I began my life in health innovation some thirty years ago as a premed student studying genetics, and remember learning about telomeres after they were first discovered some years before.  The first medical training project I developed was on the physiology of ageing and Professor Leonard Hayflick was our advisor; he discovered that cells are not immortal but replicate a finite number of times, reaching the ‘Hayflick limit’, before they die (this phenomenon is known as ‘apoptosis’, or programmed cell death).

Since then, a lot more is known about telomeres and their relationship to the ageing process. In 2009, Blackburn, Greider and Szostak received the Nobel Prize for the discovery of how chromosomes are protected by telomeres and the enzyme telomerase. Simply put, if the telomeres are shortened, cells age. Conversely, if telomerase activity is high, telomere length is maintained, and cellular ageing is delayed.

A recent paper in the Journal of Aging(click here) suggests it is a bit more complicated however. A new concept has opened up, ‘telomere stability’, a quite different concept from telomere length. Improving the activity of telomerase enzyme -that can add length back to shorter telomeres, and, in the meantime, protect longer telomeres to ensure stability- seems a way to actually turn back the biological clock.

I went to the Wired Health event recently and there was a great array of speakers and talks- on everything from artificial intelligence to precision medicine to music and psychedelic drugs- but there was one talk on ageing, given by Elizabeth Parrish, CEO of BioViva (a biotechnology company specialising in treatments to slow the ageing process),  that left me feeling both uneasy but fascinated in the same breath as it looked specifically at gene and cell therapies to ‘cure’ ageing.

You guessed it, telomeres were at the heart of the solution to ‘cure’ ageing.  I was fascinated as a genetics enthusiast but uneasy about the idea of tinkering around with the normal process of ageing at a cellular level.   Elizabeth said she was taking the gene therapy herself as the first person (‘patient zero’)  to take it in human testing. Impressive evidence was shown (click here) of her telomeres having lengthened, with positive effects on her muscle mass.

I questioned myself why I felt uneasy and I realised that my first reaction was similar to what I feel about the idea of using Botox to treat wrinkles- why worry about ageing when it is a ‘normal’ cellular process.  Isn’t it just vanity that makes people reach out for Botox?  Shouldn’t we think about the other more important things in life that will make our lives better as we get older? Like friends, family, and finding our life passions and paths to happiness?

The scientist in me realised that it wasn’t as simple as that.  And Elizabeth had a good point- why should we live our older years in continual physiological and cognitive decline when science is giving us the tools to postpone the effects of ageing?  I had been equally fascinated by the philosophies of Aubrey De Grey, pioneering biomedical gerontologist, speak recently how we can interrupt the processes of all chronic diseases on the ageing continuum.

Reading the book The 100 Year Life made me think more about this.  Accelerating advances in science and better healthcare are prolonging our lifespans -with kids born today easily living to 105 or even longer. Yet our society, culture and systems to cater for a growing ageing demographic are not moving nearly as fast which risks making our lives more and more bleak as we get older, with the need to work longer to finance a retirement with our older years increasingly blighted by frailty and loneliness.

So maybe the solution is, well, just to stay young until you decide to switch the button to death (and hopefully be in control to make it a ‘good death’- a rather nice finish to a good life)?

Following the Wired Health talk, I spoke to lots of people about their views on ageing.  I have been recommended all sorts of therapies, pills and solutions from natural bio-identical hormone treatment to yoga that will make you feel more energetic, less stressed and refreshed, with the result of feeling younger.

Sure enough, as you delve deeper, you find that all have their merits and the real answer is not clearcut.   I couldn’t help but look at the role of stress on ageing, with most of us leading very stressful lives, including myself.  Turns out there is abundance of literature on the role of stress in ageing. 

A wide range of studies (click here, here and here ) have shown that stress is associated with indicators of accelerated cellular and organismal ageing, including telomere length and telomerase activity.  Other lifestyle factors play a huge role too (see here). Obesity, insulin resistance and cardio-vascular disease processes which are related to oxidative stress and inflammation, have all been linked to shorter telomeres. Smoking, exposure to pollution, lower physical activity, psychological stress, and unhealthy diet significantly increase the oxidative burden and the rate of telomere shortening too.

