Category: Biology and Place

Take a seat.

Retirement has a way of making some questions louder. Not because they were not there before — they were — but because the activity and structure of working life provided a reliable background noise that kept them manageable. When that noise subsides, the larger questions of existence move closer.

Who am I, really? What has my life meant? What do I believe, and why? What remains, and what am I still for?

These are not questions that practical retirement planning addresses. They are not answered by a financial plan or a fitness regime, however well-constructed. They belong to a different order of human need — one that is no less real for being harder to quantify.

Spirituality, in the broadest and most honest sense, is the serious engagement with those questions. It is not the exclusive territory of organised religion, though religion could probably not exist without it.

It is available to anyone willing to attend to the larger dimensions of their own existence — the sense of connection to something beyond the immediate and the personal, the recognition that a human life is embedded in a context that extends well beyond any individual biography.

In retirement, that engagement becomes both more available and more pressing. The time is there. So, increasingly, is the occasion.

Philosophical orientation is a related but distinct matter. It is the framework — conscious or not — through which a person makes sense of their experience, holds their beliefs, and navigates uncertainty. Everyone has one, whether they have examined it or not. The question is whether yours has been arrived at deliberately or simply accumulated by default.

The most useful orientation, in this author’s view, is that of the open minded sceptic. Not the closed sceptic, who dismisses whatever cannot be immediately measured or proved, and in doing so forecloses possibilities that deserve honest consideration. Neither is it for the uncritical believer, who accepts whatever is on offer without subjecting it to the scrutiny it deserves. It is real substance for someone who brings genuine critical thinking to their beliefs — including the belief that they might be wrong — and remains willing to revise their understanding when good reason presents itself.

This combination of rigour and openness is harder to maintain than either alternative. It requires the intellectual honesty to say “I don’t know” and mean it, and the courage to change position when the evidence warrants it. At any age, that is a worthwhile standard to hold. In later life, when the questions become more insistent and the time for evasion shorter, it is close to essential.

Everyone arrives at this territory differently. What matters is that they arrive at it — thoughtfully, honestly, and on their own terms.

Jack Lack’s Listening Chair is always here, as is your welcome.

Take a seat.

For most of the history of medicine, treatment has been built on averages. A drug is tested on a population, a recommended dose is established, a guideline is issued, and that guideline is applied — more or less uniformly — to individuals whose biology may differ from an average for which the guideline was designed. This approach has produced remarkable results. It has also reached the limits of what averages can do for individuals.

The next significant development in medicine is already underway. It is the shift toward treatment and intervention based not on what works for most people, but on what is appropriate for a specific person’s specific biology.

At the centre of that shift is the genome — the complete set of genetic instructions that makes you, in biological terms, uniquely you.

Genomic sequencing — reading that genetic code in full — is no longer the exclusive territory of research laboratories. It is becoming increasingly accessible through medical channels and a growing number of reputable providers, at costs that continue to fall. What it offers is biological self-knowledge: an understanding of your individual predispositions, vulnerabilities, and the specific ways in which the hallmark processes of ageing are most likely to affect you.

That knowledge has direct practical implications for the interventions, medications, and lifestyle choices most likely to be effective for you — as distinct from the population average.

The case for individual medicine is perhaps most starkly illustrated by cancer. Tumours are approximately 97% genetically distinct — and sometimes from each other, even within the same body. The idea that a single treatment protocol is the optimal response to what is, in biological reality, a highly individual disease is one that oncology is already moving away from. 

The development of individually tailored cancer vaccines — treatments designed around the specific genetic profile of a patient’s own tumour — is not a distant prospect. It is happening now, built on the mRNA technology that most people encountered for the first time during the COVID pandemic.  mRNA was developed to assist with individual medicines for the treatment of cancer  just in time to be adapted to the Covid pandemic

It had been in development for cancer treatment for years before COVID presented an urgent new application. The speed with which mRNA vaccines were deployed for COVID surprised many people. It should not have — the platform was already mature. It is now returning to its original purpose, and the implications for individually targeted cancer treatment are considerable.

