The Great Age Reboot - Global Macro Update
Your period of twenties, thirties, forties, fifties will be expanded, so that instead of feeling at age ninety like the typical ninety -year-old does, you will feel at age ninety like the typical forty-year-old you did feel like then. How would you feel if you learned that you were going to live to be one hundred or even one hundred and ten years old? Would you be thrilled because you could now spend more time with family and friends, maybe even get to know your great-grandchildren, do all those things that you have on your bucket list that you thought you maybe wouldn’t get to? Or would you be terrified because you’re already struggling to come up with enough retirement savings to last into your eighties, and how are you possibly going to fund a retirement into your hundreds? Well, that scenario might be closer than any of us realize. Today, we’re going to explore that with Dr. Michael Roizen. He is the head of Wellness for the Cleveland Clinic, and he has got a new book coming out called, The Great Age Reboot, where he takes a look at the very real possibility, in the next decade, of healthy lifespans increasing by up to thirty years... and what that means for our retirements, what that means for our society, and our economy, and our personal finance. I hope
you enjoy this discussion with Dr. Michael Roizen. Dr. Roizen, I am so thrilled to be speaking with you today. Thank you for joining us to talk about how we are all going to live a longer, healthier life, the financial and economic ramifications of that, and what you’ve got to tell us in the upcoming book, The Great Age Reboot. Really excited to hear about it, My privilege. And thank you and John for letting me do this. And that’s really why we wrote the book, because there’s a lot of economic and policy implications that come with longevity as a disruptor. Agreed. And that’s what we do at Mauldin Economics. I’m always interested in the financial, the retirement,
the economic, societal implications. But I think before we go there, we probably need to get a preview from you of why you think we’re on the cusp of longer life. Because we’ve been hearing about this story for a while now, and for many people, it’s still science fiction. But from what I understand, you feel like we really are very close to some serious breakthroughs. What’s got you thinking that way? Well, first of all, there are fourteen different areas where there has been exponential progress in understanding the mechanism of aging. And with fourteen shots on goal, we think there’s at least an eighty percent probability that one of these will switch from whole animal models. In all fourteen have changed the rate of aging,
have actually rebooted to a younger age... those animal models, and at least two animal species. We’re now seeing human trials beginning. And we can talk about that because they’re really exciting. And what that means is, we’ve been on an upward trajectory in life expectancy of about two and a half years, every ten years. Now, you may hear if you will, “Well, what’s happening to life expectancy with COVID? And I thought there was a decline.” Yes, there was a decline, just like there was with the Spanish flu. But life expectancy as reported by the CDC is, what happens if COVID
keeps killing people at the same rate it did last year and the year before? We’re not going to have that hopefully for the next fifty years. They didn’t have it after the Spanish flu. We expect life expectancy, which has gone upward from lower left to upper right, if you will, at two and a half years per decade, per ten years, since eighteen ninety. We expect in the next ten years, there will be a thirty-year shift upward, but it won’t be you’ll have many older years—you will reboot to a younger self. We predicted in nineteen ninety-eight with Real Age, that sixty would be the new forty. That came true. I’m now predicting that ninety will be the new forty by ten years from now, which means you’ve got a lot more living to do. Wow. So, you’re saying that essentially a human’s lifespan will be stretched out if you will?
That’s right. Your period of twenties, thirties, forties, fifties will be expanded, so that instead of feeling at age ninety like the typical ninety-year-old does, you will feel at age ninety like the typical forty-year-old, you did feel like then. You’re going to get to reboot backwards. That means you’ve got a lot of productivity.
It also means a lot of difference in how you plan for the economics of this, and how society plans. You mentioned there’s fourteen key research areas that are underpinning your thoughts around this. Can you touch on two or three that you feel are the most important and give us a couple of examples? Well, I’m going to give you a couple examples that are really incredible because they’ve moved into human testing now, and you may have even seen them as headlines. One of which everyone knows about is gene editing. If you have the amyloid gene that increases your risk of heart failure substantially so that people with this gene develop heart failure and have what we call ejection fractions—the amount of blood their heart puts out with each beat is only twelve percent or less of what they have in their heart, as opposed to the normal person, you or I, hopefully, have fifty-five to sixty-five percent. They’ve got a life expectancy, when they’re at twelve percent, of about six months. You
knock out that gene that produces that amyloid protein, and in animal models, they end up with a normal lifespan. Well, they’ve now done that in twelve people that they’ve published on. So this is already done—by more than eight months—in Australia; and of those twelve, seven now have ejection fractions over thirty-five percent. And instead of six months’ life expectancy, they expect them to live over eighteen years. Radical change.
