This time the quest for longevity is different, says Dr Omar Najim MBChB DOHNS MRCS MSc, Chairman of BeehiveX and Adjunct Associate Professor at Khalifa University, Abu Dhabi
Longevity is going to be the 2025 healthcare trend in Europe, according to a doctor friend. Actually, it has been the trend in the Middle East and many other countries for the last 2 years. Initiatives such as the largest XPRIZE to date of $101m dedicated for medical intervention targeting the biology of ageing was launched in the Middle East in 2023. There was also the launch of the $1 billion a year KSA Hevolution anti-ageing fund, while the UAE’s Pure Health is setting its North Star to be a fully dedicated Accountable Care Organisation to achieve 100 years longevity for the population it serves.
So, is longevity a NEW post-COVID buzz word? Well, not quite. Actually, it’s as old as history, or at least the written part of it.
Gilgamesh and beyond
If you ever come across a quiz question about the similarity between the University of Sydney, the Civic Centre in San Francisco, Qinghai Lake (the largest lake in China), the ancient city of Uruk in Iraq and a video game series called “Final Fantasy”, I am confident that few people will know the answer and not even Google will be able to help (trust me, I already tried it). Shouting the word ‘Gilgamesh’ should win you the whole competition, not only that question.
The Uruk-based 3,500 year-old Epic of Gilgamesh is the oldest written story in the world. This classical antiquity epic was written using cuneiform letters on 12 clay tablets; it details and recounts the trials and tribulation of King Gilgamesh as, towards the end of the epic, he seeks the secret to immortality. In an audience with the immortal figure of Utnapishtim he desperately asks for the secret. He is merely handed a secret plant that will keep him and his people younger and long lasting but, unfortunately for the human race, that does not work either as the plant is stolen by a serpent while Gilgamesh was bathing.
Since then, humanity has identified longevity and the quest for healthy ageing as a key collective objective across the geographies and throughout history. The quest of Gilgamesh for longevity still correlates with many of us through cultural references in movies, books, video games and statues in Sydney, San Francesco or Qinghai.
Over the 3,400 years since that epic, mankind has become caught up in the concept and pursuit of longevity and immortality. History is littered with corpses of dead heroes and villains who have tried ‘elixirs’ or rare nutrients, ventured into magical places or crossed mountains for Shangri La and Nirvana, and built ships, vehicles and other contraptions to arrive at a better climate or gain untapped knowledge.
The ageing process today
In recent times, meaningful progress in our collective pursuit of living longer first and healthier second is being observed. In the past 150 years, human average life expectancy has jumped from 40 years to about 80 years in 2010, with thanks primarily to leaps in sanitation and health understanding. More striking, in the last 15 years we have added another 5 years to be hovering around 85 years. Our quest using science- to be more precise the convergence of sciences – is making our ambition and endeavour more meaningful and achievable this time. That said, inequality remains; while life expectancy in Europe is mostly above 80 years, for those living in Sub-Saharan Africa it is hovering around an average of 60 years old (almost 25 per cent less with big leaps from 50 years ago).
The significant addition of years in the last 15 years is mainly due to better understanding of the processes of ageing and the factors that impact, speed or even prevent it. New technological advances and the convergence of sciences in genomics, big data, computational power, integration and connectivity is allowing our ambition to go further than previously perceived.
Longevity and age-related research around the world, married with the quality of global connectivity, are allowing for ideas, research, approaches and findings to be shared at lightning speed, which in turn is leading to comprehensive understanding of the processes of biological, immunological and cognitive ageing. As a result, intervention is now becoming mainstream in our modelling and design of health and healthcare.
The importance of Blue Zones
When talking about achieving a lifespan of 100 years, we now have examples from people who have achieved this great age or societies who are living significantly longer than others. For example, comparing life expectancy in UK and Japan shows a stark difference – 84 in Japan compared to 81 in the UK. There are villages and towns in Japan itself and other areas around the world where old people are a common sight among their population, commonly known as the Blue Zone. These populations have been contributing to our understanding of ageing and the natural protection and repair mechanism.
In principle, healthy longevity is not a luxury but a basic need. Many of us, who are not in a ‘blue zone’ have experienced ageing through observing it in others and loved ones, where it is not only a physical experience but also an emotional, psychological and societal one. In the worst of scenarios, ageing can be crushing – when cognitive and physical health and agency decline, spare time is not spent on doing enjoyable things but on chasing organs that don’t function optimally. Ageing is a major -if not the MAJOR – risk factor for many diseases and ultimately death. By the age of 50 years, most of us will have diagnosed or undiagnosed at least one age-related disease, by age of 85 years, almost all of us will, and usually more than one.
The importance of AI and big data
At the time of writing, big data from millions of data points, the design and deployment of algorithms and AI to find patterns, and the current availability of super computational power to run these AI algorithms is allowing our understanding to reach literally deeper and deeper into the variables that cause ageing or stop them from happening.
At the molecular level, and in the most simplistic terms, we now know that as we age, our DNA suffers damage at our command centre. At the mitochondrial level (i.e., the cell power bank), it is begins to malfunction and shuts down frequently. It is like an old ship, where the command centre is not great at decision making so the ships’ engine coughs, power is reduced and it keeps shutting down.
The convergence of scientific and industrial disciplines of biology, physics, chemistry, computational power, telecommunication, AI and mathematics is yielding amazing advances in developing understanding and solutions for not only the prevention and slowing of ageing, but even beginning to reverse that process. There are many solutions around reversal of ageing including the use of new molecules or categories of drugs such as senolytics and seno-modulators, or old ones that have fallen out of favour including statins and HRT.
That said, the biggest contributor to preventing, slowing or even reversing ageing is in the realm of ‘Healthy Living’ and ‘Precision and Personalised Health’ models and solutions. Outfits such as BGS50 from Khalifa University and China CarbonX offer multi-omics diagnostic kits and biomarkers for effective precision prevention and treatment; the US-based Fountain Life synthesise global evidence, big data, and AI to deliver a personalised longevity journey; meanwhile, the Abu Dhabi Institute of Healthier Living (IHL), the first longevity-licensed clinic in the UAE, is supported by the forward-looking Abu Dhabi Department of Health, which has introduced the world’s first longevity regulation.
Basically, bringing our biological clock down involves healthy living, sleeping well, eating well, exercise, a stress-free lifestyle, good dental hygiene, and the reduction of alcohol/smoking and other environmental factors.
It is evident that, in the 3,500 years since the Gilgamesh epic and prophecy, humanity and its ingenuity have come a long way. Our cognitive capacity, capabilities and our desire for healthy longevity have grown beyond the imagination of the Babylonians, Sumerians, Assyrian, Egyptians, Chinese, Mayans or any other ancient civilisation (although the level of ambition does prevail).
However, the lasting words in the Epic of Gilgamesh that remain true and will echo in eternity is that achieving immortality is doable. It can be done through living happily and seeing joy in small and big things, surrounding oneself with loving family and friends, contributing to society through good deeds (in other words charity and volunteering) and focusing on making a difference in the world that will last beyond our existence in this universe – in effect, finding a purpose. To put it simply, it is paramount that in pursuing as LONG of a life as possible, it is essential that it is HAPPY and HEALTHY.