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Longevity and Aging: A New Approach Using Metformin

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    May 2020

    In 1900, U.S. life expectancy for men and women was approximately 47 years.1 A person born in 2018 was expected to live nearly 79 years, an increase of one-tenth of a year from 2017.2 Various factors contributed to this increase and some scientists believe aging could be delayed to improve the quality of life in old age.

    An online poll conducted among 3,222 adults ages 18 and older in the United States revealed that while most people do want to live longer than their average life expectancy, it is predicated on their quality of life, such as how much pain they would experience or whether they would be able to live independently.3 Retirees also have concerns about their ability to afford the expenses that come with living longer, as traditional retirement planning models were based on a shorter life span.4

    What if the quality of life could be improved and the effects of aging could be postponed?

    S. Jay Olshansky, PhD, an epidemiologist at the University of Illinois at Chicago School of Public Health, believes the upper limits to human longevity can be achieved through scientific means that intervene in the aging process.5 If the cause of aging is found, health in older age could be improved. Although there have been advances in medicine, living longer has not necessarily coincided with an improvement in the quality of life.

    Olshansky introduced the Longevity Dividend initiative to promote research that focuses on slow aging to extend a healthy lifespan and combatting the diseases of old age.5 He believes the potential benefits from advances in aging science have been underestimated by most scientists. Presently, scientists and physicians focus on the treatment for diseases to extend life.

    How can medical advancements extend a healthy lifespan and combat the diseases of old age?

    Medical Intervention to Slow Aging

    Dr. Nir Barzilai, Director of the Institute for Aging Research at Albert Einstein College of Medicine, and a group of researchers from the American Federation for Aging Research (AFAR) are working to validate metformin as the first-ever anti-aging medication.6 Metformin is a widely-used antidiabetic treatment that has also been shown to increase the production of known longevity-promoting signaling molecules in cells.6 This drug favorably influences biological outcomes that are associated with the development of age-related conditions including inflammation, oxidation, diminished autophagy and cellular senescence.7 Autophagy is the natural, destructive mechanism that disassembles unnecessary or dysfunctional components. It allows the orderly degradation and recycling of cellular components.

    Dr. Nir said, “We would rather prevent aging, and by that, prevent the onset of multiple diseases.”8 Craig Currey, a lead researcher at Cardiff University, also found that metformin already demonstrated positive results in treating cancer and cardiovascular diseases in addition to treating diabetes.8 Metformin helps control diabetes by increasing insulin sensitivity and decreasing production of glucose in the liver.9 Metformin also benefits cells in the human body by increasing oxygen molecules released into a cell.8  Non-human studies demonstrated metformin’s ability to slow the aging process in mammals; thus, it is hoped the same can be demonstrated in humans.7,8

    A groundbreaking study approved by the Food and Drug Administration (FDA) called Targeting Aging with Metformin (TAME) aims to evaluate metformin’s ability to slow aging. The clinical trials will include 3,000 people, who either suffer from or have a high risk of developing diseases, tracked over a course of six years – where half of the participants will receive metformin, and the other half will receive a placebo.6 Success of the study will be determined by whether the drug slows down the onset of major age-related chronic diseases – such as cardiovascular disease, cancer and dementia.6 Additionally, metformin helps the body repair DNA, which is critical in cancer prevention.

    Longevity-signaling molecules in human cells, known as mTOR and AMPK, are increased when taking metformin – which helps to reduce fat and sugar storage that support the cells function youthfully, and prevent the early stages in atherosclerosis development (hardening of the arteries).6 Treatment with metformin can activate AMPK by cleaning up proteins in the brain that can cause brain cells to die.6 Build-up of brain proteins can cause brain cell death and abnormality in neuro-degenerative diseases. These affects have been demonstrated in animal and laboratory studies. As humans age, AMPK activity decreases which can make the body more susceptible to disease.6,9

    Underwriting Impact

    Although further research is needed to validate the specific impact of metformin on the human body, scientists and physicians hope additional studies will provide further insight and understanding into how this medication could positively impact longevity. Underwriters in all lines of business should be aware of how treatment with the drug may impact mortality and potentially improve the quality of life in old age for patients across the United States.

    Contact the Author
    Lynn Bernstein, BSN, FALU, FLMI
    Senior Underwriting Consultant
    Underwriting Services
    1Life expectancy at birth, at 65 years of age, and at 75 years of age, by race and sex: United States, selected years 1900–2007 (2010) Centers for Disease Control and Prevention. pdf 2Adamy, J. (2020, January 30). Life Expectancy Rises in U.S. for First Time in Four Years. The Wall Street Journal. 3Poll: How many people want to live to 100. (2019, May 9). Axios. 4Singleterry, M. (2018, April 9). Your long life could be the death of your retirement savings. The Washington Post. 5Olshansky, S. J. (2016, January 8). Articulating the Case for the Longevity Dividend. Cold Spring Harbor Perspectives in Medicine. Cold Spring Harbor Perspectives in Medicine. 6Linton, R. (2017, April). Will metformin become the first anti-aging drug? Life Extension Magazine. 7Barzilai, N., et al. (2018, May 10). Metformin as a Tool to Target Aging. US National Library of Medicine / National Institutes of Health. 8(2016, February 5). Metformin may promote blog. 9Peyer, J. (2017, January 27). TAME: Teaching old diabetes drugs new tricks. Geroscience.