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Longevity medicine is advanced personalised preventive medicine driven by deep biomarkers of aging, longevity, and mortality, and is a rapidly-emerging field. The field encompasses the likewise rapidly evolving areas of biogerontology, geroscience, and precision, preventive, and functional medicine. The aim of longevity medicine is to utilize novel quantifiable and quantifying biomarkers of aging, e.g., deep aging clocks, with the intention to maintain the patient’s biological and psychological age as close to the state of optimal performance throughout the course of life as possible.

Evolution of Medicine

With modern advances in artificial intelligence and machine learning, biomarker research and drug development have produced numerous tools for early diagnostics and prevention of communicable and non-communicable diseases, which remain largely unknown to the global medical community. This unawareness is mainly due to a complete absence of structured, pedagogically-concepted educational resources tailored to specific audiences, primarily consisting of physicians, biotechnologists, and public health professionals. The notion of longevity and healthy aging as a major priority for healthcare will undoubtedly substantially impact primary, secondary, and tertiary prevention.

The development of longevity-focused medical practices greatly depends on bridging the gap between health-care providers and interdisciplinary experts, such as academic biogerontologists, artificial intelligence experts, computer scientists, and informaticians. Patients have insufficient access to the health-care providers who have been adequately trained in longevity medicine and can manage a patient from a longevity medicine standpoint. Viable longevity education with practical translation will thus ultimately improve health-care systems worldwide and decrease disease occurrence by training health-care providers to tackle the most common and strongest contributor of disease—unhealthy aging. Longevity medicine combines best practices from various fields and uses leading-edge innovations, such as deep learning and artificial intelligence to evaluate the patient's biological age throughout the course of life. Longevity physicians are looking for ways to reduce the gap between the current parameters (current biological age) and the parameters of optimal maximum physical performance (the ideal biological age, predicted by deep learning).

History of Medicine

What is considered a disease?

The term “disease” used to mean literally "lack of ease or comfort". Today it has evolved to refer to “an illness that affects a person, animal, or plant: a condition that prevents the body or mind from working normally”.

Thought history, what counts as a disease, has undergone a great amount of change, because of increasing expectations of health and because of increased ability of diagnose. Social and economic reasons play a major role, also. For example, osteoporosis was considered an unavoidable normal part of aging until 1994 when the WHO recognized it as a pathology (WHO, 1994). As a result, people suffering from osteoporosis were not considered anymore as 'normally old', but instead they received treatment and reimbursement of the costs.

Preventative medicine

As new medical technologies emerged during the last century (vaccination, antibiotics, methods of early diagnostics), together with improved access to food and water, the life expectancy increased rapidly. Over the past half century, evidence-based medicine has been immensely effective for reducing overall mortality. Nonetheless, due to the extension of lifespan, without an associated extension of health span, it has also amplified the economic burden of disease.

Still, traditional medicine, even at its advanced level of precision, evaluates the patient according to the biological age-correlated parameters. These reference ranges represent population means and do not take into consideration individual differences. In contrast, longevity (preventive) medicine allows for a personalized approach, by comparing the gap between the patient current state and their maximum of physical fitness.

This domain is extremely novel, its concepts as the aging clocks being first published in 2013 by Steven Horvath et al. (1) and deep aging clocks first being published in 2016 by Alex Zhavoronkov et al. (2).

Artificial Intelligence in Longevity Medicine

Longevity medicine as an AI-powered preventative medicine

The biomarkers of aging and longevity are predictive and prognostic, and there is also data-driven individualized prevention. Biomarkers of aging are tools able to provide a quantitative foundation upon which to evaluate the therapeutic efficacy of clinical, health-span-extending interventions. The advances in artificial intelligence over the past decade have been immense, and especially with a revolution in deep learning starting 2013, 2014. Deep learning (DL) was a breakthrough for AI research, allowing for the training of deep neural networks (DNNs) on massive longitudinal data sets, which were previously almost impossibly difficult to comprehensively mine and interpret in the longevity arena. AI-powered longevity medicine will facilitate the discovery of drug targets for specific individuals, the identification of tailored geroprotective interventions and aging and longevity biomarkers to enhance the study of aging and disease trajectories, and the identification of interventions that may help slow down or even reverse aging-associated biological, physiological or psychological processes.

Aging Clocks

The publication of the first multitissue Methylation Aging Clock was by Steven Horvath in the year of 2013. The model measures the rate at which an individual's methylome ages, which we show is impacted by gender and genetic variants. This is known as the DNA-methylation age clock or Epigenetic clock.

With AI research development, Deep Learning (DL) allows for the training of deep neural networks (DNNs) on massive longitudinal data sets, and the first aging clock study utilizing DNNs was published by the laboratory of Zhavoronkov in the year of 2016.

Another aging clock is Microbiomic Aging Clock. Scientists from Harvard Medical School and Insilico Medicine have used thousands of whole-genome sequencing samples from gut bacteria to develop and validate a new deep Microbiomic Aging Clock. Using this new tool, they found that the age of the host is a significant contributor to the dynamics of the gut community.

There are also Deep Imaging Aging Clocks which use only images of the corners of the eye, can predict the age of an individual with an accuracy of 1.9 years means absolute error.

There is no consensus on how to define human ‘biological age’, but the term usually refers to a measure that is more predictive of mortality, diseases, or frailty than chronological age, and one that changes in response to geroprotective interventions and can track some of the biological hallmarks of aging. Aging Clocks have the potential clinical application to help clinicians to better analysis biological age.

Deployments at Universities and National Healthcare Systems (NHS)

The Longevity Medicine for Physicians course was developed collaboratively between leading AI researchers, geroscientists, and practicing physicians in order to provide the first credible source of longevity medicine education for upskilling healthcare professionals. Longevity Medicine Course was launched on Udemy in December 2020, with over 2,700 learners registering immediately. In July 2021 the Course transitioned to the Longevity Degree platform and received the Continuing Medical Education (CME) accreditation from the Medical Society of Delaware (MSD). In March 2021, the Longevity Medicine Course authors worked with the leadership of the Health Data Research UK, and the course was adapted and launched on the HDR UK platform. Longevity Medicine course has also been recognized by NHS platform UK and launched on the NHS learning hub platform on 14 October 2021.