00:00hi and welcome to the a 16z podcast I'm
00:03Hannah and today we're talking about the
00:06science of life extension are we finally
00:08just around the corner from a treatment
00:10for getting old in this episode we talk
00:13about where we are in the field of
00:14geroscience which is the study of aging
00:17itself and aging as a major risk factor
00:20for diseases sometimes the buzz makes it
00:22seem like this is about the search for
00:23immortality but it's really about living
00:26a longer life of being healthy our
00:28health span we talk about all the
00:30anti-aging discoveries that look like
00:32they might translate into real treatment
00:34how these therapies will be delivered to
00:37us and what happens to society if they
00:39do work the first voice you'll hear is
00:41dr. Thomas Rando from Stanford who
00:43directs the Glenn Center for the biology
00:45of Aging then a 16-0 partner Vijay
00:48Pandey joined by Kristin Fortney CEO of
00:51bio age so let's start off with a simple
00:53question where are we now there's a big
00:56discrepancy between the notion of life
00:58extension and the notion of health span
01:01extension and that's a big distinction
01:03in the field right because life
01:05extension sounds like this issue of
01:07moving toward immortality and in fact
01:10really the the field in terms of
01:12biomedical field really focuses on
01:15taking what we learn from lifespan
01:17extension in model organisms in worms
01:19and flies and applying that to humans to
01:23mammals to make them healthier not to
01:26make them live for it forever and so
01:27it's a dichotomy between the goal being
01:29extending life versus the goal being
01:31extending health which might secondarily
01:33lead people as a population to live
01:36longer so that's an important
01:37distinction because so much
01:39experimentation goes into lifespan
01:41extension in animals but really the
01:44translation is making people healthier
01:46longer yes they may live a little longer
01:48but what we really want to do is have
01:50them live longer in a state of better
01:53health and a much shorter period of
01:55disability at the end of life because
01:56what's the point of living longer if
01:58you're unhealthy exactly it's not
02:00impossible to imagine instead of that
02:03curing all disease would be harder than
02:06curing one disease or diseases with the
02:09idea that when you have an antibiotic it
02:12in high doses will kill bacteria in the
02:14petri dish but in your body is it really
02:17killing them bacterias are simply
02:18weakening them as such that then your
02:21immune system kicks in and so it's so
02:23about your immune system more than it is
02:24about the drugs is this really something
02:26different than health care and affecting
02:28human health I would see as the natural
02:30next step I think about life extension
02:32very much as the ultimate endpoint for
02:35improving health care and why we're
02:37doing this in the first place so can you
02:39describe to us some of the recent
02:41science that you think is really
02:43exciting because it's felt like for a
02:45long time we're sort of right around the
02:46corner from a major breakthrough are we
02:49now or is that still to come certainly
02:51in the field of aging across say the
02:53decades there's a pivot happening now
02:56that I think is really remarkable it's
02:58it's changed a lot in the last two
03:00decades and then every five years you
03:01see another big increment in terms of
03:04not only our knowledge but how we
03:05approach this I would say that the
03:07conceptual change that's happened over
03:09the last ten years is this notion quote
03:11of geroscience and that is this idea
03:13that if we can understand the process of
03:16Aging and if we can do something about
03:18it if we can intervene with with a pill
03:20or an intervention and we could actually
03:23slow the process of aging the
03:25consequence of that would be the delay
03:28in onset of all age-related diseases
03:32conceptually theoretically so if that's
03:34true that really changes the way we
03:37think about health because this is
03:39preventive health in a way that's not
03:41been imagined before and how how is that
03:43different from how we used to think
03:45about it and approach it the field of
03:47aging has only reached that kind of
03:48mechanistic intervention stage in there
03:51in the last recent years having said
03:53that this idea of caloric restriction
03:55extending lifespan has been round firm
03:56since the 30s however that has just
03:59always been in the background people
04:01have mostly described aging and
04:02described age-related changes it's
04:04really been since the really discovery
04:07of individual genes and individual drugs
04:09that can extend lifespan let's change
04:12that from kind of a conceptual field of
04:15here's what happens when we age that
04:17describes it to something we can do
04:19something about but those are those days
04:21usually are on model organisms almost
04:23all almost all and well there
04:25closer is the point I think like to me
04:27the exciting point was that in the 1990s
