‘We have to shake things up’ – putting longevity medicine into practice

The Healthy Longevity Medicine Society aims to make longevity a specialty area of modern healthcare.

Amid all the cutting-edge research and drug discovery news at this year’s ARDD meeting, you may have missed a key announcement about the launch of a new organisation focused on the development of the field of longevity medicine. The Healthy Longevity Medicine Society (HLMS) aims to make the field of longevity medicine a respected and independent medical speciality.

To get the ball rolling, the HLMS has assembled an impressive list of founding council members, including professors Nir Barzilai, James Kirkland, Harold Pincus and Thomas Rando, as it seeks to establish new medical standards around extending healthspan, targeting aging mechanisms and optimising performance.

Longevity.Technology: From cellular reprogramming and senolytics to fasting and supplements, the field of longevity is awash with exciting innovations that hold great promise for the future of humanity. However, most doctors and health professionals are still unaware of progress in longevity, and most of the developments in the field have not yet filtered through into clinical practice. Working alongside the likes of the Longevity Biotechnology Association, the Healthy Longevity Medicine Society aims to lay the foundations for a future where longevity is front and centre in healthcare. We spoke with its president, Prof Andrea Maier, and vice-president, Prof Evelyne Bischof, to learn more.

Prof Andrea Maier, Health Longevity Medicine Society
Professor Andrea Maier, Healthy Longevity Medicine Society

Professor Maier, internal medicine specialist and co-director of the Centre for Healthy Longevity at the National University of Singapore, states that doctors must start thinking about what their role will be amid all the investment and research progress in longevity.

“Physicians should be having that conversation around what is wellness, what is medicine, and how do we regulate it,” she says. “Currently in medicine, we are treating patients when it’s too late, when traditional age-related diseases have already occurred – and that has to change. I was a hospital manager for a long time, and I left that sector because that it was so conservative. We have to shake it up.”

Bringing physicians together on longevity

One small but significant way to shake things up, says Maier, would be to bring like-minded healthcare professionals together to talk about how healthy longevity medicine should be implemented.

“Right now, it’s about sick care, and we need to explore how to bring preventative options to people,” she explains. “Over the last 50 years, we have seen an extension of life expectancy because of sick care, and I think we have to celebrate that. But the side-effect of that success is that we don’t die from the first disease anymore and that’s why we have 80-year-olds with five different diseases.

“In the next decade, we will fine-tune where the aging or disease trajectory starts in a person’s life. We know how diabetes occurs, we know how dementia occurs, we know when symptoms occur, and that’s at 20, 30, 40 years old, so we have to prepare modern medicine to be able to adjust.”  

Prof Evelyne Bischof, Healthy Longevity Medicine Society
Professor Evelyne Bischof, Healthy Longevity Medicine Society

Dr Bischof is a professor in medicine at Shanghai University and Tel Aviv University, and is equally passionate about the need to start preparing the path towards longevity medicine.

“We must also provide this type of healthcare to everyone, not only to selected populations, and we believe physicians can be key drivers of this,” she says. “All of the other players in the industry, especially the patients, need clear guidelines and an evidence base, because without this, we can never really know what works and what doesn’t work, what could cause harm and what is safe, and so on.”

Bischof observes that one of the main hurdles at this stage is a lack of knowledge of longevity science among healthcare professionals and beyond.

“Physicians are very often still not aware of what’s going on in the field because it requires a lot of time to get into the geroscience that is the backbone of all this,” she says. “There is also a lack of information and education about the symptoms, and even patients themselves are not educated about longevity.”

The lack of knowledge around longevity, says Bischof, is not due to any reluctance or unwillingness to learn.

“This field is so new, and so rapidly moving, and there’s unfortunately a lot of influence from areas outside of medicine that are shaping public opinion on it,” she explains. “Physicians very often have no voice, so we want to provide a network for information, for education, for working together on the science, so that the physicians can then get more into the space. We want to open the frontiers for something that is new and finally possible.”

Make healthy longevity medicine a specialty

Maier is under no illusions about the size of the task that faces the HLMS.

“Making changes in in healthcare is difficult, but that’s what we’re trying to achieve,” she says. “And first we must get our speciality recognised in the medical domain, for example, in internal medicine or primary care, which means you need guidelines and evidence-based practice. And that’s not what the field is doing at the moment.”

While getting longevity recognised as a specialty area of medicine is the initial goal, Maier intends that longevity medicine will eventually move into general practice or public health services.

“If you look at the evolution of other disciplines in healthcare, for example, the care for COPD patients initially came out of the sub-speciality of pulmonology and eventually moved into GP practices,” she says. “That’s why we see longevity medicine starting out as a speciality – getting the better understanding, knowing what to do in certain circumstances, knowing when to refer to a sub-specialist. But ultimately this is about public health, how do we get the care into everybody’s life?”

The first steps

On its website, the HLMS lists four main objectives:

  • To identify and promote educational opportunities in longevity medicine, including accreditations and credentials
  • To set and promote professional standards (including physician guidelines) in longevity medicine, thereby advancing and maintaining quality in the development and application of longevity medicine
  • To centralise, establish, facilitate and promote a clinical research agenda encompassing all aspects of longevity medicine
  • To develop relationships and collaboration opportunities with national and international entities, such as health authorities and scientific and medical societies

One of the first steps for the society, says Bischof, is to define what healthy longevity is and what is included in the scope of longevity medicine. An initial white paper is already under development.

“We need to be clear about what it includes, what are the credible points, what are we still working on, what is needed, and what is definitely not a part of it,” she explains. “The first white paper will be on the definitions, followed by further papers on important basics, such as diagnostics, biomarkers, and others. These papers will really focus on the clinical applications and the medical side of things.”

In parallel, the HLMS is also aiming to get things moving quickly on the educational aspect of its work.

“This means education of physicians, implementing various curricula that we already have, including those already with CME accreditation,” says Bischof, who is also involved in Longevity Education Hub, which offers accredited longevity medicine courses for physicians.

“There’s so much enthusiasm in longevity, but we also have to achieve quality control,” adds Maier. “We want clinicians to be able to help individuals optimise their healthspan and gain many more healthy life years, but nobody yet has the recipe for doing that.”