In this episode of The Future of Medicine, we welcome Eric Topol, MD, cardiologist, scientist, bestselling author of Super Agers, and founder of the Scripps Research Translational Institute, whose work has helped shape the field of digital medicine and the use of data, genomics, and artificial intelligence to personalize care.
Dr. Topol reflects on how medicine is shifting from treating disease to preventing it, and why extending health span—the years we live in good health—may be one of the most important goals in modern science. He explains how advances in biomarkers, wearable technology, and AI are making it possible to predict disease risk earlier and intervene before conditions like heart disease, cancer, and Alzheimer’s develop.
Dr. Topol also discusses the science behind “super agers,” people who remain physically and cognitively healthy well into older age, and what research is revealing about the roles of the immune system, inflammation, lifestyle, and emerging therapies in determining how we age.
Looking ahead, Dr. Topol shares his perspective on the future of preventive medicine, including how AI-driven prediction, organ-specific aging clocks, and new biological insights could transform healthcare from a reactive system into one focused on keeping people healthy for as long as possible.
The Intro
“If we can just prevent one or all three of these age-related diseases, we have done a most extraordinary mission for human health.”
Dr. Eric Topol is a cardiologist, scientist, and best-selling author who helped pioneer digital medicine and the use of big data to personalize care.
“And I realized the audience was the public and it changed everything.”
His book, Super Agers, explores how science and technology can help people stay exceptionally healthy and cognitively sharp into advanced age.
“We're no longer in the era of I don't want to know. We want to know because there are things we can do.”
At the Scripps Translational Science Institute, he leads efforts to bring wearables, genomics, and AI into everyday medicine. He joins us to discuss how technology is reshaping patient care and what's on the horizon for data-driven health.
“We have to get a grip on our immune system.”
Welcome to Stanford Department of Medicine's Inside Look at the Future of Medicine.
The Transcript
Dr. Euan Ashley: Well, Dr. Eric Topol, welcome to the Future of Medicine. Welcome to Stanford. Thank you for being here.
Dr. Eric Topol: It's great to be with you, Dr. Euan Ashley.
Dr. Ashley: Well, it's a pleasure. We've known each other for a long time. I've been very inspired by you and your work, and I think your influence only becomes greater. You are known as maybe the futurist in medicine — a huge influence on the way so many of us think about the future of medicine, the future of healthcare. But I wanted to start not with the future but with the past — and really your past — because one of the things we love to do on this forum is hear a little bit about how people got to where they are. You weren't always a world-renowned cardiologist with hundreds of thousands of followers and multiple bestselling books. Tell us about when medicine first became a thing for you. Did you always know you were going to be a doctor? Where did you grow up? Tell us a little bit about your background.
Dr. Topol: Well, thanks. And I'm flattered about the futurist. For me, I was in college at University of Virginia. I was working on a thesis on the future of gene therapy in man. This is 1975.
Dr. Ashley: That's pretty early.
Dr. Topol: Yeah, gene therapy — that's kind of the pattern with me. It always takes decades longer. I usually get it right but I'm off by 10, 20, or 30 years.
Dr. Ashley: But everyone else is catching up.
Dr. Topol: Anyway, while I was doing this, I wanted to be a geneticist — that was my major. And I wound up working part-time on the night shift in the UVA hospital. I got a job as a respiratory technician just by happenstance. I would change the equipment for ventilators in the ICU and on the wards. And it hit me that these people whose equipment I was working on — I thought they were going to die, and then days later they were going to be fine. I said, wow, this medicine thing looks pretty good. It works. So that influenced me to pursue it, and I had to take some extra courses to go pre-med during my time at UVA.
Dr. Ashley: So this wasn't something you thought about as a kid growing up — you were headed towards genetics.
Dr. Topol: Yeah, I thought genetics was really the thing that interested me the most. It was in the early stages — the whole idea of recombinant technology was coming about and it really allured me. But I said, you know what, I've got to be practical. Wouldn't it be great if I could be one of those doctors that helped these critically ill people get better? So it was a late move within my time at UVA.