04:29in the early 2000s we found a lot of
04:31interventions single gene interventions
04:32or drugs that extend life in yeast or in
04:35flies or in worms a lot of progress was
04:37made in invertebrates and that's because
04:38you can knock out every single gene you
04:41know in a worm and see what happens you
04:43can't do that in humans and really it's
04:45really been the last decade where
04:46they've been some successes in mammals
04:48right there's grapa myosin and mice
04:50there's senescent cells clearance and
04:51mice so we're getting closer and closer
04:53to humans which i think is what's really
04:55exciting about the state of the field
04:56right now the field has focused in
04:58academia on invertebrate models because
05:01they're sort of more attractable they
05:02have shorter life spans but because of
05:04sort of new genomic technologies we can
05:05actually finally directly study human
05:07aging which is me most relevant to
05:09extending our health spans which is also
05:11a fairly recent innovation well actually
05:14could you go into that one more I mean
05:15that that part actually is super
05:17interesting because you know just
05:19naively I think that a lot of people
05:20would think if you're trying to
05:21understand life extension or health
05:23extension for ten years that would be a
05:25very difficult state to do in under ten
05:27years yeah I completely agree with you
05:29if we have any putative intervention
05:30that we think is going to extend mouse
05:32or human lifespan how do we actually
05:34test that without waiting decades and I
05:36think that we finally have the
05:37opportunity to build real biomarkers
05:39using genomic data so we can sort of
05:42measure something in your blood that
05:43tells you what your biological age is
05:45and then after a drug or some other
05:47intervention measure it to see if it's
05:48improved so we can sort of really
05:50accelerate these discoveries so I've
05:53always been very interested in
05:54biomarkers as surrogate endpoints and
05:56these technologies are just coming out
05:58now and I think they're really going to
05:59accelerate progress to find new
06:01therapies for human aging yeah mr. Shi
06:03you cited by that approach because that
06:05gets to not your sort of chronological
06:08age but your degree of healthiness exact
06:10which is what we really care about
06:11exactly and I think you know the idea of
06:13having biomarkers is going to accelerate
06:16this field enormous Landin currently the
06:18notion of using drugs in humans is
06:21underway but the idea is you take a lot
06:24of people you watch them for a long time
06:25and you watch the onset of age-related
06:27diseases but even you know even looking
06:30for the onset of disease as opposed to
06:31looking for the end of their life you're
06:33still talking decades so if we could
06:36have a marker that over year to year
06:38could predict the rate of aging and
06:40slowing that aging we would have a much
06:43better handle on how effective any
06:45treatment we have would be from the pop
06:47culture perspective like caloric
06:48restriction this idea of old blood and
06:50new blood some of the actual science has
06:53roots in old ideas and some of it is
06:56based in completely new ideas can you
06:58break those down a little bit so that we
06:59know what we're kind of looking at
07:01there's a lot of Mythology it's very
07:05different so there are a lot of ideas
07:06that are out there now this idea of old
07:08blood and young blood actually comes
07:10from from our work from early 2000s
07:12having said that this idea has been
07:14around in the mythology for centuries in
07:18the 17th century so you know this is so
07:20they were right somehow but so what do
07:22we really know about that what we really
07:24know these days is that it does seem
07:26that if you infuse components of a blood
07:30from a young animal into an old animal
07:31it actually can revert some of the aging
07:34phenotypes from an old state to a
07:36younger state which is something quite
07:38different because that's really
07:40reversing aging as opposed to slowing
07:42aging but that's what we know we don't
07:44know like how much it would take we
07:46don't know you know where this mythology
07:48came from I don't even know I don't
07:50really know how this came about but it
07:52turns out to be quite accurate in terms
07:55of thinking that really what I think the
07:57idea is that there are circulating
07:58factors in the blood that are very
08:01promoting of youthfulness in the young
08:04individuals young mice young humans and
08:07the older we get the more in the blood
08:08are factors that suppress that
08:10youthfulness or promote aging we'd love
08:13to know what those are and we'd love to
08:14be able to use those to develop
08:17interventions that would actually either
08:19slow or maybe even to some extent revert
08:22the aging phenotypes and it speaks to
08:24the predictive capability of those
08:26biomarkers that said you can actually
08:28not just use that for DX for rx it means
08:31that there really is something there
08:32that's right what are some of the other
