LONDON — Getting into the swing of things here in Davos and here’s an awesome interview with Dame Linda Partridge who tackles one of the hottest subjects of our time – ageing. We know that the process is far more malleable than previously imagined, but the multi award winning Dame Partridge’s work takes the subject to a new level. If you’ve wanted to how how to live a long and healthy old age, and how to improve your chances of not being hit by the twin medical monsters of Alzheimer’s and Parkinson’s, you’ll find what this gifted scientist has to say absolutely riveting. I did. – Alec Hogg
This coverage of the global conversation on change is brought to you by Brightrock, the first ever needs-matched life insurance, that changes as your life changes. I’m in Davos with Dame Linda Partridge who is coming here as part of the ERC. Would you explain what that’s about, Linda?
They’re a wonderful organization. It’s the European Research Council and they’re part of the science funding branch of the European Union and they go for high-risk but potentially high gain research projects, many of them quite basic blue skies kind of science. And it’s completely transformed the European science scene. It’s five years funding. It’s very generous funding and all kinds of projects in countries where research funding is not so good are now funded and the science is really flourishing there. So, it’s been an absolutely brilliant organisation for European signs.
And allowed you to expand on your passion, which is genetics, living longer, living healthier and diseases that affect older people.
Exactly. I’m interested in trying to tackle the ageing process itself. So most of the really nasty diseases that we’re dealing with, the chronic diseases, the killer diseases. So cardiovascular disease – dementia, cancer…the major risk factor for all of them is advancing age. So, there’s a lot of interest now in trying to understand how it is the ageing itself acting as the risk factor. What is it that’s happening during ageing? And as a result of that kind of thought, particularly with animals, we’ve realised just how malleable ageing is. It’s absolutely extraordinary. So, changes in diet and exercise…also, genetic interventions, which of course we can do animal’s which then lead on to finding drugs that can intervene in the ageing process itself. So, with all these kinds of interventions, we can take a mouse or a fly or even a worm. We can make it live longer, which is interesting, but not really what we’re after. What we want to do is to keep it healthy for longer, to keep it healthy at the end of its life so that that nasty period of disability and illness at the end of life, is shorter.
And we find that we can do that with these interventions in animals. So, what it’s telling us is that if you tack on the ageing process itself, you can prevent these horrible ageing related diseases and that’s what I’m really interested in and what they’re funding me to study.
There’s a lot of interest in in ageing now in fact in Silicon Valley. It’s probably the hottest subject outside of artificial intelligence, how do we get to live longer, but how much is enough when it comes to living?
I am not primarily interested in making people or even animals live longer. I know that a lot of people want to live longer and that’s a very individual matter. But what the kind of research that I and many people, (including people in Silicon Valley) is about health. It’s not about lifespan. It’s making sure that those extra years as they come are good years and of course extra years are coming anyway for almost 200 years now. Human lifespans have been increasing at about six hours a day in the developed world and in most countries for which there are good records, it’s projected to continue to increase until at least 2030. So, people are living longer without the intervention of people like me. The issue is healthy lifespan is not keeping up with the increase in lifespan. That period of disability and illness at the end of life is actually increasing, unfortunately. So, in my view, that’s what we’ve really got to tackle, keeping those extra years healthy years. That’s the challenge.
Because you can keep people…people are living in the nineties now, but not always healthily.
Exactly. It’s a very variable thing. So, one interesting fact is that people who die at very late ages so well into their 90s or even over 100: they often actually have rather little ill health at the end of their lives. They often die quite healthy. They just die in their sleep, which I think is something we would probably be hopeful for, for ourselves and we’re very interested in trying to recapture that – that kind of healthy old age in as many people as possible. That’s what this kind of research is about.
So let’s start with the absolute basics. If you want to live longer, what should you be doing?
There’s a lot of self-help. Even people who lead blamelessly healthy lives do nonetheless get these ageing-related diseases. But there’s no doubt that a lot can be done with lifestyles. So, it’s the two obvious ones that we all know that we should be doing. It’s a healthy diet and plenty of exercise. Exercise is really important.
