Living Up to Our Potential: The Quest for Human Life Extension
An interview with Elena Milova of the Life Extension Advocacy Foundation
Interest in prolonging human life goes back to the very beginnings of history. In legends and folklore, people have projected their curiosity and imagination regarding human lifespans onto a vast array of mythical characters, from figures like Methuselah to gods and their spawn, such as Odin and Thor.
These tales held even greater significance in previous millennia, when human lives normally lasted between 30–50 years at most, with a vast swathe of the population wiped out by disease before reaching adulthood. As advances in sanitation, nutrition and medicine were steadily introduced over the last few centuries, average human lifespans have literally doubled to 70–80+ years. Most people now have the opportunity to live, grow in careers, see children raised to their own adulthood, and hope for a decade or two of more relaxed “retirement living” post ages 65–70.
With those advancements in scientific understanding, however, a new dream has arrived backed by burgeoning evidence uncovered in a rapidly growing research community dedicated to finding the root causes of aging and disease and looking for ways to slow — and even stop — those processes. Indeed, aging itself has come to be seen as a disease all its own, and as such, logically must have a cure.
Elena Milova, Board Member and Outreach Officer of the Life Extension Advocacy Foundation (LEAF) and the crowdfunding platform Lifespan.io, is at the forefront of this movement and is helping increase its visibility and improve public perception.
Predict: How did you first become involved in the life extension community?
Elena: I have always had some interest in science, which is probably explained by reading lots of science fiction as a child. Books by Isaac Asimov, Strugatsky brothers, Robert Heinlein, Ivan Yefremov, Ray Bradbury, and Anne McCaffrey made it clear for me that technology and science are great powers that will change the face of the world as I grow older.
I used to work in the pharmaceutical industry, then in pharmaceutical advertisement. At some point, I started to feel that the future that I have been expecting is not really happening fast enough. Unfortunately, I had to experience this delay in a very painful way. My mother died from cancer around ten years ago because the medicines for her disease were not powerful enough. Only a few years later, there was news on a novel approach — immunotherapy — that was capable of saving cancer patients that had stage 4.
That was a moment of great loss but also a moment of insight. I realized that, so far, we don’t have any real means to preserve health and extend life, and the investigation of the root causes of this situation brought me to a very simple conclusion. There is not enough effort invested into bringing aging under medical control just yet, which is why many age-related diseases have remained incurable.
That is when I decided that my time will be better spent on supporting research on aging rather than promoting the existing medicines that are too weak to take aging down. I joined the local transhumanist community, and after a few years of volunteering, I have found my way into the longevity industry as an international longevity advocate and science journalist.
Predict: What do you see as the biggest priorities for life extension research currently?
Elena: I would name two. One is the biomarkers of aging. The first thing you need to identify powerful cures targeting aging is a good way to measure results. If it were for short-lived animals, we would just apply the intervention and then see how much it extended their lifespan. We would also do a post-mortem analysis to see how it affected the organism. Let’s say that we test something in mice; even then, it would take several years at least to make conclusions about the effect. However, we humans are long-lived species, so to prove the potential of a therapy that increases lifespan, we would need to wait for decades. It makes such studies very long and costly. We can bypass that by identifying other parameters that indicate that the subjects will live longer and be healthier after treatment. Biomarkers of aging are exactly such parameters, as they are strongly related to certain health changes and can be used as substitutes for the traditional endpoint for lifespan studies: death.
Academia is actively working on reliable biomarkers of aging, including multiple components of blood, which are being developed by the research groups of Drs. Judith Campisi and Irina Conboy; the methylation profile of our genes, which is being investigated by Drs. Steve Horvath and Morgan Levine; physiological parameters, such as the amount of daily movement, which is being studied by Dr. Peter Fedichev’s group; complex biomarkers, which are being investigated by Dr. Alex Zhavoronkov’s team with the help of AI; Dr. Vadim Gladyshev’s age-dependent omics data, and many other things.
The other priority is a better understanding of the root mechanisms of aging and their interconnection. The fact that around ten such mechanisms have been identified as of now does not mean that we know everything about how to reverse the damage produced by them. Experiments in animals, as well as clinical trials of “cures for aging” in humans, are fraught with multiple failures and complications. There is obviously a need for more fundamental studies of aging, as we at Lifespan.io often underline. Allocating more funding to early-stage studies, whether it comes in the form of grants from the government, crowdfunding, or large-scale philanthropy, is pivotal to accelerating the development of effective interventions.
Predict: How has the public’s view of life extension changed since the turn of the century?
