“most people don’t simply want to live until 110. They want to extend the amount of time they live free of serious disease, a concept known as health span. That’s why the most sensible approach is to reduce the toll of three major age-related diseases: cancer, heart disease and neurodegenerative disorders, such as Alzheimer’s disease. It may be less flashy, but it’s more attainable than ever.
It’s estimated that at least 80 percent of cardiovascular disease cases, 40 percent of cancer cases and 45 percent of Alzheimer’s cases are preventable. Even with a long lag — these diseases can each take 20 years or more to develop — researchers have struggled to accurately define a person’s risk early enough to intervene effectively. Sure, someone can take a genetic test and learn he’s at a heightened risk for Alzheimer’s disease, but what good is that if he doesn’t know whether the disease will emerge early, when he’s 95 or not at all? [..]
Since the 2000s, scientists have used a person’s genetic sequence to calculate his inherited risk for certain diseases. In just the past five years, the amount of data the medical field can glean about a person’s health on top of that has ballooned. Beyond traditional tools such as medical records, routine lab results and imaging, doctors can draw from a range of biological clocks that help track how the body is aging. [..]
This level of insight can usher in a new way to approach such diseases: active surveillance paired with aggressive lifestyle changes. A person deemed at high risk for Alzheimer’s might undergo regular assessments and brain imaging while also taking preventive steps to lower her risk. That could include cutting back on ultra-processed foods, increasing physical activity and addressing any changes to hearing or vision loss — factors that can influence cognitive decline. Doctors could also recommend prioritizing sleep, reducing alcohol and social isolation or getting the shingles vaccine, which has recently been shown to reduce dementia risk. Some might also consider taking GLP-1s, diabetes and weight loss drugs, which appear to reduce harmful inflammation in the brain and body and are being tested in clinical trials to prevent Alzheimer’s.
Pulling together this medical information and turning it into individual plans for preventing chronic diseases is different from today’s approach. Cancer screening protocols, for instance, rely largely on a person’s age. This is also where A.I. models can best benefit medicine. These models are improving in accuracy and reasoning and could one day incorporate data from our gut microbiomes or immune systems to make disease predictions even more precise.
Getting this right will require further study and investment. We don’t want to exacerbate health inequalities by making this kind of medical care accessible only to a wealthy few. The Trump administration’s major reductions in governmental support of medical research will dim these prospects.
Getting an injection of youthful blood or taking the latest trendy anti-aging supplement might seem like a shortcut to a longer life. But extending the years people live without the burden of major age-related diseases is what should be a national priority.”
Full editorial, E Topol, New York Times, 2025.4.21