What kind of exercise?
So, with just walking – vigorous walking there’s a lot of evidence now that just getting out of the chair and going for a walk, getting the blood circulating, getting the blood to the brain – that this is a very healthy thing to do. It’s always a trade off at any age between the kind of very heavy exercise that’s actually going to damage your joints. But on the other hand, getting the benefits to your heart, to your circulatory system, to your muscles, and to your bones of the exercise. So, you need a certain amount of bashing on bones for them to maintain their structure and their strength. So, a vigorous walk is a very good compromise.
So, you don’t really have to go and push weights in the gym.
No, maintaining muscle strength is always a good thing and of course, as we all get older, muscle strength does decline. It’s called Sarcopenia and exercising all of the muscles…things like Pilates are really good for maintaining core muscle strength.
Yoga?
Yeah, Yoga too, because suppleness is another issue and yoga’s extremely good for suppleness.
If you were to take the person born today and there’s all kinds of estimates, but as a scientist, is it realistic that they will live (or should live, to 120)?
As far as we know, the world record holder did make it to 122 and about six months. She was a French lady – Jean-Louise Calment. Actually, she wasn’t a great advert for the kind of healthy lifestyle that we’re talking about. She actually gave up smoking when she was 119.
Are you saying that that’s what might have put her in the coffin (giving up?)
I think we shouldn’t look to her for how to achieve that. She came from al long-lived family. That may be relevant. It tends to run in families – long life. Although it’s not clear that that’s necessarily a genetic feature in families. It may be more to do with their lifestyles, the kind of diet and so on that they have. But anyway, it does run in families but generally the health-giving things are diet and exercise and that’s what we really should be looking at.
And the youngsters born today; are they going to live longer than our generation?
That’s a really interesting one. If they did the same things that are and some of the previous generations have done, then if you look at survival rates of people of different ages now and project all of those onto somebody being born now, something that the clever demographers do, then the prediction is that, you know, a quarter of them could live to be over a hundred. But of course, there are other things going on that are anchored. So, there’s an outbreak of obesity amongst the young. A lot of young people are getting type two diabetes, which is really shocking. It used to be a disease of ageing, but not anymore. It’s appearing in young people. So that could set the trend back. And then of course there’s social inequality, access to health care, the health of the mother before the child’s born, that kind of diet and exercise that child has as it is growing up. All of these are going to be relevant much later on when it’s ageing. So, I think social trends and medical care trends are going to have a lot to say about how long they live as well.
I’m a big fan of Warren Buffett, the Oracle of Omaha, and I’ll often go to his Berkshire Hathaway AGM’s and he’s often asked about his age (I think he’s now 88 years old) and he says that his view, his research, whatever – and this is why I’d like to bounce it off you is that half of it is genetics and half of it is lifestyle. He was eating burgers and drinking cokes until fairly recently where he started to cut back a bit being more health-conscious. But, is there truth in that, that you get a lottery ticket when you are born, through your parents (through the genetics) and then you can perhaps shape your health and your ageing by the, your environment.
There certainly is a genetic component to how long we live. I mean, estimates vary, but even the highest estimates are not very high – about 20% being the lowest estimate. So less than 10% you can get these estimates in different ways, looking at different populations, but they never go much above 20% so we are looking predominantly at lifestyle, but ageing starts pre-birth. That’s the main message I think people need to get across. It matters from the beginning what kind of environment you encounter from your parents when you’re still totally dependent on your mother as you grow up during young adulthood. All of these things are going to feed forward into how you age. And if you start with a really robust, strong, healthy body, then you can probably give it a bit of a battering as it goes through life and, not pay too much of a price. You know, early events are very important and how strong you are later in your life.
So that’s a big warning against smoking and drinking to excess in pregnancy.
