Passion Investing - 08.06.2020 - 19 min read time

Longevity: Two Opposed Megatrends of Progress and Conservatism

The Longevity industry has the potential to transform the challenge and deficit of aging into an opportunity and asset of Healthy Longevity, turning a source of stagnation into a thriving wellspring of growth, prosperity and stability. Take a deeper look here.

A guest article by Dmitry Kaminskiy, General Partner of Longevity.Capital and Deep Knowledge Group.


Throughout human history, we can see a trend of the seeds of progress attempting to rise to the surface, and the overwhelming weight of human ignorance trying to hold that back and to slow it down. Any new strand of progress of great work of technological innovation is at first only recognized and accepted by a small handful of individuals, with 99% of the rest of society resisting either due to a lack of understanding, or a willing state of disbelief, and comfort with the modes and patterns of yesterday.

And so it is with Longevity. 99% of humanity would rather die than face and accept the real potentials of progress. This is why societies have invented artificial wealth-holders such as money, power, fame, and nationalism, instead of applying their greatest energies toward realizing the only true form of value and wealth - life, health and Longevity.

As most of the wealthy cannot face this prospect, they are still trying to anchor their values to trivial pursuits such as big mansions, overvalued luxuries, cars, yachts and private jets, and other superficial values that belong to past centuries. For most of history the technical capacity to extend healthy Longevity has not been not within reach. Now that it is within reach, they face the same psychological barrier as a horseman at the beginning of the Space Age.

There is a comfort in continuing to ride that horse, even when the knowledge and reality of everything from space rockets to autonomous cars, and then to efficient AI systems, and not to the technological reality of extending the healthy period of life have emerged and can be witnessed firsthand. But it all happened so suddenly! They see it is real, but they do not understand how. A fear emerges to fill the gap in knowledge.

This fear then gets them stuck in an inferior technological circumstances, and they will not leave their comfort zone. This is the predicament we find ourselves in currently with regard to the industrialization of Longevity. With all our old enemies largely defeated - disease, poverty, ignorance, our oldest and ultimate enemy, which perhaps always had something to do with all of these still awaits us. However, there are psychological barriers standing in the way of investment and the intelligent coordination of this nascent industry. It is those barriers which this book attempts to tear down.

While we consider it our duty to share this knowledge, and our life-changing understanding of the Longevity industry with the public, and to help ever-greater numbers of people realize the feasibility of extending Healthy Human Longevity and the many opportunities it can bring, it is also our duty to do so safely and realistically. Once increasing numbers of people accept the idea, they may accept it too much, and fall into the trips and tracks of players selling scientifically-unfounded hype, either via active fraud, or passive, well-meaning but harmful negligence, to avoid spending their money on false promises. Just as the aerospace industry in its first few years saw many rockets fall at the first stage, so will it be with the rising Longevity industry before it reaches its height of maturity, wisdom and intelligence.

It will be an industry presenting equal levels of opportunity and risk, and it is critical that the public is armed with knowledge neither too conservative nor too optimistic, but rather with deep knowledge that is reasonable, pragmatic and realistic, to enable them to realize and take advantage of the opportunities of the Longevity Industry’s future growth from stage 1.0 (low-earth orbit), to 2.0 (the Moon), 3.0 (Mars) and beyond, which is similar to initially treating age-related diseases, then systemic delaying of aging, and finally rejuvenation and maintaining a state of continuous precision health.


The Industrialization of Longevity: The Transition from Advanced Science to Frontier Technology

The Longevity industry defined and described in this series began with basic research into the biology of aging in the 20th century, expanded with the emergence of advanced aging biomedicines at the turn of the 21st century, and then blossomed with involvement of financial and digital technologies.

With these developments underway in 2014, Aging Analytics Agency correctly predicted the 2018 boom in Longevity Industry investments and activity, four years in advance, believing its runaway growth to be inevitable, having considered its extreme prospects for profitability and its potential to deliver substantial ROIs while providing greater benefit to humanity than any other industry in history.


