Born to age

For most of human history, aging was an inevitable and inscrutable process—a slow unravelling that began after reaching adulthood and ended, if you were lucky, somewhere north of your 40s. And while today’s generations can expect to live a good deal longer, those extra years are not necessarily healthy ones.

This growing mismatch between the number of candles on the cake and the number of days we feel well has sparked a shift in how scientists think about aging.

“A lot of people use ‘aging’ as a bad term, but it doesn’t have to be,” says Dr. Michael Kobor, UBC professor of medical genetics and director of the Edwin S.H. Leong Centre for Healthy Aging at UBC. “It’s not about being able to live to 95 and possibly spending the last five years in declining health and dependent on healthcare services. It’s really about closing that gap between the lifespan and the healthspan to enjoy those last few years as much as possible.”

Dr. Kobor is a specialist in the relatively new field of social epigenetics, studying how life experiences, environmental factors, and behaviours shape the way our genes are expressed over time. If our DNA is the script, epigenetics is the director, deciding which lines get read and which stay silent. At the centre of this work are “epigenetic clocks”—innovative tools that measure biological age based on DNA methylation, a kind of molecular tag that accumulates over time. These clocks offer a new way to determine age, estimating not how old you are in years, but the actual rate at which your body is changing.

“You might have just turned 40, but because you live such a healthy lifestyle, your epigenetic age might be 35,” explains Dr. Kobor. “That’s generally a good thing. But if your epigenetic age is 50 and your chronological age is 40, that would suggest that perhaps your cells are showing signs of age earlier than expected.”

The study of epigenetics is breaking new ground in how we approach age-related conditions such as Alzheimer’s and dementia—not as issues to address as they occur, but as lifelong accumulations of environmental factors (such as social status and air quality) and habits (such as diet, drinking, and smoking). One of Dr. Kobor’s former post-doctoral researchers, Dr. Anke Huels, recently published a study on Alzheimer’s patients that found negative epigenetic changes as a result of air pollution. “That’s consistent with what we know from epidemiology,” says Dr. Kobor. “If you live in areas with high levels of air pollution, it accelerates dementia. Her work suggests there is an epigenetic association as well.”

Many of the epigenetic changes that shape our health trajectories begin in the womb and continue throughout life. This means earlier interventions—from prenatal care to income support—may be as important for healthy aging as late-in-life medical treatments, helping us not to live forever, but to live well.

“Part of how the Leong Centre distinguishes itself is that we take a life-course perspective on healthy aging,” says Dr. Kobor. “Epigenetics is a great example of this general paradigm, in that it’s a continuum of lasting changes in the expression of your genes. These changes can happen in the womb and for the rest of our lives, shaping the way we age. There’s some really fascinating work coming out that spans that arc between early-life environments and lifelong health.”

While there are actions individuals can take to slow down epigenetic aging, there is far greater potential in using the research to influence public policy, bringing about societal changes that increase the healthspan for everyone. “There’s this idea of social determinants of healthy aging if you look across the spectrum of societies,” Dr. Kobor explains. “People in marginalized communities often age more quickly—not because of poor choices but because of inequities like poverty, discrimination, food insecurity, and environmental exposures. It’s not helpful to tell someone who has to work multiple low-wage jobs to get by to ‘just eat better or exercise more.’ Real improvements come from policy changes that support people in meeting their basic needs, which then makes healthy choices possible.”

With members from nine faculties and 25 departments, the Leong Centre extends far beyond epigenetics, embracing a holistic approach to explore the complex processes and factors involved in aging. By looking at aging as a whole rather than isolating individual diseases or contexts, the centre aims to achieve broader, more transformative impact.

Dr. Kobor’s team, along with several other multidisciplinary investigators from the Leong Centre, is currently working with the Canadian Longitudinal Study on Aging, which has collected DNA samples from more than 26,000 Canadians. By linking these biological markers with lifestyle and environmental data, they’re beginning to paint a clearer picture of how factors like housing, income, and community shape the pace of aging.

But it’s long-term work. To study changes in individuals and populations across lifespans takes generations of accumulating and analyzing data—and translating those findings into policy or interventions is its own challenge, subject to the whims of funding and political will.

Over time, these avenues of research may shift how we define healthcare, helping us understand aging not just as a medical issue, but as a social and structural one. “If we can make it clear that the environments we create—through policy, through community supports—influence aging from before birth and across the life course,” Dr. Kobor says, “then maybe we can build a society that’s healthier and more equitable, helping us close the gap between the years we live and the years we thrive.”

The development of the Edwin S.H. Leong Centre for Healthy Aging was supported by a 2018 gift from the Tai Hung Fai Charitable Foundation. The vision of the donor, Dr. Edwin S.H. Leong (BSc’73, LLD’19) is to enhance the quality of living for older adults in communities around the world. Dr. Leong is also an Honorary Campaign Chair with FORWARD, the campaign for UBC.