Matches in various stages of being burnt

Your Healthspan Matters More Than Your Lifespan. Here’s Why

Our Chief Medical Officer breaks down the two major elements of longevity and shares why each matters.
By Jack Jeng, M.D.
December 9, 2022

Humankind has been searching for the holy grail of eternal life for as long as we can remember.  While immortality remains a fantasy, there is no dearth of products or services today promising a longer life. Our zealous pursuit of a longer lifespan, however, has come at the expense of a more important factor: improving our healthspan.

Simply defined, your “lifespan” is your years of life, while “healthspan” is your years of healthy life, or years of life spent free of disease. Ideally you want to extend both, but if you ask around most people would prefer an increase in healthspan over lifespan.

Intuitively, this makes sense. Most people don’t want live to 150, only to spend the last 75 years in a hospital, hooked up to machines, fed through a tube. What’s the point of living longer if you’re not able to enjoy that extra time?

Why Healthspan Is Vital Now

Three major factors are converging to bring healthspan into focus.

First, we’re paying more for healthcare, but we’re not seeing a commensurate rise in value because the system isn’t delivering what most of us want. 

Second, we have advanced technology to determine biological age, allowing us to measure and track aging at a cellular level.

Third, emerging evidence is showing promise for increasing healthspan using therapeutics. We have examples of drugs that actually work, and the data demonstrate that aging can be modulated with treatment.

Let’s unpack each factor.

Our Pricey Healthcare Is Underwhelming 

That healthcare in the U.S. is expensive isn’t surprising. What’s eye-opening, for many, is that the bulk of your healthcare costs come at the end of your life.

Up to 25 percent of Medicare costs are spent on people in their last year of life. Hospitals do not come cheap. 

That late-stage expense isn’t yielding much time. Despite advancements in medicine, many of our costliest interventions only extend lifespan by days, weeks, or months. People often spend their final days in the hospital or ICU, sometimes in a medically-induced coma with a breathing tube.

The takeaway: we’re shelling out thousands of dollars to stay alive, but we’re not really living. 

What our U.S. healthcare system is good at—keeping us alive incrementally longer—and what we expect—increasing healthspan by keeping us healthy—are two different things.

Once we recognize this gap, we can finally start to address it. 

Live Longer

Aging Research Is Getting Turbocharged

I have a friend in his late thirties, a start-up founder, who has worked hard his entire life and is incredibly successful. His success came at the expense of his health, however. He took a test to find out his biological age and it said he resembled a man a decade older.

This was the impetus he needed to start taking his health seriously.

He threw himself into this endeavor the same way he attacked his work, and started exercising, eating better, sleeping more, and seeing a knowledgeable clinician.

A year later, his repeat test showed that he is now biologically younger than when he first started his journey and closer to his chronological age. 

It’s incredible that we have the technology to measure this. 

We now understand that your chronological age—how much time you’ve been alive—is different from your biological age, which is the age of your body at the cellular level. 

You have probably seen this within your own family, where an elderly relative acts, looks, and feels decades younger, while another younger, sicker relative seems much older than his age. 

Tests like these are useful both for researching longevity and for individuals like my friend. Conducting clinical trials on a new drug for longevity will take a literal lifetime before knowing if it works. A test that measures biological age can show positive results sooner, giving us earlier access to this important medication. For individuals, a biological age test allows us to track how we are doing with our lifestyle interventions and treatments, making adjustments when needed.

My friend is on the right track, and seeing the improving biological age gave him the feedback he needed to keep pushing forward.

The Cutting Edge Test: DNA Methylation Biomarkers

One increasingly popular testing method is measuring DNA methylation biomarkers. You have the same DNA throughout life, but you express different genes at various times due in part to methylation.

Methylation is when one carbon and three hydrogens are added to the DNA molecule. This doesn’t change your DNA, but it can alter its activity. Methylation is like a light switch for your genes: adding the methyl group can turn a gene off and removing it turns it back on. 

When you are a growing fetus, for example, you need to develop different organs at different stages. Methylation plays an important part in this process by turning off genes when they are no longer needed, while your DNA remains unchanged. 

Another example is the differences you may notice in identical twins. While their DNA is the same, they may look different and have different health conditions. This is partially caused by DNA methylation. If you measure their methylation patterns, you will see differences, which may be from environmental exposures and lifestyle choices.

Maybe you’ve seen the biological age tests from AgelessRx or Elysium Health; both examine your DNA for methylation patterns. Elysium says it looks at more than 100,000 sites to calculate your biological age. 

Biological age tests are still considered experimental and more research is needed, but the published studies are encouraging. They show that these tests can be an accurate predictor of disease and mortality.


A Slew of Promising Drugs for Healthspan

We are seeing an increase in medications being prescribed for their powerful healthspan and lifespan benefits. Some breakthroughs in longevity are coming from human trials, but most studies use animals because it’s cheaper, more practical, and faster to track results over their lifespan. 

Metformin is one example. While originally FDA-approved to treat diabetes, large observational studies in people have shown other benefits, including decreased cardiovascular disease, cancer, and mortality. Metformin can improve both healthspan and lifespan, but it likely has a greater effect on healthspan. 

Another longevity product we offer at Hone are NAD+ injections. NAD+ is found in every cell of our body and is essential for life. Supplementation has many benefits and it is one of the most studied molecules for longevity.

Levels decline as we age and research in animals has shown that giving NAD+ improves both healthspan and lifespan. While clinical studies in humans are still limited to small sample sizes over short periods of time, the data available are promising.

Or rapamycin, a powerful drug used to reduce the risk of rejection after an organ transplant. Animal studies have shown impressive increases in healthspan and lifespan, and there is even one ongoing study with pet dogs at the University of Washington.

The Future of Increasing Healthspan

With time, additional discoveries will improve biological age testing so they are better predictors of the benefits we seek, like extending healthspan. This will accelerate the research into new treatments that are clinically proven to increase longevity. As this feedback loop strengthens, our healthspan will lengthen and the gap between lifespan and healthspan will narrow.

It won’t be a straight path forward and there will be obstacles and setbacks. The positive trends we are seeing today gives me confidence that we will eventually get there; hopefully within our lifetimes.