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Today, the momentum and diversification continues, with thousands of Longevity companies and dozens of Longevity-focused investment firms active around the globe. In more recent years, the reality of this industry’s emergence has been acknowledged by even the most conservative of entities, including top-tier business and finance media brands like The Economist, Financial Times, Bloomberg and others, by large financial institutions and investment banks (who now regularly host conferences and release analytical reports on the topic of Longevity for politicians and parliamentarians as well as their own institutional and HNWI clients. 


The Longevity Industry is a Multi-Trillion Opportunity

Older people are the fastest growing demographic group (with around 2.5% annual population growth vs. 0.7% for the entire population). With growing numbers, older adults represent a dynamic emerging market and human capital resource. The multi-trillion market of 1 billion people currently on retirement can be thought of as the world’s 7th continent. The longevity industry includes the products and services satisfying the needs of the cohort aged 50+. The substantial increase in the population of this group is the main driver of the industry.

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The global longevity economy will reach $17 trillion in 2019 and is showing stable growth to achieve $27 trillion in 2026. According to the most conservative estimates, it takes 20% of the global GDP. While, the global Longevity Economy is projected to reach $27 Trillion in 2026, the Age-Tech segment alone will reach $2.7 Trillion by 2025. This would imply 21% annual growth in the global Age-Tech market. This growth is driven by the general development of the elderly care sector enhanced by advancing IT, FinTech and other digital technologies and solutions.  

This creates both opportunities and threats for the economy as a whole and for the financial industry in particular. As for the last one, we believe aging to have a positive rather than negative impact on the global financial industry as there will be a greater need for financial products over the longer term, but of newer types and kinds - newer asset classes, newer investment strategies, and longer-dated bonds/securities will have to be developed. This will require participation and collaboration across both the public and private sectors to have a positive effect for all long-livers.


Longevity Mega-Complexity Multiplies and Magnifies Challenges and Opportunities Equally

While many analysts and investors consider the Longevity Industry to be of a much more limited scope, consisting of core anti-aging therapies at the forefront of advanced biomedicine, Deep Knowledge Ventures Group has been working for the past 5+ years to landscape, and understand the global multifaceted Longevity Industry, through the work of its analytical subsidiary Aging Analytics Agency, which has gained such an understanding through tens of thousands of pages worth of public and proprietary Longevity Industry analytical reports.

The perception of the Longevity Industry, in both its scope and its main trends, in the USA in general and Silicon Valley in particular most often it is conflated with biomedical moonshots -- very advanced biomedicine not yet on the stage of human clinical trials, and this is an angle that severely underestimates technologies which we consider to be within the scope of the Longevity industry, which are actionable and closer to market readiness.

Our work in this area has led us to define the industry much more broadly, and to include sectors that lie completely outside of biomedicine -- sectors like AgeTech, WealthTech, FinTech and the emerging Longevity Financial Industry, which are also much closer to market readiness and to market capitalization than the anti-aging biomedicine sector.

But, importantly, the uniquely intersectional nature of the Longevity industry, and the fact that it is emerging at the center of a complex web of advanced domains of science, technology, finance and governance, means that the task of actually understanding the industry presents more challenges than any other industry in history. The interaction and exchange of so many fields of frontier human activity into a single concentrated inflection point creates extreme levels of industry complexity. As a result of this unprecedented complexity and multidimensionality, the typical approaches used for analytics, investment target identification and due diligence that worked for the BioTech industry are destined to fail when applied to the Longevity industry.

This has created an unmet need for analytical methodologies and de-risking techniques of equal complexity and multidimensionality as the industry itself. And this has been a large part of Deep Knowledge Ventures Group's mission -- to create a robust and sophisticated market intelligence and analytics basement that can survive under the enormous weight of complexity of the Longevity Industry.

While the challenges to reliable assessment, benchmarking and forecasting posed by the increasingly complex and multi-faceted industry are daunting, they are not insurmountable. It simply requires the rapid development of sophisticated, quantitative methods of analysis. And is exactly what Deep Knowledge Ventures and its Longevity-focused analytical subsidiary, Aging Analytics Agency, has set out to do over the past five years.

More recently, these organizations have analysing not only the biomedical aspects of Longevity but also novel Longevity-related financial frameworks, instruments and derivatives, novel InvestTech for forecasting and due-diligence within Longevity, and analysis of proactivity, strength and relevance of various nation’s government-led national Longevity development plans.