Dr. Ashley: And that took you to medical school then?
Dr. Topol: Yeah, I applied to medical school and wound up at University of Rochester in New York. I met my wife there. I didn't know what I was going to be, but I wound up at UCSF for residency. I thought maybe I'd be a diabetologist or endocrinologist because my father had end-stage diabetes with all the complications. I thought about being a pediatrician. And then while I was at UCSF, I had the person who was the biggest influence in my career — Kanu Chatterjee. He asked what I was going to do with my life and told me I had to be a cardiologist. I talked about it with my wife and she said he's right, you should do that. So that's how I wound up in this field.
Dr. Ashley: Pretty amazing. We've heard on this podcast so many stories of people being influenced, and it seems particularly in medicine that single individuals often change the course of people's lives. Sounds like that was the case.
Dr. Topol: He really did. He recognized something in me that I wasn't even in touch with.
Dr. Ashley: So where did that take you next?
Dr. Topol: After residency, we wound up in Baltimore at Johns Hopkins for fellowship. Then basically I've had three jobs since fellowship. The first was some years at University of Michigan where I ran the cath lab. Then I went to be head of cardiology at Cleveland Clinic for 14 years, and now 19 years at Scripps Research. The longest I've ever lived in one place in my life has been in San Diego.
Dr. Ashley: I first got to know you — as many others did — as really the world's most influential cardiologist from your position at the Cleveland Clinic. How do you think about that trajectory? Because you've now spent more time in San Diego, and for a long time you were very focused on cardiology. But your more recent work — the books, the content — is much broader.
Dr. Topol: Yeah, it was cardiology, but even in the mid-90s while in Cleveland, we started the first cardiovascular gene bank. Every person who had a cardiac cath would have a sample, as long as they gave consent, put into a gene bank. So I was going back to some early roots. What happened was one of those serendipitous experiences. I went to San Diego to start the first human genomics institute — there wasn't one — even though there was a powerhouse of life science there. Within weeks of arrival, I went to a program organized by Qualcomm where a guy stood up and said we're going to have a smartphone. This is February 2007. We're going to have a smartphone connected to the internet with a camera, and you can take pictures and send them to your friends. People stood up and said, "Wait a minute, we don't need a camera on a smartphone — we have good point-and-click cameras. What kind of camera is going to be on a phone? Kodak makes what we need." And I'm thinking, whoa. All of a sudden I got into this whole digital medicine space. That was the year the iPhone was released, in November. The timing was extraordinary because we were preparing a big NIH grant — it was going to be just on genomics, but we became the first applicant for genomics and digital, and it wasn't just cardiology, it was across the board. That was the transformation — just by happening to be at that one meeting, and I almost slept through the thing. But the people raising a ruckus about why we'd need a camera — I said, what do you mean why do we need it? That's a sensor. What else could we connect to a smartphone?
Dr. Ashley: And Qualcomm of all places — they make those sensors, the electronics inside.
Dr. Topol: Exactly. And I didn't even know when I moved to San Diego how rich the wireless digital assets were in terms of the brain trust there –
Dr. Ashley: Because the original reason for the move was genomics.
Dr. Topol: I was interviewing at Scripps and they were eager to get it designated and build it, but we changed the name to translational because it was a broader thing.
Dr. Ashley: We think of you as a very close friend of Stanford anyway. Things might have been so different, but in some ways not so much — the world has moved in the direction it has. I think from San Diego, which is a real hub of genomics, digital life sciences, biology, and biotech, you've really been able to have a platform to influence the world. Was that part of your plan? The idea of being an influencer — now they say all the kids want to be influencers when they grow up. You were early. I remember one of the first times you visited Stanford after social media was a thing, you asked the audience who was on Twitter, and even at Stanford only a minority put their hands up. But already you were creating a presence and presenting information in a way — I also think of you as the ultimate information gatherer and explainer, and your Twitter feed alone is a service to the world. Now you have these longer-form Ground Truths on Substack where you explain science and medicine to a really large group of people. Was that something you were always headed towards?