08:35approaches that you're keeping an eye on
08:37at the moment that seem particularly
08:39fertile for extending the health span of
08:41a life yeah there's a few different
08:43things that have shown promise in a
08:44million systems so there's a pair of
08:47iosys as Tom discusses his which is his
08:49expertise there's also senescent cells
08:52so when your cells when you're older a
08:54lot of your cells you know after they've
08:56replicated a bunch of times they get
08:57sick and when a few things can happen
08:59they can a potosi or they can siness
09:02which is a sort of state of permanent
09:04growth the rest where they become
09:05actively toxic and they recruit your
09:06immune system and there was his
09:08hypothesis for four decades in the
09:09literature that these senescence cells
09:11were actively bad for you and you could
09:12if you could just destroy them that
09:14would be better and that was really sort
09:16of tested for the first time in a really
09:18strong paper that came out just over a
09:19year ago from the Mayo Clinic and the
09:21buck Institute it was a big
09:22collaboration and they showed that if
09:24you killed senescence cells in a mouse
09:26you could boost lifespan by 30% and
09:28that's a very hard results which even a
09:30mouse so that's really exciting the
09:32search is on for drugs that can kill
09:33senescence cells in these animals and
09:35that should translate to humans as well
09:37it's a really sort of mechanistic
09:38hypothesis for aging
09:39it speaks um one question I have which
09:41is what would this look like would this
09:44look like a small molecule that actually
09:46would if you take it every day as some
09:48sort of supplement would would it help
09:50your aging I mean what do you think the
09:52technology is gonna lead to in terms of
09:54the short term versus long term well I
09:56think in the case of that technology
09:58which is called Senna lytx license
10:01senescence cells it would be and it is
10:04being pursued as a small molecule
10:05treatment now what we really don't know
10:07is can you take these for a long time
10:09what are the what are the downsides of
10:11killing all your senescence cells
10:12there's some indication that senescence
10:14cells can actually be beneficial you
10:16might not need to know right if it's
10:17just you know right you can just
10:19accumulate you know take them take a
10:20once a month take well who know we don't
10:22know this but that definitely is a small
10:25molecule approach and so it has the
10:27flavor of a therapy that could be turned
10:29turned into a pill mm-hmm the plasma
10:32coming from the para bios's worked that
10:34idea of plasma infusions you know
10:36actually can be done but it's much more
10:37invasive you have to inject plasma to
10:40people we really don't know we don't
10:41know this at all in terms of lifespan or
10:44health span in humans right do not try
10:46this at what we know what we see that
10:51translating to is is a protein therapy
10:54you know it is a component of the blood
10:55that might be a protein it could be
10:58but that one could take or even an
11:00antibody treatment to neutralize an
11:03aging factor you might want to get rid
11:05of something in the blood as
11:06wants to add something so both of those
11:08are are feasible they're in line with
11:11you know major selling drugs around the
11:13world proteins are antibodies so one can
11:15envision a non small molecule a non pill
11:18approach that might also have that kind
11:20of benefit I can imagine a
11:21science-fiction story right now because
11:23you can develop an antigen for that
11:26antibody and now you have a vaccine for
11:28aging you know the role of data because
11:34not just right about finding them all
11:36the molecule in the protein it's also
11:37about how we process the knowledge yes I
11:39mean that's a whole feeling itself
11:41innocence Howard modern technologies
11:43outside of biology having an impact here
11:46for instance computation data science
11:48machine learning is that playing any
11:50sort of role yeah I think that's playing
11:52a very large role if you want to
11:53understand human aging you have to use
11:54you know non invasive technologies that
11:56can monitor people throughout their
11:57lives and that's that basically means
11:59genomics that means transcriptomes
12:01RNA that means looking at all the
12:03protein levels in your blood looking at
12:05the metabolites in your blood so I think
12:07that those new technologies that sort of
12:08let us study human aging in some ways
12:10for the first time did they accelerate
12:12it I mean are we still in a position
12:13where we have to actually watch people
12:15age you know decades to know whether
12:19that first there is a way around that so
12:23you can work with there are fortunately
12:25a lot of sort of forward-looking bio
12:26banks often in European countries that
12:28have mold human samples in the freezer
12:30complete with electronic health records
12:33so you can go and get those samples and
12:34you can query them with new modern
12:36technologies and you can integrate that