Longevity has stronger prospects for growth than any industry in history, but its high degree of complexity poses substantial challenges and risks. Specifically, the risk of fraud, such as that experienced in gene therapy for example, the effects of which could be drastic, and set the industry’s progress back substantially. This is why we urgently need analytical frameworks that can enable assessment and optimization now, rather than later.

Similarly, if national governments intend to progress rather than stagnate under the pressures of the oncoming Silver Tsunami, decrease the gap between their life expectancy and Healthy-Adjusted Life Expectancy, and transform the problem and deficit-model of aging into the opportunity and asset-model of Longevity, they need to embrace the development of such analytical frameworks, and utilize them to proactively prioritize Healthy Longevity as a major component of their national agendas.


The Longevity Industry as the Biggest, Most Complex and Most Ethical Industry in Human History

The overall size, complexity and market capitalization of Longevity, is set to dwarf all other industries, from real-estate to energy and many, many others. As a consequence, the challenges and opportunities that it poses to its participants and stakeholders will also grow. Its ongoing growth will eventually reach an inflection point where many of the holder’s of the world’s wealth recognize the opportunity in front of them, and understand that they have the chance to participate in something uniquely profitable that can deliver greater benefit to humanity than any other in history. Momentum will multiply and the industry will experience self-perpetuating growth.

This will attract manpower at an exponential rate. For various types of professional, a working life outside the expansive industry will be inconceivable. Longevity already attracts the best and brightest scientists and medical professionals working today, as it is already the forefront of biotechnology and biomedicine. As the borders of Longevity expand to incorporate more of the above-mentioned sectors and related sectors, we will see the most skilled entrepreneurs migrate to the Longevity sector.

In order to be productive, entrepreneurs entering Longevity will need to be highly skilled, intelligent, and adhere to a rigorous ethical code, as the repercussions of both fraud and honest mistakes in this industry are greater than in others. There will come a day when it will be almost unthinkable for any business professional or investor to not be actively involved in Longevity, considering its scope and benefits.


Formulating the Longevity Industry Framework

During the period of 2016-2017, Aging Analytics Agency undertook the challenge and opportunity of profiling the entire scope of the global Longevity industry for the very first time, which was documented in its 1300+ page series of analytical reports, “Longevity Industry Landscape Overview Volume I: The Science of Longevity” and “Volume II: The Business of Longevity.”

Landscaping the entire international Longevity sphere proved to be a significant but worthwhile challenge, and it laid the foundation for all of the more targeted analytical reports produced by Aging Analytics Agency in the several years since then.

These first two volumes introduced the Longevity Industry Framework, which serves as the basis for sector classification and categorization, and provided the initial volume of data necessary to gain a deeper understanding of the industry’s current state, near-future trajectory of development, and main players, trends and bottlenecks.

Most people naturally equate the idea of ‘Longevity’ with progress in the science of advanced biomedicine - the study of aging with the ultimate aim of delaying its diverse diseases. However, in reality it consists of many more distinct yet intersecting fields.

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Progress in Longevity is no longer simply a question of progress in geroscience (the science of aging) or advanced biomedicine, but now is more driven by the synergetic convergence of intersection of multiple distinct technological sectors and sub-sectors. Throughout the production of its many industry analytical reports and special case studies on the Longevity Industry, Aging Analytics Agency has formulated a broad industry classification framework that categorizes the Longevity Industry into four distinct segments: Geroscience R&D, P4 Medicine, AgeTech and Novel Financial System.

If Longevity only consisted of biomedicine and there were not so many intersections with other industries, then analysis and forecasting might be a comparatively simple task, similar to the analysis of the current biotech industry. But in reality, Longevity inevitably involves a synergy between advanced biomedicine, AI, digital health, financial industry, pension and national healthcare systems, governmental initiatives and even political issues partially related to stagnating economies due to the Silver Tsunami , which together create a very diverse and dynamic ecosystem whose already-rapid pace of progress and diversification only continues to accelerate, creating challenges to concrete understanding and practical forecasting.


