Swedish cohort of 9 million people modeled the effect of various anti-aging scenarios. The researchers showed that even with the most radical life-extension technology in which aging completely stopped after age 60, the population growth across 100 years was only 22%.

Currently, the world’s population is 7.9 billion, and the WHO predicts the population will peak at 11 billion in 2100 before falling due to declining birth rates in many parts of the world.

The fastest growing populations are in Africa and South-east Asia. However, several factors are thought to reduce birth rates over time, including increased access to contraceptives, female empowerment, increased education and increased employment. There is evidence that populations that move to a more advanced economy show a reduction in birth rates.

== Will anti-aging drugs only be available to the rich? ==
It is unclear who will have first access to longevity drugs. Several researchers in the field have argued that several economic factors are likely to drive down the price of drugs that slow aging.

* The cost of many biotechnologies decreases substantially over time. For example, the first human genome cost $100 million to sequence, and is now available for a few hundred dollars.

* The price of many lifesaving pharmaceuticals has fallen significantly in price once generic drugs were produced. For example, Lipitor, a statin used to prevent heart disease has fallen in price from $85 in 2011 to less than $5 today.

* Many companies in the longevity field have stated that equity of access is part of their core ethos, and many researchers are signatories to the

== Which scientists and institutions are trying to understand and reverse aging? ==
Over [https://whoswho.senescence.info/ 300 scientists are working on understanding the biology of aging] in leading institutions that include Harvard University, Stanford University, Yale University, and the University of Oxford.<ref>''Who's Who in Gerontology: Researchers and Companies Working on Aging''. (n.d.). Who's Who in Gerontology: Researchers and Companies Working on Aging. <nowiki>https://whoswho.senescence.info/</nowiki></ref> Some of the most well-known institutes and labs include:

=== The Buck Institute for Research on Aging ===
The Buck Institute for Research on Aging is one of the largest longevity research institutes with over 250 scientists. The research covers several areas including the mechanisms of aging, neurodegeneration, senescence, stem cells and regenerative medicine, cellular stress and disease, cancer associated with aging, and mitochondrial function.<ref>''Buck Institute''. (n.d.). BUCK. <nowiki>https://www.buckinstitute.org/</nowiki></ref>

=== Professor David Sinclair - Harvard Medical School ===
Professor Sinclair’s lab focuses on understanding and reversing aging. The lab focuses on a range of areas including DNA repair, mitochondrial dysfunction, and the interactions between epigenetic and genetic instability, and tissue reprogramming.<ref>''Welcome | The Sinclair Lab''. (n.d.). Welcome | The Sinclair Lab. <nowiki>https://sinclair.hms.harvard.edu/</nowiki></ref>

=== Professor Matt Kaeberlein - University of Washington ===
Professor Kaeberlein's lab focuses on biological mechanisms of aging in order to facilitate translational interventions that promote healthspan and improve quality of life. Kaeberlein is known for his work on the longevity drug rapamycin in organisms such as mice and dogs. He is Director of the Dog Aging Project, a multi-year initiative studying the genetic and environmental factors that influence health, with over 33,000 participating dogs.<ref>''Matt Kaeberlein, PhD | Faculty | Dept. of Laboratory Medicine & Pathology | UW Medicine''. (n.d.). Dept. of Laboratory Medicine & Pathology | UW Medicine. <nowiki>https://dlmp.uw.edu/faculty/kaeberlein</nowiki></ref>

=== Professor Brian Kennedy - National University of Singapore ===
Professor Kennedy’s lab focuses on understanding the biology of aging and translating research discoveries into new ways of delaying aging in humans. The lab has identified drugs that extend the healthy lifespan of worms and mice and are seeking to understand their mechanisms.<ref>''Brian Kennedy - Department of Biochemistry – School of Medicine, National University of Singapore''. (n.d.). Department of Biochemistry – School of Medicine, National University of Singapore. <nowiki>https://medicine.nus.edu.sg/bch/fa</nowiki></ref>

=== Associate Professor Lynne Cox - University of Oxford ===
Professor Cox’s lab study the molecular and cellular basis of aging to identify specific biochemical processes and pathways that change organisms age. The lab particularly cellular senescence, which underpins many age-related diseases including cancer and neurodegeneration.<ref>''Associate Prof Lynne Cox''. (n.d.). Home | Biochemistry. <nowiki>https://www.bioch.ox.ac.uk/research/cox</nowiki></ref>

== What books have been written on this topic? ==
Several books have been written on the topic of aging and longevity. These include:

* [https://www.amazon.com/Lifespan-Why-Age_and-Dont-Have/dp/1501191977 ''Lifespan: Why We Age And Why We Don't Have To'' - David Sinclair (2019)]

* [https://www.amazon.com/Ending-Aging-Rejuvenation-Breakthroughs-Lifetime/dp/0312367074 ''Ending Aging'' - Dr. Aubrey de Grey (2007)]

* [https://www.amazon.com/Ageless-Science-Getting-Older-Without/dp/0385544928 ''Ageless'' - Dr. Andrew Steele (2020)]

* [https://www.amazon.com.au/Age-Later-Health-Science-Longevity-ebook/dp/B0818MYCRR ''Age Later'' - Professor Nir Barzilai (2021)]

* [https://www.amazon.com.au/Science-Technology-Growing-Young-Breakthroughs/dp/1950665879 ''The Science and Technology of Growing Young'' - Sergey Young (2021)]

== References ==
<references />

FAQ

2021-12-15T08:41:09Z

Jack: /* Senolytics */

Longevity biotechnology is a new field of medical research and development that aims to extend healthy human lifespan and delay, prevent or reverse these diseases. This article provides an overview of the field, answering common questions.

== Why is aging a problem? ==
[[File:Aging graph.png|thumb|750x750px|The aging process results in the risk of age-related diseases increasing exponentially over time.]][[File:Gompertz-Makeham law of mortality.png|alt=Gompertz-Makeham law of mortality|thumb|257x257px|Gompertz-Makeham law of mortality<ref name=":0">En.wikipedia.org. 2021. ''Gompertz–Makeham law of mortality - Wikipedia''. [online] Available at: <<nowiki>https://en.wikipedia.org/wiki/Gompertz%E2%80%93Makeham_law_of_mortality</nowiki>> [Accessed 13 December 2021].</ref>]]Aging is the largest risk factor for the diseases that kill most people worldwide, including cancer, heart diseases and Alzheimer's disease.

In the US in 2020, 9 of the 10 leading causes of death were strongly age-related.<ref>Ahmad, F. B., & Anderson, R. N. (2021). The leading causes of death in the US for 2020. ''JAMA'', ''325''(18), 1829-1830.https://jamanetwork.com/journals/jama/fullarticle/2778234</ref> Globally, approximately 70% of deaths annually are the result of aging.<ref name=":8" />

Aging also significantly affects quality of life, as deaths due to aging are usually preceded by many months of years of chronic illnesses such as cancer, type 2 diabetes and Alzheimer’s disease.

As a result of the aging process, the risk of an individual dying increases exponentially after the age of around 30 years old.<ref name=":0" /> This increase in mortality rate is known as the Gompertz-Makeham law of mortality.<ref name=":0" />
== How many people die from aging per day? ==
The aging process results in the deaths of 100,000 people per day; more than twice the sum of all other causes of death combined.<ref name=":8">Ritchie, H. and Roser, M., 2021. ''Causes of Death''. [online] Our World in Data. Available at: <<nowiki>https://ourworldindata.org/causes-of-death</nowiki>> [Accessed 13 December 2021].
</ref> This equates to over 37 million people dying per day of aging - a population the size of Canada. This is because aging results in the exponential increasing risk of age-related diseases such as cancer and type 2 diabetes. Aging also accounts for more than 30% of all disability-adjusted life years lost (DALYs); more than any other single cause.<ref>Vizhub.healthdata.org. 2021. ''GBD Compare | IHME Viz Hub''. [online] Available at: <<nowiki>https://vizhub.healthdata.org/gbd-compare/</nowiki>> [Accessed 13 December 2021].</ref>
[[File:Leading causes of death.png|center|thumb|713x713px|9 of the top 10 causes of death in the US in 2020 were strongly age-related]]

== Can healthy lifespan be extended? ==
[[File:Life extension mice.jpg|alt=Life extension mice|thumb|431x431px|Dietary manipulation, genetic manipulation, and drugs have been shown to increase the healthy lifespan of mice by up to 30%. <ref name=":1">de Magalhaes, J., 2021. ''DrugAge: Species Detail''. [online] Genomics.senescence.info. Available at: <<nowiki>https://genomics.senescence.info/drugs/species_details.php</nowiki>> [Accessed 14 December 2021].</ref>]]Clinical trials for longevity drugs in humans are in-progress, and there is not yet evidence that drugs can slow aging in humans. However, recent experimental breakthroughs over the last few decades have shown that in mice, worms and flies have demonstrated that healthy lifespan can be extended modified. Many clinical trials in humans today are testing whether these results can be replicated in humans.

In animal models, slowing the aging process in animals can be achieved via manipulation of diet, environment, genetics, epigenetics, or with drugs. In mice, over 100 drugs have been shown to extend healthy lifespan by up to 30%.<ref name=":1" />

The effect of longevity drugs on mice is often significant, delaying or eliminating the burden of age-related problems such as frailty, cataracts, cancer, and sarcopenia. For example, a new class of drugs called senolytics have been shown to extend lifespan in mice by over 30% whilst delaying age-related dysfunction.

== Which therapies may extend healthy lifespan? ==
Several drugs are known to extend healthy lifespan in animals. While there is no conclusive data that suggests these drugs would work the same in humans, many of these drugs are now being tested in clinical trials. [[File:Unity Mice.jpg|alt=Unity Mice|thumb|723x723px|Senolytic drugs eliminate senescent cells that accumulate with age, partially reversing multiple age-related diseases and extending the healthy lifespan of mice by up to 35%.<ref name=":16" /> ]]

=== Senolytics ===
Senolytics are drugs that remove senescent cells. These are cells which accumulate in the body with age and are linked with age-related diseases such as cancer.<ref>Xu, M., Pirtskhalava, T., Farr, J. N., Weigand, B. M., Palmer, A. K., Weivoda, M. M., ... & Kirkland, J. L. (2018). Senolytics improve physical function and increase lifespan in old age. ''Nature medicine'', ''24''(8), 1246-1256.</ref>
[[File:Metformin2.jpg|thumb|258x258px|Metformin extends lifespan in mice by 6%, and may extend lifespan in humans.<ref name=":13">Kulkarni, A. S., Gubbi, S., & Barzilai, N. (2020). Benefits of metformin in attenuating the hallmarks of aging. ''Cell metabolism'', ''32''(1), 15-30.</ref>]]
In mice, senolytics have been shown to increase the healthy lifespan by up to 35%.<ref name=":16">Baker, D. J., Childs, B. G., Durik, M., Wijers, M. E., Sieben, C. J., Zhong, J., ... & Van Deursen, J. M. (2016). Naturally occurring p16 Ink4a-positive cells shorten healthy lifespan. ''Nature'', ''530''(7589), 184-189.</ref> The first clinical trials of senolytics in humans began in 2020, and demonstrated benefits to functional measures suggesting these drugs may be effective in humans.

=== [[Metformin]] ===
Metformin is an approved drug for type 2 diabetes that extends lifespan in multiple species. In mice, Metformin extends lifespan by up to 6%.<ref>Anisimov, V. N., Berstein, L. M., Popovich, I. G., Zabezhinski, M. A., Egormin, P. A., Piskunova, T. S., Semenchenko, A. V., Tyndyk, M. L., Yurova, M. N., Kovalenko, I. G., & Poroshina, T. E. (2011). If started early in life, metformin treatment increases life span and postpones tumors in female SHR mice. ''Aging'', ''3''(2), 148–157. <nowiki>https://doi.org/10.18632/aging.100273</nowiki></ref> Metformin works by improving insulin sensitivity and may target several hallmarks of aging.<ref name=":13" /> Metformin is being tested as a longevity therapy in the largest clinical trial for a longevity therapy, the Targeting Aging with Metformin (TAME) trial in the US.<ref name=":14">''TAME - Targeting Aging with Metformin - American Federation for Aging Research''. (n.d.). American Federation for Aging Research. <nowiki>https://www.afar.org/tame-trial</nowiki></ref> This is a randomized clinical trial of 3000 elderly patients comparing metformin against a placebo for the onset of age-related diseases.<ref name=":14" />

=== [[Rapamycin]] ===
[[File:Rapamune .jpg|alt=Rapamune |thumb|253x253px|Rapamycin, also known as Rapamune© is being tested as a drug to extend healthy lifespan in humans. <ref name=":15" />]]
Rapamycin, also known as Rapamune©, is a drug used to prevent the rejection of organ transplants by the immune system. Rapamycin has been shown to extend lifespan by up to 26% when given at middle age, and 14% when given in late life.<ref>Harrison, D., Strong, R., Sharp, Z. ''et al.'' Rapamycin fed late in life extends lifespan in genetically heterogeneous mice. ''Nature'' 460, 392–395 (2009). <nowiki>https://doi.org/10.1038/nature08221</nowiki>
</ref><ref>Miller, R. A., Harrison, D. E., Astle, C. M., Fernandez, E., Flurkey, K., Han, M., Javors, M. A., Li, X., Nadon, N. L., Nelson, J. F., Pletcher, S., Salmon, A. B., Sharp, Z. D., Van Roekel, S., Winkleman, L., & Strong, R. (2014). Rapamycin-mediated lifespan increase in mice is dose and sex dependent and metabolically distinct from dietary restriction. ''Aging cell'', ''13''(3), 468–477. <nowiki>https://doi.org/10.1111/acel.12194</nowiki></ref> Rapamycin is currently being tested in a large-scale clinical trial called the Participatory Evaluation (of) Aging (With) Rapamycin (for) Longevity Study (PEARL). The study is a randomized clinical trial of 1000 elderly patients comparing rapamycin against placebo for age-related outcomes.<ref name=":15">Clinicaltrials.gov. 2021. ''Participatory Evaluation (of) Aging (With) Rapamycin (for) Longevity Study - Full Text View - ClinicalTrials.gov''. [online] Available at: <<nowiki>https://clinicaltrials.gov/ct2/show/NCT04488601</nowiki>> [Accessed 14 December 2021].
</ref>

=== [[Epigenetic reprogramming]] ===
Epigenetic reprogramming is remodeling the epigenetic marks, such as methylation tags on the DNA, in cells. This technique was used in 2020 to restore vision to blind mice by fully regrowing the optic nerve.<ref>Lu, Y., Brommer, B., Tian, X. ''et al.'' Reprogramming to recover youthful epigenetic information and restore vision. ''Nature'' 588, 124–129 (2020). <nowiki>https://doi.org/10.1038/s41586-020-2975-4</nowiki></ref> The researchers at Harvard medical school and believe this approach could one day be used to regenerate other tissues of the body as a longevity strategy.<ref>''Reversing The Aging Clock With Epigenetic Reprogramming''. (n.d.). Pubs - Bio-IT World. <nowiki>https://www.bio-itworld.com/news/2021/01/13/reversing-the-aging-clock-with-epigenetic-reprogramming</nowiki></ref>

In addition, over [https://www.lifespan.io/road-maps/the-rejuvenation-roadmap 50 other drugs] are being tested in human clinical trials for slowing aging.<ref name=":2">Lifespan.io. 2021. ''The Rejuvenation Roadmap | Lifespan.io''. [online] Available at: <<nowiki>https://www.lifespan.io/road-maps/the-rejuvenation-roadmap/</nowiki>> [Accessed 13 December 2021].</ref>

== What is the goal of longevity biotechnology? ==
[[File:Healthy lifespan extension.png|alt=Healthy lifespan extension|thumb|643x643px|Healthy lifespan extension]]
Longevity biotechnology aims to slow or reverse the aging process to extend the healthy lifespan (‘healthspan’) of the population. Instead of treating diseases when they arise, one by one, longevity biotechnology aims to keep those who are already healthy, healthy by slowing the aging process. The aim is to thereby delay or prevent multiple diseases at once that are associated with aging.

The longevity biotechnology sector is rapidly growing, and there are currently over 170 private companies working on developing therapeutics to slow the aging process.<ref name=":4">Pfleger, K., 2021. ''Aging Companies''. [online] Agingbiotech.info. Available at: <<nowiki>https://agingbiotech.info/companies</nowiki>> [Accessed 13 December 2021].</ref> These companies are working on slowing or reversing the aging process by targeting one of more of the hallmarks of aging.

== Will healthy or unhealthy lifespan be extended? ==
[[File:Extending healthy lifespan.png|alt=Extending healthy lifespan|thumb|364x364px|Extending healthy lifespan]]
The stated goal of longevity biotechnology is to extend the healthy period of lifespan, before age-related diseases set in. This is in contrast to many of today's medical interventions, which extend life only after diseases (e.g. cancer, Alzheimer's) have reached a clinical level.

Age-related diseases are preceded by a long period of subclinical aging, i.e. aging that has not yet progressed far enough to produce clinical symptoms. By slowing, delaying or reversing the aging process, the healthy period of life can be extended.

Studies in mice have demonstrated that life extending drugs such as rapamycin are capable of extending the healthy, rather than unhealthy period of life.
== Should we treat specific diseases such as cancer, or aging? ==
[[File:Slowing aging versus curing cancer.jpg|alt=Slowing aging is potentially a more effective means of extending healthy lifespan than treating individual diseases due to the comorbid nature of age-related diseases. [6]|thumb|421x421px|Slowing aging is potentially a more effective means of extending healthy lifespan than treating individual diseases due to the comorbid nature of age-related diseases. ]]
Longevity biotechnology potentially offers a greater likelihood of extending healthy lifespan than attempting to find cures for the individual diseases of aging. This is because biological aging is associated with many of diseases of aging that develop as comorbidities i.e. at the same time. Even if a person survives one age-related disease such as cancer, another (e.g. diabetes, cardiovascular disease) is likely to kill the person if the underlying aging is not treated. This phenomenon is known as Taueber's paradox<ref>En.wikipedia.org. 2021. ''Taeuber Paradox - Wikipedia''. [online] Available at: <<nowiki>https://en.wikipedia.org/wiki/Taeuber_Paradox</nowiki>> [Accessed 14 December 2021].</ref>, and accounts for the much smaller projected increase in healthy lifespan associated with curing the diseases of aging, such as cancer (2-3 years), versus slowing aging itself (30+ years).<ref>Matt Kaeberlein, PhD, It is Time to Embrace 21st-Century Medicine, ''Public Policy & Aging Report'', Volume 29, Issue 4, 2019, Pages 111–115, <nowiki>https://doi.org/10.1093/ppar/prz022</nowiki></ref>
== What is biological aging? ==
There are two main types of 'age': chronological age - the number of years since birth, and biological age - a measure of the physical health of a person and their position in their lifespan. Biological age is more difficult to measure, but recent technologies are now available to estimate biological age. Over time, we age biologically. This occurs due to many processes in the body, which are generally categorised into 9 processes or 'hallmarks'.
== What are the 9 Hallmarks of Aging? ==
[[File:Hallmarks of aging.jpg|alt=Hallmarks of aging|thumb|444x444px|Hallmarks of aging]]

The hallmarks of aging framework is considered to broadly represent key biological mechanisms of the biological aging process.<ref name=":9">López-Otín C, Blasco MA, Partridge L, Serrano M, Kroemer G. The hallmarks of aging. Cell. 2013 Jun 6;153(6):1194-217.</ref> Although there are various limitations of the hallmarks framework, it has become the central framework for understanding aging biology. The nine forms of cellular and molecular ‘damage’ that comprise the hallmarks of aging are<ref name=":9" />:

* Genomic instability
* Telomere attrition
* Epigenetic alterations
* Loss of proteostasis
* Deregulated nutrient-sensing
* Mitochondrial dysfunction
* Cellular senescence
* Stem cell exhaustion
* Altered intercellular communication

These are essentially the lowest common denominators of the aging process, on a cellular or subcellular level. All of the other changes associated with aging, such as greying hair, wrinkles, frailty and an increased risk of disease is thought to stem from these underlyig processes.<ref name=":9" />

== How does the aging cause disease? ==
The nine hallmarks of aging have been shown to play an integral role in the development of many age-related diseases such as neurodegenerative diseases and cancer:
=== [[Aging and Neurodegeneration|Neurodegenerative disease]] ===
[[File:Prevalence of neuro disorders.jpg|alt=Prevalence of neuro disorders|thumb|469x469px|The prevalence of neurodegenerative disorders increases exponentially with age, due to the biological aging process.<ref name=":12">Hou, Y., Dan, X., Babbar, M., Wei, Y., Hasselbalch, S. G., Croteau, D. L., & Bohr, V. A. (2019). Ageing as a risk factor for neurodegenerative disease. ''Nature reviews. Neurology'', ''15''(10), 565–581. <nowiki>https://doi.org/10.1038/s41582-019-0244-7</nowiki></ref> ]]
All of the hallmarks of aging are associated with an increased risk of neurodegenerative diseases, such as Parkinson's disease and Alzheimer's disease.<ref>Qiu, C., Kivipelto, M., & von Strauss, E. (2009). Epidemiology of Alzheimer's disease: occurrence, determinants, and strategies toward intervention. ''Dialogues in clinical neuroscience'', ''11''(2), 111.</ref> For example, several types of DNA damage are associated with neurodegeneration. The shortening of telomeres occurs as part of biological aging and causes cellular senescence, and is associated with neurodegeneration and neurodegenerative diseases including Alzheimer's disease and Parkinson's disease.<ref name=":12" /> Additionally, mitochondrial dysfunction, altered metabolism, stem cell exhaustion and loss of proteostasis are also involved in the development of neurodegenerative diseases.<ref name=":12" />
=== [[Aging and Cancer|Cancer]] ===
Several of the hallmarks of aging such as cellular senescence and alterations in the extracellular matrix are responsible for increasing the likelihood of tumorigenesis.<ref name=":5">Fane, M., & Weeraratna, A. T. (2020). How the ageing microenvironment influences tumour progression. ''Nature Reviews Cancer'', ''20''(2), 89-106.</ref> Other hallmarks of aging such as genomic instability, loss or proteostasis, altered intercellular communication (i.e. inflammation) and epigenetic alterations are also involved in tumorigenesis.<ref name=":5" />
== How is biological age measured? ==
[[File:Epigenetic clock.png|alt=Epigenetic clock|thumb|605x605px|Epigenetic clock is the first aging clock. ]]
Recent technologies have allow biological age to be measured. These include:

=== [[Epigenetic clock|Epigenetic clocks]] ===
The first generation of aging clocks are known as [[Epigenetic clock|epigenetic clocks or Horvath’s clock]].<ref name=":6">Horvath, S., & Raj, K. (2018). DNA methylation-based biomarkers and the epigenetic clock theory of ageing. ''Nature Reviews Genetics'', ''19''(6), 371-384.</ref> This clock is based on the finding that over time, the body accumulates methylation tags on the DNA in a pattern that can be predicted with machine learning. These changes to the epigenome are influenced by lifestyle, and can be used to measure biological age.<ref name=":6" /> Factors such as exercise frequency and a low BMI have been shown to reduce the rate of biological aging, whereas obesity and smoking can accelerate the rate of aging.<ref>Quach, A., Levine, M. E., Tanaka, T., Lu, A. T., Chen, B. H., Ferrucci, L., ... & Horvath, S. (2017). Epigenetic clock analysis of diet, exercise, education, and lifestyle factors. ''Aging (Albany NY)'', ''9''(2), 419.</ref><ref>Wu, X., Huang, Q., Javed, R., Zhong, J., Gao, H., & Liang, H. (2019). Effect of tobacco smoking on the epigenetic age of human respiratory organs. ''Clinical Epigenetics'', ''11''(1), 183. <nowiki>https://doi.org/10.1186/s13148-019-0777-z</nowiki>

[[Epigenetic clock#cite%20ref-12|↑]]</ref><ref>Horvath, S., Erhart, W., Brosch, M., Ammerpohl, O., von Schönfels, W., Ahrens, M., Heits, N., Bell, J. T., Tsai, P.-C., Spector, T. D., Deloukas, P., Siebert, R., Sipos, B., Becker, T., Röcken, C., Schafmayer, C., & Hampe, J. (2014). Obesity accelerates epigenetic aging of human liver. ''Proceedings of the National Academy of Sciences'', ''111''(43), 15538–15543. <nowiki>https://doi.org/10.1073/pnas.1412759111</nowiki>

[[Epigenetic clock#cite%20ref-13|↑]]</ref> The Horvath's clock has been used to accurately predict mortality risk.<ref>Fransquet, P. D., Wrigglesworth, J., Woods, R. L., Ernst, M. E., & Ryan, J. (2019). The epigenetic clock as a predictor of disease and mortality risk: a systematic review and meta-analysis. ''Clinical epigenetics'', ''11''(1), 1-17.</ref>

=== Multi-omic clocks ===
Multi-omic clocks are being developed that incorporate data from several sources, such as body imaging scans, blood tests, and fitness tests. These clocks are built using machine learning to estimate biological age. These aging clocks are being developed that combine multiple biological functional tests to create a unique aging signature, which can be monitored over time.<ref>Kudryashova, K. S., Burka, K., Kulaga, A. Y., Vorobyeva, N. S., & Kennedy, B. K. (2020). Aging Biomarkers: From Functional Tests to Multi‐Omics Approaches. ''Proteomics'', ''20''(5-6), 1900408.</ref>
[[File:Multiomic aging clock.jpg|alt=Multiomic clocks|center|thumb|542x542px|Multiomic clocks integrate various data sources to create a unique biological aging signature that can be tracked over time. ]]
== Which companies are trying to solve aging? ==
[[File:Calico Labs.png|alt=T|thumb|Calico Labs, a subsidiary of Google, is a billion-dollar company searching for treatments for aging. ]]
There are over [https://agingbiotech.info/companies 170 longevity biotechnology companies] trying to create therapies to slow or reverse the aging process.<ref name=":4" /> There are over [https://www.lifespan.io/road-maps/the-rejuvenation-roadmap/ 50 longevity drugs] currently in clinical trials in humans.<ref name=":2" />

Many of the longevity biotechnology companies are targeting specific hallmarks of aging. For example, [https://www.clearabiotech.com/#DiscoveryTimeline Cleara Biotech] are attempting to reduce cellular senescence by developing a drug that can eliminate senescent cells.<ref>Cleara Biotech. 2021. ''Cleara Biotech''. [online] Available at: <<nowiki>https://www.clearabiotech.com/#DiscoveryTimeline</nowiki>> [Accessed 15 December 2021].</ref>

Calico Labs is a Google-backed biotech company with the goal of combating aging and age-related diseases. In 2014, the company created a partnership with pharmaceutical giant AbbVie, which has since developed into a [https://www.cnbc.com/2018/06/26/alphabet-backed-calico-and-abbvie-chip-in-1-billion-to-cure-aging.html $2.5 billion venture] in the pursuit of improving “health, wellbeing and longevity.” <ref>2021. ''Google sister company and drug giant chip in another $1 billion to cure age-related diseases''. [online] Available at: <<nowiki>https://www.cnbc.com/2018/06/26/alphabet-backed-calico-and-abbvie-chip-in-1-billion-to-cure-aging.html</nowiki>> [Accessed 15 December 2021].</ref>

Since aging is not currently considered a disease by regulatory bodies such as the Food and Drug Administration (FDA), drug developers are currently focused on specific diseases of aging such as glaucoma and osteoarthritis.<ref>Clinicaltrialsarena.com. 2021. ''Unity's Phase II osteoarthritis study of UBX0101 misses primary goal''. [online] Available at: <<nowiki>https://www.clinicaltrialsarena.com/news/unity-ubx0101-osteoarthritis/</nowiki>> [Accessed 15 December 2021].</ref>

== Which billionaires are funding longevity biotechnology? ==
[[File:Jeff Bezos is funding longevity research.jpg|alt=Jeff Bezos is funding longevity research|thumb|Jeff Bezos is funding longevity research through financing Atlos Labs.<ref name=":7">MIT Technology Review. 2021. ''Meet Altos Labs, Silicon Valley’s latest wild bet on living forever''. [online] Available at: <<nowiki>https://www.technologyreview.com/2021/09/04/1034364/altos-labs-silicon-valleys-jeff-bezos-milner-bet-living-forever/</nowiki>> [Accessed 15 December 2021].</ref>]]
Several billionaires have funded companies or initiatives to slow or reverse human aging. These include:
* [[wikipedia:Jeff_Bezos|Jeff Bezos]], co-founder of Amazon, helped raise [https://www.technologyreview.com/2021/09/04/1034364/altos-labs-silicon-valleys-jeff-bezos-milner-bet-living-forever/ $270 million for new anti-aging drug company Altos Labs] in 2021.<ref name=":7" />
* [[wikipedia:Peter_Thiel|Peter Thiel]], co-founder of PayPal, was an [https://www.cnbc.com/2018/08/29/-jeff-bezos-is-backing-this-scientist-who-is-working-on-a-cure-for-aging.html early investor in Unity Biotechnology].<ref>CNBC. 2021. ''Why Jeff Bezos is backing this Silicon Valley scientist who is working on a cure for aging''. [online] Available at: <<nowiki>https://www.cnbc.com/2018/08/29/-jeff-bezos-is-backing-this-scientist-who-is-working-on-a-cure-for-aging.html</nowiki>> [Accessed 15 December 2021].</ref>
* [[wikipedia:Sergey_Brin|Sergey Brin]], co-founder of Google, donated [https://www.cnbc.com/2017/03/31/google-co-founders-and-silicon-valley-billionaires-try-to-live-forever.html $25 million for the National Academy of Medicine’s Grand Challenge in Health Longevity] to 'end aging forever'.<ref>Google’s co-founders and other Silicon Valley billionaires are trying to live forever. (2021). Retrieved 15 December 2021, from <nowiki>https://www.cnbc.com/2017/03/31/google-co-founders-and-silicon-valley-billionaires-try-to-live-forever.html</nowiki></ref>
* [[wikipedia:Larry_Page|Larry Page]], co-founder of Google, co-founded the [[wikipedia:Calico_(company)|billion-dollar aging research company Calico Labs.]]<ref>Contributors to Wikimedia projects. (2013, September 19). ''Calico (company) - Wikipedia''. Wikipedia, the free encyclopedia. <nowiki>https://en.wikipedia.org/wiki/Calico_(company)</nowiki>
</ref>
* [[wikipedia:Mike_Cannon-Brookes|Mike Cannon-Brookes]], billionaire cofounder of Australian software giant Atlassian, has invested [https://www.forbes.com/sites/samshead/2019/08/19/billionaire-backs-uk-startup-trying-to-extend-human-lifespans/ $10 million into longevity company Juvenescenc]e.<ref>Shead, S. (2019, August 19). ''Billionaire Backs U.K. Startup Trying To Extend Human Life Spans''. Forbes. <nowiki>https://www.forbes.com/sites/samshead/2019/08/19/billionaire-backs-uk-startup-trying-to-extend-human-lifespans/</nowiki></ref>
* [[wikipedia:Naveen_Jain|Naveen Jain]], billionaire entrepeneur who has raised [https://www.geekwire.com/2021/gut-health-startup-viome-raises-54m-develop-cancer-diagnostics-sell-microbiome-kits/ $54 million for his startup Viome].<ref>''Gut health startup Viome raises $54M to develop cancer diagnostics and sell microbiome kits''. (2021, November 10). Geekwire. <nowiki>https://www.geekwire.com/2021/gut-health-startup-viome-raises-54m-develop-cancer-diagnostics-sell-microbiome-kits/</nowiki></ref>
* [[wikipedia:Jim_Mellon|Jim Mellon]], who co-founded longevity company [https://www.juvlabs.com/people/co-founder/jim-mellon Juvenescence].<ref>''Jim Mellon - Chairman & Co-Founder''. (n.d.). Juvenescence - Science of Healthy Aging & Extended Lifespan. <nowiki>https://www.juvlabs.com/people/co-founder/jim-mellon</nowiki></ref>
* [[wikipedia:Larry_Ellison|Larry Ellison]], founder of Oracle, has spent [https://www.townandcountrymag.com/society/money-and-power/a9202324/science-of-longevity/ $430 million on longevity research].<ref>Tullis, P. (2017, March 30). ''Are You Rich Enough To Live Forever?'' Town & Country. <nowiki>https://www.townandcountrymag.com/society/money-and-power/a9202324/science-of-longevity/</nowiki></ref>
*Michael Greve, founder of Kizoo Technology, who has pledged [https://Longevity.Technology. https://www.longevity.technology/michael-greve-commits-e300m-for-rejuvenation-start-ups/ €300m to rejuvenation biotechnology companies.]<ref>''Michael Greve commits €300m for rejuvenation start-ups''. (2021, May 6). Longevity.Technology. <nowiki>https://www.longevity.technology/michael-greve-commits-e300m-for-rejuvenation-start-ups/</nowiki></ref>
* [[wikipedia:Yuri_Milner|Yuri Milner]], billionaire tech investor who has helped Altos Labs raise $270 million, with Jeff Bezos.<ref name=":7" />
* [https://wikitia.com/wiki/Richard_Heart Richard Heart], founder of the cryptocurrency Hex, who helped raise [https://www.express.co.uk/finance/city/1465354/pulsechain-cryptocurrency-srf-sens-research-foundation-airdrop-pulse-charity-longevity $25 million for the anti-aging research organisation SENS.]<ref>McGleenon, B. (2021, July 20). ''Pulsechain cryptocurrency raises 'mindblowing' $25M in five days for SENS longevity group''. Express.co.uk. <nowiki>https://www.express.co.uk/finance/city/1465354/pulsechain-cryptocurrency-srf-sens-research-foundation-airdrop-pulse-charity-longevity</nowiki></ref>
*[[wikipedia:Brian_Armstrong_(businessman)|Brian Armstrong]], CEO of CoinBase, who helped found and raise [https://www.dailymail.co.uk/sciencetech/article-10310475/Billionaire-launches-new-start-hopes-REVERSE-ageing-process.html $105 million for the epigenetic reprogramming startup NewLimit.]<ref>Liberatore, S. (2021, December 14). ''Billionaire launches new start-up to REVERSE the ageing process''. Mail Online. <nowiki>https://www.dailymail.co.uk/sciencetech/article-10310475/Billionaire-launches-new-start-hopes-REVERSE-ageing-process.html</nowiki></ref>
* [[wikipedia:Vitalik_Buterin|Vitalik Buterin]], founder of the cryptocurrency Ethereum, who donated $2.4 million to SENS.<ref>Foundation, S. R. (n.d.). ''SENS Research Foundation Receives $2.4 Million Ethereum Donation From Vitalik Buterin''. GlobeNewswire News Room. <nowiki>https://www.globenewswire.com/news-release/2018/02/02/1332410/0/en/SENS-Research-Foundation-Receives-2-4-Million-Ethereum-Donation-From-Vitalik-Buterin.html</nowiki></ref>

== How large will the longevity biotechnology field be? ==
Analysts from the Bank of America have predicted that the market size of longevity biotechnology will reach $600 billion by 2025.<ref>2021. ''Human lifespan could soon pass 100 years thanks to medical tech, says BofA''. [online] Available at: <<nowiki>https://www.cnbc.com/2019/05/08/techs-next-big-disruption-could-be-delaying-death.html</nowiki>> [Accessed 14 December 2021].</ref> Others have speculated that it is a trillion dollar industry owing to the immense savings associated with delaying or preventing chronic diseases.<ref>Colangelo, M., 2021. ''AI Will Drive The Multi-Trillion Dollar Longevity Economy''. [online] Forbes. Available at: <<nowiki>https://www.forbes.com/sites/cognitiveworld/2019/12/07/ai-will-drive-the-multi-trillion-dollar-longevity-economy/?sh=294766b74965</nowiki>> [Accessed 14 December 2021].</ref>
== Is aging an important for risk factor for COVID-19 mortality? ==

Aging is the largest risk factor for COVID-19. [[File:Age is the -1 risk factor for COVID-19 mortality.jpg|alt=Age is the #1 risk factor for COVID-19 mortality - based on US CDC statistics|thumb|572x572px|* Fold risk of COVID-19 mortality versus reference group aged 5-17 [https://www.cdc.gov/coronavirus/2019-ncov/covid-data/investigations-discovery/hospitalization-death-by-age.html (US CDC statistics)]]]
====COVID-19 defined as a disease of aging====
As detailed in the paper "[https://onlinelibrary.wiley.com/doi/full/10.1111/acel.13230 COVID‐19 is an emergent disease of aging",]<ref name=":29">[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7576244/ Santesmasses, D., Castro, J. P., Zenin, A. A., Shindyapina, A. V., Gerashchenko, M. V., Zhang, B., ... & Gladyshev, V. N. (2020). COVID‐19 is an emergent disease of aging. ''Aging cell'', ''19''(10), e13230.]</ref> COVID-19 meets several criteria for definition as an age-related disease:<ref>[[Promislow, D. E. (2020). A geroscience perspective on COVID-19 mortality. The Journals of Gerontology: Series A, 75(9), e30-e33.|Promislow, D. E. (2020). A geroscience perspective on COVID-19 mortality. ''The Journals of Gerontology: Series A'', ''75''(9), e30-e33.]]</ref><ref>Alberts, S. C., Archie, E. A., Gesquiere, L. R., Altmann, J., Vaupel, J. W., & Christensen, K. (2014). The male-female health-survival paradox: a comparative perspective on sex differences in aging and mortality. In ''Sociality, hierarchy, health: comparative biodemography: a collection of papers''. National Academies Press (US).</ref><ref name=":10">[[Sierra, F. (2020). Geroscience and the Coronavirus Pandemic: The Whack‐a‐Mole Approach is not Enough. Journal of the American Geriatrics Society, 68(5), 951.|Sierra, F. (2020). Geroscience and the Coronavirus Pandemic: The Whack‐a‐Mole Approach is not Enough. ''Journal of the American Geriatrics Society'', ''68''(5), 951.]]</ref><ref name=":11">[[Barzilai, N., Appleby, J. C., Austad, S. N., Cuervo, A. M., Kaeberlein, M., Gonzalez-Billault, C., ... & Sierra, F. (2020). Geroscience in the Age of COVID-19. Aging and disease, 11(4), 725.|Barzilai, N., Appleby, J. C., Austad, S. N., Cuervo, A. M., Kaeberlein, M., Gonzalez-Billault, C., ... & Sierra, F. (2020). Geroscience in the Age of COVID-19. ''Aging and disease'', ''11''(4), 725.]]</ref><ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7288963/</ref>

1) The doubling time for COVID-19 mortality approaches that of the doubling time of 8 years for all-cause mortality (characteristic exponential increase shared among major age-related chronic diseases);

2) Greater mortality rate in men, consistent with known sex differences in rates of aging;

3) Greater mortality rate for those with comorbidities (age-related diseases), consistent with accelerated biological aging; and,

4) Age dwarfs all other putative [[wikipedia:Risk_factor|risk factors]] for mortality by several orders of magnitude, exhibiting several thousand fold increase in risk across the lifespan
== How is aging biology research different to other fields of medical research? ==
Scientists studying the biology of aging believe that aging is the root cause of all the major diseases that afflict us as we age. Therefore, targeting aging biology would treat or reverse multiple diseases, simultaneously, while maximizing the chance of a cure.

Mainstream medical research has had many successes in treating single diseases, such as infectious diseases. For age-related ones, notable successes have been seen for heart diseases. However, targeting single diseases, one at a time, leads to rapidly diminishing returns. Even if we could ''cure'' heart disease and cancer, which are leading causes of death, each would add only ~2.5 years to life expectancy. This is because the next disease in line, e.g. Alzheimer's or lung disease, will kill you. This is the Taeuber Paradox, which highlights how the exponentially increasing risk of disease accumulation with aging limits the benefit of targeting single diseases.
== Do all animals age in the same way? ==
[[File:Naked mole rat graph.png|alt=Naked mole rat graph|thumb|530x530px|The naked mole-rat does not follow the same increased risk of mortality due to aging that humans and other mammals do. ]]
Many species, due to differences in their biology, age at different rates to humans. The jellyfish ''Turritopsis dohrnii'' can revert to earlier stages of its life cycle in response to stress, and can theoretically live forever - though eventually dies, usually due to predation.

Among mammals, the naked mole rat is an exceptionally long lived organism that lives roughly ten times longer than similarly-sized rats.<ref name=":3">Ruby, J. G., Smith, M., & Buffenstein, R. (2018). Naked mole-rat mortality rates defy Gompertzian laws by not increasing with age. ''elife'', ''7'', e31157.</ref><ref>Buffenstein, R., Amoroso, V., Andziak, B., Avdieiev, S., Azpurua, J., Barker, A. J., ... & Smith, E. S. J. (2021). The naked truth: a comprehensive clarification and classification of current ‘myths’ in naked mole‐rat biology. ''Biological Reviews''.</ref> Unlike other organisms, such as humans, horses and mice, the mortality rate of the naked mole rat appears steady over time. This trend does not follow the exponential increase in mortality (Gompertz-Makeham law) that humans do.<ref name=":3" />

Scientists are now studying the naked mole rat to identify key patterns in their genetics, environmental traits, and metabolism that may be responsible for their longer lifespans.

[[File:Naked mole rat.jpg|alt=Naked mole rat|center|thumb|323x323px|The naked mole rat is unusually long-lived relative to other mice and rats. ]]

== Is aging considered a disease? ==
Aging is not currently classified as a disease by regulatory bodies such as the Food and Drug Administration (FDA) in the United States. However, several scientists in the aging field have publicly stated their wish for aging to be considered a disease, including professor David Sinclair and professor Nir Barzilai.

== What are the economic benefits of extending healthy lifespan? ==
Extending the healthy human lifespan could have significant economic benefits gobally. An economic analysis from 2021 by researchers at the University of Oxford and Harvard University estimated the benefit of a drug that slows aging by 1 year as $38 trillion. This is primarily because slowing aging reduces the incidence of age-related diseases such as cancer and Alzheimer’s disease, which require expensive treatment approaches. The study demonstrated a larger economic benefit of slowing aging than curing the individual diseases of aging.
== Which anti-aging drugs are being tested in clinical trials today? ==
There are over 50 drugs being tested in human clinical trials for aging or age-related diseases.

The largest trial is the Targeting Aging with Metformin (TAME) trial, which began in 2020. The trial is being run in the United States with a cohort of 3000 older adults. The goal of the TAME trial is to determine whether diabetes drug metformin slows the aging process in older adults. The TAME trial is a $75 million trial run by the American Federation for Aging Research.

Another large clinical trial is the Participitory Evluation of Rapamycin (PEARL) study. The goal of this study is to determine whether rapamycin, a drug currently approved for immunosuppression during organ transplants, slows biomarkers of aging in 1000 adults. The PEARL trial is being run by AgelessRx.
== Is aging a natural process that should be accepted? ==
Although aging is a natural process in humans, it is the driving force of many diseases such as cancer and Alzheimer's disease - which as a society we have decided are worth trying to find cures for. In the past, these conditions, as well as atherosclerosis and even infectious diseases were once thought of as natural processes that could not be treated. However, nowadays it is understood that they are diseases that can be treated.

Atherosclerosis, the hardening of the arteries, was once viewed as a natural process that was simply a consequence of aging. However, when treatments such as statins were later developed to prevent atherosclerosis, the disease became widely regarded as a disease to be cured. Statins are now one one of the most widely prescribed drugs in the world, used in preventing heart diseases. The inventor of statins, Akira Endo, describes in his historical paper: “Serious research on the role of cholesterol in human atherosclerosis did not really get underway until the 1940s, due to a prevailing view that the disease was a simple consequence of aging and could not be prevented.”<ref>Endo A. (2010). A historical perspective on the discovery of statins. ''Proceedings of the Japan Academy. Series B, Physical and biological sciences'', ''86''(5), 484–493. <nowiki>https://doi.org/10.2183/pjab.86.484</nowiki></ref>

== Will anti-aging technology lead to overpopulation? ==
A common objection to the development of longevity technologies is that they may lead to an unsustainably large population size.

One study of a 2005 Swedish cohort of 9 million people modeled the effect of various anti-aging scenarios. The researchers showed that even with the most radical life-extension technology in which aging completely stopped after age 60, the population growth across 100 years was only 22%.

Currently, the world’s population is 7.9 billion, and the WHO predicts the population will peak at 11 billion in 2100 before falling due to declining birth rates in many parts of the world.

The fastest growing populations are in Africa and South-east Asia. However, several factors are thought to reduce birth rates over time, including increased access to contraceptives, female empowerment, increased education and increased employment. There is evidence that populations that move to a more advanced economy show a reduction in birth rates.

== Will anti-aging drugs only be available to the rich? ==
It is unclear who will have first access to longevity drugs. Several researchers in the field have argued that several economic factors are likely to drive down the price of drugs that slow aging.

* The cost of many biotechnologies decreases substantially over time. For example, the first human genome cost $100 million to sequence, and is now available for a few hundred dollars.

* The price of many lifesaving pharmaceuticals has fallen significantly in price once generic drugs were produced. For example, Lipitor, a statin used to prevent heart disease has fallen in price from $85 in 2011 to less than $5 today.

* Many companies in the longevity field have stated that equity of access is part of their core ethos, and many researchers are signatories to the

== Which scientists and institutions are trying to understand and reverse aging? ==
Over [https://whoswho.senescence.info/ 300 scientists are working on understanding the biology of aging] in leading institutions that include Harvard University, Stanford University, Yale University, and the University of Oxford.<ref>''Who's Who in Gerontology: Researchers and Companies Working on Aging''. (n.d.). Who's Who in Gerontology: Researchers and Companies Working on Aging. <nowiki>https://whoswho.senescence.info/</nowiki></ref> Some of the most well-known institutes and labs include:

=== The Buck Institute for Research on Aging ===
The Buck Institute for Research on Aging is one of the largest longevity research institutes with over 250 scientists. The research covers several areas including the mechanisms of aging, neurodegeneration, senescence, stem cells and regenerative medicine, cellular stress and disease, cancer associated with aging, and mitochondrial function.<ref>''Buck Institute''. (n.d.). BUCK. <nowiki>https://www.buckinstitute.org/</nowiki></ref>

=== Professor David Sinclair - Harvard Medical School ===
Professor Sinclair’s lab focuses on understanding and reversing aging. The lab focuses on a range of areas including DNA repair, mitochondrial dysfunction, and the interactions between epigenetic and genetic instability, and tissue reprogramming.<ref>''Welcome | The Sinclair Lab''. (n.d.). Welcome | The Sinclair Lab. <nowiki>https://sinclair.hms.harvard.edu/</nowiki></ref>

=== Professor Matt Kaeberlein - University of Washington ===
Professor Kaeberlein's lab focuses on biological mechanisms of aging in order to facilitate translational interventions that promote healthspan and improve quality of life. Kaeberlein is known for his work on the longevity drug rapamycin in organisms such as mice and dogs. He is Director of the Dog Aging Project, a multi-year initiative studying the genetic and environmental factors that influence health, with over 33,000 participating dogs.<ref>''Matt Kaeberlein, PhD | Faculty | Dept. of Laboratory Medicine & Pathology | UW Medicine''. (n.d.). Dept. of Laboratory Medicine & Pathology | UW Medicine. <nowiki>https://dlmp.uw.edu/faculty/kaeberlein</nowiki></ref>

=== Professor Brian Kennedy - National University of Singapore ===
Professor Kennedy’s lab focuses on understanding the biology of aging and translating research discoveries into new ways of delaying aging in humans. The lab has identified drugs that extend the healthy lifespan of worms and mice and are seeking to understand their mechanisms.<ref>''Brian Kennedy - Department of Biochemistry – School of Medicine, National University of Singapore''. (n.d.). Department of Biochemistry – School of Medicine, National University of Singapore. <nowiki>https://medicine.nus.edu.sg/bch/fa</nowiki></ref>

=== Associate Professor Lynne Cox - University of Oxford ===
Professor Cox’s lab study the molecular and cellular basis of aging to identify specific biochemical processes and pathways that change organisms age. The lab particularly cellular senescence, which underpins many age-related diseases including cancer and neurodegeneration.<ref>''Associate Prof Lynne Cox''. (n.d.). Home | Biochemistry. <nowiki>https://www.bioch.ox.ac.uk/research/cox</nowiki></ref>

== What books have been written on this topic? ==
Several books have been written on the topic of aging and longevity. These include:

* [https://www.amazon.com/Lifespan-Why-Age_and-Dont-Have/dp/1501191977 ''Lifespan: Why We Age And Why We Don't Have To'' - David Sinclair (2019)]

* [https://www.amazon.com/Ending-Aging-Rejuvenation-Breakthroughs-Lifetime/dp/0312367074 ''Ending Aging'' - Dr. Aubrey de Grey (2007)]

* [https://www.amazon.com/Ageless-Science-Getting-Older-Without/dp/0385544928 ''Ageless'' - Dr. Andrew Steele (2020)]

* [https://www.amazon.com.au/Age-Later-Health-Science-Longevity-ebook/dp/B0818MYCRR ''Age Later'' - Professor Nir Barzilai (2021)]

* [https://www.amazon.com.au/Science-Technology-Growing-Young-Breakthroughs/dp/1950665879 ''The Science and Technology of Growing Young'' - Sergey Young (2021)]

== References ==
<references />

FAQ

2021-12-15T08:37:01Z

Jack: /* Why is aging a problem? */

Longevity biotechnology is a new field of medical research and development that aims to extend healthy human lifespan and delay, prevent or reverse these diseases. This article provides an overview of the field, answering common questions.

== Why is aging a problem? ==
[[File:Aging graph.png|thumb|750x750px|The aging process results in the risk of age-related diseases increasing exponentially over time.]][[File:Gompertz-Makeham law of mortality.png|alt=Gompertz-Makeham law of mortality|thumb|257x257px|Gompertz-Makeham law of mortality<ref name=":0">En.wikipedia.org. 2021. ''Gompertz–Makeham law of mortality - Wikipedia''. [online] Available at: <<nowiki>https://en.wikipedia.org/wiki/Gompertz%E2%80%93Makeham_law_of_mortality</nowiki>> [Accessed 13 December 2021].</ref>]]Aging is the largest risk factor for the diseases that kill most people worldwide, including cancer, heart diseases and Alzheimer's disease.

In the US in 2020, 9 of the 10 leading causes of death were strongly age-related.<ref>Ahmad, F. B., & Anderson, R. N. (2021). The leading causes of death in the US for 2020. ''JAMA'', ''325''(18), 1829-1830.https://jamanetwork.com/journals/jama/fullarticle/2778234</ref> Globally, approximately 70% of deaths annually are the result of aging.<ref name=":8" />

Aging also significantly affects quality of life, as deaths due to aging are usually preceded by many months of years of chronic illnesses such as cancer, type 2 diabetes and Alzheimer’s disease.

As a result of the aging process, the risk of an individual dying increases exponentially after the age of around 30 years old.<ref name=":0" /> This increase in mortality rate is known as the Gompertz-Makeham law of mortality.<ref name=":0" />
== How many people die from aging per day? ==
The aging process results in the deaths of 100,000 people per day; more than twice the sum of all other causes of death combined.<ref name=":8">Ritchie, H. and Roser, M., 2021. ''Causes of Death''. [online] Our World in Data. Available at: <<nowiki>https://ourworldindata.org/causes-of-death</nowiki>> [Accessed 13 December 2021].
</ref> This equates to over 37 million people dying per day of aging - a population the size of Canada. This is because aging results in the exponential increasing risk of age-related diseases such as cancer and type 2 diabetes. Aging also accounts for more than 30% of all disability-adjusted life years lost (DALYs); more than any other single cause.<ref>Vizhub.healthdata.org. 2021. ''GBD Compare | IHME Viz Hub''. [online] Available at: <<nowiki>https://vizhub.healthdata.org/gbd-compare/</nowiki>> [Accessed 13 December 2021].</ref>
[[File:Leading causes of death.png|center|thumb|713x713px|9 of the top 10 causes of death in the US in 2020 were strongly age-related]]

== Can healthy lifespan be extended? ==
[[File:Life extension mice.jpg|alt=Life extension mice|thumb|431x431px|Dietary manipulation, genetic manipulation, and drugs have been shown to increase the healthy lifespan of mice by up to 30%. <ref name=":1">de Magalhaes, J., 2021. ''DrugAge: Species Detail''. [online] Genomics.senescence.info. Available at: <<nowiki>https://genomics.senescence.info/drugs/species_details.php</nowiki>> [Accessed 14 December 2021].</ref>]]Clinical trials for longevity drugs in humans are in-progress, and there is not yet evidence that drugs can slow aging in humans. However, recent experimental breakthroughs over the last few decades have shown that in mice, worms and flies have demonstrated that healthy lifespan can be extended modified. Many clinical trials in humans today are testing whether these results can be replicated in humans.