Think about another one. They’ve knocked out the gene that causes hemoglobin S, so hemoglobin sickle cell in sickle and thalassemia means you can’t deliver oxygen. You knock out that gene, seventy-five of the seventy-six people who’ve been treated with that feel enormously better. Don’t have the same life expectancy pain they had. And there are a number of other areas like this. Colon cancer predisposition,
you can knock that out in animal models. It’s been done. It’s now moving into human trials. Another one that’s moving into human trials in New Zealand is knocking out the gene that causes cholesterol to accumulate in your arteries instead of processing it in your liver. Another one, and you can go on and on. These are all moving into human trials, and they’re occurring fast. How much will it cost? It’s really inexpensive, for the materials. The trials are going to do this for approval for the serious and life-threatening diseases, like Alzheimer’s—knocking out, or actually editing, the E4 gene, which increases your risk of dementia about sixfold. Knocking that into the E2 gene, which decreases that. It’s editing it
from E4 to E2. It’s just one amino acid change in the DNA, formatted one DNA peptide change. And what happens? You get an E2, which decreases your risk of dementia and Alzheimer’s disease. So that’s going to be tried. That’s one example. Another one is what we call senolytics.
When you have one old cell, the cells around it become old. It puts out a hormone, if you will, that makes each other cell old around it. The whole thing doesn’t function well. With senolytics, you knock out that old cell, and the rest of your body becomes younger, doesn’t get old. Well, guess what? Therapeutic plasma exchange
is used at the Cleveland Clinic—we did about twenty-two thousand of them for other diseases. But imagine if you did this for just aging, and you get younger. That’s what the young-blood hypothesis said was possible. Well, now it’s been done for dementia. So in the AMBAR study—you can Google AMBAR, A-M-B-A-R—in the AMBAR study, a 2B3A study that was done through FDA, two centers in Spain, two in Chile, two in the United States, Pittsburgh and Cleveland... what happened? They gave treatments for five months, and after fifteen months, every one of the twelve areas of cognitive functioning from memory to visual, spatial, cognition to speed of processing... every one of them got better. They didn’t get worse the
way the control group did. They actually improved and reversed some of the dementia. I want to make sure I understand this, Doctor. Everything that you’re saying, it sounds like it’s applicable to people living now. In other words, a fifty-, a sixty-year-old, this is going to help them. It’s not just unborn people that are going to benefit from this technology. You’re saying that is actually going to apply to... a reversal? One of my co-authors is Albert Ratner,
who’s ninety-four, was the CEO for twenty-five years—CEO and co-chair of the board—of Forest City Enterprises. And he says, “Mike, you shouldn’t say it’s in the future, because it’s happening now.” That’s right. These are beginning to happen now. And so there’s a second phase three or study, FDA approved, that’s going on AMBAR that’s already started. That the FDA has said to the company, I understand—it’s in the press release—that if they get approval for this, if they come up with the same results, the FDA will give them approval as a treatment to reverse dementia.
