Prof. Stephen Kritchevsky of Wake Forest on Geroscience

·58 min·5 clips

Professor Stephen Kritchevsky explains why aging isn't a disease and the rise of geroscience to combat disability.

The frame is aging itself. The host starts with a review paper that treats geroscience as a way to define and possibly change biological pathways tied to age-related disease. The guest is careful with the claim. He does not call aging a disease, and he separates treating one disease from the harder idea that one intervention might slow several kinds of decline at once. Metformin becomes the useful test case. It was made for one job, but its cellular effects overlap with pathways researchers would look at if they were trying to slow aging. The policy angle gets big quickly. The host asks whether low-cost drugs could matter across whole populations and health spending. The guest tightens the point. Statins mostly address atherosclerotic processes, while metformin has broader effects and stays interesting because its pathways overlap with aging biology. A trial was designed to test whether metformin could prevent new cardiometabolic disease, cancer, and Alzheimer's syndrome in this population. The funding never came. That matters because mouse studies have not settled metformin's role as a gerotherapeutic. Rapamycin looks more consistent. In the NIA's interventions testing program, metformin alone did not show the same benefit, though metformin plus rapamycin did better than rapamycin alone. Mice are still messy guides because they do not develop disease the way humans do. The conversation closes on diet timing. A pilot study of about forty people tested an eight-hour eating window and found its clearest signal in lower fasting plasma glucose. Promising, yes, but treated here as a biomarker signal, not proof about aging, disability, or disease prevention.

As heard by us

A measured look at what geroscience can test, and where its evidence still needs to catch up.

This single episode treats geroscience as a testable field rather than a promise machine. Stephen Krzyzewski explains why he would not label aging itself a disease, then follows the field's interest in biologic pathways tied to aging, including caloric restriction and metformin.

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Why you'd press play

Wonder whether metformin belongs in the aging-science conversation, or whether mouse evidence makes the picture messier than a neat promise?

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