There’s only two rules on a first date: 1.) Don’t pull up on the Segway Ninebot MAX G30LP, and 2.) Don’t say you work in Longevity.
Longevity (biotech) has a marketing issue.
Jeff Bezos invested an undisclosed amount to a $3B “startup” company that’s discovering therapies to reverse aging. Stitch together the blood vessels of an old mouse to a young mouse and the young mouse’s plasma “rejuvenates” the old mouse. The sensationalism of Bryan Johnson. The longevity biotech bro image is strong, and potent.
The field is a goldmine filled with seemingly absurd stories that can be spun into flashy headlines and misinformation, often painting a very particular, first-world image of the science and the people that work within it. But what is it really?
Instead of just saying “longevity,” I like to say I work in “age-related disease,” because what I really want to do is to help people live healthier for longer by curing diseases that come along with aging.
Of course, extending the total number of years in our lives is a big focus in the field, but much fewer people are working on life extension itself compared to age-related diseases. But even for those Scientists at the end of the day, what they really want to do is to create a future where we can live healthier and suffer less as we age.
I think the miscommunication of longevity, like DNA editing a decade ago, comes in part from the incredibly complicated technology that’s hard to understand for non-specialists. But unlike DNA editing and similar waves of hype longevity not only changes how we choose to live, but how we choose to die.
To be able to change our preconceived notions of life and death means that although longevity is a biological challenge, it’s also a societal one.
And unfortunately, these complex stories are over-sensationalized by the media (blood boys, rapamycin, metformin, etc). Today, I wanted to talk briefly about Longevity. The modern-day efforts, what’s become possible, and what people are working on, right now. I’ll be explaining the objectives of the field, its progress, and what it means to me (and maybe you, too).
Longevity – Adding Life to our Years
When I first entered this field, I thought to myself: “why would I care if I lived longer? That’ll just mean I’ll rot in a hospital alone for even longer, pop Advil like it’s candy, and be riddled with bedsores until I finally take my last breath.” I don’t love the idea of dying, but if I’m going to be sick and frail in my old age I’d rather have those final moments be quick. The last thing I want is my suffering to be drawn out because some “miracle drug” allowed me to “live” until 120. I don’t know about you, but that’s not exactly what I’d call living.
I’ve seen it all my life, just like you. My grandma has Heart Failure, and my grandpa almost definitely has Osteoarthritis. They can’t walk very fast or too far without discomfort/pain. A short flight of stairs puts them out of breath. It’s heartbreaking.
My most distinct and early memory of growing up in Japan is of routine hospital visits to see my bed-ridden +95yr old great grandma who could barely recognize my face, let alone sit up by herself. So I thought: “What’s the point of living longer, if that’s how I’ll be spending the extra few years a longevity drug gives me?”
But when I entered the field and joined my longevity startup, I realized quickly that longevity was actually about adding healthy years to our lives. People called that healthspan, our total years spent as healthy as if you were ~20. Whereas lifespan, were our total number of years we lived. In the past ~century, advances in hygiene, vaccination, and healthcare have significantly increased our lifespan, where many of us now can expect to live past 80yrs old. But what hasn’t changed much all these years is how we die. Our healthspan, and more specifically, how we spend our final ~25% of our lives. That part hasn’t really changed.
We see it all around us. Our parents, grandparents, all of them, age.
And they become frail. Their quality-of-life plummets. They can’t walk around the dining room table without bumping into it. Their knees become weak and walking downstairs starts to feel like slacklining. Walking upstairs catches you out of breath, and cancer feels like it’s just around the corner.
But what if we could change that? What if we could find ways to sustain a healthy body for longer to live as healthy as a 18yr old, basically right until we die? That’s the main objective of the longevity field. Adding healthy years to our lives. And that, I can get behind.