And in each of the fourteen areas—I’ve given you just two of them, and you can tell my excitement and my passion for this—in each of these fourteen areas, these are moving into human trials. It’s really incredibly fast. Everyone knows what exponential is from the chip. Diamandis said it best at one of your conferences: thirty linear steps— thirty yards closer to the end point. Thirty exponential steps—one, two, four, eight, sixteen, thirty-two—it’s twenty-six times around the Earth. That’s how fast the science is going. When we did Real Age, starting in about eighty six, I would read one article every three months that was key. By two thousand, it was one every three weeks. Now it’s one every thirty minutes. That’s how fast the science is going
and how fast the change is occurring. We think, based on these early results, as well as the fact there’ve been fourteen... Let me give you another one that I’m thrilled with. This is one that Patrick Cox has written about. And Mike West, who spoke at your conferences, and Patrick, who’s spoken at your conferences... described as induced tissue regeneration. It is turning white fat back into pluri-potent fat. Where does the fat cell come from? An original fat cell can go to white fat, which is what hangs off of our belly and causes inflammation. Or in the womb, it can go to brown fat. Brown fat is what
we have as kids around our organs in our chest to keep us warm when our mother isn’t swaddling us. Well, imagine taking white fat, regressing it into pluri-potent fat, and then turning it into brown fat. That’s been done in three animal species. The biggest one is lambs. I didn’t understand this, but lambs develop non-alcoholic fatty liver disease. They eat too much, apparently, and they stop producing wool—meaning they die and stop producing wool. This has even been done at Crimson in lambs. This isn’t science fiction anymore. We
may eliminate obesity if this really works in humans. And Mike West says, “We’re less than three years away from knowing whether it works in humans in a large-scale, inexpensive way.” I got to give Mike West another plug. He also took the immunogenicity of stem cells away. He’s developed that technique. Stem cells are very expensive to grow to twenty to fifty million. They’d have to take them out of you, culture them. It would take a month to three months
to get twenty million to fifty million to give you back to repair something. Stem cells are the matriarchs that will repair everything if we do it right. But if you take away their immunogenicity, instead of that being a one-off and very expensive for each person, I could grow thirty trillion heart stem cells and treat a whole bunch of people with them because you wouldn’t reject them, and we’d heal heart attacks that way. And now we even think you’re going to be able to take plaque out of the artery.
Each of these areas is advancing so fast that we think that it’s really quite likely that we’re going to change, not only the rate of aging but reboot you back. So it’s not just slowing aging, but you’re going to have many more years at a productive self. How far away do you think most of this is? For filtering into the general population? Well, if you want to try therapeutic plasma exchange, you just go to a plasma donation center and donate a unit of plasma once a week or something like that.
That’s how fast you could do that if you wanted to jump ahead. But from a standpoint of when we think we will have one of these techniques, it’s clearly within ten years. It’s probably longer than two to three years—just for the FDA approvals. Even if the AMBAR study reverses diabetes in a second trial... well, it’s about an eighteen-month trial, so that’s two years. And by the time you analyze it and get the approval, it may be as much as three years if that really works. Within ten years, then you can think of a lot of this will be actually...
If you make it ten years—and the third part of the book is what you should do now, so you can plan... the second part is the finances part, if you will. It’s all about the policies and what you do in finances, and what we should do as a country. The third part is what you should do personally. And to make sure you don’t have what we would call “something in an organ or a system that limits your ability to get a reboot.” If you will, you want to have an as good functioning brain as possible. Everyone knows it’s a lot easier to stay thin than it is to get thin if you’re fat. That’s the same with every one of these processes in the human
body. It’s a lot easier to stay healthy than it is to reverse and get healthy. You want to stay as healthy as possible so that the reboot on whatever organ you need works in a system that has everything. That brings up another point, Ed, I just want to bring. We think sometime in twenty fifty or so, thirty years from now, you may go in one end of the car wash and come out a younger person. Some of the animal models show that. But for now, it’s going to be organ by organ. And so that’s why you want to keep as many of your organs and systems young for as long as possible until the reboot comes along.
How much of an increase in lifespan do you expect, from a practical perspective, that these technologies and sciences will bring to us? Conservatively, it’s thirty years. So if you look at the animal models... The person who heads up the Google Moonshot, Calico, for longevity... they have one, and they’ve recently switched to doing what Mike West and Shinya Yamanaka are doing. They went to ITR, finally, after doing a whole bunch of other things, but the person who heads that conservatively thinks that we’ll be able to do this at least once... in these worms that extended their lifespan fivefold... that would be you living to four hundred. We don’t think that’s likely in human terms
in the near future, but in worms, she was able to do a fivefold extension. I think thirty years is conservative. We don’t know you’d be able to get a second reboot or a third. Believe it or not, the science... they rebooted mice through three
readily available drugs that turn on induced tissue reprogramming, regeneration, from one-hundred-seven-week-old mice (the equivalent of one-hundred-four-year-old humans), to thirty-seven-week-old mice, the equivalent of thirty-four human years. They haven’t had another seventy weeks or so yet on those mice—that’s how recent this is—to know whether you can do it again and again and again. At least you get one shot at thirty years older. Which means you have to change your financial thinking about things. And it also means all of our family structures will change.
