"Why they are not Dying" Centenarians and their Resilience in the Age of COVID-19

Researcher Nir Barzilai, MD Albert Einstein College of Medicine
By: American Federation For Aging Research (AFAR)
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The Centers for Disease Control reported that 77% of all Covid-19 mortality in the United States were people 65 and older.  Among those infected, people 80 and older die at 200 times the rate of someone in their 20s. Older people are at a higher risk for COVID-19 because the immune response flags as we age.  They are unable to sustain the insult of this severe disease, however remarkably, many COVID-19 positive individuals over the age of 100 are not dying.

"Centenarians, however, have not gotten sick when their friends started accumulating diseases as they grew older," says Nir Barzilai, MD, Scientific Director of the American Federation for Aging Research and Professor of Medicine and Genetics and the Director of the Institute for Aging research at the Albert Einstein College of Medicine in the Bronx. New York City. "They stayed healthy for 20-30 years beyond their friends and ~30% of them are without diseases, often taking no medicine when you study them."

Why do some of our oldest thrive without illness?

"Studying centenarians reveals that nearly half of them were overweight or obese, smokers, non-exercisers, so lifestyle has little to do with their longevity, according to Dr. Barzilai. "Rather they have changes in their genome (the genetic material of an organism. It consists of DNA. It includes both the genes and the noncoding DNA, as well as mitochondrial DNA and chloroplast DNA) that allowed them to slow their rate of aging. Some of those genetic changes have been translated to medicines for specific diseases."

"Studied families of centenarians showed that some of the genetic changes are associated with better lipid profile or a better way to divert biology from growth to repair. But why specifically would they be resistant to COV IOD-19?  It has been shown that the immune response of their white blood cells are increased."
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Translating their biology to all of us and designing therapies that can delay aging and related diseases is part of a larger scientific endeavor supported by the National Institute of Aging and others called geroscience. This is an approach to understanding and ultimately modifying the basic biology of aging and in so doing, treating multiple age-related chronic diseases at the same time. Peer-reviewed geroscience research has already identified several drugs (gerotherapeutics) and compounds that significantly slow the aging process and may even be helpful in the short- and longer-term response to COVID-19.

For example, Metformin--a common and inexpensive Type 2 diabetes drug that has been in use for more than 60 years--for uninfected people whose immune function may be compromised by age or other diseases.  Metformin acts on immunity by increasing the 'garbage disposal' of the cells, exactly which has been shown in centenarians. Metformin is one such drug, and the American Federation for Aging Research and several partner organizations are in the process of launching a multi-year, multi-site randomized trial, The Targeting Aging with Metformin (TAME Trial) to test metformin's ability to alter the aging process and among other things, influence immune response.

Nir Barzilai, MD, is a Professor of Medicine and Genetics and the Director of the Institute for Aging research at Albert Einstein College of Medicine, the Scientific Director of the American Federation for Aging Research. His new book Age Later: Health Span, Life Span, and the New Science of Longevity describes the promise in targeting aging and preventing age-related diseases to extend health span.

About The American Federation for Aging Research (AFAR)
The American Federation for Aging Research is a national non-profit organization that supports and advances pioneering biomedical research that is revolutionizing how we live healthier and longer. For nearly four decades, AFAR has served as the field's talent incubator, providing more than $181 million to nearly 4,200 investigators at premier research institutions nationwide. A trusted leader and strategist, AFAR also works with public and private funders to steer high quality grant programs and interdisciplinary research networks. www.afar.org

Fred Yaeger
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