Absolutely. Maternal health is extremely important. There are loads of evidence for that now. And also, there are things that are very hard to, for anybody to do anything about. So big mismatch and the nutritional status of the mother and then the kind of food that the young encounter can be very problematic. So often if populations moved from areas of very low nutrient status while pregnant and then emigrate somewhere where there’s a good food supply that can be actually ironic, be detrimental for the children because they’re growing up in a better nutritional status, then they’re actually programmed to expect and they tend to go into metabolic disease, that is seen a lot with immigrants into relatively wealthy countries that they have health problems to do with what happened to them when they were in the womb and just after they were born.
Yeah, completely counterintuitive. You would have thought that the mothers wanted to go to a better area for the children.
And for good reason but if there’s a mismatch, it can be a problem,
So most of us have got no control over that. And what happened when we were, we were young, but, as we get older, should you stay active? Should you stay at work longer?
Clearly you should exercise, should you retire, should you go to an easier environment? Those are questions people are asking themselves all the time. And then the fascinating questions and important questions and one were lots of work is being done as far as I can understand, not my area of expertise, but stress. They’re very different kinds of stress actually stressing yourself productively, so meeting a challenge, feeling the pain, but getting through the challenge that can I think be good fear. It enhances confidence health afterwards and as long as the stress is not too severe while you’re going through it, it actually leaves you stronger afterwards. What doesn’t kill you makes you strong. I think what’s really bad for people is chronic destructive stress. Stress that they can’t control, stress from poverty, from having a bad boss, from difficult family circumstances that can’t be overcome, you know such as a sick relative. These are things which I think, give people a real battering because they can’t meet the challenge in the sense that they can’t make the stress go away. It’s just structural in their lives, and this seems to be very bad for people’s health.
I’m not sure if you’ve come across Discovery, it’s a South African company, but it’s revolutionizing, certainly has in South Africa and is doing it all over the world now – lifestyles, they have a company in Britain called Discovery Vitality where they’re encouraging people to live healthier lives and as a consequence, they cut their premiums on their health and life assurance dramatically as a consequence. They’re expanding into all the major markets around the world. Is that something that just seems it’s taken a long time for business to catch on to the reality that that lifestyle has such a big impact on an obvious area like insurance?
Yeah, I think the companies are starting to realize this. I think, you know, even organisations like the very conservative national health service in the UK are beginning to realize that they need to take a lot more interest in the day to day lifestyle that people are leading. I think part of the problem with healthcare and without wanting to be rude, the medical profession, is that a lot of the Kudos from being a clinician comes from intervening and curing a disease and for a long time and it’s been a lot less fashionable and it’s a lot fewer brownie points to prevent things from going wrong. And I think the healthcare industry generally, and also the insurance industry businesses, even employers are starting to realise that to get the best out of people in work, in their health, in the way they look after their families, everything comes from a good lifestyle and therefore good health and good mental health, which is also very important.
We haven’t touched on that, but I would like to, if we could just get an update on Parkinson’s, and those diseases that do affect the elderly.
The ageing-related diseases… the classics, they’re responding very differently to research and medical intervention. I’d say the huge success story has been cardiovascular disease. So, it’s plummeted. There are far fewer heart attacks and strokes than there used to be. And a lot of that is to do with lifestyle and realisation that lifestyle factors matter. But it was also to do with drugs and very widespread use of very safe drugs. So, statins to deal with the bad blood lipid profile and blood pressure lowering drugs. They’ve had a huge impact and they’re taken by enormous numbers of people entirely preventatively – generally in at-risk populations. Most people or a lot of people see their blood pressure gradually increasing as they get older and dealing with that, it’s very important. But also, I think quite a lot of people take statins actually don’t have an adverse lipid profile. They’re just doing it preventatively. It’s often recommended by clinicians for older people and it’s having a huge impact. There’s no doubt about it. And that probably also explains why for a given age, fewer people are getting dementia because a lot of it’s to do with blood supply to the brain. Good cardiovascular system. So, the overall impact of dementia or the overall prevalence of dementia is still going up simply because we’re living longer. But at a particular age, (65 e.g.,) far fewer people have dementia than used to and that’s probably a secondary consequence of dealing with cardiovascular disease. With cancer we’re having a lot less success. It’s a clever disease. Cancer, some cancers, some drugs seem to work quite well. The antibody therapies are looking very promising. That’s probably going to be the next one.