In animal models, slowing the aging process in animals can be achieved via manipulation of diet, environment, genetics, epigenetics, or with drugs. In mice, over 100 drugs have been shown to extend healthy lifespan by up to 30%.<ref name=":1" />

The effect of longevity drugs on mice is often significant, delaying or eliminating the burden of age-related problems such as frailty, cataracts, cancer, and sarcopenia. For example, a new class of drugs called senolytics have been shown to extend lifespan in mice by over 30% whilst delaying age-related dysfunction.

== Which therapies may extend healthy lifespan? ==
Several drugs are known to extend healthy lifespan in animals. While there is no conclusive data that suggests these drugs would work the same in humans, many of these drugs are now being tested in clinical trials. [[File:Unity Mice.jpg|alt=Unity Mice|thumb|723x723px|Senolytic drugs eliminate senescent cells that accumulate with age, partially reversing multiple age-related diseases and extending the healthy lifespan of mice by up to 35%. ]]

=== Senolytics ===
Senolytics are drugs that remove senescent cells. These are cells which accumulate in the body with age and are linked with age-related diseases such as cancer.<ref>Xu, M., Pirtskhalava, T., Farr, J. N., Weigand, B. M., Palmer, A. K., Weivoda, M. M., ... & Kirkland, J. L. (2018). Senolytics improve physical function and increase lifespan in old age. ''Nature medicine'', ''24''(8), 1246-1256.</ref>
[[File:Metformin2.jpg|thumb|258x258px|Metformin extends lifespan in mice by 6%, and may extend lifespan in humans.<ref name=":13">Kulkarni, A. S., Gubbi, S., & Barzilai, N. (2020). Benefits of metformin in attenuating the hallmarks of aging. ''Cell metabolism'', ''32''(1), 15-30.</ref>]]
In mice, senolytics have been shown to increase the healthy lifespan by up to 35%.<ref>Baker, D. J., Childs, B. G., Durik, M., Wijers, M. E., Sieben, C. J., Zhong, J., ... & Van Deursen, J. M. (2016). Naturally occurring p16 Ink4a-positive cells shorten healthy lifespan. ''Nature'', ''530''(7589), 184-189.</ref> The first clinical trials of senolytics in humans began in 2020, and demonstrated benefits to functional measures suggesting these drugs may be effective in humans.

=== [[Metformin]] ===
Metformin is an approved drug for type 2 diabetes that extends lifespan in multiple species. In mice, Metformin extends lifespan by up to 6%.<ref>Anisimov, V. N., Berstein, L. M., Popovich, I. G., Zabezhinski, M. A., Egormin, P. A., Piskunova, T. S., Semenchenko, A. V., Tyndyk, M. L., Yurova, M. N., Kovalenko, I. G., & Poroshina, T. E. (2011). If started early in life, metformin treatment increases life span and postpones tumors in female SHR mice. ''Aging'', ''3''(2), 148–157. <nowiki>https://doi.org/10.18632/aging.100273</nowiki></ref> Metformin works by improving insulin sensitivity and may target several hallmarks of aging.<ref name=":13" /> Metformin is being tested as a longevity therapy in the largest clinical trial for a longevity therapy, the Targeting Aging with Metformin (TAME) trial in the US.<ref name=":14">''TAME - Targeting Aging with Metformin - American Federation for Aging Research''. (n.d.). American Federation for Aging Research. <nowiki>https://www.afar.org/tame-trial</nowiki></ref> This is a randomized clinical trial of 3000 elderly patients comparing metformin against a placebo for the onset of age-related diseases.<ref name=":14" />

=== [[Rapamycin]] ===
[[File:Rapamune .jpg|alt=Rapamune |thumb|253x253px|Rapamycin, also known as Rapamune© is being tested as a drug to extend healthy lifespan in humans. <ref name=":15" />]]
Rapamycin, also known as Rapamune©, is a drug used to prevent the rejection of organ transplants by the immune system. Rapamycin has been shown to extend lifespan by up to 26% when given at middle age, and 14% when given in late life.<ref>Harrison, D., Strong, R., Sharp, Z. ''et al.'' Rapamycin fed late in life extends lifespan in genetically heterogeneous mice. ''Nature'' 460, 392–395 (2009). <nowiki>https://doi.org/10.1038/nature08221</nowiki>
</ref><ref>Miller, R. A., Harrison, D. E., Astle, C. M., Fernandez, E., Flurkey, K., Han, M., Javors, M. A., Li, X., Nadon, N. L., Nelson, J. F., Pletcher, S., Salmon, A. B., Sharp, Z. D., Van Roekel, S., Winkleman, L., & Strong, R. (2014). Rapamycin-mediated lifespan increase in mice is dose and sex dependent and metabolically distinct from dietary restriction. ''Aging cell'', ''13''(3), 468–477. <nowiki>https://doi.org/10.1111/acel.12194</nowiki></ref> Rapamycin is currently being tested in a large-scale clinical trial called the Participatory Evaluation (of) Aging (With) Rapamycin (for) Longevity Study (PEARL). The study is a randomized clinical trial of 1000 elderly patients comparing rapamycin against placebo for age-related outcomes.<ref name=":15">Clinicaltrials.gov. 2021. ''Participatory Evaluation (of) Aging (With) Rapamycin (for) Longevity Study - Full Text View - ClinicalTrials.gov''. [online] Available at: <<nowiki>https://clinicaltrials.gov/ct2/show/NCT04488601</nowiki>> [Accessed 14 December 2021].
</ref>

=== [[Epigenetic reprogramming]] ===
Epigenetic reprogramming is remodeling the epigenetic marks, such as methylation tags on the DNA, in cells. This technique was used in 2020 to restore vision to blind mice by fully regrowing the optic nerve.<ref>Lu, Y., Brommer, B., Tian, X. ''et al.'' Reprogramming to recover youthful epigenetic information and restore vision. ''Nature'' 588, 124–129 (2020). <nowiki>https://doi.org/10.1038/s41586-020-2975-4</nowiki></ref> The researchers at Harvard medical school and believe this approach could one day be used to regenerate other tissues of the body as a longevity strategy.<ref>''Reversing The Aging Clock With Epigenetic Reprogramming''. (n.d.). Pubs - Bio-IT World. <nowiki>https://www.bio-itworld.com/news/2021/01/13/reversing-the-aging-clock-with-epigenetic-reprogramming</nowiki></ref>

In addition, over [https://www.lifespan.io/road-maps/the-rejuvenation-roadmap 50 other drugs] are being tested in human clinical trials for slowing aging.<ref name=":2">Lifespan.io. 2021. ''The Rejuvenation Roadmap | Lifespan.io''. [online] Available at: <<nowiki>https://www.lifespan.io/road-maps/the-rejuvenation-roadmap/</nowiki>> [Accessed 13 December 2021].</ref>

== What is the goal of longevity biotechnology? ==
[[File:Healthy lifespan extension.png|alt=Healthy lifespan extension|thumb|643x643px|Healthy lifespan extension]]
Longevity biotechnology aims to create therapies to extend the healthy human lifespan. Aging is associated with functional decline, diseases and an increased risk of death.

Longevity biotechnology attempts to slow or reverse the aging process to extend the healthy lifespan (‘healthspan’) of the population.

The longevity biotechnology sector is rapidly growing, and there are currently over 170 private companies working on developing therapeutics to slow the aging process.<ref name=":4">Pfleger, K., 2021. ''Aging Companies''. [online] Agingbiotech.info. Available at: <<nowiki>https://agingbiotech.info/companies</nowiki>> [Accessed 13 December 2021].</ref> These companies are working on slowing or reversing the aging process by targeting one of more of the hallmarks of aging.

== Will healthy or unhealthy lifespan be extended? ==
[[File:Extending healthy lifespan.png|alt=Extending healthy lifespan|thumb|364x364px|Extending healthy lifespan]]
The stated goal of longevity biotechnology is to extend the healthy period of lifespan, before age-related diseases set in. This is in contrast to many of today's medical interventions, which extend life only after diseases (e.g. cancer, Alzheimer's) have reached a clinical level.

Age-related diseases are preceded by a long period of subclinical aging, i.e. aging that has not yet progressed far enough to produce clinical symptoms. By slowing, delaying or reversing the aging process, the healthy period of life can be extended.

Studies in mice have demonstrated that life extending drugs such as rapamycin are capable of extending the healthy, rather than unhealthy period of life.
== Should we treat specific diseases such as cancer, or aging? ==
[[File:Slowing aging versus curing cancer.jpg|alt=Slowing aging is potentially a more effective means of extending healthy lifespan than treating individual diseases due to the comorbid nature of age-related diseases. [6]|thumb|421x421px|Slowing aging is potentially a more effective means of extending healthy lifespan than treating individual diseases due to the comorbid nature of age-related diseases. ]]
Longevity biotechnology potentially offers a greater likelihood of extending healthy lifespan than attempting to find cures for the individual diseases of aging. This is because biological aging is associated with many of diseases of aging that develop as comorbidities i.e. at the same time. Even if a person survives one age-related disease such as cancer, another (e.g. diabetes, cardiovascular disease) is likely to kill the person if the underlying aging is not treated. This phenomenon is known as Taueber's paradox<ref>En.wikipedia.org. 2021. ''Taeuber Paradox - Wikipedia''. [online] Available at: <<nowiki>https://en.wikipedia.org/wiki/Taeuber_Paradox</nowiki>> [Accessed 14 December 2021].</ref>, and accounts for the much smaller projected increase in healthy lifespan associated with curing the diseases of aging, such as cancer (2-3 years), versus slowing aging itself (30+ years).<ref>Matt Kaeberlein, PhD, It is Time to Embrace 21st-Century Medicine, ''Public Policy & Aging Report'', Volume 29, Issue 4, 2019, Pages 111–115, <nowiki>https://doi.org/10.1093/ppar/prz022</nowiki></ref>
== What is biological aging? ==
There are two main types of 'age': chronological age - the number of years since birth, and biological age - a measure of the physical health of a person and their position in their lifespan. Biological age is more difficult to measure, but recent technologies are now available to estimate biological age. Over time, we age biologically. This occurs due to many processes in the body, which are generally categorised into 9 processes or 'hallmarks'.
== What are the 9 Hallmarks of Aging? ==
[[File:Hallmarks of aging.jpg|alt=Hallmarks of aging|thumb|444x444px|Hallmarks of aging]]

The hallmarks of aging framework is considered to broadly represent key biological mechanisms of the biological aging process.<ref name=":9">López-Otín C, Blasco MA, Partridge L, Serrano M, Kroemer G. The hallmarks of aging. Cell. 2013 Jun 6;153(6):1194-217.</ref> Although there are various limitations of the hallmarks framework, it has become the central framework for understanding aging biology. The nine forms of cellular and molecular ‘damage’ that comprise the hallmarks of aging are<ref name=":9" />:

* Genomic instability
* Telomere attrition
* Epigenetic alterations
* Loss of proteostasis
* Deregulated nutrient-sensing
* Mitochondrial dysfunction
* Cellular senescence
* Stem cell exhaustion
* Altered intercellular communication

These are essentially the lowest common denominators of the aging process, on a cellular or subcellular level. All of the other changes associated with aging, such as greying hair, wrinkles, frailty and an increased risk of disease is thought to stem from these underlyig processes.<ref name=":9" />

== How does the aging cause disease? ==
The nine hallmarks of aging have been shown to play an integral role in the development of many age-related diseases such as neurodegenerative diseases and cancer:
=== [[Aging and Neurodegeneration|Neurodegenerative disease]] ===
[[File:Prevalence of neuro disorders.jpg|alt=Prevalence of neuro disorders|thumb|469x469px|The prevalence of neurodegenerative disorders increases exponentially with age, due to the biological aging process.<ref name=":12">Hou, Y., Dan, X., Babbar, M., Wei, Y., Hasselbalch, S. G., Croteau, D. L., & Bohr, V. A. (2019). Ageing as a risk factor for neurodegenerative disease. ''Nature reviews. Neurology'', ''15''(10), 565–581. <nowiki>https://doi.org/10.1038/s41582-019-0244-7</nowiki></ref> ]]
All of the hallmarks of aging are associated with an increased risk of neurodegenerative diseases, such as Parkinson's disease and Alzheimer's disease.<ref>Qiu, C., Kivipelto, M., & von Strauss, E. (2009). Epidemiology of Alzheimer's disease: occurrence, determinants, and strategies toward intervention. ''Dialogues in clinical neuroscience'', ''11''(2), 111.</ref> For example, several types of DNA damage are associated with neurodegeneration. The shortening of telomeres occurs as part of biological aging and causes cellular senescence, and is associated with neurodegeneration and neurodegenerative diseases including Alzheimer's disease and Parkinson's disease.<ref name=":12" /> Additionally, mitochondrial dysfunction, altered metabolism, stem cell exhaustion and loss of proteostasis are also involved in the development of neurodegenerative diseases.<ref name=":12" />
=== [[Aging and Cancer|Cancer]] ===
Several of the hallmarks of aging such as cellular senescence and alterations in the extracellular matrix are responsible for increasing the likelihood of tumorigenesis.<ref name=":5">Fane, M., & Weeraratna, A. T. (2020). How the ageing microenvironment influences tumour progression. ''Nature Reviews Cancer'', ''20''(2), 89-106.</ref> Other hallmarks of aging such as genomic instability, loss or proteostasis, altered intercellular communication (i.e. inflammation) and epigenetic alterations are also involved in tumorigenesis.<ref name=":5" />
== How is biological age measured? ==
[[File:Epigenetic clock.png|alt=Epigenetic clock|thumb|605x605px|Epigenetic clock is the first aging clock. ]]
Recent technologies have allow biological age to be measured. These include:

=== [[Epigenetic clock|Epigenetic clocks]] ===
The first generation of aging clocks are known as [[Epigenetic clock|epigenetic clocks or Horvath’s clock]].<ref name=":6">Horvath, S., & Raj, K. (2018). DNA methylation-based biomarkers and the epigenetic clock theory of ageing. ''Nature Reviews Genetics'', ''19''(6), 371-384.</ref> This clock is based on the finding that over time, the body accumulates methylation tags on the DNA in a pattern that can be predicted with machine learning. These changes to the epigenome are influenced by lifestyle, and can be used to measure biological age.<ref name=":6" /> Factors such as exercise frequency and a low BMI have been shown to reduce the rate of biological aging, whereas obesity and smoking can accelerate the rate of aging.<ref>Quach, A., Levine, M. E., Tanaka, T., Lu, A. T., Chen, B. H., Ferrucci, L., ... & Horvath, S. (2017). Epigenetic clock analysis of diet, exercise, education, and lifestyle factors. ''Aging (Albany NY)'', ''9''(2), 419.</ref><ref>Wu, X., Huang, Q., Javed, R., Zhong, J., Gao, H., & Liang, H. (2019). Effect of tobacco smoking on the epigenetic age of human respiratory organs. ''Clinical Epigenetics'', ''11''(1), 183. <nowiki>https://doi.org/10.1186/s13148-019-0777-z</nowiki>

[[Epigenetic clock#cite%20ref-12|↑]]</ref><ref>Horvath, S., Erhart, W., Brosch, M., Ammerpohl, O., von Schönfels, W., Ahrens, M., Heits, N., Bell, J. T., Tsai, P.-C., Spector, T. D., Deloukas, P., Siebert, R., Sipos, B., Becker, T., Röcken, C., Schafmayer, C., & Hampe, J. (2014). Obesity accelerates epigenetic aging of human liver. ''Proceedings of the National Academy of Sciences'', ''111''(43), 15538–15543. <nowiki>https://doi.org/10.1073/pnas.1412759111</nowiki>

[[Epigenetic clock#cite%20ref-13|↑]]</ref> The Horvath's clock has been used to accurately predict mortality risk.<ref>Fransquet, P. D., Wrigglesworth, J., Woods, R. L., Ernst, M. E., & Ryan, J. (2019). The epigenetic clock as a predictor of disease and mortality risk: a systematic review and meta-analysis. ''Clinical epigenetics'', ''11''(1), 1-17.</ref>

=== Multi-omic clocks ===
Multi-omic clocks are being developed that incorporate data from several sources, such as body imaging scans, blood tests, and fitness tests. These clocks are built using machine learning to estimate biological age. These aging clocks are being developed that combine multiple biological functional tests to create a unique aging signature, which can be monitored over time.<ref>Kudryashova, K. S., Burka, K., Kulaga, A. Y., Vorobyeva, N. S., & Kennedy, B. K. (2020). Aging Biomarkers: From Functional Tests to Multi‐Omics Approaches. ''Proteomics'', ''20''(5-6), 1900408.</ref>
[[File:Multiomic aging clock.jpg|alt=Multiomic clocks|center|thumb|542x542px|Multiomic clocks integrate various data sources to create a unique biological aging signature that can be tracked over time. ]]
== Which companies are trying to solve aging? ==
[[File:Calico Labs.png|alt=T|thumb|Calico Labs, a subsidiary of Google, is a billion-dollar company searching for treatments for aging. ]]
There are over [https://agingbiotech.info/companies 170 longevity biotechnology companies] trying to create therapies to slow or reverse the aging process.<ref name=":4" /> There are over [https://www.lifespan.io/road-maps/the-rejuvenation-roadmap/ 50 longevity drugs] currently in clinical trials in humans.<ref name=":2" />

Many of the longevity biotechnology companies are targeting specific hallmarks of aging. For example, [https://www.clearabiotech.com/#DiscoveryTimeline Cleara Biotech] are attempting to reduce cellular senescence by developing a drug that can eliminate senescent cells.<ref>Cleara Biotech. 2021. ''Cleara Biotech''. [online] Available at: <<nowiki>https://www.clearabiotech.com/#DiscoveryTimeline</nowiki>> [Accessed 15 December 2021].</ref>

Calico Labs is a Google-backed biotech company with the goal of combating aging and age-related diseases. In 2014, the company created a partnership with pharmaceutical giant AbbVie, which has since developed into a [https://www.cnbc.com/2018/06/26/alphabet-backed-calico-and-abbvie-chip-in-1-billion-to-cure-aging.html $2.5 billion venture] in the pursuit of improving “health, wellbeing and longevity.” <ref>2021. ''Google sister company and drug giant chip in another $1 billion to cure age-related diseases''. [online] Available at: <<nowiki>https://www.cnbc.com/2018/06/26/alphabet-backed-calico-and-abbvie-chip-in-1-billion-to-cure-aging.html</nowiki>> [Accessed 15 December 2021].</ref>

Since aging is not currently considered a disease by regulatory bodies such as the Food and Drug Administration (FDA), drug developers are currently focused on specific diseases of aging such as glaucoma and osteoarthritis.<ref>Clinicaltrialsarena.com. 2021. ''Unity's Phase II osteoarthritis study of UBX0101 misses primary goal''. [online] Available at: <<nowiki>https://www.clinicaltrialsarena.com/news/unity-ubx0101-osteoarthritis/</nowiki>> [Accessed 15 December 2021].</ref>

== Which billionaires are funding longevity biotechnology? ==
[[File:Jeff Bezos is funding longevity research.jpg|alt=Jeff Bezos is funding longevity research|thumb|Jeff Bezos is funding longevity research through financing Atlos Labs.<ref name=":7">MIT Technology Review. 2021. ''Meet Altos Labs, Silicon Valley’s latest wild bet on living forever''. [online] Available at: <<nowiki>https://www.technologyreview.com/2021/09/04/1034364/altos-labs-silicon-valleys-jeff-bezos-milner-bet-living-forever/</nowiki>> [Accessed 15 December 2021].</ref>]]
Several billionaires have funded companies or initiatives to slow or reverse human aging. These include:
* [[wikipedia:Jeff_Bezos|Jeff Bezos]], co-founder of Amazon, helped raise [https://www.technologyreview.com/2021/09/04/1034364/altos-labs-silicon-valleys-jeff-bezos-milner-bet-living-forever/ $270 million for new anti-aging drug company Altos Labs] in 2021.<ref name=":7" />
* [[wikipedia:Peter_Thiel|Peter Thiel]], co-founder of PayPal, was an [https://www.cnbc.com/2018/08/29/-jeff-bezos-is-backing-this-scientist-who-is-working-on-a-cure-for-aging.html early investor in Unity Biotechnology].<ref>CNBC. 2021. ''Why Jeff Bezos is backing this Silicon Valley scientist who is working on a cure for aging''. [online] Available at: <<nowiki>https://www.cnbc.com/2018/08/29/-jeff-bezos-is-backing-this-scientist-who-is-working-on-a-cure-for-aging.html</nowiki>> [Accessed 15 December 2021].</ref>
* [[wikipedia:Sergey_Brin|Sergey Brin]], co-founder of Google, donated [https://www.cnbc.com/2017/03/31/google-co-founders-and-silicon-valley-billionaires-try-to-live-forever.html $25 million for the National Academy of Medicine’s Grand Challenge in Health Longevity] to 'end aging forever'.<ref>Google’s co-founders and other Silicon Valley billionaires are trying to live forever. (2021). Retrieved 15 December 2021, from <nowiki>https://www.cnbc.com/2017/03/31/google-co-founders-and-silicon-valley-billionaires-try-to-live-forever.html</nowiki></ref>
* [[wikipedia:Larry_Page|Larry Page]], co-founder of Google, co-founded the [[wikipedia:Calico_(company)|billion-dollar aging research company Calico Labs.]]<ref>Contributors to Wikimedia projects. (2013, September 19). ''Calico (company) - Wikipedia''. Wikipedia, the free encyclopedia. <nowiki>https://en.wikipedia.org/wiki/Calico_(company)</nowiki>
</ref>
* [[wikipedia:Mike_Cannon-Brookes|Mike Cannon-Brookes]], billionaire cofounder of Australian software giant Atlassian, has invested [https://www.forbes.com/sites/samshead/2019/08/19/billionaire-backs-uk-startup-trying-to-extend-human-lifespans/ $10 million into longevity company Juvenescenc]e.<ref>Shead, S. (2019, August 19). ''Billionaire Backs U.K. Startup Trying To Extend Human Life Spans''. Forbes. <nowiki>https://www.forbes.com/sites/samshead/2019/08/19/billionaire-backs-uk-startup-trying-to-extend-human-lifespans/</nowiki></ref>
* [[wikipedia:Naveen_Jain|Naveen Jain]], billionaire entrepeneur who has raised [https://www.geekwire.com/2021/gut-health-startup-viome-raises-54m-develop-cancer-diagnostics-sell-microbiome-kits/ $54 million for his startup Viome].<ref>''Gut health startup Viome raises $54M to develop cancer diagnostics and sell microbiome kits''. (2021, November 10). Geekwire. <nowiki>https://www.geekwire.com/2021/gut-health-startup-viome-raises-54m-develop-cancer-diagnostics-sell-microbiome-kits/</nowiki></ref>
* [[wikipedia:Jim_Mellon|Jim Mellon]], who co-founded longevity company [https://www.juvlabs.com/people/co-founder/jim-mellon Juvenescence].<ref>''Jim Mellon - Chairman & Co-Founder''. (n.d.). Juvenescence - Science of Healthy Aging & Extended Lifespan. <nowiki>https://www.juvlabs.com/people/co-founder/jim-mellon</nowiki></ref>
* [[wikipedia:Larry_Ellison|Larry Ellison]], founder of Oracle, has spent [https://www.townandcountrymag.com/society/money-and-power/a9202324/science-of-longevity/ $430 million on longevity research].<ref>Tullis, P. (2017, March 30). ''Are You Rich Enough To Live Forever?'' Town & Country. <nowiki>https://www.townandcountrymag.com/society/money-and-power/a9202324/science-of-longevity/</nowiki></ref>
*Michael Greve, founder of Kizoo Technology, who has pledged [https://Longevity.Technology. https://www.longevity.technology/michael-greve-commits-e300m-for-rejuvenation-start-ups/ €300m to rejuvenation biotechnology companies.]<ref>''Michael Greve commits €300m for rejuvenation start-ups''. (2021, May 6). Longevity.Technology. <nowiki>https://www.longevity.technology/michael-greve-commits-e300m-for-rejuvenation-start-ups/</nowiki></ref>
* [[wikipedia:Yuri_Milner|Yuri Milner]], billionaire tech investor who has helped Altos Labs raise $270 million, with Jeff Bezos.<ref name=":7" />
* [https://wikitia.com/wiki/Richard_Heart Richard Heart], founder of the cryptocurrency Hex, who helped raise [https://www.express.co.uk/finance/city/1465354/pulsechain-cryptocurrency-srf-sens-research-foundation-airdrop-pulse-charity-longevity $25 million for the anti-aging research organisation SENS.]<ref>McGleenon, B. (2021, July 20). ''Pulsechain cryptocurrency raises 'mindblowing' $25M in five days for SENS longevity group''. Express.co.uk. <nowiki>https://www.express.co.uk/finance/city/1465354/pulsechain-cryptocurrency-srf-sens-research-foundation-airdrop-pulse-charity-longevity</nowiki></ref>
*[[wikipedia:Brian_Armstrong_(businessman)|Brian Armstrong]], CEO of CoinBase, who helped found and raise [https://www.dailymail.co.uk/sciencetech/article-10310475/Billionaire-launches-new-start-hopes-REVERSE-ageing-process.html $105 million for the epigenetic reprogramming startup NewLimit.]<ref>Liberatore, S. (2021, December 14). ''Billionaire launches new start-up to REVERSE the ageing process''. Mail Online. <nowiki>https://www.dailymail.co.uk/sciencetech/article-10310475/Billionaire-launches-new-start-hopes-REVERSE-ageing-process.html</nowiki></ref>
* [[wikipedia:Vitalik_Buterin|Vitalik Buterin]], founder of the cryptocurrency Ethereum, who donated $2.4 million to SENS.<ref>Foundation, S. R. (n.d.). ''SENS Research Foundation Receives $2.4 Million Ethereum Donation From Vitalik Buterin''. GlobeNewswire News Room. <nowiki>https://www.globenewswire.com/news-release/2018/02/02/1332410/0/en/SENS-Research-Foundation-Receives-2-4-Million-Ethereum-Donation-From-Vitalik-Buterin.html</nowiki></ref>

== How large will the longevity biotechnology field be? ==
Analysts from the Bank of America have predicted that the market size of longevity biotechnology will reach $600 billion by 2025.<ref>2021. ''Human lifespan could soon pass 100 years thanks to medical tech, says BofA''. [online] Available at: <<nowiki>https://www.cnbc.com/2019/05/08/techs-next-big-disruption-could-be-delaying-death.html</nowiki>> [Accessed 14 December 2021].</ref> Others have speculated that it is a trillion dollar industry owing to the immense savings associated with delaying or preventing chronic diseases.<ref>Colangelo, M., 2021. ''AI Will Drive The Multi-Trillion Dollar Longevity Economy''. [online] Forbes. Available at: <<nowiki>https://www.forbes.com/sites/cognitiveworld/2019/12/07/ai-will-drive-the-multi-trillion-dollar-longevity-economy/?sh=294766b74965</nowiki>> [Accessed 14 December 2021].</ref>
== Is aging an important for risk factor for COVID-19 mortality? ==

Aging is the largest risk factor for COVID-19. [[File:Age is the -1 risk factor for COVID-19 mortality.jpg|alt=Age is the #1 risk factor for COVID-19 mortality - based on US CDC statistics|thumb|572x572px|* Fold risk of COVID-19 mortality versus reference group aged 5-17 [https://www.cdc.gov/coronavirus/2019-ncov/covid-data/investigations-discovery/hospitalization-death-by-age.html (US CDC statistics)]]]
====COVID-19 defined as a disease of aging====
As detailed in the paper "[https://onlinelibrary.wiley.com/doi/full/10.1111/acel.13230 COVID‐19 is an emergent disease of aging",]<ref name=":29">[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7576244/ Santesmasses, D., Castro, J. P., Zenin, A. A., Shindyapina, A. V., Gerashchenko, M. V., Zhang, B., ... & Gladyshev, V. N. (2020). COVID‐19 is an emergent disease of aging. ''Aging cell'', ''19''(10), e13230.]</ref> COVID-19 meets several criteria for definition as an age-related disease:<ref>[[Promislow, D. E. (2020). A geroscience perspective on COVID-19 mortality. The Journals of Gerontology: Series A, 75(9), e30-e33.|Promislow, D. E. (2020). A geroscience perspective on COVID-19 mortality. ''The Journals of Gerontology: Series A'', ''75''(9), e30-e33.]]</ref><ref>Alberts, S. C., Archie, E. A., Gesquiere, L. R., Altmann, J., Vaupel, J. W., & Christensen, K. (2014). The male-female health-survival paradox: a comparative perspective on sex differences in aging and mortality. In ''Sociality, hierarchy, health: comparative biodemography: a collection of papers''. National Academies Press (US).</ref><ref name=":10">[[Sierra, F. (2020). Geroscience and the Coronavirus Pandemic: The Whack‐a‐Mole Approach is not Enough. Journal of the American Geriatrics Society, 68(5), 951.|Sierra, F. (2020). Geroscience and the Coronavirus Pandemic: The Whack‐a‐Mole Approach is not Enough. ''Journal of the American Geriatrics Society'', ''68''(5), 951.]]</ref><ref name=":11">[[Barzilai, N., Appleby, J. C., Austad, S. N., Cuervo, A. M., Kaeberlein, M., Gonzalez-Billault, C., ... & Sierra, F. (2020). Geroscience in the Age of COVID-19. Aging and disease, 11(4), 725.|Barzilai, N., Appleby, J. C., Austad, S. N., Cuervo, A. M., Kaeberlein, M., Gonzalez-Billault, C., ... & Sierra, F. (2020). Geroscience in the Age of COVID-19. ''Aging and disease'', ''11''(4), 725.]]</ref><ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7288963/</ref>

1) The doubling time for COVID-19 mortality approaches that of the doubling time of 8 years for all-cause mortality (characteristic exponential increase shared among major age-related chronic diseases);

2) Greater mortality rate in men, consistent with known sex differences in rates of aging;

3) Greater mortality rate for those with comorbidities (age-related diseases), consistent with accelerated biological aging; and,

4) Age dwarfs all other putative [[wikipedia:Risk_factor|risk factors]] for mortality by several orders of magnitude, exhibiting several thousand fold increase in risk across the lifespan
== How is aging biology research different to other fields of medical research? ==
Scientists studying the biology of aging believe that aging is the root cause of all the major diseases that afflict us as we age. Therefore, targeting aging biology would treat or reverse multiple diseases, simultaneously, while maximizing the chance of a cure.

Mainstream medical research has had many successes in treating single diseases, such as infectious diseases. For age-related ones, notable successes have been seen for heart diseases. However, targeting single diseases, one at a time, leads to rapidly diminishing returns. Even if we could ''cure'' heart disease and cancer, which are leading causes of death, each would add only ~2.5 years to life expectancy. This is because the next disease in line, e.g. Alzheimer's or lung disease, will kill you. This is the Taeuber Paradox, which highlights how the exponentially increasing risk of disease accumulation with aging limits the benefit of targeting single diseases.
== Do all animals age in the same way? ==
[[File:Naked mole rat graph.png|alt=Naked mole rat graph|thumb|530x530px|The naked mole-rat does not follow the same increased risk of mortality due to aging that humans and other mammals do. ]]
Many species, due to differences in their biology, age at different rates to humans. The jellyfish ''Turritopsis dohrnii'' can revert to earlier stages of its life cycle in response to stress, and can theoretically live forever - though eventually dies, usually due to predation.

Among mammals, the naked mole rat is an exceptionally long lived organism that lives roughly ten times longer than similarly-sized rats.<ref name=":3">Ruby, J. G., Smith, M., & Buffenstein, R. (2018). Naked mole-rat mortality rates defy Gompertzian laws by not increasing with age. ''elife'', ''7'', e31157.</ref><ref>Buffenstein, R., Amoroso, V., Andziak, B., Avdieiev, S., Azpurua, J., Barker, A. J., ... & Smith, E. S. J. (2021). The naked truth: a comprehensive clarification and classification of current ‘myths’ in naked mole‐rat biology. ''Biological Reviews''.</ref> Unlike other organisms, such as humans, horses and mice, the mortality rate of the naked mole rat appears steady over time. This trend does not follow the exponential increase in mortality (Gompertz-Makeham law) that humans do.<ref name=":3" />

Scientists are now studying the naked mole rat to identify key patterns in their genetics, environmental traits, and metabolism that may be responsible for their longer lifespans.

[[File:Naked mole rat.jpg|alt=Naked mole rat|center|thumb|323x323px|The naked mole rat is unusually long-lived relative to other mice and rats. ]]

== Is aging considered a disease? ==
Aging is not currently classified as a disease by regulatory bodies such as the Food and Drug Administration (FDA) in the United States. However, several scientists in the aging field have publicly stated their wish for aging to be considered a disease, including professor David Sinclair and professor Nir Barzilai.

== What are the economic benefits of extending healthy lifespan? ==
Extending the healthy human lifespan could have significant economic benefits gobally. An economic analysis from 2021 by researchers at the University of Oxford and Harvard University estimated the benefit of a drug that slows aging by 1 year as $38 trillion. This is primarily because slowing aging reduces the incidence of age-related diseases such as cancer and Alzheimer’s disease, which require expensive treatment approaches. The study demonstrated a larger economic benefit of slowing aging than curing the individual diseases of aging.
== Which anti-aging drugs are being tested in clinical trials today? ==
There are over 50 drugs being tested in human clinical trials for aging or age-related diseases.

The largest trial is the Targeting Aging with Metformin (TAME) trial, which began in 2020. The trial is being run in the United States with a cohort of 3000 older adults. The goal of the TAME trial is to determine whether diabetes drug metformin slows the aging process in older adults. The TAME trial is a $75 million trial run by the American Federation for Aging Research.

Another large clinical trial is the Participitory Evluation of Rapamycin (PEARL) study. The goal of this study is to determine whether rapamycin, a drug currently approved for immunosuppression during organ transplants, slows biomarkers of aging in 1000 adults. The PEARL trial is being run by AgelessRx.
== Is aging a natural process that should be accepted? ==
Although aging is a natural process in humans, it is the driving force of many diseases such as cancer and Alzheimer's disease - which as a society we have decided are worth trying to find cures for. In the past, these conditions, as well as atherosclerosis and even infectious diseases were once thought of as natural processes that could not be treated. However, nowadays it is understood that they are diseases that can be treated.

Atherosclerosis, the hardening of the arteries, was once viewed as a natural process that was simply a consequence of aging. However, when treatments such as statins were later developed to prevent atherosclerosis, the disease became widely regarded as a disease to be cured. Statins are now one one of the most widely prescribed drugs in the world, used in preventing heart diseases. The inventor of statins, Akira Endo, describes in his historical paper: “Serious research on the role of cholesterol in human atherosclerosis did not really get underway until the 1940s, due to a prevailing view that the disease was a simple consequence of aging and could not be prevented.”<ref>Endo A. (2010). A historical perspective on the discovery of statins. ''Proceedings of the Japan Academy. Series B, Physical and biological sciences'', ''86''(5), 484–493. <nowiki>https://doi.org/10.2183/pjab.86.484</nowiki></ref>

== Will anti-aging technology lead to overpopulation? ==
A common objection to the development of longevity technologies is that they may lead to an unsustainably large population size.

One study of a 2005 Swedish cohort of 9 million people modeled the effect of various anti-aging scenarios. The researchers showed that even with the most radical life-extension technology in which aging completely stopped after age 60, the population growth across 100 years was only 22%.

Currently, the world’s population is 7.9 billion, and the WHO predicts the population will peak at 11 billion in 2100 before falling due to declining birth rates in many parts of the world.

The fastest growing populations are in Africa and South-east Asia. However, several factors are thought to reduce birth rates over time, including increased access to contraceptives, female empowerment, increased education and increased employment. There is evidence that populations that move to a more advanced economy show a reduction in birth rates.

== Will anti-aging drugs only be available to the rich? ==
It is unclear who will have first access to longevity drugs. Several researchers in the field have argued that several economic factors are likely to drive down the price of drugs that slow aging.

* The cost of many biotechnologies decreases substantially over time. For example, the first human genome cost $100 million to sequence, and is now available for a few hundred dollars.

* The price of many lifesaving pharmaceuticals has fallen significantly in price once generic drugs were produced. For example, Lipitor, a statin used to prevent heart disease has fallen in price from $85 in 2011 to less than $5 today.

* Many companies in the longevity field have stated that equity of access is part of their core ethos, and many researchers are signatories to the

== Which scientists and institutions are trying to understand and reverse aging? ==
Over [https://whoswho.senescence.info/ 300 scientists are working on understanding the biology of aging] in leading institutions that include Harvard University, Stanford University, Yale University, and the University of Oxford.<ref>''Who's Who in Gerontology: Researchers and Companies Working on Aging''. (n.d.). Who's Who in Gerontology: Researchers and Companies Working on Aging. <nowiki>https://whoswho.senescence.info/</nowiki></ref> Some of the most well-known institutes and labs include:

=== The Buck Institute for Research on Aging ===
The Buck Institute for Research on Aging is one of the largest longevity research institutes with over 250 scientists. The research covers several areas including the mechanisms of aging, neurodegeneration, senescence, stem cells and regenerative medicine, cellular stress and disease, cancer associated with aging, and mitochondrial function.<ref>''Buck Institute''. (n.d.). BUCK. <nowiki>https://www.buckinstitute.org/</nowiki></ref>

=== Professor David Sinclair - Harvard Medical School ===
Professor Sinclair’s lab focuses on understanding and reversing aging. The lab focuses on a range of areas including DNA repair, mitochondrial dysfunction, and the interactions between epigenetic and genetic instability, and tissue reprogramming.<ref>''Welcome | The Sinclair Lab''. (n.d.). Welcome | The Sinclair Lab. <nowiki>https://sinclair.hms.harvard.edu/</nowiki></ref>

=== Professor Matt Kaeberlein - University of Washington ===
Professor Kaeberlein's lab focuses on biological mechanisms of aging in order to facilitate translational interventions that promote healthspan and improve quality of life. Kaeberlein is known for his work on the longevity drug rapamycin in organisms such as mice and dogs. He is Director of the Dog Aging Project, a multi-year initiative studying the genetic and environmental factors that influence health, with over 33,000 participating dogs.<ref>''Matt Kaeberlein, PhD | Faculty | Dept. of Laboratory Medicine & Pathology | UW Medicine''. (n.d.). Dept. of Laboratory Medicine & Pathology | UW Medicine. <nowiki>https://dlmp.uw.edu/faculty/kaeberlein</nowiki></ref>

=== Professor Brian Kennedy - National University of Singapore ===
Professor Kennedy’s lab focuses on understanding the biology of aging and translating research discoveries into new ways of delaying aging in humans. The lab has identified drugs that extend the healthy lifespan of worms and mice and are seeking to understand their mechanisms.<ref>''Brian Kennedy - Department of Biochemistry – School of Medicine, National University of Singapore''. (n.d.). Department of Biochemistry – School of Medicine, National University of Singapore. <nowiki>https://medicine.nus.edu.sg/bch/fa</nowiki></ref>

=== Associate Professor Lynne Cox - University of Oxford ===
Professor Cox’s lab study the molecular and cellular basis of aging to identify specific biochemical processes and pathways that change organisms age. The lab particularly cellular senescence, which underpins many age-related diseases including cancer and neurodegeneration.<ref>''Associate Prof Lynne Cox''. (n.d.). Home | Biochemistry. <nowiki>https://www.bioch.ox.ac.uk/research/cox</nowiki></ref>

== What books have been written on this topic? ==
Several books have been written on the topic of aging and longevity. These include:

* [https://www.amazon.com/Lifespan-Why-Age_and-Dont-Have/dp/1501191977 ''Lifespan: Why We Age And Why We Don't Have To'' - David Sinclair (2019)]

* [https://www.amazon.com/Ending-Aging-Rejuvenation-Breakthroughs-Lifetime/dp/0312367074 ''Ending Aging'' - Dr. Aubrey de Grey (2007)]

* [https://www.amazon.com/Ageless-Science-Getting-Older-Without/dp/0385544928 ''Ageless'' - Dr. Andrew Steele (2020)]

* [https://www.amazon.com.au/Age-Later-Health-Science-Longevity-ebook/dp/B0818MYCRR ''Age Later'' - Professor Nir Barzilai (2021)]

* [https://www.amazon.com.au/Science-Technology-Growing-Young-Breakthroughs/dp/1950665879 ''The Science and Technology of Growing Young'' - Sergey Young (2021)]

== References ==
<references />

About

2021-12-15T08:35:14Z

Jack: /* Who is involved? */

== What is Longevity Wiki? ==
Longevity Wiki is the world’s first open access longevity education platform. It is a global non-profit Wiki created to democratise information on research efforts in aging biology. The Wiki's contents is currently still in draft form but we expect to 'officially' go live 15 December 2021.

== What is its purpose? ==
Longevity Wiki exists to bridge the knowledge gap between doctors, scientists and the public with aging biology research.

Aging is the largest cause of death and suffering worldwide, accounting for more than 70% of deaths globally. However, there is widespread lack of understanding about biological aging and its critical role in age-related diseases such as cancer, Alzheimer's, and cardiovascular disease. This is a bottleneck towards accelerating the rate of geroscience research - a nascent field of medicine that seeks to understand how the underlying biological mechanisms of aging can be targeted to prevent and treat age-related diseases.

Longevity Wiki provides clear, concise information and empowers readers to contribute to this field. Our goal is to progress the longevity field by providing free educational material in the form of informative articles. It should be valuable for both specialists and non-specialists.

== Why a Wiki? ==
The major benefit of using a Wiki is that it allows anybody to [[How to contribute|contribute]]. The longevity field is vast, and having a system that allows users to easily amend and update content is crucial to ensuring the value of the Wiki.

== Why not use Wikipedia? ==
Although Wikipedia is a great source of information on an immense number of topics, its information on longevity science is rather limited. This probably has to do with the fact that the longevity field is still very new and, for some reason or another, considered by some still as controversial. With Longevity Wiki we like to provide a platform that's more open to new ideas in this field, but still honour the same ideals as Wikipedia like taking an objective, neutral and unbiased point of view. In the future, when the longevity field becomes more mainstream, a separate Wiki might not be necessary anymore.

== Who is involved? ==
Longevity Wiki is an open-access project and anyone can contribute. Here are some of the key team members:

'''Jack Harley'''

Jack Harley is a neuroscientist trained at the University of Oxford. He is the author of the popular article, [https://www.lesswrong.com/posts/RcifQCKkRc9XTjxC2/anti-aging-state-of-the-art Anti-Aging: State of the Art] published on the rationality forum, LessWrong. Jack is the former Vice President of the Oxford Society of Ageing and Longevity and has 8+ years’ experience in for-profit roles in Biotech and non-for-profit roles in the Effective Altruism community.

'''Bogdan Dziewierz'''

Bogdan Dziewierz is software architect and engineer with a specialisation in digital, web and mobile. He has 15+ years experience architecting and building multi-tiered, distributed web and mobile applications.

'''Marc Smeehuijzen'''

Marc Smeehuijzen is a User Experience designer with over 15 years experience in web design and usability. He has worked for a variety of international companies making their technology easier to use.

'''Benjamin Wu'''

Benjamin Wu is an Australian healthcare professional working in primary eye care, serving a predominantly geriatric patient base. He is chiefly interested in the biology of aging, translational medicine, and advancing the geroscience hypothesis.
== More information ==
More information about our organization and available roles, can be found in our [[Handbook:Handbook|Handbook]].
== Contact us ==
See our [[Contact]] page.

FAQ

2021-12-15T08:34:10Z

Jack: /* Professor David Sinclair - Harvard Medical School */

Aging is the driving force of many diseases. Longevity biotechnology is a new field of medical research and development that aims to extend healthy human lifespan and delay, prevent or reverse these diseases. This article provides an overview of the field, answering common questions.

== Why is aging a problem? ==
[[File:Aging graph.png|thumb|750x750px|The aging process results in the risk of age-related diseases increasing exponentially over time.]][[File:Gompertz-Makeham law of mortality.png|alt=Gompertz-Makeham law of mortality|thumb|257x257px|Gompertz-Makeham law of mortality<ref name=":0">En.wikipedia.org. 2021. ''Gompertz–Makeham law of mortality - Wikipedia''. [online] Available at: <<nowiki>https://en.wikipedia.org/wiki/Gompertz%E2%80%93Makeham_law_of_mortality</nowiki>> [Accessed 13 December 2021].</ref>]]Aging is the largest risk factor for the diseases that kill most people worldwide, including cancer, heart diseases and Alzheimer's disease.

In the US in 2020, 9 of the 10 leading causes of death were strongly age-related.<ref>Ahmad, F. B., & Anderson, R. N. (2021). The leading causes of death in the US for 2020. ''JAMA'', ''325''(18), 1829-1830.https://jamanetwork.com/journals/jama/fullarticle/2778234</ref> Globally, approximately 70% of deaths annually are the result of aging.<ref name=":8" />

Aging also significantly affects quality of life, as deaths due to aging are usually preceded by many months of years of chronic illnesses such as cancer, type 2 diabetes and Alzheimer’s disease.

As a result of the aging process, the risk of an individual dying increases exponentially after the age of around 30 years old.<ref name=":0" /> This increase in mortality rate is known as the Gompertz-Makeham law of mortality.<ref name=":0" />
== How many people die from aging per day? ==
The aging process results in the deaths of 100,000 people per day; more than twice the sum of all other causes of death combined.<ref name=":8">Ritchie, H. and Roser, M., 2021. ''Causes of Death''. [online] Our World in Data. Available at: <<nowiki>https://ourworldindata.org/causes-of-death</nowiki>> [Accessed 13 December 2021].
</ref> This equates to over 37 million people dying per day of aging - a population the size of Canada. This is because aging results in the exponential increasing risk of age-related diseases such as cancer and type 2 diabetes. Aging also accounts for more than 30% of all disability-adjusted life years lost (DALYs); more than any other single cause.<ref>Vizhub.healthdata.org. 2021. ''GBD Compare | IHME Viz Hub''. [online] Available at: <<nowiki>https://vizhub.healthdata.org/gbd-compare/</nowiki>> [Accessed 13 December 2021].</ref>
[[File:Leading causes of death.png|center|thumb|713x713px|9 of the top 10 causes of death in the US in 2020 were strongly age-related]]

== Can healthy lifespan be extended? ==
[[File:Life extension mice.jpg|alt=Life extension mice|thumb|431x431px|Dietary manipulation, genetic manipulation, and drugs have been shown to increase the healthy lifespan of mice by up to 30%. <ref name=":1">de Magalhaes, J., 2021. ''DrugAge: Species Detail''. [online] Genomics.senescence.info. Available at: <<nowiki>https://genomics.senescence.info/drugs/species_details.php</nowiki>> [Accessed 14 December 2021].</ref>]]Clinical trials for longevity drugs in humans are in-progress, and there is not yet evidence that drugs can slow aging in humans. However, recent experimental breakthroughs over the last few decades have shown that in mice, worms and flies have demonstrated that healthy lifespan can be extended modified. Many clinical trials in humans today are testing whether these results can be replicated in humans.

In animal models, slowing the aging process in animals can be achieved via manipulation of diet, environment, genetics, epigenetics, or with drugs. In mice, over 100 drugs have been shown to extend healthy lifespan by up to 30%.<ref name=":1" />

The effect of longevity drugs on mice is often significant, delaying or eliminating the burden of age-related problems such as frailty, cataracts, cancer, and sarcopenia. For example, a new class of drugs called senolytics have been shown to extend lifespan in mice by over 30% whilst delaying age-related dysfunction.

== Which therapies may extend healthy lifespan? ==
Several drugs are known to extend healthy lifespan in animals. While there is no conclusive data that suggests these drugs would work the same in humans, many of these drugs are now being tested in clinical trials. [[File:Unity Mice.jpg|alt=Unity Mice|thumb|723x723px|Senolytic drugs eliminate senescent cells that accumulate with age, partially reversing multiple age-related diseases and extending the healthy lifespan of mice by up to 35%. ]]

=== Senolytics ===
Senolytics are drugs that remove senescent cells. These are cells which accumulate in the body with age and are linked with age-related diseases such as cancer.<ref>Xu, M., Pirtskhalava, T., Farr, J. N., Weigand, B. M., Palmer, A. K., Weivoda, M. M., ... & Kirkland, J. L. (2018). Senolytics improve physical function and increase lifespan in old age. ''Nature medicine'', ''24''(8), 1246-1256.</ref>
[[File:Metformin2.jpg|thumb|258x258px|Metformin extends lifespan in mice by 6%, and may extend lifespan in humans.<ref name=":13">Kulkarni, A. S., Gubbi, S., & Barzilai, N. (2020). Benefits of metformin in attenuating the hallmarks of aging. ''Cell metabolism'', ''32''(1), 15-30.</ref>]]
In mice, senolytics have been shown to increase the healthy lifespan by up to 35%.<ref>Baker, D. J., Childs, B. G., Durik, M., Wijers, M. E., Sieben, C. J., Zhong, J., ... & Van Deursen, J. M. (2016). Naturally occurring p16 Ink4a-positive cells shorten healthy lifespan. ''Nature'', ''530''(7589), 184-189.</ref> The first clinical trials of senolytics in humans began in 2020, and demonstrated benefits to functional measures suggesting these drugs may be effective in humans.

=== [[Metformin]] ===
Metformin is an approved drug for type 2 diabetes that extends lifespan in multiple species. In mice, Metformin extends lifespan by up to 6%.<ref>Anisimov, V. N., Berstein, L. M., Popovich, I. G., Zabezhinski, M. A., Egormin, P. A., Piskunova, T. S., Semenchenko, A. V., Tyndyk, M. L., Yurova, M. N., Kovalenko, I. G., & Poroshina, T. E. (2011). If started early in life, metformin treatment increases life span and postpones tumors in female SHR mice. ''Aging'', ''3''(2), 148–157. <nowiki>https://doi.org/10.18632/aging.100273</nowiki></ref> Metformin works by improving insulin sensitivity and may target several hallmarks of aging.<ref name=":13" /> Metformin is being tested as a longevity therapy in the largest clinical trial for a longevity therapy, the Targeting Aging with Metformin (TAME) trial in the US.<ref name=":14">''TAME - Targeting Aging with Metformin - American Federation for Aging Research''. (n.d.). American Federation for Aging Research. <nowiki>https://www.afar.org/tame-trial</nowiki></ref> This is a randomized clinical trial of 3000 elderly patients comparing metformin against a placebo for the onset of age-related diseases.<ref name=":14" />

=== [[Rapamycin]] ===
[[File:Rapamune .jpg|alt=Rapamune |thumb|253x253px|Rapamycin, also known as Rapamune© is being tested as a drug to extend healthy lifespan in humans. <ref name=":15" />]]
Rapamycin, also known as Rapamune©, is a drug used to prevent the rejection of organ transplants by the immune system. Rapamycin has been shown to extend lifespan by up to 26% when given at middle age, and 14% when given in late life.<ref>Harrison, D., Strong, R., Sharp, Z. ''et al.'' Rapamycin fed late in life extends lifespan in genetically heterogeneous mice. ''Nature'' 460, 392–395 (2009). <nowiki>https://doi.org/10.1038/nature08221</nowiki>
</ref><ref>Miller, R. A., Harrison, D. E., Astle, C. M., Fernandez, E., Flurkey, K., Han, M., Javors, M. A., Li, X., Nadon, N. L., Nelson, J. F., Pletcher, S., Salmon, A. B., Sharp, Z. D., Van Roekel, S., Winkleman, L., & Strong, R. (2014). Rapamycin-mediated lifespan increase in mice is dose and sex dependent and metabolically distinct from dietary restriction. ''Aging cell'', ''13''(3), 468–477. <nowiki>https://doi.org/10.1111/acel.12194</nowiki></ref> Rapamycin is currently being tested in a large-scale clinical trial called the Participatory Evaluation (of) Aging (With) Rapamycin (for) Longevity Study (PEARL). The study is a randomized clinical trial of 1000 elderly patients comparing rapamycin against placebo for age-related outcomes.<ref name=":15">Clinicaltrials.gov. 2021. ''Participatory Evaluation (of) Aging (With) Rapamycin (for) Longevity Study - Full Text View - ClinicalTrials.gov''. [online] Available at: <<nowiki>https://clinicaltrials.gov/ct2/show/NCT04488601</nowiki>> [Accessed 14 December 2021].
</ref>

=== [[Epigenetic reprogramming]] ===
Epigenetic reprogramming is remodeling the epigenetic marks, such as methylation tags on the DNA, in cells. This technique was used in 2020 to restore vision to blind mice by fully regrowing the optic nerve.<ref>Lu, Y., Brommer, B., Tian, X. ''et al.'' Reprogramming to recover youthful epigenetic information and restore vision. ''Nature'' 588, 124–129 (2020). <nowiki>https://doi.org/10.1038/s41586-020-2975-4</nowiki></ref> The researchers at Harvard medical school and believe this approach could one day be used to regenerate other tissues of the body as a longevity strategy.<ref>''Reversing The Aging Clock With Epigenetic Reprogramming''. (n.d.). Pubs - Bio-IT World. <nowiki>https://www.bio-itworld.com/news/2021/01/13/reversing-the-aging-clock-with-epigenetic-reprogramming</nowiki></ref>

In addition, over [https://www.lifespan.io/road-maps/the-rejuvenation-roadmap 50 other drugs] are being tested in human clinical trials for slowing aging.<ref name=":2">Lifespan.io. 2021. ''The Rejuvenation Roadmap | Lifespan.io''. [online] Available at: <<nowiki>https://www.lifespan.io/road-maps/the-rejuvenation-roadmap/</nowiki>> [Accessed 13 December 2021].</ref>

== What is the goal of longevity biotechnology? ==
[[File:Healthy lifespan extension.png|alt=Healthy lifespan extension|thumb|643x643px|Healthy lifespan extension]]
Longevity biotechnology aims to create therapies to extend the healthy human lifespan. Aging is associated with functional decline, diseases and an increased risk of death.