12:38with health records and say can I
12:39predict on the basis of a combination of
12:41things I can measure in blood you know
12:43who's gonna live for ten years versus
12:46who's gonna live for 20 years and what
12:47were those samples taken for what was
12:49the context of this Bank yeah lots of
12:51these bio banks you know it was they had
12:54the exact right idea they thought that
12:55new technologies will be able to you
12:57know this this will be useful in the
12:58future so we're gonna start storing it
13:00now Wow yeah yeah so we work a lot of
13:03with a lot of those and I'm pretty
13:04excited about that and the second answer
13:06to that question is that I think that
13:08aside from accelerating research into
13:10human aging it's also accelerating
13:12research into mammalian aging in general
13:14because even with mice if you want to
13:16see if a drug makes a mouse
13:17live longer you do that's a three and a
13:19experiment the National Cancer Institute
13:21the total number of drugs they've given
13:23to mice to see if they cure mouse cancer
13:25is over a hundred and ten thousand the
13:27number of drugs the National Institute
13:29on Aging has given to mice to see if
13:30they live longer is thirty no so you
13:33know basically zero even though they've
13:35only tested thirty there's already been
13:36one success rapamycin that came out of
13:38that which which is a very exciting
13:39discovery basically the first molecule
13:41that came out of this large-scale
13:42program they started to feed it to mice
13:44at middle age and they found that the
13:47mice that got the rapamycin lived about
13:48thirty percent longer than the mice that
13:50didn't and it delayed the onset of
13:52pretty much every bad age-related
13:54phenotype or disease so it's something
13:56that if it worked that way in humans
13:57we'd all love to take there's of course
13:59safety issues but this is exactly the
14:05kind of therapy that we're looking for
14:06and I think there's going to be a lot of
14:07other success stories once we have a
14:09system for you know evaluated many more
14:12drugs than thirty so I think there's a
14:14lot of low-hanging fruit there what is
14:16intriguing about the ability to get this
14:19information from blood whether we're
14:20talking about markers or we're talking
14:22about the ability for this to be
14:23therapeutics this is something where we
14:25can be dealing with the science of this
14:26now in an age where a lot of this is
14:29perhaps often been more speculative and
14:33uncertain for whether it's really useful
14:35that's the part that that I think makes
14:37me think there's something different in
14:38this what we're seeing today so if this
14:41time is different we're gonna start
14:43seeing a whole bunch of new businesses
14:45and startups in the space what is it
14:47like to start a business up in this area
14:49what's it like to enter in the scene
14:51from the business side you're dealing
14:53with a lot of very entrenched incumbents
14:54a lot of different interests and
14:56invested parties what are some of the
14:58challenges and how do businesses begin
14:59to navigate them yeah that's that's an
15:02like you know biotech companies drug
15:03discovery companies have a lot of
15:04challenges to face and I think there's
15:06even more in the case of an aging
15:07company because even if we do discover
15:09another rep of mice and another drug
15:11that slows aging then what's the FDA
15:13indication for that how do we get that
15:14approved as a therapy so again we can
15:17sort of look back and see what happened
15:19with rapamycin and right and there are
15:20pharmaceuticals companies that are
15:22trying to work with they call them rep
15:23alocs their sort of chemical analogs are
15:25fo Meissen and they're basically just
15:27sort of throwing them against various
15:28age-related diseases to see what sticks
15:30because that's how you get better api--
15:32approved at the FDA you have
15:33to have a particular disease indication
15:35and at there a drug that slows aging
15:37when you give it to healthy people isn't
15:39necessarily going to be the best therapy
15:40for someone who's already very sick so
15:43that's that's sort of a unique challenge
15:44that we're facing there's a team trial
15:46so yeah so that's the trial for of using
15:48this drug metformin which is a commonly
15:50used drug for diabetes but has also been
15:53shown to extend lifespan and model
15:55organisms and lots of Americans are on
15:57it and there's there's epidemiologic
15:59data which is associative it doesn't
16:01prove causal effect that metformin
16:04treatment actually does enhance lifespan
16:06especially people who have diabetes so
16:09the notion is maybe everyone will live
16:12longer if they take the med foreman so
16:13especially in people who have diabetes
16:15but also in people who do what
16:16epidemiologic data is that so there's no
16:18epidemiologic data on anything don't
16:20have a starting point for taking
16:21metformin because they're not on because
16:23it doesn't happen right right so but but
16:25the question is because it happens in