The beast, there’s no doubt about it. It’s neurodegenerative disease. So far there’s very little in the way of either prevention or treatment. And I think that’s the next big frontier for medical research, honestly.
Is there much of an understanding of why or how they occur?
The etiology, the disease process; I think for both of the main neurodegenerative diseases. So, dementia or Alzheimer’s Disease and Parkinson’s are pretty well understood now. The same is true for motor neuron disease. I think we can understand what happens, but we can’t understand how to stop it happening at the moment. It’s proving very difficult. Partly, it probably starts so far back long before you can tell that the person is going to develop the illness. We probably need to intervene much earlier. By the time someone was showing symptoms, there’s so much damage to the nerve cells that it’s really difficult to reverse it.
So, what we need is early biomarkers. We need to know who’s going to get it and then think. Have a look at those people and see what it is that we can do to intervene. And I think the development of biomarkers is coming quite well. Now there are a number of long-term population studies where you start with a disease-free population and measure all kinds of things about them e.g. what’s in the blood? What’s in their cerebrospinal fluid? What’s the genotype, etc. And then go on and see who gets these diseases. And that’s proving very informative for figuring out who the at-risk population are and what might be done to prevent them from progressing into disease.
But for those who can’t wait for science to come up with solutions; is there anything preventative that that one can do in your daily life?
I think the only thing you can do with dementia, which is sometimes a vascular disease is to keep active. The blood supply to the brain is having a healthy blood supply generally and a good blood supply to the brain is important in preventing dementia, but there’s no doubt that for some diseases at the moment and into the foreseeable future, people can adopt as healthy a lifestyle as they like and they may be lucky. It will certainly help some people – a lot of people – but some people are going to get ill anyway and we really need to try and figure out how to find drugs that are going to help them not get ill. Preventative drugs, I think, are going to be a massive thing in the future. I think we’re seeing a future not so far off where aged maybe even 50, people start taking a poly pill that’s going to protect them against these diseases that come with advancing age despite healthy lifestyles.
Just to close off within a completely alternative area, there’s a lot in the consciousness movement about telomeres and extending the length of the telomeres and so on. Can you give us any insight into that?
Telomeres are interesting. They’re the ends of the chromosomes, the little structures in cells which contain the genetic material and our cells replicate and replace themselves. They shorten and you can find cells in older people where the telomeres have become critically short and it causes a number of problems. One of them is called cellular senescence. So with either damaged DNA or shortened telomeres, which comes to the same thing, we’ll go into a state called senescence. And normally these senescent cells are actually part of the wound healing process. They come along, they remote of the tissue after the injury so that it looks correct once it’s healed and other cells come along and remove. During ageing, that doesn’t happen and with telomere shortening, they sit around and for some reason the cells that would normally take them away don’t work so in an older person, and it turns out that in a mouse, if you remove those cells, you can do it with a genetic trick or with a drug. You hugely increase the health of all of the tissues in the mouse that have these senescent cells kidneys, lungs, joints, a lot of the organs and functions that go wrong during ageing… You get a much healthier mouse. So, there’s quite a bit of commercial activity and spinout companies at the moment looking at the possibility of removing these senescent cells, some of which will have the shortened telomeres to see if that is a way of improving the house of tissues. I think probably the first thing that it will be useful for is tissues for transplant. So, kidneys; it would be possible to get a transplant kidney, remove, these nascent cells from it and then do the transplant so that the recipient would get a healthier donor kidney than otherwise. I think that that’s coming quite soon.
Davos 2019. This coverage of the global conversation on change is brought to you by Brightrock – the first ever needs-matched life insurance that chances as your life chances.