Longevity biotechnology attempts to slow or reverse the aging process to extend the healthy lifespan (‘healthspan’) of the population.

The longevity biotechnology sector is rapidly growing, and there are currently over 170 private companies working on developing therapeutics to slow the aging process.<ref name=":4">Pfleger, K., 2021. ''Aging Companies''. [online] Agingbiotech.info. Available at: <<nowiki>https://agingbiotech.info/companies</nowiki>> [Accessed 13 December 2021].</ref> These companies are working on slowing or reversing the aging process by targeting one of more of the hallmarks of aging.

== Will healthy or unhealthy lifespan be extended? ==
[[File:Extending healthy lifespan.png|alt=Extending healthy lifespan|thumb|364x364px|Extending healthy lifespan]]
The stated goal of longevity biotechnology is to extend the healthy period of lifespan, before age-related diseases set in. This is in contrast to many of today's medical interventions, which extend life only after diseases (e.g. cancer, Alzheimer's) have reached a clinical level.

Age-related diseases are preceded by a long period of subclinical aging, i.e. aging that has not yet progressed far enough to produce clinical symptoms. By slowing, delaying or reversing the aging process, the healthy period of life can be extended.

Studies in mice have demonstrated that life extending drugs such as rapamycin are capable of extending the healthy, rather than unhealthy period of life.
== Should we treat specific diseases such as cancer, or aging? ==
[[File:Slowing aging versus curing cancer.jpg|alt=Slowing aging is potentially a more effective means of extending healthy lifespan than treating individual diseases due to the comorbid nature of age-related diseases. [6]|thumb|421x421px|Slowing aging is potentially a more effective means of extending healthy lifespan than treating individual diseases due to the comorbid nature of age-related diseases. ]]
Longevity biotechnology potentially offers a greater likelihood of extending healthy lifespan than attempting to find cures for the individual diseases of aging. This is because biological aging is associated with many of diseases of aging that develop as comorbidities i.e. at the same time. Even if a person survives one age-related disease such as cancer, another (e.g. diabetes, cardiovascular disease) is likely to kill the person if the underlying aging is not treated. This phenomenon is known as Taueber's paradox<ref>En.wikipedia.org. 2021. ''Taeuber Paradox - Wikipedia''. [online] Available at: <<nowiki>https://en.wikipedia.org/wiki/Taeuber_Paradox</nowiki>> [Accessed 14 December 2021].</ref>, and accounts for the much smaller projected increase in healthy lifespan associated with curing the diseases of aging, such as cancer (2-3 years), versus slowing aging itself (30+ years).<ref>Matt Kaeberlein, PhD, It is Time to Embrace 21st-Century Medicine, ''Public Policy & Aging Report'', Volume 29, Issue 4, 2019, Pages 111–115, <nowiki>https://doi.org/10.1093/ppar/prz022</nowiki></ref>
== What is biological aging? ==
There are two main types of 'age': chronological age - the number of years since birth, and biological age - a measure of the physical health of a person and their position in their lifespan. Biological age is more difficult to measure, but recent technologies are now available to estimate biological age. Over time, we age biologically. This occurs due to many processes in the body, which are generally categorised into 9 processes or 'hallmarks'.
== What are the 9 Hallmarks of Aging? ==
[[File:Hallmarks of aging.jpg|alt=Hallmarks of aging|thumb|444x444px|Hallmarks of aging]]

The hallmarks of aging framework is considered to broadly represent key biological mechanisms of the biological aging process.<ref name=":9">López-Otín C, Blasco MA, Partridge L, Serrano M, Kroemer G. The hallmarks of aging. Cell. 2013 Jun 6;153(6):1194-217.</ref> Although there are various limitations of the hallmarks framework, it has become the central framework for understanding aging biology. The nine forms of cellular and molecular ‘damage’ that comprise the hallmarks of aging are<ref name=":9" />:

* Genomic instability
* Telomere attrition
* Epigenetic alterations
* Loss of proteostasis
* Deregulated nutrient-sensing
* Mitochondrial dysfunction
* Cellular senescence
* Stem cell exhaustion
* Altered intercellular communication

These are essentially the lowest common denominators of the aging process, on a cellular or subcellular level. All of the other changes associated with aging, such as greying hair, wrinkles, frailty and an increased risk of disease is thought to stem from these underlyig processes.<ref name=":9" />

== How does the aging cause disease? ==
The nine hallmarks of aging have been shown to play an integral role in the development of many age-related diseases such as neurodegenerative diseases and cancer:
=== [[Aging and Neurodegeneration|Neurodegenerative disease]] ===
[[File:Prevalence of neuro disorders.jpg|alt=Prevalence of neuro disorders|thumb|469x469px|The prevalence of neurodegenerative disorders increases exponentially with age, due to the biological aging process.<ref name=":12">Hou, Y., Dan, X., Babbar, M., Wei, Y., Hasselbalch, S. G., Croteau, D. L., & Bohr, V. A. (2019). Ageing as a risk factor for neurodegenerative disease. ''Nature reviews. Neurology'', ''15''(10), 565–581. <nowiki>https://doi.org/10.1038/s41582-019-0244-7</nowiki></ref> ]]
All of the hallmarks of aging are associated with an increased risk of neurodegenerative diseases, such as Parkinson's disease and Alzheimer's disease.<ref>Qiu, C., Kivipelto, M., & von Strauss, E. (2009). Epidemiology of Alzheimer's disease: occurrence, determinants, and strategies toward intervention. ''Dialogues in clinical neuroscience'', ''11''(2), 111.</ref> For example, several types of DNA damage are associated with neurodegeneration. The shortening of telomeres occurs as part of biological aging and causes cellular senescence, and is associated with neurodegeneration and neurodegenerative diseases including Alzheimer's disease and Parkinson's disease.<ref name=":12" /> Additionally, mitochondrial dysfunction, altered metabolism, stem cell exhaustion and loss of proteostasis are also involved in the development of neurodegenerative diseases.<ref name=":12" />
=== [[Aging and Cancer|Cancer]] ===
Several of the hallmarks of aging such as cellular senescence and alterations in the extracellular matrix are responsible for increasing the likelihood of tumorigenesis.<ref name=":5">Fane, M., & Weeraratna, A. T. (2020). How the ageing microenvironment influences tumour progression. ''Nature Reviews Cancer'', ''20''(2), 89-106.</ref> Other hallmarks of aging such as genomic instability, loss or proteostasis, altered intercellular communication (i.e. inflammation) and epigenetic alterations are also involved in tumorigenesis.<ref name=":5" />
== How is biological age measured? ==
[[File:Epigenetic clock.png|alt=Epigenetic clock|thumb|605x605px|Epigenetic clock is the first aging clock. ]]
Recent technologies have allow biological age to be measured. These include:

=== [[Epigenetic clock|Epigenetic clocks]] ===
The first generation of aging clocks are known as [[Epigenetic clock|epigenetic clocks or Horvath’s clock]].<ref name=":6">Horvath, S., & Raj, K. (2018). DNA methylation-based biomarkers and the epigenetic clock theory of ageing. ''Nature Reviews Genetics'', ''19''(6), 371-384.</ref> This clock is based on the finding that over time, the body accumulates methylation tags on the DNA in a pattern that can be predicted with machine learning. These changes to the epigenome are influenced by lifestyle, and can be used to measure biological age.<ref name=":6" /> Factors such as exercise frequency and a low BMI have been shown to reduce the rate of biological aging, whereas obesity and smoking can accelerate the rate of aging.<ref>Quach, A., Levine, M. E., Tanaka, T., Lu, A. T., Chen, B. H., Ferrucci, L., ... & Horvath, S. (2017). Epigenetic clock analysis of diet, exercise, education, and lifestyle factors. ''Aging (Albany NY)'', ''9''(2), 419.</ref><ref>Wu, X., Huang, Q., Javed, R., Zhong, J., Gao, H., & Liang, H. (2019). Effect of tobacco smoking on the epigenetic age of human respiratory organs. ''Clinical Epigenetics'', ''11''(1), 183. <nowiki>https://doi.org/10.1186/s13148-019-0777-z</nowiki>

[[Epigenetic clock#cite%20ref-12|↑]]</ref><ref>Horvath, S., Erhart, W., Brosch, M., Ammerpohl, O., von Schönfels, W., Ahrens, M., Heits, N., Bell, J. T., Tsai, P.-C., Spector, T. D., Deloukas, P., Siebert, R., Sipos, B., Becker, T., Röcken, C., Schafmayer, C., & Hampe, J. (2014). Obesity accelerates epigenetic aging of human liver. ''Proceedings of the National Academy of Sciences'', ''111''(43), 15538–15543. <nowiki>https://doi.org/10.1073/pnas.1412759111</nowiki>

[[Epigenetic clock#cite%20ref-13|↑]]</ref> The Horvath's clock has been used to accurately predict mortality risk.<ref>Fransquet, P. D., Wrigglesworth, J., Woods, R. L., Ernst, M. E., & Ryan, J. (2019). The epigenetic clock as a predictor of disease and mortality risk: a systematic review and meta-analysis. ''Clinical epigenetics'', ''11''(1), 1-17.</ref>

=== Multi-omic clocks ===
Multi-omic clocks are being developed that incorporate data from several sources, such as body imaging scans, blood tests, and fitness tests. These clocks are built using machine learning to estimate biological age. These aging clocks are being developed that combine multiple biological functional tests to create a unique aging signature, which can be monitored over time.<ref>Kudryashova, K. S., Burka, K., Kulaga, A. Y., Vorobyeva, N. S., & Kennedy, B. K. (2020). Aging Biomarkers: From Functional Tests to Multi‐Omics Approaches. ''Proteomics'', ''20''(5-6), 1900408.</ref>
[[File:Multiomic aging clock.jpg|alt=Multiomic clocks|center|thumb|542x542px|Multiomic clocks integrate various data sources to create a unique biological aging signature that can be tracked over time. ]]
== Which companies are trying to solve aging? ==
[[File:Calico Labs.png|alt=T|thumb|Calico Labs, a subsidiary of Google, is a billion-dollar company searching for treatments for aging. ]]
There are over [https://agingbiotech.info/companies 170 longevity biotechnology companies] trying to create therapies to slow or reverse the aging process.<ref name=":4" /> There are over [https://www.lifespan.io/road-maps/the-rejuvenation-roadmap/ 50 longevity drugs] currently in clinical trials in humans.<ref name=":2" />

Many of the longevity biotechnology companies are targeting specific hallmarks of aging. For example, [https://www.clearabiotech.com/#DiscoveryTimeline Cleara Biotech] are attempting to reduce cellular senescence by developing a drug that can eliminate senescent cells.<ref>Cleara Biotech. 2021. ''Cleara Biotech''. [online] Available at: <<nowiki>https://www.clearabiotech.com/#DiscoveryTimeline</nowiki>> [Accessed 15 December 2021].</ref>

Calico Labs is a Google-backed biotech company with the goal of combating aging and age-related diseases. In 2014, the company created a partnership with pharmaceutical giant AbbVie, which has since developed into a [https://www.cnbc.com/2018/06/26/alphabet-backed-calico-and-abbvie-chip-in-1-billion-to-cure-aging.html $2.5 billion venture] in the pursuit of improving “health, wellbeing and longevity.” <ref>2021. ''Google sister company and drug giant chip in another $1 billion to cure age-related diseases''. [online] Available at: <<nowiki>https://www.cnbc.com/2018/06/26/alphabet-backed-calico-and-abbvie-chip-in-1-billion-to-cure-aging.html</nowiki>> [Accessed 15 December 2021].</ref>

Since aging is not currently considered a disease by regulatory bodies such as the Food and Drug Administration (FDA), drug developers are currently focused on specific diseases of aging such as glaucoma and osteoarthritis.<ref>Clinicaltrialsarena.com. 2021. ''Unity's Phase II osteoarthritis study of UBX0101 misses primary goal''. [online] Available at: <<nowiki>https://www.clinicaltrialsarena.com/news/unity-ubx0101-osteoarthritis/</nowiki>> [Accessed 15 December 2021].</ref>

== Which billionaires are funding longevity biotechnology? ==
[[File:Jeff Bezos is funding longevity research.jpg|alt=Jeff Bezos is funding longevity research|thumb|Jeff Bezos is funding longevity research through financing Atlos Labs.<ref name=":7">MIT Technology Review. 2021. ''Meet Altos Labs, Silicon Valley’s latest wild bet on living forever''. [online] Available at: <<nowiki>https://www.technologyreview.com/2021/09/04/1034364/altos-labs-silicon-valleys-jeff-bezos-milner-bet-living-forever/</nowiki>> [Accessed 15 December 2021].</ref>]]
Several billionaires have funded companies or initiatives to slow or reverse human aging. These include:
* [[wikipedia:Jeff_Bezos|Jeff Bezos]], co-founder of Amazon, helped raise [https://www.technologyreview.com/2021/09/04/1034364/altos-labs-silicon-valleys-jeff-bezos-milner-bet-living-forever/ $270 million for new anti-aging drug company Altos Labs] in 2021.<ref name=":7" />
* [[wikipedia:Peter_Thiel|Peter Thiel]], co-founder of PayPal, was an [https://www.cnbc.com/2018/08/29/-jeff-bezos-is-backing-this-scientist-who-is-working-on-a-cure-for-aging.html early investor in Unity Biotechnology].<ref>CNBC. 2021. ''Why Jeff Bezos is backing this Silicon Valley scientist who is working on a cure for aging''. [online] Available at: <<nowiki>https://www.cnbc.com/2018/08/29/-jeff-bezos-is-backing-this-scientist-who-is-working-on-a-cure-for-aging.html</nowiki>> [Accessed 15 December 2021].</ref>
* [[wikipedia:Sergey_Brin|Sergey Brin]], co-founder of Google, donated [https://www.cnbc.com/2017/03/31/google-co-founders-and-silicon-valley-billionaires-try-to-live-forever.html $25 million for the National Academy of Medicine’s Grand Challenge in Health Longevity] to 'end aging forever'.<ref>Google’s co-founders and other Silicon Valley billionaires are trying to live forever. (2021). Retrieved 15 December 2021, from <nowiki>https://www.cnbc.com/2017/03/31/google-co-founders-and-silicon-valley-billionaires-try-to-live-forever.html</nowiki></ref>
* [[wikipedia:Larry_Page|Larry Page]], co-founder of Google, co-founded the [[wikipedia:Calico_(company)|billion-dollar aging research company Calico Labs.]]<ref>Contributors to Wikimedia projects. (2013, September 19). ''Calico (company) - Wikipedia''. Wikipedia, the free encyclopedia. <nowiki>https://en.wikipedia.org/wiki/Calico_(company)</nowiki>
</ref>
* [[wikipedia:Mike_Cannon-Brookes|Mike Cannon-Brookes]], billionaire cofounder of Australian software giant Atlassian, has invested [https://www.forbes.com/sites/samshead/2019/08/19/billionaire-backs-uk-startup-trying-to-extend-human-lifespans/ $10 million into longevity company Juvenescenc]e.<ref>Shead, S. (2019, August 19). ''Billionaire Backs U.K. Startup Trying To Extend Human Life Spans''. Forbes. <nowiki>https://www.forbes.com/sites/samshead/2019/08/19/billionaire-backs-uk-startup-trying-to-extend-human-lifespans/</nowiki></ref>
* [[wikipedia:Naveen_Jain|Naveen Jain]], billionaire entrepeneur who has raised [https://www.geekwire.com/2021/gut-health-startup-viome-raises-54m-develop-cancer-diagnostics-sell-microbiome-kits/ $54 million for his startup Viome].<ref>''Gut health startup Viome raises $54M to develop cancer diagnostics and sell microbiome kits''. (2021, November 10). Geekwire. <nowiki>https://www.geekwire.com/2021/gut-health-startup-viome-raises-54m-develop-cancer-diagnostics-sell-microbiome-kits/</nowiki></ref>
* [[wikipedia:Jim_Mellon|Jim Mellon]], who co-founded longevity company [https://www.juvlabs.com/people/co-founder/jim-mellon Juvenescence].<ref>''Jim Mellon - Chairman & Co-Founder''. (n.d.). Juvenescence - Science of Healthy Aging & Extended Lifespan. <nowiki>https://www.juvlabs.com/people/co-founder/jim-mellon</nowiki></ref>
* [[wikipedia:Larry_Ellison|Larry Ellison]], founder of Oracle, has spent [https://www.townandcountrymag.com/society/money-and-power/a9202324/science-of-longevity/ $430 million on longevity research].<ref>Tullis, P. (2017, March 30). ''Are You Rich Enough To Live Forever?'' Town & Country. <nowiki>https://www.townandcountrymag.com/society/money-and-power/a9202324/science-of-longevity/</nowiki></ref>
*Michael Greve, founder of Kizoo Technology, who has pledged [https://Longevity.Technology. https://www.longevity.technology/michael-greve-commits-e300m-for-rejuvenation-start-ups/ €300m to rejuvenation biotechnology companies.]<ref>''Michael Greve commits €300m for rejuvenation start-ups''. (2021, May 6). Longevity.Technology. <nowiki>https://www.longevity.technology/michael-greve-commits-e300m-for-rejuvenation-start-ups/</nowiki></ref>
* [[wikipedia:Yuri_Milner|Yuri Milner]], billionaire tech investor who has helped Altos Labs raise $270 million, with Jeff Bezos.<ref name=":7" />
* [https://wikitia.com/wiki/Richard_Heart Richard Heart], founder of the cryptocurrency Hex, who helped raise [https://www.express.co.uk/finance/city/1465354/pulsechain-cryptocurrency-srf-sens-research-foundation-airdrop-pulse-charity-longevity $25 million for the anti-aging research organisation SENS.]<ref>McGleenon, B. (2021, July 20). ''Pulsechain cryptocurrency raises 'mindblowing' $25M in five days for SENS longevity group''. Express.co.uk. <nowiki>https://www.express.co.uk/finance/city/1465354/pulsechain-cryptocurrency-srf-sens-research-foundation-airdrop-pulse-charity-longevity</nowiki></ref>
*[[wikipedia:Brian_Armstrong_(businessman)|Brian Armstrong]], CEO of CoinBase, who helped found and raise [https://www.dailymail.co.uk/sciencetech/article-10310475/Billionaire-launches-new-start-hopes-REVERSE-ageing-process.html $105 million for the epigenetic reprogramming startup NewLimit.]<ref>Liberatore, S. (2021, December 14). ''Billionaire launches new start-up to REVERSE the ageing process''. Mail Online. <nowiki>https://www.dailymail.co.uk/sciencetech/article-10310475/Billionaire-launches-new-start-hopes-REVERSE-ageing-process.html</nowiki></ref>
* [[wikipedia:Vitalik_Buterin|Vitalik Buterin]], founder of the cryptocurrency Ethereum, who donated $2.4 million to SENS.<ref>Foundation, S. R. (n.d.). ''SENS Research Foundation Receives $2.4 Million Ethereum Donation From Vitalik Buterin''. GlobeNewswire News Room. <nowiki>https://www.globenewswire.com/news-release/2018/02/02/1332410/0/en/SENS-Research-Foundation-Receives-2-4-Million-Ethereum-Donation-From-Vitalik-Buterin.html</nowiki></ref>

== How large will the longevity biotechnology field be? ==
Analysts from the Bank of America have predicted that the market size of longevity biotechnology will reach $600 billion by 2025.<ref>2021. ''Human lifespan could soon pass 100 years thanks to medical tech, says BofA''. [online] Available at: <<nowiki>https://www.cnbc.com/2019/05/08/techs-next-big-disruption-could-be-delaying-death.html</nowiki>> [Accessed 14 December 2021].</ref> Others have speculated that it is a trillion dollar industry owing to the immense savings associated with delaying or preventing chronic diseases.<ref>Colangelo, M., 2021. ''AI Will Drive The Multi-Trillion Dollar Longevity Economy''. [online] Forbes. Available at: <<nowiki>https://www.forbes.com/sites/cognitiveworld/2019/12/07/ai-will-drive-the-multi-trillion-dollar-longevity-economy/?sh=294766b74965</nowiki>> [Accessed 14 December 2021].</ref>
== Is aging an important for risk factor for COVID-19 mortality? ==

Aging is the largest risk factor for COVID-19. [[File:Age is the -1 risk factor for COVID-19 mortality.jpg|alt=Age is the #1 risk factor for COVID-19 mortality - based on US CDC statistics|thumb|572x572px|* Fold risk of COVID-19 mortality versus reference group aged 5-17 [https://www.cdc.gov/coronavirus/2019-ncov/covid-data/investigations-discovery/hospitalization-death-by-age.html (US CDC statistics)]]]
====COVID-19 defined as a disease of aging====
As detailed in the paper "[https://onlinelibrary.wiley.com/doi/full/10.1111/acel.13230 COVID‐19 is an emergent disease of aging",]<ref name=":29">[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7576244/ Santesmasses, D., Castro, J. P., Zenin, A. A., Shindyapina, A. V., Gerashchenko, M. V., Zhang, B., ... & Gladyshev, V. N. (2020). COVID‐19 is an emergent disease of aging. ''Aging cell'', ''19''(10), e13230.]</ref> COVID-19 meets several criteria for definition as an age-related disease:<ref>[[Promislow, D. E. (2020). A geroscience perspective on COVID-19 mortality. The Journals of Gerontology: Series A, 75(9), e30-e33.|Promislow, D. E. (2020). A geroscience perspective on COVID-19 mortality. ''The Journals of Gerontology: Series A'', ''75''(9), e30-e33.]]</ref><ref>Alberts, S. C., Archie, E. A., Gesquiere, L. R., Altmann, J., Vaupel, J. W., & Christensen, K. (2014). The male-female health-survival paradox: a comparative perspective on sex differences in aging and mortality. In ''Sociality, hierarchy, health: comparative biodemography: a collection of papers''. National Academies Press (US).</ref><ref name=":10">[[Sierra, F. (2020). Geroscience and the Coronavirus Pandemic: The Whack‐a‐Mole Approach is not Enough. Journal of the American Geriatrics Society, 68(5), 951.|Sierra, F. (2020). Geroscience and the Coronavirus Pandemic: The Whack‐a‐Mole Approach is not Enough. ''Journal of the American Geriatrics Society'', ''68''(5), 951.]]</ref><ref name=":11">[[Barzilai, N., Appleby, J. C., Austad, S. N., Cuervo, A. M., Kaeberlein, M., Gonzalez-Billault, C., ... & Sierra, F. (2020). Geroscience in the Age of COVID-19. Aging and disease, 11(4), 725.|Barzilai, N., Appleby, J. C., Austad, S. N., Cuervo, A. M., Kaeberlein, M., Gonzalez-Billault, C., ... & Sierra, F. (2020). Geroscience in the Age of COVID-19. ''Aging and disease'', ''11''(4), 725.]]</ref><ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7288963/</ref>

1) The doubling time for COVID-19 mortality approaches that of the doubling time of 8 years for all-cause mortality (characteristic exponential increase shared among major age-related chronic diseases);

2) Greater mortality rate in men, consistent with known sex differences in rates of aging;

3) Greater mortality rate for those with comorbidities (age-related diseases), consistent with accelerated biological aging; and,

4) Age dwarfs all other putative [[wikipedia:Risk_factor|risk factors]] for mortality by several orders of magnitude, exhibiting several thousand fold increase in risk across the lifespan
== How is aging biology research different to other fields of medical research? ==
Scientists studying the biology of aging believe that aging is the root cause of all the major diseases that afflict us as we age. Therefore, targeting aging biology would treat or reverse multiple diseases, simultaneously, while maximizing the chance of a cure.

Mainstream medical research has had many successes in treating single diseases, such as infectious diseases. For age-related ones, notable successes have been seen for heart diseases. However, targeting single diseases, one at a time, leads to rapidly diminishing returns. Even if we could ''cure'' heart disease and cancer, which are leading causes of death, each would add only ~2.5 years to life expectancy. This is because the next disease in line, e.g. Alzheimer's or lung disease, will kill you. This is the Taeuber Paradox, which highlights how the exponentially increasing risk of disease accumulation with aging limits the benefit of targeting single diseases.
== Do all animals age in the same way? ==
[[File:Naked mole rat graph.png|alt=Naked mole rat graph|thumb|530x530px|The naked mole-rat does not follow the same increased risk of mortality due to aging that humans and other mammals do. ]]
Many species, due to differences in their biology, age at different rates to humans. The jellyfish ''Turritopsis dohrnii'' can revert to earlier stages of its life cycle in response to stress, and can theoretically live forever - though eventually dies, usually due to predation.

Among mammals, the naked mole rat is an exceptionally long lived organism that lives roughly ten times longer than similarly-sized rats.<ref name=":3">Ruby, J. G., Smith, M., & Buffenstein, R. (2018). Naked mole-rat mortality rates defy Gompertzian laws by not increasing with age. ''elife'', ''7'', e31157.</ref><ref>Buffenstein, R., Amoroso, V., Andziak, B., Avdieiev, S., Azpurua, J., Barker, A. J., ... & Smith, E. S. J. (2021). The naked truth: a comprehensive clarification and classification of current ‘myths’ in naked mole‐rat biology. ''Biological Reviews''.</ref> Unlike other organisms, such as humans, horses and mice, the mortality rate of the naked mole rat appears steady over time. This trend does not follow the exponential increase in mortality (Gompertz-Makeham law) that humans do.<ref name=":3" />

Scientists are now studying the naked mole rat to identify key patterns in their genetics, environmental traits, and metabolism that may be responsible for their longer lifespans.

[[File:Naked mole rat.jpg|alt=Naked mole rat|center|thumb|323x323px|The naked mole rat is unusually long-lived relative to other mice and rats. ]]

== Is aging considered a disease? ==
Aging is not currently classified as a disease by regulatory bodies such as the Food and Drug Administration (FDA) in the United States. However, several scientists in the aging field have publicly stated their wish for aging to be considered a disease, including professor David Sinclair and professor Nir Barzilai.

== What are the economic benefits of extending healthy lifespan? ==
Extending the healthy human lifespan could have significant economic benefits gobally. An economic analysis from 2021 by researchers at the University of Oxford and Harvard University estimated the benefit of a drug that slows aging by 1 year as $38 trillion. This is primarily because slowing aging reduces the incidence of age-related diseases such as cancer and Alzheimer’s disease, which require expensive treatment approaches. The study demonstrated a larger economic benefit of slowing aging than curing the individual diseases of aging.
== Which anti-aging drugs are being tested in clinical trials today? ==
There are over 50 drugs being tested in human clinical trials for aging or age-related diseases.

The largest trial is the Targeting Aging with Metformin (TAME) trial, which began in 2020. The trial is being run in the United States with a cohort of 3000 older adults. The goal of the TAME trial is to determine whether diabetes drug metformin slows the aging process in older adults. The TAME trial is a $75 million trial run by the American Federation for Aging Research.

Another large clinical trial is the Participitory Evluation of Rapamycin (PEARL) study. The goal of this study is to determine whether rapamycin, a drug currently approved for immunosuppression during organ transplants, slows biomarkers of aging in 1000 adults. The PEARL trial is being run by AgelessRx.
== Is aging a natural process that should be accepted? ==
Although aging is a natural process in humans, it is the driving force of many diseases such as cancer and Alzheimer's disease - which as a society we have decided are worth trying to find cures for. In the past, these conditions, as well as atherosclerosis and even infectious diseases were once thought of as natural processes that could not be treated. However, nowadays it is understood that they are diseases that can be treated.

Atherosclerosis, the hardening of the arteries, was once viewed as a natural process that was simply a consequence of aging. However, when treatments such as statins were later developed to prevent atherosclerosis, the disease became widely regarded as a disease to be cured. Statins are now one one of the most widely prescribed drugs in the world, used in preventing heart diseases. The inventor of statins, Akira Endo, describes in his historical paper: “Serious research on the role of cholesterol in human atherosclerosis did not really get underway until the 1940s, due to a prevailing view that the disease was a simple consequence of aging and could not be prevented.”<ref>Endo A. (2010). A historical perspective on the discovery of statins. ''Proceedings of the Japan Academy. Series B, Physical and biological sciences'', ''86''(5), 484–493. <nowiki>https://doi.org/10.2183/pjab.86.484</nowiki></ref>

== Will anti-aging technology lead to overpopulation? ==
A common objection to the development of longevity technologies is that they may lead to an unsustainably large population size.

One study of a 2005 Swedish cohort of 9 million people modeled the effect of various anti-aging scenarios. The researchers showed that even with the most radical life-extension technology in which aging completely stopped after age 60, the population growth across 100 years was only 22%.

Currently, the world’s population is 7.9 billion, and the WHO predicts the population will peak at 11 billion in 2100 before falling due to declining birth rates in many parts of the world.

The fastest growing populations are in Africa and South-east Asia. However, several factors are thought to reduce birth rates over time, including increased access to contraceptives, female empowerment, increased education and increased employment. There is evidence that populations that move to a more advanced economy show a reduction in birth rates.

== Will anti-aging drugs only be available to the rich? ==
It is unclear who will have first access to longevity drugs. Several researchers in the field have argued that several economic factors are likely to drive down the price of drugs that slow aging.

* The cost of many biotechnologies decreases substantially over time. For example, the first human genome cost $100 million to sequence, and is now available for a few hundred dollars.

* The price of many lifesaving pharmaceuticals has fallen significantly in price once generic drugs were produced. For example, Lipitor, a statin used to prevent heart disease has fallen in price from $85 in 2011 to less than $5 today.

* Many companies in the longevity field have stated that equity of access is part of their core ethos, and many researchers are signatories to the

== Which scientists and institutions are trying to understand and reverse aging? ==
Over [https://whoswho.senescence.info/ 300 scientists are working on understanding the biology of aging] in leading institutions that include Harvard University, Stanford University, Yale University, and the University of Oxford.<ref>''Who's Who in Gerontology: Researchers and Companies Working on Aging''. (n.d.). Who's Who in Gerontology: Researchers and Companies Working on Aging. <nowiki>https://whoswho.senescence.info/</nowiki></ref> Some of the most well-known institutes and labs include:

=== The Buck Institute for Research on Aging ===
The Buck Institute for Research on Aging is one of the largest longevity research institutes with over 250 scientists. The research covers several areas including the mechanisms of aging, neurodegeneration, senescence, stem cells and regenerative medicine, cellular stress and disease, cancer associated with aging, and mitochondrial function.<ref>''Buck Institute''. (n.d.). BUCK. <nowiki>https://www.buckinstitute.org/</nowiki></ref>

=== Professor David Sinclair - Harvard Medical School ===
Professor Sinclair’s lab focuses on understanding and reversing aging. The lab focuses on a range of areas including DNA repair, mitochondrial dysfunction, and the interactions between epigenetic and genetic instability, and tissue reprogramming.<ref>''Welcome | The Sinclair Lab''. (n.d.). Welcome | The Sinclair Lab. <nowiki>https://sinclair.hms.harvard.edu/</nowiki></ref>

=== Professor Matt Kaeberlein - University of Washington ===
Professor Kaeberlein's lab focuses on biological mechanisms of aging in order to facilitate translational interventions that promote healthspan and improve quality of life. Kaeberlein is known for his work on the longevity drug rapamycin in organisms such as mice and dogs. He is Director of the Dog Aging Project, a multi-year initiative studying the genetic and environmental factors that influence health, with over 33,000 participating dogs.<ref>''Matt Kaeberlein, PhD | Faculty | Dept. of Laboratory Medicine & Pathology | UW Medicine''. (n.d.). Dept. of Laboratory Medicine & Pathology | UW Medicine. <nowiki>https://dlmp.uw.edu/faculty/kaeberlein</nowiki></ref>

=== Professor Brian Kennedy - National University of Singapore ===
Professor Kennedy’s lab focuses on understanding the biology of aging and translating research discoveries into new ways of delaying aging in humans. The lab has identified drugs that extend the healthy lifespan of worms and mice and are seeking to understand their mechanisms.<ref>''Brian Kennedy - Department of Biochemistry – School of Medicine, National University of Singapore''. (n.d.). Department of Biochemistry – School of Medicine, National University of Singapore. <nowiki>https://medicine.nus.edu.sg/bch/fa</nowiki></ref>

=== Associate Professor Lynne Cox - University of Oxford ===
Professor Cox’s lab study the molecular and cellular basis of aging to identify specific biochemical processes and pathways that change organisms age. The lab particularly cellular senescence, which underpins many age-related diseases including cancer and neurodegeneration.<ref>''Associate Prof Lynne Cox''. (n.d.). Home | Biochemistry. <nowiki>https://www.bioch.ox.ac.uk/research/cox</nowiki></ref>

== What books have been written on this topic? ==
Several books have been written on the topic of aging and longevity. These include:

* [https://www.amazon.com/Lifespan-Why-Age_and-Dont-Have/dp/1501191977 ''Lifespan: Why We Age And Why We Don't Have To'' - David Sinclair (2019)]

* [https://www.amazon.com/Ending-Aging-Rejuvenation-Breakthroughs-Lifetime/dp/0312367074 ''Ending Aging'' - Dr. Aubrey de Grey (2007)]

* [https://www.amazon.com/Ageless-Science-Getting-Older-Without/dp/0385544928 ''Ageless'' - Dr. Andrew Steele (2020)]

* [https://www.amazon.com.au/Age-Later-Health-Science-Longevity-ebook/dp/B0818MYCRR ''Age Later'' - Professor Nir Barzilai (2021)]

* [https://www.amazon.com.au/Science-Technology-Growing-Young-Breakthroughs/dp/1950665879 ''The Science and Technology of Growing Young'' - Sergey Young (2021)]

== References ==
<references />

Longevity Wiki

2021-12-15T08:23:40Z

Jack: /* Get a taste of our content... */

{{DISPLAYTITLE:Longevity Wiki}}

What is aging? Can we cure age-related diseases? Is it possible to eliminate the suffering we all experience as we grow older? Can we live longer, without declining health? On this Wiki you’ll find the '''latest scientific findings on longevity'''. Our aim is to be an accessible, objective and unbiased source of information for this exciting new field.

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=== Get a taste of our content... ===
Read our [[FAQ|Longevity FAQ which covers the 20+ most common questions about longevity biotechnology.]] You can also read this article about [[Rapamycin]]'','' a potential longevity drug. Or, check out our complete [[Articles|list of articles]].
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If you wish to contribute to the content, or in another way, you're more than welcome to learn how you can [[How_to_contribute|contribute by clicking here]]. You can also [https://gitcoin.co/grants/3936/longevity-wiki financially support] the Wiki through the open-source platform Gitcoin by clicking [https://gitcoin.co/grants/3936/longevity-wiki here]. '''The Grants Round 12 until December 16th, 2021.'''

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Longevity Wiki

2021-12-15T08:23:07Z

Jack: /* Get a taste of our content... */

{{DISPLAYTITLE:Longevity Wiki}}

What is aging? Can we cure age-related diseases? Is it possible to eliminate the suffering we all experience as we grow older? Can we live longer, without declining health? On this Wiki you’ll find the '''latest scientific findings on longevity'''. Our aim is to be an accessible, objective and unbiased source of information for this exciting new field.

<div class="container my-5">
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<div>'''Science based'''</div>
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=== Get a taste of our content... ===
Read our [[FAQ|Longevity FAQ which covers the 20+ most common questions about longevity biotechnology.]]

Read this article about [[Rapamycin]]'','' a potential longevity drug

Or, check out our complete [[Articles|list of articles]].
=== Want to help out? ===
If you wish to contribute to the content, or in another way, you're more than welcome to learn how you can [[How_to_contribute|contribute by clicking here]].

You can also [https://gitcoin.co/grants/3936/longevity-wiki financially support] the Wiki through the open-source platform Gitcoin by clicking [https://gitcoin.co/grants/3936/longevity-wiki here]. '''The Grants Round 12 until December 16th, 2021.'''

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FAQ

2021-12-15T08:16:58Z

Jack: /* Rapamycin */

Aging is the driving force of many diseases. Longevity biotechnology is a new field of medical research and development that aims to extend healthy human lifespan and delay, prevent or reverse these diseases. This article provides an overview of the field, answering common questions.

== Why is aging a problem? ==
[[File:Aging graph.png|thumb|750x750px|The aging process results in the risk of age-related diseases increasing exponentially over time.]][[File:Gompertz-Makeham law of mortality.png|alt=Gompertz-Makeham law of mortality|thumb|257x257px|Gompertz-Makeham law of mortality<ref name=":0">En.wikipedia.org. 2021. ''Gompertz–Makeham law of mortality - Wikipedia''. [online] Available at: <<nowiki>https://en.wikipedia.org/wiki/Gompertz%E2%80%93Makeham_law_of_mortality</nowiki>> [Accessed 13 December 2021].</ref>]]Aging is the largest risk factor for the diseases that kill most people worldwide, including cancer, heart diseases and Alzheimer's disease.

In the US in 2020, 9 of the 10 leading causes of death were strongly age-related.<ref>Ahmad, F. B., & Anderson, R. N. (2021). The leading causes of death in the US for 2020. ''JAMA'', ''325''(18), 1829-1830.https://jamanetwork.com/journals/jama/fullarticle/2778234</ref> Globally, approximately 70% of deaths annually are the result of aging.<ref name=":8" />

Aging also significantly affects quality of life, as deaths due to aging are usually preceded by many months of years of chronic illnesses such as cancer, type 2 diabetes and Alzheimer’s disease.

As a result of the aging process, the risk of an individual dying increases exponentially after the age of around 30 years old.<ref name=":0" /> This increase in mortality rate is known as the Gompertz-Makeham law of mortality.<ref name=":0" />
== How many people die from aging per day? ==
The aging process results in the deaths of 100,000 people per day; more than twice the sum of all other causes of death combined.<ref name=":8">Ritchie, H. and Roser, M., 2021. ''Causes of Death''. [online] Our World in Data. Available at: <<nowiki>https://ourworldindata.org/causes-of-death</nowiki>> [Accessed 13 December 2021].
</ref> This equates to over 37 million people dying per day of aging - a population the size of Canada. This is because aging results in the exponential increasing risk of age-related diseases such as cancer and type 2 diabetes. Aging also accounts for more than 30% of all disability-adjusted life years lost (DALYs); more than any other single cause.<ref>Vizhub.healthdata.org. 2021. ''GBD Compare | IHME Viz Hub''. [online] Available at: <<nowiki>https://vizhub.healthdata.org/gbd-compare/</nowiki>> [Accessed 13 December 2021].</ref>
[[File:Leading causes of death.png|center|thumb|713x713px|9 of the top 10 causes of death in the US in 2020 were strongly age-related]]

== Can healthy lifespan be extended? ==
[[File:Life extension mice.jpg|alt=Life extension mice|thumb|431x431px|Dietary manipulation, genetic manipulation, and drugs have been shown to increase the healthy lifespan of mice by up to 30%. <ref name=":1">de Magalhaes, J., 2021. ''DrugAge: Species Detail''. [online] Genomics.senescence.info. Available at: <<nowiki>https://genomics.senescence.info/drugs/species_details.php</nowiki>> [Accessed 14 December 2021].</ref>]]Clinical trials for longevity drugs in humans are in-progress, and there is not yet evidence that drugs can slow aging in humans. However, recent experimental breakthroughs over the last few decades have shown that in mice, worms and flies have demonstrated that healthy lifespan can be extended modified. Many clinical trials in humans today are testing whether these results can be replicated in humans.

In animal models, slowing the aging process in animals can be achieved via manipulation of diet, environment, genetics, epigenetics, or with drugs. In mice, over 100 drugs have been shown to extend healthy lifespan by up to 30%.<ref name=":1" />

The effect of longevity drugs on mice is often significant, delaying or eliminating the burden of age-related problems such as frailty, cataracts, cancer, and sarcopenia. For example, a new class of drugs called senolytics have been shown to extend lifespan in mice by over 30% whilst delaying age-related dysfunction.

== Which therapies may extend healthy lifespan? ==
Several drugs are known to extend healthy lifespan in animals. While there is no conclusive data that suggests these drugs would work the same in humans, many of these drugs are now being tested in clinical trials. [[File:Unity Mice.jpg|alt=Unity Mice|thumb|723x723px|Senolytic drugs eliminate senescent cells that accumulate with age, partially reversing multiple age-related diseases and extending the healthy lifespan of mice by up to 35%. ]]

=== Senolytics ===
Senolytics are drugs that remove senescent cells. These are cells which accumulate in the body with age and are linked with age-related diseases such as cancer.<ref>Xu, M., Pirtskhalava, T., Farr, J. N., Weigand, B. M., Palmer, A. K., Weivoda, M. M., ... & Kirkland, J. L. (2018). Senolytics improve physical function and increase lifespan in old age. ''Nature medicine'', ''24''(8), 1246-1256.</ref>
[[File:Metformin2.jpg|thumb|258x258px|Metformin extends lifespan in mice by 6%, and may extend lifespan in humans.<ref name=":13">Kulkarni, A. S., Gubbi, S., & Barzilai, N. (2020). Benefits of metformin in attenuating the hallmarks of aging. ''Cell metabolism'', ''32''(1), 15-30.</ref>]]
In mice, senolytics have been shown to increase the healthy lifespan by up to 35%.<ref>Baker, D. J., Childs, B. G., Durik, M., Wijers, M. E., Sieben, C. J., Zhong, J., ... & Van Deursen, J. M. (2016). Naturally occurring p16 Ink4a-positive cells shorten healthy lifespan. ''Nature'', ''530''(7589), 184-189.</ref> The first clinical trials of senolytics in humans began in 2020, and demonstrated benefits to functional measures suggesting these drugs may be effective in humans.

=== [[Metformin]] ===
Metformin is an approved drug for type 2 diabetes that extends lifespan in multiple species. In mice, Metformin extends lifespan by up to 6%.<ref>Anisimov, V. N., Berstein, L. M., Popovich, I. G., Zabezhinski, M. A., Egormin, P. A., Piskunova, T. S., Semenchenko, A. V., Tyndyk, M. L., Yurova, M. N., Kovalenko, I. G., & Poroshina, T. E. (2011). If started early in life, metformin treatment increases life span and postpones tumors in female SHR mice. ''Aging'', ''3''(2), 148–157. <nowiki>https://doi.org/10.18632/aging.100273</nowiki></ref> Metformin works by improving insulin sensitivity and may target several hallmarks of aging.<ref name=":13" /> Metformin is being tested as a longevity therapy in the largest clinical trial for a longevity therapy, the Targeting Aging with Metformin (TAME) trial in the US.<ref name=":14">''TAME - Targeting Aging with Metformin - American Federation for Aging Research''. (n.d.). American Federation for Aging Research. <nowiki>https://www.afar.org/tame-trial</nowiki></ref> This is a randomized clinical trial of 3000 elderly patients comparing metformin against a placebo for the onset of age-related diseases.<ref name=":14" />

=== [[Rapamycin]] ===
[[File:Rapamune .jpg|alt=Rapamune |thumb|253x253px|Rapamycin, also known as Rapamune© is being tested as a drug to extend healthy lifespan in humans. <ref name=":15" />]]
Rapamycin, also known as Rapamune©, is a drug used to prevent the rejection of organ transplants by the immune system. Rapamycin has been shown to extend lifespan by up to 26% when given at middle age, and 14% when given in late life.<ref>Harrison, D., Strong, R., Sharp, Z. ''et al.'' Rapamycin fed late in life extends lifespan in genetically heterogeneous mice. ''Nature'' 460, 392–395 (2009). <nowiki>https://doi.org/10.1038/nature08221</nowiki>
</ref><ref>Miller, R. A., Harrison, D. E., Astle, C. M., Fernandez, E., Flurkey, K., Han, M., Javors, M. A., Li, X., Nadon, N. L., Nelson, J. F., Pletcher, S., Salmon, A. B., Sharp, Z. D., Van Roekel, S., Winkleman, L., & Strong, R. (2014). Rapamycin-mediated lifespan increase in mice is dose and sex dependent and metabolically distinct from dietary restriction. ''Aging cell'', ''13''(3), 468–477. <nowiki>https://doi.org/10.1111/acel.12194</nowiki></ref> Rapamycin is currently being tested in a large-scale clinical trial called the Participatory Evaluation (of) Aging (With) Rapamycin (for) Longevity Study (PEARL). The study is a randomized clinical trial of 1000 elderly patients comparing rapamycin against placebo for age-related outcomes.<ref name=":15">Clinicaltrials.gov. 2021. ''Participatory Evaluation (of) Aging (With) Rapamycin (for) Longevity Study - Full Text View - ClinicalTrials.gov''. [online] Available at: <<nowiki>https://clinicaltrials.gov/ct2/show/NCT04488601</nowiki>> [Accessed 14 December 2021].
</ref>

=== [[Epigenetic reprogramming]] ===
Epigenetic reprogramming is remodeling the epigenetic marks, such as methylation tags on the DNA, in cells. This technique was used in 2020 to restore vision to blind mice by fully regrowing the optic nerve.<ref>Lu, Y., Brommer, B., Tian, X. ''et al.'' Reprogramming to recover youthful epigenetic information and restore vision. ''Nature'' 588, 124–129 (2020). <nowiki>https://doi.org/10.1038/s41586-020-2975-4</nowiki></ref> The researchers at Harvard medical school and believe this approach could one day be used to regenerate other tissues of the body as a longevity strategy.<ref>''Reversing The Aging Clock With Epigenetic Reprogramming''. (n.d.). Pubs - Bio-IT World. <nowiki>https://www.bio-itworld.com/news/2021/01/13/reversing-the-aging-clock-with-epigenetic-reprogramming</nowiki></ref>

In addition, over [https://www.lifespan.io/road-maps/the-rejuvenation-roadmap 50 other drugs] are being tested in human clinical trials for slowing aging.<ref name=":2">Lifespan.io. 2021. ''The Rejuvenation Roadmap | Lifespan.io''. [online] Available at: <<nowiki>https://www.lifespan.io/road-maps/the-rejuvenation-roadmap/</nowiki>> [Accessed 13 December 2021].</ref>

== What is the goal of longevity biotechnology? ==
[[File:Healthy lifespan extension.png|alt=Healthy lifespan extension|thumb|643x643px|Healthy lifespan extension]]
Longevity biotechnology aims to create therapies to extend the healthy human lifespan. Aging is associated with functional decline, diseases and an increased risk of death.

Longevity biotechnology attempts to slow or reverse the aging process to extend the healthy lifespan (‘healthspan’) of the population.

The longevity biotechnology sector is rapidly growing, and there are currently over 170 private companies working on developing therapeutics to slow the aging process.<ref name=":4">Pfleger, K., 2021. ''Aging Companies''. [online] Agingbiotech.info. Available at: <<nowiki>https://agingbiotech.info/companies</nowiki>> [Accessed 13 December 2021].</ref> These companies are working on slowing or reversing the aging process by targeting one of more of the hallmarks of aging.

== Will healthy or unhealthy lifespan be extended? ==
[[File:Extending healthy lifespan.png|alt=Extending healthy lifespan|thumb|364x364px|Extending healthy lifespan]]
The stated goal of longevity biotechnology is to extend the healthy period of lifespan, before age-related diseases set in. This is in contrast to many of today's medical interventions, which extend life only after diseases (e.g. cancer, Alzheimer's) have reached a clinical level.

Age-related diseases are preceded by a long period of subclinical aging, i.e. aging that has not yet progressed far enough to produce clinical symptoms. By slowing, delaying or reversing the aging process, the healthy period of life can be extended.

