Industry
Living beyond 100: We’ve entered the geroscience era
Summary
- The world’s tech elite continues to project the powerful idea of buying controlled longevity—one of the biggest fodders for bio-sciences research around the world today. India’s longevity efforts are nascent and promising. Where will this revolution take us?
Mumbai: In tech utopia, living upto 100 and more isn’t a chimera. It’s enterprise and ambition multiplied manifold, worth multi-billion dollars of “biohacking"—a fetching pop science word that often just means a blood test. Just skim through the timeline of Bryan Johnson, founder-chief executive officer (CEO) of Kernel, a brain monitoring and recording company in Silicon Valley. At 45, Johnson has resuscitated the “blood boy" with vampiric ambition. In April this year, Johnson announced Project Blueprint. A team of dedicated medical professionals are putting him through extreme tests, infusions, exercise, brain mapping, sleep science solutions and other tools to facilitate a 126-year lifespan. These days, Johnson looks youthful and ripped—and also a bit spectral and waxy.
The latest in Project Blueprint is generational plasma swap. Recently, images of Johnson, his 14-year-old son and 70-year-old father treating themselves to a plasma swap at a Dallas wellness centre went viral. The teenager is the sacrificial guinea pig, the “blood boy": He would give one litre to his father, and his father would then give one litre to his grandfather. If you believe Instagram reels, you’d believe eternal youth is within this family’s reach. The 2006 film The Fountain, produced by Darren Aronofsky and Ari Handel, about a man searching for everlasting youth, had this chilling dialogue: “Death is a disease, it’s like any other. And there’s a cure. A cure—and I will find it." No other words are more apt than this film dialogue to describe this moment in human endeavour when Death is the unparalleled villain. Movies often exaggerate or distort reality. Aronofsky, known for a zany brand of provocative storytelling, last year directed a docuseries for National Geographic that takes the death cure idea to test. Hollywood actor Chris Hemsworth plunges into Arctic waters in Limitless, dangles a thousand feet over a canyon while climbing a rope, swims in a fjord’s 36-degree water, fasts for four days, and prepares for his own eventual death—all in the pursuit of living long. It is a hard show to watch. The action is riveting, the stunts seem pointless. The “blood boy" will probably be a movie character soon, too.
In 2017, a 33-year-old doctor named Jesse Karmazin started Ambrosia in Monterey, California, which was offering teen plasma to older people. After an FDA warning on its apocryphal, unethical nature, Ambrosia folded up in 2019. But demands continued, and with Johnson’s endorsement, the practice will likely again become popular.
In the epilogue of his staggering tome on the history, biology and mystery of the cell, The Song of the Cell, Pulitzer-winning author Siddhartha Mukherjee dwells briefly on the moral framework that binds start-ups like Ambrosia. Mukherjee writes that Ambrosia, “supposedly rejuvenates the creaking but wealthy, shrivelling bodies of ageing billionaires". The mechanics of the plasma transfer process are elitist and unsavoury—and an extreme outcome of post-covid obsession with super healthy pursuits. In most cases, a wealthier person is receiving the plasma of a much younger, less well-off person. Teenage plasma comes out light yellow and clear—“platonic plasma", as Silicon Valley impresarios have christened it. For Johnson, of course, the fuel is his curiosity to birth the next, foolproof frontier of longevity science.
Trillion dollar industry
Green powders of all kinds, turmeric concoctions of all kinds, cold plunges, low-angle morning sunlight, continuous glucose monitors (for non-diabetics), box breathing, crispr gene therapy (on humans as well as pets), guided use of mushrooms and psilocybin, app data for empathy and connection, avoiding seed oil, avoiding fruits, drugs such as rapamycin and ozempic and a dizzying spectrum of supplements for nerves, brain, organs, skin and everything that constitutes a human being, shunning everything but bone broth or plant protein powders—the wellness industry wants to facilitate solutions for the quantity and quality of living by the minute. Inflammaging (acute inflammation in the body triggered by ageing) and homeostasis (a state of balance in all the systems that run our bodies) are outside of hallowed medical journals and into podcast pods of the world. Humanity has made a monster out of a god-given condition: Senescence.
While obsession with health and longevity have long dogged humanity, going far back to epics and myths where all male gods and prophets are born to live for thousands of years, this latest version has the support of an ecosystem in which influencers and podcasters profit from our quest for wholesomeness by getting sponsorships from supplement companies, sleep trackers and several other wellness products and services which don’t necessarily have the stamp of genuine scientific evidential sanction. A major study by the US-based Global Wellness Institute concluded earlier this year that the supplements market is projected to hit nearly $310 billion within the next four years.
McKinsey and Company’s Future of Wellness Report published earlier this year projects the world wellness industry to be worth around $1.8 trillion.
