From post-war baby boomers to the current Generation Alphas, stage-of-life labels beloved of cultural commentators, researchers and marketers, will soon be a thing of the past, predicts the head of the globally influential UK National Innovation Centre for Ageing.

Researcher, teacher, writer and TEDx speaker, Professor Nic Palmarini, has told the latest Agetech World podcast he believes the arbitrary grouping of people born within a certain time frame and deemed to reflect the narrative of a particular period in world history, will no longer be a thing.

Click here to listen to the latest Agetech World podcast

Instead, the director of the NICA, said he expects to see a merging of the current peer groups to form one inter-generation, with no need for distinct categories.

“It is quite foolish to put cohorts who are born in very nearby years, but different years, different areas of the world, (and with) different experiences, to put them all together,” he said.

“We think that in the future there will be no more generations. We are literally thinking that there is a kind of fluidity on how we are interfacing our future society.

“My personal opinion, and again it is my opinion, but I think we are just going towards a sense of melting the generations one with the other and coming to one mega fluid generation where experiences are just more quickly flowing one to the other, not necessarily stopping at the station of each generation.

“And if you think, for example, what happened in the United States, where President Biden has been elected basically with the votes of the Gen Z, there is a sort of understanding of Gen Z and the Silent Generation (born up to the mid-1940s and including Joe Biden)…trusting each other, understanding each other, empowering each other, which I think is something we will see more and more often because, I guess, the only way to solve the main, or big issues, that we are seeing forward in our future…(is through) collaboration between the generations instead of framing the generations.”

He added there would always be some intergenerational conflict “which is good, because somehow it is making the generations in this case understand what could be the pain point that maybe others don’t see.”

The way to solve this discord he explained, was with collaboration.

The UK National Innovation Centre for Ageing is based at the Catalyst Newcastle Helix in the North East of England

“We know there is no other way. So I think that also this will probably lead us to a kind of inter-generation, as we call it.

“I keep on saying that the next generation won’t be called Alpha as they say. My point is it will be called ‘inter’ because it will be a generation made of many generations working together.”

Prof Palmarini was appointed director of the NICA in 2019. Headquartered in the North East of England, the NICA is jointly funded by the Medical Research Council and Newcastle University, and was set-up to work across academia, industry and the public to explore, test, and bring to market products which promote healthy ageing and wellbeing through life.

Prof Palmarini’s previous job was as head of AI for Healthy Ageing at IBM Research and AI Ethics Lead and Research Manager at the MIT-IBM Watson AI Lab in Massachusetts in the US.

He has a decade of experience in research in supporting older adults’ autonomy and independence, and his internationally-recognised career has demonstrated his commitment to exploring the impact of technologies and their applications in the life of the ageing population and people with disabilities.

With the longevity sphere potentially worth trillions of pounds in the UK and worldwide, a major part of the NICA’s work is to convince industries, such as the big technology players, the health sector, entertainment, fashion, and financial services, of the importance of targeting age discrimination through collaboration, innovation, exchange and interaction.

Prof Palmarini told the podcast that society also needs to rethink ‘age’ and the concept of retirement, especially as people are living longer thanks to medical and scientific advances.

He has no plans to retire, he said. “I’m very biased because on one side, not my research side, my father is 93 and is working. He is a doctor and he keeps on going to work, he drives, he lives his life like it was 20 or 30 years ago, which obviously teaches me one thing, that we all need a purpose to be that way.

“So, how do I see myself? I can’t think myself out of being engaged in things that matter to me, and I am very good in putting myself in things that matter to me. So that is my everyday job. I am curious. My job is to understand what are the dynamics happening now – and in the future.

“I am quite good in spotting what are the things that could be meaningful in the future, hence my future will probably be what I am doing today for the next whatever years until I die.

“I haven’t thought about retirement. Again, I don’t have examples in my day-to-day life of retirement. I have examples of people living their own life, being relevant to themselves and to others, which is something still I think we have to sustain and push, not for everybody. Do not misunderstand me. There are people that need to stop. People that need to slow down in certain stages of their life.

“I am saying in general we tend to think of this idea of retirement, like stopping being part of a society because that is how retirement, from a narrative perspective, has been designed.

“I think we have to go against the stigma of retirement; you just watch birds and take long walks every day, which is absolutely wonderful and must be done by whoever wants to do it, but also I think this idea of giving back permanently to others in the process of life, is something that we should have to start thinking more consistently, and understand that working in later life could be a blessing, not a bad thing.”

LongeVC CEO and founder Garri Zmudze speaks about the firm’s mission to create an ageless future with its support for innovative longevity tech companies. 

