Legends of a miracle cure for old age have been told for millennia, but the concept flourished around the 16th century after rumours spread that Spanish explorer Juan Ponce de León was on a quest to find a fountain of youth, rumoured to be located in Florida. To this day, tourists flock to a stone well in St Augustine in the hope that its sulphur-smelling water will smooth the wrinkles on their faces.
For now, death remains a certainty, but it is true that we are living longer than ever before. Life expectancies have been trending upwards since the late 19th century and, according to the United Nations, the global population of those aged 60 and older more than doubled from 1980 to 2017, reaching 962 million. By the end of the century, this group is poised to hit 3.1 billion. With birth rates tumbling, the global population is inevitably becoming older. By 2100, a quarter of the Earth’s residents will be aged 60 or above.
Having an older population is not necessarily a bad thing. Ageing only becomes a problem when a person’s quality of life, otherwise known as their health span or healthy life years, stagnates. “Sadly, the [healthy life years] index does not grow as fast as life expectancy does: people live longer, but they are also sick for longer,” Elena Milova, a board member and outreach officer at the longevity non-profit Life Extension Advocacy Foundation (LEAF), told The New Economy.
Current public health approaches to ageing are ineffective, according to the World Health Organisation’s (WHO) 2015 World Report on Ageing and Health. The Geneva-based agency explained that, even in high-income countries, current health systems are not prepared to meet the needs of older populations. Long-term care models are “inadequate and unsustainable”, and physical and social environments are filled with barriers that stop the elderly from participating.
Many companies will thrive in ‘hyperageing’ societies by targeting older populations with new products and services that extend healthy life years
These issues must be addressed by supporting healthy ageing, combating ageism and enabling autonomy in the elderly, the WHO concluded. Some ways of doing this, detailed in the group’s 2017 action plan on ageing, include investing in health systems and infrastructure, creating age-friendly housing and establishing health services that focus on meeting the multidimensional needs of the elderly.
Assistive technology, or ‘agetech’, is one way that older people can gain greater independence. The elderly are able to live self-sufficiently for longer with smart devices that automatically dispense medication, technologies that monitor cognitive skills and networking apps that improve social connectivity.
Agetech can also include financial products and services optimised for older users. “Today, most fintech banks are aimed at younger people using smartphones,” Dmitry Kaminskiy told The New Economy. Kaminskiy is working to build the Global Longevity Consortium, a group of companies that provide resources for the longevity industry.
In the next two or three years, Kaminskiy expects big financial corporations to show agetech the same level of excitement they had for fintech in the mid-2010s. “A lot of venture investors, angel investors and big financial institutions will recognise the opportunity of the market, and they will start to invest in it,” he said.
Ageing Analytics Agency, which Kaminskiy co-founded as part of his consortium, published a report in 2019 on the proactive steps Singapore has taken to address the problems caused by its ageing population. In 2015, the city-state launched an action plan for successful ageing. This included preventative and active ageing programmes that begin at age 40, such as the National Silver Academy – a network of organisations that offer seniors educational programmes – and the Silver Generation Ambassadors, who make health services and government schemes more accessible through home visits.
Global population aged 60+
End of 21st century
Japan is another interesting country for longevity industry players. Currently, it boasts the world’s longest life expectancy, with half the population aged over 50 and more than a quarter over 65. Japan also holds the title of the highest ratio of centenarians per capita.
But these credentials have come with a price: the country is facing a dementia crisis, with one in five people aged 65 or older expected to suffer from the memory-loss disease by 2025. Because of Japan’s unique position, a study by the consultancy firm McKinsey said the country’s response to the “unprecedented” economic and social challenge of ageing would become a roadmap for other governments contending with ageing populations, such as Spain and Italy.
Corporate leaders have a big role to play in these countries too. In fact, many companies will thrive in ‘hyperageing’ societies by targeting older populations with new products and services that extend healthy life years, McKinsey said. For example, the report described a social network in Japan where users aged 50 and older can chat with others about their hobbies and interests. The product, created by Kozocom, aims to tackle social isolation in older people, who often live alone, by helping them become part of a community.
A disease-free world
While one side of the longevity industry prepares for a world with significantly more elderly people, another aims to stop ageing from being a concern at all. Numerous scientific research firms are taking a preventative approach to the health implications of ageing by developing medical therapies that address the causes. Drugs that aim to extend the healthy period of peoples’ lives are already being trialled on humans.
“Science is increasingly showing that biological ageing consists of about a dozen root mechanisms; it is basically the accumulation of several types of damage that happen due to normal bodily functions, regardless of our lifestyle,” Milova said. “These root mechanisms of ageing can be addressed by medical means and, as a result, people will age more slowly with an extended period of good health, while the development of age-related diseases will be significantly postponed or even prevented.”
In the long run, focusing on the root causes of ageing will reduce the strain on nursing homes, healthcare providers, caregivers and assistive technologies in a world with a growing elderly population. This mission is already big business in Silicon Valley.
Facebook creator Mark Zuckerberg and his wife, paediatrician Priscilla Chan, announced in 2016 that they would donate $3bn through the Chan Zuckerberg Initiative to curing, preventing or managing all diseases by the end of the century. In their announcement, they said current spending on treatments is 50 times higher than investments into preventative medicine, which would stop people from getting sick in the first place.
Google’s parent company, Alphabet, has been working to unlock the secrets of ageing since 2013 with its biotech company, Calico. The firm has received a budget of $2.5bn to date, but the details of its operations are mostly a mystery. In 2018, the firm made a rare announcement about its research on naked mole rats, which defy the usual ageing process. In a statement on its findings, Calico said research found that naked mole rats’ risk of death does not increase with age, as is typical with other mammals.
