Quotations by Eric Topol

About 7 hours is the optimal duration of sleep. Every 1 hour a night decrease in sleep below the 7-8 hour threshold is associated with 6% higher risk of total cardiovascular disease. Every 1 hour a night increase in sleep duration above that 7-8 hour threshold is associated with 12% higher risk of total cardiovascular disease. [2025] - Eric Topol

Whatever your body weight status, knowing your risk of diabetes can help promote its prevention. Many thin people of Asian ancestry are prone due to their genetic markup. Getting your polygenic risk score shouldn't be expensive or difficult. The data can be derived from a gene chip (array) used by companies like 23andMe or AncestryDNA or low-pass genome sequencing. Either method detects the several hundred letter variants among the 3 billion letters of the human genome, and a formula is used to calculate the score, with weighting of specific variants by their importance, and critical attention to the person's ancestry. [2025] - Eric Topol

A polygenic risk score can be inexpensively obtained from a gene chip (array) that assesses over a million common genomic variants that have been quantitatively validated to be associated with risk of a particular cancer, in terms of a score. While these were initially based on European ancestry cohorts, their accuracy and clinical utility have been markedly improved with diverse ancestry and large population data. The principal goal of a polygenic risk score is to identify high-risk individuals so that they can be followed closely. Polygenic risk scores can miss high-risk cases, which is why it's so important to have multiple layers of orthogonal (complementary, additive) data. [2025] - Eric Topol

Whole genome sequencing of our 3 billion letters can now be done for about $200. Some biomarkers can be used that are associated with a higher risk of specific cancers, such as proteins for risk of pancreatic cancer or a circulating microbiome DNA for lung cancer. Clonal hematopoiesis of indeterminate potential, clones of blood stem cells with driver gene mutation frequency ≥ 2%, is one such example, and it can be derived through genome sequencing. Its presence, which is increasingly common with aging, carries an elevenfold risk for blood cancer and increased risk of lung cancer and nonmelanoma skin cancer. [2025] - Eric Topol

Multicancer Early Detection (MCED) assays are constantly getting refined. There are also assays that detect certain proteins or metabolic markers, such as glycosaminoglycans, that indicate a higher likelihood that cancer may be present, as well as blood tests that combine cell-free tumor DNA and proteins in a panel. The test with the most extensive clinical experience to date is known as the GRAIL Galleri. It uses AI to determine whether there is a "cancer signal" and, if present, to help localize its likely organ source. The problem with this test that is marketed for $949 for people aged 50 and older is that the yield is remarkably low. Only 5 per 1,000 people test positive, and, of these, just 2 per 1,000 were actually diagnosed early, in stage 1 or 2, before the cancer spread. The proportion of false negatives among every 1,000 people tested is unknowable. [2025] - Eric Topol

Instead of theoretically spotting cancer at its earliest microscopic stage, MRI can only detect cancer once it exceeds a certain mass size; it's macroscopic and even less likely to find a tumor early than the micro testing. The chance that an abnormal MRI could promote "incidentalomas," benign findings such as nonmalignant nodule or cyst, is high: a meta-analysis of all the studies indicates that it occurs in at least 19% of people. That, along with the lack of sufficient evidence, is why the American College of Radiology recommends against total body-screening MRIs. [2025] - Eric Topol

Multiple studies in midlife and older adults indicate that sleep disturbance is the risk for late-onset dementia. Note the 7-hour cutoff for association with the lowest hazard ratio. After 7 hours, more sleep is associated with more risk. Other cardiovascular factors are tied to risk of Alzheimer's and all-cause dementia, including a very high HDL, high LDL, and elevation of systolic blood pressure. A retina image is independently helpful for prediction of high risk. Speech, analyzed with AI methods, can predict Alzheimer's disease within 6 years. People deemed at high risk must undergo further assessment and close surveillance. This includes a conventional brain MRI, or a resting-state functional MRI that can further differentiate risk and predict the disease up to 9 years in advance. [2025] - Eric Topol

As we await vaccines directed against Alzheimer's disease, more evidence of an association of the recombinant shingles vaccine (Shingrix) with reduction of dementia, including Alzheimer's, has emerged, which also raises the potential role of herpes zoster virus. Generally recommended for all people aged 50 years and older, this would be another specific consideration for high-risk individuals. [2025] - Eric Topol

From 137 studies in approximately 13,000 individuals, skin-to-skin touch significantly improved sleep, blood pressure, and mobility, while reducing fatigue, anxiety, pain, and depression. Whether it's a one-off brief hug or handshake or a 60-minute massage session, human touch appears to be consistently therapeutic, perhaps to an even greater extent among women. [2025] - Eric Topol

The smartphone app Rejoyn, by Otsuka Pharmaceuticals, for people with at least moderate depression, was the first to be FDA cleared for mental health, even though it didn't fulfill the clinical trail's primary endpoint. There is no shortage of non-FDA-cleared dCBT apps on the market, including Sanvello, MindDoc, Happify, Evolve, CBT-i Coach, Mindshift CBT, MoodMission, and many others, most of which charge, with a range from $5 to $50 per month. Many of these are indexed at mindapps.org. [2025] - Eric Topol

TruDiagnostic provides the DunedinPACE result and metrics for immune cell function, "fitness," telomere length, and other reports; GlycanAge ($348 for one test, $599 for two); Generation Lab (4 biological age tests for $149 per month and a VIP program for $3,499 per year). Companies including Tally Health, Elysium Health, and Novos Labs offer aging clocks and supplements to pair with them. I don't recommend any of these tests (or supplements), including telomere length and epigenetic clocks. There are useful in research studies, but there is lack of clinical validation from rigorous randomized trails that having some body clock information leads to improvement in metrics or health outcomes. [2025] - Eric Topol

Valter Longo and Rozalyn Anderson, researchers based at the University of Southern California, described the "longevity diet" for extended lifespan and health span as "characterized by a mild to high carbohydrate and low but sufficient protein intake that is mostly plant based but includes regular consumption of pesco-vegetarian-derived proteins." On the other hand, a high-fat or ketogenic diet, particularly on a long-term basis, has been linked to accelerated aging in mice and humans, reflected by increased cellular senescence. [2025] - Eric Topol

While there are no dietary supplements that have been shown to promote health span, there is one good candidate-taurine. Taurine levels in people decline with age, and deficiency has been correlated with higher levels of inflammation and age-related diseases. Supplementation promoted health span in monkeys and reduced cellular senescence, inflammaging, and mitochondrial dysfunction. We await randomized trails to verify the effects in animal models. [2025] - Eric Topol