On today’s episode, we’re exploring the process of aging: why it happens, if anything can (or should) be done to slow it, and what problems we face as we all grow older.
According to some estimates, we’re spending $62 billion dollars a year on “anti-aging” products: everything from supplements to hair dye, to injectables.
Aesthetically, it might be working. In some online spaces there’s hot debates about how Millennials (people between the ages of 27 and 43 this year), look significantly younger than many of their Gen X or Boomer counterparts did when they were the same age.
The obsession with youthful appearance seems to spare no one, including the youth. The recent trend of so called “Sephora Babies” has parents and dermatologists concerned about tweens buying powerful anti-aging products containing ingredients to stave off wrinkles.
The desire to revert back to a baby face (or even just slow the natural progression of time) can have disastrous outcomes.
In April of 2024, a CDC investigation into a spa service known as “vampire facials” found three people who had been infected with HIV as a result of the procedure.
The service takes blood from the client and removes the platelets to be reinjected into the skin to give it a more youthful appearance.
The spa did not have the proper staff, equipment, or licensing for the procedure and as a result, their non-sterile techniques passed the virus on from one client to others via contaminated equipment.
What IS aging, anyway?
The biological reasons for aging aren’t entirely clear. If they were, we’d have a better understanding of how to slow them.
So far, we have all the obvious interventions that help people age more healthily: things like not smoking, eating right, and exercising.
But the key to longevity and health doesn’t seem to be one-size fits all.
Consider the semi-regular, feel-good news clips we get about someone celebrating their hundred and something birthday and saying their key to long life is the opposite of what we’ve been told is healthy, like drinking three Dr. Peppers a day.
Aging at the cellular level falls into two main categories.
These categories are: the wear and tear cells experience over time and the decline in our body’s ability to remove or repair damaged cells.
Chromosomes are the structures found in the nucleus of the cell that contain our DNA, and at the end of each chromosome is a cap called a telomere.
Each time your cells copy themselves, your telomeres get a little bit shorter. Once they hit a certain length, it acts as a signal to stop replicating that cell.
For the most part this is a good thing, because it prevents replication of damaged cells. But when stem cells—which are essential to rejuvenate cells in our lungs, livers, and other organs—get too short, those essential body parts begin to lose their ability to repair.
Another essential part of our cells is the mitochondria, which you may have heard is the powerhouse of the cell.
This is because it literally provides the energy your cells use to function. But over time, they produce less and less energy, impairing cell function.
Damaged mitochondria can also leak out of the cell, causing inflammation, one of the hallmarks of aging.
In addition to factors inside our cells that cause us to age, there are also factors on the cells that we have to consider.
Chemical modifications to the genome can influence what genes are turned on and off, and therefore what proteins they produce or don’t produce.
This is known as epigenetics.
A good example of this is the role that air pollution plays in the development of Alzheimer’s. Increasingly, studies are showing that exposure to fine particulate matter (the kind that comes from car exhaust pipes) can increase an individual’s risk of developing Alzheimer’s or other neurodegenerative diseases.
It’s likely that exposure to the particles directly impacts gene function in the brain, leading to cognitive decline.
It’s not just the environment influencing gene expression– genes can also be impacted by mutations during cell replication.
Errors can be introduced into genes either through accidents when cells are copied, or through damage from environmental exposure, like radiation from the sun.
When we are young, our bodies are better able to correct these errors or detect and remove them.
As we age, that process becomes less and less efficient, resulting in a higher likelihood of genes with errors. Over time this accumulation can impact how your cells function.
As we age, it’s not only our cells that encounter problems more often, but also our body’s ability to clear those defective cells out.
Senescence is the process by which aged cells stop dividing, but don't die.
A buildup of these cells, which are not cleared out by the immune system, can cause an increase in inflammation, potentially damaging nearby healthy cells.
Aging at the cellular level is an important concept to understand because it means our lifespan isn’t always connected to our healthspan.