Elena: Health and youth have been valued since the dawn of humanity. Progress in medicine is mostly explained by the desire to avoid pain and disease and to remain strong, good looking, and independent. In this regard, nothing has changed. What has changed is that, thanks to technological progress, we are now turning this ancient dream into reality.
The public’s view follows the principle of feasibility. If something is just a dream, why should we approve it? If something is a real means to preserve health, avoid disease, and turn back age-related changes, then it has public approval and support. However, proof that aging can be modified and even reversed is relatively recent. In sociological studies, only a small share of people (4–7%) said that they knew “a lot” about progress in aging research. If only 4–7% of all people know that we have already managed to reverse some aspects of aging in animals, this pretty much explains why society, in general, is still mostly skeptical. We have a long way to go to disseminate information about progress in geroscience.
In my experience, if you properly explain the idea, you get the majority of people on board. The story is actually very simple to parse. Aging is the accumulation of several types of damage. As this damage builds up, our bodies stop functioning properly and age-related diseases develop. When the amount of damage becomes critical, we die from one or several age-related diseases at once. If we develop treatments that would remove this damage or prevent it from accumulating in the first place, then we will be able to prevent and cure age-related diseases, which, in turn, will greatly extend the healthy period of life and, as a consequence of health, will extend lifespan. This is how longevity treatments work in animals, and this is where researchers are heading by developing treatments for people. Life extension is not the extension of the period of frailty and illness, it is the extension or the regaining of full health and vibrancy of youth regardless of age.
The best part is that we have started to get interesting results in humans. This is something that will ease the life of longevity advocates, as it is always more exciting for people to hear about therapies that have rejuvenated humans rather than something that made mice live twice as long.
Predict: What do you see as the top three goals of LEAF and Lifespan.io?
Elena: Education, education, and once more, education.
Lifespan.io directly supports research on aging and runs the Longevity Investor Network, with which young biotech companies can pitch their projects to investors. This is what is necessary to create cures.
However, we are making an even bigger effort to disseminate accurate information about rejuvenation biotechnology among the general public. We are the most trafficked news outlet that covers this topic, and we are running schools of longevity journalism to help our colleagues from other news publications to spread the word more effectively. Last year, we started our own edutainment show on YouTube, LifeXtenShow, and we just recently started to work on documentaries focused on the longevity industry. Apart from that, we are hosting an annual scientific conference on aging in NYC.
We need to go from 7% to 100% of people properly informed on rejuvenation biotechnology. Literacy defines attitude and preparedness. Right now, a lot of people live their lives as if nothing major were happening. In reality, the creation of longevity technologies will affect all aspects of our lives, and this influence will manifest in the near future.
How do we ensure technology transfer to every country? How do we control prices and ensure equal access to rejuvenation or priority access for people who are suffering from age-related diseases? If we will be able to rejuvenate old people, what has to be done to ensure their inclusion, re-education, and employment? Do we need to control population dynamics proactively? How will indefinitely long youth, which is now on the horizon, reflect on our long-term strategy as a civilization? We can’t find proper answers to these questions alone; we need a global dialogue.
Predict: Many of us have read work by or listened to interviews of Dr. Judith Campisi or Dr. Aubrey de Grey, well known for research into senolytics and regenerative medicine, respectively. Both are also scientific advisors of LEAF. Are there any life extension researchers that you feel need more recognition in the field?
Elena: Yes. It is women. Female researchers have already greatly contributed to the field. People like Drs. Judith Campisi, Linda Partridge, Cynthia Kenyon, Vera Gorbunova, Maria Blasco, Irina Conboy, Morgan Levine, Amutha Boominathan and Polina Mamoshina have already stamped their names into history. We are lucky to have thought leaders like Laura Deming, the head of Longevity Fund, Dr. Daria Khaltourina, a public health advocate from the International Longevity Alliance who is in negotiations with WHO about considering aging a disease, Dr. Natasha Vita-More, the Executive Director of Humanity+, Inc, a tireless proponent of life extension technologies, and Tina Woods, who is doing top-quality journalism in our field and runs the All-Party Parliamentary Group for Longevity in UK. However, there are many other brilliant women who have important things to say if we pay attention to equal representation.
My call to all longevity supporters is, please, invite more female researchers and public figures to your events. When there are only men on stage, it looks disappointing and short-sighted. There is no lack of women among the researchers. Apart from that, women are primary health decision-makers in their families, and they are primary caregivers to the old, too, in most countries. Sociological studies show that they are as supportive of healthy life extension as men, but they are much less active. In order to become a more active part of the longevity community, they need role models; they need to see female thought leaders on stage.