16:26healthy animals and in some humans maybe
16:29it happens in all humans so the trial is
16:32to give a subset of patients who are
16:35healthy metformin and as we were saying
16:38before watch for the onset of
16:39age-related diseases over a long time
16:41period with the idea that if it works in
16:44this kind of geroscience way you know
16:47treating Aging to treat all diseases all
16:50of these diseases will come on later in
16:52this group of patients on metformin
16:53versus those on not on metformin and
16:55part of the real fundamental shift here
16:57is usually one would think treating two
16:59diseases or three diseases is much
17:01harder than one but this perspective is
17:04by attacking the central aspect that's
17:07common to all you can't address many
17:09diseases at once that's right so it's
17:11really not treating three diseases it's
17:14really it's it's the notion is that it's
17:17preventing the notion is that that agent
17:20whether the concept that's out there's
17:21aging is the major risk factor for all
17:23of these nieces heart disease cancer
17:25Alzheimer's disease and that if we
17:27understood why older people get all
17:29these diseases and we could get at that
17:31fundamental mechanism we could in theory
17:33delay all of these I don't know what the
17:36right latin is but you know there's DX
17:37and rx we should have px or sometimes
17:41new class of how we think about this
17:43well yeah in some ways it might be an
17:45easier problem right like if some
17:47presents with late stage lung cancer
17:48fixing that drugs to fix that that's
17:50that's really hard you know it's it's a
17:52it's you come and you're very damaged
17:53system but what we know from these these
17:56most trials of drugs that delay aging
17:58you can intervene when the system is
17:59still mostly working and you can just
18:00nudge it in the right direction and
18:02delay the onset of all these stabilities
18:04so that's at the root cause right all of
18:07these approaches are getting at the root
18:08cause not all the symptoms and diseases
18:10that are associated that so how does
18:12that tie back into your conceptual
18:14framing of it as how increasing
18:16yeah i mean it is increasing health span
18:19because obviously avoid these
18:21age-related diseases by staying young i
18:22eyeing this fundamental shift of towards
18:26prevention being more than just eat less
18:28or exercise prevention meaning what yeah
18:31so prevention meaning like potential
18:33small molecules or other types of things
18:35we would consider as therapeutics but
18:37for the disease being aging itself in
18:39sometimes and and that's gonna take our
18:41shifts is gonna be i have to be a shift
18:43in how i think about from a regulatory
18:44point of view how we think about it from
18:46a clinical point of view part of i think
18:48the challenge here is not just the
18:50science but shifting that mindset i mean
18:51i think that's really important what
18:53christmas saying before about this
18:54notion of fda regulations is going to
18:57have to change because there's no way
18:58right now that any any drug is going to
19:01be approved for treatment of healthy
19:03people and is that because of the time
19:05because it takes so long or is it no
19:07it's just just the historical context
19:09and i remember so probably 15 years ago
19:11i was talking about our work to
19:13accompany a big pharma company about
19:15this idea which you know we were it was
19:18way ahead of the time back then because
19:20we really didn't have even the knowledge
19:21of this but this idea that one could
19:23potentially treat aging and i wouldn't
19:26say they left me out of the room but but
19:28at the end of the day the answer was
19:29that will never happen because it will
19:31have to be as safe as water well because
19:34it will never be approved for it to give
19:36a drug to healthy people unless it's as
19:38safe as water and the premise of that is
19:40because no because you don't want to
19:42mess up right things can only go wrong
19:45essentially don't we would have no trial
19:48basis to say over the course of you know
19:52decades that it works you're still
19:53healthy you're still healthy so it would
19:55take a very long time now again that
19:57mindset is shifting that that i think
20:00now the notion is maybe we can treat
20:02healthy people in a preventive way and
20:05it doesn't have to be as safe as water
20:06has to be very safe but but that's the
20:09big change how do you see it starting to
20:11shift a little bit well even this tame
20:14trial being discussed and being
20:16presented to the FDA and the FDA
20:17discussing it is already a major step
20:20forward I mean that that would not have
20:22happened 10 years ago
20:23so I think the the caveats and the
20:26constraints are being loosened and we're
20:29moving that in that direction we're not
20:30there we'll see how this first yeah I'm
20:33really excited by the team trial and by
20:34what they're doing I think there's a lot
20:36that can we can do in parallel to like
20:38like companies in this space what we
20:39have to do basically is choose a