Dr. Topol: It's really interesting you bring that up. The idea that our audience is the public and not our medical microcosm only hit me with the Vioxx debacle. This was back in 2004. Vioxx was withdrawn, and instead of letting it go — since we had written the paper in JAMA three years prior saying we had a real problem — only three years later they withdrew the drug, and the CEO of Merck claimed that was the first time they had any signal, which was of course a lie. Anyway, I wrote my first op-ed. This is 2004 — 21 years ago. And I realized the audience was the public, and it changed everything. I always now encourage everybody that your audience isn't your peers — it's a much broader one, because your work, if it's going to be important, needs to include them and hopefully have a positive impact for everyone. That was the beginning of the whole idea that writing and being on social media — that came up beginning in 2009 — and then most recently I've really enjoyed Substack's Ground Truths because it gives me a long-form chance to interview people like you who I think are the most interesting people changing the future of health. I try to get younger folks to do this, but it's hard because to write the first essay for the public, or to speak — in grand rounds, I would show those exact same slides to a lay audience. There's nothing I would show differently. I might just be a little more careful about abbreviations. We shouldn't be using inside jargon. We have to communicate the excitement of what we're doing to the broad public. I wish I had known this 30 years before I started doing it.
Dr. Ashley: It's such an important point. We've tried to train our residents and grad students to understand that communicating science isn't just about your peers — of course that's an important part of publication — but the people who pay the taxes that fund our science, those are not them, mostly. The lay public are the ones who will actually make a difference, and they're the ones paying for the science. This move towards open science and preprints makes our science available quickly to everybody, but it also needs explainers.
Dr. Topol: The only real criticism I've gotten from the Super Agers book — which has gotten a lot of non-science-based people to read it — is "Why didn't you make it even easier to understand?" I said, I tried. My editor tried. But some things like the immune system and genome editing are tough areas to distill into completely common, understandable language. I wish I were even better at that. When I'm rehearsing with our residents and fellows about their presentations, one thing I do is point out when slides are too inside-baseball. You've got to make it so anyone can understand — and don't use your slides as a crutch. You should be able to communicate with passion, and that's something it took me too long to learn.
Dr. Ashley: I definitely want to get to your book because I was really excited to read it — it's been very successful. But two things I wanted to clarify for our audience: you do still see patients. You are an active cardiologist. And this is, to me, the most remarkable thing — you read all of those papers yourself. Not everybody realizes that. I think many assume you have a team of 50 people who read and post for you, but that's actually you.
Dr. Topol: The team is one. That's me. People think that, and it's kind of crazy, but I wouldn't want other people to read or post for me. I've always felt that way. Better not to do it if you're not going to do it yourself.
Dr. Ashley: Today's Grand Rounds was a great example — three or four times you referred to work that came out in the last few days. So this is obviously a daily ritual. Do you do it early in the morning?
Dr. Topol: Yes, I get up around 5:30 and spend a couple of hours reading almost every day. I love ingesting what's new. I've always been a voracious reader — Tyler Cowen calls it being an "inforvore," and he's even more of one than I am. Even when I'm on vacation or holidays, I'm still reading. A lot of people read as much — they just don't share what they read. If we did more of that, we'd all get smarter faster. The main difference isn't as much the reading as the sharing.
Dr. Ashley: Well, another way of sharing — and maybe the longest form before new media — was books, and you've written a number of bestselling books.
Dr. Topol: Every one of the books I wrote, I've been off by years. Creative Destruction — I said we're going digital in the medicine world. We're still not quite there, but that was like 15 years ago. Then The Patient Will See You Now — I said it was all going to be democratized. We're not there yet. Then Deep Medicine — we're going to be using AI. Well, we're just starting. I've tried to write books about where we're headed thinking it wouldn't take as long, and I'm always wrong about the timeline. I get the right idea with the wrong timeline.