Some people can stay alive for a very long time, but their quality of life isn’t necessarily great. This is a case of someone having a great lifespan, but not a great healthspan.
Or you could run into the issue of someone who should be in great health, due to their younger age, but they’re not.
In recent years, rates of cancer (a disease most common in older populations) have increased in younger generations. And one recent study found evidence that this could be the result of cells aging faster.
The study, which was reported on at a conference but has yet to be published, looked at the chronological age of people (their age in actual years since birth) and compared it to their biological age, which is calculated by taking into account various biomarkers in the blood.
That study found that each cohort of people born in 5 year increments between 1950 and 1974 had a higher rate of biological age compared to the age groups born before them.
It also found that the rate of certain cancers was significantly higher in people with a high biological age.
Why this is happening is the billion-dollar question.
The rise in cancer at younger ages is a global problem, and some theories include the spread of a westernized diet, increases in stress, and exposure to environmental factors.
Over the last century we’ve had large and rapid increases in life expectancy thanks to innovations in vaccines, medicine, and public health.
But recent studies show that might be slowing down: younger generations are still living long lives, but not significantly longer than the generation before them.
Progress to slow aging itself is being made.
In March of this year a paper was published demonstrating that aging immune systems could be revitalized to better fight off viral infection and reduce inflammation…in mice.
It’s a very early step in the process to understand what mechanisms of aging could be targeted to have the biggest impact. And to learn what, exactly, contributes to a decline in health overtime.
As we learn more about the factors that induce aging, fighting them will be a challenge. Aging isn’t seen as a disease by the FDA, which makes it difficult to get approval for drugs targeting it.
Instead, drugmakers have to target diseases of aging, which can make the ultimate goal of overall prevention difficult.
But aging isn’t all bad. Afterall, as the saying goes, “aging is a gift.”
And research has backed up the saying that “with age comes wisdom.” One paper found that, in Americans at least, an increase in age was associated with a better ability to recognize multiple perspectives, to see the limits of one’s own knowledge, and to know the importance of compromise.
Other studies have shown that older adults are better at regulating their responses to extreme circumstances, are less likely to let negative experiences affect them, and have better decision making tactics based on previous experiences.
Of course, not everyone sees the benefits of aging.
Take, for example, millionaires like Bryan Johnson who have made it their personal mission to attempt to not only live forever, but to do so at a low biological age.
Johnson has gone as far as to take plasma infusions from his own 17-year-old son in an attempt to reduce aging-related brain decline. It didn’t work.
As scientists scale up their immune system reversals from mice to humans and Mr. Johnson fine tunes his 100-pill-a-day regimen, what do the rest of us do in the meantime?
For now, there’s no secret key to anti-aging.
It’s still just the same boring stuff like eat better, exercise more, don’t smoke, and get enough sleep, all things we know improve your healthspan.
The more immediate question we need to be asking is not how do we prevent aging, but where do we age?
According to an AARP survey, 77% of adults aged 50 and over want to stay in their homes for the long term. And many of them, in addition to younger people with disabilities, will need help to stay there.
Home health aides are predicted to be the fastest-growing field of employment over the next decade, propelled even further by the fact that the number of people over 65 years old is expected to increase 47% by the year 2050.
And the number of people with Alzheimer’s is expected to double from 6 million today to 13 million over that same time frame.
But just because the job market will have openings, doesn’t mean they will be filled.
The field of home health is chronically understaffed, forcing people out of their homes and into assisted living.
But even that is no guarantee of consistent care. In 2022 the median turnover for nursing home staff after 12 months was 53%.
The gaps in care are sometimes filled with what’s known as the “gray market,” people paying community members like neighbors and relatives under the table to care for their aging parents and loved ones.
While community care has often stepped up in areas where government assistance is lacking, it’s not always sustainable, or even available, over time.
Afterall, in 2023 47% of adults reported that they never intend to have children.