But how does the science actually work? The field of Longevity stems from gerontology, the study of old age and process of aging. It’s a broad field that has informed policy-making around health and elderly populations as well as basic research on how organisms age. They’re academics and scientific experts that have observed how we die for decades and sought ways to change it.
Over the past decade the field has intersected with cutting-edge technology from lots of different fields in molecular biology, gene editors, single cell transcriptomics, high-dimensional data analysis, enabling dozens of companies to try to find cures to age-related diseases and ways to extend lifespan.
Many of these companies operate under the gerontology (aka Longevity) hypothesis and it is the foundation of these companies’ theses.
The Longevity Hypothesis
The gerontology hypothesis from Martin B. Jensen’s seminar on aging at 50Years.
In the past decade, the field has experienced a large push for longevity biotech. Yes, the majority of funding comes from large institutional investors, billionaires, Sam Altman and the likes. But no, the drugs that’re discovered are not just for them.
Because “longevity biotech” is actually a poorly phrased umbrella term for a huge array of companies that exist. These companies can range from tiny startups like Deciduous that at seed-stage with <$15M in funding, to huge ones like Calico, an Alphabet-backed company with bountiful of capital and resources that operate more like an academic lab than a “company.” These longevity companies target different diseases, organs, and pathways of aging. But their theses are derived from the same central hypothesis that essentially says:
If we can understand the key pathways of aging as a series of chronological biological events, we can change the process of aging to prevent or cure age-related diseases and even aging itself.
It’s moonshot-y but hear me out.
Babies don’t get cancer. They don’t get Heart Failure, Osteoarthritis, dementia, diabetes, lung fibrosis, or metabolic dysfunction-associated steatohepatitis. It’s only in later stages in life where we often see these diseases crash into us at full-speed, often a few at once. What if there’s something happening in our bodies as we age that is causing our cells to slip up, and the damage is exhibiting as “disease”?
What if aging is the cause, and the diseases are the symptoms?
This is the central hypothesis of longevity and the biotechs in the industry as a whole. The mission to allow us to live healthier for longer. Some companies like New Limit targets aging as the disease itself, and tries to find ways to slow, halt, or reverse that biological process. Others like Gordian target specific diseases that occur throughout the aging process (Heart Failure, Osteoarthritis, MASH, Pulmonary Fibrosis) and tries to find cures for those specific diseases.
Despite what you might hear on the news, many “longevity biotechs” are in the second category that want to add health years to our lives. No one wants you to just live longer in poor health.
Cuz I mean, what’s the point of that?
“I work in longevity!” Ok, why should I care?
I, probably like you, want to live healthily for as long as possible to spend time with the people I love.
I’ve always dreamed of curing a disease. It just feels like something I could dedicate my life to. I work in longevity because I feel like we have a real chance to give people a choice to live a healthier life for longer through medicine, now more than ever.
Growing up, my mom would always say she wanted to die a quick and painless death. She doesn’t want her end to be drawn out like so many others: bed-ridden in a hospital or a retirement community.
Honestly, I want the same ending. And I think a part of me is a Drug Hunter because this is my way to make this ending a reality. Not bed-ridden in a hospital hooked up to a machine. I want to be able to play tennis whenever I want, walk to Tartine for a pastry in the morning (Arsicault > Tartine tho), pick up some free BiRite bread between 9-10pm on 18th & Guerrero after tennis. I just want live my life however I want right up to my final moment.
Our search for longevity is not some Sisyphean quest, and it won’t just be for the uber rich. These drugs that increase our healthspan will be for all of us.
And we’re going to see it in this century. In the next 10-20yrs we’ll see more and more drugs that fight age-related diseases in clinical trials. And in the next 30-50yrs, there will be drugs in the market that will give us the choice to make 70 the new 50.
We’ll be able to run along Embarcadero, finally hike Half Dome, have dinner in the Sunset at Mandalay… just the life we all know and love, for longer.
To close: a letter from Investor (and now ___), Laura Demming, on Longevity.