Dr. Ashley: I don't think you're always wrong — I think you're ahead. And in particular, think of this AI revolution that's happening now. You were talking about the ways AI could impact care before GPT-2, really.
Dr. Topol: When I was pulling together Deep Medicine in 2017, I met with people like Fei-Fei Li, Andrew Ng, and many other leaders, and they all thought we would have something like ChatGPT — it just wasn't out there yet, it was germinating. It really was with GPT-2, and the whole transformer architecture. It was widely anticipated that what happened at the end of November 2022 was going to happen — just not exactly when. That it could read, edit, write, handle images, and so on. That helped me feel out what our deep AI world would be like, not knowing when it would hit. Implementation is different from having the potential, and we're still early in trying to bring AI into medicine.
Dr. Ashley: Obviously a huge focus here at Stanford — we have many of the architects of the revolution here.
Dr. Topol: I look to Stanford as a leader in this space. I've been on Fei-Fei's AI board here and I see the talent pool — it's extraordinary. Particularly the imaging AI work — leading imaging AI of anywhere in the country.
Dr. Ashley: Sharing has been part of that, and making sure data is available to the world to compete and make algorithms better. Our digital scribe technology is going well. Doctors really like it. Patients love it. It brings the doctor and patient closer together. And bringing the LLM into the patient's medical record — not just a secure version for functionality, but an LLM that can read the patient's record including records from other centers where a patient has received care — is pretty novel. It was launched here just a few months ago, but there are already thousands of users. It's very transformative, given that digital technology had somewhat gotten in the way of patient interaction. We've had a generation of fellows and residents who are good at scrolling through screens to find the information they need, and now the technology can help solve a problem that the technology itself kind of created. Your most recent book, Super Agers — there's so much out there on aging, and one of your first slides was about the supplement world. People are desperate and believe there must be some untapped fountain of youth. What's great about your book is that it's grounded in evidence and in our understanding over many decades of the diseases that are killing us. How did you decide to write a book on Super Agers?
Dr. Topol: It's interesting. I've had a long interest in this — when we did the Wellderly Study, it took seven years. The idea of what accounts for exceptional longevity had been a kind of mystery in my mind. I thought we were going to nail it with the whole genome sequence. And we saw basically nothing. We said, whoa, what is going on here? The lack of familial patterns for health span and all that. I saw the patient Lee Roso — she was so intact — and I said I need to get back on this. At the same time I was seeing her, I had patients coming into my clinic saying, "That's not what Dr. Attia said." I heard this a lot — I should take one gram of protein per pound, I should take rapamycin, I should get a total-body MRI. I said, what's going on with this guy? I had met him. He used to live in San Diego. I read the book and said, wait a minute — there's a lot of things wrong here, and some things good. And I said, we have some science here. Since I'm organized about papers — I don't just read them, I have everything filed — I had it all ready to go once I decided I'm going to get into the whole health span and longevity space. Somebody's got to do it. I pulled together about 1,800 different citations and laid out the real evidence, as well as a road map for where we can take that with prevention of disease.
Dr. Ashley: So there's practical advice as well —
Dr. Topol: What do we know now? What's the real deal on sleep, protein, supplements, and everything else? And what are the breakthroughs that are occurring that maybe you don't know about but are worth building on to prevent these age-related diseases? Because if we can just prevent one or all three of these age-related diseases, we have done a most extraordinary mission for human health. There are huge investments and companies here in San Diego, and up in the Bay Area, to reverse aging and slow the aging process directly. I wish them well — they have billions of dollars and wonderful investors. But that will take a long time and may not be safe. A lot of these things actually induce tumors and have sequelae that are not so light. So I said, wait a minute, isn't there a safer strategy? That was the inspiration to go after primary prevention of age-related diseases. While I was doing the research, I didn't know where it was going to take me, but I started saying, wait a minute — we have these aging clocks from work done here at Stanford, we've got incredible biomarkers, advances in omics, sensors, and AI — particularly multimodal AI. That gave me a whole perspective on how to put it all together.