Predict: Is there one specific challenge to the life extension community or the research work itself that is proving very difficult to overcome? How can we (or anyone) help?
Elena: Typically, when we interview researchers, they don’t complain about the complexity of their studies. It does not mean that the biology of aging is an easy subject, but if enough work is put into it, things can be studied and eventually understood. What they do complain about is a lack of funding. Lab equipment, reagents, mice, mouse food, drugs to test, lab specialists’ salaries — all these things require money. The same is true for advocacy activities. To maintain a news outlet, one needs to pay for writers, editors, website support, and social media marketing; to give a talk at a conference, you need to pay travel costs; to attend a meeting with wealthy individuals, you often have to pay the registration fee. Lots of what we at Lifespan.io are doing is happening thanks to the generosity of our donors, and it is the same for our colleagues at other pro-longevity organizations.
The best way to help is to focus your charity activities on supporting one or several non-profits doing or advocating for rejuvenation research. Aging kills over 100,000 people per day. It is the biggest source of human suffering in the world, as it affects more people than all current wars, infectious diseases, traffic accidents, natural disasters, and acts of terrorism combined. The donations supporting longevity research and advocacy can have the biggest positive impact on human life of all.
Predict: What recent developments in life extension have you most excited and optimistic?
Elena: The fact that there are several senolytics in human clinical trials and the fact that we are gaining more control over cell behavior. Senolytics are drugs that selectively remove senescent cells, which have impaired function and no longer divide. Treatment with senolytics shows impressive results in small mammals, up to partial reversal of age-related changes in several organs and tissues. If you look at the Rejuvenation Roadmap, our curated database that tracks the progress of rejuvenation biotechnology companies and research institutions, you will see that the section on senolytics is well populated. I personally am very curious to see the results of the U.S.-based Mayo Clinic’s tests on fisetin, a natural senolytic. They are expected this summer, and I hope that Dr. James Kirkland, the head of the study, will tell us something encouraging.
Regarding cell behavior, it is a large field, but I will mention just one example to explain why I am so excited about it. The laboratory of Dr. Helen Blau at Stanford is working on the problem of sarcopenia — muscle tissue loss due to aging. One of the reasons why we lose our muscles with age is that muscle stem cells are deactivated. Dr. Blau’s team has identified the factors that can switch on these stem cells, thus leading to gaining muscle tissue back. They are now working on a molecule that can do that in people, and if they succeed — or when they succeed — we might not suffer from sarcopenia ever again. You would just need to be taking a pill against it starting from, say, 60 years old, and it will keep your muscles strong and prominent.
Predict: How do you see the technologies of transhumanism, such as cybernetics and brain-computer interfaces, fitting into the biological side of life extension?
Elena: I will start by saying that medical devices are already playing a big role in aging research. Simple step counting on your smartphone or fitness tracker, combined with a health check-up, provides important data that longevity researchers can use. Apart from wearable devices, there are implants that can monitor your health parameters and even intervene if necessary, releasing drugs or hormones that your body needs to maintain health.
The more data we collect, the more we know about our bodies and the better we will be able to control our health and our longevity — especially if big data analysis with neural networks is engaged.
Actually, the application of AI to medical research deserves a separate mention. Last year, the artificial intelligence company Insilico Medicine has used machine learning to find credible drug candidates in a matter of 46 days. Just to put things into perspective, researchers usually spend years on finding a good candidate. The way that AI has accelerated this process is incredible. The best part of it is that the head of this company, Dr. Alex Zhavoronkov, is a long-term proponent of bringing aging under medical control, and it is planned to use this technology to identify drugs that target the root mechanisms of aging as well.
As for brain-computer interfaces, I have not been following recent developments, but I think that they will be soon helping us a lot in understanding the human brain and consciousness, paving the way to faster communication, education, and decision making.
Predict: Is cryonics a viable stopgap measure in the eyes of the life extension community?
Elena: I cannot speak for the whole community, but I can state my opinion. During human history, the point of no return (the moment after which it was impossible to bring a person back to life) has been progressively delayed. It used to be minutes, now it is already hours. In 2014 in Pittsburgh, and more recently at the University of Maryland School of Medicine, there were studies where people were put in a state of suspended animation for several hours in order to perform a complicated medical intervention. The method is called emergency preservation and resuscitation (EPR) and it implies cooling the patient to 10 to 15 degrees Celsius, which is a state of hypothermia.