Studies in mice have demonstrated that life extending drugs such as rapamycin are capable of extending the healthy, rather than unhealthy period of life.
== Should we treat specific diseases such as cancer, or aging? ==
[[File:Slowing aging versus curing cancer.jpg|alt=Slowing aging is potentially a more effective means of extending healthy lifespan than treating individual diseases due to the comorbid nature of age-related diseases. [6]|thumb|421x421px|Slowing aging is potentially a more effective means of extending healthy lifespan than treating individual diseases due to the comorbid nature of age-related diseases. ]]
Longevity biotechnology potentially offers a greater likelihood of extending healthy lifespan than attempting to find cures for the individual diseases of aging. This is because biological aging is associated with many of diseases of aging that develop as comorbidities i.e. at the same time. Even if a person survives one age-related disease such as cancer, another (e.g. diabetes, cardiovascular disease) is likely to kill the person if the underlying aging is not treated. This phenomenon is known as Taueber's paradox<ref>En.wikipedia.org. 2021. ''Taeuber Paradox - Wikipedia''. [online] Available at: <<nowiki>https://en.wikipedia.org/wiki/Taeuber_Paradox</nowiki>> [Accessed 14 December 2021].</ref>, and accounts for the much smaller projected increase in healthy lifespan associated with curing the diseases of aging, such as cancer (2-3 years), versus slowing aging itself (30+ years).<ref>Matt Kaeberlein, PhD, It is Time to Embrace 21st-Century Medicine, ''Public Policy & Aging Report'', Volume 29, Issue 4, 2019, Pages 111–115, <nowiki>https://doi.org/10.1093/ppar/prz022</nowiki></ref>
== What is biological aging? ==
There are two main types of 'age': chronological age - the number of years since birth, and biological age - a measure of the physical health of a person and their position in their lifespan. Biological age is more difficult to measure, but recent technologies are now available to estimate biological age. Over time, we age biologically. This occurs due to many processes in the body, which are generally categorised into 9 processes or 'hallmarks'.
== What are the 9 Hallmarks of Aging? ==
[[File:Hallmarks of aging.jpg|alt=Hallmarks of aging|thumb|444x444px|Hallmarks of aging]]

The hallmarks of aging framework is considered to broadly represent key biological mechanisms of the biological aging process.<ref name=":9">López-Otín C, Blasco MA, Partridge L, Serrano M, Kroemer G. The hallmarks of aging. Cell. 2013 Jun 6;153(6):1194-217.</ref> Although there are various limitations of the hallmarks framework, it has become the central framework for understanding aging biology. The nine forms of cellular and molecular ‘damage’ that comprise the hallmarks of aging are<ref name=":9" />:

* Genomic instability
* Telomere attrition
* Epigenetic alterations
* Loss of proteostasis
* Deregulated nutrient-sensing
* Mitochondrial dysfunction
* Cellular senescence
* Stem cell exhaustion
* Altered intercellular communication

These are essentially the lowest common denominators of the aging process, on a cellular or subcellular level. All of the other changes associated with aging, such as greying hair, wrinkles, frailty and an increased risk of disease is thought to stem from these underlyig processes.<ref name=":9" />

== How does the aging cause disease? ==
The nine hallmarks of aging have been shown to play an integral role in the development of many age-related diseases such as neurodegenerative diseases and cancer:
=== [[Aging and Neurodegeneration|Neurodegenerative disease]] ===
[[File:Prevalence of neuro disorders.jpg|alt=Prevalence of neuro disorders|thumb|469x469px|The prevalence of neurodegenerative disorders increases exponentially with age, due to the biological aging process.<ref name=":12">Hou, Y., Dan, X., Babbar, M., Wei, Y., Hasselbalch, S. G., Croteau, D. L., & Bohr, V. A. (2019). Ageing as a risk factor for neurodegenerative disease. ''Nature reviews. Neurology'', ''15''(10), 565–581. <nowiki>https://doi.org/10.1038/s41582-019-0244-7</nowiki></ref> ]]
All of the hallmarks of aging are associated with an increased risk of neurodegenerative diseases, such as Parkinson's disease and Alzheimer's disease.<ref>Qiu, C., Kivipelto, M., & von Strauss, E. (2009). Epidemiology of Alzheimer's disease: occurrence, determinants, and strategies toward intervention. ''Dialogues in clinical neuroscience'', ''11''(2), 111.</ref> For example, several types of DNA damage are associated with neurodegeneration. The shortening of telomeres occurs as part of biological aging and causes cellular senescence, and is associated with neurodegeneration and neurodegenerative diseases including Alzheimer's disease and Parkinson's disease.<ref name=":12" /> Additionally, mitochondrial dysfunction, altered metabolism, stem cell exhaustion and loss of proteostasis are also involved in the development of neurodegenerative diseases.<ref name=":12" />
=== [[Aging and Cancer|Cancer]] ===
Several of the hallmarks of aging such as cellular senescence and alterations in the extracellular matrix are responsible for increasing the likelihood of tumorigenesis.<ref name=":5">Fane, M., & Weeraratna, A. T. (2020). How the ageing microenvironment influences tumour progression. ''Nature Reviews Cancer'', ''20''(2), 89-106.</ref> Other hallmarks of aging such as genomic instability, loss or proteostasis, altered intercellular communication (i.e. inflammation) and epigenetic alterations are also involved in tumorigenesis.<ref name=":5" />
== How is biological age measured? ==
[[File:Epigenetic clock.png|alt=Epigenetic clock|thumb|605x605px|Epigenetic clock is the first aging clock. ]]
Recent technologies have allow biological age to be measured. These include:

=== [[Epigenetic clock|Epigenetic clocks]] ===
The first generation of aging clocks are known as [[Epigenetic clock|epigenetic clocks or Horvath’s clock]].<ref name=":6">Horvath, S., & Raj, K. (2018). DNA methylation-based biomarkers and the epigenetic clock theory of ageing. ''Nature Reviews Genetics'', ''19''(6), 371-384.</ref> This clock is based on the finding that over time, the body accumulates methylation tags on the DNA in a pattern that can be predicted with machine learning. These changes to the epigenome are influenced by lifestyle, and can be used to measure biological age.<ref name=":6" /> Factors such as exercise frequency and a low BMI have been shown to reduce the rate of biological aging, whereas obesity and smoking can accelerate the rate of aging.<ref>Quach, A., Levine, M. E., Tanaka, T., Lu, A. T., Chen, B. H., Ferrucci, L., ... & Horvath, S. (2017). Epigenetic clock analysis of diet, exercise, education, and lifestyle factors. ''Aging (Albany NY)'', ''9''(2), 419.</ref><ref>Wu, X., Huang, Q., Javed, R., Zhong, J., Gao, H., & Liang, H. (2019). Effect of tobacco smoking on the epigenetic age of human respiratory organs. ''Clinical Epigenetics'', ''11''(1), 183. <nowiki>https://doi.org/10.1186/s13148-019-0777-z</nowiki>

[[Epigenetic clock#cite%20ref-12|↑]]</ref><ref>Horvath, S., Erhart, W., Brosch, M., Ammerpohl, O., von Schönfels, W., Ahrens, M., Heits, N., Bell, J. T., Tsai, P.-C., Spector, T. D., Deloukas, P., Siebert, R., Sipos, B., Becker, T., Röcken, C., Schafmayer, C., & Hampe, J. (2014). Obesity accelerates epigenetic aging of human liver. ''Proceedings of the National Academy of Sciences'', ''111''(43), 15538–15543. <nowiki>https://doi.org/10.1073/pnas.1412759111</nowiki>

[[Epigenetic clock#cite%20ref-13|↑]]</ref> The Horvath's clock has been used to accurately predict mortality risk.<ref>Fransquet, P. D., Wrigglesworth, J., Woods, R. L., Ernst, M. E., & Ryan, J. (2019). The epigenetic clock as a predictor of disease and mortality risk: a systematic review and meta-analysis. ''Clinical epigenetics'', ''11''(1), 1-17.</ref>

=== Multi-omic clocks ===
Multi-omic clocks are being developed that incorporate data from several sources, such as body imaging scans, blood tests, and fitness tests. These clocks are built using machine learning to estimate biological age. These aging clocks are being developed that combine multiple biological functional tests to create a unique aging signature, which can be monitored over time.<ref>Kudryashova, K. S., Burka, K., Kulaga, A. Y., Vorobyeva, N. S., & Kennedy, B. K. (2020). Aging Biomarkers: From Functional Tests to Multi‐Omics Approaches. ''Proteomics'', ''20''(5-6), 1900408.</ref>
[[File:Multiomic aging clock.jpg|alt=Multiomic clocks|center|thumb|542x542px|Multiomic clocks integrate various data sources to create a unique biological aging signature that can be tracked over time. ]]
== Which companies are trying to solve aging? ==
[[File:Calico Labs.png|alt=T|thumb|Calico Labs, a subsidiary of Google, is a billion-dollar company searching for treatments for aging. ]]
There are over [https://agingbiotech.info/companies 170 longevity biotechnology companies] trying to create therapies to slow or reverse the aging process.<ref name=":4" /> There are over [https://www.lifespan.io/road-maps/the-rejuvenation-roadmap/ 50 longevity drugs] currently in clinical trials in humans.<ref name=":2" />

Many of the longevity biotechnology companies are targeting specific hallmarks of aging. For example, [https://www.clearabiotech.com/#DiscoveryTimeline Cleara Biotech] are attempting to reduce cellular senescence by developing a drug that can eliminate senescent cells.<ref>Cleara Biotech. 2021. ''Cleara Biotech''. [online] Available at: <<nowiki>https://www.clearabiotech.com/#DiscoveryTimeline</nowiki>> [Accessed 15 December 2021].</ref>

Calico Labs is a Google-backed biotech company with the goal of combating aging and age-related diseases. In 2014, the company created a partnership with pharmaceutical giant AbbVie, which has since developed into a [https://www.cnbc.com/2018/06/26/alphabet-backed-calico-and-abbvie-chip-in-1-billion-to-cure-aging.html $2.5 billion venture] in the pursuit of improving “health, wellbeing and longevity.” <ref>2021. ''Google sister company and drug giant chip in another $1 billion to cure age-related diseases''. [online] Available at: <<nowiki>https://www.cnbc.com/2018/06/26/alphabet-backed-calico-and-abbvie-chip-in-1-billion-to-cure-aging.html</nowiki>> [Accessed 15 December 2021].</ref>

Since aging is not currently considered a disease by regulatory bodies such as the Food and Drug Administration (FDA), drug developers are currently focused on specific diseases of aging such as glaucoma and osteoarthritis.<ref>Clinicaltrialsarena.com. 2021. ''Unity's Phase II osteoarthritis study of UBX0101 misses primary goal''. [online] Available at: <<nowiki>https://www.clinicaltrialsarena.com/news/unity-ubx0101-osteoarthritis/</nowiki>> [Accessed 15 December 2021].</ref>

== Which billionaires are funding longevity biotechnology? ==
[[File:Jeff Bezos is funding longevity research.jpg|alt=Jeff Bezos is funding longevity research|thumb|Jeff Bezos is funding longevity research through financing Atlos Labs.<ref name=":7">MIT Technology Review. 2021. ''Meet Altos Labs, Silicon Valley’s latest wild bet on living forever''. [online] Available at: <<nowiki>https://www.technologyreview.com/2021/09/04/1034364/altos-labs-silicon-valleys-jeff-bezos-milner-bet-living-forever/</nowiki>> [Accessed 15 December 2021].</ref>]]
Several billionaires have funded companies or initiatives to slow or reverse human aging. These include:
* [[wikipedia:Jeff_Bezos|Jeff Bezos]], co-founder of Amazon, helped raise [https://www.technologyreview.com/2021/09/04/1034364/altos-labs-silicon-valleys-jeff-bezos-milner-bet-living-forever/ $270 million for new anti-aging drug company Altos Labs] in 2021.<ref name=":7" />
* [[wikipedia:Peter_Thiel|Peter Thiel]], co-founder of PayPal, was an [https://www.cnbc.com/2018/08/29/-jeff-bezos-is-backing-this-scientist-who-is-working-on-a-cure-for-aging.html early investor in Unity Biotechnology].<ref>CNBC. 2021. ''Why Jeff Bezos is backing this Silicon Valley scientist who is working on a cure for aging''. [online] Available at: <<nowiki>https://www.cnbc.com/2018/08/29/-jeff-bezos-is-backing-this-scientist-who-is-working-on-a-cure-for-aging.html</nowiki>> [Accessed 15 December 2021].</ref>
* [[wikipedia:Sergey_Brin|Sergey Brin]], co-founder of Google, donated [https://www.cnbc.com/2017/03/31/google-co-founders-and-silicon-valley-billionaires-try-to-live-forever.html $25 million for the National Academy of Medicine’s Grand Challenge in Health Longevity] to 'end aging forever'.<ref>Google’s co-founders and other Silicon Valley billionaires are trying to live forever. (2021). Retrieved 15 December 2021, from <nowiki>https://www.cnbc.com/2017/03/31/google-co-founders-and-silicon-valley-billionaires-try-to-live-forever.html</nowiki></ref>
* [[wikipedia:Larry_Page|Larry Page]], co-founder of Google, co-founded the [[wikipedia:Calico_(company)|billion-dollar aging research company Calico Labs.]]<ref>Contributors to Wikimedia projects. (2013, September 19). ''Calico (company) - Wikipedia''. Wikipedia, the free encyclopedia. <nowiki>https://en.wikipedia.org/wiki/Calico_(company)</nowiki>
</ref>
* [[wikipedia:Mike_Cannon-Brookes|Mike Cannon-Brookes]], billionaire cofounder of Australian software giant Atlassian, has invested [https://www.forbes.com/sites/samshead/2019/08/19/billionaire-backs-uk-startup-trying-to-extend-human-lifespans/ $10 million into longevity company Juvenescenc]e.<ref>Shead, S. (2019, August 19). ''Billionaire Backs U.K. Startup Trying To Extend Human Life Spans''. Forbes. <nowiki>https://www.forbes.com/sites/samshead/2019/08/19/billionaire-backs-uk-startup-trying-to-extend-human-lifespans/</nowiki></ref>
* [[wikipedia:Naveen_Jain|Naveen Jain]], billionaire entrepeneur who has raised [https://www.geekwire.com/2021/gut-health-startup-viome-raises-54m-develop-cancer-diagnostics-sell-microbiome-kits/ $54 million for his startup Viome].<ref>''Gut health startup Viome raises $54M to develop cancer diagnostics and sell microbiome kits''. (2021, November 10). Geekwire. <nowiki>https://www.geekwire.com/2021/gut-health-startup-viome-raises-54m-develop-cancer-diagnostics-sell-microbiome-kits/</nowiki></ref>
* [[wikipedia:Jim_Mellon|Jim Mellon]], who co-founded longevity company [https://www.juvlabs.com/people/co-founder/jim-mellon Juvenescence].<ref>''Jim Mellon - Chairman & Co-Founder''. (n.d.). Juvenescence - Science of Healthy Aging & Extended Lifespan. <nowiki>https://www.juvlabs.com/people/co-founder/jim-mellon</nowiki></ref>
* [[wikipedia:Larry_Ellison|Larry Ellison]], founder of Oracle, has spent [https://www.townandcountrymag.com/society/money-and-power/a9202324/science-of-longevity/ $430 million on longevity research].<ref>Tullis, P. (2017, March 30). ''Are You Rich Enough To Live Forever?'' Town & Country. <nowiki>https://www.townandcountrymag.com/society/money-and-power/a9202324/science-of-longevity/</nowiki></ref>
*Michael Greve, founder of Kizoo Technology, who has pledged [https://Longevity.Technology. https://www.longevity.technology/michael-greve-commits-e300m-for-rejuvenation-start-ups/ €300m to rejuvenation biotechnology companies.]<ref>''Michael Greve commits €300m for rejuvenation start-ups''. (2021, May 6). Longevity.Technology. <nowiki>https://www.longevity.technology/michael-greve-commits-e300m-for-rejuvenation-start-ups/</nowiki></ref>
* [[wikipedia:Yuri_Milner|Yuri Milner]], billionaire tech investor who has helped Altos Labs raise $270 million, with Jeff Bezos.<ref name=":7" />
* [https://wikitia.com/wiki/Richard_Heart Richard Heart], founder of the cryptocurrency Hex, who helped raise [https://www.express.co.uk/finance/city/1465354/pulsechain-cryptocurrency-srf-sens-research-foundation-airdrop-pulse-charity-longevity $25 million for the anti-aging research organisation SENS.]<ref>McGleenon, B. (2021, July 20). ''Pulsechain cryptocurrency raises 'mindblowing' $25M in five days for SENS longevity group''. Express.co.uk. <nowiki>https://www.express.co.uk/finance/city/1465354/pulsechain-cryptocurrency-srf-sens-research-foundation-airdrop-pulse-charity-longevity</nowiki></ref>
*[[wikipedia:Brian_Armstrong_(businessman)|Brian Armstrong]], CEO of CoinBase, who helped found and raise [https://www.dailymail.co.uk/sciencetech/article-10310475/Billionaire-launches-new-start-hopes-REVERSE-ageing-process.html $105 million for the epigenetic reprogramming startup NewLimit.]<ref>Liberatore, S. (2021, December 14). ''Billionaire launches new start-up to REVERSE the ageing process''. Mail Online. <nowiki>https://www.dailymail.co.uk/sciencetech/article-10310475/Billionaire-launches-new-start-hopes-REVERSE-ageing-process.html</nowiki></ref>
* [[wikipedia:Vitalik_Buterin|Vitalik Buterin]], founder of the cryptocurrency Ethereum, who donated $2.4 million to SENS.<ref>Foundation, S. R. (n.d.). ''SENS Research Foundation Receives $2.4 Million Ethereum Donation From Vitalik Buterin''. GlobeNewswire News Room. <nowiki>https://www.globenewswire.com/news-release/2018/02/02/1332410/0/en/SENS-Research-Foundation-Receives-2-4-Million-Ethereum-Donation-From-Vitalik-Buterin.html</nowiki></ref>

== How large will the longevity biotechnology field be? ==
Analysts from the Bank of America have predicted that the market size of longevity biotechnology will reach $600 billion by 2025.<ref>2021. ''Human lifespan could soon pass 100 years thanks to medical tech, says BofA''. [online] Available at: <<nowiki>https://www.cnbc.com/2019/05/08/techs-next-big-disruption-could-be-delaying-death.html</nowiki>> [Accessed 14 December 2021].</ref> Others have speculated that it is a trillion dollar industry owing to the immense savings associated with delaying or preventing chronic diseases.<ref>Colangelo, M., 2021. ''AI Will Drive The Multi-Trillion Dollar Longevity Economy''. [online] Forbes. Available at: <<nowiki>https://www.forbes.com/sites/cognitiveworld/2019/12/07/ai-will-drive-the-multi-trillion-dollar-longevity-economy/?sh=294766b74965</nowiki>> [Accessed 14 December 2021].</ref>
== Is aging an important for risk factor for COVID-19 mortality? ==

Aging is the largest risk factor for COVID-19. [[File:Age is the -1 risk factor for COVID-19 mortality.jpg|alt=Age is the #1 risk factor for COVID-19 mortality - based on US CDC statistics|thumb|572x572px|* Fold risk of COVID-19 mortality versus reference group aged 5-17 [https://www.cdc.gov/coronavirus/2019-ncov/covid-data/investigations-discovery/hospitalization-death-by-age.html (US CDC statistics)]]]
====COVID-19 defined as a disease of aging====
As detailed in the paper "[https://onlinelibrary.wiley.com/doi/full/10.1111/acel.13230 COVID‐19 is an emergent disease of aging",]<ref name=":29">[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7576244/ Santesmasses, D., Castro, J. P., Zenin, A. A., Shindyapina, A. V., Gerashchenko, M. V., Zhang, B., ... & Gladyshev, V. N. (2020). COVID‐19 is an emergent disease of aging. ''Aging cell'', ''19''(10), e13230.]</ref> COVID-19 meets several criteria for definition as an age-related disease:<ref>[[Promislow, D. E. (2020). A geroscience perspective on COVID-19 mortality. The Journals of Gerontology: Series A, 75(9), e30-e33.|Promislow, D. E. (2020). A geroscience perspective on COVID-19 mortality. ''The Journals of Gerontology: Series A'', ''75''(9), e30-e33.]]</ref><ref>Alberts, S. C., Archie, E. A., Gesquiere, L. R., Altmann, J., Vaupel, J. W., & Christensen, K. (2014). The male-female health-survival paradox: a comparative perspective on sex differences in aging and mortality. In ''Sociality, hierarchy, health: comparative biodemography: a collection of papers''. National Academies Press (US).</ref><ref name=":10">[[Sierra, F. (2020). Geroscience and the Coronavirus Pandemic: The Whack‐a‐Mole Approach is not Enough. Journal of the American Geriatrics Society, 68(5), 951.|Sierra, F. (2020). Geroscience and the Coronavirus Pandemic: The Whack‐a‐Mole Approach is not Enough. ''Journal of the American Geriatrics Society'', ''68''(5), 951.]]</ref><ref name=":11">[[Barzilai, N., Appleby, J. C., Austad, S. N., Cuervo, A. M., Kaeberlein, M., Gonzalez-Billault, C., ... & Sierra, F. (2020). Geroscience in the Age of COVID-19. Aging and disease, 11(4), 725.|Barzilai, N., Appleby, J. C., Austad, S. N., Cuervo, A. M., Kaeberlein, M., Gonzalez-Billault, C., ... & Sierra, F. (2020). Geroscience in the Age of COVID-19. ''Aging and disease'', ''11''(4), 725.]]</ref><ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7288963/</ref>

1) The doubling time for COVID-19 mortality approaches that of the doubling time of 8 years for all-cause mortality (characteristic exponential increase shared among major age-related chronic diseases);

2) Greater mortality rate in men, consistent with known sex differences in rates of aging;

3) Greater mortality rate for those with comorbidities (age-related diseases), consistent with accelerated biological aging; and,

4) Age dwarfs all other putative [[wikipedia:Risk_factor|risk factors]] for mortality by several orders of magnitude, exhibiting several thousand fold increase in risk across the lifespan
== How is aging biology research different to other fields of medical research? ==
Scientists studying the biology of aging believe that aging is the root cause of all the major diseases that afflict us as we age. Therefore, targeting aging biology would treat or reverse multiple diseases, simultaneously, while maximizing the chance of a cure.

Mainstream medical research has had many successes in treating single diseases, such as infectious diseases. For age-related ones, notable successes have been seen for heart diseases. However, targeting single diseases, one at a time, leads to rapidly diminishing returns. Even if we could ''cure'' heart disease and cancer, which are leading causes of death, each would add only ~2.5 years to life expectancy. This is because the next disease in line, e.g. Alzheimer's or lung disease, will kill you. This is the Taeuber Paradox, which highlights how the exponentially increasing risk of disease accumulation with aging limits the benefit of targeting single diseases.
== Do all animals age in the same way? ==
[[File:Naked mole rat graph.png|alt=Naked mole rat graph|thumb|530x530px|The naked mole-rat does not follow the same increased risk of mortality due to aging that humans and other mammals do. ]]
Many species, due to differences in their biology, age at different rates to humans. The jellyfish ''Turritopsis dohrnii'' can revert to earlier stages of its life cycle in response to stress, and can theoretically live forever - though eventually dies, usually due to predation.

Among mammals, the naked mole rat is an exceptionally long lived organism that lives roughly ten times longer than similarly-sized rats.<ref name=":3">Ruby, J. G., Smith, M., & Buffenstein, R. (2018). Naked mole-rat mortality rates defy Gompertzian laws by not increasing with age. ''elife'', ''7'', e31157.</ref><ref>Buffenstein, R., Amoroso, V., Andziak, B., Avdieiev, S., Azpurua, J., Barker, A. J., ... & Smith, E. S. J. (2021). The naked truth: a comprehensive clarification and classification of current ‘myths’ in naked mole‐rat biology. ''Biological Reviews''.</ref> Unlike other organisms, such as humans, horses and mice, the mortality rate of the naked mole rat appears steady over time. This trend does not follow the exponential increase in mortality (Gompertz-Makeham law) that humans do.<ref name=":3" />

Scientists are now studying the naked mole rat to identify key patterns in their genetics, environmental traits, and metabolism that may be responsible for their longer lifespans.

[[File:Naked mole rat.jpg|alt=Naked mole rat|center|thumb|323x323px|The naked mole rat is unusually long-lived relative to other mice and rats. ]]

== Is aging considered a disease? ==
Aging is not currently classified as a disease by regulatory bodies such as the Food and Drug Administration (FDA) in the United States. However, several scientists in the aging field have publicly stated their wish for aging to be considered a disease, including professor David Sinclair and professor Nir Barzilai.

== What are the economic benefits of extending healthy lifespan? ==
Extending the healthy human lifespan could have significant economic benefits gobally. An economic analysis from 2021 by researchers at the University of Oxford and Harvard University estimated the benefit of a drug that slows aging by 1 year as $38 trillion. This is primarily because slowing aging reduces the incidence of age-related diseases such as cancer and Alzheimer’s disease, which require expensive treatment approaches. The study demonstrated a larger economic benefit of slowing aging than curing the individual diseases of aging.
== Which anti-aging drugs are being tested in clinical trials today? ==
There are over 50 drugs being tested in human clinical trials for aging or age-related diseases.

The largest trial is the Targeting Aging with Metformin (TAME) trial, which began in 2020. The trial is being run in the United States with a cohort of 3000 older adults. The goal of the TAME trial is to determine whether diabetes drug metformin slows the aging process in older adults. The TAME trial is a $75 million trial run by the American Federation for Aging Research.

Another large clinical trial is the Participitory Evluation of Rapamycin (PEARL) study. The goal of this study is to determine whether rapamycin, a drug currently approved for immunosuppression during organ transplants, slows biomarkers of aging in 1000 adults. The PEARL trial is being run by AgelessRx.
== Is aging a natural process that should be accepted? ==
Although aging is a natural process in humans, it is the driving force of many diseases such as cancer and Alzheimer's disease - which as a society we have decided are worth trying to find cures for. In the past, these conditions, as well as atherosclerosis and even infectious diseases were once thought of as natural processes that could not be treated. However, nowadays it is understood that they are diseases that can be treated.

Atherosclerosis, the hardening of the arteries, was once viewed as a natural process that was simply a consequence of aging. However, when treatments such as statins were later developed to prevent atherosclerosis, the disease became widely regarded as a disease to be cured. Statins are now one one of the most widely prescribed drugs in the world, used in preventing heart diseases. The inventor of statins, Akira Endo, describes in his historical paper: “Serious research on the role of cholesterol in human atherosclerosis did not really get underway until the 1940s, due to a prevailing view that the disease was a simple consequence of aging and could not be prevented.”<ref>Endo A. (2010). A historical perspective on the discovery of statins. ''Proceedings of the Japan Academy. Series B, Physical and biological sciences'', ''86''(5), 484–493. <nowiki>https://doi.org/10.2183/pjab.86.484</nowiki></ref>

== Will anti-aging technology lead to overpopulation? ==
A common objection to the development of longevity technologies is that they may lead to an unsustainably large population size.

One study of a 2005 Swedish cohort of 9 million people modeled the effect of various anti-aging scenarios. The researchers showed that even with the most radical life-extension technology in which aging completely stopped after age 60, the population growth across 100 years was only 22%.

Currently, the world’s population is 7.9 billion, and the WHO predicts the population will peak at 11 billion in 2100 before falling due to declining birth rates in many parts of the world.

The fastest growing populations are in Africa and South-east Asia. However, several factors are thought to reduce birth rates over time, including increased access to contraceptives, female empowerment, increased education and increased employment. There is evidence that populations that move to a more advanced economy show a reduction in birth rates.

== Will anti-aging drugs only be available to the rich? ==
It is unclear who will have first access to longevity drugs. Several researchers in the field have argued that several economic factors are likely to drive down the price of drugs that slow aging.

* The cost of many biotechnologies decreases substantially over time. For example, the first human genome cost $100 million to sequence, and is now available for a few hundred dollars.

* The price of many lifesaving pharmaceuticals has fallen significantly in price once generic drugs were produced. For example, Lipitor, a statin used to prevent heart disease has fallen in price from $85 in 2011 to less than $5 today.

* Many companies in the longevity field have stated that equity of access is part of their core ethos, and many researchers are signatories to the

== Which scientists and institutions are trying to understand and reverse aging? ==
Hundreds of scientists are working on understanding the biology of aging in leading institutions like Harvard University, Stanford University, Yale University, and the University of Oxford. Some of the most well-known institutes and labs include:

=== The Buck Institute for Research on Aging ===
The Buck Institute for Research on Aging is one of the largest longevity research institutes with over 250 scientists. The research covers several areas including the mechanisms of aging, neurodegeneration, senescence, stem cells and regenerative medicine, cellular stress and disease, cancer associated with aging, and mitochondrial function.<ref>''Buck Institute''. (n.d.). BUCK. <nowiki>https://www.buckinstitute.org/</nowiki></ref>

=== Professor David Sinclair - Harvard Medical School ===
Professor Sinclair’s lab focuses on understanding and reversing aging. The lab focuses on a range of areas including DNA repair, mitochondrial dysfunction, and the interactions between epigenetic and genetic instability, and tissue reprogramming. Sinclair is also the author of the bestselling book, Lifespan: why we age and why we don’t have to.

=== Professor Matt Kaeberlein - University of Washington ===
Professor Kaeberlein's lab focuses on biological mechanisms of aging in order to facilitate translational interventions that promote healthspan and improve quality of life. Kaeberlein is known for his work on the longevity drug rapamycin in organisms such as mice and dogs. He is Director of the Dog Aging Project, a multi-year initiative studying the genetic and environmental factors that influence health, with over 33,000 participating dogs.

=== Professor Brian Kennedy - National University of Singapore ===
Professor Kennedy’s lab focuses on understanding the biology of aging and translating research discoveries into new ways of delaying aging in humans. The lab has identified drugs that extend the healthy lifespan of worms and mice and are seeking to understand their mechanisms.

=== Associate Professor Lynne Cox - University of Oxford ===
Professor Cox’s lab study the molecular and cellular basis of aging to identify specific biochemical processes and pathways that change organisms age. The lab particularly cellular senescence, which underpins many age-related diseases including cancer and neurodegeneration.

== What books have been written on this topic? ==
Several books have been written on the topic of aging and longevity. These include:

* ''Lifespan: Why We Age And Why We Don't Have To'' - David Sinclair (2019)

* ''Ending Aging'' - Dr. Aubrey de Grey (2007)

* ''Ageless'' - Dr. Andrew Steele (2020)

* ''Age Later'' - Professor Nir Barzilai (2021)

* ''The Science and Technology of Growing Young'' - Sergey Young (2021)

== References ==
<references />

File:Rapamune .jpg

2021-12-15T08:04:47Z

Jack:

Rapamune

FAQ

2021-12-15T08:03:48Z

Jack: /* Can healthy lifespan be extended? */

Aging is the driving force of many diseases. Longevity biotechnology is a new field of medical research and development that aims to extend healthy human lifespan and delay, prevent or reverse these diseases. This article provides an overview of the field, answering common questions.

== Why is aging a problem? ==
[[File:Aging graph.png|thumb|750x750px|The aging process results in the risk of age-related diseases increasing exponentially over time.]][[File:Gompertz-Makeham law of mortality.png|alt=Gompertz-Makeham law of mortality|thumb|257x257px|Gompertz-Makeham law of mortality<ref name=":0">En.wikipedia.org. 2021. ''Gompertz–Makeham law of mortality - Wikipedia''. [online] Available at: <<nowiki>https://en.wikipedia.org/wiki/Gompertz%E2%80%93Makeham_law_of_mortality</nowiki>> [Accessed 13 December 2021].</ref>]]Aging is the largest risk factor for the diseases that kill most people worldwide, including cancer, heart diseases and Alzheimer's disease.

In the US in 2020, 9 of the 10 leading causes of death were strongly age-related.<ref>Ahmad, F. B., & Anderson, R. N. (2021). The leading causes of death in the US for 2020. ''JAMA'', ''325''(18), 1829-1830.https://jamanetwork.com/journals/jama/fullarticle/2778234</ref> Globally, approximately 70% of deaths annually are the result of aging.<ref name=":8" />

Aging also significantly affects quality of life, as deaths due to aging are usually preceded by many months of years of chronic illnesses such as cancer, type 2 diabetes and Alzheimer’s disease.

As a result of the aging process, the risk of an individual dying increases exponentially after the age of around 30 years old.<ref name=":0" /> This increase in mortality rate is known as the Gompertz-Makeham law of mortality.<ref name=":0" />
== How many people die from aging per day? ==
The aging process results in the deaths of 100,000 people per day; more than twice the sum of all other causes of death combined.<ref name=":8">Ritchie, H. and Roser, M., 2021. ''Causes of Death''. [online] Our World in Data. Available at: <<nowiki>https://ourworldindata.org/causes-of-death</nowiki>> [Accessed 13 December 2021].
</ref> This equates to over 37 million people dying per day of aging - a population the size of Canada. This is because aging results in the exponential increasing risk of age-related diseases such as cancer and type 2 diabetes. Aging also accounts for more than 30% of all disability-adjusted life years lost (DALYs); more than any other single cause.<ref>Vizhub.healthdata.org. 2021. ''GBD Compare | IHME Viz Hub''. [online] Available at: <<nowiki>https://vizhub.healthdata.org/gbd-compare/</nowiki>> [Accessed 13 December 2021].</ref>
[[File:Leading causes of death.png|center|thumb|713x713px|9 of the top 10 causes of death in the US in 2020 were strongly age-related]]

== Can healthy lifespan be extended? ==
[[File:Life extension mice.jpg|alt=Life extension mice|thumb|431x431px|Dietary manipulation, genetic manipulation, and drugs have been shown to increase the healthy lifespan of mice by up to 30%. <ref name=":1">de Magalhaes, J., 2021. ''DrugAge: Species Detail''. [online] Genomics.senescence.info. Available at: <<nowiki>https://genomics.senescence.info/drugs/species_details.php</nowiki>> [Accessed 14 December 2021].</ref>]]Clinical trials for longevity drugs in humans are in-progress, and there is not yet evidence that drugs can slow aging in humans. However, recent experimental breakthroughs over the last few decades have shown that in mice, worms and flies have demonstrated that healthy lifespan can be extended modified. Many clinical trials in humans today are testing whether these results can be replicated in humans.

In animal models, slowing the aging process in animals can be achieved via manipulation of diet, environment, genetics, epigenetics, or with drugs. In mice, over 100 drugs have been shown to extend healthy lifespan by up to 30%.<ref name=":1" />

The effect of longevity drugs on mice is often significant, delaying or eliminating the burden of age-related problems such as frailty, cataracts, cancer, and sarcopenia. For example, a new class of drugs called senolytics have been shown to extend lifespan in mice by over 30% whilst delaying age-related dysfunction.

== Which therapies may extend healthy lifespan? ==
Several drugs are known to extend healthy lifespan in animals. While there is no conclusive data that suggests these drugs would work the same in humans, many of these drugs are now being tested in clinical trials. [[File:Unity Mice.jpg|alt=Unity Mice|thumb|723x723px|Senolytic drugs eliminate senescent cells that accumulate with age, partially reversing multiple age-related diseases and extending the healthy lifespan of mice by up to 35%. ]]

=== Senolytics ===
Senolytics are drugs that remove senescent cells. These are cells which accumulate in the body with age and are linked with age-related diseases such as cancer.<ref>Xu, M., Pirtskhalava, T., Farr, J. N., Weigand, B. M., Palmer, A. K., Weivoda, M. M., ... & Kirkland, J. L. (2018). Senolytics improve physical function and increase lifespan in old age. ''Nature medicine'', ''24''(8), 1246-1256.</ref>
[[File:Metformin2.jpg|thumb|258x258px|Metformin extends lifespan in mice, and may extend lifespan in humans.<ref name=":13">Kulkarni, A. S., Gubbi, S., & Barzilai, N. (2020). Benefits of metformin in attenuating the hallmarks of aging. ''Cell metabolism'', ''32''(1), 15-30.</ref>]]
In mice, senolytics have been shown to increase the healthy lifespan by up to 35%.<ref>Baker, D. J., Childs, B. G., Durik, M., Wijers, M. E., Sieben, C. J., Zhong, J., ... & Van Deursen, J. M. (2016). Naturally occurring p16 Ink4a-positive cells shorten healthy lifespan. ''Nature'', ''530''(7589), 184-189.</ref> The first clinical trials of senolytics in humans began in 2020, and demonstrated benefits to functional measures suggesting these drugs may be effective in humans.

=== [[Metformin]] ===
Metformin is an approved drug for type 2 diabetes that extends lifespan in multiple species. In mice, Metformin extends lifespan by up to 6%.<ref>Anisimov, V. N., Berstein, L. M., Popovich, I. G., Zabezhinski, M. A., Egormin, P. A., Piskunova, T. S., Semenchenko, A. V., Tyndyk, M. L., Yurova, M. N., Kovalenko, I. G., & Poroshina, T. E. (2011). If started early in life, metformin treatment increases life span and postpones tumors in female SHR mice. ''Aging'', ''3''(2), 148–157. <nowiki>https://doi.org/10.18632/aging.100273</nowiki></ref> Metformin works by improving insulin sensitivity and may target several hallmarks of aging.<ref name=":13" /> Metformin is being tested as a longevity therapy in the largest clinical trial for a longevity therapy, the Targeting Aging with Metformin (TAME) trial in the US.<ref name=":14">''TAME - Targeting Aging with Metformin - American Federation for Aging Research''. (n.d.). American Federation for Aging Research. <nowiki>https://www.afar.org/tame-trial</nowiki></ref> This is a randomized clinical trial of 3000 elderly patients comparing metformin against a placebo for the onset of age-related diseases.<ref name=":14" />

=== [[Rapamycin]] ===

Rapamycin is a drug used to prevent the rejection of organ transplants by the immune system. Rapamycin has been shown to extend lifespan by up to 26% when given at middle age, and 14% when given in late life.<ref>Harrison, D., Strong, R., Sharp, Z. ''et al.'' Rapamycin fed late in life extends lifespan in genetically heterogeneous mice. ''Nature'' 460, 392–395 (2009). <nowiki>https://doi.org/10.1038/nature08221</nowiki>
</ref><ref>Miller, R. A., Harrison, D. E., Astle, C. M., Fernandez, E., Flurkey, K., Han, M., Javors, M. A., Li, X., Nadon, N. L., Nelson, J. F., Pletcher, S., Salmon, A. B., Sharp, Z. D., Van Roekel, S., Winkleman, L., & Strong, R. (2014). Rapamycin-mediated lifespan increase in mice is dose and sex dependent and metabolically distinct from dietary restriction. ''Aging cell'', ''13''(3), 468–477. <nowiki>https://doi.org/10.1111/acel.12194</nowiki></ref> Rapamycin is currently being tested in a large-scale clinical trial called the Participatory Evaluation (of) Aging (With) Rapamycin (for) Longevity Study (PEARL). The study is a randomized clinical trial of 1000 elderly patients comparing rapamycin against placebo for age-related outcomes.<ref>Clinicaltrials.gov. 2021. ''Participatory Evaluation (of) Aging (With) Rapamycin (for) Longevity Study - Full Text View - ClinicalTrials.gov''. [online] Available at: <<nowiki>https://clinicaltrials.gov/ct2/show/NCT04488601</nowiki>> [Accessed 14 December 2021].
</ref>

=== Epigenetic reprogramming ===
In addition, over 50 other drugs being tested in human clinical trials for slowing aging.<ref name=":2">Lifespan.io. 2021. ''The Rejuvenation Roadmap | Lifespan.io''. [online] Available at: <<nowiki>https://www.lifespan.io/road-maps/the-rejuvenation-roadmap/</nowiki>> [Accessed 13 December 2021].</ref>

== What is the goal of longevity biotechnology? ==
[[File:Healthy lifespan extension.png|alt=Healthy lifespan extension|thumb|643x643px|Healthy lifespan extension]]
Longevity biotechnology aims to create therapies to extend the healthy human lifespan. Aging is associated with functional decline, diseases and an increased risk of death.

Longevity biotechnology attempts to slow or reverse the aging process to extend the healthy lifespan (‘healthspan’) of the population.

The longevity biotechnology sector is rapidly growing, and there are currently over 170 private companies working on developing therapeutics to slow the aging process.<ref name=":4">Pfleger, K., 2021. ''Aging Companies''. [online] Agingbiotech.info. Available at: <<nowiki>https://agingbiotech.info/companies</nowiki>> [Accessed 13 December 2021].</ref> These companies are working on slowing or reversing the aging process by targeting one of more of the hallmarks of aging.

== Will healthy or unhealthy lifespan be extended? ==
[[File:Extending healthy lifespan.png|alt=Extending healthy lifespan|thumb|364x364px|Extending healthy lifespan]]
The stated goal of longevity biotechnology is to extend the healthy period of lifespan, before age-related diseases set in. This is in contrast to many of today's medical interventions, which extend life only after diseases (e.g. cancer, Alzheimer's) have reached a clinical level.

Age-related diseases are preceded by a long period of subclinical aging, i.e. aging that has not yet progressed far enough to produce clinical symptoms. By slowing, delaying or reversing the aging process, the healthy period of life can be extended.

Studies in mice have demonstrated that life extending drugs such as rapamycin are capable of extending the healthy, rather than unhealthy period of life.
== Should we treat specific diseases such as cancer, or aging? ==
[[File:Slowing aging versus curing cancer.jpg|alt=Slowing aging is potentially a more effective means of extending healthy lifespan than treating individual diseases due to the comorbid nature of age-related diseases. [6]|thumb|421x421px|Slowing aging is potentially a more effective means of extending healthy lifespan than treating individual diseases due to the comorbid nature of age-related diseases. ]]
Longevity biotechnology potentially offers a greater likelihood of extending healthy lifespan than attempting to find cures for the individual diseases of aging. This is because biological aging is associated with many of diseases of aging that develop as comorbidities i.e. at the same time. Even if a person survives one age-related disease such as cancer, another (e.g. diabetes, cardiovascular disease) is likely to kill the person if the underlying aging is not treated. This phenomenon is known as Taueber's paradox<ref>En.wikipedia.org. 2021. ''Taeuber Paradox - Wikipedia''. [online] Available at: <<nowiki>https://en.wikipedia.org/wiki/Taeuber_Paradox</nowiki>> [Accessed 14 December 2021].</ref>, and accounts for the much smaller projected increase in healthy lifespan associated with curing the diseases of aging, such as cancer (2-3 years), versus slowing aging itself (30+ years).<ref>Matt Kaeberlein, PhD, It is Time to Embrace 21st-Century Medicine, ''Public Policy & Aging Report'', Volume 29, Issue 4, 2019, Pages 111–115, <nowiki>https://doi.org/10.1093/ppar/prz022</nowiki></ref>
== What is biological aging? ==
There are two main types of 'age': chronological age - the number of years since birth, and biological age - a measure of the physical health of a person and their position in their lifespan. Biological age is more difficult to measure, but recent technologies are now available to estimate biological age. Over time, we age biologically. This occurs due to many processes in the body, which are generally categorised into 9 processes or 'hallmarks'.
== What are the 9 Hallmarks of Aging? ==
[[File:Hallmarks of aging.jpg|alt=Hallmarks of aging|thumb|444x444px|Hallmarks of aging]]

The hallmarks of aging framework is considered to broadly represent key biological mechanisms of the biological aging process.<ref name=":9">López-Otín C, Blasco MA, Partridge L, Serrano M, Kroemer G. The hallmarks of aging. Cell. 2013 Jun 6;153(6):1194-217.</ref> Although there are various limitations of the hallmarks framework, it has become the central framework for understanding aging biology. The nine forms of cellular and molecular ‘damage’ that comprise the hallmarks of aging are<ref name=":9" />:

* Genomic instability
* Telomere attrition
* Epigenetic alterations
* Loss of proteostasis
* Deregulated nutrient-sensing
* Mitochondrial dysfunction
* Cellular senescence
* Stem cell exhaustion
* Altered intercellular communication

These are essentially the lowest common denominators of the aging process, on a cellular or subcellular level. All of the other changes associated with aging, such as greying hair, wrinkles, frailty and an increased risk of disease is thought to stem from these underlyig processes.<ref name=":9" />

== How does the aging cause disease? ==
The nine hallmarks of aging have been shown to play an integral role in the development of many age-related diseases such as neurodegenerative diseases and cancer:
=== [[Aging and Neurodegeneration|Neurodegenerative disease]] ===
[[File:Prevalence of neuro disorders.jpg|alt=Prevalence of neuro disorders|thumb|469x469px|The prevalence of neurodegenerative disorders increases exponentially with age, due to the biological aging process.<ref name=":12">Hou, Y., Dan, X., Babbar, M., Wei, Y., Hasselbalch, S. G., Croteau, D. L., & Bohr, V. A. (2019). Ageing as a risk factor for neurodegenerative disease. ''Nature reviews. Neurology'', ''15''(10), 565–581. <nowiki>https://doi.org/10.1038/s41582-019-0244-7</nowiki></ref> ]]
All of the hallmarks of aging are associated with an increased risk of neurodegenerative diseases, such as Parkinson's disease and Alzheimer's disease.<ref>Qiu, C., Kivipelto, M., & von Strauss, E. (2009). Epidemiology of Alzheimer's disease: occurrence, determinants, and strategies toward intervention. ''Dialogues in clinical neuroscience'', ''11''(2), 111.</ref> For example, several types of DNA damage are associated with neurodegeneration. The shortening of telomeres occurs as part of biological aging and causes cellular senescence, and is associated with neurodegeneration and neurodegenerative diseases including Alzheimer's disease and Parkinson's disease.<ref name=":12" /> Additionally, mitochondrial dysfunction, altered metabolism, stem cell exhaustion and loss of proteostasis are also involved in the development of neurodegenerative diseases.<ref name=":12" />
=== [[Aging and Cancer|Cancer]] ===
Several of the hallmarks of aging such as cellular senescence and alterations in the extracellular matrix are responsible for increasing the likelihood of tumorigenesis.<ref name=":5">Fane, M., & Weeraratna, A. T. (2020). How the ageing microenvironment influences tumour progression. ''Nature Reviews Cancer'', ''20''(2), 89-106.</ref> Other hallmarks of aging such as genomic instability, loss or proteostasis, altered intercellular communication (i.e. inflammation) and epigenetic alterations are also involved in tumorigenesis.<ref name=":5" />
== How is biological age measured? ==
[[File:Epigenetic clock.png|alt=Epigenetic clock|thumb|605x605px|Epigenetic clock is the first aging clock. ]]
Recent technologies have allow biological age to be measured. These include:

=== [[Epigenetic clock|Epigenetic clocks]] ===
The first generation of aging clocks are known as [[Epigenetic clock|epigenetic clocks or Horvath’s clock]].<ref name=":6">Horvath, S., & Raj, K. (2018). DNA methylation-based biomarkers and the epigenetic clock theory of ageing. ''Nature Reviews Genetics'', ''19''(6), 371-384.</ref> This clock is based on the finding that over time, the body accumulates methylation tags on the DNA in a pattern that can be predicted with machine learning. These changes to the epigenome are influenced by lifestyle, and can be used to measure biological age.<ref name=":6" /> Factors such as exercise frequency and a low BMI have been shown to reduce the rate of biological aging, whereas obesity and smoking can accelerate the rate of aging.<ref>Quach, A., Levine, M. E., Tanaka, T., Lu, A. T., Chen, B. H., Ferrucci, L., ... & Horvath, S. (2017). Epigenetic clock analysis of diet, exercise, education, and lifestyle factors. ''Aging (Albany NY)'', ''9''(2), 419.</ref><ref>Wu, X., Huang, Q., Javed, R., Zhong, J., Gao, H., & Liang, H. (2019). Effect of tobacco smoking on the epigenetic age of human respiratory organs. ''Clinical Epigenetics'', ''11''(1), 183. <nowiki>https://doi.org/10.1186/s13148-019-0777-z</nowiki>

[[Epigenetic clock#cite%20ref-12|↑]]</ref><ref>Horvath, S., Erhart, W., Brosch, M., Ammerpohl, O., von Schönfels, W., Ahrens, M., Heits, N., Bell, J. T., Tsai, P.-C., Spector, T. D., Deloukas, P., Siebert, R., Sipos, B., Becker, T., Röcken, C., Schafmayer, C., & Hampe, J. (2014). Obesity accelerates epigenetic aging of human liver. ''Proceedings of the National Academy of Sciences'', ''111''(43), 15538–15543. <nowiki>https://doi.org/10.1073/pnas.1412759111</nowiki>

[[Epigenetic clock#cite%20ref-13|↑]]</ref> The Horvath's clock has been used to accurately predict mortality risk.<ref>Fransquet, P. D., Wrigglesworth, J., Woods, R. L., Ernst, M. E., & Ryan, J. (2019). The epigenetic clock as a predictor of disease and mortality risk: a systematic review and meta-analysis. ''Clinical epigenetics'', ''11''(1), 1-17.</ref>

=== Multi-omic clocks ===
Multi-omic clocks are being developed that incorporate data from several sources, such as body imaging scans, blood tests, and fitness tests. These clocks are built using machine learning to estimate biological age. These aging clocks are being developed that combine multiple biological functional tests to create a unique aging signature, which can be monitored over time.<ref>Kudryashova, K. S., Burka, K., Kulaga, A. Y., Vorobyeva, N. S., & Kennedy, B. K. (2020). Aging Biomarkers: From Functional Tests to Multi‐Omics Approaches. ''Proteomics'', ''20''(5-6), 1900408.</ref>
[[File:Multiomic aging clock.jpg|alt=Multiomic clocks|center|thumb|542x542px|Multiomic clocks integrate various data sources to create a unique biological aging signature that can be tracked over time. ]]
== Which companies are trying to solve aging? ==
[[File:Calico Labs.png|alt=T|thumb|Calico Labs, a subsidiary of Google, is a billion-dollar company searching for treatments for aging. ]]
There are over [https://agingbiotech.info/companies 170 longevity biotechnology companies] trying to create therapies to slow or reverse the aging process.<ref name=":4" /> There are over [https://www.lifespan.io/road-maps/the-rejuvenation-roadmap/ 50 longevity drugs] currently in clinical trials in humans.<ref name=":2" />

Many of the longevity biotechnology companies are targeting specific hallmarks of aging. For example, [https://www.clearabiotech.com/#DiscoveryTimeline Cleara Biotech] are attempting to reduce cellular senescence by developing a drug that can eliminate senescent cells.<ref>Cleara Biotech. 2021. ''Cleara Biotech''. [online] Available at: <<nowiki>https://www.clearabiotech.com/#DiscoveryTimeline</nowiki>> [Accessed 15 December 2021].</ref>

Calico Labs is a Google-backed biotech company with the goal of combating aging and age-related diseases. In 2014, the company created a partnership with pharmaceutical giant AbbVie, which has since developed into a [https://www.cnbc.com/2018/06/26/alphabet-backed-calico-and-abbvie-chip-in-1-billion-to-cure-aging.html $2.5 billion venture] in the pursuit of improving “health, wellbeing and longevity.” <ref>2021. ''Google sister company and drug giant chip in another $1 billion to cure age-related diseases''. [online] Available at: <<nowiki>https://www.cnbc.com/2018/06/26/alphabet-backed-calico-and-abbvie-chip-in-1-billion-to-cure-aging.html</nowiki>> [Accessed 15 December 2021].</ref>

Since aging is not currently considered a disease by regulatory bodies such as the Food and Drug Administration (FDA), drug developers are currently focused on specific diseases of aging such as glaucoma and osteoarthritis.<ref>Clinicaltrialsarena.com. 2021. ''Unity's Phase II osteoarthritis study of UBX0101 misses primary goal''. [online] Available at: <<nowiki>https://www.clinicaltrialsarena.com/news/unity-ubx0101-osteoarthritis/</nowiki>> [Accessed 15 December 2021].</ref>

== Which billionaires are funding longevity biotechnology? ==
[[File:Jeff Bezos is funding longevity research.jpg|alt=Jeff Bezos is funding longevity research|thumb|Jeff Bezos is funding longevity research through financing Atlos Labs.<ref name=":7">MIT Technology Review. 2021. ''Meet Altos Labs, Silicon Valley’s latest wild bet on living forever''. [online] Available at: <<nowiki>https://www.technologyreview.com/2021/09/04/1034364/altos-labs-silicon-valleys-jeff-bezos-milner-bet-living-forever/</nowiki>> [Accessed 15 December 2021].</ref>]]
Several billionaires have funded companies or initiatives to slow or reverse human aging. These include:
* [[wikipedia:Jeff_Bezos|Jeff Bezos]], co-founder of Amazon, helped raise [https://www.technologyreview.com/2021/09/04/1034364/altos-labs-silicon-valleys-jeff-bezos-milner-bet-living-forever/ $270 million for new anti-aging drug company Altos Labs] in 2021.<ref name=":7" />
* [[wikipedia:Peter_Thiel|Peter Thiel]], co-founder of PayPal, was an [https://www.cnbc.com/2018/08/29/-jeff-bezos-is-backing-this-scientist-who-is-working-on-a-cure-for-aging.html early investor in Unity Biotechnology].<ref>CNBC. 2021. ''Why Jeff Bezos is backing this Silicon Valley scientist who is working on a cure for aging''. [online] Available at: <<nowiki>https://www.cnbc.com/2018/08/29/-jeff-bezos-is-backing-this-scientist-who-is-working-on-a-cure-for-aging.html</nowiki>> [Accessed 15 December 2021].</ref>
* [[wikipedia:Sergey_Brin|Sergey Brin]], co-founder of Google, donated [https://www.cnbc.com/2017/03/31/google-co-founders-and-silicon-valley-billionaires-try-to-live-forever.html $25 million for the National Academy of Medicine’s Grand Challenge in Health Longevity] to 'end aging forever'.<ref>Google’s co-founders and other Silicon Valley billionaires are trying to live forever. (2021). Retrieved 15 December 2021, from <nowiki>https://www.cnbc.com/2017/03/31/google-co-founders-and-silicon-valley-billionaires-try-to-live-forever.html</nowiki></ref>
* [[wikipedia:Larry_Page|Larry Page]], co-founder of Google, co-founded the [[wikipedia:Calico_(company)|billion-dollar aging research company Calico Labs.]]<ref>Contributors to Wikimedia projects. (2013, September 19). ''Calico (company) - Wikipedia''. Wikipedia, the free encyclopedia. <nowiki>https://en.wikipedia.org/wiki/Calico_(company)</nowiki>
</ref>
* [[wikipedia:Mike_Cannon-Brookes|Mike Cannon-Brookes]], billionaire cofounder of Australian software giant Atlassian, has invested [https://www.forbes.com/sites/samshead/2019/08/19/billionaire-backs-uk-startup-trying-to-extend-human-lifespans/ $10 million into longevity company Juvenescenc]e.<ref>Shead, S. (2019, August 19). ''Billionaire Backs U.K. Startup Trying To Extend Human Life Spans''. Forbes. <nowiki>https://www.forbes.com/sites/samshead/2019/08/19/billionaire-backs-uk-startup-trying-to-extend-human-lifespans/</nowiki></ref>
* [[wikipedia:Naveen_Jain|Naveen Jain]], billionaire entrepeneur who has raised [https://www.geekwire.com/2021/gut-health-startup-viome-raises-54m-develop-cancer-diagnostics-sell-microbiome-kits/ $54 million for his startup Viome].<ref>''Gut health startup Viome raises $54M to develop cancer diagnostics and sell microbiome kits''. (2021, November 10). Geekwire. <nowiki>https://www.geekwire.com/2021/gut-health-startup-viome-raises-54m-develop-cancer-diagnostics-sell-microbiome-kits/</nowiki></ref>
* [[wikipedia:Jim_Mellon|Jim Mellon]], who co-founded longevity company [https://www.juvlabs.com/people/co-founder/jim-mellon Juvenescence].<ref>''Jim Mellon - Chairman & Co-Founder''. (n.d.). Juvenescence - Science of Healthy Aging & Extended Lifespan. <nowiki>https://www.juvlabs.com/people/co-founder/jim-mellon</nowiki></ref>
* [[wikipedia:Larry_Ellison|Larry Ellison]], founder of Oracle, has spent [https://www.townandcountrymag.com/society/money-and-power/a9202324/science-of-longevity/ $430 million on longevity research].<ref>Tullis, P. (2017, March 30). ''Are You Rich Enough To Live Forever?'' Town & Country. <nowiki>https://www.townandcountrymag.com/society/money-and-power/a9202324/science-of-longevity/</nowiki></ref>
*Michael Greve, founder of Kizoo Technology, who has pledged [https://Longevity.Technology. https://www.longevity.technology/michael-greve-commits-e300m-for-rejuvenation-start-ups/ €300m to rejuvenation biotechnology companies.]<ref>''Michael Greve commits €300m for rejuvenation start-ups''. (2021, May 6). Longevity.Technology. <nowiki>https://www.longevity.technology/michael-greve-commits-e300m-for-rejuvenation-start-ups/</nowiki></ref>
* [[wikipedia:Yuri_Milner|Yuri Milner]], billionaire tech investor who has helped Altos Labs raise $270 million, with Jeff Bezos.<ref name=":7" />
* [https://wikitia.com/wiki/Richard_Heart Richard Heart], founder of the cryptocurrency Hex, who helped raise [https://www.express.co.uk/finance/city/1465354/pulsechain-cryptocurrency-srf-sens-research-foundation-airdrop-pulse-charity-longevity $25 million for the anti-aging research organisation SENS.]<ref>McGleenon, B. (2021, July 20). ''Pulsechain cryptocurrency raises 'mindblowing' $25M in five days for SENS longevity group''. Express.co.uk. <nowiki>https://www.express.co.uk/finance/city/1465354/pulsechain-cryptocurrency-srf-sens-research-foundation-airdrop-pulse-charity-longevity</nowiki></ref>
*[[wikipedia:Brian_Armstrong_(businessman)|Brian Armstrong]], CEO of CoinBase, who helped found and raise [https://www.dailymail.co.uk/sciencetech/article-10310475/Billionaire-launches-new-start-hopes-REVERSE-ageing-process.html $105 million for the epigenetic reprogramming startup NewLimit.]<ref>Liberatore, S. (2021, December 14). ''Billionaire launches new start-up to REVERSE the ageing process''. Mail Online. <nowiki>https://www.dailymail.co.uk/sciencetech/article-10310475/Billionaire-launches-new-start-hopes-REVERSE-ageing-process.html</nowiki></ref>
* [[wikipedia:Vitalik_Buterin|Vitalik Buterin]], founder of the cryptocurrency Ethereum, who donated $2.4 million to SENS.<ref>Foundation, S. R. (n.d.). ''SENS Research Foundation Receives $2.4 Million Ethereum Donation From Vitalik Buterin''. GlobeNewswire News Room. <nowiki>https://www.globenewswire.com/news-release/2018/02/02/1332410/0/en/SENS-Research-Foundation-Receives-2-4-Million-Ethereum-Donation-From-Vitalik-Buterin.html</nowiki></ref>

== How large will the longevity biotechnology field be? ==
Analysts from the Bank of America have predicted that the market size of longevity biotechnology will reach $600 billion by 2025.<ref>2021. ''Human lifespan could soon pass 100 years thanks to medical tech, says BofA''. [online] Available at: <<nowiki>https://www.cnbc.com/2019/05/08/techs-next-big-disruption-could-be-delaying-death.html</nowiki>> [Accessed 14 December 2021].</ref> Others have speculated that it is a trillion dollar industry owing to the immense savings associated with delaying or preventing chronic diseases.<ref>Colangelo, M., 2021. ''AI Will Drive The Multi-Trillion Dollar Longevity Economy''. [online] Forbes. Available at: <<nowiki>https://www.forbes.com/sites/cognitiveworld/2019/12/07/ai-will-drive-the-multi-trillion-dollar-longevity-economy/?sh=294766b74965</nowiki>> [Accessed 14 December 2021].</ref>
== Is aging an important for risk factor for COVID-19 mortality? ==

Aging is the largest risk factor for COVID-19. [[File:Age is the -1 risk factor for COVID-19 mortality.jpg|alt=Age is the #1 risk factor for COVID-19 mortality - based on US CDC statistics|thumb|572x572px|* Fold risk of COVID-19 mortality versus reference group aged 5-17 [https://www.cdc.gov/coronavirus/2019-ncov/covid-data/investigations-discovery/hospitalization-death-by-age.html (US CDC statistics)]]]
====COVID-19 defined as a disease of aging====
As detailed in the paper "[https://onlinelibrary.wiley.com/doi/full/10.1111/acel.13230 COVID‐19 is an emergent disease of aging",]<ref name=":29">[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7576244/ Santesmasses, D., Castro, J. P., Zenin, A. A., Shindyapina, A. V., Gerashchenko, M. V., Zhang, B., ... & Gladyshev, V. N. (2020). COVID‐19 is an emergent disease of aging. ''Aging cell'', ''19''(10), e13230.]</ref> COVID-19 meets several criteria for definition as an age-related disease:<ref>[[Promislow, D. E. (2020). A geroscience perspective on COVID-19 mortality. The Journals of Gerontology: Series A, 75(9), e30-e33.|Promislow, D. E. (2020). A geroscience perspective on COVID-19 mortality. ''The Journals of Gerontology: Series A'', ''75''(9), e30-e33.]]</ref><ref>Alberts, S. C., Archie, E. A., Gesquiere, L. R., Altmann, J., Vaupel, J. W., & Christensen, K. (2014). The male-female health-survival paradox: a comparative perspective on sex differences in aging and mortality. In ''Sociality, hierarchy, health: comparative biodemography: a collection of papers''. National Academies Press (US).</ref><ref name=":10">[[Sierra, F. (2020). Geroscience and the Coronavirus Pandemic: The Whack‐a‐Mole Approach is not Enough. Journal of the American Geriatrics Society, 68(5), 951.|Sierra, F. (2020). Geroscience and the Coronavirus Pandemic: The Whack‐a‐Mole Approach is not Enough. ''Journal of the American Geriatrics Society'', ''68''(5), 951.]]</ref><ref name=":11">[[Barzilai, N., Appleby, J. C., Austad, S. N., Cuervo, A. M., Kaeberlein, M., Gonzalez-Billault, C., ... & Sierra, F. (2020). Geroscience in the Age of COVID-19. Aging and disease, 11(4), 725.|Barzilai, N., Appleby, J. C., Austad, S. N., Cuervo, A. M., Kaeberlein, M., Gonzalez-Billault, C., ... & Sierra, F. (2020). Geroscience in the Age of COVID-19. ''Aging and disease'', ''11''(4), 725.]]</ref><ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7288963/</ref>

1) The doubling time for COVID-19 mortality approaches that of the doubling time of 8 years for all-cause mortality (characteristic exponential increase shared among major age-related chronic diseases);

2) Greater mortality rate in men, consistent with known sex differences in rates of aging;

3) Greater mortality rate for those with comorbidities (age-related diseases), consistent with accelerated biological aging; and,

4) Age dwarfs all other putative [[wikipedia:Risk_factor|risk factors]] for mortality by several orders of magnitude, exhibiting several thousand fold increase in risk across the lifespan
== How is aging biology research different to other fields of medical research? ==
Scientists studying the biology of aging believe that aging is the root cause of all the major diseases that afflict us as we age. Therefore, targeting aging biology would treat or reverse multiple diseases, simultaneously, while maximizing the chance of a cure.

