A brief tour of Boston’s anti-aging industry

The quest to turn back the clock has never been more desirable — or more lucrative.

Dr. Thomas T. Perls, professor of medicine at Boston University, and Frederick Blizard, 105, pose for a portrait in Blizard’s home in Norwood. Michael Swensen for The Boston Globe

WITH THE “SILVER TSUNAMI” of baby boomers on the horizon, the quest to turn back the ravages of time has never been more desirable — or more lucrative. The anti-aging remedy industry, with products aimed at everything from filling laugh lines to reversing bald spots, is set to be a $303 billion market by 2025, according to a report by P&S Intelligence. And researchers aren’t simply advancing the latest techniques to erase wrinkles — they’re exploring whether it’s possible to slow the process of aging itself.

“The idea of slowing down aging, and decreasing risk for aging-related diseases, is tremendously on the minds of a large group of people,” says Dr. Thomas Perls, a geriatrician and director of the New England Centenarian Study at Boston Medical Center. “It’s a quick sell.”

At the New England Centenarian Study, Perls has enrolled 600 seniors over age 105 and 200 “supercentenarians” over age 110, one of the largest studies of its kind in the world. In addition to studying lifestyle factors that may influence longevity — such as diet, religion, and wealth — the study has found a strong genetic component in certain families. He expects that sequencing their genomes may reveal existing drugs and small molecules that could be developed into anti-aging therapies that apply to the rest of us. “We’re hoping to discover the mechanisms by which these people are doing what they’re doing naturally,” he says. “It’s going to be many, many genes, and the right combination associated with getting to these extreme ages.”

What do the seniors themselves believe is the secret to their longevity? Their answers vary. “They say, ‘It’s my diet; my belief in God; it’s the whiskey every night.’ I don’t think it was worrying about wrinkles,” Perls says. Yet when a recent study in JAMA Dermatology asked more than 500 patients seeking cosmetic procedures what motivated them, looking good professionally in a youth-oriented workforce and in photos on social media were top of mind.

“We’re in the selfie generation,” explains cosmetic laser surgeon Dr. Dianne Quibell of MD TLC in Wellesley, whose patients often want to look their youngest for events like a child’s upcoming wedding or a class reunion. “If they’re going in two weeks, we don’t have a lot of options; if they give me three months lead time, that helps.”

As new technologies emerge, patients no longer have to go under the knife to shed a few years from their faces. The latest tool in Quibell’s arsenal against crow’s feet is an FDA-approved energy device released this year from Cynosure, a Westford-based medical aesthetics firm. Like other energy devices, the TempSure Envi uses deep-tissue radio frequency waves to stimulate collagen production and return elasticity to the treated area. It’s pain free and fast, with minimal recovery time, Quibell says. “It feels like a hot stone massage,” she says. “You can come in at lunch time, go back to work, and look better right away.” The primary downside is cost: a series of two to four treatments starts at around $300 per 30-minute session.

Fighting the outward signs of aging is one thing, but what about the process itself? One buzzword in this arena is caloric restriction. Severely restricted diets have been shown to increase life spans in various animals and have shown promise in humans. For example, a 10-year study on lemurs by French researchers found those who were forced on a 30 percent reduced diet lived nearly 50 percent longer. In a two-year human trial, those who managed to cut calories by 25 percent showed improvement in markers for metabolic health.

But, really, who wants to live that way? Experts agree that the current focus is not so much to extend the seemingly finite 122-year maximum human life span, but to delay deterioration until as late as possible — in other words, to stay healthier, longer. To that end, researchers in Boston and worldwide continue tinkering with the different metabolic processes within cells that play a role in aging, toward promising leads and down the occasional rabbit hole. The latest molecular darling is nicotinamide riboside (NR), a vitamin B-3-like compound found in cow’s milk, which seems to work on the metabolism by stimulating a crucial cell-repairing metabolite known as NAD. NAD naturally drops as we age, leading researchers to wonder if propping up those levels could halt or reverse aging.

An encouraging 2018 study published in the journal Cell by researchers at Harvard Medical School’s Paul F. Glenn Center for the Biology of Aging found that mice administered a NAD-booster showed improved blood vessel flow and revived stamina. A clinical trial published last November in Nature Partner Journals: Aging and Mechanisms of Disease confirmed that a similar supplement safely raised NAD levels in humans. So, will popping these NAD boosters work? One startup, New York-based Elysium Health, believes the evidence is compelling. They’ve brought to market a nutritional supplement called Basis, which combines NR with pterostilbene, an antioxidant found in blueberries. Consumers can buy it online for about $50 a month (you’ve likely seen ads for it popping up in your Facebook feed, marketed as a way to “help your cells today”). A California-based competitor, ChromaDex, also manufactures and sells a competing version called Tru Niagen.

Elysium boasts an impressive scientific advisory board led by scientific director Lenny Guarente, head of the Paul F. Glenn Center for Biology of Aging Research at MIT. Some critics say the verdict is still out on the effectiveness of such supplements, pointing out that pursuing classification as a dietary supplement allows manufacturers to skirt the FDA’s high bar of proof for prescription drug approval.

Elysium’s goal was to get the product into consumers’ hands faster than the other route would allow, concedes Guarente. More clinical trials on metabolic outcomes are underway. “You have to be rigorous with your approach, and the data, hopefully, will speak for itself,” he says.

Whatever the ultimate outcome, the quest will likely continue. “To me, the most important thing is quality of life, rather than how long you live,” Guarente adds. “The phrase I like is adding life to our years.”