Investments in longevity start-ups are galloping in the US, with various initiatives and investments enlarging in most countries around the world. Artificial intelligence, big data, cellular reprogramming, and an increasingly exquisite understanding of the molecules that keep our bodies working propel this work. Some researchers have even talked of “curing" ageing. While most wealthy countries are laying down these protocols and prescriptions with relentless promise, in India, the longevity movement is nascent and just about taking off. According to 2024 data, the current life expectancy in India is 70.62 years, a 0.29% increase from 2023. In longevity science, we are in a spot of beginner’s moderation in all things tech.
Controlled ageing
Darshit Patel, founder-CEO of Decode Age, a Mumbai-based longevity start-up, is hopeful as well as cautious. He prefers not to use the term “biohacking" to describe what Decode Age, set up in 2021, does—“because it is a hyped word, it just sounds fancy".
Patel says the biggest threat to longevity has always been diseases that are metabolic in nature: Type 2 diabetes, Parkinson’s, cardiovascular diseases, rheumatoid arthritis, and even cancer, where your body goes rogue after a particular age. In a majority of incidences, these diseases have ageing at the root of it. “So the hope is, if we control ageing in some way or the other, we are controlling many chronic diseases. What penicillin was to the infectious world, anti-ageing is to the chronic diseases world."
Patel’s company undertakes an exhaustive list of blood tests based on medical history, age and disabilities or weaknesses and offers personalized treatments that could cost anywhere between ₹3,000 and ₹10,000 for the basic therapies. Their nicotinamide mononucleotide (NMN) supplement, described in medical journals as a stable, and reliable activator of nicotinamide adenine dinucleotide (NAD+), and an anti-ageing molecule made famous by Hollywood celebrities, is available to buy on Amazon for ₹2,999. Taken orally, NMN is rapidly absorbed and converted to NAD+.
In numerous studies, supplementation with NMN has increased NAD+ biosynthesis, suppressed age-related adipose tissue inflammation, enhanced insulin secretion and insulin action, improved mitochondrial function, improved neuronal function in the brain, and more.
Decode Age focuses on the microbiome—the term for the combined genetic material of a body’s microorganisms in a particular environment. A microbiome protects us against germs, breaks down food to release energy, and produces vitamins.
In mid-2022, Patel personally took on the case of a legendary Indian sportsperson who is now around 85. When he first consulted with Decode Age, he was severely lethargic, was unwilling to be active, had a pile of cardiovascular risks, and the body signature of almost all Indian men above 50: excess fat around the abdomen. Within a year, this outlook transformed. He is walking, climbing stairs without holding railings, appetite and sleep are considerably better. He literally has a spring in his steps, although he chooses to remain anonymous—let the world keep guessing, perhaps, the secrets to his turnaround. Patel says raising awareness about these possibilities is one of his biggest challenges.
A long career
Dr Naganath Narasimhan Prem, chief consultant geriatrician and elderly care specialist, at Jaslok Hospital and Research Centre, Mumbai, says in India, as elsewhere, lifestyle modification will always be a strong pillar for longevity. He says among the elderly who come to his clinic every day, mostly people in their 80s and 90s have cognitive issues besides metabolic disorders like diabetes.
“The pandemic has increased the factor of isolation and loneliness and that is a key factor for good health. And ageism is still a big issue in India. Being active and engaged after retirement is uncommon. To address the demand for longevity, India needs many more geriatricians," Narasimhan Prem says.
As we grasp that our days are limited, we tend to abdicate our need for control; we may even try to close the gap between what we want and what we have. Healthy ageing, as mandated today, seems to require a shift in thinking and believing as much as it is a shift in muscle mass.
Today, ageing Indians are better off compared to even a decade ago, at least in the metros. There are companies that focus on their health, employment and social life.
Neeraj Sagar, founder of Wisdom Circle, a company that helps the retired find work, says, “We call our senior members ‘WisGen’ (short for The Wisdom Generation). For many WisGen, traditional retirement is no longer the norm. They are embracing a new phase of life characterised by independence, community engagement, lifelong passions and holistic wellness. Their reasons for rejoining the workforce are diverse. At the core of it is a strong desire to eliminate cognitive decline by remaining actively engaged and pursuing meaningful endeavours."
The long-serving tradition is this: Our grandparents may be sharper than us, but most families and communities see the septuagenarian or nanogenarian as repositories of wisdom, good for narrating stories but not to be out and about or risk a second go at life. At the level of policy and governance, we don’t have infrastructure and facilities that make life easier for the elderly. Except for luxurious “senior living facilities" in satellite townships that promise the moon and more, day-to-day movement in urban India is still difficult for the elderly.
