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This episode of Longevity by Design is all about longevity medicine, diving deep into the topic of longevity clinics, practical tools for using longevity medicine, and how this approach to healthspan differs from traditional methods of care.
In this episode of Longevity by Design, our host, Dr. Gil Blander, is joined by Dr. Evelyne Bischof, Chief Physician Associate of Internal Medicine at University Hospital Renji of Jiaotong University Shanghai and Concierge Longevity Physician for executive longevity patients. Tune in as Dr. Bischof, a healthspan enthusiast and practitioner, shares interesting and exciting information about the growing field of longevity medicine.
Dr. Evelyne Bischof is a Chief Physician Associate of Internal Medicine at University Hospital Renji of Jiaotong University Shanghai and a Concierge Longevity Physician for executive longevity patients. Her research interests include oncology and longevity medicine, Artificial Intelligence (AI), digital health, precision medicine, biogerontology, and geronto-oncology. In addition to publishing over 80 peer-reviewed papers, she is a frequent speaker at scientific and medical conferences in Asia and Europe. In addition, Dr. Bischof sits on several scientific and advisory boards of biotech and longevity hubs.
Longevity is recently gaining attention as an approach to healthcare. While public interest and scientific discoveries have both exploded in recent years, a clear definition of how to translate a longevity approach into medical practice is still being defined.
Traditionally, people seek care during an annual physical or when something has already gone wrong. However, the rising interest in longevity medicine—which involves quantifying biological age through your body’s data to achieve optimal healthspan—has flipped this concept on its head. Rather than waiting until a health issue has snowballed into a more significant issue, longevity medicine takes a proactive approach to health.
A relatively new concept, longevity medicine is currently practiced in longevity clinics. Longevity clinics are centers where physicians utilize data collection methods such as full-body MRIs, genetic testing, and aging clocks to analyze an individual’s health and aging status comprehensively.
According to Dr. Bischof, there is a growing demand for longevity practitioners, and she shares her excitement for progress in the field. “I am most excited for the creation of longevity departments—essentially a longevity clinic within a hospital or university,” she says. “These departments will allow direct translation between science and medicine—physicians being with patients and being well educated to practice longevity medicine.”
She hopes the field will develop globally and establish evidence-based, credible, and validated guidelines. The medical society that Dr. Bischof helped create addresses gaps in practice. Established in August 2022, Healthy Longevity Medicine Society aims to “build a clinically credible framework and platform for longevity medicine that promotes the highest standards of interdisciplinary collaboration in the field,” targeted primarily at medical doctors and other healthcare professionals. [1] In the future, Dr. Bischof plans to establish a curriculum taught in universities, hospitals, and other healthcare clinics.
So what distinguishes longevity medicine from traditional medicine? Dr. Bischof explains that the diagnostic tools that longevity clinicians utilize make this form of healthcare unique.
Tools of longevity medicine are now fairly developed and include measurements of continuous monitoring and yearly monitoring systems. "Biological age is the ultimate guide for the physician, but we still have to figure out which part of the biological age is most important. We know that every organ and every system is aging at a different speed and that they influence each other. It's all intersected. I believe we will see a variety of new validated biological aging clocks come up, and perhaps there will be an algorithm to measure the rate of biological age within the organism," says Dr. Bischof.
Dr. Bischof further distinguishes longevity medccine from traditional healthcare by their intended outcome. In traditional medicine, practitioners screen, diagnose, and treat diseases. Conversely, longevity practitioners measure a patient's biological age and work to optimize this age. "It's important to mention to restore the biological age to optimal performance does not mean that we have to reverse the biological age on the clock as much as possible. It's not about the quantity, but rather where the optimal biological age is at that point in time for this specific patient," she says.
Interestingly, traditional medical settings incorporate certain aspects of longevity medicine. Dr. Bischof recalls that in the University Hospital of Basel Switzerland, the oncology department is implementing biological aging clocks and other longevity diagnostic tools—namely speech recording and saliva testing—to better triage the patients. She says these tools are helping to guide cancer therapies and follow-up practices after treatment while optimizing patients' biological age. "Hopefully, at some point, the decision of which therapies and guidelines to follow for a specific patient will be made not based on their chronological age, but rather biological age. That would be a big success for medicine in general," Dr. Bischof expresses.
A common misconception about longevity medicine is that it is designed for an older population. Dr. Bischof clarifies that she sees patients of all ages, starting as early as their mid-twenties. Her team at the Healthy Longevity Medicine Society defines the field of healthy longevity as the extension of healthspan and optimization of the healthspan across the lifespan. “If the lifespan is extended in good health, great. However, the extension of lifespan without extension of healthspan has already been done, and this is why we have a huge elderly population currently living with a chronic disease. Longevity medicine is for every age group,” she explains. The ultimate extension of healthspan is better achieved when practiced early in life and carried through life.
Longevity medicine determines a patient's biological age using artificial intelligence (AI). A patient's body data is complex and heterogeneous, making AI critically important in answering the two fundamental questions of longevity medicine—first, what is the patient's biological age, and second, what is the optimal biological age of the patient. “We combine everything from genetics, physiological testing, imaging scans, liquid biopsies, 24/7 monitoring systems, and epigenetic factors. We also combine cerebral information, both neuropsychological and mental. So, AI is a tool that is almost mandatory to really make sense of this huge amount of data,” she explains.
In addition to AI, biological aging clocks are a major tool for longevity physicians. Many available aging clocks predict biological age based on epigenetics, proteomics, blood biomarkers, the gut microbiome, the brain, and more. Dr. Bischof says that she particularly likes blood-based aging clocks because they allow her to frequently track the impact of the interventions she suggests to her patients. She also notes the benefit of combining this information with other clock data, including photo age, psychological age, brain age and epigenetic age.
She explains that these clocks have different levels of accuracy and she specifically uses the ones that are well published. “For example, blood aging clocks are very precise. In practice, this means that when I see that somebody's biological age is higher than their chronological age, usually there is something that is quite, let's say not pathologic, but immediate action is advisable.”
Longevity conferences and other similar events occur in various countries worldwide. Dr. Bischof says that depending on the country, different developments and different speeds of development occur.
“Everybody's a bit different. The direction towards the patients are different and the policies are different. So I think we see great successes in some smaller areas and on different continents. And that's why it's important to collaborate in this field,” Dr. Bischof observes.
To close the episode, Dr. Bischof shares her top tips for improving healthspan. “The most important intervention is different for everyone, however, my best advice is to find a good physician that can guide you through longevity interventions. Do not experiment without good advice.
“Let's say you cannot find a longevity physician and don't know what you could improve besides a better lifestyle, try to track yourself. Collect your data. Because at some point, we'll hopefully have physicians that will take your data and run it through an algorithm to compute your biological age and figure out the best interventions for you.”
[1] https://hlms.co