So, what a better way to counteract the ‘biological clock’ by reactivating telomerase through stress reduction, diet and lifestyle interventions?

Sure enough, specific lifestyle behaviours that can mitigate the effects of stress are associated with longer telomere lengths. For example, studies have shown that people who lower stress levels through yoga have longer telomeres (click here and here and here and here ). 

What has this led me to conclude? I think I might try yoga first before resorting to gene therapy, but I will follow Elizabeth Parrish’s journey with interest!  The geneticist in me shall forever remain curious, but for now, I shall roll out the yoga mat and learn to breathe like the yogis do.

The story of Ridhi Tariyal who invented the ‘tampon of the future’ (as the New York Times headlined it when they published it in 2016) tells us many things about the need for more women entrepreneurs, investors and scientists.  It took a woman to design a tampon that could capture monthly blood for medical testing without the need for needles- a brilliant idea which is now being explored to help women test for endometriosis and fertility.

This story reminds us of what Eric von Hippel, the MIT scholar of innovation, has studied intensely from an academic perspective: that people who suffer from a problem are uniquely equipped to solve it.  They persist in their quest to see their innovation succeed because they understand the need first hand and they have ‘skin in the game’.

Thanks to my friend Clare Delmar, I was invited recently to this incredibly funny but also hugely educational comedy show put on by Gusset Grippers (aka Elaine Miller, who is a physiotherapist specialising in urology) at the Sick of the Fringe festival which made me ponder over this idea of who best to solve some of the big health challenges of today.  For an hour Clare and I were entertained and taught by Elaine about the importance of pelvic floor muscles—essential to keep in shape to avoid incontinence (that haunts many women after childbirth and the menopause) but also to have a much better sex life…

The talk made me think and ask some questions.  Why aren’t we doing more to help the one third of women who suffer from incontinence at some point in their lives (that’s right, one third, 33%)?  This is a huge issue yet is one of the “hidden epidemics” that causes so much misery for so many women (men are not immune either…). Pelvic floor exercises are very simple and there is one UK company, Elvie, crusading about pelvic floor and using the latest design technology to help women ‘tighten up’.  It is no surprise that the entrepreneur behind Elvie, Tania Boler, is a woman.

There are other women too leading the way to designing more products for women. At this year's Consumer Electronics Show (CES) in Las Vegas,  Willow, a new wearable breast pump, won Best Digital Health and Fitness Product.  CB Insights also recently published a great summary of some of the companies in 'FemTech' that together ave raised over $1.1 billion (see the map here , also published in an great article, Vive la Difference, by Medium).

But why aren’t there more women, including older women,  leading the way like Tania with the innovations desperately needed by society to address these and other big problems requiring urgent attention, especially with the growing ageing population- from the elderly suffering in hospitals who should be in their homes to those women suffering through the menopause - all the ills that add up to a lot of misery that we currently put up with?

There are some older pioneers like the amazing Mary Matthews who set up Memrica, a memory tool for dementia sufferers, and the inspiring Jackie Marshall-Cyrus who led Innovate UK’s Long Term Care Revolution, but we need more. I was heartened recently reading about the wonderful group of older women who set up the Older Women’s Co-housing  Group which is focussed on building communities for the over fifties to make living as you grow older more fun and less lonely (click here).  And I will always remember the start-up, Growing Old Disgracefully,  a network for older women who pitched at a recent Aging 2.0 global start-up search (I thought, I will have some of that when the time comes....).  

While this shows the trend changing with more women taking charge, there is still plenty of room for a lot more, and especially those looking out for older women.  At a recent talk the always incredible (and young) Maxine Mackintosh from HealthTech Women reminded us that women represent only 9% of the founders of health tech businesses at the moment.  If you look at the Apple Think Different video you will see it is mostly men who feature as the rebels and disrupters.   This has to change and women need to get noticed.  Calling all women provocateurs, innovators and entrepreneurs, especially if you are over 50, let’s get cracking!   I know Clare is busy with her idea….#BeBoldForChange.