Inside the new longevity elite: the startups redefining how we age

Drawing on emerging evidence and the latest industry developments, Dr. Aleks Letnikovs, MD, MSc in Preventive Medicine and expert in longevity and health science, examines the startups driving this new era — and what their breakthroughs and failures reveal about the future of how we age.

What once felt like fringe biohacking experiments has become a battleground of billion-dollar startups, Nobel laureates, and investors chasing the dream of slowing — or even reversing — aging. But behind the headlines, the truth is more nuanced. Some therapies stall after years of research, while others promise more than science can yet deliver.

Altos Labs made waves with a $3 billion funding spree starting in 2022, aiming to use Yamanaka factors to partially rejuvenate cells. The concept is exciting, but whether it can ever be applied safely in humans remains an open question. Retro Biosciences, backed by $1.2 billion, is exploring similar pathways. Unity Biotechnology’s much-anticipated 2020 osteoarthritis trial was expected to be a breakthrough; instead, it failed to meet its primary endpoints. Oisín Biotechnologies continues to develop gene therapies targeting senescent cells, though human trials are still forthcoming. These examples underline a simple reality: what works in animals does not always translate to real human biology.

Some ventures embrace risk more openly than others. Retro Biosciences says it aims to “move fast and aim high,” while Altos Labs takes a more restrained tone: “If what we do prolongs life, it will be a happy accident” — a reminder that skepticism remains central to good science.

Alongside these ambitious research programs, companies such as Juvenescence, CohBar, Tally Health, InsideTracker, and Aging.ai offer tools people can actually use today. These are not deep-cellular rejuvenation therapies, but practical solutions available now rather than a decade away.

While most longevity startups are still in early-stage or animal studies, a handful of human trials are beginning to show meaningful insights. One of the most closely watched is the Targeting Aging with Metformin (TAME) trial, enrolling around 3,000 adults aged 65 to 79 who will take 1,500 mg of metformin daily for six years. If successful, metformin could become the first drug aimed explicitly at slowing biological aging rather than treating a disease.

Humans, in fact, have taken part in longevity experiments for decades. Biosphere 2 attempted to observe how extreme isolation and controlled diets affected long-term health. CALERIE explored sustained calorie restriction. These projects — strange as they may seem today — were early prototypes of modern longevity clinics: people monitored closely, experimenting with life itself.

Recent studies continue to offer intriguing clues. Therapeutic plasma exchange in 2022 showed shifts in blood markers toward profiles more typical of younger adults. Rapamycin, in a 2018 Novartis trial, improved immune responses in older populations and reduced inflammatory markers. In the TRIIM trial (2019–2020), participants not only saw reductions in biological age, but also reported improvements in energy and mood.

The sector has attracted vast amounts of venture capital. But while money accelerates research, it cannot bypass biology. Investors are gradually shifting from consumer supplements toward therapeutics regulated as true medical interventions — a challenging path, especially since aging itself is not officially classified as a disease.

Meanwhile, scientific progress is accelerating. Epigenetics, mitochondrial repair, and proteostasis are mapping the mechanisms of aging with unprecedented clarity. Demographic pressure adds urgency: by 2030, more than 20% of populations in Europe and the United States will be over 65, with Asia rapidly following.

On the consumer side, technology has made biological age testing almost effortless. People experiment with fasting, supplements, personalised nutrition and a growing ecosystem of anti-aging consultations. But the landscape can be confusing: a self-taught biohacker or “preventive specialist” may work in the same building as a certified medical doctor — leaving many unsure what is evidence-based and what is hype. As the field expands, it attracts both serious clinicians and enthusiastic amateurs.

Longevity science is rarely tidy. It is messy, full of breakthroughs and failures, moon-shot ideas and incremental progress. Cellular rejuvenation, metabolic repair, anti-aging supplements — none are purely theoretical anymore, yet most have not reached everyday clinical practice. Some startups will fail dramatically; others may quietly add a few healthy years to human life.

Imagine aging not as a single disease to cure but as a series of targeted interventions: drugs, diagnostics, lifestyle changes — a patchwork rather than a miracle fix. This is no longer science fiction. It is an emerging, imperfect, deeply human frontier. Aging may soon become something we manage, engineer, and influence — with all the uncertainties that come with it.

So the real question becomes: If a medicine could make you five to ten years younger, would you try it?