Book review: Outlive: The Science and Art of Longevity, by Peter Attia.

This year’s book on aging focuses mostly on healthspan rather than lifespan, in an effort to combat the tendency of people in the developed world to have a wasted decade around age 80.

Attia calls his approach Medicine 3.0. He wants people to pay a lot more attention to their lifestyle starting a couple of decades before problems such as diabetes and Alzheimer’s create obvious impacts.

He complains about Medicine 2.0 (i.e. mainstream medicine) treating disease as a binary phenomenon. There’s lots of evidence suggesting that age-related diseases develop slowly over periods of more than a decade.

He’s not aiming to cure aging. He aims to enjoy life until age 100 or 120.

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BioVie Inc recently reported some unusual results from a clinical trial for Alzheimer’s.

They report some mildly encouraging cognitive improvements, but it’s only 3 months into the trial and there’s no placebo group, so it’s easy to imagine they’re just seeing a placebo effect (Annovis’ results show a clear placebo effect, presumably influencing the measurement rather than the actual health).

What interested me is this:

Reduces Horvath DNA Methylation SkinBlood Clock by 3.3 years after 3 months of treatment.

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I previously sounded vaguely optimistic about the Baze blood test technology. They shut down their blood test service this spring, “for the foreseeable future”. Their web site suggests that they plan to resume it someday. I don’t have much hope that they’ll resume selling it.

Shortly after I posted about Baze, they stopped reporting numbers for magnesium, vitamin D, and vitamin B12. I.e. they only told me results such as “low”, “optimal”, “normal”, etc. This was apparently was due to FDA regulations, although I’m unclear why.

I’d like to believe that Baze is working on getting permission to report results the way that companies such as Life Extension report a wide variety of tests that are conducted via LabCorp.

At roughly the same time, Thorne Research announced study results of a device that sounds very similar to the Baze device (maybe a bit more reliable?).

Thorne is partly a supplement company, but also already has enough of a focus on testing that I don’t expect it to use tests primarily for selling vitamins, the way Baze did.

I’m debating whether to invest in Thorne.


The US, and to a lesser extent much of the developed world, has concentrated interest groups (e.g. big pharma), which have incentives to increase medical spending. The main check on pro-expense interest groups used to be patients’ desire to spend less of their money. We’ve carefully eliminated that incentive for most patients. That leaves us with a situation in which spending increases to absorb much of the increase in disposable income.

I originally started writing this post in reaction to Aduhelm’s conspicuously bloated price. But it now seems that the system has enough sanity to avoid major waste there.

I’m also interested in the situation with statins. There’s reasonably good evidence that they saves the lives of a small fraction of people who take statins, but also some reason to doubt that cholesterol best describes what problem they fix (I don’t have a good link for these doubts. Here are some mediocre ones: 1, 2, 3).

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New Dementia Trial Results

There’s a new clinical trial result showing that Bredesen’s approach is able to at least partially cure common forms of Alzheimer-like dementia. (Press release here). It has not received as much attention as it deserves.

The 9 month study seemed a bit less impressive than what I’d hoped for, but the outcomes still support the claim that common forms of dementia are partly curable.

Out of 25 patients, 21 or 19 improved their cognition compared to the start of the trial, depending on which measure I look at, and 2 or 3 declined.

Side effects included occasional improvements in hypertension and diabetes, enough to allow patients to stop taking medications for those conditions.

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Functional Medicine

Mainstream medicine has become increasingly standardized over the past few decades.

Standardization has some benefits: reduced inequality, improved procedures for minimizing mistakes, and increased predictability. Those attributes are often easier to verify than health effects.

Standardization is not so great for promoting innovation (standardizing a few building blocks may promote innovation, but that’s not what medicine has done). Yet medicine is an area where we have a relatively high need for more innovation.

It would be nice if one system of medicine provided everything that I want from medicine. Just like it would be nice if one company could provide all my transportation needs, or every type of food that I want, or an operating system with all the software that I want to use.

Alas, none of those seem close to being feasible this decade. Yet I get the impression that many more people expect it of medicine than is the case for food or transportation.

I’ve reached an age when it’s valuable to ask a good deal from medicine. So in addition to a standard doctor, I’ve engaged with a competing “brand” of medicine.

Specifically, the functional medicine practitioners at Chris Kresser’s Adapt180.

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Book review: The End of Alzheimer’s Program, by Dale Bredesen.

This sequel to The End of Alzheimer’s is an attempt at a complete guide to a healthy lifestyle.

Alas, science is still too primitive to enable an impressive version of that. So what we end up with is this guide that would overwhelm anyone who tries to follow it thoroughly, while still lacking the kind of evidence that would convince a skeptic.

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