In fact, the rodents showed little to no sign of ageing, and their risk of death did not increase even at 25 times past their reproductive maturity. “These findings reinforce our belief that naked mole rats are exceptional animals to study to further our understanding of the biological mechanisms of longevity,” said Rochelle Buffenstein, Senior Principal Investigator at Calico, in a statement.
Reaching for immortality
Anti-ageing medicine is not just a Silicon Valley trend; today, these once-fringe ideas are gaining traction all around the world. Even big banks are beginning to realise their disruptive force.
According to a recent report by investment bank Citi, the current anti-ageing market is worth about $200bn globally, but this only involves non-therapeutics such as cosmetic products and procedures. Recent breakthroughs in the science of ageing could produce commercial therapeutics within the next decade.
Citi claimed the most promising anti-ageing approach was one undertaken by biotech firms, including Unity Biotechnology, a US-based company that is backed by Amazon founder Jeff Bezos. These firms are developing a class of drugs called senolytics that are designed to eliminate senescent cells, or cells that have ceased to divide and replicate.
The removal of these cells in mice delayed age-related diseases, according to research funded by the US National Institutes of Health and published in Nature Medicine. In naturally ageing mice, the drugs also extended both their life and health span. One senolytic therapy made by Unity is designed to treat patients with osteoarthritis of the knee by essentially returning the knee tissue to a more youthful state. If successful, the therapy could be commercially available by 2023.
Steve Hill, Board Member and Editor in Chief at LEAF, told The New Economy that it currently takes about 17 years for a new drug to be developed from start to finish. Treatments such as senolytics, which are making waves now, have been in the works for years. Hill said: “The defeat of age-related diseases is a long haul, not something that will suddenly occur overnight; it will likely happen in small steps, each of which brings us closer to the goal.”
Therapies that delay or even reverse certain diseases of ageing could hit the market within the next decade, Hill said, but a more comprehensive control of age-related diseases will likely take much longer. “However, as our knowledge grows and automation and AI become increasingly present in the research setting, we could see that progress happening faster than it currently is,” he added.
Another barrier to the development of new medicines is cost. Most funding for early-stage scientific ventures comes from government investment and philanthropy, according to LEAF. Profit-focused investors are often wary of these projects as returns can take decades to materialise, if at all. But what was unthinkable to corporate investors like insurance companies or pension funds just half a decade ago is not so unconventional anymore.
“There is a tremendous change in the general perception towards longevity and actually even an acceptance of the technical possibility of extending life, or at least the healthy period of life,” Kaminskiy said. He expects 2019 to be a turning point for many bigger investors.
Longevity investor and billionaire Jim Mellon said in a white paper published by British bank Barclays that “billions of dollars” would soon be flowing into the longevity sector as its growth continues. “There are very few companies available to the general public today, but there will be hundreds lining up over the next two or three years.”
The economics of ageing
As the population turns increasingly grey, the economy will change in a number of ways. The European Commission’s 2018 Ageing Report said the EU’s working-age population, defined as those aged 15 to 64, is shrinking “significantly” due to a combination of increased life expectancy, declining fertility and migration flow dynamics. As a result, the EU will go from having 3.3 working-age people for every person over 65 to just two working-age people by 2070.
The commission also expects spending on healthcare and pharmaceuticals for age-related diseases to surge. It predicted spending on long-term care systems in the EU would rise by 73 percent to a total of 2.7 percent of GDP by 2070, from 1.6 percent of GDP in 2018. Meanwhile, spending on public health in the EU, which was 6.8 percent of GDP in 2016, could rise between 0.9 and 1.6 percentage points by 2070. As Milova points out, these issues create a double burden for healthcare and social welfare systems, which are dependent on taxpayer funding.
However, the advent of drugs that improve our healthy life years will have different implications for the global economy. In the bank’s white paper, Barclays’ Chief Economist for Europe, Antonio Garcia Pascual, said rising life expectancies – so long as they coincide with rising health spans – could be advantageous for the global economy. If people remain fit and healthy into their old age, they could continue to work for longer and boost long-term economic growth. Governments would also be collecting more taxes and thus have bigger budgets.
Elsewhere, the traditional economic dynamic will be turned on its head. Savings and investment plans will change as people work out how to finance their longer lives. This impact will extend to monetary policy, as Pascual explained in the white paper: “As a population ages, savings tend to rise and that brings down interest rates. That’s one reason why we are already seeing central banks struggling to lift interest rates; the long-term equilibrium rate is being dragged down by population dynamics.”
A handful of cities could benefit further by positioning themselves as hubs for longevity research. Aside from Singapore and Japan, the UK stands out as having expertise in a unique mix of three sectors that the longevity industry relies on: biotechnology, AI and finance. It is also home to an ageing population, with centenarians being the fastest-growing age group in the UK.
The British Government has already displayed an interest in the sector, providing a £98m ($130m) challenge fund for healthy ageing. Kaminskiy said accelerators could also be built within the next couple of years to kick-start the growth of advanced biomedicine, agetech and other aspects of the longevity industry. According to a report by AAA, there were 260 longevity-related companies operating in the UK as of 2018.
As far-fetched as the idea of curing all diseases sounds today, similar feats have already been done on a smaller scale with vaccines. To date, only smallpox has been declared completely eradicated by the WHO, though other diseases have been eliminated in certain areas. This work gives hope to the idea that, with more supportive environments, preventative medicine and anti-ageing therapies, humans could live longer and healthier lives. While the longevity industry still has some growing up to do, the way we age is already transforming.