Investment firm, LongeVC has a portfolio of companies across the likes of consumer health, AI for drug discovery, biotech and gene therapy. Connecting them all is a shared mission to create an “ageless future”.

With the longevity and anti-ageing market expected to rise from $26.12 billion in 2022 to $44.92 billion by 2030, AgeTech World hears from LongeVC CEO and founding partner, Garri Zmudze about the investment landscape in this rapidly growing sector.

Zmudze first entered the biotech space while working in the banking industry in Switzerland. He became an early investor in Insilico Medicine, a leader in AI for drug discovery, after his friend and former classmate, Alex Zhavoronkov approached him.

It turned out to be a valuable investment for Zmudze but there was also a personal reason for turning his focus to biotech and longevity. Both his parents have suffered from age-related diseases. His father passed away from cancer while his mother has struggled with Parkinson’s and Alzheimer’s for the last 12 years.

Zmudze speaks about the misconceptions surrounding longevity, the latest trends that are piquing the interest of him and his team of investors and what he looks for in a company before investing.

AgeTech World: You have said that there is some misunderstanding among the public around what longevity is and how it differentiates itself from popular buzzwords like biohacking. Can you explain some of these misconceptions? 

Garri Zmudze: As I spend a lot of time in Miami, Florida, I have visited most of the so-called longevity clinics around the state. What I discovered there is a wild west. And what I mean by that is they’re giving patients peptides, exosomes and stem cells for very high prices.

However, from my perspective, it is not evidence-based and it can be harmful and dangerous for patients. Maybe not right now, but in the longer term, there can be consequences.

I believe that longevity must be standardised and must be promoted to a broader audience and explained in simple terms why biohacking can be dangerous for you. Nothing is proven. There is no hard evidence.

But, we have early therapeutics and we have more evidence-based approaches that can adjust and ultimately prolong a healthy human lifespan.

LongeVC says is investing in an “ageless future”. What does this concept mean to you and what is needed to get there? 

Longevity will never be a magic pill that will make us younger. We have to understand that it is a family of technologies and that’s what we’re pushing forward. That’s why one of our main focus is early diagnostics of age-related diseases.

I believe the whole system must be changed. When we talk about longevity, it’s not just therapeutics against age-related diseases or early-stage diagnostics, it’s a wider term. It includes new insurance plans – because of the Silver Tsunami – and new pension plans. There are a lot of [elements] that fit the topic of longevity.

We live longer and healthier, but pension plans and insurance plans cannot cover that. Nowadays, insurance plans in the US do not cover an expansive range of early-stage diagnostics at this stage. I believe that the whole paradigm must change for that.

What are some of the latest trends and opportunities in the longevity sector that you are particularly excited about? 

The biggest trend that I see and support is public clinics that are opening in Singapore in the National University of Singapore. The [Centre for Healthy Longevity is led by Professor Andrea Maier.

There is also Sheba Longevity Clinic [in Tel Aviv] that is led by Professor Tzipi Strauss and Professor Evelyn Bischof and where I’m a part of the executive board.

I believe that these types of projects will have a huge impact on the whole industry because first of all, they are free public hospitals that will generate a lot of data for research. I think that’s huge because before, that was a privilege mostly for wealthy people.

I think that’s the biggest trend and I’m a big supporter of it. I hope that there will be more and more public clinics around the globe.

In terms of LongeVC’s portfolio, what are the common threads that run through the companies that you invest in? 

All our portfolio companies are chosen in a way that fits our thesis. There are different pillars like early diagnostics, age-related therapeutics and different tech that enables those processes, including standardising longevity and AI for drug discovery.

I believe that the best indicator for the fund we have is that so far, for two years, we have had zero write-offs. Our portfolio is structured in a way that we have early diagnostics, therapeutics, AI for drug discovery and mental health applications.

Now, we are also focusing on ovarian ageing, fertility and reproduction. The main focus we will be having in the next 12 months is on mental health and female reproduction.

Where do fertility and reproductive health fit into longevity? 

Ovarian ageing and reproductive health is an important part of longevity. A lot of women dedicate their lives to careers and they may want a child after 40, for example, when there are additional risks.

This is something we want to [do]. We want to prolong reproductive age. I think that that’s important.

We recently appointed a new advisor, Professor Yousin Suh, who is a professor at Columbia University in New York. We are getting additional competencies on board in this field and making some early-stage investments.

What do you look for in the companies you invest in? 

We are not investing in something that slightly changes or slightly adjusts existing processes. We’re looking for innovations [and] breakthrough technologies.

We make our investment decisions based mostly on the team and the leadership because in the early stage, that is very important.

We also look for fundraising skills as it’s a very challenging environment nowadays.

