Age Later: Health Span, Life Span, and the New Science of Longevity

To say that mortality has always been something to avoid is an understatement. In the evolutionary history of life delaying mortality must have been a powerful selectable trait. Delaying mortality is something not all species are equally good at. For example, while bowhead whales can live for over 200 years, our most favorite experimental animal, the mouse, cannot expect to live longer than about 3 years, and that is under optimal conditions in our animal facilities. In the wild they usually die around 8 months, from cold, lack of food or predation. Humans soon found out that even in the best of times mortality was a given. Especially the rich and powerful had a problem with that, which explains that so many kings and emperors tried their utmost to gain immortality. Since then humans never stopped trying to find ways to ward off death from old age and even now there are plenty of aggressively advertised interventions to save us from aging. Alas, the far majority of such interventions are far from the realm of regular medicine and can better be avoided.But very recently something changed in anti-aging medicine and this time it came not from charlatans but from serious scientists. This is not obvious because regular science for quite a long time expressed no interest in research on aging, which was considered the exclusive domain of charlatans. What happened and led serious scientists change their mind was the discovery that aging, like a disease, could be targeted for intervention. Not for gaining immortality but for increasing the health span of life. This is the topic of the book Age Later, Health Span, Life Span, and the New Science of Longevity by Nir Barzilai. Nir is a friend and colleague of mine and I know him for a long time. His new book describes the promise of the new science of aging in a lighthearted, entertaining style, but with all the facts in good order and narrated so clearly that also the non-scientist will be able to follow the main concepts presented.The book is focused on the recently emerged new field of “Geroscience”, the study of aging at the interface of its basic biological principles and the diseases it will cause late in life. Why is this an important book? The main problem investigators who study aging have always experienced is the lack of practical appeal of the science of aging and therefore very limited funding. This is primarily based on vested interest. The established behemoths of medical research, cancer, cardiovascular disease, diabetes, have incentives to block a switch to a different universe where individual diseases are no longer the be-all and end-all of medicine. That is, until Geroscience came along. As described in the book, the main impact of Geroscience is to once and for all put the lie to the idea that aging is inevitable and cannot be targeted for medical intervention. This book, for example, does that very effectively in Chapter 7, Making Eighty the New Sixty, providing a lucid description of where we can go from here based on the stream of new, convincing scientific data that interventions in aging are possible and will have a major impact on prevention and treatment of chronic disease. It should open the eyes of politicians, investors and the medical establishment to a new world that is coming.One way to turn Geroscience into the disruptive technology that it could be is to make people understand that things do not need to be the way they are. That is, it should not be necessary to become increasingly fearful when approaching 60 and then 70 that one of the big diseases will catch you. Age Later is a manifesto to underscore a new future. A future where everybody will have access to medication that targets multiple chronic diseases simultaneously rather than one by one by targeting the basic mechanisms of aging that underlie all these diseases. This also makes economic sense. As described in Chapter 1, One Hundred Years Young, those who live to a hundred because they have the right genes suffer less and have many more years of healthy old age than the average human. However, also the health care costs of such a lucky individual are only a fraction of the health care costs of that average individual. As described further on in the book, the genomes of these slow agers have now become treasure troves for investigators interested in finding out how they do it. What are the genetic variants that dictate a healthy long live? If we would know that, we could use such genes as starting points to develop drugs that mimic these good genes so that also the far majority of humanity, which normally would have to do without, can still profit from them.Age Later does the job of providing all that critical information in a way that is clear to the non-scientist, convincing for investors and persuasive for politicians to make the necessary changes in the medical establishment. In this respect the story of the TAME trial in Chapter six, The Quest to Prove Aging can be Targeted, is critically important because it shows that it actually is possible to get at least some of the regulators on your side.The book is well organized with a number of informative boxes to quickly outline specific scientific aspects important in following the reasoning. It ends, quite appropriately, with the future, in a Chapter called Bright Horizons that discusses some of the hottest areas of potential interventions. Overall a book to point the way as to how Geroscience is on its way to disrupt the medical sciences and change our future.

The beauty of science is to make things simple- and this is the essence of this book. Dr Barzilai is a world-class leading geroscientist who did a great service to the public by relaying the complexities of geroscience in a very straightforward and engaging language. The book is a fascinating exploration of the most exciting current research in the field of ageing and longevity. The humble and enticing narration of the scientific facts often adorned with witty rhetorics makes the book exceptionally enjoyable to read.The book not only explores different aspects of ageing research but also narrates the fascinating journey of groundbreaking research led by Professor Barzilai at Albert Einstein College of Medicine. Chapters three to eight cover different hallmarks of ageing and introduce the novel discoveries- and ongoing efforts- in the pharmaceutical front to stop ageing.This book is truly a "must-read" for both the experts and the general audience alike.

The book speaks about the research for how to add years of healthy life, to life, but it mainly is not a recommendations book. It definitely has less recommendations that his collegue's book Span. It is more about the research and development. The hopes, the obstacles, etc. It though has a chapter on recommendation, where he mentions some of the recommendations made by Sinclair. It is interesting to see both how careful you should be in research, and how the money makes an issue.

I am a geriatrician who is very interested in understanding the biology of aging. I have followed Dr Barzilai’s research on centenarians for many years. When I learned of his recent book, I bought it immediately. The book provides a detailed look at the studies that Dr Barzilai has done over the last 20 years. It is written very clearly and covers many areas that impact on aging especially genetics, biochemistry and life style. One interesting focus is on his work to discover factors that confer resistance to aging. If you would like to learn about the frontiers of current aging research, I would recommend this book.

great book and very good to pair with David Sinclair's book "Lifespan". highly recommend if you care about aging or want to understand the stories behind those that live past 100. Barzilai does a great job making the book very accessible and also clearly spells out his learnings from studying centenarians.

Great book on health and secrets to anti-aging research! I really enjoy this book as it got technical without being too overly technical. This is a great book to read in addition to David Sinclair’s lifespan. These are all things that everyone can do in the hopes of having a greater health span and a lifespan. Highly recommended!

I am more than halfway through this book about the superagers in our society. Barzalai describes their HDL, growth factors and other biological differences. Then moves on to discuss recent research on Metformin, NMN and other substances that seem to slow aging. Some typos but overall great information. Yeah!

Nir is a legend in the anti aging field. His interview with Peter Attia on his podcast was amazing. I'm very excited for results of TAME trial. I finished the book in literally one day. Definitely some new info in it that I hadn't heard before, which is surprising as I'm pretty plugged into this field. Would recommend.