Even now, when you were born, it was unusual for grandparents and parents to be both there and be viable, et cetera. Now we’re talking about great-great-grandparents, great-grandparents, grandparents, parents, and children all living at the same time... and with divorce and other things, you’re going to have tribes if you want. And stretching out the human lifespan—I’m just trying to think through the societal implications—does that mean that, for example, women would be having children into their fifties if they so choose? You’re pretty good at asking questions. Almost all of the animal models have used male animals to do the regression. And the males are able to regain testicular function, regain sperm, even after they’ve lost it. Meaning, the mice. Now, the eggs seem to be limited still.
Now there is a major project, again, with part of Google’s help—and part of Jeff Bezos and a number of others —that’s going on in New York City to talk about ovarian regeneration. But so far, that has not been a major focus of many groups. I think that some people hearing this type of information, Doctor, are going to be absolutely thrilled. And I think others are going to be terrified. Because we already are on the cusp of a retirement crisis in this country. I think [for] a
lot of people, the thought of living a financially secure life into their eighties is a challenge. What do you and your co-authors come up with for how to deal with living to one hundred and ten? That’s daunting. Well, I’m going to tell you that something occurred while we were writing this that we didn’t expect. Peter Linneman is an emeritus professor at Wharton, who is another co-author on the book, and he took the lead on this. But
in Australia, Singapore, and Denmark, they force you to save 3 percent of your income starting the first year you go to work, not in a Social Security fund—they have that as well—but in a separate retirement fund that is guaranteed to earn 4 percent per year. If you do that, at 3 percent of even a fifteen-dollar income that grows and, if you will, principal grows four percent per year... and you do that with just even a fifteen-dollar per week income starting at age 22 and working to 65, you end up with around two hundred and fifty thousand in today’s dollars at retirement. But if you work to 95, it’s one point million dollars. And if you work for an employer who matches it, it’s two point eight million in today’s dollars. Well, that’s mandated in those three countries, and it’s working well, but it does away with a lot of the wealth inequality.
Well, imagine that the US did that. The incredible thing is, while we were proofing the book in the last six months, the House of Representatives—in a bipartisan way, without any fanfare, four hundred forty-to-five—passed this. You probably even haven’t heard of it. I didn’t know that. And it’s now in the Senate. I’m told it’s working its way through the Senate. I don’t know whether they’ll have time to do it before they go on whatever the leave is that they go on, but this happened. And so maybe...
How did I miss this? How did all of us? Maybe this will actually happen in a way... a policy will actually lead the way. But essentially it is if you save, save, save early—which, saving early is just postponing consumption; it’s being able to consume later—if you do that, the extra compounding, the extra years of compounding make a huge benefit. In addition, if you’re going to live thirty extra years, you’ll probably work twenty more of it because you don’t want to have nothing to do for fifty years. If you work and pay taxes and pay Social Security and pay Medicare... those trust funds—which Neil Howe, who also spoke at your conference, says they’re going to go bust, based on the CBO estimates, sometime in the early thirties—will be solvent. And there won’t be a problem with it because you’ll be not taking it out but paying in. Now, it will require the policymakers to change the eligibility years. And they’ll probably do it
gradually, but as Peter Linneman says, there will be a huge political fight on it. But if there’s enough money, things always get worked out. They will fight over who pays for it. Each group wants the other group to pay for it. But it will end up... there’ll be enough money, so it will get paid for. The thought is that retirement funding won’t be the problem it is now, even with the decreased birthrate that’s occurring now. What about implications for the healthcare sector, Doctor? You’re talking about some pretty amazing technologies that are going to need to be implemented for a lot of people, but at the same time, you’re talking about making people healthier. Does it bring healthcare costs down, or does it increase them? Does it
force a change in the way that our medical system is structured? What are the impacts, in your mind? All of those three occur. Let me go in first. Obviously, plastic surgery will do well. If you’re living to 95 and feeling forty, you want to look forty. Now, believe or not, many of these have not been tried on skin aging. One of which has is hyperbaric oxygen, and out of the ninety people who did the trial, only 13, all men, volunteered for the 12 biopsies that showed what happened to their skin. But as they healed and
got younger in their brain and in their muscle in that trial, their skin also got younger, and they increased both elastin and collagen production from what’s called hermetic hyperbaric oxygen. What it is, is it’s two atmospheres down to one atmosphere, two to one, two to one, tricking the body into thinking it was going from one to 0.4... that is when the body gets hypoxic, it regenerates stem cells and repairs things. Well, going from two to one in hyperbaric oxygen, the body thought it was still getting hypoxic and generated more stem cells and skin, brain, muscle, pancreas all got younger.