Dr. Ashley: I think longevity has become almost a staple of popular conversation now — everybody understands the idea of living a long time. But the understanding of living well, living healthy — putting that in the context of your individual patient was a really good way to kick off the evidence trail, because at some level we're all very aware that there are people out there who are living very sharp — mentally, physically — with lots of connections into older age, while others who are 40 or 50 chronologically might as well be 80 or 90 from an aging perspective.
Dr. Topol: The fact that we can anticipate these diseases 20 years in advance, and find out which organ is off-kilter in its pace of aging — when Tony Wyss-Coray published that paper in 2023, I wasn't aware that work was coming, and I thought it was the most seminal paper I'd seen in years. I think it's going to have a huge impact on how we get ahead of people's age-related diseases.
Dr. Ashley: I was lucky enough to know the first author in his lab and be part of his committee here, so I had a chance to see that work evolve over a few years. You mentioned Steve Horvath's work in the early days and the idea of aging clocks. Within cardiology we thought about heart age for a while — trying to help people understand if their heart is younger or older than their chronological age. We've been slowly putting more detail on the idea of an aging clock. But Tony really put significant biological detail, single individual tissue detail, onto that for the first time. A lot of the questions come back to: what part is about measuring it and what part is about intervening? I wonder what surprised you most as you were pulling all of this together. I mean, you're this information sponge going through 1,800 papers. For me, I hadn't been following the PTAU-217 story, and I'm actually a homozygote for APOE4. You showed the slide — one in four people are heterozygotes with increased risk, but I'm one of the two in a hundred with significantly increased risk. So I pay particular attention to this work. As a biomarker, it really does seem significant.
Dr. Topol: When I got it and it was almost zero, it was very reassuring — I've got a good stretch and don't need to worry. I'll get it again in a number of years to see if there's any change. But for people at high risk, it's a good test. It's been available in the US for over two years and people don't know it. That's what gets me — all these things. Like the mammogram that tells you you're at high risk for breast cancer in the next three to five years even when it looks normal. People should have that information. We're no longer in the era of "I don't want to know" — the Cassandra effect. We want to know because there are things we can do. And we're getting to a level of accuracy and timing that never would have been thought possible. People talk about incredible weather forecasting accuracy coming because of multimodal AI — but this is something precious to have for your health and your life.
Dr. Ashley: I love that you highlighted the work by Mads Melbye and Bernie and the paper in Nature a few months ago. Everyone now has a sense of what a language model can do — predicting the next token. But that's also a time series of events, and if the tokens are not words but rather health incidents, we should be able to bring this technology to really help forecast for people.
Dr. Topol: What's amazing about that is it's from millions of people — we don't see those patterns, we don't have superhuman vision like AI does. And it picks them up. What's also fascinating is that was just with electronic health records and some lifestyle data. When they added polygenic risk scores, it took accuracy to a whole other level — and that didn't even include biomarkers or organ clocks. To me that was ultimate validation that with all the things percolating right now, we're going to be able to say you are or are not at high risk, and when. And here's how we're going to prevent it.
Dr. Ashley: And the granularity of that information matters. People understand risk generally, but they respond generally — "maybe I should do a bit more of this." But there's evidence that when they have something very specific — this is about you and your risk — it becomes much more real.
Dr. Topol: See, this was the problem with polygenic risk scores and why they're still not widely adopted. At the individual level, if you were at high risk, you didn't know when. You could be 90 or 95 before it hits. This is different now. With these different layers of data and temporal timing specificity — if the large health model says you're going to have a heart attack in 7.9 years — that's a whole different look. It might be off by a plus or minus some months, but it's a whole different way of predicting risk. Not just yes or no, but the timing is what takes it to another level.