20:40particular disease indication get
20:42approved for that disease indication and
20:44then hopefully be used more broadly or
20:45interesting it's almost like an
20:46artificial specification that's right so
20:49everyone would like sort of a story like
20:50statins which basically are an aging
20:52drug now the indication is oh you're
20:53over 40 have some statins that's more
20:55the mayor and well but statins are
20:58actually approved in practice right so
21:01that's sort of the path that we would
21:03like to take with any sort of therapy
21:04that we'd like to take forward so there
21:05is still the hope that even though it
21:07gets approved for a narrow indication it
21:08can be used more widely when people
21:10realize what the benefits are and when
21:11it's you know been through the process I
21:13think one of the challenges for the
21:15companies will be picking the indication
21:17yes challenge because it could fail in
21:21certain indications and you could throw
21:23the baby out with the bathwater and I
21:25think that will be a major advance the
21:27company on the corporate side will make
21:28in terms of identifying indications that
21:32are become kind of the standard for if
21:34you have an anti-aging drug or aging
21:36prevention slowing drug test it in these
21:39conditions if it works then you may be
21:41on to something so can you pick multiple
21:43ones and are there certain ones that are
21:45that tend to crop up over and over again
21:47or it's just right now it's just a
21:48free-for-all of well yeah part of it is
21:50just that the question of choosing the
21:51best regulatory path right I mean the
21:53regulatory path for some therapies is
21:55better than others like even if we came
21:56up with a drug that we thought slowed
21:58Aging tomorrow and I thought it would be
22:00wonderful for diabetes I probably
22:02wouldn't want to go out and pay for a
22:03diabetes trial right it's a very
22:05competitive space you need a huge
22:07expensive trial with lots of people so
22:08that would have been a poor choice of
22:10indication if your goal is really just
22:11sort of to get it through the process
22:14so you actually want to choose smaller
22:15indications that you think are still
22:16gonna be relevant and this is actually
22:18common even in other areas that even for
22:20cancer drugs they'll pick an indication
22:23for a cancer which would be first in
22:25class even if the drug could be helpful
22:26more broadly and so is a game plan that
22:29at least is well known familiar pattern
22:31so what you talked a little bit about
22:33this but what what might it look like is
22:34it most likely to be a pill are there
22:36other or will it be I don't want to go
22:38there blood you know what what do you
22:42think it might look like and who will it
22:43be for first you know I mean is it
22:45really only the province of sort of the
22:47elite and wealthy in the beginning or is
22:50it how will this how will we actually
22:52start to see this being delivered to us
22:54if we do well it's a it's a good
22:56question it's a big question so let me
22:58just say first of all that the company
23:00based on the kind of this work of the
23:02blood transfusions is currently
23:04conducting a trial of delivering plasma
23:06from young individuals to patients with
23:09early onset Alzheimer's disease so it's
23:12in trial and we don't you know don't
23:13know if it'll work yet but but so in
23:15theory in a short time plasma infusions
23:18for certain diseases might be as might
23:20be a treatment now who's going to get it
23:22is going to be a major economic issue
23:25because will insurance companies pay for
23:27it will they not pay for it if they
23:28don't it will be limited to people who
23:30can afford it and that would be a
23:31tragedy so these will end up being I
23:34think basically societal issues that
23:38will have to be worked out as to who's
23:39going to pay for these things if they're
23:40effective now will it be a protein will
23:42be a drug all of these are being pursued
23:44which ones will get there first I think
23:46is or will they be all of them yeah I
23:47suspect there will be many different
23:49purchase yes small molecule ones will
23:51eventually go off patent and so then
23:53they will be generics and be very
23:55inexpensive that's right but years from
23:57now right I mean we're talking about
23:59longevity so yeah but realistically like
24:07you know it may take some of the pen
24:08windows are not that big anymore hmm you
24:11know by the time they get past clinical
24:12trials so you know it wouldn't take that
24:14long and so I think that one thing I
24:17think the protein therapeutics is much
24:18more yeah I guess I'm expecting small
24:20molecules to come first because that's
24:21what Pharma is used to you know that's
24:23we have all the models to make that work
24:25and the space of chemicals
24:27bencao unexplored so I think there are
24:29going to be other rapid myosins other
24:30med Foreman's that become available in
24:32the next few years and just from a kind
24:34of a step back point of you from an
24:36economic point of view if it turned out
