Medicine is Moving From Calendars to Clocks

Summary

This week Tony Wyss-Coray and I published an invited review paper in Nature Medicine entitled “Biological Aging Clocks in Health and Disease.” The concepts and content of the paper may be difficult to understand for people not working in life science, but they are groundbreaking and have exciting implications for the future of medicine. So this edition of Ground Truths is intended to make all of the progress comprehensible for you and to hopefully see the coming inflection point in medicine. I’ll divide this into 4 key sections: (1) the chronological illusion of aging; (2) aging is synchronous in our body—the value of organ clocks, (3) cell clocks and the master regulators of aging; and (4) impact for routine medical practice. Share The Chronological Illusion: Aging Isn’t Linear It is well recognized that each of us age at a different pace, exemplified by person aged 90 who has never been sick and physically appears to be decades younger (what we’ve called the Wellderly or Super Agers ). But the overall assumption has been that all of us undergo a gradual, steady, linear process of aging, predictable wear and tear throughout lifespan, as assessed via the calendar. That “chronological illusion” (the dotted line below) has now been debunked. Multiple studies that used large-scale proteomics (proteins or other omics/biological metrics and imaging) and have found 3 major waves of aging that occur around ages 34, 60 and 78 years, as shown below. Simplified redraw of Figure 1 from the review which cited 7 studies, made with ChatGPT Subscribe now Aging Is Asynchronous in Our Body It also turns out our organs age at a different pace. We might not have known that without the ability to do high-throughput proteomics with AI analytics. By that I mean being able to assess up to 11,000 proteins from a tube of blood and use AI to define which proteins are tracking which organ and the immune system. Perhaps the best way to prove this asynchronous process within our body is from the world’s oldest longitudinally followed birth cohort— the UK’s National Survey of Health and Development (NSHD). All of the 1,800 participants were born in the same week in 1946. At age 63, proteomics were assessed for 6 organs and the immune system. In the Figure below, you can see there is about a 10-year spread of organ and immune system pace of aging among the cohort. Conventional, top left,…