In this week’s newsletter

✅ We actually don’t need to call aging a disease. ✅ Cryonics with the help of AI. ✅ Novartis extends partnership with BioAge. ✅ Two new longevity cities. ✅ Already meme of the year. ✅ Report on progress in 2024.

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How ”intrinsic capacity” could unlock the future of longevity medicine

If you need a longevity slogan you probably want something better than ”intrinsic capacity”. I’m pretty confident that Bryan Johnson won’t swap ”don’t die” for ”intrinsic capacity” anytime soon.

But if you really don’t want to die and are prepared to properly educate yourself on what’s needed for that (hint: it’s not whatever Bryan Johnson is selling) then you should pay attention to those two words. Intrinsic capacity.

Allow me to explain.

ARPA-H is the Advanced Research Projects Agency for Health, a US federal agency launched in 2022 with a $1.3 billion budget. It’s DARPA's healthcare-focused sibling. While DARPA brought us the internet and GPS (among many, many other things), ARPA-H aims to transform how we prevent and treat disease.

One of their newest programs, PROSPR (Proactive Solutions for Prolonging Resilience), might just change how we approach aging. Instead of getting lost in the energy zapping debate about whether aging is a disease, they're trying something cleverer.

This is where those two words - intrinsic capacity - could become a potential regulatory gateway for aging treatments.

You see, ”intrinsic capacity” is a WHO-defined measure of how well your body functions across multiple domains. It’s ”the composite of all the physical and mental capacities that an individual can draw on at any point in time”.

While the FDA doesn't recognize aging as a disease, they might approve treatments for declining ”intrinsic capacity”. After all, losing your strength, cognitive function, and resilience isn't just ”getting old” - it's a measurable decline in health that correlates with serious outcomes. And if you can measure it, you can potentially treat it.

It's actually sounds like an ingenious regulatory workaround.

In my book, Evigt Ung (2022), I proposed we call aging a ”fluffy cloud”. It was my silly way of saying that we can't afford to get bogged down in semantic debates while over 100,000 people die every day from the ravages of aging. Don’t call it a disease, I don’t care, as long as we solve the problem.

Intrinsic capacity is, for all intents and purposes, ARPA-H’s fluffy cloud.
Consider a drug like metformin. It’s a medication that shows promise in addressing multiple aspects of aging, yet it's trapped in a regulatory framework that only allows its prescription for diabetes.

PROSPR's approach is three-pronged:

1. Build better ways to measure aging through biomarkers and in-home monitoring.

2. Test existing FDA-approved drugs to see if they can maintain intrinsic capacity.

3. Develop new drugs specifically designed to extend healthspan.*

We've seen other attempts at this regulatory puzzle. The TAME (Targeting Aging with Metformin) trial proposed one approach which was approved by the FDA, but the actual trial hasn’t been funded and remains in limbo.

ARPA-H, on the other hand, has the financial backing to make this a reality.

To sweeten the deal, policy makers will probably like the economic case too. Extending healthspan by just one year in 10% of aging adults could save $29 billion annually in healthcare costs (in the US alone) and increase value to the US economy by $80 billion per year, according to the Kaiser Family Foundation.

* By framing it in terms of health maintenance and economic benefits rather than something like radical life extension or - God forbid! - lifespan, they're creating a pathway for longevity research that might actually get funded and approved.

So while ”intrinsic capacity” might not have the marketing punch of ”don't die”, it could be the trojan horse that gets aging treatments through the FDA's gates. It might finally address what I described in Evigt Ung as a form of ”drug discrimination” - where potentially beneficial treatments are restricted not by science, but by semantic stubbornness about how we classify aging.

News from around the longevity and health space.

TimeShift aims to revolutionize cryonics

It’s definitely not the world’s first cryopreservation facility, despite their claims. In fact, it’s not even a facility yet - at least for now. TimeShift is more of an R&D concept exploring innovative approaches to cryopreserving a person, with a working prototype unlikely to be ready before 2030.

That said, what makes it noteworthy is that one of the key figures behind TimeShift is Insilico CEO Alex Zhavoronkov. And that fact alone tells us several important things:

1. A credibility boost for cryonics: Having a figure of Zhavoronkov’s stature involved further legitimizes the field of cryonics.

2. AI will play a central role: Insilico uses AI for drug discovery, and from the promotional material, it’s clear that AI will also be a core component of TimeShift’s approach.

3. Growing scientific interest in cryonics: When we had Emil Kendziorra on the LEVITY podcast, he pointed out that many prominent aging researchers are turning to cryonics, feeling progress in solving aging isn’t moving fast enough.

4. The AI timeline debate: Some argue that if an AI expert like Zhavoronkov is focusing on cryonics, it must mean he doesn’t believe AI will reach longevity escape velocity anytime soon. However, let’s not forget that even leading AI figures - like Nobel laureate Geoffrey Hinton - have previously underestimated the pace of AI progress.

Two new longevity cities

Vitalia was envisioned as a longevity-focused city within Próspera, a special economic zone on Roatán, Honduras. However, its co-founders, Niklas Anzinger and Laurence Ion, have recently decided to part ways, leading to the creation of two separate longevity cities.

Anzinger will continue his efforts with Infinita City, which will also be based in Próspera, while Ion’s new project, Viva City, has yet to announce its physical location.

If you're curious about Próspera, Vitalia, and Niklas Anzinger's vision, we recently hosted him as a guest on the LEVITY podcast - definitely worth a listen!

A promising partnership

It seems like big pharma - or at least one of its players - got the memo: a successful drug that targets aging could will be extremely valuable. Novartis’ decision to extend its partnership with BioAge, even after the startup recently halted its Phase 2 trial due to safety concerns, is a promising sign for the future.

A reasonable report on progress in 2024

Reason has put together his annual ”state of longevity” report. There's a heavy emphasis on the SENS approach to damage repair and aging mechanisms, with some shorter sections on cryonics and aging clocks. It's a deep, technically detailed read - just know that emerging areas like AI/computational biology and alternative paradigms get little coverage.

What is aging, really?

Speaking of annual reflections - here’s a great summary of our current understanding of what aging actually is.

Worth your time.

Why do you want to die?

Have you sometimes noticed that you flinch when someone under the pro aging trance asks you the forever question? Like you’re a weirdo for wanting to keep living? Well, here’s how to respond.

Already meme of the year.

A raad conversation with James Strole

Here’s a sneak peek of our next LEVITY episode with the wonderful James Strole. We had a really great time recording this! Premiere Tuesday January 14 at 6 pm CET. Make sure to subscribe to our Youtube channel!

Hey, you’ve made it all the way here! Thank you so much for reading! 🫶🏼