Dr. Ashley: You made the point that AI is here in the sense that the foundation models are built and available. We're all in academic medical centers working with our own data and using the foundation models to see what we can do. Inference is pretty cheap these days. But one of our faculty made the point that if we add all of this up and try to do it for every single member of society, that could be a lot of money. Well, first of all, people choose to spend money on things — if you add up the amount people spend on haircuts over their lifetime, that's a lot of money. Some of it is an individual responsibility element. And decisions might be different at a population level from a government perspective.
Dr. Topol: The first thing is you don't do anything until you know someone's at high risk. The expense of these added layers of data — which don't include anything particularly expensive, mainly omics or AI algorithms — you don't even get to that unless someone is at definite high risk. For most of the population, you'd start screening at age 40 to 50. Not the dumbed-down approach we have for mass cancer screening, where everyone because they're age 40 or 50 gets a scan. Those are expensive scans. Why don't we define people's risk before we put them through screening that has false positives, low yield, and false negatives? We can do much better than that. The whole idea is to stop with this dumb-down age criteria.
Dr. Ashley: The idea that we define pre-probability as just "what age are you today" doesn't make sense in a world where we have so much rich data. Painting a picture of a great future is easier than plotting the path from here to there. I often think about things in medicine — even the blood pressure cuff. We measure blood pressure because that's a technology that was available a long time ago, but we still measure blood pressure and do blood pressure trials. It's probably a marker for vascular health and a few other things — we wouldn't invent it that way today. How do we disrupt the past in order to move to that new world?
Dr. Topol: I think there are some things so glaringly important that we're not attending to. We have to get a grip on our immune system. It's fundamental, and it's just unfathomable to me that we're going to be in 2026 and we have not a single way in the clinic to do that. Our first crack will be the immune system pace of aging clock. But we need more than that. I'm hoping some really good work from Scott Boyd at Stanford and others will help us get to a low-cost immunome that we'll get as part of a yearly checkup. We need that. The other thing is the images — like the retina — are so amazingly rich, and why aren't we using this? We're leaving all this information on the table.
Dr. Ashley: It's literally a window into your blood vessels — the only place you can see them.
Dr. Topol: You can tell about the heart, the heart blood vessels, the kidney, the liver — risk of everything. And it's an inexpensive test. It should be part of our annual eye exam as we get older, and not just getting the picture but getting AI analytics. We'll get there eventually. A lot of patients today are taking their labs and putting them into ChatGPT or Gemini or whatever, and it's telling them things their doctor didn't tell them — explaining things. We're going to see a lot more of that. But I think the US is not well positioned for a large-scale preventive medicine campaign because of our misaligned incentives. It's much more likely that other countries — because they care for patients at a true population level, not with insurance companies and all the ridiculous expense we have here — are going to invest and exploit AI for prevention. That small investment will pay huge dividends for reducing the burden of disease and the economic hit. Whereas here, I don't yet see the chance —
Dr. Ashley: We don't have that closed system where there's a real incentive to put the work in early to make the savings later.
Dr. Topol: So I think we're going to see a lot more super agers outside the US as a result of preventing these age-related diseases. I'm obviously very disappointed about that because we have the potential here, but it needs a lot of restructuring.
Dr. Ashley: Talking of other systems — I know you spent time in the UK looking at the National Health Service, and the Topol Report has been pretty influential in their policy making over the last few years. That's a very different — and very closed — system. What were some of the real takeaways from that process?
Dr. Topol: I think the UK is likely to be the one to do this first. I was amazed at their aspiration to use AI and change the workforce to provide better care. I had an incredible experience working with almost 50 people on a team to pull together — I didn't want it named after me, but they did that — this NHS review. We came up with a lot of ideas, and I think they're on it now. They're obviously going through a lot of economic hardships for the NHS that weren't all there when I was involved, but they're still committed. The idea is: how do we prevent these major age-related diseases now that we have the potential to do it? The whole idea is to do a randomized trial — like we're going to do in Alzheimer's starting in January — and then get to a point where we have interventions, call them preventions, and then export them to the UK to go to grand scale. One of the big things about the metrics of aging we have is that we can use those as surrogates to show we're making a difference — you can't wait 15 years like the UK Biobank's 17-year follow-up. We can't wait that long. If something really changes the trajectory of a major disease, we'll know it by these clocks and markers.
