You get older every day. But how old are your cells and organs, really?
Understanding that could help us live longer, healthier lives, many longevity experts believe. Dr. Douglas Vaughan is among them. He is the director of Northwestern University’s Potocsnak Longevity Institute and its Human Longevity Laboratory, where people can go to get their so-called biological age calculated. By gleaning whether a 50-year-old person’s cells and organs look more like a 65-year-old’s—or a 30-year-old’s—scientists like Vaughan hope to pinpoint treatments and lifestyle changes to help people live healthier for longer, a notion known among longevity enthusiasts as “healthspan.”
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Vaughan believes that researchers are getting close to being able to find treatments to slow or even reverse aging in people. He says he wants to ensure that everyone benefits from these advancements and not just the ultra-rich.
“We want to find ways to slow down aging for the 99% of people in the world, not the 0.01%,” says Vaughan, former chief of cardiology at Vanderbilt University. He joined Northwestern in 2008 and formerly chaired its department of medicine.
The Institute intends to help establish a network of longevity labs in almost every continent by next year, Vaughan says. Plans are already underway for labs in Japan, the U.K., and South Africa.
As part of TIME’s series interviewing leaders in the longevity field, we caught up with Vaughan to talk about this effort and all things aging.
This interview has been condensed and edited for clarity.
What drew you to longevity research?
As a cardiologist, I spent years studying a protein called plasminogen activator inhibitor, or PAI-1 [which plays a role in blood-clot regulation]. About a decade ago, we discovered that a rare genetic mutation in the gene that codes for PAI-1 protects against aging in humans. This genetic variant is present in 10% of the members of an Old Order Amish community that lives in and around Adams County, Indiana. Similar genetic variants are very rare in people outside of this community.
We discovered that carriers of the variant are protected from aging in a variety of different ways. They live about 10 years longer than other members of the community. They don’t get diabetes. Their cardiovascular system is younger than their unaffected kindred. They have longer telomeres. That was my entreé into the world of the role of PAI-1 and aging, and was the springboard that eventually pushed us to develop the Human Longevity Laboratory.
Before we move on, we should probably define what aging even is.
There are at least two versions of aging. One is your chronological age, and that’s something everybody’s familiar with. Every time you complete an orbit of the sun, you add a year to your chronological age. There’s also a version of your age that we call your biological age, and that’s a cumulative expression of the aging of your organs and your system as a whole.
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Biological age and chronological age don’t always match up. We all know people who appear to be protected from aging: People who live well into their 80s or 90s and who don’t experience many of the frailties and other problems that commonly occur in people after a certain age. We also all know people who seem to age more rapidly. This can be due to chronic conditions or circumstances such as a chronic HIV infection, chronic kidney disease or diabetes; also, adult survivors of childhood cancer or people who just live in the wrong place and have the wrong diet and climate.
Differences between biological age and chronological age speaks to the possibility that aging is malleable.
What do you do at the Human Longevity Laboratory?
We measure peoples’ biological age by performing a series of tests. We do a DEXA scan to find body composition; we measure cardiac and vascular aging; we test gait speed and grip strength and pulmonary function. We also use molecular-based tools and AI-based biological age clocks.
One of the AI-based tools we use involves taking a picture of a person’s retina. We work with a group in New Zealand that has analyzed hundreds of thousands of human retinal photographs. We put the images up in the cloud and we get your biological age back in a few seconds. So those are the kinds of fun things that we do that you wouldn’t get done when you visit your primary care provider.
What are you hoping to achieve by testing peoples’ biological age?
We try to understand if you have a gap between your chronological age and your biological one. You want your biological age to be less than your chronological age if you can, but certainly we see people that have a biological age that’s greater than their chronological age, and those are really the people that we’re focused on. We’re trying to see if we can slow down aging in people that are disadvantaged with regard to aging because of a chronic condition or a circumstance. The big hypothesis is related to the idea that age is the most important risk factor for almost every disease we deal with in adult human beings. So if we can slow down aging just a little bit, we might be able to extend peoples’ healthspan.
How accurate are these biological age measurements?
Since we opened the first version of our lab more than a year and a half ago, we’ve had more than 300 people go through our protocol. That’s given us a chance to actually compare the different measurements to see which ones are most reliable. That’s given us confidence that we can do these measures relatively quickly, accurately, and precisely.
