⏳ Beyond longevity: The push to make every extra year a healthy year

Welcome back to the 50th issue of Healthy Innovations! 👋

I recently came across a McKinsey Health Institute report - Healthspan science may enable healthier lives for all - that highlighted investment opportunities in the growing field of longevity research.

So this week, I'm taking a closer look at the gap between lifespan and healthspan - and what the healthcare startup community is doing to help us make the most of what Peter Attia calls our "marginal decade": our last 10 years.

Let’s dive in!

We've added decades to human life over the past century.

Global life expectancy jumped from around 50 years in the 1950s to 73 years today. In high-income countries, it's now close to 80. That's remarkable progress, but here's the part nobody talks about: we're spending roughly nine years of that extra time sick.

On average, people live about 20% of their lives managing chronic illness, disability, or frailty. The healthspan gap varies significantly by region: in the US, healthspan ends around age 63 with total lifespan reaching 79 (a 16-year gap). The UK shows healthspan at 72 versus lifespan of 81 (a 9-year gap). Even Japan, known for exceptional longevity at 84 years, has an 8-year healthspan gap with healthy years ending around 76.

This gap between how long we live (lifespan) and how long we live well (healthspan) is now driving a fundamental shift in medical research. Scientists are asking a better question: Instead of just adding years to life, how can we add life to years?

The global picture

Here's why this matters: the global elderly population is projected to reach 2.1 billion by 2050. Without interventions that extend healthspan, we're looking at massive increases in healthcare costs, overwhelmed caregiving systems, and millions more people spending their final years in poor health.

As societies age, dependency ratios shrink. Fewer working-age people support more retirees. Social security systems face pressure from Europe to Asia. Healthcare expenditures balloon globally. The human cost includes families watching loved ones decline for years, caregivers burning out, and individuals losing independence.

The chronic disease challenge

Age-related conditions (cardiovascular disease, cancer, diabetes, neurodegeneration, arthritis) are now the leading causes of disability worldwide. Medical interventions focused solely on prolonging life may lead to longer periods of illness if they don't address the underlying aging process.

Some researchers argue that biomedical advances targeting lifespan extension may simultaneously promote healthspan, since delaying the aging process could defer the onset of chronic diseases.

This is the core hypothesis driving the emerging field of healthspan science.

Targeting the biology of aging

Researchers have identified hallmarks of aging: biological processes including genomic instability, cellular senescence, mitochondrial dysfunction, chronic inflammation, and stem cell exhaustion. The hallmarks were first proposed in 2013 with nine mechanisms, then expanded in 2023 to include disabled macroautophagy and other processes.

Several therapeutic strategies show promise:

• Senolytics eliminate senescent "zombie cells" that secrete harmful inflammatory molecules. Early human trials with dasatinib plus quercetin have shown decreases in senescent cell load, reduced inflammation, and improvements in frailty measures.

• Metabolic interventions include metformin and rapamycin, which show geroprotective potential by improving mitochondrial function and reducing inflammation.

• NAD+ boosters are being developed by several companies.

• Regenerative approaches are being pursued by Altos Labs (San Diego/Cambridge UK), which launched in 2022 with $3 billion in funding to develop cellular rejuvenation therapies. The company is exploring partial cellular reprogramming to restore youthful function without losing cell identity.

Companies to watch

• BioAge Labs uses AI and longitudinal human data to discover drugs targeting resilience pathways that decline with age. Their lead candidate targets muscle atrophy and metabolic dysfunction.

• Gero has developed AI algorithms to measure biological age and is developing geroprotective therapies. The company's research suggests there may be fundamental limits to human lifespan that could be extended through interventions. Chugai Pharmaceutical has also partnered with Gero to develop antobody-based therapies for age-related diseases.

• Turn Biotechnologies is working on mRNA-based epigenetic reprogramming to reverse cellular age without changing cell type.

• Rejuvenate Bio uses gene therapy in dogs to test longevity interventions, with plans to translate successful approaches to human medicine.

• Juvenescence is developing therapies across multiple aging mechanisms, including senolytics, stem cell therapeutics, and metabolic interventions.

The measurement challenge

Biological age, unlike chronological age, reflects the underlying state of the body's systems and predicts disease risk more accurately. Epigenetic clocks (which measure DNA methylation patterns) can now estimate biological age distinct from chronological age.

Companies are commercializing these tools.

• Elysium Health offers Index, a biological age test measuring DNA methylation.

• TruDiagnostic provides TruAge tests for consumers and researchers.

• MyDNAge from Yale researchers is available through several testing companies.

The policy shift

Recognition of the healthspan challenge is driving policy changes globally.

WHO has proclaimed 2021-2030 a decade of healthy aging. The American Heart Association's 2030 Impact Goal aims to lengthen health-adjusted life expectancy by three years.

