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A Pill to Slow Aging?

Researchers have been looking for decades for ways to delay human aging and prevent diseases. The prognosis for success appears to be improving


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Medical professionals have figured out a way to treat many of the diseases that accompany aging: We have medications for heart disease, diabetes, arthritis — even Alzheimer’s.

But what if a pill could help prevent these diseases from ever occurring?

For decades now, scientists have been searching for such a medical Holy Grail: safe medicines that treat aging as a whole by slowing cellular decay or by making your body more resilient to the factors that trigger physical and mental decline.

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Despite the research costs and scientific challenges, the path toward such a pill is attracting more interest than ever. The federal government is involved, as well as many prominent academic institutions. Billionaire “biohackers” have joined the fray, pursuing their own age-defying theories and sparing no expense.

There’s a reason for the urgency: People over 85 represent the fastest-growing segment of the U.S. population. “Suddenly we’re confronted with this world that’s going to have more and more people living into their 80s, 90s and 100s in the near future,” says Steven Austad, a biology professor at the University of Alabama at Birmingham and senior scientific director for the American Federation for Aging Research.

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Steven N. Austad works with lab equipment at the University of Alabama at Birmingham in Birmingham, Alabama.
Rory Doyle

Finding a way to keep these adults healthy in their latter decades not only enhances their quality of life, but experts say it could be a boon for the economy and a break for the health care system, which shells out trillions of dollars each year to treat chronic diseases that become more common with age. “It’s not about living to 200; it’s about living to 90 in good health,” says Sofiya Milman, M.D., an associate professor of medicine and genetics at Albert Einstein College of Medicine.

But if the race to finding such a disease-blocking pill was 10 miles long, Austad says we’re only at mile 2. What’s holding back progress? A dearth of data. While various medicines are showing promise in animals, it will take considerable time and money to test their long-term impact on humans.

Then there’s regulatory red tape: Aging is not currently recognized as a preventable condition by the Food and Drug Administration, so there’s no clear pathway to approve medications to treat it. However, experts in the field are hopeful this will change.

Promising treatments that never panned out, like resveratrol or biotech-backed experimental drugs, have also muddied the course. Still, there have been “real breakthroughs,” Austad says, and a handful of medications stand out as top contenders for usage in ways that transcend individual diseases and that could help sustain health more broadly.

Here’s a look at three of them.

Metformin

The diabetes medication taken by millions has been under the anti-aging microscope for years, and experts say it remains a front-runner in the race toward a broad-purpose anti-disease drug. Studies show metformin has protective benefits against cardiovascular disease and may be able to reduce the risk of other age-related illnesses like cancer, dementia and stroke.

More recent research published in July in Aging Cell found the decades-old medication may also protect against loss of muscle in older adults. It’s a drug “that targets all the biological hallmarks of aging,” says Nir Barzilai, M.D., director of the Institute for Aging Research at the Albert Einstein College of Medicine. “By the way, metformin is also safe, has few side effects, it’s generic, it’s cheap.”

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Nir Barzilai, M.D., director of the Institute for Aging Research at the Albert Einstein College of Medicine.
Rick Wenner

Barzilai is in the process of launching a large, six-year clinical trial, called TAME, to test whether older adults taking metformin can escape, or at least delay, the development of age-related diseases. He hopes the 3,000-person study will also show that the aging process can be a target for drug development, which could help usher in other drug approvals.

“It’s [aging] that drives the diseases,” Barzilai says. “The idea is if you target aging, you prevent not one disease but a huge number of diseases.”

A lack of funding has slowed the study’s start. The estimated $50 million trial isn’t one that the pharmaceutical industry is eager to bankroll, since metformin is a generic drug that sells for mere cents a pill, says Richard Miller, an aging expert at the University of Michigan. Researchers are instead working off a patchwork of grants and donations. But those in the know predict the trial will be ready to go in a few years.

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Rapamycin

Rapamycin, discovered in the 1970s, is currently used to help prevent organ rejection after a kidney transplant and to treat certain types of cancer. In mice, Austad says, it does much more.

It has repeatedly been shown to help prevent cancer in rodents and slow down the progression of dementia. Researchers say it helps mice maintain their muscle, delays heart disease and improves vaccine response. A pivotal study found that the drug can extend the life of older mice by 14 percent for females and 9 percent for males by postponing disease; other studies have produced similar results.

The focus now is on humans and whether rapamycin will afford them the same disease-delaying benefits. A small number of early-phase human trials are underway. Dog trials, too — and those are the ones to pay attention to while we wait for more human data. “They are a much better indicator of what you might expect in people than mice,” Austad says.

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Senolytics

This newer class of drugs takes aim at senescent cells, also called zombie cells, which are damaged cells that refuse to die. As we age, the body becomes less effective at removing them, so they start to accumulate and release chemicals that can cause inflammation, damaging neighboring cells and driving disease, Barzilai says.

Some senolytics have been approved by the FDA to treat conditions like cancer; others are naturally occurring and are sold as supplements.

Now, researchers from several universities and medical centers are testing the ability of senolytics to prevent or slow the development of human diseases like Alzheimer’s, osteoarthritis and kidney disease. Private companies are also pouring money into senolytics research — so stay tuned.

If you’re tempted to run to the pharmacy for senolytics supplements in the meantime, just remember the potential benefits are “completely unproven in people,” Austad says. Keep in mind, too, that supplements are not regulated like other over-the-counter medications and could cause side effects or interact with other drugs you’re taking.

In fact, that cautionary advice holds true for all products that claim to cure aging. “There’s nothing you can buy over the counter or in a prescription drug that has been proven to slow aging in people,” Miller says.

The most powerful prescriptions for now, medical researchers agree, are the everyday habits that help keep the body and brain in top shape — diet, exercise, sleep and meaningful relationships. One day, a pill may be more effective than these. It may be years away or never truly achieved. But what has been proven is that the notion “is no longer silly,” Miller says. 

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