Listening to: Eric Topol on the Changing Face of Medicine and Aging, Sean Carroll’s Mindscape podcast, 5 May 2025.

I like Eric Topol’s writing, and I’ve pre-ordered his latest book, which is on ageing. So somewhat spoiling it for myself, I listened to this book-tour podcast. These notes are the bits I found most interesting.

NB: the links below were added from my own follow-up search, not from the podcast.

The focus is on healthy ageing: ageing without chronic disease

This is an interesting area of study because it may be possible to add 7 or even 10 years of healthspan. That may or may not mean living longer, but living without chronic disease.

There’s some good news in that it’s not down to just lucky genes entirely. Based on a study of old people in good health (“the wellderly”) there’s no strong genetic signal. Instead, it’s about the immune system and inflammation.

Immune system’s role in three age-related diseases

The immune system is the common thread in three important diseases of ageing:

• Heart disease: plaque build happens over decades, even seen in autopsies of 20-year-olds. This bad cholesterol ends up in the artery wall, where it’s not supposed to be, triggering inflammation.
• Neurodegeneration: there are now good blood tests for Alzheimer’s disease, and the immune system again is implicated.
• Cancer: it’s hard for a cancer to spread if the immune system is strong. The idea here is that boosting the immune system, but avoiding autoimmune diseases, is a way to attack cancer.

Immune boost

These diseases take decades to show up. If there was a routine lab test for immune system strength, there could be an intervention to boost your immune response as you age.

GLP-1

Related to this is the interest in GLP-1 drugs. The brain is a master regulator of inflammation, and GLP-1 drugs have an impact on inflammation. Namely, it drops before weight loss kicks in. A fascinating area as it’s been suggested that GLP-1 drugs are longevity drugs.

Keep eating well, exercising, and getting good sleep

The podcast mentions other aspects of ageing, including social isolation and time in nature. But not in any detail.

It’s worth a listen if you’re interested in the concepts, but skip if you’re looking for advice you can use today. What I’ve noted above is from the 25 minute mark into the recording.