Mainstream medical research has had many successes in treating single diseases, such as infectious diseases. For age-related ones, notable successes have been seen for heart diseases. However, targeting single diseases, one at a time, leads to rapidly diminishing returns. Even if we could ''cure'' heart disease and cancer, which are leading causes of death, each would add only ~2.5 years to life expectancy. This is because the next disease in line, e.g. Alzheimer's or lung disease, will kill you. This is the Taeuber Paradox, which highlights how the exponentially increasing risk of disease accumulation with aging limits the benefit of targeting single diseases.
== Do all animals age in the same way? ==
[[File:Naked mole rat graph.png|alt=Naked mole rat graph|thumb|530x530px|The naked mole-rat does not follow the same increased risk of mortality due to aging that humans and other mammals do. ]]
Many species, due to differences in their biology, age at different rates to humans. The jellyfish ''Turritopsis dohrnii'' can revert to earlier stages of its life cycle in response to stress, and can theoretically live forever - though eventually dies, usually due to predation.

Among mammals, the naked mole rat is an exceptionally long lived organism that lives roughly ten times longer than similarly-sized rats.<ref name=":3">Ruby, J. G., Smith, M., & Buffenstein, R. (2018). Naked mole-rat mortality rates defy Gompertzian laws by not increasing with age. ''elife'', ''7'', e31157.</ref><ref>Buffenstein, R., Amoroso, V., Andziak, B., Avdieiev, S., Azpurua, J., Barker, A. J., ... & Smith, E. S. J. (2021). The naked truth: a comprehensive clarification and classification of current ‘myths’ in naked mole‐rat biology. ''Biological Reviews''.</ref> Unlike other organisms, such as humans, horses and mice, the mortality rate of the naked mole rat appears steady over time. This trend does not follow the exponential increase in mortality (Gompertz-Makeham law) that humans do.<ref name=":3" />

Scientists are now studying the naked mole rat to identify key patterns in their genetics, environmental traits, and metabolism that may be responsible for their longer lifespans.

[[File:Naked mole rat.jpg|alt=Naked mole rat|center|thumb|323x323px|The naked mole rat is unusually long-lived relative to other mice and rats. ]]

== Is aging considered a disease? ==
Aging is not currently classified as a disease by regulatory bodies such as the Food and Drug Administration (FDA) in the United States. However, several scientists in the aging field have publicly stated their wish for aging to be considered a disease, including professor David Sinclair and professor Nir Barzilai.

== What are the economic benefits of extending healthy lifespan? ==
Extending the healthy human lifespan could have significant economic benefits gobally. An economic analysis from 2021 by researchers at the University of Oxford and Harvard University estimated the benefit of a drug that slows aging by 1 year as $38 trillion. This is primarily because slowing aging reduces the incidence of age-related diseases such as cancer and Alzheimer’s disease, which require expensive treatment approaches. The study demonstrated a larger economic benefit of slowing aging than curing the individual diseases of aging.
== Which anti-aging drugs are being tested in clinical trials today? ==
There are over 50 drugs being tested in human clinical trials for aging or age-related diseases.

The largest trial is the Targeting Aging with Metformin (TAME) trial, which began in 2020. The trial is being run in the United States with a cohort of 3000 older adults. The goal of the TAME trial is to determine whether diabetes drug metformin slows the aging process in older adults. The TAME trial is a $75 million trial run by the American Federation for Aging Research.

Another large clinical trial is the Participitory Evluation of Rapamycin (PEARL) study. The goal of this study is to determine whether rapamycin, a drug currently approved for immunosuppression during organ transplants, slows biomarkers of aging in 1000 adults. The PEARL trial is being run by AgelessRx.
== Is aging a natural process that should be accepted? ==
Although aging is a natural process in humans, it is the driving force of many diseases such as cancer and Alzheimer's disease - which as a society we have decided are worth trying to find cures for. In the past, these conditions, as well as atherosclerosis and even infectious diseases were once thought of as natural processes that could not be treated. However, nowadays it is understood that they are diseases that can be treated.

Atherosclerosis, the hardening of the arteries, was once viewed as a natural process that was simply a consequence of aging. However, when treatments such as statins were later developed to prevent atherosclerosis, the disease became widely regarded as a disease to be cured. Statins are now one one of the most widely prescribed drugs in the world, used in preventing heart diseases. The inventor of statins, Akira Endo, describes in his historical paper: “Serious research on the role of cholesterol in human atherosclerosis did not really get underway until the 1940s, due to a prevailing view that the disease was a simple consequence of aging and could not be prevented.”<ref>Endo A. (2010). A historical perspective on the discovery of statins. ''Proceedings of the Japan Academy. Series B, Physical and biological sciences'', ''86''(5), 484–493. <nowiki>https://doi.org/10.2183/pjab.86.484</nowiki></ref>

== Will anti-aging technology lead to overpopulation? ==
A common objection to the development of longevity technologies is that they may lead to an unsustainably large population size.

One study of a 2005 Swedish cohort of 9 million people modeled the effect of various anti-aging scenarios. The researchers showed that even with the most radical life-extension technology in which aging completely stopped after age 60, the population growth across 100 years was only 22%.

Currently, the world’s population is 7.9 billion, and the WHO predicts the population will peak at 11 billion in 2100 before falling due to declining birth rates in many parts of the world.

The fastest growing populations are in Africa and South-east Asia. However, several factors are thought to reduce birth rates over time, including increased access to contraceptives, female empowerment, increased education and increased employment. There is evidence that populations that move to a more advanced economy show a reduction in birth rates.

== Will anti-aging drugs only be available to the rich? ==
It is unclear who will have first access to longevity drugs. Several researchers in the field have argued that several economic factors are likely to drive down the price of drugs that slow aging.

* The cost of many biotechnologies decreases substantially over time. For example, the first human genome cost $100 million to sequence, and is now available for a few hundred dollars.

* The price of many lifesaving pharmaceuticals has fallen significantly in price once generic drugs were produced. For example, Lipitor, a statin used to prevent heart disease has fallen in price from $85 in 2011 to less than $5 today.

* Many companies in the longevity field have stated that equity of access is part of their core ethos, and many researchers are signatories to the

== Which scientists and institutions are trying to understand and reverse aging? ==
Hundreds of scientists are working on understanding the biology of aging in leading institutions like Harvard University, Stanford University, Yale University, and the University of Oxford. Some of the most well-known institutes and labs include:

=== The Buck Institute for Research on Aging ===
The Buck Institute for Research on Aging is one of the largest longevity research institutes with over 250 scientists. The research covers several areas including the mechanisms of aging, neurodegeneration, senescence, stem cells and regenerative medicine, cellular stress and disease, cancer associated with aging, and mitochondrial function.

=== Professor David Sinclair - Harvard Medical School ===
Professor Sinclair’s lab focuses on understanding and reversing aging. The lab focuses on a range of areas including DNA repair, mitochondrial dysfunction, and the interactions between epigenetic and genetic instability, and tissue reprogramming. Sinclair is also the author of the bestselling book, Lifespan: why we age and why we don’t have to.

=== Professor Matt Kaeberlein - University of Washington ===
Professor Kaeberlein's lab focuses on biological mechanisms of aging in order to facilitate translational interventions that promote healthspan and improve quality of life. Kaeberlein is known for his work on the longevity drug rapamycin in organisms such as mice and dogs. He is Director of the Dog Aging Project, a multi-year initiative studying the genetic and environmental factors that influence health, with over 33,000 participating dogs.

=== Professor Brian Kennedy - National University of Singapore ===
Professor Kennedy’s lab focuses on understanding the biology of aging and translating research discoveries into new ways of delaying aging in humans. The lab has identified drugs that extend the healthy lifespan of worms and mice and are seeking to understand their mechanisms.

=== Associate Professor Lynne Cox - University of Oxford ===
Professor Cox’s lab study the molecular and cellular basis of aging to identify specific biochemical processes and pathways that change organisms age. The lab particularly cellular senescence, which underpins many age-related diseases including cancer and neurodegeneration.

== What books have been written on this topic? ==
Several books have been written on the topic of aging and longevity. These include:

* ''Lifespan: Why We Age And Why We Don't Have To'' - David Sinclair (2019)

* ''Ending Aging'' - Dr. Aubrey de Grey (2007)

* ''Ageless'' - Dr. Andrew Steele (2020)

* ''Age Later'' - Professor Nir Barzilai (2021)

* ''The Science and Technology of Growing Young'' - Sergey Young (2021)

== References ==
<references />

File:Metformin2.jpg

2021-12-15T08:00:23Z

Jack:

Metformin

FAQ

2021-12-15T07:37:47Z

Jack: /* How many people die from aging per day? */

Aging is the driving force of many diseases. Longevity biotechnology is a new field of medical research and development that aims to extend healthy human lifespan and delay, prevent or reverse these diseases. This article provides an overview of the field, answering common questions.

== Why is aging a problem? ==
[[File:Aging graph.png|thumb|750x750px|The aging process results in the risk of age-related diseases increasing exponentially over time.]][[File:Gompertz-Makeham law of mortality.png|alt=Gompertz-Makeham law of mortality|thumb|257x257px|Gompertz-Makeham law of mortality<ref name=":0">En.wikipedia.org. 2021. ''Gompertz–Makeham law of mortality - Wikipedia''. [online] Available at: <<nowiki>https://en.wikipedia.org/wiki/Gompertz%E2%80%93Makeham_law_of_mortality</nowiki>> [Accessed 13 December 2021].</ref>]]Aging is the largest risk factor for the diseases that kill most people worldwide, including cancer, heart diseases and Alzheimer's disease.

In the US in 2020, 9 of the 10 leading causes of death were strongly age-related.<ref>Ahmad, F. B., & Anderson, R. N. (2021). The leading causes of death in the US for 2020. ''JAMA'', ''325''(18), 1829-1830.https://jamanetwork.com/journals/jama/fullarticle/2778234</ref> Globally, approximately 70% of deaths annually are the result of aging.<ref name=":8" />

Aging also significantly affects quality of life, as deaths due to aging are usually preceded by many months of years of chronic illnesses such as cancer, type 2 diabetes and Alzheimer’s disease.

As a result of the aging process, the risk of an individual dying increases exponentially after the age of around 30 years old.<ref name=":0" /> This increase in mortality rate is known as the Gompertz-Makeham law of mortality.<ref name=":0" />
== How many people die from aging per day? ==
The aging process results in the deaths of 100,000 people per day; more than twice the sum of all other causes of death combined.<ref name=":8">Ritchie, H. and Roser, M., 2021. ''Causes of Death''. [online] Our World in Data. Available at: <<nowiki>https://ourworldindata.org/causes-of-death</nowiki>> [Accessed 13 December 2021].
</ref> This equates to over 37 million people dying per day of aging - a population the size of Canada. This is because aging results in the exponential increasing risk of age-related diseases such as cancer and type 2 diabetes. Aging also accounts for more than 30% of all disability-adjusted life years lost (DALYs); more than any other single cause.<ref>Vizhub.healthdata.org. 2021. ''GBD Compare | IHME Viz Hub''. [online] Available at: <<nowiki>https://vizhub.healthdata.org/gbd-compare/</nowiki>> [Accessed 13 December 2021].</ref>
[[File:Leading causes of death.png|center|thumb|713x713px|9 of the top 10 causes of death in the US in 2020 were strongly age-related]]

== Can healthy lifespan be extended? ==
[[File:Life extension mice.jpg|alt=Life extension mice|thumb|431x431px|Dietary manipulation, genetic manipulation, and drugs have been shown to increase the healthy lifespan of mice by up to 30%. <ref name=":1">de Magalhaes, J., 2021. ''DrugAge: Species Detail''. [online] Genomics.senescence.info. Available at: <<nowiki>https://genomics.senescence.info/drugs/species_details.php</nowiki>> [Accessed 14 December 2021].</ref>]]Clinical trials for longevity drugs in humans are in-progress, and there is not yet evidence that drugs can slow aging in humans. However, recent experimental breakthroughs over the last few decades have shown that mice, worms and flies have demonstrated that healthy lifespan can be extended modified.

Slowing the aging process in animals can be achieved via manipulation of diet, environment, genetics, epigenetics, or with drugs. In mice, over 100 drugs have been shown to extend healthy lifespan by up to 30%.<ref name=":1" />

The effect of longevity drugs on mice is often significant, delaying or eliminating the burden of age-related problems such as frailty, cataracts, cancer, and sarcopenia. A new class of drugs called senolytics have been shown to extend healthy lifespan in mice by over 30%.

== Which drugs may extend healthy lifespan? ==
Several drugs are known to extend healthy lifespan in animals. While there is no conclusive data that suggests these drugs would work the same in humans, many of these drugs are now being tested in clinical trials. [[File:Unity Mice.jpg|alt=Unity Mice|thumb|723x723px|Senolytic drugs remove senescent cells, partially reversing multiple age-related diseases and extending the healthy lifespan of mice. ]]

=== Senolytics ===
Senolytics are drugs that remove senescent cells. These are cells which accumulate in the body with age and are linked with age-related diseases such as cancer.

In mice, senolytics have been shown to increase the healthy period of lifespan by up to 35%. The first clinical trials of senolytics in humans began in 2020, and demonstrated promise that these drugs may be effective in humans.

=== [[Metformin]] ===
Metformin is an approved drug for type 2 diabetes that extends lifespan in multiple species. In mice, Metformin extends lifespan by up to 6%. Metformin is being tested as a longevity therapy in the largest clinical trial for a longevity therapy, the Targeting Aging with Metformin (TAME) trial in the US. This is a randomized clinical trial of 3000 elderly patients comparing metformin against a placebo for the onset of age-related diseases.

=== [[Rapamycin]] ===

Rapamycin is a drug used to prevent the rejection of organ transplants by the immune system. Rapamycin has been shown to extend lifespan by up to 26% when given at middle age, and 14% when given in late life.<ref>Harrison, D., Strong, R., Sharp, Z. ''et al.'' Rapamycin fed late in life extends lifespan in genetically heterogeneous mice. ''Nature'' 460, 392–395 (2009). <nowiki>https://doi.org/10.1038/nature08221</nowiki>
</ref><ref>Miller, R. A., Harrison, D. E., Astle, C. M., Fernandez, E., Flurkey, K., Han, M., Javors, M. A., Li, X., Nadon, N. L., Nelson, J. F., Pletcher, S., Salmon, A. B., Sharp, Z. D., Van Roekel, S., Winkleman, L., & Strong, R. (2014). Rapamycin-mediated lifespan increase in mice is dose and sex dependent and metabolically distinct from dietary restriction. ''Aging cell'', ''13''(3), 468–477. <nowiki>https://doi.org/10.1111/acel.12194</nowiki></ref> Rapamycin is currently being tested in a large-scale clinical trial called the Participatory Evaluation (of) Aging (With) Rapamycin (for) Longevity Study (PEARL). The study is a randomized clinical trial of 1000 elderly patients comparing rapamycin against placebo for age-related outcomes.<ref>Clinicaltrials.gov. 2021. ''Participatory Evaluation (of) Aging (With) Rapamycin (for) Longevity Study - Full Text View - ClinicalTrials.gov''. [online] Available at: <<nowiki>https://clinicaltrials.gov/ct2/show/NCT04488601</nowiki>> [Accessed 14 December 2021].
</ref>

In addition, over 50 other drugs being tested in human clinical trials for slowing aging.<ref name=":2">Lifespan.io. 2021. ''The Rejuvenation Roadmap | Lifespan.io''. [online] Available at: <<nowiki>https://www.lifespan.io/road-maps/the-rejuvenation-roadmap/</nowiki>> [Accessed 13 December 2021].</ref>

== What is the goal of longevity biotechnology? ==
[[File:Healthy lifespan extension.png|alt=Healthy lifespan extension|thumb|643x643px|Healthy lifespan extension]]
Longevity biotechnology aims to create therapies to extend the healthy human lifespan. Aging is associated with functional decline, diseases and an increased risk of death.

Longevity biotechnology attempts to slow or reverse the aging process to extend the healthy lifespan (‘healthspan’) of the population.

The longevity biotechnology sector is rapidly growing, and there are currently over 170 private companies working on developing therapeutics to slow the aging process.<ref name=":4">Pfleger, K., 2021. ''Aging Companies''. [online] Agingbiotech.info. Available at: <<nowiki>https://agingbiotech.info/companies</nowiki>> [Accessed 13 December 2021].</ref> These companies are working on slowing or reversing the aging process by targeting one of more of the hallmarks of aging.

== Will healthy or unhealthy lifespan be extended? ==
[[File:Extending healthy lifespan.png|alt=Extending healthy lifespan|thumb|364x364px|Extending healthy lifespan]]
The stated goal of longevity biotechnology is to extend the healthy period of lifespan, before age-related diseases set in. This is in contrast to many of today's medical interventions, which extend life only after diseases (e.g. cancer, Alzheimer's) have reached a clinical level.

Age-related diseases are preceded by a long period of subclinical aging, i.e. aging that has not yet progressed far enough to produce clinical symptoms. By slowing, delaying or reversing the aging process, the healthy period of life can be extended.

Studies in mice have demonstrated that life extending drugs such as rapamycin are capable of extending the healthy, rather than unhealthy period of life.
== Should we treat specific diseases such as cancer, or aging? ==
[[File:Slowing aging versus curing cancer.jpg|alt=Slowing aging is potentially a more effective means of extending healthy lifespan than treating individual diseases due to the comorbid nature of age-related diseases. [6]|thumb|421x421px|Slowing aging is potentially a more effective means of extending healthy lifespan than treating individual diseases due to the comorbid nature of age-related diseases. ]]
Longevity biotechnology potentially offers a greater likelihood of extending healthy lifespan than attempting to find cures for the individual diseases of aging. This is because biological aging is associated with many of diseases of aging that develop as comorbidities i.e. at the same time. Even if a person survives one age-related disease such as cancer, another (e.g. diabetes, cardiovascular disease) is likely to kill the person if the underlying aging is not treated. This phenomenon is known as Taueber's paradox<ref>En.wikipedia.org. 2021. ''Taeuber Paradox - Wikipedia''. [online] Available at: <<nowiki>https://en.wikipedia.org/wiki/Taeuber_Paradox</nowiki>> [Accessed 14 December 2021].</ref>, and accounts for the much smaller projected increase in healthy lifespan associated with curing the diseases of aging, such as cancer (2-3 years), versus slowing aging itself (30+ years).<ref>Matt Kaeberlein, PhD, It is Time to Embrace 21st-Century Medicine, ''Public Policy & Aging Report'', Volume 29, Issue 4, 2019, Pages 111–115, <nowiki>https://doi.org/10.1093/ppar/prz022</nowiki></ref>
== What is biological aging? ==
There are two main types of 'age': chronological age - the number of years since birth, and biological age - a measure of the physical health of a person and their position in their lifespan. Biological age is more difficult to measure, but recent technologies are now available to estimate biological age. Over time, we age biologically. This occurs due to many processes in the body, which are generally categorised into 9 processes or 'hallmarks'.
== What are the 9 Hallmarks of Aging? ==
[[File:Hallmarks of aging.jpg|alt=Hallmarks of aging|thumb|444x444px|Hallmarks of aging]]

The hallmarks of aging framework is considered to broadly represent key biological mechanisms of the biological aging process.<ref name=":9">López-Otín C, Blasco MA, Partridge L, Serrano M, Kroemer G. The hallmarks of aging. Cell. 2013 Jun 6;153(6):1194-217.</ref> Although there are various limitations of the hallmarks framework, it has become the central framework for understanding aging biology. The nine forms of cellular and molecular ‘damage’ that comprise the hallmarks of aging are<ref name=":9" />:

* Genomic instability
* Telomere attrition
* Epigenetic alterations
* Loss of proteostasis
* Deregulated nutrient-sensing
* Mitochondrial dysfunction
* Cellular senescence
* Stem cell exhaustion
* Altered intercellular communication

These are essentially the lowest common denominators of the aging process, on a cellular or subcellular level. All of the other changes associated with aging, such as greying hair, wrinkles, frailty and an increased risk of disease is thought to stem from these underlyig processes.<ref name=":9" />

== How does the aging cause disease? ==
The nine hallmarks of aging have been shown to play an integral role in the development of many age-related diseases such as neurodegenerative diseases and cancer:
=== [[Aging and Neurodegeneration|Neurodegenerative disease]] ===
[[File:Prevalence of neuro disorders.jpg|alt=Prevalence of neuro disorders|thumb|469x469px|The prevalence of neurodegenerative disorders increases exponentially with age, due to the biological aging process.<ref name=":12">Hou, Y., Dan, X., Babbar, M., Wei, Y., Hasselbalch, S. G., Croteau, D. L., & Bohr, V. A. (2019). Ageing as a risk factor for neurodegenerative disease. ''Nature reviews. Neurology'', ''15''(10), 565–581. <nowiki>https://doi.org/10.1038/s41582-019-0244-7</nowiki></ref> ]]
All of the hallmarks of aging are associated with an increased risk of neurodegenerative diseases, such as Parkinson's disease and Alzheimer's disease.<ref>Qiu, C., Kivipelto, M., & von Strauss, E. (2009). Epidemiology of Alzheimer's disease: occurrence, determinants, and strategies toward intervention. ''Dialogues in clinical neuroscience'', ''11''(2), 111.</ref> For example, several types of DNA damage are associated with neurodegeneration. The shortening of telomeres occurs as part of biological aging and causes cellular senescence, and is associated with neurodegeneration and neurodegenerative diseases including Alzheimer's disease and Parkinson's disease.<ref name=":12" /> Additionally, mitochondrial dysfunction, altered metabolism, stem cell exhaustion and loss of proteostasis are also involved in the development of neurodegenerative diseases.<ref name=":12" />
=== [[Aging and Cancer|Cancer]] ===
Several of the hallmarks of aging such as cellular senescence and alterations in the extracellular matrix are responsible for increasing the likelihood of tumorigenesis.<ref name=":5">Fane, M., & Weeraratna, A. T. (2020). How the ageing microenvironment influences tumour progression. ''Nature Reviews Cancer'', ''20''(2), 89-106.</ref> Other hallmarks of aging such as genomic instability, loss or proteostasis, altered intercellular communication (i.e. inflammation) and epigenetic alterations are also involved in tumorigenesis.<ref name=":5" />
== How is biological age measured? ==
[[File:Epigenetic clock.png|alt=Epigenetic clock|thumb|605x605px|Epigenetic clock is the first aging clock. ]]
Recent technologies have allow biological age to be measured. These include:

=== [[Epigenetic clock|Epigenetic clocks]] ===
The first generation of aging clocks are known as [[Epigenetic clock|epigenetic clocks or Horvath’s clock]].<ref name=":6">Horvath, S., & Raj, K. (2018). DNA methylation-based biomarkers and the epigenetic clock theory of ageing. ''Nature Reviews Genetics'', ''19''(6), 371-384.</ref> This clock is based on the finding that over time, the body accumulates methylation tags on the DNA in a pattern that can be predicted with machine learning. These changes to the epigenome are influenced by lifestyle, and can be used to measure biological age.<ref name=":6" /> Factors such as exercise frequency and a low BMI have been shown to reduce the rate of biological aging, whereas obesity and smoking can accelerate the rate of aging.<ref>Quach, A., Levine, M. E., Tanaka, T., Lu, A. T., Chen, B. H., Ferrucci, L., ... & Horvath, S. (2017). Epigenetic clock analysis of diet, exercise, education, and lifestyle factors. ''Aging (Albany NY)'', ''9''(2), 419.</ref><ref>Wu, X., Huang, Q., Javed, R., Zhong, J., Gao, H., & Liang, H. (2019). Effect of tobacco smoking on the epigenetic age of human respiratory organs. ''Clinical Epigenetics'', ''11''(1), 183. <nowiki>https://doi.org/10.1186/s13148-019-0777-z</nowiki>

[[Epigenetic clock#cite%20ref-12|↑]]</ref><ref>Horvath, S., Erhart, W., Brosch, M., Ammerpohl, O., von Schönfels, W., Ahrens, M., Heits, N., Bell, J. T., Tsai, P.-C., Spector, T. D., Deloukas, P., Siebert, R., Sipos, B., Becker, T., Röcken, C., Schafmayer, C., & Hampe, J. (2014). Obesity accelerates epigenetic aging of human liver. ''Proceedings of the National Academy of Sciences'', ''111''(43), 15538–15543. <nowiki>https://doi.org/10.1073/pnas.1412759111</nowiki>

[[Epigenetic clock#cite%20ref-13|↑]]</ref> The Horvath's clock has been used to accurately predict mortality risk.<ref>Fransquet, P. D., Wrigglesworth, J., Woods, R. L., Ernst, M. E., & Ryan, J. (2019). The epigenetic clock as a predictor of disease and mortality risk: a systematic review and meta-analysis. ''Clinical epigenetics'', ''11''(1), 1-17.</ref>

=== Multi-omic clocks ===
Multi-omic clocks are being developed that incorporate data from several sources, such as body imaging scans, blood tests, and fitness tests. These clocks are built using machine learning to estimate biological age. These aging clocks are being developed that combine multiple biological functional tests to create a unique aging signature, which can be monitored over time.<ref>Kudryashova, K. S., Burka, K., Kulaga, A. Y., Vorobyeva, N. S., & Kennedy, B. K. (2020). Aging Biomarkers: From Functional Tests to Multi‐Omics Approaches. ''Proteomics'', ''20''(5-6), 1900408.</ref>
[[File:Multiomic aging clock.jpg|alt=Multiomic clocks|center|thumb|542x542px|Multiomic clocks integrate various data sources to create a unique biological aging signature that can be tracked over time. ]]
== Which companies are trying to solve aging? ==
[[File:Calico Labs.png|alt=T|thumb|Calico Labs, a subsidiary of Google, is a billion-dollar company searching for treatments for aging. ]]
There are over [https://agingbiotech.info/companies 170 longevity biotechnology companies] trying to create therapies to slow or reverse the aging process.<ref name=":4" /> There are over [https://www.lifespan.io/road-maps/the-rejuvenation-roadmap/ 50 longevity drugs] currently in clinical trials in humans.<ref name=":2" />

Many of the longevity biotechnology companies are targeting specific hallmarks of aging. For example, [https://www.clearabiotech.com/#DiscoveryTimeline Cleara Biotech] are attempting to reduce cellular senescence by developing a drug that can eliminate senescent cells.<ref>Cleara Biotech. 2021. ''Cleara Biotech''. [online] Available at: <<nowiki>https://www.clearabiotech.com/#DiscoveryTimeline</nowiki>> [Accessed 15 December 2021].</ref>

Calico Labs is a Google-backed biotech company with the goal of combating aging and age-related diseases. In 2014, the company created a partnership with pharmaceutical giant AbbVie, which has since developed into a [https://www.cnbc.com/2018/06/26/alphabet-backed-calico-and-abbvie-chip-in-1-billion-to-cure-aging.html $2.5 billion venture] in the pursuit of improving “health, wellbeing and longevity.” <ref>2021. ''Google sister company and drug giant chip in another $1 billion to cure age-related diseases''. [online] Available at: <<nowiki>https://www.cnbc.com/2018/06/26/alphabet-backed-calico-and-abbvie-chip-in-1-billion-to-cure-aging.html</nowiki>> [Accessed 15 December 2021].</ref>

Since aging is not currently considered a disease by regulatory bodies such as the Food and Drug Administration (FDA), drug developers are currently focused on specific diseases of aging such as glaucoma and osteoarthritis.<ref>Clinicaltrialsarena.com. 2021. ''Unity's Phase II osteoarthritis study of UBX0101 misses primary goal''. [online] Available at: <<nowiki>https://www.clinicaltrialsarena.com/news/unity-ubx0101-osteoarthritis/</nowiki>> [Accessed 15 December 2021].</ref>

== Which billionaires are funding longevity biotechnology? ==
[[File:Jeff Bezos is funding longevity research.jpg|alt=Jeff Bezos is funding longevity research|thumb|Jeff Bezos is funding longevity research through financing Atlos Labs.<ref name=":7">MIT Technology Review. 2021. ''Meet Altos Labs, Silicon Valley’s latest wild bet on living forever''. [online] Available at: <<nowiki>https://www.technologyreview.com/2021/09/04/1034364/altos-labs-silicon-valleys-jeff-bezos-milner-bet-living-forever/</nowiki>> [Accessed 15 December 2021].</ref>]]
Several billionaires have funded companies or initiatives to slow or reverse human aging. These include:
* [[wikipedia:Jeff_Bezos|Jeff Bezos]], co-founder of Amazon, helped raise [https://www.technologyreview.com/2021/09/04/1034364/altos-labs-silicon-valleys-jeff-bezos-milner-bet-living-forever/ $270 million for new anti-aging drug company Altos Labs] in 2021.<ref name=":7" />
* [[wikipedia:Peter_Thiel|Peter Thiel]], co-founder of PayPal, was an [https://www.cnbc.com/2018/08/29/-jeff-bezos-is-backing-this-scientist-who-is-working-on-a-cure-for-aging.html early investor in Unity Biotechnology].<ref>CNBC. 2021. ''Why Jeff Bezos is backing this Silicon Valley scientist who is working on a cure for aging''. [online] Available at: <<nowiki>https://www.cnbc.com/2018/08/29/-jeff-bezos-is-backing-this-scientist-who-is-working-on-a-cure-for-aging.html</nowiki>> [Accessed 15 December 2021].</ref>
* [[wikipedia:Sergey_Brin|Sergey Brin]], co-founder of Google, donated [https://www.cnbc.com/2017/03/31/google-co-founders-and-silicon-valley-billionaires-try-to-live-forever.html $25 million for the National Academy of Medicine’s Grand Challenge in Health Longevity] to 'end aging forever'.<ref>Google’s co-founders and other Silicon Valley billionaires are trying to live forever. (2021). Retrieved 15 December 2021, from <nowiki>https://www.cnbc.com/2017/03/31/google-co-founders-and-silicon-valley-billionaires-try-to-live-forever.html</nowiki></ref>
* [[wikipedia:Larry_Page|Larry Page]], co-founder of Google, co-founded the [[wikipedia:Calico_(company)|billion-dollar aging research company Calico Labs.]]<ref>Contributors to Wikimedia projects. (2013, September 19). ''Calico (company) - Wikipedia''. Wikipedia, the free encyclopedia. <nowiki>https://en.wikipedia.org/wiki/Calico_(company)</nowiki>
</ref>
* [[wikipedia:Mike_Cannon-Brookes|Mike Cannon-Brookes]], billionaire cofounder of Australian software giant Atlassian, has invested [https://www.forbes.com/sites/samshead/2019/08/19/billionaire-backs-uk-startup-trying-to-extend-human-lifespans/ $10 million into longevity company Juvenescenc]e.<ref>Shead, S. (2019, August 19). ''Billionaire Backs U.K. Startup Trying To Extend Human Life Spans''. Forbes. <nowiki>https://www.forbes.com/sites/samshead/2019/08/19/billionaire-backs-uk-startup-trying-to-extend-human-lifespans/</nowiki></ref>
* [[wikipedia:Naveen_Jain|Naveen Jain]], billionaire entrepeneur who has raised [https://www.geekwire.com/2021/gut-health-startup-viome-raises-54m-develop-cancer-diagnostics-sell-microbiome-kits/ $54 million for his startup Viome].<ref>''Gut health startup Viome raises $54M to develop cancer diagnostics and sell microbiome kits''. (2021, November 10). Geekwire. <nowiki>https://www.geekwire.com/2021/gut-health-startup-viome-raises-54m-develop-cancer-diagnostics-sell-microbiome-kits/</nowiki></ref>
* [[wikipedia:Jim_Mellon|Jim Mellon]], who co-founded longevity company [https://www.juvlabs.com/people/co-founder/jim-mellon Juvenescence].<ref>''Jim Mellon - Chairman & Co-Founder''. (n.d.). Juvenescence - Science of Healthy Aging & Extended Lifespan. <nowiki>https://www.juvlabs.com/people/co-founder/jim-mellon</nowiki></ref>
* [[wikipedia:Larry_Ellison|Larry Ellison]], founder of Oracle, has spent [https://www.townandcountrymag.com/society/money-and-power/a9202324/science-of-longevity/ $430 million on longevity research].<ref>Tullis, P. (2017, March 30). ''Are You Rich Enough To Live Forever?'' Town & Country. <nowiki>https://www.townandcountrymag.com/society/money-and-power/a9202324/science-of-longevity/</nowiki></ref>
*Michael Greve, founder of Kizoo Technology, who has pledged [https://Longevity.Technology. https://www.longevity.technology/michael-greve-commits-e300m-for-rejuvenation-start-ups/ €300m to rejuvenation biotechnology companies.]<ref>''Michael Greve commits €300m for rejuvenation start-ups''. (2021, May 6). Longevity.Technology. <nowiki>https://www.longevity.technology/michael-greve-commits-e300m-for-rejuvenation-start-ups/</nowiki></ref>
* [[wikipedia:Yuri_Milner|Yuri Milner]], billionaire tech investor who has helped Altos Labs raise $270 million, with Jeff Bezos.<ref name=":7" />
* [https://wikitia.com/wiki/Richard_Heart Richard Heart], founder of the cryptocurrency Hex, who helped raise [https://www.express.co.uk/finance/city/1465354/pulsechain-cryptocurrency-srf-sens-research-foundation-airdrop-pulse-charity-longevity $25 million for the anti-aging research organisation SENS.]<ref>McGleenon, B. (2021, July 20). ''Pulsechain cryptocurrency raises 'mindblowing' $25M in five days for SENS longevity group''. Express.co.uk. <nowiki>https://www.express.co.uk/finance/city/1465354/pulsechain-cryptocurrency-srf-sens-research-foundation-airdrop-pulse-charity-longevity</nowiki></ref>
*[[wikipedia:Brian_Armstrong_(businessman)|Brian Armstrong]], CEO of CoinBase, who helped found and raise [https://www.dailymail.co.uk/sciencetech/article-10310475/Billionaire-launches-new-start-hopes-REVERSE-ageing-process.html $105 million for the epigenetic reprogramming startup NewLimit.]<ref>Liberatore, S. (2021, December 14). ''Billionaire launches new start-up to REVERSE the ageing process''. Mail Online. <nowiki>https://www.dailymail.co.uk/sciencetech/article-10310475/Billionaire-launches-new-start-hopes-REVERSE-ageing-process.html</nowiki></ref>
* [[wikipedia:Vitalik_Buterin|Vitalik Buterin]], founder of the cryptocurrency Ethereum, who donated $2.4 million to SENS.<ref>Foundation, S. R. (n.d.). ''SENS Research Foundation Receives $2.4 Million Ethereum Donation From Vitalik Buterin''. GlobeNewswire News Room. <nowiki>https://www.globenewswire.com/news-release/2018/02/02/1332410/0/en/SENS-Research-Foundation-Receives-2-4-Million-Ethereum-Donation-From-Vitalik-Buterin.html</nowiki></ref>

== How large will the longevity biotechnology field be? ==
Analysts from the Bank of America have predicted that the market size of longevity biotechnology will reach $600 billion by 2025.<ref>2021. ''Human lifespan could soon pass 100 years thanks to medical tech, says BofA''. [online] Available at: <<nowiki>https://www.cnbc.com/2019/05/08/techs-next-big-disruption-could-be-delaying-death.html</nowiki>> [Accessed 14 December 2021].</ref> Others have speculated that it is a trillion dollar industry owing to the immense savings associated with delaying or preventing chronic diseases.<ref>Colangelo, M., 2021. ''AI Will Drive The Multi-Trillion Dollar Longevity Economy''. [online] Forbes. Available at: <<nowiki>https://www.forbes.com/sites/cognitiveworld/2019/12/07/ai-will-drive-the-multi-trillion-dollar-longevity-economy/?sh=294766b74965</nowiki>> [Accessed 14 December 2021].</ref>
== Is aging an important for risk factor for COVID-19 mortality? ==

Aging is the largest risk factor for COVID-19. [[File:Age is the -1 risk factor for COVID-19 mortality.jpg|alt=Age is the #1 risk factor for COVID-19 mortality - based on US CDC statistics|thumb|572x572px|* Fold risk of COVID-19 mortality versus reference group aged 5-17 [https://www.cdc.gov/coronavirus/2019-ncov/covid-data/investigations-discovery/hospitalization-death-by-age.html (US CDC statistics)]]]
====COVID-19 defined as a disease of aging====
As detailed in the paper "[https://onlinelibrary.wiley.com/doi/full/10.1111/acel.13230 COVID‐19 is an emergent disease of aging",]<ref name=":29">[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7576244/ Santesmasses, D., Castro, J. P., Zenin, A. A., Shindyapina, A. V., Gerashchenko, M. V., Zhang, B., ... & Gladyshev, V. N. (2020). COVID‐19 is an emergent disease of aging. ''Aging cell'', ''19''(10), e13230.]</ref> COVID-19 meets several criteria for definition as an age-related disease:<ref>[[Promislow, D. E. (2020). A geroscience perspective on COVID-19 mortality. The Journals of Gerontology: Series A, 75(9), e30-e33.|Promislow, D. E. (2020). A geroscience perspective on COVID-19 mortality. ''The Journals of Gerontology: Series A'', ''75''(9), e30-e33.]]</ref><ref>Alberts, S. C., Archie, E. A., Gesquiere, L. R., Altmann, J., Vaupel, J. W., & Christensen, K. (2014). The male-female health-survival paradox: a comparative perspective on sex differences in aging and mortality. In ''Sociality, hierarchy, health: comparative biodemography: a collection of papers''. National Academies Press (US).</ref><ref name=":10">[[Sierra, F. (2020). Geroscience and the Coronavirus Pandemic: The Whack‐a‐Mole Approach is not Enough. Journal of the American Geriatrics Society, 68(5), 951.|Sierra, F. (2020). Geroscience and the Coronavirus Pandemic: The Whack‐a‐Mole Approach is not Enough. ''Journal of the American Geriatrics Society'', ''68''(5), 951.]]</ref><ref name=":11">[[Barzilai, N., Appleby, J. C., Austad, S. N., Cuervo, A. M., Kaeberlein, M., Gonzalez-Billault, C., ... & Sierra, F. (2020). Geroscience in the Age of COVID-19. Aging and disease, 11(4), 725.|Barzilai, N., Appleby, J. C., Austad, S. N., Cuervo, A. M., Kaeberlein, M., Gonzalez-Billault, C., ... & Sierra, F. (2020). Geroscience in the Age of COVID-19. ''Aging and disease'', ''11''(4), 725.]]</ref><ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7288963/</ref>

1) The doubling time for COVID-19 mortality approaches that of the doubling time of 8 years for all-cause mortality (characteristic exponential increase shared among major age-related chronic diseases);

2) Greater mortality rate in men, consistent with known sex differences in rates of aging;

3) Greater mortality rate for those with comorbidities (age-related diseases), consistent with accelerated biological aging; and,

4) Age dwarfs all other putative [[wikipedia:Risk_factor|risk factors]] for mortality by several orders of magnitude, exhibiting several thousand fold increase in risk across the lifespan
== How is aging biology research different to other fields of medical research? ==
Scientists studying the biology of aging believe that aging is the root cause of all the major diseases that afflict us as we age. Therefore, targeting aging biology would treat or reverse multiple diseases, simultaneously, while maximizing the chance of a cure.

Mainstream medical research has had many successes in treating single diseases, such as infectious diseases. For age-related ones, notable successes have been seen for heart diseases. However, targeting single diseases, one at a time, leads to rapidly diminishing returns. Even if we could ''cure'' heart disease and cancer, which are leading causes of death, each would add only ~2.5 years to life expectancy. This is because the next disease in line, e.g. Alzheimer's or lung disease, will kill you. This is the Taeuber Paradox, which highlights how the exponentially increasing risk of disease accumulation with aging limits the benefit of targeting single diseases.
== Do all animals age in the same way? ==
[[File:Naked mole rat graph.png|alt=Naked mole rat graph|thumb|530x530px|The naked mole-rat does not follow the same increased risk of mortality due to aging that humans and other mammals do. ]]
Many species, due to differences in their biology, age at different rates to humans. The jellyfish ''Turritopsis dohrnii'' can revert to earlier stages of its life cycle in response to stress, and can theoretically live forever - though eventually dies, usually due to predation.

Among mammals, the naked mole rat is an exceptionally long lived organism that lives roughly ten times longer than similarly-sized rats.<ref name=":3">Ruby, J. G., Smith, M., & Buffenstein, R. (2018). Naked mole-rat mortality rates defy Gompertzian laws by not increasing with age. ''elife'', ''7'', e31157.</ref><ref>Buffenstein, R., Amoroso, V., Andziak, B., Avdieiev, S., Azpurua, J., Barker, A. J., ... & Smith, E. S. J. (2021). The naked truth: a comprehensive clarification and classification of current ‘myths’ in naked mole‐rat biology. ''Biological Reviews''.</ref> Unlike other organisms, such as humans, horses and mice, the mortality rate of the naked mole rat appears steady over time. This trend does not follow the exponential increase in mortality (Gompertz-Makeham law) that humans do.<ref name=":3" />

Scientists are now studying the naked mole rat to identify key patterns in their genetics, environmental traits, and metabolism that may be responsible for their longer lifespans.

[[File:Naked mole rat.jpg|alt=Naked mole rat|center|thumb|323x323px|The naked mole rat is unusually long-lived relative to other mice and rats. ]]

== Is aging considered a disease? ==
Aging is not currently classified as a disease by regulatory bodies such as the Food and Drug Administration (FDA) in the United States. However, several scientists in the aging field have publicly stated their wish for aging to be considered a disease, including professor David Sinclair and professor Nir Barzilai.

== What are the economic benefits of extending healthy lifespan? ==
Extending the healthy human lifespan could have significant economic benefits gobally. An economic analysis from 2021 by researchers at the University of Oxford and Harvard University estimated the benefit of a drug that slows aging by 1 year as $38 trillion. This is primarily because slowing aging reduces the incidence of age-related diseases such as cancer and Alzheimer’s disease, which require expensive treatment approaches. The study demonstrated a larger economic benefit of slowing aging than curing the individual diseases of aging.
== Which anti-aging drugs are being tested in clinical trials today? ==
There are over 50 drugs being tested in human clinical trials for aging or age-related diseases.

The largest trial is the Targeting Aging with Metformin (TAME) trial, which began in 2020. The trial is being run in the United States with a cohort of 3000 older adults. The goal of the TAME trial is to determine whether diabetes drug metformin slows the aging process in older adults. The TAME trial is a $75 million trial run by the American Federation for Aging Research.

Another large clinical trial is the Participitory Evluation of Rapamycin (PEARL) study. The goal of this study is to determine whether rapamycin, a drug currently approved for immunosuppression during organ transplants, slows biomarkers of aging in 1000 adults. The PEARL trial is being run by AgelessRx.
== Is aging a natural process that should be accepted? ==
Although aging is a natural process in humans, it is the driving force of many diseases such as cancer and Alzheimer's disease - which as a society we have decided are worth trying to find cures for. In the past, these conditions, as well as atherosclerosis and even infectious diseases were once thought of as natural processes that could not be treated. However, nowadays it is understood that they are diseases that can be treated.

Atherosclerosis, the hardening of the arteries, was once viewed as a natural process that was simply a consequence of aging. However, when treatments such as statins were later developed to prevent atherosclerosis, the disease became widely regarded as a disease to be cured. Statins are now one one of the most widely prescribed drugs in the world, used in preventing heart diseases. The inventor of statins, Akira Endo, describes in his historical paper: “Serious research on the role of cholesterol in human atherosclerosis did not really get underway until the 1940s, due to a prevailing view that the disease was a simple consequence of aging and could not be prevented.”<ref>Endo A. (2010). A historical perspective on the discovery of statins. ''Proceedings of the Japan Academy. Series B, Physical and biological sciences'', ''86''(5), 484–493. <nowiki>https://doi.org/10.2183/pjab.86.484</nowiki></ref>

== Will anti-aging technology lead to overpopulation? ==
A common objection to the development of longevity technologies is that they may lead to an unsustainably large population size.

One study of a 2005 Swedish cohort of 9 million people modeled the effect of various anti-aging scenarios. The researchers showed that even with the most radical life-extension technology in which aging completely stopped after age 60, the population growth across 100 years was only 22%.

Currently, the world’s population is 7.9 billion, and the WHO predicts the population will peak at 11 billion in 2100 before falling due to declining birth rates in many parts of the world.

The fastest growing populations are in Africa and South-east Asia. However, several factors are thought to reduce birth rates over time, including increased access to contraceptives, female empowerment, increased education and increased employment. There is evidence that populations that move to a more advanced economy show a reduction in birth rates.

== Will anti-aging drugs only be available to the rich? ==
It is unclear who will have first access to longevity drugs. Several researchers in the field have argued that several economic factors are likely to drive down the price of drugs that slow aging.

* The cost of many biotechnologies decreases substantially over time. For example, the first human genome cost $100 million to sequence, and is now available for a few hundred dollars.

* The price of many lifesaving pharmaceuticals has fallen significantly in price once generic drugs were produced. For example, Lipitor, a statin used to prevent heart disease has fallen in price from $85 in 2011 to less than $5 today.

* Many companies in the longevity field have stated that equity of access is part of their core ethos, and many researchers are signatories to the

== Which scientists and institutions are trying to understand and reverse aging? ==
Hundreds of scientists are working on understanding the biology of aging in leading institutions like Harvard University, Stanford University, Yale University, and the University of Oxford. Some of the most well-known institutes and labs include:

=== The Buck Institute for Research on Aging ===
The Buck Institute for Research on Aging is one of the largest longevity research institutes with over 250 scientists. The research covers several areas including the mechanisms of aging, neurodegeneration, senescence, stem cells and regenerative medicine, cellular stress and disease, cancer associated with aging, and mitochondrial function.

