What do you mean by "rejuvenation biotechnologies"?

Rejuvenation biotechnology is a new platform of biomedicines, based on the application of the principles of regenerative medicine to the structure of the body at all levels: from organs and tissues, to cells, and down to the molecular structures within and surrounding them.

Rejuvenation biotechnologies are therapies that directly remove, repair, replace, or render harmless the cellular and molecular damage caused by the biological aging process. It is the accumulation of this damage which results in the progressive rise in frailty, disease, and disability that people now suffer with age.

Once people benefit from rejuvenation biotechnologies, metabolism – the everyday biochemical processes that occur in our cells and tissues to keep us alive – will continue as usual, and still cause aging damage. But by keeping the total burden of such damage at levels similar to a biologically young person's, we can preserve youthful health and functionality.

Can anything really be done about age-related degeneration and disease? Isn't getting sicker as we get older just a fact of life?

It is informative to think about similar questions which might have been asked at different points over the past century. Can we really do anything about wound infections? After the invention of antibiotics the answer was a resounding, 'Yes'. When will the next outbreak of smallpox occur? After the WHO's program of eradication the answer became, 'Never'. Cholera, and John Snow's work on its epidemiology; polio, and the Salk vaccine... the list goes on. All these advances in medicine changed the answers to questions, and showed that a "fact of life" is often just a problem waiting for a solution.

So it is with the sickness of older age. It has not yet been addressed effectively, but that does not mean that it cannot be addressed. It simply means that we have to find new ways to tackle the problem, and the most promising of these is rejuvenation biotechnology.

Wouldn't we just wind up spending a long time sick and old? Isn't it more important to live a healthy life than a long one?

Our primary concern is curing disease and maintaining health, and we agree that it is more important to live a healthy life than a long one. (Well, within reason: most people would consider 60 years of life with the occasional headache to be more desirable than 20 years without any headaches, for example.)

Unaddressed, aging causes a great deal of suffering within the scope of the lives we live now. Rejuvenation biotechnologies are all about retaining youthful vigor and function throughout life. Certainly, if someone doesn’t get ill – or hit by a bus – then he or she will continue to live, and healthy lifespan will be increased. (That's also true of almost all existing medicine, which shares our focus on maintaining health, with the side-effect of increasing lifespan.) But the crucial word there, and the driver for all our work, is 'healthy'.

Wouldn't it be easier to find ways to slow down age-related degeneration than to reverse it?

First, let’s be clear on what "reversing age-related degeneration" means, in rejuvenation biotechnology. We are not trying to reverse the process which causes degeneration: that process is highly complicated and not well understood. Rather, we are working to repair the result of that process, sidestepping our ignorance of the process itself. We believe that this side of the problem of age-related degeneration can be solved more rapidly and effectively.

The human body, by its nature, is a very complex system, built from finely-regulated, metabolic subsystems. Tinkering with one aspect inevitably ripples in unexpected ways through the entire system, and in ways which we can rarely predict with any great confidence. This entails a high risk of negative side-effects occurring when any one of them is modified.

Reversing age-related degeneration – in the damage repair sense – avoids the complex pathways of metabolism, and has the potential to be simpler and more effective than methods which only slow it down.

How soon could we have a comprehensive rejuvenation platform?

This is a question of just how fast the required biomedical technologies are developed. The answer depends on just how much we collectively and individually invest into advancing the science. If rejuvenation biotechnologies had sufficient funding today – and we are far from that position – an optimistic estimate gives a 50-50 chance of having a comprehensive platform (one which addresses every form of aging damage) in 25 years.

The absence of complete funding, and a less optimistic outlook, would suggest that rejuvenation biotechnology is likely to provide a comprehensive solution later than that, in perhaps 50 years.

However, it is important to understand that we do not need to have developed a comprehensive set of rejuvenation biotechnologies in order to postpone the diseases of aging indefinitely. Different types of aging damage become problematic at different times in life; some earlier, some later. The first rejuvenation therapies will target the damage which occurs earlier in life, buying extra years of youthful life, free from the disease of aging. During these extra years the existing therapies will be refined, and new therapies developed, addressing the remaining types of damage, and buying further disease-free years. And so on. (If one needs an analogy, consider car maintenance: it is important to learn how to top up the washer fluid before learning how to change the oil, before learning how to rebuild the gearbox, and so on, since those things tend to need attention in that order.)

In this way, the rejuvenation biotechnology platform can be considered to be comprehensive (in the sense of avoiding current and future age-related ill health) long before it is complete (in the sense of every necessary intervention’s having been perfected). (This effect has been termed 'longevity escape velocity', or LEV: a reference to the extension of healthy life resulting from the repair of damage before it causes disease.)

The chances of reaping the benefits of rejuvenation therapies are quite good for young students, and decrease for older individuals. But the question is not just if you, individually, will benefit, but how great you consider the need to prevent others from suffering the slow slide into disease and frailty.

The media keep talking about modifying genes and Calorie restriction as ways to maintain youthful health. Why aren't you working on those, or drugs that would have similar effects?

There are several answers to that question.

i) Many, if not all, of these other approaches only slow down the effects of age-related disease. We believe that rejuvenation biotechnology can stop those effects completely.

ii) These approaches modify the body's metabolic processes. These processes are immensely complex, interconnected and not well understood, which means a high risk of negative side-effects occurring when any one of them is modified.

iii) Rejuvenation biotechnologies provide a relatively small, core platform of damage repair approaches which enable focused research on all the diseases of aging.

iv) Rejuvenation biotechnologies offer the chance to redesign the tortuous and expensive ways in which medicines are brought to market, shifting away from niche solutions for certain classes of people and disease, reducing costs, and reducing the time required to bring a cure to the public.

v) Other people are working on these other approaches. Some of the technologies being developed in their research will be invaluable to the damage repair technologies on which we are working. However, we are committed to funding those areas which are currently neglected, and so our work does not repeat that of other organizations.