Andrew J. Scott, a professor at the London Business School, whose work posits the sociological implications of longevity, whose latest book, The Longevity Imperative: How to Build a Healthier and More Productive Society to Support Our Longer Lives, touches upon problems in this area unique to India. He says in a Zoom interview: “To rethink retirement and to rethink the idea of age-related disability is the most pressing need in countries like Japan. Right now, India has more young people but with a falling birth rate, those people will be old in 30 years. We have ageing societies everywhere now. Currently, we underestimate the capacity of elderly people. Companies should plan for longer careers, incorporate older workers’ skills and support them in the workplace."
Scott’s argument, which he applies to the UK in the book, that without fundamental societal transformation, we are moving towards a dystopian future of spiralling healthcare costs, a pensions crisis and overwhelmed care homes, could well be a reality in many parts of the world if along with the “biohacking" wellsprings, governments and policy-makers don’t find ways to integrate older citizens into society or the workforce.
Our healthspan
Suramya Asthana, scientist, longevity & translational research, Indian Institute of Science, Bengaluru, who is in the core team of Longevity India, an initiative to study longevity across the country and find solutions keeping the specific socio-economic parameters of the country in mind, says that Longevity India concerns itself with healthspan, which is the number of years spent in good health, as much as lifespan.
“India is essentially a curative society and not a preventive health society. We want to enable preventive health to increase the number of healthy years a person spends in their lifespan. We are studying ageing at a cellular, molecular, physiological and genetic level to identify indicators that can be linked to declining health. We have designed our study in a way that will sample the population across urban and rural areas, across genders, and across different socio-economic backgrounds. This strategy helps us delineate the effect of these parameters on ageing markers," Asthana says.
Most doctors, scientists and wellness experts believe without the right lifestyle, which includes diet, exercise, our emotional and social contentment and social connections, no longevity experiment can work—the really lived practices that American author and explorer Dan Buettner shows in the Netflix documentary about his work on the Blue Zones—places around the world where there is the highest concentration of centenarians.
K.M. Matthapan, 100, who lives in Sion, Mumbai, with his daughter, could be from any of these Blue Zones.
Matthapan loves to talk about rowing. How, as a child, in the pristine, wet Kerala village of his childhood, he and his nine siblings would row in boats made of local wood and coconut fibre to their school, and row to neighbouring villages and markets. Or row just for fun under pouring rain. He obviously started flexing his muscles early. But there is more to this centenarian, to his longevity, than a history of tensile muscles.
I met Matthapan and his daughter Mary Matthapan, 53, recently at the laughter club he’s been starting his day with, for the past 25 years. During the pandemic years, when Mary set the strictly-indoors rule for her father, he spent his time creating an exhaustive family tree going back a few generations. In the close-knit laughter group, Matthapan is the only centenarian. Some others are in their eighties and late seventies. As the group started their routine, and the hah-hah-hah peals filled the crisp early morning air in a residential cul-de-sac in Sion, an otherwise industrially-dense neighbourhood in Mumbai, Matthapan adducted with ease—only his fingers unable to touch his feet.
Matthapan doesn’t sit easily. He walks about a mile every day, is flexible enough, stretching his body in all directions. He eats what he has been eating all his life—local, seasonal vegetables and fruits, grains, fish and chicken, prepared the Malayali way. The father of two—his elder daughter Anne Varghese lives close by with her family—socialises with great enthusiasm within his community church group, family members, friends from the laughter club and elsewhere, and colleagues he has stayed in touch with since his years as a real estate lawyer in Mumbai. He was diagnosed with diabetes just before the pandemic. After a laser surgery on his eyes, his vision is perfect. He has two pills in a day.
“Helping people, community charity work, we have seen dad do this all his life," says Varghese. “It sometimes tired my mother, how much he would want to do all the time," Mary Matthapan adds.
The centenarian’s wife, who he says was a creative lady fond of handwork, crafts, art and cooking, died in her late eighties two years ago.
According to the Longitudinal Ageing Study of India undertaken by the ministry of health and family welfare in 2021, Kerala has the highest life expectancy at 75.1. Other states such as Manipur are high on the list. Darshit Patel of Decode Age says that they find a lack of birth certificates and paper documentation of birth and seminal events in a person’s life come in the way of identifying India’s Blue Zones. “We know that in rural Manipur, for example, the concentration of centenarians is very high. But that doesn’t translate to research because often, there is no paperwork in their names," Patel says. American author Ernest Hemingway likened something as primal, cellular and biological as ageing to bankruptcy: It happens two ways; slowly, and then all at once. The slow way is familiar and less daunting: middle age arrives with, maybe, a name forgotten, a lumbar ache, a sprinkling of white hairs and wrinkled under eyes. The fast way is like a hurtle-down: eyes occlude, hearing dwindles, a hand trembles where it hadn’t, a hip goes immobile. Middle age usually gets sorted with probiotics and nutraceutic skincare. The second is the inspiration for a further twisted Marvel universe come eerily alive.
Sanjukta Sharma is a Mumbai-based writer and behind The Slow Fix, an online space for wellness, heath, conscious living and climate.