24:38there were treatments that delayed the
24:40onset of age-related diseases when you
24:42think of the cost savings this would be
24:45globally government's would be lining up
24:48to get these treatments so it would you
24:51know again this is assuming this all
24:52works in this is effective there would
24:55be a huge incentive on the public side
24:57on the government side to institute
24:59treatments to preserve health it needs
25:02to be thought in a different way and
25:03that it's you know more akin to like
25:04seatbelts and airbags but but there is
25:12also a cost I mean say we did all add 40
25:15years to our lives you know which would
25:17be amazing but you have a generation
25:19then on the planet that's hanging around
25:21for much longer using resources and food
25:23supply and over time it gets pushed back
25:25for years because of 40 productive years
25:29interesting actually they you could sing
25:31in other way around that when you're 70
25:33if your youthful in 70 the amount of
25:35information expertise you've gathered
25:37and to apply that in a way that had the
25:39energy of a 30 year old mm-hmm you know
25:42I often wish I knew now what I knew when
25:45I was 20 and all the things I could do
25:47I imagine now making that really
25:49possible that's true but but I think the
25:51point you raise is important which is
25:53how to society change if we add 40 years
25:56right you would have to change you know
25:58it's interesting because really over the
26:00last century plus we've doubled human
26:03life expectancy already already doubled
26:05but all of those extra years have been
26:07added at the end so we still get married
26:09at the same time have kids retire that's
26:12all stayed exactly the same and now we
26:14have these and we what we don't want to
26:15do as a society is just keep adding them
26:18on at the end because I think there
26:19really has to be this global shift even
26:22as we're extending lifespan just by what
26:24is happening naturally the interesting
26:25thing about this is that if it really is
26:27extending health you could imagine that
26:29the age in which women can bear children
26:31could be extended out yes that would be
26:33a very different world and actually that
26:35would have a huge impact in terms of
26:36women in the workforce and their ability
26:40and so on it could have fundamental
26:42implications in very very positive ways
26:44I mean to be human is to be finite right
26:47and we think about our very humanity in
26:50these terms and what does it mean when
26:51you when we when we open that and how we
26:55think about humanity . we're still not
26:58talking about infinity there's a big
26:59difference in 40 in a right not in 100
27:02so I think it doesn't fundamentally
27:04redefine that I think you know it ends
27:06up being much more of a demographic
27:07issue and if you if you look at the
27:09extension of lifespan obviously in
27:11developed countries that has been
27:13paralleled by a decrease in fertility
27:16right so so you know if this were about
27:18population explosion that would be one
27:20thing but in fact populations are
27:22shrinking because birth rates are going
27:24down in a lot of developed countries so
27:25there really is already this huge
27:27demographic shift going on we are living
27:29longer we're having fewer children
27:31that's changing the nature of society
27:33and that's continuing and then if we add
27:35on top of that even longer life that
27:37just puts more pressure I think on
27:39society to adapt to that kind of
27:42changing demographic we adapt very
27:44slowly to changing demographics we like
27:46our institutions we like when we go to
27:47school we like when we start jobs we
27:49like retirement 65 those are very much
27:51you know they're rooted in very old
27:53fashioned demographics so there's a very
27:57slow process for society to catch up
27:59with these kind of demographics yeah so
28:01some extent we can sort of already go
28:02and see what that would be like I mean I
28:04think the near-term therapies are gonna
28:06add say 10 to 20 years and there are
28:08groups of people now who have
28:10exceptional longevity which is a
28:12heritable genetic trait there are
28:14families that are enriched for this and
28:1510 to 20 good years exactly all five
28:25siblings live to be over a hundred and
28:27they were still working into their you
28:29know hundreds and still mentally their
28:32into their hundreds and still physically
28:34active you know they weren't so we know
28:35that this can exist I mean we sort of
28:37know what it will look like from
28:38studying these along their populations I
28:39think that's what we all want longer
28:41life without increased stability it's
28:43already been getting longer and longer
28:45and I do think you would I mean you
28:46would live your life totally different
28:48very differently okay well thank you for
28:50joining us in the a 16z podcast thank
![How To Succeed As A NEW & YOUNG Realtor [Deals Every Month + Luxury Listings]](/_next/image?url=https%3A%2F%2Fi.ytimg.com%2Fvi%2FrtrRghgTayc%2Fhqdefault.jpg&w=3840&q=75)