Global Longevity Industry Landscape

The Longevity industry has gone from an underrepresented field of R&D to the rapidly expanding and diversifying frontier of advanced biomedicine. In 2014, Dmitry Kaminskiy predicted the 2018 boom in Longevity Industry investments and activity four years in advance, noting the inevitability of its growth considering the impact it would have on global healthcare systems and the business models of modern medicine, its extreme prospects for profitability and the fact that it is the most ethical form of business, with potentials to simultaneously deliver substantial ROIs while providing more benefits to humanity than any other industry in history.

Today, its advanced dynamic of progress and its strong trajectory of growth and diversification is quite obvious, with thousands of Longevity companies active around the globe, dozens of Longevity-focused investment firms, and the fact that in more recent years, it has begin to be embraced by even the most conservative of entities, including top-tier business and finance media brands like The Economist, Financial Times, Bloomberg and others, by large financial institutions and investment banks (who now regularly host conferences and release analytical reports on the topic of Longevity for their institutional and HNWI clients), and even politicians and parliamentarians (the recent launch of the All-Party Parliamentary Group being perhaps the best example of the recent emergence of Longevity Politics).


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Geroscience R&D - The Science of Aging and Longevity

The first segment of the Longevity Industry is Geroscience R&D - the segment of biomedical science and research that aims to treat the root causes of aging. Some of the most early-stage forms of geroscience attempt to treat aging as an engineering issue to be solved using advanced biomedical engineering. These areas are at the very forefront of biotech and biomedicine, and so even these alone require highly specialized approaches to assessment and forecasting, beyond those that have proven adequate for the biotech industry generally.


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P4 (Preventive, Precision, Personalized and Participatory) Medicine

P4 medicine - preventive, personalized, precision and participatory medicine: leading edge technologies that have already achieved a state of market-readiness and clinical implementation.

This segment has a clear history of paradigm shifts toward greater precision, personalization, prevention and patient participation, driven forward and enabled by advances in biomedicine, data science and Artificial Intelligence. For example, as AI for R&D in drug discovery becomes more sophisticated, drugs will become more customized to specific diseases and even specific patients. Drug development companies will transition from the current form of “blockbuster drugs” (standard drug formulations applicable to many millions of patients) to P4 medicine, tailoring drugs to specific patient cases based on age, gender, ethnicity, state of health and genetics.

The first and second “P” in P4 Medicine are ‘personalized’ and ‘precision’, which refers to the drugs and treatments that will be designed and applied using precise, individually-tailored methods of dosing, cocktail compositions of micro-dosages, and efficient methods of delivery.

Such advances also represent a move toward greater prevention (the third “P” in P4 Medicine), and a shift away from reactionary treatment and towards optimized disease prevention applying micro-dosages of drugs, long before the underlying pathology develops into actual chronic disease.

Healthy Longevity means prevention rather than treatment, through the maintenance of optimal states of health via continuous monitoring of disease-associated biomarkers, and micro-adjustments in therapeutic, lifestyle and behavioural regimes to normalize those biomarkers.

The fourth “P” in P4 Medicine is “participatory”, which refers to the increasingly active role that patients are taking in managing their own health, culminating in a situation where citizens are empowered with the tools, approaches and services capable of enabling continual micro-adjustments to their behavioural, lifestyle and therapeutic regimens in response to continuous AI-empowered monitoring of micro-changes in biomarkers that measure state of health and predict risk of diseases long before their actual onset and progression.

This paradigm is described very precisely in the book “The Patient as CEO: How Technology Empowers the Healthcare Consumer” by Robin Farmanfarmanian, a guest author of Longevity Industry 1.0.

These changes are already being embraced by the medical communities and healthcare systems of progressive countries. In coming years, as P4 becomes the new norm, the new definition of failure will be when patients are forced to get doctors involved. In a world in which P4 medicine triumphs, citizens will have no need to engage with doctors until the very end of life.

P4 (personalized, Preventive, Precision and Participatory) Medicine = Precision Health.

The term “Precision Health” is becoming increasingly common, and refers to the idea that the ideal and most comprehensive case of P4 Medicine will naturally and inevitably lead to a state of Precision Health, where diseases and other sub-optimal forms of health are delayed for as long as possible, until near the very end of life.