=== Professor David Sinclair - Harvard Medical School ===
Professor Sinclair’s lab focuses on understanding and reversing aging. The lab focuses on a range of areas including DNA repair, mitochondrial dysfunction, and the interactions between epigenetic and genetic instability, and tissue reprogramming. Sinclair is also the author of the bestselling book, Lifespan: why we age and why we don’t have to.

=== Professor Matt Kaeberlein - University of Washington ===
Professor Kaeberlein's lab focuses on biological mechanisms of aging in order to facilitate translational interventions that promote healthspan and improve quality of life. Kaeberlein is known for his work on the longevity drug rapamycin in organisms such as mice and dogs. He is Director of the Dog Aging Project, a multi-year initiative studying the genetic and environmental factors that influence health, with over 33,000 participating dogs.

=== Professor Brian Kennedy - National University of Singapore ===
Professor Kennedy’s lab focuses on understanding the biology of aging and translating research discoveries into new ways of delaying aging in humans. The lab has identified drugs that extend the healthy lifespan of worms and mice and are seeking to understand their mechanisms.

=== Associate Professor Lynne Cox - University of Oxford ===
Professor Cox’s lab study the molecular and cellular basis of aging to identify specific biochemical processes and pathways that change organisms age. The lab particularly cellular senescence, which underpins many age-related diseases including cancer and neurodegeneration.

== What books have been written on this topic? ==
Several books have been written on the topic of aging and longevity. These include:

* ''Lifespan: Why We Age And Why We Don't Have To'' - David Sinclair (2019)

* ''Ending Aging'' - Dr. Aubrey de Grey (2007)

* ''Ageless'' - Dr. Andrew Steele (2020)

* ''Age Later'' - Professor Nir Barzilai (2021)

* ''The Science and Technology of Growing Young'' - Sergey Young (2021)

== References ==
<references />

FAQ

2021-12-15T07:37:30Z

Jack: /* How many people die from aging per day? */

Aging is the driving force of many diseases. Longevity biotechnology is a new field of medical research and development that aims to extend healthy human lifespan and delay, prevent or reverse these diseases. This article provides an overview of the field, answering common questions.

== Why is aging a problem? ==
[[File:Aging graph.png|thumb|750x750px|The aging process results in the risk of age-related diseases increasing exponentially over time.]][[File:Gompertz-Makeham law of mortality.png|alt=Gompertz-Makeham law of mortality|thumb|291x291px|Gompertz-Makeham law of mortality<ref name=":0">En.wikipedia.org. 2021. ''Gompertz–Makeham law of mortality - Wikipedia''. [online] Available at: <<nowiki>https://en.wikipedia.org/wiki/Gompertz%E2%80%93Makeham_law_of_mortality</nowiki>> [Accessed 13 December 2021].</ref>]]Aging is the largest risk factor for the diseases that kill most people worldwide, including cancer, heart diseases and Alzheimer's disease.

In the US in 2020, 9 of the 10 leading causes of death were strongly age-related.<ref>Ahmad, F. B., & Anderson, R. N. (2021). The leading causes of death in the US for 2020. ''JAMA'', ''325''(18), 1829-1830.https://jamanetwork.com/journals/jama/fullarticle/2778234</ref> Globally, approximately 70% of deaths annually are the result of aging.<ref name=":8" />

Aging also significantly affects quality of life, as deaths due to aging are usually preceded by many months of years of chronic illnesses such as cancer, type 2 diabetes and Alzheimer’s disease.

As a result of the aging process, the risk of an individual dying increases exponentially after the age of around 30 years old.<ref name=":0" /> This increase in mortality rate is known as the Gompertz-Makeham law of mortality.<ref name=":0" />
== How many people die from aging per day? ==
The aging process results in the deaths of 100,000 people per day; more than twice the sum of all other causes of death combined.<ref name=":8">Ritchie, H. and Roser, M., 2021. ''Causes of Death''. [online] Our World in Data. Available at: <<nowiki>https://ourworldindata.org/causes-of-death</nowiki>> [Accessed 13 December 2021].
</ref> This equates to over 37 million people dying per day of aging - a population the size of Canada. This is because aging results in the exponential increasing risk of age-related diseases such as cancer and type 2 diabetes. Aging also accounts for more than 30% of all disability-adjusted life years lost (DALYs); more than any other single cause.<ref>Vizhub.healthdata.org. 2021. ''GBD Compare | IHME Viz Hub''. [online] Available at: <<nowiki>https://vizhub.healthdata.org/gbd-compare/</nowiki>> [Accessed 13 December 2021].</ref>
[[File:Leading causes of death.png|center|thumb|713x713px|9 of the top 10 causes of death in the US in 2020 were strongly age-related]]

== Can healthy lifespan be extended? ==
[[File:Life extension mice.jpg|alt=Life extension mice|thumb|431x431px|Dietary manipulation, genetic manipulation, and drugs have been shown to increase the healthy lifespan of mice by up to 30%. <ref name=":1">de Magalhaes, J., 2021. ''DrugAge: Species Detail''. [online] Genomics.senescence.info. Available at: <<nowiki>https://genomics.senescence.info/drugs/species_details.php</nowiki>> [Accessed 14 December 2021].</ref>]]Clinical trials for longevity drugs in humans are in-progress, and there is not yet evidence that drugs can slow aging in humans. However, recent experimental breakthroughs over the last few decades have shown that mice, worms and flies have demonstrated that healthy lifespan can be extended modified.

Slowing the aging process in animals can be achieved via manipulation of diet, environment, genetics, epigenetics, or with drugs. In mice, over 100 drugs have been shown to extend healthy lifespan by up to 30%.<ref name=":1" />

The effect of longevity drugs on mice is often significant, delaying or eliminating the burden of age-related problems such as frailty, cataracts, cancer, and sarcopenia. A new class of drugs called senolytics have been shown to extend healthy lifespan in mice by over 30%.

== Which drugs may extend healthy lifespan? ==
Several drugs are known to extend healthy lifespan in animals. While there is no conclusive data that suggests these drugs would work the same in humans, many of these drugs are now being tested in clinical trials. [[File:Unity Mice.jpg|alt=Unity Mice|thumb|723x723px|Senolytic drugs remove senescent cells, partially reversing multiple age-related diseases and extending the healthy lifespan of mice. ]]

=== Senolytics ===
Senolytics are drugs that remove senescent cells. These are cells which accumulate in the body with age and are linked with age-related diseases such as cancer.

In mice, senolytics have been shown to increase the healthy period of lifespan by up to 35%. The first clinical trials of senolytics in humans began in 2020, and demonstrated promise that these drugs may be effective in humans.

=== [[Metformin]] ===
Metformin is an approved drug for type 2 diabetes that extends lifespan in multiple species. In mice, Metformin extends lifespan by up to 6%. Metformin is being tested as a longevity therapy in the largest clinical trial for a longevity therapy, the Targeting Aging with Metformin (TAME) trial in the US. This is a randomized clinical trial of 3000 elderly patients comparing metformin against a placebo for the onset of age-related diseases.

=== [[Rapamycin]] ===

Rapamycin is a drug used to prevent the rejection of organ transplants by the immune system. Rapamycin has been shown to extend lifespan by up to 26% when given at middle age, and 14% when given in late life.<ref>Harrison, D., Strong, R., Sharp, Z. ''et al.'' Rapamycin fed late in life extends lifespan in genetically heterogeneous mice. ''Nature'' 460, 392–395 (2009). <nowiki>https://doi.org/10.1038/nature08221</nowiki>
</ref><ref>Miller, R. A., Harrison, D. E., Astle, C. M., Fernandez, E., Flurkey, K., Han, M., Javors, M. A., Li, X., Nadon, N. L., Nelson, J. F., Pletcher, S., Salmon, A. B., Sharp, Z. D., Van Roekel, S., Winkleman, L., & Strong, R. (2014). Rapamycin-mediated lifespan increase in mice is dose and sex dependent and metabolically distinct from dietary restriction. ''Aging cell'', ''13''(3), 468–477. <nowiki>https://doi.org/10.1111/acel.12194</nowiki></ref> Rapamycin is currently being tested in a large-scale clinical trial called the Participatory Evaluation (of) Aging (With) Rapamycin (for) Longevity Study (PEARL). The study is a randomized clinical trial of 1000 elderly patients comparing rapamycin against placebo for age-related outcomes.<ref>Clinicaltrials.gov. 2021. ''Participatory Evaluation (of) Aging (With) Rapamycin (for) Longevity Study - Full Text View - ClinicalTrials.gov''. [online] Available at: <<nowiki>https://clinicaltrials.gov/ct2/show/NCT04488601</nowiki>> [Accessed 14 December 2021].
</ref>

In addition, over 50 other drugs being tested in human clinical trials for slowing aging.<ref name=":2">Lifespan.io. 2021. ''The Rejuvenation Roadmap | Lifespan.io''. [online] Available at: <<nowiki>https://www.lifespan.io/road-maps/the-rejuvenation-roadmap/</nowiki>> [Accessed 13 December 2021].</ref>

== What is the goal of longevity biotechnology? ==
[[File:Healthy lifespan extension.png|alt=Healthy lifespan extension|thumb|643x643px|Healthy lifespan extension]]
Longevity biotechnology aims to create therapies to extend the healthy human lifespan. Aging is associated with functional decline, diseases and an increased risk of death.

Longevity biotechnology attempts to slow or reverse the aging process to extend the healthy lifespan (‘healthspan’) of the population.

The longevity biotechnology sector is rapidly growing, and there are currently over 170 private companies working on developing therapeutics to slow the aging process.<ref name=":4">Pfleger, K., 2021. ''Aging Companies''. [online] Agingbiotech.info. Available at: <<nowiki>https://agingbiotech.info/companies</nowiki>> [Accessed 13 December 2021].</ref> These companies are working on slowing or reversing the aging process by targeting one of more of the hallmarks of aging.

== Will healthy or unhealthy lifespan be extended? ==
[[File:Extending healthy lifespan.png|alt=Extending healthy lifespan|thumb|364x364px|Extending healthy lifespan]]
The stated goal of longevity biotechnology is to extend the healthy period of lifespan, before age-related diseases set in. This is in contrast to many of today's medical interventions, which extend life only after diseases (e.g. cancer, Alzheimer's) have reached a clinical level.

Age-related diseases are preceded by a long period of subclinical aging, i.e. aging that has not yet progressed far enough to produce clinical symptoms. By slowing, delaying or reversing the aging process, the healthy period of life can be extended.

Studies in mice have demonstrated that life extending drugs such as rapamycin are capable of extending the healthy, rather than unhealthy period of life.
== Should we treat specific diseases such as cancer, or aging? ==
[[File:Slowing aging versus curing cancer.jpg|alt=Slowing aging is potentially a more effective means of extending healthy lifespan than treating individual diseases due to the comorbid nature of age-related diseases. [6]|thumb|421x421px|Slowing aging is potentially a more effective means of extending healthy lifespan than treating individual diseases due to the comorbid nature of age-related diseases. ]]
Longevity biotechnology potentially offers a greater likelihood of extending healthy lifespan than attempting to find cures for the individual diseases of aging. This is because biological aging is associated with many of diseases of aging that develop as comorbidities i.e. at the same time. Even if a person survives one age-related disease such as cancer, another (e.g. diabetes, cardiovascular disease) is likely to kill the person if the underlying aging is not treated. This phenomenon is known as Taueber's paradox<ref>En.wikipedia.org. 2021. ''Taeuber Paradox - Wikipedia''. [online] Available at: <<nowiki>https://en.wikipedia.org/wiki/Taeuber_Paradox</nowiki>> [Accessed 14 December 2021].</ref>, and accounts for the much smaller projected increase in healthy lifespan associated with curing the diseases of aging, such as cancer (2-3 years), versus slowing aging itself (30+ years).<ref>Matt Kaeberlein, PhD, It is Time to Embrace 21st-Century Medicine, ''Public Policy & Aging Report'', Volume 29, Issue 4, 2019, Pages 111–115, <nowiki>https://doi.org/10.1093/ppar/prz022</nowiki></ref>
== What is biological aging? ==
There are two main types of 'age': chronological age - the number of years since birth, and biological age - a measure of the physical health of a person and their position in their lifespan. Biological age is more difficult to measure, but recent technologies are now available to estimate biological age. Over time, we age biologically. This occurs due to many processes in the body, which are generally categorised into 9 processes or 'hallmarks'.
== What are the 9 Hallmarks of Aging? ==
[[File:Hallmarks of aging.jpg|alt=Hallmarks of aging|thumb|444x444px|Hallmarks of aging]]

The hallmarks of aging framework is considered to broadly represent key biological mechanisms of the biological aging process.<ref name=":9">López-Otín C, Blasco MA, Partridge L, Serrano M, Kroemer G. The hallmarks of aging. Cell. 2013 Jun 6;153(6):1194-217.</ref> Although there are various limitations of the hallmarks framework, it has become the central framework for understanding aging biology. The nine forms of cellular and molecular ‘damage’ that comprise the hallmarks of aging are<ref name=":9" />:

* Genomic instability
* Telomere attrition
* Epigenetic alterations
* Loss of proteostasis
* Deregulated nutrient-sensing
* Mitochondrial dysfunction
* Cellular senescence
* Stem cell exhaustion
* Altered intercellular communication

These are essentially the lowest common denominators of the aging process, on a cellular or subcellular level. All of the other changes associated with aging, such as greying hair, wrinkles, frailty and an increased risk of disease is thought to stem from these underlyig processes.<ref name=":9" />

== How does the aging cause disease? ==
The nine hallmarks of aging have been shown to play an integral role in the development of many age-related diseases such as neurodegenerative diseases and cancer:
=== [[Aging and Neurodegeneration|Neurodegenerative disease]] ===
[[File:Prevalence of neuro disorders.jpg|alt=Prevalence of neuro disorders|thumb|469x469px|The prevalence of neurodegenerative disorders increases exponentially with age, due to the biological aging process.<ref name=":12">Hou, Y., Dan, X., Babbar, M., Wei, Y., Hasselbalch, S. G., Croteau, D. L., & Bohr, V. A. (2019). Ageing as a risk factor for neurodegenerative disease. ''Nature reviews. Neurology'', ''15''(10), 565–581. <nowiki>https://doi.org/10.1038/s41582-019-0244-7</nowiki></ref> ]]
All of the hallmarks of aging are associated with an increased risk of neurodegenerative diseases, such as Parkinson's disease and Alzheimer's disease.<ref>Qiu, C., Kivipelto, M., & von Strauss, E. (2009). Epidemiology of Alzheimer's disease: occurrence, determinants, and strategies toward intervention. ''Dialogues in clinical neuroscience'', ''11''(2), 111.</ref> For example, several types of DNA damage are associated with neurodegeneration. The shortening of telomeres occurs as part of biological aging and causes cellular senescence, and is associated with neurodegeneration and neurodegenerative diseases including Alzheimer's disease and Parkinson's disease.<ref name=":12" /> Additionally, mitochondrial dysfunction, altered metabolism, stem cell exhaustion and loss of proteostasis are also involved in the development of neurodegenerative diseases.<ref name=":12" />
=== [[Aging and Cancer|Cancer]] ===
Several of the hallmarks of aging such as cellular senescence and alterations in the extracellular matrix are responsible for increasing the likelihood of tumorigenesis.<ref name=":5">Fane, M., & Weeraratna, A. T. (2020). How the ageing microenvironment influences tumour progression. ''Nature Reviews Cancer'', ''20''(2), 89-106.</ref> Other hallmarks of aging such as genomic instability, loss or proteostasis, altered intercellular communication (i.e. inflammation) and epigenetic alterations are also involved in tumorigenesis.<ref name=":5" />
== How is biological age measured? ==
[[File:Epigenetic clock.png|alt=Epigenetic clock|thumb|605x605px|Epigenetic clock is the first aging clock. ]]
Recent technologies have allow biological age to be measured. These include:

=== [[Epigenetic clock|Epigenetic clocks]] ===
The first generation of aging clocks are known as [[Epigenetic clock|epigenetic clocks or Horvath’s clock]].<ref name=":6">Horvath, S., & Raj, K. (2018). DNA methylation-based biomarkers and the epigenetic clock theory of ageing. ''Nature Reviews Genetics'', ''19''(6), 371-384.</ref> This clock is based on the finding that over time, the body accumulates methylation tags on the DNA in a pattern that can be predicted with machine learning. These changes to the epigenome are influenced by lifestyle, and can be used to measure biological age.<ref name=":6" /> Factors such as exercise frequency and a low BMI have been shown to reduce the rate of biological aging, whereas obesity and smoking can accelerate the rate of aging.<ref>Quach, A., Levine, M. E., Tanaka, T., Lu, A. T., Chen, B. H., Ferrucci, L., ... & Horvath, S. (2017). Epigenetic clock analysis of diet, exercise, education, and lifestyle factors. ''Aging (Albany NY)'', ''9''(2), 419.</ref><ref>Wu, X., Huang, Q., Javed, R., Zhong, J., Gao, H., & Liang, H. (2019). Effect of tobacco smoking on the epigenetic age of human respiratory organs. ''Clinical Epigenetics'', ''11''(1), 183. <nowiki>https://doi.org/10.1186/s13148-019-0777-z</nowiki>

[[Epigenetic clock#cite%20ref-12|↑]]</ref><ref>Horvath, S., Erhart, W., Brosch, M., Ammerpohl, O., von Schönfels, W., Ahrens, M., Heits, N., Bell, J. T., Tsai, P.-C., Spector, T. D., Deloukas, P., Siebert, R., Sipos, B., Becker, T., Röcken, C., Schafmayer, C., & Hampe, J. (2014). Obesity accelerates epigenetic aging of human liver. ''Proceedings of the National Academy of Sciences'', ''111''(43), 15538–15543. <nowiki>https://doi.org/10.1073/pnas.1412759111</nowiki>

[[Epigenetic clock#cite%20ref-13|↑]]</ref> The Horvath's clock has been used to accurately predict mortality risk.<ref>Fransquet, P. D., Wrigglesworth, J., Woods, R. L., Ernst, M. E., & Ryan, J. (2019). The epigenetic clock as a predictor of disease and mortality risk: a systematic review and meta-analysis. ''Clinical epigenetics'', ''11''(1), 1-17.</ref>

=== Multi-omic clocks ===
Multi-omic clocks are being developed that incorporate data from several sources, such as body imaging scans, blood tests, and fitness tests. These clocks are built using machine learning to estimate biological age. These aging clocks are being developed that combine multiple biological functional tests to create a unique aging signature, which can be monitored over time.<ref>Kudryashova, K. S., Burka, K., Kulaga, A. Y., Vorobyeva, N. S., & Kennedy, B. K. (2020). Aging Biomarkers: From Functional Tests to Multi‐Omics Approaches. ''Proteomics'', ''20''(5-6), 1900408.</ref>
[[File:Multiomic aging clock.jpg|alt=Multiomic clocks|center|thumb|542x542px|Multiomic clocks integrate various data sources to create a unique biological aging signature that can be tracked over time. ]]
== Which companies are trying to solve aging? ==
[[File:Calico Labs.png|alt=T|thumb|Calico Labs, a subsidiary of Google, is a billion-dollar company searching for treatments for aging. ]]
There are over [https://agingbiotech.info/companies 170 longevity biotechnology companies] trying to create therapies to slow or reverse the aging process.<ref name=":4" /> There are over [https://www.lifespan.io/road-maps/the-rejuvenation-roadmap/ 50 longevity drugs] currently in clinical trials in humans.<ref name=":2" />

Many of the longevity biotechnology companies are targeting specific hallmarks of aging. For example, [https://www.clearabiotech.com/#DiscoveryTimeline Cleara Biotech] are attempting to reduce cellular senescence by developing a drug that can eliminate senescent cells.<ref>Cleara Biotech. 2021. ''Cleara Biotech''. [online] Available at: <<nowiki>https://www.clearabiotech.com/#DiscoveryTimeline</nowiki>> [Accessed 15 December 2021].</ref>

Calico Labs is a Google-backed biotech company with the goal of combating aging and age-related diseases. In 2014, the company created a partnership with pharmaceutical giant AbbVie, which has since developed into a [https://www.cnbc.com/2018/06/26/alphabet-backed-calico-and-abbvie-chip-in-1-billion-to-cure-aging.html $2.5 billion venture] in the pursuit of improving “health, wellbeing and longevity.” <ref>2021. ''Google sister company and drug giant chip in another $1 billion to cure age-related diseases''. [online] Available at: <<nowiki>https://www.cnbc.com/2018/06/26/alphabet-backed-calico-and-abbvie-chip-in-1-billion-to-cure-aging.html</nowiki>> [Accessed 15 December 2021].</ref>

Since aging is not currently considered a disease by regulatory bodies such as the Food and Drug Administration (FDA), drug developers are currently focused on specific diseases of aging such as glaucoma and osteoarthritis.<ref>Clinicaltrialsarena.com. 2021. ''Unity's Phase II osteoarthritis study of UBX0101 misses primary goal''. [online] Available at: <<nowiki>https://www.clinicaltrialsarena.com/news/unity-ubx0101-osteoarthritis/</nowiki>> [Accessed 15 December 2021].</ref>

== Which billionaires are funding longevity biotechnology? ==
[[File:Jeff Bezos is funding longevity research.jpg|alt=Jeff Bezos is funding longevity research|thumb|Jeff Bezos is funding longevity research through financing Atlos Labs.<ref name=":7">MIT Technology Review. 2021. ''Meet Altos Labs, Silicon Valley’s latest wild bet on living forever''. [online] Available at: <<nowiki>https://www.technologyreview.com/2021/09/04/1034364/altos-labs-silicon-valleys-jeff-bezos-milner-bet-living-forever/</nowiki>> [Accessed 15 December 2021].</ref>]]
Several billionaires have funded companies or initiatives to slow or reverse human aging. These include:
* [[wikipedia:Jeff_Bezos|Jeff Bezos]], co-founder of Amazon, helped raise [https://www.technologyreview.com/2021/09/04/1034364/altos-labs-silicon-valleys-jeff-bezos-milner-bet-living-forever/ $270 million for new anti-aging drug company Altos Labs] in 2021.<ref name=":7" />
* [[wikipedia:Peter_Thiel|Peter Thiel]], co-founder of PayPal, was an [https://www.cnbc.com/2018/08/29/-jeff-bezos-is-backing-this-scientist-who-is-working-on-a-cure-for-aging.html early investor in Unity Biotechnology].<ref>CNBC. 2021. ''Why Jeff Bezos is backing this Silicon Valley scientist who is working on a cure for aging''. [online] Available at: <<nowiki>https://www.cnbc.com/2018/08/29/-jeff-bezos-is-backing-this-scientist-who-is-working-on-a-cure-for-aging.html</nowiki>> [Accessed 15 December 2021].</ref>
* [[wikipedia:Sergey_Brin|Sergey Brin]], co-founder of Google, donated [https://www.cnbc.com/2017/03/31/google-co-founders-and-silicon-valley-billionaires-try-to-live-forever.html $25 million for the National Academy of Medicine’s Grand Challenge in Health Longevity] to 'end aging forever'.<ref>Google’s co-founders and other Silicon Valley billionaires are trying to live forever. (2021). Retrieved 15 December 2021, from <nowiki>https://www.cnbc.com/2017/03/31/google-co-founders-and-silicon-valley-billionaires-try-to-live-forever.html</nowiki></ref>
* [[wikipedia:Larry_Page|Larry Page]], co-founder of Google, co-founded the [[wikipedia:Calico_(company)|billion-dollar aging research company Calico Labs.]]<ref>Contributors to Wikimedia projects. (2013, September 19). ''Calico (company) - Wikipedia''. Wikipedia, the free encyclopedia. <nowiki>https://en.wikipedia.org/wiki/Calico_(company)</nowiki>
</ref>
* [[wikipedia:Mike_Cannon-Brookes|Mike Cannon-Brookes]], billionaire cofounder of Australian software giant Atlassian, has invested [https://www.forbes.com/sites/samshead/2019/08/19/billionaire-backs-uk-startup-trying-to-extend-human-lifespans/ $10 million into longevity company Juvenescenc]e.<ref>Shead, S. (2019, August 19). ''Billionaire Backs U.K. Startup Trying To Extend Human Life Spans''. Forbes. <nowiki>https://www.forbes.com/sites/samshead/2019/08/19/billionaire-backs-uk-startup-trying-to-extend-human-lifespans/</nowiki></ref>
* [[wikipedia:Naveen_Jain|Naveen Jain]], billionaire entrepeneur who has raised [https://www.geekwire.com/2021/gut-health-startup-viome-raises-54m-develop-cancer-diagnostics-sell-microbiome-kits/ $54 million for his startup Viome].<ref>''Gut health startup Viome raises $54M to develop cancer diagnostics and sell microbiome kits''. (2021, November 10). Geekwire. <nowiki>https://www.geekwire.com/2021/gut-health-startup-viome-raises-54m-develop-cancer-diagnostics-sell-microbiome-kits/</nowiki></ref>
* [[wikipedia:Jim_Mellon|Jim Mellon]], who co-founded longevity company [https://www.juvlabs.com/people/co-founder/jim-mellon Juvenescence].<ref>''Jim Mellon - Chairman & Co-Founder''. (n.d.). Juvenescence - Science of Healthy Aging & Extended Lifespan. <nowiki>https://www.juvlabs.com/people/co-founder/jim-mellon</nowiki></ref>
* [[wikipedia:Larry_Ellison|Larry Ellison]], founder of Oracle, has spent [https://www.townandcountrymag.com/society/money-and-power/a9202324/science-of-longevity/ $430 million on longevity research].<ref>Tullis, P. (2017, March 30). ''Are You Rich Enough To Live Forever?'' Town & Country. <nowiki>https://www.townandcountrymag.com/society/money-and-power/a9202324/science-of-longevity/</nowiki></ref>
*Michael Greve, founder of Kizoo Technology, who has pledged [https://Longevity.Technology. https://www.longevity.technology/michael-greve-commits-e300m-for-rejuvenation-start-ups/ €300m to rejuvenation biotechnology companies.]<ref>''Michael Greve commits €300m for rejuvenation start-ups''. (2021, May 6). Longevity.Technology. <nowiki>https://www.longevity.technology/michael-greve-commits-e300m-for-rejuvenation-start-ups/</nowiki></ref>
* [[wikipedia:Yuri_Milner|Yuri Milner]], billionaire tech investor who has helped Altos Labs raise $270 million, with Jeff Bezos.<ref name=":7" />
* [https://wikitia.com/wiki/Richard_Heart Richard Heart], founder of the cryptocurrency Hex, who helped raise [https://www.express.co.uk/finance/city/1465354/pulsechain-cryptocurrency-srf-sens-research-foundation-airdrop-pulse-charity-longevity $25 million for the anti-aging research organisation SENS.]<ref>McGleenon, B. (2021, July 20). ''Pulsechain cryptocurrency raises 'mindblowing' $25M in five days for SENS longevity group''. Express.co.uk. <nowiki>https://www.express.co.uk/finance/city/1465354/pulsechain-cryptocurrency-srf-sens-research-foundation-airdrop-pulse-charity-longevity</nowiki></ref>
*[[wikipedia:Brian_Armstrong_(businessman)|Brian Armstrong]], CEO of CoinBase, who helped found and raise [https://www.dailymail.co.uk/sciencetech/article-10310475/Billionaire-launches-new-start-hopes-REVERSE-ageing-process.html $105 million for the epigenetic reprogramming startup NewLimit.]<ref>Liberatore, S. (2021, December 14). ''Billionaire launches new start-up to REVERSE the ageing process''. Mail Online. <nowiki>https://www.dailymail.co.uk/sciencetech/article-10310475/Billionaire-launches-new-start-hopes-REVERSE-ageing-process.html</nowiki></ref>
* [[wikipedia:Vitalik_Buterin|Vitalik Buterin]], founder of the cryptocurrency Ethereum, who donated $2.4 million to SENS.<ref>Foundation, S. R. (n.d.). ''SENS Research Foundation Receives $2.4 Million Ethereum Donation From Vitalik Buterin''. GlobeNewswire News Room. <nowiki>https://www.globenewswire.com/news-release/2018/02/02/1332410/0/en/SENS-Research-Foundation-Receives-2-4-Million-Ethereum-Donation-From-Vitalik-Buterin.html</nowiki></ref>

== How large will the longevity biotechnology field be? ==
Analysts from the Bank of America have predicted that the market size of longevity biotechnology will reach $600 billion by 2025.<ref>2021. ''Human lifespan could soon pass 100 years thanks to medical tech, says BofA''. [online] Available at: <<nowiki>https://www.cnbc.com/2019/05/08/techs-next-big-disruption-could-be-delaying-death.html</nowiki>> [Accessed 14 December 2021].</ref> Others have speculated that it is a trillion dollar industry owing to the immense savings associated with delaying or preventing chronic diseases.<ref>Colangelo, M., 2021. ''AI Will Drive The Multi-Trillion Dollar Longevity Economy''. [online] Forbes. Available at: <<nowiki>https://www.forbes.com/sites/cognitiveworld/2019/12/07/ai-will-drive-the-multi-trillion-dollar-longevity-economy/?sh=294766b74965</nowiki>> [Accessed 14 December 2021].</ref>
== Is aging an important for risk factor for COVID-19 mortality? ==

Aging is the largest risk factor for COVID-19. [[File:Age is the -1 risk factor for COVID-19 mortality.jpg|alt=Age is the #1 risk factor for COVID-19 mortality - based on US CDC statistics|thumb|572x572px|* Fold risk of COVID-19 mortality versus reference group aged 5-17 [https://www.cdc.gov/coronavirus/2019-ncov/covid-data/investigations-discovery/hospitalization-death-by-age.html (US CDC statistics)]]]
====COVID-19 defined as a disease of aging====
As detailed in the paper "[https://onlinelibrary.wiley.com/doi/full/10.1111/acel.13230 COVID‐19 is an emergent disease of aging",]<ref name=":29">[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7576244/ Santesmasses, D., Castro, J. P., Zenin, A. A., Shindyapina, A. V., Gerashchenko, M. V., Zhang, B., ... & Gladyshev, V. N. (2020). COVID‐19 is an emergent disease of aging. ''Aging cell'', ''19''(10), e13230.]</ref> COVID-19 meets several criteria for definition as an age-related disease:<ref>[[Promislow, D. E. (2020). A geroscience perspective on COVID-19 mortality. The Journals of Gerontology: Series A, 75(9), e30-e33.|Promislow, D. E. (2020). A geroscience perspective on COVID-19 mortality. ''The Journals of Gerontology: Series A'', ''75''(9), e30-e33.]]</ref><ref>Alberts, S. C., Archie, E. A., Gesquiere, L. R., Altmann, J., Vaupel, J. W., & Christensen, K. (2014). The male-female health-survival paradox: a comparative perspective on sex differences in aging and mortality. In ''Sociality, hierarchy, health: comparative biodemography: a collection of papers''. National Academies Press (US).</ref><ref name=":10">[[Sierra, F. (2020). Geroscience and the Coronavirus Pandemic: The Whack‐a‐Mole Approach is not Enough. Journal of the American Geriatrics Society, 68(5), 951.|Sierra, F. (2020). Geroscience and the Coronavirus Pandemic: The Whack‐a‐Mole Approach is not Enough. ''Journal of the American Geriatrics Society'', ''68''(5), 951.]]</ref><ref name=":11">[[Barzilai, N., Appleby, J. C., Austad, S. N., Cuervo, A. M., Kaeberlein, M., Gonzalez-Billault, C., ... & Sierra, F. (2020). Geroscience in the Age of COVID-19. Aging and disease, 11(4), 725.|Barzilai, N., Appleby, J. C., Austad, S. N., Cuervo, A. M., Kaeberlein, M., Gonzalez-Billault, C., ... & Sierra, F. (2020). Geroscience in the Age of COVID-19. ''Aging and disease'', ''11''(4), 725.]]</ref><ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7288963/</ref>

1) The doubling time for COVID-19 mortality approaches that of the doubling time of 8 years for all-cause mortality (characteristic exponential increase shared among major age-related chronic diseases);

2) Greater mortality rate in men, consistent with known sex differences in rates of aging;

3) Greater mortality rate for those with comorbidities (age-related diseases), consistent with accelerated biological aging; and,

4) Age dwarfs all other putative [[wikipedia:Risk_factor|risk factors]] for mortality by several orders of magnitude, exhibiting several thousand fold increase in risk across the lifespan
== How is aging biology research different to other fields of medical research? ==
Scientists studying the biology of aging believe that aging is the root cause of all the major diseases that afflict us as we age. Therefore, targeting aging biology would treat or reverse multiple diseases, simultaneously, while maximizing the chance of a cure.

Mainstream medical research has had many successes in treating single diseases, such as infectious diseases. For age-related ones, notable successes have been seen for heart diseases. However, targeting single diseases, one at a time, leads to rapidly diminishing returns. Even if we could ''cure'' heart disease and cancer, which are leading causes of death, each would add only ~2.5 years to life expectancy. This is because the next disease in line, e.g. Alzheimer's or lung disease, will kill you. This is the Taeuber Paradox, which highlights how the exponentially increasing risk of disease accumulation with aging limits the benefit of targeting single diseases.
== Do all animals age in the same way? ==
[[File:Naked mole rat graph.png|alt=Naked mole rat graph|thumb|530x530px|The naked mole-rat does not follow the same increased risk of mortality due to aging that humans and other mammals do. ]]
Many species, due to differences in their biology, age at different rates to humans. The jellyfish ''Turritopsis dohrnii'' can revert to earlier stages of its life cycle in response to stress, and can theoretically live forever - though eventually dies, usually due to predation.

Among mammals, the naked mole rat is an exceptionally long lived organism that lives roughly ten times longer than similarly-sized rats.<ref name=":3">Ruby, J. G., Smith, M., & Buffenstein, R. (2018). Naked mole-rat mortality rates defy Gompertzian laws by not increasing with age. ''elife'', ''7'', e31157.</ref><ref>Buffenstein, R., Amoroso, V., Andziak, B., Avdieiev, S., Azpurua, J., Barker, A. J., ... & Smith, E. S. J. (2021). The naked truth: a comprehensive clarification and classification of current ‘myths’ in naked mole‐rat biology. ''Biological Reviews''.</ref> Unlike other organisms, such as humans, horses and mice, the mortality rate of the naked mole rat appears steady over time. This trend does not follow the exponential increase in mortality (Gompertz-Makeham law) that humans do.<ref name=":3" />

Scientists are now studying the naked mole rat to identify key patterns in their genetics, environmental traits, and metabolism that may be responsible for their longer lifespans.

[[File:Naked mole rat.jpg|alt=Naked mole rat|center|thumb|323x323px|The naked mole rat is unusually long-lived relative to other mice and rats. ]]

== Is aging considered a disease? ==
Aging is not currently classified as a disease by regulatory bodies such as the Food and Drug Administration (FDA) in the United States. However, several scientists in the aging field have publicly stated their wish for aging to be considered a disease, including professor David Sinclair and professor Nir Barzilai.

== What are the economic benefits of extending healthy lifespan? ==
Extending the healthy human lifespan could have significant economic benefits gobally. An economic analysis from 2021 by researchers at the University of Oxford and Harvard University estimated the benefit of a drug that slows aging by 1 year as $38 trillion. This is primarily because slowing aging reduces the incidence of age-related diseases such as cancer and Alzheimer’s disease, which require expensive treatment approaches. The study demonstrated a larger economic benefit of slowing aging than curing the individual diseases of aging.
== Which anti-aging drugs are being tested in clinical trials today? ==
There are over 50 drugs being tested in human clinical trials for aging or age-related diseases.

The largest trial is the Targeting Aging with Metformin (TAME) trial, which began in 2020. The trial is being run in the United States with a cohort of 3000 older adults. The goal of the TAME trial is to determine whether diabetes drug metformin slows the aging process in older adults. The TAME trial is a $75 million trial run by the American Federation for Aging Research.

Another large clinical trial is the Participitory Evluation of Rapamycin (PEARL) study. The goal of this study is to determine whether rapamycin, a drug currently approved for immunosuppression during organ transplants, slows biomarkers of aging in 1000 adults. The PEARL trial is being run by AgelessRx.
== Is aging a natural process that should be accepted? ==
Although aging is a natural process in humans, it is the driving force of many diseases such as cancer and Alzheimer's disease - which as a society we have decided are worth trying to find cures for. In the past, these conditions, as well as atherosclerosis and even infectious diseases were once thought of as natural processes that could not be treated. However, nowadays it is understood that they are diseases that can be treated.

Atherosclerosis, the hardening of the arteries, was once viewed as a natural process that was simply a consequence of aging. However, when treatments such as statins were later developed to prevent atherosclerosis, the disease became widely regarded as a disease to be cured. Statins are now one one of the most widely prescribed drugs in the world, used in preventing heart diseases. The inventor of statins, Akira Endo, describes in his historical paper: “Serious research on the role of cholesterol in human atherosclerosis did not really get underway until the 1940s, due to a prevailing view that the disease was a simple consequence of aging and could not be prevented.”<ref>Endo A. (2010). A historical perspective on the discovery of statins. ''Proceedings of the Japan Academy. Series B, Physical and biological sciences'', ''86''(5), 484–493. <nowiki>https://doi.org/10.2183/pjab.86.484</nowiki></ref>

== Will anti-aging technology lead to overpopulation? ==
A common objection to the development of longevity technologies is that they may lead to an unsustainably large population size.

One study of a 2005 Swedish cohort of 9 million people modeled the effect of various anti-aging scenarios. The researchers showed that even with the most radical life-extension technology in which aging completely stopped after age 60, the population growth across 100 years was only 22%.

Currently, the world’s population is 7.9 billion, and the WHO predicts the population will peak at 11 billion in 2100 before falling due to declining birth rates in many parts of the world.

The fastest growing populations are in Africa and South-east Asia. However, several factors are thought to reduce birth rates over time, including increased access to contraceptives, female empowerment, increased education and increased employment. There is evidence that populations that move to a more advanced economy show a reduction in birth rates.

== Will anti-aging drugs only be available to the rich? ==
It is unclear who will have first access to longevity drugs. Several researchers in the field have argued that several economic factors are likely to drive down the price of drugs that slow aging.

* The cost of many biotechnologies decreases substantially over time. For example, the first human genome cost $100 million to sequence, and is now available for a few hundred dollars.

* The price of many lifesaving pharmaceuticals has fallen significantly in price once generic drugs were produced. For example, Lipitor, a statin used to prevent heart disease has fallen in price from $85 in 2011 to less than $5 today.

* Many companies in the longevity field have stated that equity of access is part of their core ethos, and many researchers are signatories to the

== Which scientists and institutions are trying to understand and reverse aging? ==
Hundreds of scientists are working on understanding the biology of aging in leading institutions like Harvard University, Stanford University, Yale University, and the University of Oxford. Some of the most well-known institutes and labs include:

=== The Buck Institute for Research on Aging ===
The Buck Institute for Research on Aging is one of the largest longevity research institutes with over 250 scientists. The research covers several areas including the mechanisms of aging, neurodegeneration, senescence, stem cells and regenerative medicine, cellular stress and disease, cancer associated with aging, and mitochondrial function.

=== Professor David Sinclair - Harvard Medical School ===
Professor Sinclair’s lab focuses on understanding and reversing aging. The lab focuses on a range of areas including DNA repair, mitochondrial dysfunction, and the interactions between epigenetic and genetic instability, and tissue reprogramming. Sinclair is also the author of the bestselling book, Lifespan: why we age and why we don’t have to.

=== Professor Matt Kaeberlein - University of Washington ===
Professor Kaeberlein's lab focuses on biological mechanisms of aging in order to facilitate translational interventions that promote healthspan and improve quality of life. Kaeberlein is known for his work on the longevity drug rapamycin in organisms such as mice and dogs. He is Director of the Dog Aging Project, a multi-year initiative studying the genetic and environmental factors that influence health, with over 33,000 participating dogs.

=== Professor Brian Kennedy - National University of Singapore ===
Professor Kennedy’s lab focuses on understanding the biology of aging and translating research discoveries into new ways of delaying aging in humans. The lab has identified drugs that extend the healthy lifespan of worms and mice and are seeking to understand their mechanisms.

=== Associate Professor Lynne Cox - University of Oxford ===
Professor Cox’s lab study the molecular and cellular basis of aging to identify specific biochemical processes and pathways that change organisms age. The lab particularly cellular senescence, which underpins many age-related diseases including cancer and neurodegeneration.

== What books have been written on this topic? ==
Several books have been written on the topic of aging and longevity. These include:

* ''Lifespan: Why We Age And Why We Don't Have To'' - David Sinclair (2019)

* ''Ending Aging'' - Dr. Aubrey de Grey (2007)

* ''Ageless'' - Dr. Andrew Steele (2020)

* ''Age Later'' - Professor Nir Barzilai (2021)

* ''The Science and Technology of Growing Young'' - Sergey Young (2021)

== References ==
<references />

FAQ

2021-12-15T07:36:59Z

Jack: /* How does the aging cause disease? */

Aging is the driving force of many diseases. Longevity biotechnology is a new field of medical research and development that aims to extend healthy human lifespan and delay, prevent or reverse these diseases. This article provides an overview of the field, answering common questions.

== Why is aging a problem? ==
[[File:Aging graph.png|thumb|750x750px|The aging process results in the risk of age-related diseases increasing exponentially over time.]][[File:Gompertz-Makeham law of mortality.png|alt=Gompertz-Makeham law of mortality|thumb|310x310px|Gompertz-Makeham law of mortality<ref name=":0">En.wikipedia.org. 2021. ''Gompertz–Makeham law of mortality - Wikipedia''. [online] Available at: <<nowiki>https://en.wikipedia.org/wiki/Gompertz%E2%80%93Makeham_law_of_mortality</nowiki>> [Accessed 13 December 2021].</ref>]]Aging is the largest risk factor for the diseases that kill most people worldwide, including cancer, heart diseases and Alzheimer's disease.

In the US in 2020, 9 of the 10 leading causes of death were strongly age-related.<ref>Ahmad, F. B., & Anderson, R. N. (2021). The leading causes of death in the US for 2020. ''JAMA'', ''325''(18), 1829-1830.https://jamanetwork.com/journals/jama/fullarticle/2778234</ref> Globally, approximately 70% of deaths annually are the result of aging.<ref name=":8" />

Aging also significantly affects quality of life, as deaths due to aging are usually preceded by many months of years of chronic illnesses such as cancer, type 2 diabetes and Alzheimer’s disease.

As a result of the aging process, the risk of an individual dying increases exponentially after the age of around 30 years old.<ref name=":0" /> This increase in mortality rate is known as the Gompertz-Makeham law of mortality.<ref name=":0" />
== How many people die from aging per day? ==
The aging process results in the deaths of 100,000 people per day; more than twice the sum of all other causes of death combined.<ref name=":8">Ritchie, H. and Roser, M., 2021. ''Causes of Death''. [online] Our World in Data. Available at: <<nowiki>https://ourworldindata.org/causes-of-death</nowiki>> [Accessed 13 December 2021].
</ref> This equates to over 37 million people dying per day of aging - a population the size of Canada. This is because aging results in the exponential increasing risk of age-related diseases such as cancer and type 2 diabetes. Aging also accounts for more than 30% of all disability-adjusted life years lost (DALYs); more than any other single cause.<ref>Vizhub.healthdata.org. 2021. ''GBD Compare | IHME Viz Hub''. [online] Available at: <<nowiki>https://vizhub.healthdata.org/gbd-compare/</nowiki>> [Accessed 13 December 2021].</ref>
[[File:Leading causes of death.png|center|thumb|713x713px|9 of the top 10 causes of death in the US in 2020 were strongly age-related]]

== Can healthy lifespan be extended? ==
[[File:Life extension mice.jpg|alt=Life extension mice|thumb|431x431px|Dietary manipulation, genetic manipulation, and drugs have been shown to increase the healthy lifespan of mice by up to 30%. <ref name=":1">de Magalhaes, J., 2021. ''DrugAge: Species Detail''. [online] Genomics.senescence.info. Available at: <<nowiki>https://genomics.senescence.info/drugs/species_details.php</nowiki>> [Accessed 14 December 2021].</ref>]]Clinical trials for longevity drugs in humans are in-progress, and there is not yet evidence that drugs can slow aging in humans. However, recent experimental breakthroughs over the last few decades have shown that mice, worms and flies have demonstrated that healthy lifespan can be extended modified.

Slowing the aging process in animals can be achieved via manipulation of diet, environment, genetics, epigenetics, or with drugs. In mice, over 100 drugs have been shown to extend healthy lifespan by up to 30%.<ref name=":1" />

The effect of longevity drugs on mice is often significant, delaying or eliminating the burden of age-related problems such as frailty, cataracts, cancer, and sarcopenia. A new class of drugs called senolytics have been shown to extend healthy lifespan in mice by over 30%.

== Which drugs may extend healthy lifespan? ==
Several drugs are known to extend healthy lifespan in animals. While there is no conclusive data that suggests these drugs would work the same in humans, many of these drugs are now being tested in clinical trials. [[File:Unity Mice.jpg|alt=Unity Mice|thumb|723x723px|Senolytic drugs remove senescent cells, partially reversing multiple age-related diseases and extending the healthy lifespan of mice. ]]

=== Senolytics ===
Senolytics are drugs that remove senescent cells. These are cells which accumulate in the body with age and are linked with age-related diseases such as cancer.

In mice, senolytics have been shown to increase the healthy period of lifespan by up to 35%. The first clinical trials of senolytics in humans began in 2020, and demonstrated promise that these drugs may be effective in humans.

=== [[Metformin]] ===
Metformin is an approved drug for type 2 diabetes that extends lifespan in multiple species. In mice, Metformin extends lifespan by up to 6%. Metformin is being tested as a longevity therapy in the largest clinical trial for a longevity therapy, the Targeting Aging with Metformin (TAME) trial in the US. This is a randomized clinical trial of 3000 elderly patients comparing metformin against a placebo for the onset of age-related diseases.

=== [[Rapamycin]] ===

Rapamycin is a drug used to prevent the rejection of organ transplants by the immune system. Rapamycin has been shown to extend lifespan by up to 26% when given at middle age, and 14% when given in late life.<ref>Harrison, D., Strong, R., Sharp, Z. ''et al.'' Rapamycin fed late in life extends lifespan in genetically heterogeneous mice. ''Nature'' 460, 392–395 (2009). <nowiki>https://doi.org/10.1038/nature08221</nowiki>
</ref><ref>Miller, R. A., Harrison, D. E., Astle, C. M., Fernandez, E., Flurkey, K., Han, M., Javors, M. A., Li, X., Nadon, N. L., Nelson, J. F., Pletcher, S., Salmon, A. B., Sharp, Z. D., Van Roekel, S., Winkleman, L., & Strong, R. (2014). Rapamycin-mediated lifespan increase in mice is dose and sex dependent and metabolically distinct from dietary restriction. ''Aging cell'', ''13''(3), 468–477. <nowiki>https://doi.org/10.1111/acel.12194</nowiki></ref> Rapamycin is currently being tested in a large-scale clinical trial called the Participatory Evaluation (of) Aging (With) Rapamycin (for) Longevity Study (PEARL). The study is a randomized clinical trial of 1000 elderly patients comparing rapamycin against placebo for age-related outcomes.<ref>Clinicaltrials.gov. 2021. ''Participatory Evaluation (of) Aging (With) Rapamycin (for) Longevity Study - Full Text View - ClinicalTrials.gov''. [online] Available at: <<nowiki>https://clinicaltrials.gov/ct2/show/NCT04488601</nowiki>> [Accessed 14 December 2021].
</ref>

In addition, over 50 other drugs being tested in human clinical trials for slowing aging.<ref name=":2">Lifespan.io. 2021. ''The Rejuvenation Roadmap | Lifespan.io''. [online] Available at: <<nowiki>https://www.lifespan.io/road-maps/the-rejuvenation-roadmap/</nowiki>> [Accessed 13 December 2021].</ref>

== What is the goal of longevity biotechnology? ==
[[File:Healthy lifespan extension.png|alt=Healthy lifespan extension|thumb|643x643px|Healthy lifespan extension]]
Longevity biotechnology aims to create therapies to extend the healthy human lifespan. Aging is associated with functional decline, diseases and an increased risk of death.

Longevity biotechnology attempts to slow or reverse the aging process to extend the healthy lifespan (‘healthspan’) of the population.

The longevity biotechnology sector is rapidly growing, and there are currently over 170 private companies working on developing therapeutics to slow the aging process.<ref name=":4">Pfleger, K., 2021. ''Aging Companies''. [online] Agingbiotech.info. Available at: <<nowiki>https://agingbiotech.info/companies</nowiki>> [Accessed 13 December 2021].</ref> These companies are working on slowing or reversing the aging process by targeting one of more of the hallmarks of aging.

== Will healthy or unhealthy lifespan be extended? ==
[[File:Extending healthy lifespan.png|alt=Extending healthy lifespan|thumb|364x364px|Extending healthy lifespan]]
The stated goal of longevity biotechnology is to extend the healthy period of lifespan, before age-related diseases set in. This is in contrast to many of today's medical interventions, which extend life only after diseases (e.g. cancer, Alzheimer's) have reached a clinical level.

Age-related diseases are preceded by a long period of subclinical aging, i.e. aging that has not yet progressed far enough to produce clinical symptoms. By slowing, delaying or reversing the aging process, the healthy period of life can be extended.