Singapore's Healthier SG initiative subsidizes preventive services to reduce healthcare system burden. The UK's Office for Health Improvement and Disparities is developing healthy aging frameworks. Japan's Society 5.0 initiative integrates technology and healthcare to support healthy longevity as the population ages.

These models recognize that investing in health maintenance is more cost-effective than managing late-stage disease.

What's coming

No intervention has yet proven it can meaningfully extend human healthspan at scale. Clinical trials are underway, investment in the field has quadrupled over the past decade, and dozens of companies are pursuing aging-related therapies. Most results remain preliminary and mainstream medical adoption is years away.

The scientific foundation is solid and the research focus has shifted from simply keeping people alive to keeping them healthy and functional. Recent advances in geroscience, regenerative medicine, and epigenetics suggest we can potentially delay chronic disease onset.

The goal isn't immortality. As one geriatrician noted, reducing time spent in disability and frailty is often more important to patients than increasing overall life expectancy.

For the first time in history, we're not just asking how to live longer. We're building the science to live better while we're here.

Innovation highlights

🧠 Tiny brain chips hitch rides. MIT researchers developed injectable "cellular cyborg" chips that piggyback on immune cells to reach inflamed brain areas without surgery. These sub-cellular wireless devices, called SWEDs, travel through the bloodstream and deliver targeted electrical stimulation to treat neurological diseases. Successfully tested in rodents with wireless control, the Circulatronics platform could eventually treat Alzheimer's, multiple sclerosis, strokes, and spinal injuries. The technology may extend beyond the brain to other body parts, though human clinical trials are still three years away.

🚁 Drones get a friendlier face. VITA, a Red Dot award-winning EMS drone, ditches the intimidating military look for an approachable design featuring a simple, friendly face. This first-responder drone uses enclosed ducted fans instead of exposed blades, allowing people to safely approach without injury risk at chaotic accident scenes. Small enough to hold in one hand and nimble enough for tight spaces, VITA delivers critical emergency aid while reducing panic. The design philosophy centers on functional empathy - making high-tech emergency care feel helpful rather than hostile when it matters most.

🦴 Fat cells repair fragile bones. Japanese researchers successfully used stem cells from fat tissue to repair spinal fractures in mice with osteoporosis-like injuries. The team transformed fat-derived stem cells into 3D bone-mimicking clusters called spheroids, paired them with beta-tricalcium phosphate, and watched mice regain healthier, stronger backbones. Genes responsible for bone formation became more active after treatment, suggesting the approach stimulates natural healing. Since fat cells are easy to collect with minimal body strain - even from elderly patients - this technique could offer a gentle, minimally invasive treatment for osteoporosis fractures.

Cool tool

🎙️ ElevenLabs has developed an AI voice generator app for iOS and Android that creates ultra-realistic voiceovers using advanced deep learning models. Clone your own voice in seconds or design entirely new voices with just a prompt.

The app's Eleven v3 model delivers nuanced intonation and emotion that closely mirrors natural human speech. Perfect for social media creators, finished audio clips export directly to CapCut, iMovie, TikTok, Instagram, and YouTube Shorts. The platform supports voice synthesis in over 70 languages, letting you automatically translate and dub video content while keeping the original voice's emotion and style intact.

There's even a Reader App that converts articles, PDFs, and ePubs into audio for listening on the go. For doctors, this means turning dense medical journals and research papers into audio you can absorb during your commute or between patients. Whether you need voiceovers for patient education videos or quick audio summaries of clinical updates, ElevenLabs puts professional-grade voice tools right in your pocket.

Random fact: Matthew McConaughey has been part of the ElevenLabs story since 2023, as both an early supporter and investor.

Weird and wonderful

🐍 Scientists discovered that snakes and lizards have cracked the code on handling uric acid – the stuff that causes kidney stones and gout in humans. Unlike people who flush waste away as liquid urine, reptiles cleverly crystallize their pee into tiny solid spheres (just 0.0004 inches!) to conserve water. Georgetown University researchers examined waste from 20+ reptile species and found these microspheres safely convert toxic ammonia into harmless solids using uric acid.

Here's where it gets interesting: the same uric acid that reptiles handle like champions is what forms painful crystals in human joints and kidneys. Scientists hope studying how pythons and tree boas safely excrete these compounds could inspire new treatments for gout and kidney stones. Who knew the answer to your joint pain might come from a snake's bladder?

Thank you for reading the Healthy Innovations newsletter!

Keep an eye out for next week’s issue, where I will highlight the healthcare innovations you need to know about.

Have a great week!

Alison ✨

P.S. If you enjoyed reading the Healthy Innovations newsletter, please subscribe so I know the content is valuable to you!

P.P.S. If you're considering starting your own newsletter to share your expertise and build a community around your healthcare niche, check out beehiiv (affiliate link). There's never been a better time to start sharing your knowledge with the world!