Let's consider a scenario: before your morning tech huddle, you visit a nearby clinic to learn about what your genetic and biological assessment has to report. Six months later, you are again at the clinic, but this time to undergo a cocktail of CRISPR therapies that will not only drastically reduce your risk of inherited Alzheimer’s but also boost levels of the neurotrophic factors that best enhance your learning capacity and memory. Forty years later, you still feel and look as vigorous as a 30-year-old.

This somewhat Huxleyan narrative underpins what may become the practical elements of a movement pervasive in Silicon Valley: that of the longevity-striving ‘immortalists’. With funding from the likes of Sam Altman, Jeff Bezos, Larry Ellison, and Larry Page, companies are now springing up all over the globe that look to ‘kick the can’ on that most permanent of problems: death. As early as 2014, at an Oxford lecture, I recall Aubrey de Grey claiming that the first person to live to 1000 is alive today.  David Sinclair, another advocate of the longevity moment, believes that 80-90% of dementia and cardiovascular disease cases are caused by processes that are akin to ageing. With the promise of therapeutic and supplement stacks that look to wipe the signatures of ageing from our cells and mimic the mechanisms of exercise and dieting, who would not be intrigued? 

Beyond the gilded layer of health tech celebrity is the hard reality of the entrepreneurs' stress and sacrifices. In proper doses, the challenges of a startup drive learning, adaptation, and ultimately, resilience to the many challenges one faces in business and life. However, if prolonged, the anxiety, depression and stress can increase the risk of chronic disease and accelerate the hallmarks of ageing.  It is a welcoming thought then that we could soon wield a molecular toothbrush to scrub away the biological tide mark that accumulates in our bodies. But, despite the recent progress in longevity science, the treatments these companies offer are expensive and have only been tested in short-lived animal models that fail to replicate the pluralistic nature of the human experience.

Genetics is also crucial to our ageing trajectory and disease risk. Scientists have identified thousands of genetic variants that can impact our susceptibility to different diseases. Due to their genetic makeup, some people may have a higher risk of developing cardiovascular disease, dementia, cancer, or mental health conditions. Although genetic tests cannot predict chronic illness with certainty, they offer points of clarity that can help us better evaluate our health as we strive through life. One striking example is that of the actor Chris Hemsworth, who, in his late 30s, found out he carried two copies of the ɛ4 version of the apolipoprotein E gene (APOE), which is the strongest genetic risk factor for Alzheimer's disease. This mutant form of the protein negatively impacts how fats and other molecules are processed in the brain, increasing inflammatory processes that cause nerve cell death. By the age of 85, it may be that 80% of all people carrying the ɛ4 version will have a form of dementia. Upon finding out his result, it was reported that Chris Hemsworth changed his work life to improve his physical and mental health. In support of this action, an increasing body of evidence shows how lifestyle changes can reduce the risk of Alzheimer’s disease and prolong the time we can remain healthy. Strength exercise, diets enriched in vegetables and omega oils (including the DASH and Mediterranean diets), and lifelong learning reduce risk. Conversely, type 2 diabetes, high blood pressure, vitamin D deficiency, alcohol consumption, and social isolation can increase the risk. With many of these factors linked to lifestyle, we are moving into an era where personalised medicine is a reality.

Building a company is all-encompassing and involves making many sacrifices. This makes it easy to overlook our health while endeavouring to achieve our next funding round, sales target, or technology build. However, chronic health conditions such as Alzheimer's disease develop over many decades, and the true nature of the associated cellular damage and, importantly, its reversibility are not well understood. With the ever-increasing canon of scientific knowledge and advancements in diagnostic technologies, we can take more targeted action to mitigate our biological susceptibilities and focus on our health needs. Early action is essential if prevention is the goal. This understanding of the importance of early action can instil a sense of urgency and responsibility in us to prioritise our health and fitness, even in the midst of our busy entrepreneurial lives.

With their philosophy emphasising that senescence is optional, the ‘immortalists’ will continue in their pursuit to end ageing. These advancements will profoundly impact our economics, society, and culture if they are right. Notwithstanding, I think they will find that the biological basis of long-term survival, like growing a startup, involves many trade-offs and a good helping of luck.