Studies in mice have demonstrated that life extending drugs such as rapamycin are capable of extending the healthy, rather than unhealthy period of life.
== Should we treat specific diseases such as cancer, or aging? ==
[[File:Slowing aging versus curing cancer.jpg|alt=Slowing aging is potentially a more effective means of extending healthy lifespan than treating individual diseases due to the comorbid nature of age-related diseases. [6]|thumb|421x421px|Slowing aging is potentially a more effective means of extending healthy lifespan than treating individual diseases due to the comorbid nature of age-related diseases. ]]
Longevity biotechnology potentially offers a greater likelihood of extending healthy lifespan than attempting to find cures for the individual diseases of aging. This is because biological aging is associated with many of diseases of aging that develop as comorbidities i.e. at the same time. Even if a person survives one age-related disease such as cancer, another (e.g. diabetes, cardiovascular disease) is likely to kill the person if the underlying aging is not treated. This phenomenon is known as Taueber's paradox<ref>En.wikipedia.org. 2021. ''Taeuber Paradox - Wikipedia''. [online] Available at: <<nowiki>https://en.wikipedia.org/wiki/Taeuber_Paradox</nowiki>> [Accessed 14 December 2021].</ref>, and accounts for the much smaller projected increase in healthy lifespan associated with curing the diseases of aging, such as cancer (2-3 years), versus slowing aging itself (30+ years).<ref>Matt Kaeberlein, PhD, It is Time to Embrace 21st-Century Medicine, ''Public Policy & Aging Report'', Volume 29, Issue 4, 2019, Pages 111–115, <nowiki>https://doi.org/10.1093/ppar/prz022</nowiki></ref>
== What is biological aging? ==
There are two main types of 'age': chronological age - the number of years since birth, and biological age - a measure of the physical health of a person and their position in their lifespan. Biological age is more difficult to measure, but recent technologies are now available to estimate biological age. Over time, we age biologically. This occurs due to many processes in the body, which are generally categorised into 9 processes or 'hallmarks'.
== What are the 9 Hallmarks of Aging? ==
[[File:Hallmarks of aging.jpg|alt=Hallmarks of aging|thumb|444x444px|Hallmarks of aging]]

The hallmarks of aging framework is considered to broadly represent key biological mechanisms of the biological aging process.<ref name=":9">López-Otín C, Blasco MA, Partridge L, Serrano M, Kroemer G. The hallmarks of aging. Cell. 2013 Jun 6;153(6):1194-217.</ref> Although there are various limitations of the hallmarks framework, it has become the central framework for understanding aging biology. The nine forms of cellular and molecular ‘damage’ that comprise the hallmarks of aging are<ref name=":9" />:

* Genomic instability
* Telomere attrition
* Epigenetic alterations
* Loss of proteostasis
* Deregulated nutrient-sensing
* Mitochondrial dysfunction
* Cellular senescence
* Stem cell exhaustion
* Altered intercellular communication

These are essentially the lowest common denominators of the aging process, on a cellular or subcellular level. All of the other changes associated with aging, such as greying hair, wrinkles, frailty and an increased risk of disease is thought to stem from these underlyig processes.<ref name=":9" />

== How does the aging cause disease? ==
The nine hallmarks of aging have been shown to play an integral role in the development of many age-related diseases such as neurodegenerative diseases and cancer:
=== [[Aging and Neurodegeneration|Neurodegenerative disease]] ===
[[File:Prevalence of neuro disorders.jpg|alt=Prevalence of neuro disorders|thumb|469x469px|The prevalence of neurodegenerative disorders increases exponentially with age, due to the biological aging process.<ref name=":12">Hou, Y., Dan, X., Babbar, M., Wei, Y., Hasselbalch, S. G., Croteau, D. L., & Bohr, V. A. (2019). Ageing as a risk factor for neurodegenerative disease. ''Nature reviews. Neurology'', ''15''(10), 565–581. <nowiki>https://doi.org/10.1038/s41582-019-0244-7</nowiki></ref> ]]
All of the hallmarks of aging are associated with an increased risk of neurodegenerative diseases, such as Parkinson's disease and Alzheimer's disease.<ref>Qiu, C., Kivipelto, M., & von Strauss, E. (2009). Epidemiology of Alzheimer's disease: occurrence, determinants, and strategies toward intervention. ''Dialogues in clinical neuroscience'', ''11''(2), 111.</ref> For example, several types of DNA damage are associated with neurodegeneration. The shortening of telomeres occurs as part of biological aging and causes cellular senescence, and is associated with neurodegeneration and neurodegenerative diseases including Alzheimer's disease and Parkinson's disease.<ref name=":12" /> Additionally, mitochondrial dysfunction, altered metabolism, stem cell exhaustion and loss of proteostasis are also involved in the development of neurodegenerative diseases.<ref name=":12" />
=== [[Aging and Cancer|Cancer]] ===
Several of the hallmarks of aging such as cellular senescence and alterations in the extracellular matrix are responsible for increasing the likelihood of tumorigenesis.<ref name=":5">Fane, M., & Weeraratna, A. T. (2020). How the ageing microenvironment influences tumour progression. ''Nature Reviews Cancer'', ''20''(2), 89-106.</ref> Other hallmarks of aging such as genomic instability, loss or proteostasis, altered intercellular communication (i.e. inflammation) and epigenetic alterations are also involved in tumorigenesis.<ref name=":5" />
== How is biological age measured? ==
[[File:Epigenetic clock.png|alt=Epigenetic clock|thumb|605x605px|Epigenetic clock is the first aging clock. ]]
Recent technologies have allow biological age to be measured. These include:

=== [[Epigenetic clock|Epigenetic clocks]] ===
The first generation of aging clocks are known as [[Epigenetic clock|epigenetic clocks or Horvath’s clock]].<ref name=":6">Horvath, S., & Raj, K. (2018). DNA methylation-based biomarkers and the epigenetic clock theory of ageing. ''Nature Reviews Genetics'', ''19''(6), 371-384.</ref> This clock is based on the finding that over time, the body accumulates methylation tags on the DNA in a pattern that can be predicted with machine learning. These changes to the epigenome are influenced by lifestyle, and can be used to measure biological age.<ref name=":6" /> Factors such as exercise frequency and a low BMI have been shown to reduce the rate of biological aging, whereas obesity and smoking can accelerate the rate of aging.<ref>Quach, A., Levine, M. E., Tanaka, T., Lu, A. T., Chen, B. H., Ferrucci, L., ... & Horvath, S. (2017). Epigenetic clock analysis of diet, exercise, education, and lifestyle factors. ''Aging (Albany NY)'', ''9''(2), 419.</ref><ref>Wu, X., Huang, Q., Javed, R., Zhong, J., Gao, H., & Liang, H. (2019). Effect of tobacco smoking on the epigenetic age of human respiratory organs. ''Clinical Epigenetics'', ''11''(1), 183. <nowiki>https://doi.org/10.1186/s13148-019-0777-z</nowiki>

[[Epigenetic clock#cite%20ref-12|↑]]</ref><ref>Horvath, S., Erhart, W., Brosch, M., Ammerpohl, O., von Schönfels, W., Ahrens, M., Heits, N., Bell, J. T., Tsai, P.-C., Spector, T. D., Deloukas, P., Siebert, R., Sipos, B., Becker, T., Röcken, C., Schafmayer, C., & Hampe, J. (2014). Obesity accelerates epigenetic aging of human liver. ''Proceedings of the National Academy of Sciences'', ''111''(43), 15538–15543. <nowiki>https://doi.org/10.1073/pnas.1412759111</nowiki>

[[Epigenetic clock#cite%20ref-13|↑]]</ref> The Horvath's clock has been used to accurately predict mortality risk.<ref>Fransquet, P. D., Wrigglesworth, J., Woods, R. L., Ernst, M. E., & Ryan, J. (2019). The epigenetic clock as a predictor of disease and mortality risk: a systematic review and meta-analysis. ''Clinical epigenetics'', ''11''(1), 1-17.</ref>

=== Multi-omic clocks ===
Multi-omic clocks are being developed that incorporate data from several sources, such as body imaging scans, blood tests, and fitness tests. These clocks are built using machine learning to estimate biological age. These aging clocks are being developed that combine multiple biological functional tests to create a unique aging signature, which can be monitored over time.<ref>Kudryashova, K. S., Burka, K., Kulaga, A. Y., Vorobyeva, N. S., & Kennedy, B. K. (2020). Aging Biomarkers: From Functional Tests to Multi‐Omics Approaches. ''Proteomics'', ''20''(5-6), 1900408.</ref>
[[File:Multiomic aging clock.jpg|alt=Multiomic clocks|center|thumb|542x542px|Multiomic clocks integrate various data sources to create a unique biological aging signature that can be tracked over time. ]]
== Which companies are trying to solve aging? ==
[[File:Calico Labs.png|alt=T|thumb|Calico Labs, a subsidiary of Google, is a billion-dollar company searching for treatments for aging. ]]
There are over [https://agingbiotech.info/companies 170 longevity biotechnology companies] trying to create therapies to slow or reverse the aging process.<ref name=":4" /> There are over [https://www.lifespan.io/road-maps/the-rejuvenation-roadmap/ 50 longevity drugs] currently in clinical trials in humans.<ref name=":2" />

Many of the longevity biotechnology companies are targeting specific hallmarks of aging. For example, [https://www.clearabiotech.com/#DiscoveryTimeline Cleara Biotech] are attempting to reduce cellular senescence by developing a drug that can eliminate senescent cells.<ref>Cleara Biotech. 2021. ''Cleara Biotech''. [online] Available at: <<nowiki>https://www.clearabiotech.com/#DiscoveryTimeline</nowiki>> [Accessed 15 December 2021].</ref>

Calico Labs is a Google-backed biotech company with the goal of combating aging and age-related diseases. In 2014, the company created a partnership with pharmaceutical giant AbbVie, which has since developed into a [https://www.cnbc.com/2018/06/26/alphabet-backed-calico-and-abbvie-chip-in-1-billion-to-cure-aging.html $2.5 billion venture] in the pursuit of improving “health, wellbeing and longevity.” <ref>2021. ''Google sister company and drug giant chip in another $1 billion to cure age-related diseases''. [online] Available at: <<nowiki>https://www.cnbc.com/2018/06/26/alphabet-backed-calico-and-abbvie-chip-in-1-billion-to-cure-aging.html</nowiki>> [Accessed 15 December 2021].</ref>

Since aging is not currently considered a disease by regulatory bodies such as the Food and Drug Administration (FDA), drug developers are currently focused on specific diseases of aging such as glaucoma and osteoarthritis.<ref>Clinicaltrialsarena.com. 2021. ''Unity's Phase II osteoarthritis study of UBX0101 misses primary goal''. [online] Available at: <<nowiki>https://www.clinicaltrialsarena.com/news/unity-ubx0101-osteoarthritis/</nowiki>> [Accessed 15 December 2021].</ref>

== Which billionaires are funding longevity biotechnology? ==
[[File:Jeff Bezos is funding longevity research.jpg|alt=Jeff Bezos is funding longevity research|thumb|Jeff Bezos is funding longevity research through financing Atlos Labs.<ref name=":7">MIT Technology Review. 2021. ''Meet Altos Labs, Silicon Valley’s latest wild bet on living forever''. [online] Available at: <<nowiki>https://www.technologyreview.com/2021/09/04/1034364/altos-labs-silicon-valleys-jeff-bezos-milner-bet-living-forever/</nowiki>> [Accessed 15 December 2021].</ref>]]
Several billionaires have funded companies or initiatives to slow or reverse human aging. These include:
* [[wikipedia:Jeff_Bezos|Jeff Bezos]], co-founder of Amazon, helped raise [https://www.technologyreview.com/2021/09/04/1034364/altos-labs-silicon-valleys-jeff-bezos-milner-bet-living-forever/ $270 million for new anti-aging drug company Altos Labs] in 2021.<ref name=":7" />
* [[wikipedia:Peter_Thiel|Peter Thiel]], co-founder of PayPal, was an [https://www.cnbc.com/2018/08/29/-jeff-bezos-is-backing-this-scientist-who-is-working-on-a-cure-for-aging.html early investor in Unity Biotechnology].<ref>CNBC. 2021. ''Why Jeff Bezos is backing this Silicon Valley scientist who is working on a cure for aging''. [online] Available at: <<nowiki>https://www.cnbc.com/2018/08/29/-jeff-bezos-is-backing-this-scientist-who-is-working-on-a-cure-for-aging.html</nowiki>> [Accessed 15 December 2021].</ref>
* [[wikipedia:Sergey_Brin|Sergey Brin]], co-founder of Google, donated [https://www.cnbc.com/2017/03/31/google-co-founders-and-silicon-valley-billionaires-try-to-live-forever.html $25 million for the National Academy of Medicine’s Grand Challenge in Health Longevity] to 'end aging forever'.<ref>Google’s co-founders and other Silicon Valley billionaires are trying to live forever. (2021). Retrieved 15 December 2021, from <nowiki>https://www.cnbc.com/2017/03/31/google-co-founders-and-silicon-valley-billionaires-try-to-live-forever.html</nowiki></ref>
* [[wikipedia:Larry_Page|Larry Page]], co-founder of Google, co-founded the [[wikipedia:Calico_(company)|billion-dollar aging research company Calico Labs.]]<ref>Contributors to Wikimedia projects. (2013, September 19). ''Calico (company) - Wikipedia''. Wikipedia, the free encyclopedia. <nowiki>https://en.wikipedia.org/wiki/Calico_(company)</nowiki>
</ref>
* [[wikipedia:Mike_Cannon-Brookes|Mike Cannon-Brookes]], billionaire cofounder of Australian software giant Atlassian, has invested [https://www.forbes.com/sites/samshead/2019/08/19/billionaire-backs-uk-startup-trying-to-extend-human-lifespans/ $10 million into longevity company Juvenescenc]e.<ref>Shead, S. (2019, August 19). ''Billionaire Backs U.K. Startup Trying To Extend Human Life Spans''. Forbes. <nowiki>https://www.forbes.com/sites/samshead/2019/08/19/billionaire-backs-uk-startup-trying-to-extend-human-lifespans/</nowiki></ref>
* [[wikipedia:Naveen_Jain|Naveen Jain]], billionaire entrepeneur who has raised [https://www.geekwire.com/2021/gut-health-startup-viome-raises-54m-develop-cancer-diagnostics-sell-microbiome-kits/ $54 million for his startup Viome].<ref>''Gut health startup Viome raises $54M to develop cancer diagnostics and sell microbiome kits''. (2021, November 10). Geekwire. <nowiki>https://www.geekwire.com/2021/gut-health-startup-viome-raises-54m-develop-cancer-diagnostics-sell-microbiome-kits/</nowiki></ref>
* [[wikipedia:Jim_Mellon|Jim Mellon]], who co-founded longevity company [https://www.juvlabs.com/people/co-founder/jim-mellon Juvenescence].<ref>''Jim Mellon - Chairman & Co-Founder''. (n.d.). Juvenescence - Science of Healthy Aging & Extended Lifespan. <nowiki>https://www.juvlabs.com/people/co-founder/jim-mellon</nowiki></ref>
* [[wikipedia:Larry_Ellison|Larry Ellison]], founder of Oracle, has spent [https://www.townandcountrymag.com/society/money-and-power/a9202324/science-of-longevity/ $430 million on longevity research].<ref>Tullis, P. (2017, March 30). ''Are You Rich Enough To Live Forever?'' Town & Country. <nowiki>https://www.townandcountrymag.com/society/money-and-power/a9202324/science-of-longevity/</nowiki></ref>
*Michael Greve, founder of Kizoo Technology, who has pledged [https://Longevity.Technology. https://www.longevity.technology/michael-greve-commits-e300m-for-rejuvenation-start-ups/ €300m to rejuvenation biotechnology companies.]<ref>''Michael Greve commits €300m for rejuvenation start-ups''. (2021, May 6). Longevity.Technology. <nowiki>https://www.longevity.technology/michael-greve-commits-e300m-for-rejuvenation-start-ups/</nowiki></ref>
* [[wikipedia:Yuri_Milner|Yuri Milner]], billionaire tech investor who has helped Altos Labs raise $270 million, with Jeff Bezos.<ref name=":7" />
* [https://wikitia.com/wiki/Richard_Heart Richard Heart], founder of the cryptocurrency Hex, who helped raise [https://www.express.co.uk/finance/city/1465354/pulsechain-cryptocurrency-srf-sens-research-foundation-airdrop-pulse-charity-longevity $25 million for the anti-aging research organisation SENS.]<ref>McGleenon, B. (2021, July 20). ''Pulsechain cryptocurrency raises 'mindblowing' $25M in five days for SENS longevity group''. Express.co.uk. <nowiki>https://www.express.co.uk/finance/city/1465354/pulsechain-cryptocurrency-srf-sens-research-foundation-airdrop-pulse-charity-longevity</nowiki></ref>
*[[wikipedia:Brian_Armstrong_(businessman)|Brian Armstrong]], CEO of CoinBase, who helped found and raise [https://www.dailymail.co.uk/sciencetech/article-10310475/Billionaire-launches-new-start-hopes-REVERSE-ageing-process.html $105 million for the epigenetic reprogramming startup NewLimit.]<ref>Liberatore, S. (2021, December 14). ''Billionaire launches new start-up to REVERSE the ageing process''. Mail Online. <nowiki>https://www.dailymail.co.uk/sciencetech/article-10310475/Billionaire-launches-new-start-hopes-REVERSE-ageing-process.html</nowiki></ref>
* [[wikipedia:Vitalik_Buterin|Vitalik Buterin]], founder of the cryptocurrency Ethereum, who donated $2.4 million to SENS.<ref>Foundation, S. R. (n.d.). ''SENS Research Foundation Receives $2.4 Million Ethereum Donation From Vitalik Buterin''. GlobeNewswire News Room. <nowiki>https://www.globenewswire.com/news-release/2018/02/02/1332410/0/en/SENS-Research-Foundation-Receives-2-4-Million-Ethereum-Donation-From-Vitalik-Buterin.html</nowiki></ref>

== How large will the longevity biotechnology field be? ==
Analysts from the Bank of America have predicted that the market size of longevity biotechnology will reach $600 billion by 2025.<ref>2021. ''Human lifespan could soon pass 100 years thanks to medical tech, says BofA''. [online] Available at: <<nowiki>https://www.cnbc.com/2019/05/08/techs-next-big-disruption-could-be-delaying-death.html</nowiki>> [Accessed 14 December 2021].</ref> Others have speculated that it is a trillion dollar industry owing to the immense savings associated with delaying or preventing chronic diseases.<ref>Colangelo, M., 2021. ''AI Will Drive The Multi-Trillion Dollar Longevity Economy''. [online] Forbes. Available at: <<nowiki>https://www.forbes.com/sites/cognitiveworld/2019/12/07/ai-will-drive-the-multi-trillion-dollar-longevity-economy/?sh=294766b74965</nowiki>> [Accessed 14 December 2021].</ref>
== Is aging an important for risk factor for COVID-19 mortality? ==

Aging is the largest risk factor for COVID-19. [[File:Age is the -1 risk factor for COVID-19 mortality.jpg|alt=Age is the #1 risk factor for COVID-19 mortality - based on US CDC statistics|thumb|572x572px|* Fold risk of COVID-19 mortality versus reference group aged 5-17 [https://www.cdc.gov/coronavirus/2019-ncov/covid-data/investigations-discovery/hospitalization-death-by-age.html (US CDC statistics)]]]
====COVID-19 defined as a disease of aging====
As detailed in the paper "[https://onlinelibrary.wiley.com/doi/full/10.1111/acel.13230 COVID‐19 is an emergent disease of aging",]<ref name=":29">[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7576244/ Santesmasses, D., Castro, J. P., Zenin, A. A., Shindyapina, A. V., Gerashchenko, M. V., Zhang, B., ... & Gladyshev, V. N. (2020). COVID‐19 is an emergent disease of aging. ''Aging cell'', ''19''(10), e13230.]</ref> COVID-19 meets several criteria for definition as an age-related disease:<ref>[[Promislow, D. E. (2020). A geroscience perspective on COVID-19 mortality. The Journals of Gerontology: Series A, 75(9), e30-e33.|Promislow, D. E. (2020). A geroscience perspective on COVID-19 mortality. ''The Journals of Gerontology: Series A'', ''75''(9), e30-e33.]]</ref><ref>Alberts, S. C., Archie, E. A., Gesquiere, L. R., Altmann, J., Vaupel, J. W., & Christensen, K. (2014). The male-female health-survival paradox: a comparative perspective on sex differences in aging and mortality. In ''Sociality, hierarchy, health: comparative biodemography: a collection of papers''. National Academies Press (US).</ref><ref name=":10">[[Sierra, F. (2020). Geroscience and the Coronavirus Pandemic: The Whack‐a‐Mole Approach is not Enough. Journal of the American Geriatrics Society, 68(5), 951.|Sierra, F. (2020). Geroscience and the Coronavirus Pandemic: The Whack‐a‐Mole Approach is not Enough. ''Journal of the American Geriatrics Society'', ''68''(5), 951.]]</ref><ref name=":11">[[Barzilai, N., Appleby, J. C., Austad, S. N., Cuervo, A. M., Kaeberlein, M., Gonzalez-Billault, C., ... & Sierra, F. (2020). Geroscience in the Age of COVID-19. Aging and disease, 11(4), 725.|Barzilai, N., Appleby, J. C., Austad, S. N., Cuervo, A. M., Kaeberlein, M., Gonzalez-Billault, C., ... & Sierra, F. (2020). Geroscience in the Age of COVID-19. ''Aging and disease'', ''11''(4), 725.]]</ref><ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7288963/</ref>

1) The doubling time for COVID-19 mortality approaches that of the doubling time of 8 years for all-cause mortality (characteristic exponential increase shared among major age-related chronic diseases);

2) Greater mortality rate in men, consistent with known sex differences in rates of aging;

3) Greater mortality rate for those with comorbidities (age-related diseases), consistent with accelerated biological aging; and,

4) Age dwarfs all other putative [[wikipedia:Risk_factor|risk factors]] for mortality by several orders of magnitude, exhibiting several thousand fold increase in risk across the lifespan
== How is aging biology research different to other fields of medical research? ==
Scientists studying the biology of aging believe that aging is the root cause of all the major diseases that afflict us as we age. Therefore, targeting aging biology would treat or reverse multiple diseases, simultaneously, while maximizing the chance of a cure.

Mainstream medical research has had many successes in treating single diseases, such as infectious diseases. For age-related ones, notable successes have been seen for heart diseases. However, targeting single diseases, one at a time, leads to rapidly diminishing returns. Even if we could ''cure'' heart disease and cancer, which are leading causes of death, each would add only ~2.5 years to life expectancy. This is because the next disease in line, e.g. Alzheimer's or lung disease, will kill you. This is the Taeuber Paradox, which highlights how the exponentially increasing risk of disease accumulation with aging limits the benefit of targeting single diseases.
== Do all animals age in the same way? ==
[[File:Naked mole rat graph.png|alt=Naked mole rat graph|thumb|530x530px|The naked mole-rat does not follow the same increased risk of mortality due to aging that humans and other mammals do. ]]
Many species, due to differences in their biology, age at different rates to humans. The jellyfish ''Turritopsis dohrnii'' can revert to earlier stages of its life cycle in response to stress, and can theoretically live forever - though eventually dies, usually due to predation.

Among mammals, the naked mole rat is an exceptionally long lived organism that lives roughly ten times longer than similarly-sized rats.<ref name=":3">Ruby, J. G., Smith, M., & Buffenstein, R. (2018). Naked mole-rat mortality rates defy Gompertzian laws by not increasing with age. ''elife'', ''7'', e31157.</ref><ref>Buffenstein, R., Amoroso, V., Andziak, B., Avdieiev, S., Azpurua, J., Barker, A. J., ... & Smith, E. S. J. (2021). The naked truth: a comprehensive clarification and classification of current ‘myths’ in naked mole‐rat biology. ''Biological Reviews''.</ref> Unlike other organisms, such as humans, horses and mice, the mortality rate of the naked mole rat appears steady over time. This trend does not follow the exponential increase in mortality (Gompertz-Makeham law) that humans do.<ref name=":3" />

Scientists are now studying the naked mole rat to identify key patterns in their genetics, environmental traits, and metabolism that may be responsible for their longer lifespans.

[[File:Naked mole rat.jpg|alt=Naked mole rat|center|thumb|323x323px|The naked mole rat is unusually long-lived relative to other mice and rats. ]]

== Is aging considered a disease? ==
Aging is not currently classified as a disease by regulatory bodies such as the Food and Drug Administration (FDA) in the United States. However, several scientists in the aging field have publicly stated their wish for aging to be considered a disease, including professor David Sinclair and professor Nir Barzilai.

== What are the economic benefits of extending healthy lifespan? ==
Extending the healthy human lifespan could have significant economic benefits gobally. An economic analysis from 2021 by researchers at the University of Oxford and Harvard University estimated the benefit of a drug that slows aging by 1 year as $38 trillion. This is primarily because slowing aging reduces the incidence of age-related diseases such as cancer and Alzheimer’s disease, which require expensive treatment approaches. The study demonstrated a larger economic benefit of slowing aging than curing the individual diseases of aging.
== Which anti-aging drugs are being tested in clinical trials today? ==
There are over 50 drugs being tested in human clinical trials for aging or age-related diseases.

The largest trial is the Targeting Aging with Metformin (TAME) trial, which began in 2020. The trial is being run in the United States with a cohort of 3000 older adults. The goal of the TAME trial is to determine whether diabetes drug metformin slows the aging process in older adults. The TAME trial is a $75 million trial run by the American Federation for Aging Research.

Another large clinical trial is the Participitory Evluation of Rapamycin (PEARL) study. The goal of this study is to determine whether rapamycin, a drug currently approved for immunosuppression during organ transplants, slows biomarkers of aging in 1000 adults. The PEARL trial is being run by AgelessRx.
== Is aging a natural process that should be accepted? ==
Although aging is a natural process in humans, it is the driving force of many diseases such as cancer and Alzheimer's disease - which as a society we have decided are worth trying to find cures for. In the past, these conditions, as well as atherosclerosis and even infectious diseases were once thought of as natural processes that could not be treated. However, nowadays it is understood that they are diseases that can be treated.

Atherosclerosis, the hardening of the arteries, was once viewed as a natural process that was simply a consequence of aging. However, when treatments such as statins were later developed to prevent atherosclerosis, the disease became widely regarded as a disease to be cured. Statins are now one one of the most widely prescribed drugs in the world, used in preventing heart diseases. The inventor of statins, Akira Endo, describes in his historical paper: “Serious research on the role of cholesterol in human atherosclerosis did not really get underway until the 1940s, due to a prevailing view that the disease was a simple consequence of aging and could not be prevented.”<ref>Endo A. (2010). A historical perspective on the discovery of statins. ''Proceedings of the Japan Academy. Series B, Physical and biological sciences'', ''86''(5), 484–493. <nowiki>https://doi.org/10.2183/pjab.86.484</nowiki></ref>

== Will anti-aging technology lead to overpopulation? ==
A common objection to the development of longevity technologies is that they may lead to an unsustainably large population size.

One study of a 2005 Swedish cohort of 9 million people modeled the effect of various anti-aging scenarios. The researchers showed that even with the most radical life-extension technology in which aging completely stopped after age 60, the population growth across 100 years was only 22%.

Currently, the world’s population is 7.9 billion, and the WHO predicts the population will peak at 11 billion in 2100 before falling due to declining birth rates in many parts of the world.

The fastest growing populations are in Africa and South-east Asia. However, several factors are thought to reduce birth rates over time, including increased access to contraceptives, female empowerment, increased education and increased employment. There is evidence that populations that move to a more advanced economy show a reduction in birth rates.

== Will anti-aging drugs only be available to the rich? ==
It is unclear who will have first access to longevity drugs. Several researchers in the field have argued that several economic factors are likely to drive down the price of drugs that slow aging.

* The cost of many biotechnologies decreases substantially over time. For example, the first human genome cost $100 million to sequence, and is now available for a few hundred dollars.

* The price of many lifesaving pharmaceuticals has fallen significantly in price once generic drugs were produced. For example, Lipitor, a statin used to prevent heart disease has fallen in price from $85 in 2011 to less than $5 today.

* Many companies in the longevity field have stated that equity of access is part of their core ethos, and many researchers are signatories to the

== Which scientists and institutions are trying to understand and reverse aging? ==
Hundreds of scientists are working on understanding the biology of aging in leading institutions like Harvard University, Stanford University, Yale University, and the University of Oxford. Some of the most well-known institutes and labs include:

=== The Buck Institute for Research on Aging ===
The Buck Institute for Research on Aging is one of the largest longevity research institutes with over 250 scientists. The research covers several areas including the mechanisms of aging, neurodegeneration, senescence, stem cells and regenerative medicine, cellular stress and disease, cancer associated with aging, and mitochondrial function.

=== Professor David Sinclair - Harvard Medical School ===
Professor Sinclair’s lab focuses on understanding and reversing aging. The lab focuses on a range of areas including DNA repair, mitochondrial dysfunction, and the interactions between epigenetic and genetic instability, and tissue reprogramming. Sinclair is also the author of the bestselling book, Lifespan: why we age and why we don’t have to.

=== Professor Matt Kaeberlein - University of Washington ===
Professor Kaeberlein's lab focuses on biological mechanisms of aging in order to facilitate translational interventions that promote healthspan and improve quality of life. Kaeberlein is known for his work on the longevity drug rapamycin in organisms such as mice and dogs. He is Director of the Dog Aging Project, a multi-year initiative studying the genetic and environmental factors that influence health, with over 33,000 participating dogs.

=== Professor Brian Kennedy - National University of Singapore ===
Professor Kennedy’s lab focuses on understanding the biology of aging and translating research discoveries into new ways of delaying aging in humans. The lab has identified drugs that extend the healthy lifespan of worms and mice and are seeking to understand their mechanisms.

=== Associate Professor Lynne Cox - University of Oxford ===
Professor Cox’s lab study the molecular and cellular basis of aging to identify specific biochemical processes and pathways that change organisms age. The lab particularly cellular senescence, which underpins many age-related diseases including cancer and neurodegeneration.

== What books have been written on this topic? ==
Several books have been written on the topic of aging and longevity. These include:

* ''Lifespan: Why We Age And Why We Don't Have To'' - David Sinclair (2019)

* ''Ending Aging'' - Dr. Aubrey de Grey (2007)

* ''Ageless'' - Dr. Andrew Steele (2020)

* ''Age Later'' - Professor Nir Barzilai (2021)

* ''The Science and Technology of Growing Young'' - Sergey Young (2021)

== References ==
<references />

FAQ

2021-12-15T07:22:54Z

Jack: /* Why is aging a problem? */

Aging is the driving force of many diseases. Longevity biotechnology is a new field of medical research and development that aims to extend healthy human lifespan and delay, prevent or reverse these diseases. This article provides an overview of the field, answering common questions.

== Why is aging a problem? ==
[[File:Aging graph.png|thumb|750x750px|The aging process results in the risk of age-related diseases increasing exponentially over time.]][[File:Gompertz-Makeham law of mortality.png|alt=Gompertz-Makeham law of mortality|thumb|310x310px|Gompertz-Makeham law of mortality<ref name=":0">En.wikipedia.org. 2021. ''Gompertz–Makeham law of mortality - Wikipedia''. [online] Available at: <<nowiki>https://en.wikipedia.org/wiki/Gompertz%E2%80%93Makeham_law_of_mortality</nowiki>> [Accessed 13 December 2021].</ref>]]Aging is the largest risk factor for the diseases that kill most people worldwide, including cancer, heart diseases and Alzheimer's disease.

In the US in 2020, 9 of the 10 leading causes of death were strongly age-related.<ref>Ahmad, F. B., & Anderson, R. N. (2021). The leading causes of death in the US for 2020. ''JAMA'', ''325''(18), 1829-1830.https://jamanetwork.com/journals/jama/fullarticle/2778234</ref> Globally, approximately 70% of deaths annually are the result of aging.

Aging also significantly affects quality of life, as deaths due to aging are usually preceded by 10-15 years of chronic illnesses such as cancer, type 2 diabetes and Alzheimer’s disease.

As a result of the aging process, the risk of dying increases exponentially after the age of around 30 years old.<ref name=":0" /> The risk of dying in a year as a 30 years old is less than 0.1%, but this risk increases to over 10% as a 90 year old. This increase in mortality rate is known as the Gompertz-Makeham law of mortality.<ref name=":0" />
== How many people die from aging per day? ==
The aging process results in the deaths of 100,000 people per day; more than twice the sum of all other causes of death combined.<ref>Ritchie, H. and Roser, M., 2021. ''Causes of Death''. [online] Our World in Data. Available at: <<nowiki>https://ourworldindata.org/causes-of-death</nowiki>> [Accessed 13 December 2021].
</ref> This equates to over 37 million people dying per day of aging - a population the size of Canada. This is because aging results in the exponential increasing risk of age-related diseases such as cancer and type 2 diabetes. Aging also accounts for more than 30% of all disability-adjusted life years lost (DALYs); more than any other single cause.<ref>Vizhub.healthdata.org. 2021. ''GBD Compare | IHME Viz Hub''. [online] Available at: <<nowiki>https://vizhub.healthdata.org/gbd-compare/</nowiki>> [Accessed 13 December 2021].</ref>
[[File:Leading causes of death.png|center|thumb|713x713px|9 of the top 10 causes of death in the US in 2020 were strongly age-related]]

== Can healthy lifespan be extended? ==
[[File:Life extension mice.jpg|alt=Life extension mice|thumb|431x431px|Dietary manipulation, genetic manipulation, and drugs have been shown to increase the healthy lifespan of mice by up to 30%. <ref name=":1">de Magalhaes, J., 2021. ''DrugAge: Species Detail''. [online] Genomics.senescence.info. Available at: <<nowiki>https://genomics.senescence.info/drugs/species_details.php</nowiki>> [Accessed 14 December 2021].</ref>]]Clinical trials for longevity drugs in humans are in-progress, and there is not yet evidence that drugs can slow aging in humans. However, recent experimental breakthroughs over the last few decades have shown that mice, worms and flies have demonstrated that healthy lifespan can be extended modified.

Slowing the aging process in animals can be achieved via manipulation of diet, environment, genetics, epigenetics, or with drugs. In mice, over 100 drugs have been shown to extend healthy lifespan by up to 30%.<ref name=":1" />

The effect of longevity drugs on mice is often significant, delaying or eliminating the burden of age-related problems such as frailty, cataracts, cancer, and sarcopenia. A new class of drugs called senolytics have been shown to extend healthy lifespan in mice by over 30%.

== Which drugs may extend healthy lifespan? ==
Several drugs are known to extend healthy lifespan in animals. While there is no conclusive data that suggests these drugs would work the same in humans, many of these drugs are now being tested in clinical trials. [[File:Unity Mice.jpg|alt=Unity Mice|thumb|723x723px|Senolytic drugs remove senescent cells, partially reversing multiple age-related diseases and extending the healthy lifespan of mice. ]]

=== Senolytics ===
Senolytics are drugs that remove senescent cells. These are cells which accumulate in the body with age and are linked with age-related diseases such as cancer.

In mice, senolytics have been shown to increase the healthy period of lifespan by up to 35%. The first clinical trials of senolytics in humans began in 2020, and demonstrated promise that these drugs may be effective in humans.

=== [[Metformin]] ===
Metformin is an approved drug for type 2 diabetes that extends lifespan in multiple species. In mice, Metformin extends lifespan by up to 6%. Metformin is being tested as a longevity therapy in the largest clinical trial for a longevity therapy, the Targeting Aging with Metformin (TAME) trial in the US. This is a randomized clinical trial of 3000 elderly patients comparing metformin against a placebo for the onset of age-related diseases.

=== [[Rapamycin]] ===

Rapamycin is a drug used to prevent the rejection of organ transplants by the immune system. Rapamycin has been shown to extend lifespan by up to 26% when given at middle age, and 14% when given in late life.<ref>Harrison, D., Strong, R., Sharp, Z. ''et al.'' Rapamycin fed late in life extends lifespan in genetically heterogeneous mice. ''Nature'' 460, 392–395 (2009). <nowiki>https://doi.org/10.1038/nature08221</nowiki>
</ref><ref>Miller, R. A., Harrison, D. E., Astle, C. M., Fernandez, E., Flurkey, K., Han, M., Javors, M. A., Li, X., Nadon, N. L., Nelson, J. F., Pletcher, S., Salmon, A. B., Sharp, Z. D., Van Roekel, S., Winkleman, L., & Strong, R. (2014). Rapamycin-mediated lifespan increase in mice is dose and sex dependent and metabolically distinct from dietary restriction. ''Aging cell'', ''13''(3), 468–477. <nowiki>https://doi.org/10.1111/acel.12194</nowiki></ref> Rapamycin is currently being tested in a large-scale clinical trial called the Participatory Evaluation (of) Aging (With) Rapamycin (for) Longevity Study (PEARL). The study is a randomized clinical trial of 1000 elderly patients comparing rapamycin against placebo for age-related outcomes.<ref>Clinicaltrials.gov. 2021. ''Participatory Evaluation (of) Aging (With) Rapamycin (for) Longevity Study - Full Text View - ClinicalTrials.gov''. [online] Available at: <<nowiki>https://clinicaltrials.gov/ct2/show/NCT04488601</nowiki>> [Accessed 14 December 2021].
</ref>

In addition, over 50 other drugs being tested in human clinical trials for slowing aging.<ref name=":2">Lifespan.io. 2021. ''The Rejuvenation Roadmap | Lifespan.io''. [online] Available at: <<nowiki>https://www.lifespan.io/road-maps/the-rejuvenation-roadmap/</nowiki>> [Accessed 13 December 2021].</ref>

== What is the goal of longevity biotechnology? ==
[[File:Healthy lifespan extension.png|alt=Healthy lifespan extension|thumb|643x643px|Healthy lifespan extension]]
Longevity biotechnology aims to create therapies to extend the healthy human lifespan. Aging is associated with functional decline, diseases and an increased risk of death.

Longevity biotechnology attempts to slow or reverse the aging process to extend the healthy lifespan (‘healthspan’) of the population.

The longevity biotechnology sector is rapidly growing, and there are currently over 170 private companies working on developing therapeutics to slow the aging process.<ref name=":4">Pfleger, K., 2021. ''Aging Companies''. [online] Agingbiotech.info. Available at: <<nowiki>https://agingbiotech.info/companies</nowiki>> [Accessed 13 December 2021].</ref> These companies are working on slowing or reversing the aging process by targeting one of more of the hallmarks of aging.

== Will healthy or unhealthy lifespan be extended? ==
[[File:Extending healthy lifespan.png|alt=Extending healthy lifespan|thumb|364x364px|Extending healthy lifespan]]
The stated goal of longevity biotechnology is to extend the healthy period of lifespan, before age-related diseases set in. This is in contrast to many of today's medical interventions, which extend life only after diseases (e.g. cancer, Alzheimer's) have reached a clinical level.

Age-related diseases are preceded by a long period of subclinical aging, i.e. aging that has not yet progressed far enough to produce clinical symptoms. By slowing, delaying or reversing the aging process, the healthy period of life can be extended.

Studies in mice have demonstrated that life extending drugs such as rapamycin are capable of extending the healthy, rather than unhealthy period of life.

== Should we treat specific diseases such as cancer, or aging? ==
[[File:Slowing aging versus curing cancer.jpg|alt=Slowing aging is potentially a more effective means of extending healthy lifespan than treating individual diseases due to the comorbid nature of age-related diseases. [6]|thumb|421x421px|Slowing aging is potentially a more effective means of extending healthy lifespan than treating individual diseases due to the comorbid nature of age-related diseases. ]]
Longevity biotechnology potentially offers a greater likelihood of extending healthy lifespan than attempting to find cures for the individual diseases of aging. This is because biological aging is associated with many of diseases of aging that develop as comorbidities i.e. at the same time. Even if a person survives one age-related disease such as cancer, another (e.g. diabetes, cardiovascular disease) is likely to kill the person if the underlying aging is not treated. This phenomenon is known as Taueber's paradox<ref>En.wikipedia.org. 2021. ''Taeuber Paradox - Wikipedia''. [online] Available at: <<nowiki>https://en.wikipedia.org/wiki/Taeuber_Paradox</nowiki>> [Accessed 14 December 2021].</ref>, and accounts for the much smaller projected increase in healthy lifespan associated with curing the diseases of aging, such as cancer (2-3 years), versus slowing aging itself (30+ years).<ref>Matt Kaeberlein, PhD, It is Time to Embrace 21st-Century Medicine, ''Public Policy & Aging Report'', Volume 29, Issue 4, 2019, Pages 111–115, <nowiki>https://doi.org/10.1093/ppar/prz022</nowiki></ref>

== What is biological aging? ==
There are two main types of 'age': chronological age - the number of years since birth, and biological age - a measure of the physical health of a person and their position in their lifespan. Biological age is more difficult to measure, but recent technologies are now available to estimate biological age. Over time, we age biologically. This occurs due to many processes in the body, which are generally categorised into 9 processes or 'hallmarks'.
== What are the 9 Hallmarks of Aging? ==
[[File:Hallmarks of aging.jpg|alt=Hallmarks of aging|thumb|515x515px|Hallmarks of aging]]

The hallmarks of aging framework is considered to broadly represent key biological mechanisms of the biological aging process.<ref>López-Otín C, Blasco MA, Partridge L, Serrano M, Kroemer G. The hallmarks of aging. Cell. 2013 Jun 6;153(6):1194-217.</ref> Like all models, there are various limitations of the hallmarks framework, but it is a useful primer for a basic understanding of aging biology.

The nine forms of cellular and molecular ‘damage’ that comprise the hallmarks of aging are:

* Genomic instability
* Telomere attrition
* Epigenetic alterations
* Loss of proteostasis
* Deregulated nutrient-sensing
* Mitochondrial dysfunction
* Cellular senescence
* Stem cell exhaustion
* Altered intercellular communication

These are essentially the lowest common denominators of the aging process, on a cellular or subcellular level. All of the other changes associated with aging, such as greying hair, wrinkles, frailty and an increased risk of diseases is thought to orinate from these processes.

== How does the aging cause disease? ==
The hallmarks of aging that underpin biological aging are part of the etiology of the diseases of aging.
[[File:Prevalence of neuro disorders.jpg|alt=The prevalence of neurodegenerative disease increases exponentially in older age. Source: https://www.nature.com/articles/s41582-019-0244-7|thumb|567x567px|The prevalence of neurodegenerative disease increases exponentially in older age. Source: <nowiki>https://www.nature.com/articles/s41582-019-0244-7</nowiki>]]

=== [[Aging and Neurodegeneration|Neurodegenerative disease]] ===
All of the hallmarks of aging are associated with an increased risk of neurodegenerative diseases, such as Parkinson's disease and Alzheimer's disease. For example, several types of DNA damage are associated with neurodegeneration. The shortening of telomeres occurs as part of biological aging and causes cellular senescence, and is associated with neurodegeneration and neurodegenerative diseases including Alzheimer's disease and Parkinson's disease. Additionally, mitochondrial dysfunction, altered metabolism, stem cell exhaustion and loss of proteostasis are also involved in the development of neurodegenerative diseases.
=== [[Aging and Cancer|Cancer]] ===
Several of the hallmarks of aging such as cellular senescence and alterations in the extracellular matrix are responsible for increasing the likelihood of tumorigenesis.<ref name=":5">Fane, M., & Weeraratna, A. T. (2020). How the ageing microenvironment influences tumour progression. ''Nature Reviews Cancer'', ''20''(2), 89-106.</ref> Other hallmarks of aging such as genomic instability, loss or proteostasis, altered intercellular communication (i.e. inflammation) and epigenetic alterations are also involved in tumorigenesis.<ref name=":5" />
== How is biological age measured? ==
[[File:Epigenetic clock.png|alt=Epigenetic clock|thumb|605x605px|Epigenetic clock is the first aging clock. ]]
Recent technologies have allow biological age to be measured. These include:

=== [[Epigenetic clock|Epigenetic clocks]] ===
The first generation of aging clocks are known as [[Epigenetic clock|epigenetic clocks or Horvath’s clock]].<ref name=":6">Horvath, S., & Raj, K. (2018). DNA methylation-based biomarkers and the epigenetic clock theory of ageing. ''Nature Reviews Genetics'', ''19''(6), 371-384.</ref> This clock is based on the finding that over time, the body accumulates methylation tags on the DNA in a pattern that can be predicted with machine learning. These changes to the epigenome are influenced by lifestyle, and can be used to measure biological age.<ref name=":6" /> Factors such as exercise frequency and a low BMI have been shown to reduce the rate of biological aging, whereas obesity and smoking can accelerate the rate of aging.<ref>Quach, A., Levine, M. E., Tanaka, T., Lu, A. T., Chen, B. H., Ferrucci, L., ... & Horvath, S. (2017). Epigenetic clock analysis of diet, exercise, education, and lifestyle factors. ''Aging (Albany NY)'', ''9''(2), 419.</ref><ref>Wu, X., Huang, Q., Javed, R., Zhong, J., Gao, H., & Liang, H. (2019). Effect of tobacco smoking on the epigenetic age of human respiratory organs. ''Clinical Epigenetics'', ''11''(1), 183. <nowiki>https://doi.org/10.1186/s13148-019-0777-z</nowiki>

[[Epigenetic clock#cite%20ref-12|↑]]</ref><ref>Horvath, S., Erhart, W., Brosch, M., Ammerpohl, O., von Schönfels, W., Ahrens, M., Heits, N., Bell, J. T., Tsai, P.-C., Spector, T. D., Deloukas, P., Siebert, R., Sipos, B., Becker, T., Röcken, C., Schafmayer, C., & Hampe, J. (2014). Obesity accelerates epigenetic aging of human liver. ''Proceedings of the National Academy of Sciences'', ''111''(43), 15538–15543. <nowiki>https://doi.org/10.1073/pnas.1412759111</nowiki>

[[Epigenetic clock#cite%20ref-13|↑]]</ref> The Horvath's clock has been used to accurately predict mortality risk.<ref>Fransquet, P. D., Wrigglesworth, J., Woods, R. L., Ernst, M. E., & Ryan, J. (2019). The epigenetic clock as a predictor of disease and mortality risk: a systematic review and meta-analysis. ''Clinical epigenetics'', ''11''(1), 1-17.</ref>

=== Multi-omic clocks ===
Multi-omic clocks are being developed that incorporate data from several sources, such as body imaging scans, blood tests, and fitness tests. These clocks are built using machine learning to estimate biological age. These aging clocks are being developed that combine multiple biological functional tests to create a unique aging signature, which can be monitored over time.<ref>Kudryashova, K. S., Burka, K., Kulaga, A. Y., Vorobyeva, N. S., & Kennedy, B. K. (2020). Aging Biomarkers: From Functional Tests to Multi‐Omics Approaches. ''Proteomics'', ''20''(5-6), 1900408.</ref>
[[File:Multiomic aging clock.jpg|alt=Multiomic clocks|center|thumb|542x542px|Multiomic clocks integrate various data sources to create a unique biological aging signature that can be tracked over time. ]]
== Is aging an important for risk factor for COVID-19 mortality? ==

Aging is the largest risk factor for COVID-19. [[File:Age is the -1 risk factor for COVID-19 mortality.jpg|alt=Age is the #1 risk factor for COVID-19 mortality - based on US CDC statistics|thumb|572x572px|* Fold risk of COVID-19 mortality versus reference group aged 5-17 [https://www.cdc.gov/coronavirus/2019-ncov/covid-data/investigations-discovery/hospitalization-death-by-age.html (US CDC statistics)]]]
====COVID-19 defined as a disease of aging====
As detailed in the paper "[https://onlinelibrary.wiley.com/doi/full/10.1111/acel.13230 COVID‐19 is an emergent disease of aging",]<ref name=":29">[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7576244/ Santesmasses, D., Castro, J. P., Zenin, A. A., Shindyapina, A. V., Gerashchenko, M. V., Zhang, B., ... & Gladyshev, V. N. (2020). COVID‐19 is an emergent disease of aging. ''Aging cell'', ''19''(10), e13230.]</ref> COVID-19 meets several criteria for definition as an age-related disease:<ref>[[Promislow, D. E. (2020). A geroscience perspective on COVID-19 mortality. The Journals of Gerontology: Series A, 75(9), e30-e33.|Promislow, D. E. (2020). A geroscience perspective on COVID-19 mortality. ''The Journals of Gerontology: Series A'', ''75''(9), e30-e33.]]</ref><ref>Alberts, S. C., Archie, E. A., Gesquiere, L. R., Altmann, J., Vaupel, J. W., & Christensen, K. (2014). The male-female health-survival paradox: a comparative perspective on sex differences in aging and mortality. In ''Sociality, hierarchy, health: comparative biodemography: a collection of papers''. National Academies Press (US).</ref><ref name=":10">[[Sierra, F. (2020). Geroscience and the Coronavirus Pandemic: The Whack‐a‐Mole Approach is not Enough. Journal of the American Geriatrics Society, 68(5), 951.|Sierra, F. (2020). Geroscience and the Coronavirus Pandemic: The Whack‐a‐Mole Approach is not Enough. ''Journal of the American Geriatrics Society'', ''68''(5), 951.]]</ref><ref name=":11">[[Barzilai, N., Appleby, J. C., Austad, S. N., Cuervo, A. M., Kaeberlein, M., Gonzalez-Billault, C., ... & Sierra, F. (2020). Geroscience in the Age of COVID-19. Aging and disease, 11(4), 725.|Barzilai, N., Appleby, J. C., Austad, S. N., Cuervo, A. M., Kaeberlein, M., Gonzalez-Billault, C., ... & Sierra, F. (2020). Geroscience in the Age of COVID-19. ''Aging and disease'', ''11''(4), 725.]]</ref><ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7288963/</ref>

1) The doubling time for COVID-19 mortality approaches that of the doubling time of 8 years for all-cause mortality (characteristic exponential increase shared among major age-related chronic diseases);

2) Greater mortality rate in men, consistent with known sex differences in rates of aging;

3) Greater mortality rate for those with comorbidities (age-related diseases), consistent with accelerated biological aging; and,

4) Age dwarfs all other putative [[wikipedia:Risk_factor|risk factors]] for mortality by several orders of magnitude, exhibiting several thousand fold increase in risk across the lifespan
== Which companies are trying to solve aging? ==
[[File:Calico Labs.png|alt=T|thumb|Calico Labs, a subsidiary of Google, is a billion-dollar company searching for treatments for aging. ]]
There are over [https://agingbiotech.info/companies 170 longevity biotechnology companies] trying to create therapies to slow or reverse the aging process.<ref name=":4" /> There are over [https://www.lifespan.io/road-maps/the-rejuvenation-roadmap/ 50 longevity drugs] currently in clinical trials in humans.<ref name=":2" />

Many of the longevity biotechnology companies are targeting specific hallmarks of aging. For example, [https://www.clearabiotech.com/#DiscoveryTimeline Cleara Biotech] are attempting to reduce cellular senescence by developing a drug that can eliminate senescent cells.<ref>Cleara Biotech. 2021. ''Cleara Biotech''. [online] Available at: <<nowiki>https://www.clearabiotech.com/#DiscoveryTimeline</nowiki>> [Accessed 15 December 2021].</ref>

Calico Labs is a Google-backed biotech company with the goal of combating aging and age-related diseases. In 2014, the company created a partnership with pharmaceutical giant AbbVie, which has since developed into a [https://www.cnbc.com/2018/06/26/alphabet-backed-calico-and-abbvie-chip-in-1-billion-to-cure-aging.html $2.5 billion venture] in the pursuit of improving “health, wellbeing and longevity.” <ref>2021. ''Google sister company and drug giant chip in another $1 billion to cure age-related diseases''. [online] Available at: <<nowiki>https://www.cnbc.com/2018/06/26/alphabet-backed-calico-and-abbvie-chip-in-1-billion-to-cure-aging.html</nowiki>> [Accessed 15 December 2021].</ref>

Since aging is not currently considered a disease by regulatory bodies such as the Food and Drug Administration (FDA), drug developers are currently focused on specific diseases of aging such as glaucoma and osteoarthritis.<ref>Clinicaltrialsarena.com. 2021. ''Unity's Phase II osteoarthritis study of UBX0101 misses primary goal''. [online] Available at: <<nowiki>https://www.clinicaltrialsarena.com/news/unity-ubx0101-osteoarthritis/</nowiki>> [Accessed 15 December 2021].</ref>

== Which billionaires are funding longevity biotechnology? ==
[[File:Jeff Bezos is funding longevity research.jpg|alt=Jeff Bezos is funding longevity research|thumb|Jeff Bezos is funding longevity research through financing Atlos Labs.<ref name=":7">MIT Technology Review. 2021. ''Meet Altos Labs, Silicon Valley’s latest wild bet on living forever''. [online] Available at: <<nowiki>https://www.technologyreview.com/2021/09/04/1034364/altos-labs-silicon-valleys-jeff-bezos-milner-bet-living-forever/</nowiki>> [Accessed 15 December 2021].</ref>]]
Several billionaires have funded companies or initiatives to slow or reverse human aging. These include:
* [[wikipedia:Jeff_Bezos|Jeff Bezos]], co-founder of Amazon, helped raise [https://www.technologyreview.com/2021/09/04/1034364/altos-labs-silicon-valleys-jeff-bezos-milner-bet-living-forever/ $270 million for new anti-aging drug company Altos Labs] in 2021.<ref name=":7" />
* [[wikipedia:Peter_Thiel|Peter Thiel]], co-founder of PayPal, was an [https://www.cnbc.com/2018/08/29/-jeff-bezos-is-backing-this-scientist-who-is-working-on-a-cure-for-aging.html early investor in Unity Biotechnology].<ref>CNBC. 2021. ''Why Jeff Bezos is backing this Silicon Valley scientist who is working on a cure for aging''. [online] Available at: <<nowiki>https://www.cnbc.com/2018/08/29/-jeff-bezos-is-backing-this-scientist-who-is-working-on-a-cure-for-aging.html</nowiki>> [Accessed 15 December 2021].</ref>
* [[wikipedia:Sergey_Brin|Sergey Brin]], co-founder of Google, donated [https://www.cnbc.com/2017/03/31/google-co-founders-and-silicon-valley-billionaires-try-to-live-forever.html $25 million for the National Academy of Medicine’s Grand Challenge in Health Longevity] to 'end aging forever'.<ref>Google’s co-founders and other Silicon Valley billionaires are trying to live forever. (2021). Retrieved 15 December 2021, from <nowiki>https://www.cnbc.com/2017/03/31/google-co-founders-and-silicon-valley-billionaires-try-to-live-forever.html</nowiki></ref>
* [[wikipedia:Larry_Page|Larry Page]], co-founder of Google, co-founded the [[wikipedia:Calico_(company)|billion-dollar aging research company Calico Labs.]]<ref>Contributors to Wikimedia projects. (2013, September 19). ''Calico (company) - Wikipedia''. Wikipedia, the free encyclopedia. <nowiki>https://en.wikipedia.org/wiki/Calico_(company)</nowiki>

</ref>
* [[wikipedia:Mike_Cannon-Brookes|Mike Cannon-Brookes]], billionaire cofounder of Australian software giant Atlassian, has invested [https://www.forbes.com/sites/samshead/2019/08/19/billionaire-backs-uk-startup-trying-to-extend-human-lifespans/ $10 million into longevity company Juvenescenc]e.<ref>Shead, S. (2019, August 19). ''Billionaire Backs U.K. Startup Trying To Extend Human Life Spans''. Forbes. <nowiki>https://www.forbes.com/sites/samshead/2019/08/19/billionaire-backs-uk-startup-trying-to-extend-human-lifespans/</nowiki></ref>
* [[wikipedia:Naveen_Jain|Naveen Jain]], billionaire entrepeneur who has raised [https://www.geekwire.com/2021/gut-health-startup-viome-raises-54m-develop-cancer-diagnostics-sell-microbiome-kits/ $54 million for his startup Viome].<ref>''Gut health startup Viome raises $54M to develop cancer diagnostics and sell microbiome kits''. (2021, November 10). Geekwire. <nowiki>https://www.geekwire.com/2021/gut-health-startup-viome-raises-54m-develop-cancer-diagnostics-sell-microbiome-kits/</nowiki></ref>
* [[wikipedia:Jim_Mellon|Jim Mellon]], who co-founded longevity company [https://www.juvlabs.com/people/co-founder/jim-mellon Juvenescence].<ref>''Jim Mellon - Chairman & Co-Founder''. (n.d.). Juvenescence - Science of Healthy Aging & Extended Lifespan. <nowiki>https://www.juvlabs.com/people/co-founder/jim-mellon</nowiki></ref>
* [[wikipedia:Larry_Ellison|Larry Ellison]], founder of Oracle, has spent [https://www.townandcountrymag.com/society/money-and-power/a9202324/science-of-longevity/ $430 million on longevity research].<ref>Tullis, P. (2017, March 30). ''Are You Rich Enough To Live Forever?'' Town & Country. <nowiki>https://www.townandcountrymag.com/society/money-and-power/a9202324/science-of-longevity/</nowiki></ref>
*Michael Greve, founder of Kizoo Technology, who has pledged [https://Longevity.Technology. https://www.longevity.technology/michael-greve-commits-e300m-for-rejuvenation-start-ups/ €300m to rejuvenation biotechnology companies.]<ref>''Michael Greve commits €300m for rejuvenation start-ups''. (2021, May 6). Longevity.Technology. <nowiki>https://www.longevity.technology/michael-greve-commits-e300m-for-rejuvenation-start-ups/</nowiki></ref>
* [[wikipedia:Yuri_Milner|Yuri Milner]], billionaire tech investor who has helped Altos Labs raise $270 million, with Jeff Bezos.<ref name=":7" />
* [https://wikitia.com/wiki/Richard_Heart Richard Heart], founder of the cryptocurrency Hex, who helped raise [https://www.express.co.uk/finance/city/1465354/pulsechain-cryptocurrency-srf-sens-research-foundation-airdrop-pulse-charity-longevity $25 million for the anti-aging research organisation SENS.]<ref>McGleenon, B. (2021, July 20). ''Pulsechain cryptocurrency raises 'mindblowing' $25M in five days for SENS longevity group''. Express.co.uk. <nowiki>https://www.express.co.uk/finance/city/1465354/pulsechain-cryptocurrency-srf-sens-research-foundation-airdrop-pulse-charity-longevity</nowiki></ref>
*[[wikipedia:Brian_Armstrong_(businessman)|Brian Armstrong]], CEO of CoinBase, who helped found and raise [https://www.dailymail.co.uk/sciencetech/article-10310475/Billionaire-launches-new-start-hopes-REVERSE-ageing-process.html $105 million for the epigenetic reprogramming startup NewLimit.]<ref>Liberatore, S. (2021, December 14). ''Billionaire launches new start-up to REVERSE the ageing process''. Mail Online. <nowiki>https://www.dailymail.co.uk/sciencetech/article-10310475/Billionaire-launches-new-start-hopes-REVERSE-ageing-process.html</nowiki></ref>
* [[wikipedia:Vitalik_Buterin|Vitalik Buterin]], founder of the cryptocurrency Ethereum, who donated $2.4 million to SENS.<ref>Foundation, S. R. (n.d.). ''SENS Research Foundation Receives $2.4 Million Ethereum Donation From Vitalik Buterin''. GlobeNewswire News Room. <nowiki>https://www.globenewswire.com/news-release/2018/02/02/1332410/0/en/SENS-Research-Foundation-Receives-2-4-Million-Ethereum-Donation-From-Vitalik-Buterin.html</nowiki></ref>

== How large will the longevity biotechnology field be? ==
Analysts from the Bank of America have predicted that the market size of longevity biotechnology will reach $600 billion by 2025.<ref>2021. ''Human lifespan could soon pass 100 years thanks to medical tech, says BofA''. [online] Available at: <<nowiki>https://www.cnbc.com/2019/05/08/techs-next-big-disruption-could-be-delaying-death.html</nowiki>> [Accessed 14 December 2021].</ref> Others have speculated that it is a trillion dollar industry owing to the immense savings associated with delaying or preventing chronic diseases.<ref>Colangelo, M., 2021. ''AI Will Drive The Multi-Trillion Dollar Longevity Economy''. [online] Forbes. Available at: <<nowiki>https://www.forbes.com/sites/cognitiveworld/2019/12/07/ai-will-drive-the-multi-trillion-dollar-longevity-economy/?sh=294766b74965</nowiki>> [Accessed 14 December 2021].</ref>

== How is aging biology research different to other fields of medical research? ==
Scientists studying the biology of aging believe that aging is the root cause of all the major diseases that afflict us as we age. Therefore, targeting aging biology would treat or reverse multiple diseases, simultaneously, while maximizing the chance of a cure.

