World’s first integrated pre-clinical and clinical aging research institute seeks to lead the longevity medicine field with clinical research to prolong healthspan by delaying aging.
The NUHS Centre for Healthy Longevity (NUHS CHL) is set to initiate, for the first time in a South-East Asian population, geroscience-based clinical research in order to target the biggest risk factor for chronic disease – biological age.
The Centre will focus on key geroscience projects and develop and validate aging clocks in the Singapore population to test the efficacies of novel geroprotectors in delaying biological aging and enhancing healthspan. The Centre also plans to develop an integrative pre-clinical laboratory model and clinical human research pipeline that will focus on identifying, and treating biological hallmarks of disease.
Longevity.Technology: Global societies are experiencing a sharp rise in the number of older adults relative to the rest of the population. The silver tsunami is coming, and Singapore will be hard hit, with, 25% of its population estimated to be aged 65 or older by 2030. Although medical advancement has improved life expectancy among Singaporeans by 8.7 years to 84.8 years, one of the longest in the world, its healthy life expectancy – or healthspan – has increased by only 7.2 years to 74.2 years.
The grim reality is that Singaporeans are spending about 10 years of their twilight years in poor health, and as the gap between life expectancy and health adjusted life expectancy increases, healthcare and caregiving costs will represent an unsustainable socioeconomic burden for society.
NUHS CHL has set itself one clear mission: to enhance healthspan by five years in the Singapore population by slowing biological aging. Its strategy is to embark on geroscience and longevity medicine-based approaches to achieve this mission. Geroscience and longevity medicine are paradigm-shifting concepts in research and medicine, that acknowledge species-conserved pathways of biological aging, and view biological ageing as the greatest risk factor for chronic, age-related diseases. Proponents of geroscience/ longevity medicine also advocate the implementation of the use of biomarkers and interventions with the use of artificial intelligence to enhance healthspan.
Pre-clinical model organisms have traditionally been used in early pharmaceutical trials, but do not always translate successfully to human trials. NUHS CHL plans to use age-appropriate models for discovering mechanistic pathways that respond well to novel interventions, called geroprotectors. These treatments will then be translated into clinical human studies of CHL.
Both clinical and pre-clinical divisions in the centre will work iteratively to identify, refine and implement promising geroprotectors. To date, the South-East Asian population has been traditionally understudied in clinical research; with the three major races, Chinese, Malay and Indian, numbering about 2.5 billion people and accounting for more than a quarter of humanity, results gleaned from the CHL’s research will have significant global impact, particularly in Asia.
NUHS CHL is also the clinical and translational partner of the Healthy Longevity Translational Research Programme (TRP) at NUS Medicine, whose research to slow aging, and improve healthspan for the broader population has received generous funding ($5 million) from the Lien Foundation.
Termed ‘Hacking Ageing’, the research initiative comprises three broad themes, which will contribute to the creation of an integrated biomarker-AI platform that will be the world’s first in testing supplements and repurposed drugs combined with lifestyle interventions in the Asian population. This will allow for better early detection, risk stratification and development of personalised, preventive and therapeutic strategies to improve healthspan.
Lee Poh Wah, CEO, Lien Foundation said: “Through the ‘Hacking Ageing’ initiatives, we hope to contribute to the national agenda to shift the healthcare paradigm from the present state of reactive ‘sick care’ towards a population health prevention approach. Socioeconomic factors are often at the root of health inequalities. As a society, we have a moral duty to ensure anti-ageing therapeutics are not confined to the realm of the rich and exacerbate existing disparities. Developing biomarkers and interventions that are accessible to all in the community, is necessary towards narrowing this gap and democratising healthy longevity.”
The first research theme funded under the ‘Hacking Ageing’ initiative is a series of clinical studies to test novel nutritional supplements and repurposed drugs to slow aging in middle-aged adults (40-60 years). The second research theme is to use deep omics data to personalise these supplements and repurposed drugs and other interventions for optimal healthspan extension in middle-aged participants. The third research theme focuses on extending healthspan in older adults through strength training exercise, harnessing the Foundation’s Gym Tonic community of seniors.
Professor Brian Keith Kennedy, internationally recognised for his research in the biology of aging and for his work to translate research discoveries into new ways of delaying, detecting, and preventing human ageing and its associated diseases, is helming the Centre with co-director, Professor Andrea Britta Maier, a geriatrician by training and intensivist of chronic diseases.
The 1,600 square feet Centre for Healthy Longevity (CHL) located at Alexandra Hospital and a laboratory at NUS Medicine, will conduct trials and execute validation studies with healthy participants from the age of 30 years old. The Centre will also develop and test these interventions using newly identified biomarkers of human aging. Once the approaches are validated, the Centre will develop strategies that integrate a combination of nutritional, medicinal and exercise approaches for personalised adoption in the Singapore population, with an ultimate goal of bringing the individual closer to their state of optimal peak performance during the entire lifespan. This means starting the screening programme from an approximate age of 30.
CHL will be looking at blood-based biomarkers, probably the most investigated group due to a large amount of data accumulated in clinical trials, rather than genetic markers, which can reflect predispositions to certain aging phenotypes, characterised by the prevalence of specific pathological processes and age-related diseases.
One biomarker CHL is looking at is DNA methylation, which measures the degree of chemical modification in the human genome to predict biological age. CHL is also measuring aging using inflammation markers, metabolomics and other novel parameters like facial aging analysis.
“Developing new interventions to slow ageing and developing new biomarkers to measure ageing, are what we are trying to do here in Singapore through the new Centre, and then, we can recommend inventions to see if they can slowly reverse aspects of ageing in the Asian population,” said Professor Kennedy.
Co-director, Professor Andrea Maier added: “The body’s ability to fight diseases reduces dramatically with age. If we can address the physiological changes of ageing, we may be able to slow or stop the onset of disease. In three to five years, healthy longevity will not only exist as a lab-proven concept, but will become part of everyone’s life.”
She explained: “The aim of geroscience is to prevent age-related diseases like the occurrence of dementia, cancer, lung diseases, osteoarthritis or sarcopenia, all the diseases we know of. So next time, tell your GP, your biological age, not your chronological age, for a more targeted, customised and precise prognosis and treatment or intervention plan. This also gives the physician a better association with risk of outcomes one will not want to have like impairment and death.”
Photos: National University Health System (NUHS) and NUHS Centre for Healthy Longevity