We establish relationships with the tech transfer departments from the big universities. We’re getting access to the spin-offs from universities and other projects where our advisors are involved. These are the projects that we want to support and mostly they come from big universities.

These companies we invest in already have a team in place and they already have their IP protected. But mostly, it’s all about people. There are a lot of brilliant ideas that were not properly executed. At the early stage, that’s maybe the most important point.

Can you give a couple of examples of the innovative companies that LongeVC has invested in? 

For example, we [support] a company called Haut.AI. This is a very interesting B2B solution that is moving into B2C. It is AI that analyses your skin and offers personalised cosmetics for your type of skin.

There’s a brilliant team that already established business relationships with big brands like she’s Zaheda, Unilever and Ulta Beauty in the US, one of the biggest retailers. This is the dream team you want to have in your portfolio and this is a good example of consumer application.

Freedom Biosciences is a new-generation mental health application that is a spin-off out of Yale University.

They created a type of ketamine which follows on from the drug [developed] by Johnson & Johnson called Spravato.

Freedom Biosciences mix it with other compounds that prolong the efficacy and also [cause] less addiction. They also significantly reduce the price from around $700 for Spravato to [around] $100. IT will be accessible to a broader audience of patients and ultimately will be covered by insurance.

A new app developed by a second-year medical student could hold the key to helping doctors and other health professionals communicate better with older patients.

Various studies have shown that physicians often find it difficult to converse with older people, leading to many over-65s avoiding seeking medical care.

Research published in the Journal of Applied Gerontology in 2020 looking at Medical Care Avoidance Among Older Adults in the US found that one-fourth of people aged 65 and older had side-stepped remedial help.

The findings based on 2,155 participants from the 2008 Health Information National Trends Survey, revealed that while feeling uncomfortable about having their bodies examined and fearing being diagnosed with a serious illness were major factors in medical care avoidance amongst older people, lower confidence in obtaining health information and less trust in doctors and patient-centred communication, also played a part.

Meanwhile, a National Health and Retirement study published in 2015 found that one in five adults over 50 in the US, claimed to have experienced age-related discrimination in healthcare settings, with one in 17 saying they were subjected to it often.

Other studies have found that compared to younger patients, older adults were less involved in their own healthcare decisions, with doctors cited as being less tolerant, respectful, and optimistic.

Age-based discrimination was found to be common when it came to diagnostic procedures and the types of treatment offered, most especially regarding stroke and cardiological and oncological conditions.

But the new app which uses artificial intelligence to give unique rather than pre-prescribed responses to help medical students develop empathy with patients, could in the future play a vital role in facilitating better communication, diagnosis, and treatment for older people.

It is the brainchild of Eddie Guo, a second-year medical student at the University of Calgary’s Cummings School of Medicine in Canada.

The 23-year-old who is hoping to specialise in neurosurgery, was prompted to develop the platform after realising he needed more practice talking to patients.

The result is OSCE-GPT, a free-to-use objective structured clinical examination program where the computer is the patient.

Users choose whether the patient is male or female and either select a specific scenario or allow the computer to pick a random one for them, letting them practice inquiry-based conversations.

Believed to be the first app of its kind to use one-off replies every time, it is already being used by healthcare professionals in 35 countries, including Canada, the US, Japan, Australia, India, and the UK.

Powered by Whisper, GPT-4, and Google text-to-speech, users speak any language they want, and the app translates it into English.

Developed with the support of the Canadian Federation of Medical Students, scenarios currently include everything from dealing with a patient presenting with a brain bleed, chest pain, or spine trauma, to how to break bad news.

But Guo – who was inspired to become a medic after a neurosurgeon visited his school resulting in an invitation to sit in on a Parkinson’s disease consultation – said within the next few months he hoped to have included scenarios dealing with geriatric care and how to talk to older patients.

He told Agetech World: “It’s certainly an area that needs looking at. I remember we had a geriatric session, and I was just mind-blown by the amount of various complex medical issues that are present in that patient population. Certainly, some cases can be added.

“The reason why there aren’t any cases currently is because I personally haven’t come across them in the clinic. But some things I can think of off the top of my head, are issues such as polypharmacy.

“Oftentimes, older individuals are on quite a few drugs for various medical conditions, and sometimes those drugs can add up, and they each have side effects. Sometimes with these side effects, patients are prescribed more drugs to fix the secondary issue, and it’s just a perpetual cycle.

“That is one major area that could be easily added to the scenarios for someone to manage. Just having that conversation about what drugs an older patient is taking, what doses they are taking, and how can we best manage this with you.

“Other scenarios that could be added in the future are with multiple people all speaking in different voices, such as a provider, an older individual, as well as their primary care giver if they have one, or their children.

