The Ageing Effect Ep. 3: 'Ageing Can Be Reversed'
Longevity and age-related mortality, with geroscientist Nir Barzilai and Swiss Re Global Chief Medical Officer John Schoonbee
While not exactly an issue limited to Asia, the increase in elderly populations raises questions about trends in life expectancy, age-specific mortality and morbidity. Greater understanding of the dynamics of ageing will help us improve provision of health and social care; as well as addressing the pressing need of funding an ageing population. The age-old question of how long we can live, how we can extend our life expectancy and how much of that lifespan is actually worth living may be answered within the next decades – at least, according to our guest speakers Nir Barzilai, Director of the Institute for Aging Research, Albert Einstein College of Medicine, and recent author of Age later, and John Schoonbee, Global Chief Medical Officer at Swiss Re.
Our key takeaways
Geroscientist Nir Barzilai points out general misconceptions about ageing right away: “Ageing is flexible – [it] can be targeted, delayed, and stopped and reversed in some instances”, he says. The main danger, then, that ageing processes pose is as leading causes of disease. The likelihood of, for example, cardiovascular disease or cancer increases with age and degree of ageing – not necessarily with what is commonly to as risk factors, such as cholesterol. Medicine can and should look into ways of targeting hallmarks of ageing such as inflammation and immune dysfunction – which happen to be the main causes of death in COVID-19 patients.
One of the arguments in favor of this approach is, according to Dr. Barzilai, the existence of super-agers. People who make it up to a hundred and beyond get age-related diseases later and live longer without them. This phenomenon is called compression of morbidity. If this compression is achieved across the board, there will be a longevity dividend in the form of lower medical and social costs. This is why Dr. Barzilai and his team are interested in repurposing existing medications with little side effects that decrease overall incidence of disease in order to increase longevity.
For obvious reasons, the question of lifespans and quality of life is of interest to (re-)insurers. While medical advances in the past centuries have led to an increase in longevity, lifestyle diseases such as obesity have put a dent in that upward trend. This is relevant for both businesses and individuals, as assessing an insurant’s risk is contingent on health factors, among other things. That is why research is conducted on the relationship between lifestyle factors and ageing, including disease.
To answer the titular question of this episode, both speakers think that there appears to be a lifespan plateau of around 100 to 115 years, though it is questionable whether this can be achieved on a wide scale without extensive interventions. Treatment does not have to be genetic, however, as both lifestyle choices and medications can help lower the likelihood of age-related illnesses. However, the question of whether quality of life can be sustained still stands.
Both Dr. Barzilai and Dr. Schoonbee think that the need for intervention is more pressing in East Asia, where projections predict rapid ageing. All the more reason to invest in medical research and public outreach to promote the measures mentioned above.
John Schoonbee is a medical doctor who has been working in the insurance field for about 20 years and directly for reinsurers since 2005. John began working at Swiss Re in July 2011 and is their Global Chief Medical Officer, in addition to specifically covering the EMEA region. He is involved in many aspects of life insurance, including product development, risk and claims assessment, as well as helping with pricing some of the more complex medical life and health products. John coordinates a team of over 20 permanent and consultant medical doctors at Swiss Re, in addition to focusing on key global health topics.
Nir Barzilai is a Professor of Medicine and Genetics and the Director of the Institute for Aging Research at the Albert Einstein College of Medicine. His research interests are in the biology and genetics of aging, with one project focusing on the genetic of exceptional longevity, another one on the metabolic decline of aging. He is currently leading an international effort to approve drugs that can target aging.