The life expectancy is Since the 1800s, the number of countries that perform best has increased by 3 months each year. Throughout most of human history, you had a roughly 50–50 chance of making it into your twenties, mainly due to deaths from infectious diseases and accidents. Thanks to medical advances, we’ve gradually found ways to avoid and treat such causes of death; the end result is perhaps humanity’s greatest ever achievement—we’ve literally doubled what it means to be human, increasing lifespans from 40 to 80 years. On the other hand, this has allowed one scourge to rise above all the others to become the world’s largest cause of death: aging.
Aging is now responsible for over two-thirds of deaths globally—more than 100,000 people every day. This is because, counterintuitive though it may sound, the chief risk factor for most of the modern world’s leading killers is the aging process itself: Cancer, heart disease, dementia, and many more health problems become radically more common as we get older. Although smoking and poor nutrition can all increase your risk for chronic diseases such as heart disease, diabetes, or other serious illnesses, these factors are minor in comparison to the effects of aging. High blood pressure increases the risk of having heart attacks by twofold, while being older than 40 makes your risk increase by ten. The number of deaths and suffering that aging causes will increase as the world population age.
But this isn’t my prediction—apart from being depressing, extrapolating a two-century trend for a further year is hardly groundbreaking. What’s far more exciting is that, in 2023, we may see the first drug that targets the biology of aging itself.
Scientists now have a good handle on what causes us to age, biologically speaking: The so-called “hallmarks” of the aging process range from damage to our DNA—the instruction manual within each of our cells—to proteins that misbehave because of alterations to their chemical structure. The best part is that we have now ideas about how to Treat them.
By the end of 2023, it’s likely that one of these ideas will be shown to work in humans. One strong contender is “senolytics,” a class of treatments that targets aged cells—which biologists call senescent cells—that accumulate in our bodies as we age. These cells seem to drive the aging process—from causing cancers to neurodegeneration—and, conversely, removing them seems to slow it down, and perhaps even reverse it.
In 2018, a 2018 study showed that mice treated with senolytic cocktails of quercetin and dasatinib, a cancer drug, not only lived longer but were also less likely to develop diseases such as cancer. They could even run faster and farther on tiny treadmills designed for mice.
Over two dozen companies are searching for ways to safely and effectively eliminate these senescent human cells. Unity Biotechnology is the largest company. It was founded by Mayo Clinic scientists and investors, including Jeff Bezos. They are currently testing a variety of senolytic medications against lung diseases such as macular degeneration, which can cause blindness, and lung fibrosis. There are many approaches under investigation, including small proteins that target senescent cells, vaccines to encourage the immune system to clear them out, and even gene therapy by a company called Oisín Biotechnologies, named after an Irish mythological character who travels to Tir na nÓg, the land of eternal youth.
Senolytics aren’t the only contenders, either: Others currently in human trials include Proclara Biosciences’ protein GAIM, which clears up sticky “amyloid” proteins, or Verve Therapeutics’ gene therapy to reduce cholesterol by modifying a gene called PCSK9. It is likely that the first anti-aging drug will target an individual age-related condition, not aging in general. We will soon be able to look at this goal if we see a drug which targets an aspect of aging through clinical trials.
These treatments may be the catalyst for the biggest medical revolution since the invention of antibiotics in 2023. Rather than going to the doctor when we’re sick and picking off age-related problems like cancer and dementia in their late stages when they’re very hard to fix, we’ll intervene preventively to stop people getting ill in the first place—and, if those treadmill-shredding mice are anything to go by, we’ll reduce frailty and other problems that don’t always elicit a medical diagnosis at the same time.