Why does the media keep saying that the Foundation is pursuing immortality research? I don't see anything about that here. Are you?

There’s no doubt that a word like 'immortality' sells papers and gets viewers. The reality is that nothing the Foundation does will lead to immortality: accidents will happen, natural disasters will take their toll, pianos will fall on hapless individuals...

Some people have begun to use the word 'immortality' in an unusual, and more restrictive sense, to mean simply the indefinite extension of healthy life, in an environment free from external causes of death. Even in those terms, the Foundation isn't interested in life extension as an end in itself. We want people to stay healthy. We want to repeat the successes of medicine's fight against communicative disease, this time with the diseases of aging. And we believe we can do so in a comprehensive manner. Whilst it is true that the success of rejuvenation biotechnologies will lead to the extension of healthy life, that's no different to almost the entirety of medicine today: curing disease keeps people healthy, and alive.

Aren't there more immediate medical concerns, like transmissible disease in the developing world?

It is hard to imagine any mission against disease as standing alone in a complex world. These other concerns are important, and we're delighted that a great deal of invaluable work is being done to address them. However, the diseases of aging cause real suffering around the globe and, as other programs flourish, are set to become ever-more prevalent in developing countries. This is particularly the case in the time-frames proposed for rejuvenation technologies - some 30 to 50 years.

How can we afford to provide widespread access to rejuvenation biotechnologies? Wouldn't the medical costs be huge?

The cost of widespread access to rejuvenation biotechnologies has to be compared with the existing costs of looking after people with Alzheimer's, Parkinson's, and other age-related diseases. These existing costs are extremely high, and look set to increase. So, whilst providing access to rejuvenation biotechnologies will, indeed, be expensive, it is likely to be far cheaper than existing costs of healthcare, particularly as rejuvenation biotechnologies become more mature.

It's not just the savings in treatment costs which benefit insurance companies, governments and individuals. Healthy individuals are able to work, providing for themselves and their loved ones, and making positive contributions to their countries' economies.

If this leads people living longer, healthier lives, what will be the effect on world population and the global environment?

There are two things to bear in mind when considering these questions. First, almost all medicine has an effect on population, and the potential difference in impact of rejuvenation biotechnology is one of degree rather than nature. Second, as with so many modern technologies, the heart of any answer is about choice: choosing how we apply the technology, how it should change our behavior, and how we balance its positive and negative aspects to improve the human condition.

At the Foundation we look at the diseases of aging and ask: should we cure Alzheimer's? Should we cure Parkinson's? Cancer? Heart disease? Rheumatoid arthritis? And the answer always comes back, "Yes".

The donations we receive have been given with the intention of allowing us to achieve our mission to cure diseases of aging, and our efforts are very much focused on delivering on that promise. However, we recognize the need for constructive debate about the issues of population growth and its impact on our environment. Ending the suffering which arises from the aging process may require difficult choices to be made, between the value of new life and the health of those already alive. We are not experts in demography or associated fields, but we are committed to ensuring that data are available to underpin the debates and dialogues arising as the development of rejuvenation biotechnology gains momentum.

How might greatly-extended healthy lifespans affect pensions costs?

The main purpose of pensions is to provide for individuals whose age has rendered them infirm and unable to generate an income of their own. Rejuvenation biotechnologies are designed to avoid the infirmities of old age, removing one of the major drivers of pension provisions.

It is certainly the case that pensions are paid for other reasons, which would not be affected by rejuvenation biotechnologies: military pensions for those injured in the course of duty, for example. In addition, medical science has progressed, and many people have come to see a pension as giving them the chance to have some years of healthy life free from the need to work every day. That's an understandable desire, but there will be a need for some reconsideration of what it means to take a pension when clearly not at the end of one's working life: government policies in those countries which provide state-funded pensions will change; a single lifetime may contain many extended 'work breaks' funded from savings; etc.

I want to stave off aging now. What diet, lifestyle, and supplement program would you recommend?

If you want to reverse the damage of aging right now I'm afraid the simple answer is, you can't. The required biomedical interventions can be developed, but they don't exist right now, and it will be some decades before they are available. That's one reason why we’re working so hard to accelerate the progress of rejuvenation biotechnologies.

It's important to understand that nothing we can do now has been definitively shown to affect the aging process itself, or have more than a marginal impact on life expectancy or years of end-stage frailty and decay. Aging is, by its nature, a product of basic metabolic processes which aren't appreciably altered by environmental influences, and it's for this reason that, whereas genes only account for about 25% of your chances of reaching an age of about 75, they are a huge factor in your odds of becoming a centenarian once you have already lived that long, rather than dying shortly thereafter: at that point, it's all about basic aging, with little influence of environmental factors.

That doesn't mean that taking care of yourself is worthless. Eating well and exercising will greatly reduce your odds of prematurely suffering from many age-associated disabilities and diseases (such as heart disease, diabetes, and some cancers). Lifestyle factors are major predictors of your odds of reaching what was once 'old age' – 75 years or so – but which is now actually below the average life expectancy in advanced economies. In a sense, living a healthy lifestyle has less to do with aging and more to do with avoiding killing yourself early by treating your body badly.

The Foundation itself retains a sharp focus on its mission to advance rejuvenation biotechnologies and true damage repair.

I want to help you accelerate progress in rejuvenation biotechnologies! What can I do?

We have a page dedicated to just that question: Other ways to help.