“That way it could simulate the sort of conversations you’re likely to have to face, so medical students will have the opportunity to practice with it.

“There is a lot of opportunity to add these sorts of cases involving older people. The way the program is structured is such that if anyone has an idea of a case they want to share, it is quite easy to add it.”

Medical students practice their communication skills in what are known as Objective Structured Clinical Examination (OSCE) stations. However, these require a room, a preceptor, an actor, and a student.

The chance to take part in additional practice opportunities are usually few and far between.

Mehul Gupta, left, and Eddie Guo. Credit: Nada Hassanin, University of Calgary

As Guo said: “It’s really hard to practice communication skills with friends as it’s difficult to replicate what a professional actor can do. Also, when you’re in a clinic, or shadowing someone, patients don’t give feedback on a person’s communication skills.”

It’s not just medical students that could benefit from the platform. Seasoned professionals could too. Guo said: “As you go through medical school, residency, and practice, there is often a trend that physicians become less empathetic.

“There was a study on this a while ago that showed that when you first enter medical school is when you have the most empathy. That slowly declined over the years of training. You’re also working crazy hours and if you can imagine having to go through that for a decade, two decades, then you become worn down.

“It doesn’t make up for the loss of empathy, but it perhaps explains why practicing physicians who are older, may show less empathy with their communication skills compared to their younger counterparts.”

It’s never been more important, however, that those skills are honed when dealing with older patients – especially as we’re living with an ageing planet. The populations of many countries will soon have significantly higher proportions of older people than young adults.

Globally, one-fifth of the population is predicted to be over the age of 60 by 2050.

This demographic timebomb brings with it a host of serious health implications with diabetes, certain types of cancer, dementia, cardiovascular diseases, stroke, mental health issues, and age-related hearing and sight loss and mobility problems, all becoming more prevalent.

Yet despite the health issues facing many older people, they are less likely to seek out medical help because of an assumption that pain, tiredness, dependency, and depression are all part of the ‘ageing process’ – a belief shared by many physicians.

And as research has shown, those who do seek medical help often find themselves undertreated because of factors like hearing loss, mobility problems, or cognitive decline, which may make it difficult to communicate and be mistakenly seen as non-cooperation.

Studies from the American Society on Aging have revealed that healthcare professionals also communicate differently with older people than with younger ones, often being less patient and engaged, and providing less information.

Guo said around three weeks had been given over to geriatrics as part of an ageing, neurosciences and special senses course, and added: “Geriatrics was emphasised during our small group cases as being an area to really consider and focus on, especially with the ageing population.

“As the population ages, the more patients you will be seeing that are of an older age and oftentimes they will be sicker patients, simply because they gather so many medical issues.

Mehul Gupta, left, and Eddie Guo discuss how an AI tool will work to help students develop empathy. Credit: Nada Hassanin, University of Calgary

“Currently, the way we are trained, the model is you have an issue and either we go in and fix it or we investigate and we come up with a plan and we try to tackle it.

“However, if you have multiple issues, for example, heart failure, liver failure, or perhaps multi-system organ failure, or even just disease of multiple organs, that is something that is a little trickier to deal with, because the way we are taught is system by system currently.

“I think medical schools should begin transitioning into more of these complex patient presentations, especially towards the end of medical training as you gain foundational knowledge.”

It is in situations such as this that Guo’s app could come into its own.

“Having that set base of this is actually the general direction you want to take this conversation before going in and seeing the patient, is likely going to be a positive experience for both the patient and the provider,” he said.

Currently medical students the world over use the Calgary-Cambridge guides for interviewing patients. These were developed by a team based at the University of Calgary and the University of Cambridge in the UK.

The first publication was in 1998 and the model which is based on 71 skills and techniques to improve patient interviews, has since been adapted for veterinarians.

Guo was helped in the creation of OSCE-GPT by University of Calgary alumini, Dr Mehul Gupta.

He said of his decision to become involved: “As a resident, I see what a critical skill communication is. How you phrase things and approach situations matters. Communicating effectively requires practice. This system has the promise to really change the way health professionals interact with patients.”

Guo maintains the interaction with the computer is surprisingly human-like.

He explained: “Developing empathy is a critical skill for health professionals and the real world can be intimidating. The platform offers a safe environment so someone can practice and fumble and learn from mistakes so they can be more confident when they do see a real patient.

“As you can imagine, it might not be the best idea to go see a real patient to learn to communicate with them, especially if they are coming in with an issue and you don’t know how to approach it.

“That decreases the care for both the patient and provider. But by having extra practice with this app, providers and trainees get the opportunity to have seen a case, to have seen a general approach, and to have seen what does and doesn’t work, and what does and doesn’t come naturally to them.”