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What We Can Learn About Longevity From SuperAgers and Centenarians

A conversation with Dr. Nir Barzilai, author of 'Age Later'

By The American Federation for Aging Research (AFAR)

Editor's note: This article is part of an editorial partnership between Next Avenue and The American Federation for Aging Research (AFAR), a national nonprofit whose mission is to support and advance healthy aging through biomedical research.

Dr. Nir Barzilai, Scientific Director for the American Federation for Aging Research, in his lab at the Albert Einstein College of Medicine, Bronx, NY
Dr. Nir Barzilai, Scientific Director for the American Federation for Aging Research  |  Credit: Albert Einstein College of Medicine

Dr. Nir Barzilai's research as director of the Einstein-Institute for Aging Research and AFAR scientific director explores the genetics and biology of aging through the lens of exceptional longevity. He is a pioneer in the study of centenarians and, as one step in the process of understanding how we age, looking at the cellular level to see how centenarians' genes can point to opportunities to delay aging or protect against age-related disease.

"Centenarians, as well as many older adults, do survive COVID-19."

He is also co-founder of biotech firms CohBar and Lifebiosciences, who are developing therapies to extend health by targeting aging, and is principal investigator for the TAME (Targeting Aging with Metformin) Trial, which aims to provide proof of concept that aging can be targeted and treated.

How to 'Age Later'

Barzilai recently published his first book, Age Later: Health Span, Life Span, and the Science of Longevity. We spoke with him to learn about his research on those who live past 100.

American Federation of Aging Research: What are SuperAgers and what does the study of these individuals tell you about longevity?

Dr. Nir Barzilai: SuperAgers are people who have aged more slowly than others. In other words, SuperAgers' chronological age does not reflect their biological age. They do not accumulate age-related disease and require treatment, which allows them to work longer, enjoy post-retirement interests, to live life to the fullest.

In my studies, not only did SuperAgers live twenty to thirty more healthy years, they also had a contraction of morbidity. This means they spent less time being sick and therefore there is a 'longevity dividend' among SuperAgers as medical costs are saved.

How can your study of genes in centenarians or their offspring translate to drug discovery efforts?

The interesting thing about discovering specific changes in the genes of centenarians and their offspring is that those genes can point to a mechanism that can be targeted for intervention. We can look to these mechanisms for developing drugs that inhibit or stimulate these genes.

Through the Longevity Genes Project at Einstein, we have found two such changes in genes that control the good aspect of lipid metabolism. These discoveries led to the development of a drug and successful Phase 2 studies by the pharmaceutical companies Merck and Ionis. [Barzilai is on Merck's advisory board.] The indications for the development of these drugs was cardiovascular disease, but they may impact other diseases as well.

Aging and COVID-19

The disproportionate impact of COVID-19 on older adults has been well documented, but what can be learned from older adults, even centenarians, who survive the virus?

Centenarians, as well as many older adults, do survive COVID-19. While we must be sensitive to the range of socioeconomic factors impacting how and who COVID-19 is affecting in America, it's important to look at the 'hallmarks of aging.''

"Age Later" book

On a cellular level, these hallmarks are processes that are considered to be the core underlying machinery controlling how our bodies age. COVID-19 vulnerability is linked to two of the hallmarks of aging: immune decline and inflammation. Some older adults experience these hallmarks at lower levels.

Further, research has shown that immunity among offspring of centenarians is better than that of others their age. Because all hallmarks of aging are involved, not just the immune system, these individuals are able to survive through a severe disease like COVID-19.

In 'Age Later,' you pose the question: 'Is it possible to grow older without getting sicker?' How have your thoughts on this question changed since the coronavirus pandemic?

COVID-19 has put a spotlight on how the biology of aging makes some of us more or less vulnerable to viruses and sickness. The field of aging research has been looking at this for decades, and now we can apply our expertise to COVID-19 and expand the conversation on targeting age-related diseases and extending health span — our years of health as we age.


I always say that a future of healthy aging is not just a hope, but a promise: not only have we gone from the promise of targeting aging, but there are drugs that can do this in use by humans today. Those drugs can change biological age and improve immunity — not only against COVID-19, but against the next pathogen.

For example, metformin is a drug that can target aging in humans. There are several papers that show COVID-19 patients on metformin were hospitalized less and had lower mortality than patients with similar problems who were not treated with metformin. We need to move rapidly to consider available drugs like this that can help defend older adults against threats like COVID-19 now and those in the future.

This also why we need the TAME Trial. At fourteen leading research institutions across the country, we hope to engage over three thousand individuals between the ages of sixty-five and seventy-nine to test whether those taking metformin experience delayed development or progression of age-related chronic diseases such as heart disease, cancer, and dementia.

The TAME Trial seeks an indication for aging from the FDA [Food and Drug Administration], and this would open the door to so many promising therapies to extend health.

I'm passionate about the therapeutics that are within our reach and their promise to extend health as we grow older. My book may be called 'Age Later,' but it really could be called 'Healthier Longer.' The promise that we all can live healthier for longer as we grow older and decrease the pain of disease and illness is really what motivates me and my inspiring colleagues in the field.

Dr. Barzilai will be talking about his book at an online event on Thursday, Aug. 27, 2020 at 2 pm ET  (RSVP required). The talk is part of AFAR's Live Better Longer series with Prevention magazine, and is part of an editorial and promotional partnership with Next Avenue.

By The American Federation for Aging Research (AFAR)
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