But the point is that, if you will, plastic surgery will probably thrive. Pediatrics, with a decreased birthrate, will probably not grow at all. But when you look at it as a whole, if you are able to eliminate obesity, if you eliminate chronic disease, we go back to the 1974 cost structure. Since 1974, our genes haven’t changed. What changed is our habits and our lifestyle that made chronic disease more likely.
Obesity, which was on the order of 8 percent in 1974, is now 44.3 percent or something. Well, if you eliminate obesity, you’ll go back to the cost structure of 1974. If you do that, what happens to medicine is, instead of growing four times the cost of medical care, which is now about... it’s 19.6 percent of GDP... goes back to about 13.6 percent. And that’s a conservative figure as well. But if you do it that way in the US,
you don’t grow medicine. It grows at about the same rate as GDP does. So it doesn’t get bigger, even with the increase in these treatments. It stays at about the same rate and actually regresses as you eliminate chronic disease slowly over the next thirty years. When is The Great Age Reboot, when is it coming out? Is it this month? The book comes out September 13th.
Okay. And you can pre-order that book on Amazon, I understand. Absolutely. And so, as John mentioned it in one of the newsletters—thanks to you and John and Patrick Watson—I think, I should say thank you because the book jumped up a considerable amount. Obviously,
his readership, Mauldin Economics, have a sizable impact. And there will be a sizable impact and a sizable discussion in the book. What happens to housing? We’ll, if you’re going to live in the same place for thirty years longer, we’re going to have a great economic boom. You’ll need more housing. Not only that, the extra workforce, the human capital you’ll get by...
if you now say you’ve got a forty-year life-work span, meaning 25–65, if you expand that twenty years because you’re going to live thirty years longer, you have increased human capital by fifty percent. Which means a huge benefit in GDP, a huge benefit in economics, housing boom, and every other thing. Now, there’s a whole bunch of spinoffs from this research. One of those is, we could make food in bioreactors like we make beer. Just imagine making, if you will, all the wheat we need, all the wheat Africa needs, all the wheat South America needs, all the wheat the world needs in bioreactors. Is it practical? Sure. How much would you need? You would need a city the size of Los Angeles with just bioreactor plants in it.
And you would produce twice as much food as is needed for the entire world. That’s a spinoff of being able to gene edit efficiently. With beer, it’s tough. You had to wait for the darn yeasts to decide they wanted to make beer, and then you keep that yeast spread.
But now we can edit it so the yeasts can produce grain. They can produce wheat. They can produce rice. They can produce beans. Whatever you want, we can now do in a bioreactor. And the incredible things that are going to happen... And again, yes,
we did speculate on some of those in the book, but it is a huge... the reason I want people to look at the book, whether they borrow it from a friend, or get it from the library, or buy it themselves. The key point is, what we want people to do is to start to be able to think about and plan for this future, so they’re ready for it. And so your listeners
and readers are ready for it before others. Well, there is certainly a lot to think about and plan for, based on everything that you’ve said today. Dr. Michael Roizen from the Cleveland Clinic, thank you so much for joining us. I look forward to getting a copy of your book the day that it comes out, September 13th. Thank you.
Viewers, you can access Dr. Roizen’s latest book, The Great Age Reboot, by pre-ordering on amazon.com. The book will be coming out on September 13th. I hope you enjoyed this interview. If you did, please do me a favor—take a moment to subscribe to our YouTube channel. I’m Ed D’Agostino, thanks for watching. 11,000 steps so far today... yesterday was 11,000
as well... the day before, 13,000... The point is that with walking... just walking gives you half the total benefit of every physical activity. So there are four physical activities that make a difference how long and well you live—but walking is the key, the basis, for all of them.