The Longevity Dividend

The attractiveness of aging economies as an investment target

One could ask: what is interesting or attractive about aging? Is it not dreary and almost dreadful to speak about aging? Is aging and death not inevitable? Why not accept it as a fact of life?

Well, wait a minute. Human history is full of scientists turning dreadful, dreary situations into opportunities and saving billions of lives. Remember the discovery of antibiotics and the impact they had in saving and extending lives? We live in an age where we come across breathtaking breakthrough scientific discoveries every day in one field or the other. To say that finding medicines to cure aging should be left to fate is almost laughable.

If aging were a phenomenon that ended peacefully and had no suffering associated in the form of a plethora of age-related diseases — and, mind you, did not present an enticing scientific challenge — we could have overlooked it as a non-issue. It is increasingly being accepted, however, that most chronic diseases have one common causal factor: aging. The human body is a highly coordinated machine and can be thought of as a web of highly coordinated networks. In youth, any imbalance is countered by built-in checks and bounds and repair mechanisms. Prolonged usage of these, however, can result in evasion of the repair mechanisms that ends up in the damage that can be defined as aging.

Average longevity almost doubled over the last century. The global population of those aged 60 and older more than doubled from 1980 to 2017 (reaching 962 million), and societies having to bear the burden of aging populations had to pause and rethink their strategy on aging, from negligence and acceptance as an inevitable fate, to a resolvable condition driving a burgeoning industry. A few statistics that argue the case for the necessity for aging interventions include:

• In 2015, the aged population (50+) was at 1.6 billion and by 2050, the aged population is poised to hit 3.2 billion (1).
• With birth rates tumbling, the global population is inevitably becoming older. By 2100, a quarter of the world population will be aged 60 or above (2).
• A Health care survey showed that more than 60% of the healthcare spending was by 60+ and with the world population aging, 1 in 8 people were 65+ in 2017 and 1 in 5 will be 65+ by 2050 (3).

According to CNBC, two Bank of America Merrill Lynch analysts stated in a recent report (4) that one of the biggest investment opportunities over the next decade will be in companies working to delay death. With a market size already at $110 billion, it is expected to be worth at least $600 billion by 2025, highlighting the importance of the longevity industry and why it should be a focal point for investors.

When the percentage of population that are 65+ is tabulated by country, those with the largest aging populations are Japan (28%) , Italy (22%), Greece and Portugal (21.8%) , Germany (21.4%) etc. (5). These are sometimes termed “super-aged” countries (more than 20% of the population over the age of 65). With a combination of falling fertility rates and increased life expectancy, population age profiles are changing rapidly, attracting the attention of policy makers and the mindsets of the public, as the focus shifts at 65+ to retirement, pensions and ill health.

Given the magnitude of the problems involved in rapidly changing demographics and of the economies involved, this field is fast emerging to be the challenge that every country, and every scientific community, wants to take on and solve.

Let’s try and distinguish between two popular terms: healthspan and lifespan. Lifespan is simply the time between birth and death, whereas healthspan is the time between birth and the point at which one or more currently incurable health problems of old age become significantly debilitating. Both terms can be used to refer to a single individual or to a population; in the latter case we can speak of average lifespan/healthspan, or (as is often of more interest to biologists, though of less interest to demographers) maximum lifespan/healthspan. Many variations on these themes are commonly seen: for example, one can turn these numbers around and get the proportion of a population that lives (or lives healthily) to a given age. There is one key drawback inherent in the concept of healthspan, however: two people (even two researchers) may have very different definitions of how severe a person’s loss of function must be before it is classed as significantly debilitating. It is this that underpins often uninformative debates concerning, in particular, whether lifespan is rising faster or slower than healthspan in a given population.

The “geroscience hypothesis” states that most, if not all, diseases of aging have shared molecular roots that are collectively defined as the “hallmarks of aging”. Irrespective of how many hallmarks any given scientist believes in, or what nuances are used for classification into one or the other hallmark, the advantage of this hypothesis is that these suddenly become defined problems with defined solutions. Technological advances are being made every day, with more and more druggable targets, underlying pathways and repair mechanisms being discovered.

The perception of policy makers is changing in line with these discoveries. The economic and health impact is being realized and the race is on to fund these and make wide-ranging changes to accommodate these emerging areas of research. An international delegation of scientists organized by AFAR (the Alliance For Aging Research) coined the term “Longevity Dividend” to define the economic and health benefit of decelerating aging and extending healthspan. This group of more than 90 scientists and advocates from 19 countries stated “we now believe that extending the duration of healthy life in humans by slowing down the process of aging is a scientifically plausible goal” (6). They drew attention to some very disturbing data:

• The cost of Alzheimer’s disease is currently more than 100 billion and could quadruple by 2050
• In less than 10 years from now, more than 300,000 new prostate cancer cases will be diagnosed, a 50% increase since 2004
• More than one million Americans will have a first stroke every year by 2050, an increase of 167% for men and 140% for women (6) (7)

These statistics highlight the opportunity that lies in finding ways to resolve such health issues. The spending power of those over 65, sometimes called the “grey economy”, is making longevity one of the most coveted fields that attracts students, researchers, investors and, critically, the interest of policy makers.

But wait: wasn’t that logic just as true when the Longevity Dividend initiative was first launched? Indeed it was. Back then, however, progress in the laboratories of geroscientists around the world was still fitful and fragmented — to the point that it was still unfashionable, even risky for one’s career, to claim that serious medical progress against aging was on the horizon. That is no longer the case: in fact, it’s almost become the case that the reverse is true. Thus, policy-makers can no longer hear the Longevity Dividend message and walk away thinking that it’s all very logical in theory but that theory is all it will ever be. The age of medical progress against aging is well and truly here, and that’s why so many companies — and, yes, venture funds — are betting on it.

Let me close by just giving one illustrative example of how these numbers of people translate into numbers of dollars, so that you understand the ways in which healthspan extension research pays for itself. When 80 becomes the new 60, “workspan” (the time that the average person stays in the workforce) increases. As a result, estimates for the UK suggest that an increase in the working age by just one year can increase the GDP by 1%. (8)

References:

1. https://www.oxfordeconomics.com/recent-releases/the-longevity-economy
2. https://www.theneweconomy.com/business/the-longevity-industry-comes-of-age
3. https://www.un.org/en/development/desa/population/publications/pdf/ageing/WPA2017_Highlights.pdf
4. https://www.cnbc.com/2019/05/08/techs-next-big-disruption-could-be-delaying-death.html
5. https://www.prb.org/resources/countries-with-the-oldest-populations-in-the-world/
6. https://www.agingresearch.org/press-release/in-pursuit-of-the-longevity-dividend/
7. http://sjayolshansky.com/sjo/Background_files/TheScientist.pdf.
8. https://www.pwc.com/gx/en/news-room/docs/pwc-golden-age-index.pdf

Prime Movers Lab invests in breakthrough scientific startups founded by Prime Movers, the inventors who transform billions of lives. We invest in companies reinventing energy, transportation, infrastructure, manufacturing, human augmentation, and agriculture.

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