This hypothermia, during which the patient is in a state of clinical death, allows pushing the point of no return further. For suspended animation, it is several hours. In the case of cryonics, it is decades or even centuries. One can argue that the medical technology that is required for bringing back cryopreserved people must be much more powerful than the one that is used for reversible hypothermia, and, right now, it does not even exist. This is accurate. The state of cryopatients is typically much worse, so they are far beyond the point of no return. However, the amount of time reserved by cryonics is also much larger, and there is a good chance that during this time, the necessary medical technology will be created.
To express my view on cryonics, it would be enough to say that my cat Laska is cryopreserved, and I plan to have a cryocontract for myself and my family members. I love life, I don’t want to die and disappear, and I think that having even a small chance to keep living is better than no chance at all.
Predict: Where do you see the near-term future of life extension research leading? How long might people expect to live in 2050, in 2100 or beyond?
Elena: That is a very good question. And a big question. In the last two centuries, we have achieved impressive growth in life expectancy, which was mostly due to reducing child mortality. One should understand that when you are saving the life of a child, you are getting a lot of added years as a result, and the overall life expectancy grows quickly. However, the biggest causes of death are currently age-related diseases. When you save an adult from a single ARD, that person only gains a few more years of life. It largely explains why life expectancy is not growing that fast anymore, and why in some developed countries where there are negative lifestyle changes, such as the epidemic of fast food loving and corresponding obesity, it even started going down. You can check my recent interview with the demographer of aging Dr. S. Jay Olshansky for more details.
So, I will put it this way. People who maintain a healthy lifestyle (healthy eating, a lot of physical activity, stress management, good sleep, social inclusion), and who have access to rejuvenation biotechnologies as they arrive, will probably be able to live past 120 in the next 20 years. That is to say, the current healthy centenarians with access to the most advanced longevity therapies should be able to live past 120.
In reality, however, the knowledge about longevity treatments and longevity lifestyle is poorly disseminated. Do you remember when I said that 4–7% of people are informed of longevity research? The share of people who know the practical side of it is greatly smaller. This knowledge is also poorly applied, and the existing treatments, including classical modern medicine, are not available to the majority of people. So, we have some knowledge and some means, but we can’t really benefit from them just yet. On the population level — absolutely not.
I, as a moderate biohacker, have to analyze lots of scientific literature and educate myself on the matter in order to keep track of the most promising trends and compose my strategy of longevity maintenance. Keep in mind that it is easier for me, as I deal with the researchers of aging on a regular basis and I learn things directly from them, sometimes even before they get published. I am spending quite a bit on extensive check-ups and medical advice, and it looks like what I am doing works for me. But is this strategy optimal? Am I using everything that I could? I don’t think so.
So, instead of asking how long might people expect to live in 2050, I ask myself and the readers another question: what has to be done so that people in 2050 could live past 150?
First, the dissemination of knowledge about the advances in rejuvenation research. Learn a little bit yourself, then talk about the promise of longevity with literally everyone around you. Informing others is our duty as good relatives, friends, and neighbors. I use each opportunity; I even speak with people who sit next to me on a plane when I am going to conferences. This is the only way we can give people around us the possibility to make informed decisions about their life and health. In a way, it is our moral duty.
Second, the allocation of additional funding to rejuvenation research. You can talk to your local officials, you can ask your colleagues to donate to research organizations or advocacy organizations together with you, and you can try convincing wealthy individuals or your company to become a patron of some research group or study. Donating to aging research is the most effective sort of charity activity because targeting aging would bring relief from the greatest source of suffering.
Third, engage in informing the government in your respective country in order to ensure a green light for rejuvenation technology transfer, local clinical trials of longevity treatments, easier procedures of registration for proven therapies, and reasonable prices.
Fourth, find a good source of news on the matter, and keep track of it and educate yourself deeper on the existing means of preserving and extending health. Start taking better care of yourself and try implementing everything that is evidence-based and becomes available to you and your family. The more people will do that, the larger will be the impact on the population level.
Fifth, find meaning in life. If you are to cross the limit of 120 years, you better have a strong reason why you should go on. Even if you reach the point where aging will be fully under medical control, life is not going to become easier; it is just going to be difficult in a different way. For me, to live to the end of this century will mean somehow coping with climate change, global migration, ecological problems, a food crisis (expected around 2030s), an economic crisis, and the drug resistance problem on top of population aging. I am an optimist; I believe in human ingenuity and human potential. However, I am a scared optimist, which is why I am not only working on aging but also doing what I can to mitigate other issues that humanity has or going to have in the near future. My drive is a love for life and curiosity. I hope that somewhere on the path to extreme longevity, you will find yours, and then we’ll celebrate 2100 together.
Predict: Thank you very much for taking the time to answer our questions, and for helping promote scientific endeavors that will benefit us all.