Progress in medical care, and improvements in living conditions and nutrition has led to substantially faster population aging than in the past. In 2020, the number of people over 60 years of age out-numbered the amount of children under the age of five worldwide, according to the WHO.

An aging population means we’re seeing unprecedented levels of age-related diseases such as cardiovascular diseases, neurodegenerative diseases like Alzhemier’s and Parkinson’s Disease, and many other conditions. This poses two primary challenges: firstly the quality of life of the elderly population, and secondly the costs to society and the healthcare system.

We have the possibility to live longer, but the drawback is that we live longer with a higher burden of disease.

At the multidisciplinary Aging Research Centre (ARC) at the Karolinska Institute (KI) in Stockholm, a team of about 90 researchers tackle different aspects of aging. 

Davide Vetrano, associate professor, Aging Research Centre, Karolinska Institutet

“Aging touches each and every one of us sooner or later. Today, we’re able to treat a number of diseases that were previously fatal, like stroke, myocardial infarction, and cancer – we’ve turned them into chronic diseases instead. We have the possibility to live longer, but the drawback is that we live longer with a higher burden of disease,” says Dr Davide Vetrano, an associate professor who leads one of ARC’s research groups.

“Aging research is important to enable people to live a longer health span, to increase the proportion of life lived in good health, and to try to compress the years lived with disability and impairments during the very last years of life,” he says.

Societal changes

In Denmark, Dr Morten Scheibye-Knudsen, associate professor at the University of Copenhagen, leads a group that conducts research into the cellular and organismal consequences of DNA damage and how this affects aging. 

It will be extremely expensive. These societal changes are really prominent and difficult to handle, if we cannot ensure that people live healthier for a little bit longer.

“The number of 80-year-olds in the Nordic countries will double by 2050. Birth rates are falling. We will have fewer young people and more elderly. Right now in Denmark we spend about EUR 10 billion a year on elderly care, particularly care from the age of 80 years and up. That means that by 2050 that figure will double. It will be extremely expensive. These societal changes are really prominent and difficult to handle, if we cannot ensure that people live healthier for a little bit longer,” he says. 

Tremendous growth

The field of aging research has seen tremendous growth in the past two decades, and we’re now on the verge of turning those discoveries into practical ways to boost the health of older adults. It’s also a field that’s gaining more attention due to the imminent need for better elderly care that shifting demographics bring about, and thanks to the new possibilities that modern research opens up.

We all age in different ways, and being able to measure the speed at which we are aging has allowed us to design trials and interventions that could impact this.

“One big change is that we’re now beginning to be able to test interventions in humans. About 13 years ago it was discovered that we can measure biological age. We all age in different ways, and being able to measure the speed at which we are aging has allowed us to design trials and interventions that could impact this. This has been done in animal models where you can see how it affects the animal’s lifespan – in humans you can’t do these lifespan models because they take literally a lifetime. That’s why biomarkers of biological aging have become so important,” Scheibye-Knudsen says. 

Geroscience

Another big step forward in aging research is the advent of geroscience – a novel research discipline dedicated to uncovering the fundamental drivers of aging, with key areas of study encompassing inflammation, stress response, epigenetics, metabolism, macromolecular damage, proteostasis, and stem cells. The founding hypothesis of geroscience is that the same mechanisms that are responsible for the aging of an individual are also responsible for the onset of multiple diseases later on. 

These mechanisms are extremely important later in life when we accumulate diseases that appear to be different, but which are based on the same mechanisms. Most of the diseases that emerge later on can be prevented if we are able to slow down these aging processes.

“It means that there are fewer mechanisms for us to focus on, instead of looking at individual diseases one by one. If we can delay the mechanism of aging we will be able to reduce the onset of many different diseases, like dementia, heart failure, stroke, respiratory conditions, autoimmune conditions, and so on,” Vetrano says.

“This is ground-breaking. These mechanisms are extremely important later in life when we accumulate diseases that appear to be different, but which are based on the same mechanisms. Most of the diseases that emerge later on can be prevented if we are able to slow down these aging processes,” he adds. 

Other cutting-edge approaches in aging research and geroscience include senolytics, a class of drugs that specifically target and eliminate senescent cells that contribute to aging and disease. Leveraging precise gene editing tools like CRISPR to correct genetic errors and modify genes that influence aging and age-related diseases offers novel routes to prevention and treatment. Stem-cell therapy and regenerative medicine are exploring the potential of stem cells to repair and rejuvenate tissues and organs damaged by aging.

Telomerase activation strategies focus on protecting and extending telomeres to potentially lengthen cellular lifespan and thereby the organism’s lifespan. AI and machine learning are being applied to analyze the complex data from aging research, enabling the discovery of patterns, prediction of aging trajectories, and the development of personalized interventions.

A great deal of snake oil

With longevity increasingly capturing the imagination of the public, a problem arises that has plagued the medical field throughout the ages: snake oil, a term used to describe deceptive marketing and healthcare fraud.

Morten Scheibye-Knudsen, associate professor, University of Copenhagen

“In the longevity space in particular, there are a lot of people who sell nonsense. Separating what is real and what is fake is a big challenge,” says Morten Scheibye-Knudsen.

“People want interventions that make them healthier, so it’s easy to sell them anything and claim that it improves their health,” he adds.

“Unfortunately we’ve only started scratching the surface of what actually works in terms of aging. So there is a great deal of snake oil around – a lot of stuff that’s being sold that has no effect,” he adds. 

“But there is also an opportunity here. Given that there is growing interest and a lot of people want to buy products for healthy aging, there’s a financial incentive both from companies and from people in general. We need to be able to tackle this in the right way and get the right interventions to people,” he concludes.