Dr. Ashley: You were getting at this with your question about what surprised me pulling those 1,800 papers together.
Dr. Topol: When the obesity story was cracked with the GLP-1 drugs, it made me think — we'd been working on that for decades and most people were going to give up. And now here we have something, even though it looks like a forever drug, with huge impact. The cost will keep coming down, it'll be made into pills, and so on. So we have a precedent for something profoundly difficult being solved. Aging is even more difficult than obesity. But with all the investments and some really good science, I changed my mind from "impossible" to "possible." There are so many different shots on goal. The question is, if this is really expensive and it slows aging by a year or two — it would be kind of like some of our cancer drugs today where you pay hundreds of thousands of dollars and get three more months. That's not going to be the world-changing impact we're seeing in obesity intervention. It has to be a really big impact — a Benjamin Button kind of thing. I don't know if we'll see that. Plus I am worried that when you start with stem cell factors, senolytics, or these other strategies, this isn't kids' stuff. Instead of just getting the markers showing clocks have reversed — great — what about the downsides? We can't just use the markers for these potent interventions to reverse aging. We have to get long-term follow-up. Some people jump the gun and say, "If I can get three years younger across the board on my clocks and body-wide aging, I want it." But they may be paying a price for that.
Dr. Ashley: And we have lots of people on rapamycin or metformin.
Dr. Topol: One of the other issues in the book is people asking what dose of rapamycin they should take. We have no way to measure the immune system. These advocates — Attia, Bryan Johnson, and so many others, Huberman — telling people they should take rapamycin, all at different doses. And now they're saying don't take it because I get infections, after years of telling people they should take it. We have no way to check the immune system. Somebody could take a low dose and their immune system could be shut down. It would be one thing if we could measure and titrate so that you don't disrupt immune protection. But to play with that kind of firepower without measurement — I'm amazed at that.
Dr. Ashley: So what is your prescription for all of us if we want to be super agers?
Dr. Topol: The lifestyle factors — there are like 20 of them — are fundamental, but we know we can't get everybody to do all of this.
Dr. Ashley: We're talking diet, exercise, sleep.
Dr. Topol: Exercise is number one, with the biggest impact — not just aerobic, but also resistance and balance. The research has been so compelling. Sleep health I changed too — I wasn't paying enough attention to that. I was a poor quality sleeper, not just in terms of quantity. I really worked on that. And of course, having an anti-inflammatory diet, being at the right weight. Then you've got social connections, purpose, being out in nature.
Dr. Ashley: The data for being out in nature is quite amazing.
Dr. Topol: We're lucky in California — we have a better shot than people in the tundra zone where I lived in Cleveland for many years. There are many more factors beyond that. The point is that's the easiest path if everybody could do it. But in order to get people to be super agers, we have to go beyond that. I know too many patients and friends who are very conscientious but still get these bad diseases. So what can we do to prevent them? That's where we need immune system modulators. We need things that block inflammation in the brain and the body — that's where the GLP-1 drugs look very good. And other things specific for the organ age-related disease at risk in that individual. We're going to get there. I'm confident we will make a huge dent in age-related diseases going forward. And this, I think, is going to be the singular most important contribution of AI in medicine — preventing diseases. People are talking about drug discovery, and drug discovery is going to help prevent diseases, not just treat them. All the other things we're doing with AI in medicine — accuracy, increasing humanistic interactions — they're great, but this one I think is going to wind up, years from now, being the biggest.
Dr. Ashley: Well, apart from anything else, Eric, we're very happy that you're focused on super aging so we can have another 20 or 30 years of you leading us into the future.
Dr. Topol: I hope that comes about. But thank you — really appreciate it.
Dr. Ashley: Thanks for joining us here.
Dr. Topol: It was so much fun. Thanks.