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Of course, when we sit down with people, the conversations we have are kind of complicated. We go through the different results and explain that there are caveats and they may not be perfect. Based on the findings, we provide some guidance on areas of their health or lifestyle. We’ve had people, even celebrities, come through that have found that they’re not as “young” as they thought they were, and it’s provided kind of an epiphany to rethink the way they live and how they take care of themselves.
What are some recommendations you’ve made to participants?
We encourage people to have a healthy weight and have a BMI under 25. We encourage people to exercise regularly. Both those things, not surprisingly, are beneficial, and they can even lower your biological age.
Also, you might be a person where everything’s fine except you have evidence that your kidneys are aging or your cardiovascular system is aging, then you might be directed to specialists in those areas to optimize your medical plan to do what they can do to protect you from aging in those organs.
Now, it gets harder when you start talking about other interventions like drugs and supplements that people want to take.That’s kind of a mess right now. I don’t think we’ve got clear evidence with respect to creatine or NAD or stem-cell infusions or plasma-cell infusions. I don’t think there’s any good scientific data around any of those kinds of interventions.
I think we will be able to find interventions that work. We [at Northwestern] are going to be testing different interventions. We are committed to the idea of measuring age in multiple dimensions and then testing the impact of interventions on these various dimensions, whether that’s a stress-reduction program or rapamycin or metformin or Ozempic.
There are biological age clocks that anyone can order online and try for themselves at home. What do you think of those?
I wouldn’t endorse any of them right now. There’s more to it than one single test, so I think we still have a lot of work to do to figure out what combination of tests are actually the best and which are the most informative for the average person.
How much does it cost to get your biological age measured at the Human Longevity Lab?
Our clinic charges $4,200. I think it’s the most comprehensive testing you can get almost anywhere in the world with regard to biological age. So in terms of value for what you get, it’s probably at the top of the chart, but that’s not an insignificant amount of money. We also have people who we bring in through our research side who have enrolled in clinical trials and we underwrite those costs.
The research you mentioned is being conducted under the umbrella of the Longevity Institute, of which the clinic is a part. What other work is the Institute doing?
We have several different centers in the Institute, including HIV & Aging and Population Science & Aging. We have a [researcher] developing new wearable devices that register aging-related changes in a variety of different systems and others doing amazing work looking at environmental factors that drive biological aging.
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For example, we already know that one of the worst things you can do to accelerate your age is smoke, but it turns out that using cannabinoids also accelerates aging. Also our group here is one of many that have shown that Long COVID seems to age people more rapidly. On the other hand, living near a green space slows your aging.
The Institute is also planning on collaborating with international partners to open more longevity labs in the near future, right?
Yes, Tohoku University in Japan is partnering with us. We also have a collaborator at Mount Sinai Medical Center in Miami and a partnership with the London Clinic. We also have a longstanding collaborative relationship with Stellenbosch University in South Africa, and we will have a lab down there within the next 12 months.
We don’t just want to measure people’s biological ages at these clinics. We’re going to enroll people in pragmatic short-term clinical trials to see if we can find interventions that can slow the pace of aging in human beings around the world—no matter where you live, what your ethnic background is, what you eat or what air you breathe—and that will provide some truth for this science. The first study that we’re planning and that will start enrolling participants relatively soon is a study on how stress reduction could affect biological age.
How big of a role does genetics play in aging vs. environmental factors?
I think the common perception is that genetics are the key driver of your expected lifespan. But I think that algorithm is changing quite a bit. If you really crunch the numbers and look at the data seriously, the genetic influence of aging is certainly less than 20%. Other factors are more important, such as where you live and how you live and what you’re exposed to.
So although I’m sure everybody knows people that seem to have longevity in their family—they can recount ancestors that lived well into their 90s or over 100—that’s pretty uncommon, and finding those specific genetic variants is extremely challenging.
Do you think that within the next half-century or so we’ll be able to get people to live to 150?
I think we might have an outlier or two that could get up there. But if somebody who is 50 right now has the illusion or the fantasy to be 150, they’ve got to live for another century, and, well, most of us are not going to be around to see.
Our goal is to actually try to extend the healthspan of people to give people two, three, or four more healthy years. If we could accomplish just that, that would do so much for society.
This article is part of TIME Longevity, an editorial platform dedicated to exploring how and why people are living longer and what this means for individuals, institutions, and the future of society. For other articles on this topic, click here.