So you wanna build an aging company

Summary

Today, aging is cool. In 2024 alone, investors deployed about $8.5B into longevity-focused biotech companies. Aging biotech companies have entered clinical trials. The field has come a long way.But as “aging” (and “longevity”) have become more mainstream, there’s a temptation to stretch the definition to things that don’t belong in the category. Aging is not a single process. It’s a complex interplay of multiple biological processes that, over time, become dysregulated. Understanding it as such is crucial for developing effective interventions. So it’s worth thinking about what makes something genuinely an “aging” biotech approach, and how to tell if you’re really tackling aging.A successful aging treatment would be something that:prevents diseases of aging, ideally more than one;preserves a healthy function that normally declines with age (like fertility, immune function, cognitive function, resilience, or physical fitness); orreverses the course of at least one age-related disease.This seems pretty obvious, but it has non-trivial implications.If the goal is to prevent or delay age-related disease and loss of function, then we’re envisioning a treatment that people start taking when they’re healthy (no clinical disease). It would look like “Take this pill and reduce your risk of heart attacks, diabetes, cancer, and so on.”That’s not unprecedented. People with high cholesterol take statins to reduce heart attack risk, and people taking GLP-1 receptor agonists for diabetes or obesity have a lower risk of all-cause mortality.But it does present special challenges.A drug that prevents age-related diseases needs to be safe enough for a healthy person to take. And, it needs to target a clinical endpoint that’s relevant to preventing age-related disease, but doesn’t take an unrealistically long time to test in trials.Alternatively, if your goal is to reverse age-related disease, you’re often trying to intervene on seriously damaged tissue.Tackling a neurodegenerative diso...