The role of AI in P4 medicine is already remarkably apparent, especially in places such as the UK, USA, Switzerland and Singapore. For example we have seen very proactive efforts by the UK government, both through their AI Industrial Grand Challenge and their aging Industrial Grand Challenge, to rapidly apply AI to preventive medicine, advanced biomedicine and digital health, and the recent establishment of the All-Party Parliamentary Group for Longevity, where Aging Analytics Agency was proactively involved.

Furthermore, its high degree of complexity necessitates not only innovative frameworks for general benchmarking and forecasting, but also for the general assessment of its technologies’ and therapies basic safety and efficacy. Take, for example, the common use of model organisms to assess the safety and efficacy of therapeutics.

While this works in a good enough way for single diseases, it will become increasingly ineffective when applied to Longevity therapeutics due to the vast genetic difference between the aging processes in model organisms and humans. This situation has created an urgent need for a shift away from model organisms and towards more human-centered approaches for safety and efficacy testing, utilizing comprehensive yet actionable panels of biomarkers of aging in patient populations.


AI for Longevity

As the complexities of Longevity science and technology increase, and as the volume of data continues to amass, the role of AI in both analyzing and understanding becomes completely necessary for continued progress and industry development. While AI for Longevity is still an emerging and underrepresented sector within the global Longevity industry, its extreme disruptive potential makes its eventual emergence as a core and integral area of growth and development inevitable. AI for Longevity will become one of the most impactful sectors within the industry in the next several years, and make its potential to accelerate the continue development of the industry apparent in almost every sector, from Longevity R&D to therapeutic development, P4 medicine, biomarker discovery, and even non-biomedical sectors such as the Longevity Financial Industry.

Precision medicine with its DNA sequencing, high-tech diagnostic tests, and individually targeted therapies might be significantly less costly than conventional approaches. Awareness of the importance of utilising Artificial intelligence (AI) within aging and longevity research is rapidly increasing in academia and industry. Modern deep learning techniques used to develop age predictors offer new possibilities for diverse data types, enabling a holistic view to identify novel geroprotectors, biomarkers, drug discovery and biotechnology in the healthcare and pharmaceutical industry.

The main concept of precision medicine is providing health care which is individually tailored on the basis of a person’s genes, lifestyle and environment. With the advances in genetics, artificial intelligence and the growing availability of health data, present an opportunity to make precise personalized patient care a clinical reality.

A second important application of AI for Longevity is on so called “Lifetime Wellness” - non-medical factors (including financial, psychological and social wellness) that impact quality of life and functionality for seniors, ranging from financial wellness, continuing education, happiness, psychological wellbeing, neuroplasticity and active social involvement.

Considering the vast amount of life data and information about citizens being collected in most developed nations by financial institutions, telecom companies, etc., there are a large number of options and avenues for how AI, big data analysis and predictive analytical techniques could utilize that data to create personalized recommendations for how citizens 60 years and older can optimize their lifestyles and behaviours to achieve a high degree of wellness, stability, happiness, social involvement and life activity.

The number of companies, researchers, projects and technologies active in this space (AgeTech, FinTech for the Elderly, Continuing Education, Brain Training, etc.) is significant, and rapidly growing. Therefore, the demand for practical and sophisticated AI-driven approaches for improving and optimizing the products and services in this space is also very high.

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The intensive application of AI to all stages of Longevity and Preventive Medicine R&D has the potential to rapidly accelerate the clinical translation of both validated and experimental diagnostics, prognostics and therapeutics, to empower patients to become the CEOs of their own health through continuous AI-driven monitoring of minor fluctuations in biomarkers, and the rapid development of the global Longevity Industry to scale.


Biomarkers of Aging

The development of precise and actionable biomarkers of aging is one of the most prevalent and important areas of Longevity research today, as well as an area where practical implementation is lagging behind the science. This is one of the most important diagnostic services that could be offered, and yet it does not receive the attention it deserves compared to the amount of tangible benefits it can deliver.

How do we know when a biomarker is a biomarker of aging? It depends on how it is sourced. The current approach to biomarkers is to take them from people at various stages of a disease’s known progress, which in practice means sourcing them from hospital patients. Isolating biomarkers of aging, however, means collecting data which marks the difference between healthy people only, e.g. between the young and even younger, with no traces of any officially recognised diseases. This presents a challenge because whereas hospital patients remain in dedicated areas, and are available for analysis at the doctor's convenience, collecting biomarkers of aging means collecting vast amounts of data from the daily lives of people who have no reason to be in hospital. There are however options available for aggregating such data.