Mainstream medical research has had many successes in treating single diseases, such as infectious diseases. For age-related ones, notable successes have been seen for heart diseases. However, targeting single diseases, one at a time, leads to rapidly diminishing returns. Even if we could ''cure'' heart disease and cancer, which are leading causes of death, each would add only ~2.5 years to life expectancy. This is because the next disease in line, e.g. Alzheimer's or lung disease, will kill you. This is the Taeuber Paradox, which highlights how the exponentially increasing risk of disease accumulation with aging limits the benefit of targeting single diseases.
== Do all animals age in the same way? ==
[[File:Naked mole rat graph.png|alt=Naked mole rat graph|thumb|530x530px|The naked mole-rat does not follow the same increased risk of mortality due to aging that humans and other mammals do. ]]
Many species, due to differences in their biology, age at different rates to humans. The jellyfish ''Turritopsis dohrnii'' can revert to earlier stages of its life cycle in response to stress, and can theoretically live forever - though eventually dies, usually due to predation.

Among mammals, the naked mole rat is an exceptionally long lived organism that lives roughly ten times longer than similarly-sized rats.<ref name=":3">Ruby, J. G., Smith, M., & Buffenstein, R. (2018). Naked mole-rat mortality rates defy Gompertzian laws by not increasing with age. ''elife'', ''7'', e31157.</ref><ref>Buffenstein, R., Amoroso, V., Andziak, B., Avdieiev, S., Azpurua, J., Barker, A. J., ... & Smith, E. S. J. (2021). The naked truth: a comprehensive clarification and classification of current ‘myths’ in naked mole‐rat biology. ''Biological Reviews''.</ref> Unlike other organisms, such as humans, horses and mice, the mortality rate of the naked mole rat appears steady over time. This trend does not follow the exponential increase in mortality (Gompertz-Makeham law) that humans do.<ref name=":3" />

Scientists are now studying the naked mole rat to identify key patterns in their genetics, environmental traits, and metabolism that may be responsible for their longer lifespans.

[[File:Naked mole rat.jpg|alt=Naked mole rat|center|thumb|323x323px|The naked mole rat is unusually long-lived relative to other mice and rats. ]]

== Is aging considered a disease? ==
Aging is not currently classified as a disease by regulatory bodies such as the Food and Drug Administration (FDA) in the United States. However, several scientists in the aging field have publicly stated their wish for aging to be considered a disease, including professor David Sinclair and professor Nir Barzilai.

== What are the economic benefits of extending healthy lifespan? ==
Extending the healthy human lifespan could have significant economic benefits gobally. An economic analysis from 2021 by researchers at the University of Oxford and Harvard University estimated the benefit of a drug that slows aging by 1 year as $38 trillion. This is primarily because slowing aging reduces the incidence of age-related diseases such as cancer and Alzheimer’s disease, which require expensive treatment approaches. The study demonstrated a larger economic benefit of slowing aging than curing the individual diseases of aging.
== Which anti-aging drugs are being tested in clinical trials today? ==
There are over 50 drugs being tested in human clinical trials for aging or age-related diseases.

The largest trial is the Targeting Aging with Metformin (TAME) trial, which began in 2020. The trial is being run in the United States with a cohort of 3000 older adults. The goal of the TAME trial is to determine whether diabetes drug metformin slows the aging process in older adults. The TAME trial is a $75 million trial run by the American Federation for Aging Research.

Another large clinical trial is the Participitory Evluation of Rapamycin (PEARL) study. The goal of this study is to determine whether rapamycin, a drug currently approved for immunosuppression during organ transplants, slows biomarkers of aging in 1000 adults. The PEARL trial is being run by AgelessRx.
== Is aging a natural process that should be accepted? ==
Although aging is a natural process in humans, it is the driving force of many diseases such as cancer and Alzheimer's disease - which as a society we have decided are worth trying to find cures for. In the past, these conditions, as well as atherosclerosis and even infectious diseases were once thought of as natural processes that could not be treated. However, nowadays it is understood that they are diseases that can be treated.

Atherosclerosis, the hardening of the arteries, was once viewed as a natural process that was simply a consequence of aging. However, when treatments such as statins were later developed to prevent atherosclerosis, the disease became widely regarded as a disease to be cured. Statins are now one one of the most widely prescribed drugs in the world, used in preventing heart diseases. The inventor of statins, Akira Endo, describes in his historical paper: “Serious research on the role of cholesterol in human atherosclerosis did not really get underway until the 1940s, due to a prevailing view that the disease was a simple consequence of aging and could not be prevented.”<ref>Endo A. (2010). A historical perspective on the discovery of statins. ''Proceedings of the Japan Academy. Series B, Physical and biological sciences'', ''86''(5), 484–493. <nowiki>https://doi.org/10.2183/pjab.86.484</nowiki></ref>

== Will anti-aging technology lead to overpopulation? ==
A common objection to the development of longevity technologies is that they may lead to an unsustainably large population size.

One study of a 2005 Swedish cohort of 9 million people modeled the effect of various anti-aging scenarios. The researchers showed that even with the most radical life-extension technology in which aging completely stopped after age 60, the population growth across 100 years was only 22%.

Currently, the world’s population is 7.9 billion, and the WHO predicts the population will peak at 11 billion in 2100 before falling due to declining birth rates in many parts of the world.

The fastest growing populations are in Africa and South-east Asia. However, several factors are thought to reduce birth rates over time, including increased access to contraceptives, female empowerment, increased education and increased employment. There is evidence that populations that move to a more advanced economy show a reduction in birth rates.

== Will anti-aging drugs only be available to the rich? ==
It is unclear who will have first access to longevity drugs. Several researchers in the field have argued that several economic factors are likely to drive down the price of drugs that slow aging.

* The cost of many biotechnologies decreases substantially over time. For example, the first human genome cost $100 million to sequence, and is now available for a few hundred dollars.

* The price of many lifesaving pharmaceuticals has fallen significantly in price once generic drugs were produced. For example, Lipitor, a statin used to prevent heart disease has fallen in price from $85 in 2011 to less than $5 today.

* Many companies in the longevity field have stated that equity of access is part of their core ethos, and many researchers are signatories to the

== Which scientists and institutions are trying to understand and reverse aging? ==
Hundreds of scientists are working on understanding the biology of aging in leading institutions like Harvard University, Stanford University, Yale University, and the University of Oxford. Some of the most well-known institutes and labs include:

=== The Buck Institute for Research on Aging ===
The Buck Institute for Research on Aging is one of the largest longevity research institutes with over 250 scientists. The research covers several areas including the mechanisms of aging, neurodegeneration, senescence, stem cells and regenerative medicine, cellular stress and disease, cancer associated with aging, and mitochondrial function.

=== Professor David Sinclair - Harvard Medical School ===
Professor Sinclair’s lab focuses on understanding and reversing aging. The lab focuses on a range of areas including DNA repair, mitochondrial dysfunction, and the interactions between epigenetic and genetic instability, and tissue reprogramming. Sinclair is also the author of the bestselling book, Lifespan: why we age and why we don’t have to.

=== Professor Matt Kaeberlein - University of Washington ===
Professor Kaeberlein's lab focuses on biological mechanisms of aging in order to facilitate translational interventions that promote healthspan and improve quality of life. Kaeberlein is known for his work on the longevity drug rapamycin in organisms such as mice and dogs. He is Director of the Dog Aging Project, a multi-year initiative studying the genetic and environmental factors that influence health, with over 33,000 participating dogs.

=== Professor Brian Kennedy - National University of Singapore ===
Professor Kennedy’s lab focuses on understanding the biology of aging and translating research discoveries into new ways of delaying aging in humans. The lab has identified drugs that extend the healthy lifespan of worms and mice and are seeking to understand their mechanisms.

=== Associate Professor Lynne Cox - University of Oxford ===
Professor Cox’s lab study the molecular and cellular basis of aging to identify specific biochemical processes and pathways that change organisms age. The lab particularly cellular senescence, which underpins many age-related diseases including cancer and neurodegeneration.

== What books have been written on this topic? ==
Several books have been written on the topic of aging and longevity. These include:

* ''Lifespan: Why We Age And Why We Don't Have To'' - David Sinclair (2019)

* ''Ending Aging'' - Dr. Aubrey de Grey (2007)

* ''Ageless'' - Dr. Andrew Steele (2020)

* ''Age Later'' - Professor Nir Barzilai (2021)

* ''The Science and Technology of Growing Young'' - Sergey Young (2021)

== References ==
<references />

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Longevity biotechnology is a new field of research and development that aims to extend healthy human lifespan. This page answers common questions that people have about the field.

== What is longevity biotechnology? ==
[[File:Healthy lifespan extension.png|alt=Healthy lifespan extension|thumb|643x643px|Healthy lifespan extension]]
Longevity biotechnology is an emerging industry that aims to create therapies to extend the healthy human lifespan. Aging is associated with functional decline, and longevity biotechnology aims to extend the healthy period of lifespan before the diseases of aging become more prevalent.

Slowing or completely treating the aging process aims to extend the healthy lifespan (‘healthspan’) of the population.

Since aging is not currently considered a disease by regulatory bodies such as the Food and Drug Administration (FDA), drug developers are currently focused on specific diseases of aging such as glaucoma and osteoarthritis.

The longevity biotechnology sector is rapidly growing, and there are currently over 170 private companies<ref>Pfleger, K., 2021. ''Aging Companies''. [online] Agingbiotech.info. Available at: <<nowiki>https://agingbiotech.info/companies</nowiki>> [Accessed 13 December 2021].</ref> working on developing therapeutics to slow the aging process. These companies are working on slowing or reversing the aging process by targeting one of more of the hallmarks of aging. For example, Cleara Biotech are attempting to reduce cellular senescence by developing a new drug that can eliminate senescent cells. Over 50 drugs are currently in clinical trials in humans.<ref>Lifespan.io. 2021. ''The Rejuvenation Roadmap | Lifespan.io''. [online] Available at: <<nowiki>https://www.lifespan.io/road-maps/the-rejuvenation-roadmap/</nowiki>> [Accessed 13 December 2021].</ref>
== Can healthy lifespan be extended? ==
Clinical trials for longevity drugs are in-progress, and there is no data currently available that shows a drug slows or reverses aging in humans. However, trials in mice, worms and flies have demonstrated that healthy lifespan can be extended with therapeutic interventions.

In mice, over 100 drugs have been shown to extend healthy lifespan by up to 30%. [[File:Life extension mice.jpg|alt=Life extension mice|thumb|648x648px|Life extension mice]][[File:Unity Mice.jpg|alt=Unity Mice|thumb|723x723px|Unity Mice]]

== Why is aging a problem? ==

Aging is the largest risk factor for the diseases that kill most people - such as cancer, Alzheimer's and cardiovascular disease. Aging is also associated with significant disability. In the US in 2020, 8 of the 10 leading causes of death were age-related.<ref>Ahmad, F. B., & Anderson, R. N. (2021). The leading causes of death in the US for 2020. ''JAMA'', ''325''(18), 1829-1830.https://jamanetwork.com/journals/jama/fullarticle/2778234</ref>

Aging is the largest risk factor for the diseases that kill most people worldwide, and also the largest source of morbidity. The aging process results in the deaths of 100,000 people per day; more than twice the sum of all other causes of death combined.<ref>Ritchie, H. and Roser, M., 2021. ''Causes of Death''. [online] Our World in Data. Available at: <<nowiki>https://ourworldindata.org/causes-of-death</nowiki>> [Accessed 13 December 2021].

</ref> This equates to 37 million people - a population the size of Canada - dying per year of aging. In developed countries, 9 out of 10 deaths are due to aging.

Aging also accounts for more than 30% of all disability-adjusted life years lost (DALYs); more than any other single cause. Deaths due to aging are not usually quick and painless, but preceded by 10-15 years of chronic illnesses such as cancer, type 2 diabetes and Alzheimer’s disease.<ref>Vizhub.healthdata.org. 2021. ''GBD Compare | IHME Viz Hub''. [online] Available at: <<nowiki>https://vizhub.healthdata.org/gbd-compare/</nowiki>> [Accessed 13 December 2021].</ref> Quality of life typically deteriorates in older age, and the highest rates of depression worldwide are among the elderly.

Aging causes an exponentially increasing risk of death due to chronic diseases such as cancer over time.
[[File:Aging graph.png|thumb|738x738px|The risk of age-related diseases increases exponentially over time, due to the aging process.]]

[[File:Leading causes of death.png|thumb|724x724px|Leading causes of death, USA]]

== Why does the risk of death increase over time? ==
[[File:Gompertz Curve.svg|alt=Gompertz Curve|thumb|Gompertz Curve]]
As a result of the aging process, the risk of dying increases exponentially after the age of around 30 years old.<ref name=":0">En.wikipedia.org. 2021. ''Gompertz–Makeham law of mortality - Wikipedia''. [online] Available at: <<nowiki>https://en.wikipedia.org/wiki/Gompertz%E2%80%93Makeham_law_of_mortality</nowiki>> [Accessed 13 December 2021].</ref> This increase in mortality rate is known as the Gompertz-Makeham law of mortality.<ref name=":0" />

== Which drugs may extend lifespan in humans? ==

=== Metformin ===
Metformin is an approved drug for type 2 diabetes that extends lifespan in multiple species. Metformin is being tested as a longevity therapy in the largest clinical trial for a longevity therapy, the Targeting Aging with Metformin (TAME) trial in the US.

=== Rapamycin ===

== What is aging? ==
There are two types of age: chronological age, which is simply the number of years since birth, and biological age. Biological age is a measure of the physical health of a person and their position in their lifespan. Biological age is more difficult to measure,

Aging is generally divided into 9 processes or 'hallmarks'.

== What are the 9 Hallmarks of Aging? ==
[[File:Hallmarks of aging.jpg|alt=Hallmarks of aging|thumb|515x515px|Hallmarks of aging]]

The hallmarks of aging framework is considered to broadly represent key biological mechanisms of the biological aging process. Like all models, there are various limitations of the hallmarks framework, but it is a useful primer for a basic understanding of aging biology

The nine forms of cellular and molecular ‘damage’ that comprise the hallmarks of aging are:

* Genomic instability
* Telomere attrition
* Epigenetic alterations
* Loss of proteostasis
* Deregulated nutrient-sensing
* Mitochondrial dysfunction
* Cellular senescence
* Stem cell exhaustion
* Altered intercellular communication

== Is aging a risk factor in COVID-19? ==
Aging is the largest risk factor for COVID-19.

== How is aging measured? ==
New technologies are being developed to measure biological age. These include:

=== Epigenetic clocks ===

=== Multi-omic clocks ===

== Do all animals age? ==
Some animals, due to differences in their biology, age at different rates.

The naked mole rat has similar genetics to a mouse, but lives ten times longer.

== Is aging considered a disease? ==
Aging is not currently classified as a disease by regulatory bodies such as the Food and Drug Administration (FDA) in the United States. However, several scientists in the aging field have publicly stated their wish for aging to be considered a disease, including professor David Sinclair and professor Nir Barzilai.

== What are the economic benefits of extending healthy lifespan? ==
Extending the healthy human lifespan could have significant economic benefits gobally. An economic analysis from 2021 by researchers at the University of Oxford and Harvard University estimated the benefit of a drug that slows aging by 1 year as $38 trillion. This is primarily because slowing aging reduces the incidence of age-related diseases such as cancer and Alzheimer’s disease, which require expensive treatment approaches. The study demonstrated a larger economic benefit of slowing aging than curing the individual diseases of aging.

== Will healthy or unhealthy lifespan be extended? ==
[[File:Extending healthy human lifespan.jpg|alt=Extending healthy human lifespan|thumb|409x409px|Extending healthy human lifespan]]The stated goal of longevity biotechnology is to extend the healthy period of lifespan, before age-related diseases set in. This is in contrast to many of today's medical interventions, which extend life only after diseases (e.g. cancer, Alzheimer's) have reached a clinical level.

Age-related diseases are preceded by a long period of subclinical aging, i.e. aging that has not yet progressed far enough to produce clinical symptoms. By slowing, delaying or reversing the aging process, the healthy period of life can be extended.

Studies in mice have demonstrated that life extending drugs such as rapamycin are capable of extending the healthy, rather than unhealthy period of life.

== Which anti-aging drugs are being tested in clinical trials today? ==
There are over 50 drugs being tested in human clinical trials for aging or age-related diseases.

The largest trial is the Targeting Aging with Metformin (TAME) trial, which began in 2020. The trial is being run in the United States with a cohort of 3000 older adults. The goal of the TAME trial is to determine whether diabetes drug metformin slows the aging process in older adults. The TAME trial is a $75 million trial run by the American Federation for Aging Research.

Another large clinical trial is the Participitory Evluation of Rapamycin (PEARL) study. The goal of this study is to determine whether rapamycin, a drug currently approved for immunosuppression during organ transplants, slows biomarkers of aging in 1000 adults. The PEARL trial is being run by AgelessRx.

== Is aging natural? ==
<nowiki>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3108295/</nowiki>

Atherosclerosis, the hardening of the arteries, was once viewed as simply a consequence of aging that should be accepted as natural. However, when treatments were later developed, atherosclerosis became widely regarded as a disease to be cured. Statins are now one one of the most widely prescribed drugs in the world, used in preventing heart diseases. The inventor of statins, Akira Endo, describes in his historical paper:

“Serious research on the role of cholesterol in human atherosclerosis did not really get underway until the 1940s, due to a prevailing view that the disease was a simple consequence of aging and could not be prevented.”

== Are billionaires funding longevity biotechnology? ==
Several billionaires have funded companies or initiatives to slow or reverse human aging. These include:
[[File:Jeff Bezos is funding longevity research.jpg|alt=Jeff Bezos is funding longevity research|thumb|Jeff Bezos is funding longevity research]]
* Jeff Bezos, co-founder of Amazon who helped to raise $270 million for a new anti-aging drug company called Altos Labs in 2021.
* Peter Thiel, co-founder of PayPal who was an early investor in Unity Biotechnology.
* Sergey Brin, co-founder of Google, who provided $25 million funding for the National Academy of Medicine’s Grand Challenge in Health Longevity to 'end aging forever'.
* Larry Page, co-founder of Google, who helped to found the billion-dollar research initiative Calico Labs.
* Dr. Mehmood Khan
* Mark Zuckerberg
* Mike Cannon-Brookes, billionaire cofounder of Australian software giant Atlassian, has invested $10 million into longevity company Juvenescence.
* Naveen Jain, billionaire entrepeneur who has created Viome.
* Jim Mellon, who has invested in longevity company Juvenescence.
* Larry Ellison, founder of Oracle, has spent $430 million on longevity research.
* Yuri Milner, billionaire tech investor who has helped Altos Labs raise $270 million, with Jeff Bezos
* Richard Heart, founder of the cryptocurrency Hex, who helped to raise $27 million to anti-aging research organisation SENS.
* Vitalik Buterin, founder of the cryptocurrency Ethereum, who donated $2.4 million to SENS.

== How large will the longevity biotechnology field be? ==
Analysts from the Bank of America have predicted that the market size of longevity biotechnology will reach $600 billion by 2025. Others have speculated that it is a trillion dollar industry owing to the immense savings associated with delaying or preventing chronic diseases

== Will anti-aging technology lead to overpopulation? ==
A common objection to the development of longevity technologies is that they may lead to an unsustainably large population size.

One study of a 2005 Swedish cohort of 9 million people modeled the effect of various anti-aging scenarios. The researchers showed that even with the most radical life-extension technology in which aging completely stopped after age 60, the population growth across 100 years was only 22%.

Currently, the world’s population is 7.9 billion, and the WHO predicts the population will peak at 11 billion in 2100 before falling due to declining birth rates in many parts of the world.

The fastest growing populations are in Africa and South-east Asia. However, several factors are thought to reduce birth rates over time, including increased access to contraceptives, female empowerment, increased education and increased employment. There is evidence that populations that move to a more advanced economy show a reduction in birth rates.

== Will anti-aging drugs only be available to the rich? ==
It is unclear who will have first access to longevity drugs. Several researchers in the field have argued that several economic factors are likely to drive down the price of drugs that slow aging.

* The cost of many biotechnologies decreases substantially over time. For example, the first human genome cost $100 million to sequence, and is now available for a few hundred dollars.

* The price of many lifesaving pharmaceuticals has fallen significantly in price once generic drugs were produced. For example, Lipitor, a statin used to prevent heart disease has fallen in price from $85 in 2011 to less than $5 today.

* Many companies in the longevity field have stated that equity of access is part of their core ethos, and many researchers are signatories to the

== Which scientists and institutions are trying to understand and reverse aging? ==
Hundreds of scientists are working on understanding the biology of aging in leading institutions like Harvard University, Stanford University, Yale University, and the University of Oxford. Some of the most well-known institutes and labs include:

=== The Buck Institute for Research on Aging ===
The Buck Institute for Research on Aging is one of the largest longevity research institutes with over 250 scientists. The research covers several areas including the mechanisms of aging, neurodegeneration, senescence, stem cells and regenerative medicine, cellular stress and disease, cancer associated with aging, and mitochondrial function.

=== Professor David Sinclair - Harvard Medical School ===
Professor Sinclair’s lab focuses on understanding and reversing aging. The lab focuses on a range of areas including DNA repair, mitochondrial dysfunction, and the interactions between epigenetic and genetic instability, and tissue reprogramming. Sinclair is also the author of the bestselling book, Lifespan: why we age and why we don’t have to.

=== Professor Brian Kennedy - National University of Singapore ===
Professor Kennedy’s lab focuses on understanding the biology of aging and translating research discoveries into new ways of delaying aging in humans. The lab has identified drugs that extend the healthy lifespan of worms and mice and are seeking to understand their mechanisms.

=== Associate Professor Lynne Cox - University of Oxford ===
Professor Cox’s lab study the molecular and cellular basis of aging to identify specific biochemical processes and pathways that change organisms age. The lab particularly cellular senescence, which underpins many age-related diseases including cancer and neurodegeneration.

== What books have been written on this topic? ==
Several books have been written on the topic of aging and longevity therapeutics. These include:

Lifespan -- Professor David Sinclair (2019)

Ending Aging -- Dr. Aubrey de Grey (2007)

Ageless -- Dr. Andrew Steele (2020)

Age Later -- Professor Nir Barzilai (2021)

The Science and Technology of Growing Young - Sergey Young (2021)

FAQ

2021-12-13T06:49:24Z

Jack:

Longevity biotechnology is a new field of research and development that aims to extend healthy human lifespan. This page answers common questions that people have about the field.

== What is longevity biotechnology? ==
[[File:Healthy lifespan extension.png|alt=Healthy lifespan extension|thumb|643x643px|Healthy lifespan extension]]
Longevity biotechnology is an emerging industry that aims to create therapies to extend the healthy human lifespan. Aging is associated with functional decline, and longevity biotechnology aims to extend the healthy period of lifespan before the diseases of aging become more prevalent.

Slowing or completely treating the aging process aims to extend the healthy lifespan (‘healthspan’) of the population.

Since aging is not currently considered a disease by regulatory bodies such as the Food and Drug Administration (FDA), drug developers are currently focused on specific diseases of aging such as glaucoma and osteoarthritis.

The longevity biotechnology sector is rapidly growing, and there are currently over 170 private companies working on developing therapeutics to slow the aging process. These companies are working on slowing or reversing the aging process by targeting one of more of the hallmarks of aging. For example, Cleara Biotech are attempting to reduce cellular senescence by developing a new drug that can eliminate senescent cells. Over 50 drugs are currently in clinical trials in humans.
== Can healthy lifespan be extended? ==
Clinical trials for longevity drugs are in-progress, and there is no data currently available that shows a drug slows or reverses aging in humans. However, trials in mice, worms and flies have demonstrated that healthy lifespan can be extended with therapeutic interventions.

In mice, over 100 drugs have been shown to extend healthy lifespan by up to 30%.
[[File:Unity Mice.jpg|alt=Unity Mice|thumb|723x723px|Unity Mice]]

[[File:Life extension mice.jpg|alt=Life extension mice|thumb|648x648px|Life extension mice]]

== Why is aging a problem? ==

Aging is the largest risk factor for the diseases that kill most people - such as cancer, Alzheimer's and cardiovascular disease. Aging is also associated with significant disability. In the US in 2020, 8 of the 10 leading causes of death were age-related.

Aging is the largest risk factor for the diseases that kill most people worldwide, and also the largest source of morbidity. The aging process results in the deaths of 100,000 people per day; more than twice the sum of all other causes of death combined. This equates to 37 million people - a population the size of Canada - dying per year of aging. In developed countries, 9 out of 10 deaths are primarily due to aging.

Aging also accounts for more than 30% of all disability-adjusted life years lost (DALYs); more than any other single cause. Deaths due to aging are not usually quick and painless, but preceded by 10-15 years of chronic illnesses such as cancer, type 2 diabetes and Alzheimer’s disease. Quality of life typically deteriorates in older age, and the highest rates of depression worldwide are among the elderly.

Aging causes an exponentially increasing risk of death due to chronic diseases such as cancer over time.
[[File:Aging graph.png|thumb|738x738px|The risk of age-related diseases increases exponentially over time, due to the aging process.]]

[[File:Leading causes of death.png|thumb|724x724px|Leading causes of death, USA]]

== Why does the risk of death increase over time? ==
[[File:Gompertz Curve.svg|alt=Gompertz Curve|thumb|Gompertz Curve]]
As a result of the aging process, the risk of dying increases exponentially after the age of around 30 years old. This increase in mortality rate is known as the Gompertz-Makeham law of mortality.

== Which drugs may extend lifespan in humans? ==

=== Metformin ===
Metformin is an approved drug for type 2 diabetes that extends lifespan in multiple species. Metformin is being tested as a longevity therapy in the largest clinical trial for a longevity therapy, the Targeting Aging with Metformin (TAME) trial in the US.

=== Rapamycin ===

== What is aging? ==
There are two types of age: chronological age, which is simply the number of years since birth, and biological age. Biological age is a measure of the physical health of a person and their position in their lifespan. Biological age is more difficult to measure,

Aging is generally divided into 9 processes or 'hallmarks'.

== What are the 9 Hallmarks of Aging? ==
[[File:Hallmarks of aging.jpg|alt=Hallmarks of aging|thumb|515x515px|Hallmarks of aging]]

The hallmarks of aging framework is considered to broadly represent key biological mechanisms of the biological aging process. Like all models, there are various limitations of the hallmarks framework, but it is a useful primer for a basic understanding of aging biology

The nine forms of cellular and molecular ‘damage’ that comprise the hallmarks of aging are:

* Genomic instability
* Telomere attrition
* Epigenetic alterations
* Loss of proteostasis
* Deregulated nutrient-sensing
* Mitochondrial dysfunction
* Cellular senescence
* Stem cell exhaustion
* Altered intercellular communication

== Is aging a risk factor in COVID-19? ==
Aging is the largest risk factor for COVID-19.

== How is aging measured? ==
New technologies are being developed to measure biological age. These include:

=== Epigenetic clocks ===

=== Multi-omic clocks ===

== Do all animals age? ==
Some animals, due to differences in their biology, age at different rates.

The naked mole rat has similar genetics to a mouse, but lives ten times longer.

== Is aging considered a disease? ==
Aging is not currently classified as a disease by regulatory bodies such as the Food and Drug Administration (FDA) in the United States. However, several scientists in the aging field have publicly stated their wish for aging to be considered a disease, including professor David Sinclair and professor Nir Barzilai.

== What are the economic benefits of extending healthy lifespan? ==
Extending the healthy human lifespan could have significant economic benefits gobally. An economic analysis from 2021 by researchers at the University of Oxford and Harvard University estimated the benefit of a drug that slows aging by 1 year as $38 trillion. This is primarily because slowing aging reduces the incidence of age-related diseases such as cancer and Alzheimer’s disease, which require expensive treatment approaches. The study demonstrated a larger economic benefit of slowing aging than curing the individual diseases of aging.

== Will healthy or unhealthy lifespan be extended? ==
[[File:Extending healthy human lifespan.jpg|alt=Extending healthy human lifespan|thumb|409x409px|Extending healthy human lifespan]]The stated goal of longevity biotechnology is to extend the healthy period of lifespan, before age-related diseases set in. This is in contrast to many of today's medical interventions, which extend life only after diseases (e.g. cancer, Alzheimer's) have reached a clinical level.

Age-related diseases are preceded by a long period of subclinical aging, i.e. aging that has not yet progressed far enough to produce clinical symptoms. By slowing, delaying or reversing the aging process, the healthy period of life can be extended.

Studies in mice have demonstrated that life extending drugs such as rapamycin are capable of extending the healthy, rather than unhealthy period of life.

== Which anti-aging drugs are being tested in clinical trials today? ==
There are over 50 drugs being tested in human clinical trials for aging or age-related diseases.

The largest trial is the Targeting Aging with Metformin (TAME) trial, which began in 2020. The trial is being run in the United States with a cohort of 3000 older adults. The goal of the TAME trial is to determine whether diabetes drug metformin slows the aging process in older adults. The TAME trial is a $75 million trial run by the American Federation for Aging Research.

Another large clinical trial is the Participitory Evluation of Rapamycin (PEARL) study. The goal of this study is to determine whether rapamycin, a drug currently approved for immunosuppression during organ transplants, slows biomarkers of aging in 1000 adults. The PEARL trial is being run by AgelessRx.

== Is aging natural? ==
<nowiki>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3108295/</nowiki>

Atherosclerosis, the hardening of the arteries, was once viewed as simply a consequence of aging that should be accepted as natural. However, when treatments were later developed, atherosclerosis became widely regarded as a disease to be cured. Statins are now one one of the most widely prescribed drugs in the world, used in preventing heart diseases. The inventor of statins, Akira Endo, describes in his historical paper:

“Serious research on the role of cholesterol in human atherosclerosis did not really get underway until the 1940s, due to a prevailing view that the disease was a simple consequence of aging and could not be prevented.”

== Are billionaires funding longevity biotechnology? ==
Several billionaires have funded companies or initiatives to slow or reverse human aging. These include:
[[File:Jeff Bezos is funding longevity research.jpg|alt=Jeff Bezos is funding longevity research|thumb|Jeff Bezos is funding longevity research]]
* Jeff Bezos, co-founder of Amazon who helped to raise $270 million for a new anti-aging drug company called Altos Labs in 2021.
* Peter Thiel, co-founder of PayPal who was an early investor in Unity Biotechnology.
* Sergey Brin, co-founder of Google, who provided $25 million funding for the National Academy of Medicine’s Grand Challenge in Health Longevity to 'end aging forever'.
* Larry Page, co-founder of Google, who helped to found the billion-dollar research initiative Calico Labs.
* Dr. Mehmood Khan
* Mark Zuckerberg
* Mike Cannon-Brookes, billionaire cofounder of Australian software giant Atlassian, has invested $10 million into longevity company Juvenescence.
* Naveen Jain, billionaire entrepeneur who has created Viome.
* Jim Mellon, who has invested in longevity company Juvenescence.
* Larry Ellison, founder of Oracle, has spent $430 million on longevity research.
* Yuri Milner, billionaire tech investor who has helped Altos Labs raise $270 million, with Jeff Bezos
* Richard Heart, founder of the cryptocurrency Hex, who helped to raise $27 million to anti-aging research organisation SENS.
* Vitalik Buterin, founder of the cryptocurrency Ethereum, who donated $2.4 million to SENS.

== How large will the longevity biotechnology field be? ==
Analysts from the Bank of America have predicted that the market size of longevity biotechnology will reach $600 billion by 2025. Others have speculated that it is a trillion dollar industry owing to the immense savings associated with delaying or preventing chronic diseases

== Will anti-aging technology lead to overpopulation? ==
A common objection to the development of longevity technologies is that they may lead to an unsustainably large population size.

One study of a 2005 Swedish cohort of 9 million people modeled the effect of various anti-aging scenarios. The researchers showed that even with the most radical life-extension technology in which aging completely stopped after age 60, the population growth across 100 years was only 22%.

Currently, the world’s population is 7.9 billion, and the WHO predicts the population will peak at 11 billion in 2100 before falling due to declining birth rates in many parts of the world.

The fastest growing populations are in Africa and South-east Asia. However, several factors are thought to reduce birth rates over time, including increased access to contraceptives, female empowerment, increased education and increased employment. There is evidence that populations that move to a more advanced economy show a reduction in birth rates.

== Will anti-aging drugs only be available to the rich? ==
It is unclear who will have first access to longevity drugs. Several researchers in the field have argued that several economic factors are likely to drive down the price of drugs that slow aging.

* The cost of many biotechnologies decreases substantially over time. For example, the first human genome cost $100 million to sequence, and is now available for a few hundred dollars.

* The price of many lifesaving pharmaceuticals has fallen significantly in price once generic drugs were produced. For example, Lipitor, a statin used to prevent heart disease has fallen in price from $85 in 2011 to less than $5 today.

* Many companies in the longevity field have stated that equity of access is part of their core ethos, and many researchers are signatories to the

== Which scientists and institutions are trying to understand and reverse aging? ==
Hundreds of scientists are working on understanding the biology of aging in leading institutions like Harvard University, Stanford University, Yale University, and the University of Oxford. Some of the most well-known institutes and labs include:

=== The Buck Institute for Research on Aging ===
The Buck Institute for Research on Aging is one of the largest longevity research institutes with over 250 scientists. The research covers several areas including the mechanisms of aging, neurodegeneration, senescence, stem cells and regenerative medicine, cellular stress and disease, cancer associated with aging, and mitochondrial function.

=== Professor David Sinclair - Harvard Medical School ===
Professor Sinclair’s lab focuses on understanding and reversing aging. The lab focuses on a range of areas including DNA repair, mitochondrial dysfunction, and the interactions between epigenetic and genetic instability, and tissue reprogramming. Sinclair is also the author of the bestselling book, Lifespan: why we age and why we don’t have to.

=== Professor Brian Kennedy - National University of Singapore ===
Professor Kennedy’s lab focuses on understanding the biology of aging and translating research discoveries into new ways of delaying aging in humans. The lab has identified drugs that extend the healthy lifespan of worms and mice and are seeking to understand their mechanisms.

=== Associate Professor Lynne Cox - University of Oxford ===
Professor Cox’s lab study the molecular and cellular basis of aging to identify specific biochemical processes and pathways that change organisms age. The lab particularly cellular senescence, which underpins many age-related diseases including cancer and neurodegeneration.

== What books have been written on this topic? ==
Several books have been written on the topic of aging and longevity therapeutics. These include:

Lifespan -- Professor David Sinclair (2019)

Ending Aging -- Dr. Aubrey de Grey (2007)

Ageless -- Dr. Andrew Steele (2020)

Age Later -- Professor Nir Barzilai (2021)

The Science and Technology of Growing Young - Sergey Young (2021)

FAQ

2021-12-13T06:45:22Z

Jack: /* Are billionaires funding longevity biotechnology? */

== What is longevity biotechnology? ==
[[File:Healthy lifespan extension.png|alt=Healthy lifespan extension|thumb|643x643px|Healthy lifespan extension]]
Longevity biotechnology is an emerging industry that aims to create therapies to extend the healthy human lifespan. Aging is associated with functional decline, and longevity biotechnology aims to extend the healthy period of lifespan before the diseases of aging become more prevalent.

Slowing or completely treating the aging process aims to extend the healthy lifespan (‘healthspan’) of the population.

Since aging is not currently considered a disease by regulatory bodies such as the Food and Drug Administration (FDA), drug developers are currently focused on specific diseases of aging such as glaucoma and osteoarthritis.

The longevity biotechnology sector is rapidly growing, and there are currently over 170 private companies working on developing therapeutics to slow the aging process. These companies are working on slowing or reversing the aging process by targeting one of more of the hallmarks of aging. For example, Cleara Biotech are attempting to reduce cellular senescence by developing a new drug that can eliminate senescent cells. Over 50 drugs are currently in clinical trials in humans.
== Can healthy lifespan be extended? ==
Clinical trials for longevity drugs are in-progress, and there is no data currently available that shows a drug slows or reverses aging in humans. However, trials in mice, worms and flies have demonstrated that healthy lifespan can be extended with therapeutic interventions.

In mice, over 100 drugs have been shown to extend healthy lifespan by up to 30%.
[[File:Unity Mice.jpg|alt=Unity Mice|thumb|723x723px|Unity Mice]]

[[File:Life extension mice.jpg|alt=Life extension mice|thumb|648x648px|Life extension mice]]

== Why is aging a problem? ==

Aging is the largest risk factor for the diseases that kill most people - such as cancer, Alzheimer's and cardiovascular disease. Aging is also associated with significant disability. In the US in 2020, 8 of the 10 leading causes of death were age-related.

Aging is the largest risk factor for the diseases that kill most people worldwide, and also the largest source of morbidity. The aging process results in the deaths of 100,000 people per day; more than twice the sum of all other causes of death combined. This equates to 37 million people - a population the size of Canada - dying per year of aging. In developed countries, 9 out of 10 deaths are primarily due to aging.

Aging also accounts for more than 30% of all disability-adjusted life years lost (DALYs); more than any other single cause. Deaths due to aging are not usually quick and painless, but preceded by 10-15 years of chronic illnesses such as cancer, type 2 diabetes and Alzheimer’s disease. Quality of life typically deteriorates in older age, and the highest rates of depression worldwide are among the elderly.

Aging causes an exponentially increasing risk of death due to chronic diseases such as cancer over time.
[[File:Aging graph.png|thumb|738x738px|The risk of age-related diseases increases exponentially over time, due to the aging process.]]

[[File:Leading causes of death.png|thumb|724x724px|Leading causes of death, USA]]

== Why does the risk of death increase over time? ==
[[File:Gompertz Curve.svg|alt=Gompertz Curve|thumb|Gompertz Curve]]
As a result of the aging process, the risk of dying increases exponentially after the age of around 30 years old. This increase in mortality rate is known as the Gompertz-Makeham law of mortality.

== Which drugs may extend lifespan in humans? ==

=== Metformin ===
Metformin is an approved drug for type 2 diabetes that extends lifespan in multiple species. Metformin is being tested as a longevity therapy in the largest clinical trial for a longevity therapy, the Targeting Aging with Metformin (TAME) trial in the US.

=== Rapamycin ===

== What is aging? ==
There are two types of age: chronological age, which is simply the number of years since birth, and biological age. Biological age is a measure of the physical health of a person and their position in their lifespan. Biological age is more difficult to measure,

Aging is generally divided into 9 processes or 'hallmarks'.

== What are the 9 Hallmarks of Aging? ==
[[File:Hallmarks of aging.jpg|alt=Hallmarks of aging|thumb|515x515px|Hallmarks of aging]]

The hallmarks of aging framework is considered to broadly represent key biological mechanisms of the biological aging process. Like all models, there are various limitations of the hallmarks framework, but it is a useful primer for a basic understanding of aging biology

The nine forms of cellular and molecular ‘damage’ that comprise the hallmarks of aging are:

* Genomic instability
* Telomere attrition
* Epigenetic alterations
* Loss of proteostasis
* Deregulated nutrient-sensing
* Mitochondrial dysfunction
* Cellular senescence
* Stem cell exhaustion
* Altered intercellular communication

== Is aging a risk factor in COVID-19? ==
Aging is the largest risk factor for COVID-19.

== How is aging measured? ==
New technologies are being developed to measure biological age. These include:

=== Epigenetic clocks ===

=== Multi-omic clocks ===

== Do all animals age? ==
Some animals, due to differences in their biology, age at different rates.

The naked mole rat has similar genetics to a mouse, but lives ten times longer.

== Is aging considered a disease? ==
Aging is not currently classified as a disease by regulatory bodies such as the Food and Drug Administration (FDA) in the United States. However, several scientists in the aging field have publicly stated their wish for aging to be considered a disease, including professor David Sinclair and professor Nir Barzilai.

== What are the economic benefits of extending healthy lifespan? ==
Extending the healthy human lifespan could have significant economic benefits gobally. An economic analysis from 2021 by researchers at the University of Oxford and Harvard University estimated the benefit of a drug that slows aging by 1 year as $38 trillion. This is primarily because slowing aging reduces the incidence of age-related diseases such as cancer and Alzheimer’s disease, which require expensive treatment approaches. The study demonstrated a larger economic benefit of slowing aging than curing the individual diseases of aging.

== Will healthy or unhealthy lifespan be extended? ==
[[File:Extending healthy human lifespan.jpg|alt=Extending healthy human lifespan|thumb|409x409px|Extending healthy human lifespan]]The stated goal of longevity biotechnology is to extend the healthy period of lifespan, before age-related diseases set in. This is in contrast to many of today's medical interventions, which extend life only after diseases (e.g. cancer, Alzheimer's) have reached a clinical level.

Age-related diseases are preceded by a long period of subclinical aging, i.e. aging that has not yet progressed far enough to produce clinical symptoms. By slowing, delaying or reversing the aging process, the healthy period of life can be extended.

Studies in mice have demonstrated that life extending drugs such as rapamycin are capable of extending the healthy, rather than unhealthy period of life.

== Which anti-aging drugs are being tested in clinical trials today? ==
There are over 50 drugs being tested in human clinical trials for aging or age-related diseases.

The largest trial is the Targeting Aging with Metformin (TAME) trial, which began in 2020. The trial is being run in the United States with a cohort of 3000 older adults. The goal of the TAME trial is to determine whether diabetes drug metformin slows the aging process in older adults. The TAME trial is a $75 million trial run by the American Federation for Aging Research.

Another large clinical trial is the Participitory Evluation of Rapamycin (PEARL) study. The goal of this study is to determine whether rapamycin, a drug currently approved for immunosuppression during organ transplants, slows biomarkers of aging in 1000 adults. The PEARL trial is being run by AgelessRx.

== Is aging natural? ==
<nowiki>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3108295/</nowiki>

Atherosclerosis, the hardening of the arteries, was once viewed as simply a consequence of aging that should be accepted as natural. However, when treatments were later developed, atherosclerosis became widely regarded as a disease to be cured. Statins are now one one of the most widely prescribed drugs in the world, used in preventing heart diseases. The inventor of statins, Akira Endo, describes in his historical paper:

“Serious research on the role of cholesterol in human atherosclerosis did not really get underway until the 1940s, due to a prevailing view that the disease was a simple consequence of aging and could not be prevented.”

== Are billionaires funding longevity biotechnology? ==
Several billionaires have funded companies or initiatives to slow or reverse human aging. These include:
[[File:Jeff Bezos is funding longevity research.jpg|alt=Jeff Bezos is funding longevity research|thumb|Jeff Bezos is funding longevity research]]
* Jeff Bezos, co-founder of Amazon who helped to raise $270 million for a new anti-aging drug company called Altos Labs in 2021.
* Peter Thiel, co-founder of PayPal who was an early investor in Unity Biotechnology.
* Sergey Brin, co-founder of Google, who provided $25 million funding for the National Academy of Medicine’s Grand Challenge in Health Longevity to 'end aging forever'.
* Larry Page, co-founder of Google, who helped to found the billion-dollar research initiative Calico Labs.
* Dr. Mehmood Khan
* Mark Zuckerberg
* Mike Cannon-Brookes, billionaire cofounder of Australian software giant Atlassian, has invested $10 million into longevity company Juvenescence.
* Naveen Jain, billionaire entrepeneur who has created Viome.
* Jim Mellon, who has invested in longevity company Juvenescence.
* Larry Ellison, founder of Oracle, has spent $430 million on longevity research.
* Yuri Milner, billionaire tech investor who has helped Altos Labs raise $270 million, with Jeff Bezos
* Richard Heart, founder of the cryptocurrency Hex, who helped to raise $27 million to anti-aging research organisation SENS.
* Vitalik Buterin, founder of the cryptocurrency Ethereum, who donated $2.4 million to SENS.

== How large will the longevity biotechnology field be? ==
Analysts from the Bank of America have predicted that the market size of longevity biotechnology will reach $600 billion by 2025. Others have speculated that it is a trillion dollar industry owing to the immense savings associated with delaying or preventing chronic diseases

== Will anti-aging technology lead to overpopulation? ==
A common objection to the development of longevity technologies is that they may lead to an unsustainably large population size.

One study of a 2005 Swedish cohort of 9 million people modeled the effect of various anti-aging scenarios. The researchers showed that even with the most radical life-extension technology in which aging completely stopped after age 60, the population growth across 100 years was only 22%.

Currently, the world’s population is 7.9 billion, and the WHO predicts the population will peak at 11 billion in 2100 before falling due to declining birth rates in many parts of the world.

The fastest growing populations are in Africa and South-east Asia. However, several factors are thought to reduce birth rates over time, including increased access to contraceptives, female empowerment, increased education and increased employment. There is evidence that populations that move to a more advanced economy show a reduction in birth rates.

== Will anti-aging drugs only be available to the rich? ==
It is unclear who will have first access to longevity drugs. Several researchers in the field have argued that several economic factors are likely to drive down the price of drugs that slow aging.

* The cost of many biotechnologies decreases substantially over time. For example, the first human genome cost $100 million to sequence, and is now available for a few hundred dollars.

* The price of many lifesaving pharmaceuticals has fallen significantly in price once generic drugs were produced. For example, Lipitor, a statin used to prevent heart disease has fallen in price from $85 in 2011 to less than $5 today.

* Many companies in the longevity field have stated that equity of access is part of their core ethos, and many researchers are signatories to the

== Which scientists and institutions are trying to understand and reverse aging? ==
Hundreds of scientists are working on understanding the biology of aging in leading institutions like Harvard University, Stanford University, Yale University, and the University of Oxford. Some of the most well-known institutes and labs include:

=== The Buck Institute for Research on Aging ===
The Buck Institute for Research on Aging is one of the largest longevity research institutes with over 250 scientists. The research covers several areas including the mechanisms of aging, neurodegeneration, senescence, stem cells and regenerative medicine, cellular stress and disease, cancer associated with aging, and mitochondrial function.

=== Professor David Sinclair - Harvard Medical School ===
Professor Sinclair’s lab focuses on understanding and reversing aging. The lab focuses on a range of areas including DNA repair, mitochondrial dysfunction, and the interactions between epigenetic and genetic instability, and tissue reprogramming. Sinclair is also the author of the bestselling book, Lifespan: why we age and why we don’t have to.

=== Professor Brian Kennedy - National University of Singapore ===
Professor Kennedy’s lab focuses on understanding the biology of aging and translating research discoveries into new ways of delaying aging in humans. The lab has identified drugs that extend the healthy lifespan of worms and mice and are seeking to understand their mechanisms.

=== Associate Professor Lynne Cox - University of Oxford ===
Professor Cox’s lab study the molecular and cellular basis of aging to identify specific biochemical processes and pathways that change organisms age. The lab particularly cellular senescence, which underpins many age-related diseases including cancer and neurodegeneration.

== What books have been written on this topic? ==
Several books have been written on the topic of aging and longevity therapeutics. These include:

Lifespan -- Professor David Sinclair (2019)

Ending Aging -- Dr. Aubrey de Grey (2007)

Ageless -- Dr. Andrew Steele (2020)

Age Later -- Professor Nir Barzilai (2021)

The Science and Technology of Growing Young - Sergey Young (2021)

File:Jeff Bezos is funding longevity research.jpg

2021-12-13T06:40:01Z

Jack:

Jeff Bezos is funding longevity research

FAQ

2021-12-13T06:34:45Z

Jack: /* Why is aging a problem? */

File:Life extension mice.jpg

2021-12-13T06:07:23Z

Jack:

Life extension mice

File:Unity Mice.jpg

2021-12-13T06:00:33Z

Jack:

Unity Mice

File:Healthy lifespan extension.png

2021-12-13T05:58:22Z

Jack:

Healthy lifespan extension