Also important is the degree of emphasis on achieving a panel of biomarkers which are not only comprehensive but also actionable. A panel of less precise but easily implementable biomarkers of aging would be much better than an extremely precise and comprehensive panel of biomarkers of aging that is too hard or expensive to translate easily into widespread practical use across nations.

For example, a panel of aging biomarkers was developed recently which is based on Deep Learning analysis of standard blood biomarkers, which is less precise than the most precise available biomarkers of aging (DNA Methylation clocks), but which is nonetheless precise enough, and can be implemented by any researcher, doctor and clinician that has access to routine blood tests.

As a further example of actionability, consider that biomarkers of aging have been constructed using Deep Learning-based analysis of photographs of mice, which could quite easily be extended to humans. Their accuracy alone is not enough to make them a research priority, but the increasing video capabilities of smart-phones means that these rapid development of photographic biomarkers of aging (e.g. of the face or the eye) could now be a very actionable area of research whose practical level of precision and accuracy will develop quite rapidly in coming years.

However, the use of AI in R&D is lagging behind in its application to geroscience. While there is a small handful of companies that are working at this frontier, the overall proportion in comparison to the total size of the Longevity industry is still quite small. Deep Knowledge Ventures has been identifying and supporting companies working on the frontlines of AI for Longevity since 2014, when it provided the seed funding for Insilico Medicine, now a leader in the application of AI for Longevity research, drug discovery and biomarker development.


Longevity and the AgeTech Market

The third segment of the Longevity industry is AgeTech, which broadly refers to all IT and digital technologies that help to maintain greater functionality into older age, and that improve quality of life using non-medical means.

This segment of the market is a rapidly growing one, with the number of people in retirement globally growing past 1 billion. This segment also includes such things as advanced and progressive forms of social care, as well as products and services that help to preserve neuroplasticity into older ages.

While AgeTech can provided little benefit to the actual slowing of biological age, it can provide innumerable benefits to retaining functionality and improving quality of life into older ages, enhancing psychological well being, mental functioning and neuroplasticity, and increasing levels of independence and social activity. As such, it is one of the sectors of the Longevity industry poised to grow the most in the shorter-term horizon.


The Longevity Financial Industry

The final and most recent segment of the Longevity industry is the Longevity Financial sector, which has emerged naturally out of the clear economic and socioeconomic consequences of an aging population and Healthy Longevity for national economies, pension funds, insurance companies and other financial institutions.

The above factors have combined to produce an inevitable coming paradigm shift in the standard operating procedures, products, services and core business models of global finance within the next 2-5 years.

The global finance industry is currently worth several tens of trillions of dollars, and for the last 50 years it has been marked by a distinct lack of innovation, a resistance to embracing technological change, and to re-tuning business models in a manner that is relevant for the dynamic of scientific and technological progress. But we can already see fundamental changes taking place specifically due to innovations in Longevity.

As the industry grows, certain parts of it will naturally become commoditized. In the coming years we will see the formation of specialized stock exchanges for Longevity companies, and the creation of marketplaces for tradable financial instruments and derivatives based on the Longevity companies, technologies, products and services.

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Deep Knowledge Ventures and Aging Analytics Agency consider this topic particularly important, and are working on it in various ways. We are for example launching a Longevity-focused hybrid investment fund Longevity.Capital, which will utilize data-driven analytical assessment and forecasting frameworks combined with novel innovations in InvestTech adapted specifically for Longevity.


Dmitry Kaminskiy
General Partner of Longevity.Capital and Deep Knowledge Group; Co-Author of Longevity Industry 1.0: Defining the Biggest and Most Complex Industry in Human History, Co-Founder of Longevity Swiss Foundation
Head of International Collaboration for the All Party Parliamentary Group for Longevity Secretariat Longevity International UK, Senior Advisor to the Longevity AI Consortium at King’s College London, Managing Trustee of the Biogerontology Research Foundation, Co-Founder of Aging Analytics Agency.


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