All of this is relevant to anyone thinking seriously about their health in retirement. Understanding your own genome is not a guarantee of anything. It is not a medical intervention in itself. But it is a foundation — a piece of self-knowledge that is likely to become increasingly useful as individual medicine develops, and which very few people have yet thought to acquire.

That will change. Being already in possession of this knowledge in the future is likely to be as invaluable to your medical advisers  as removal of the delay might be to you.  The question is whether you are among those who act early or among those who wonder later why they waited.

Jack Lack’s Listening Chair is always here, as is your welcome.  

Take a seat.

Ageing has long been treated as a single, undifferentiated process — an inevitable and largely mysterious decline that begins at some point in midlife and proceeds on its own terms regardless of what we do. That understanding is now significantly out of date.

In 2013, a research team led by Carlos López-Otín published a landmark paper in the journal Cell -identifying nine distinct biological mechanisms underlying the ageing process. These became known as the Hallmarks of Ageing. 

A decade of intensive research followed, and in 2023 the same team published an updated framework expanding the hallmarks to twelve.

What this work established, with scientific rigour, is that ageing is not one thing. It is a collection of identifiable, measurable, and in a growing number of cases, addressable biological processes — each distinct, each consequential, and each increasingly the subject of serious research into intervention.

The twelve hallmarks as they currently stand are these:

Genomic Instability — accumulating damage to DNA over time. 

Telomere Attrition — the shortening of protective caps on chromosomes with each cell division. 

Epigenetic Alterations — changes in how genes are expressed without changes to the DNA sequence itself.

 Loss of Proteostasis — the breakdown of the system that maintains healthy protein production and clearance. 

Disabled Macroautophagy — the declining ability of cells to clean out damaged components.

 Deregulated Nutrient Sensing — the loss of precise cellular responses to nutritional signals. 

Mitochondrial Dysfunction — declining efficiency of the cellular energy production system. 

Cellular Senescence — the accumulation of aged cells that stop dividing but remain within the body and cause inflammation.

 Stem Cell Exhaustion — the declining capacity of stem cells to repair and renew tissues.

 Altered Intercellular Communication — disruption of the signalling systems between cells. 

Chronic Inflammation — persistent low grade inflammation that accelerates tissue damage. 

Dysbiosis — imbalance in the microbial communities, particularly in the gut, that affect overall health.

Each of these is important and each will receive its own Commentary in due course. 

For now the important point is the framework itself: ageing is not a single event but a set of distinct processes, operating simultaneously and interacting with each other, each of which is now understood well enough to be named, studied, and properly addressed.

That is a different picture from the one most people know. It does not promise immortality or the reversal of time. 

What it does offer is more useful — the understanding that how we age is not entirely beyond our influence, and that the choices made across the other Commentaries in this series are not merely lifestyle preferences. They are, in a number of cases, direct interventions in the hallmark processes themselves. 

The connections between sarcopenia and stem cell exhaustion, between diet and deregulated nutrient sensing, between deep sleep and cellular repair, are not coincidental. They are biological.

The next Commentary will take this one step further — into the territory of the individual. Understanding the hallmarks in general is one thing. Understanding which of them is most relevant to your particular biology is another, and  this knowledge is now within reach.

Jack Lack’s Listening Chair is always here, as is your welcome.

Take a seat.

Where you live matters more to the quality of your retirement than most planning conversations acknowledge. The physical environment you inhabit daily — its layout, its proximity to the people and services that sustain you, its capacity to support movement and social connection — shapes almost everything else.

A good environment quietly enables. A poor one quietly undermines. The difference accumulates over time in ways that are easy to miss until they become difficult to reverse.

Most people, given the choice, do not simply stay where they are when retirement arrives. The decision about where and how to live in later life is one that thoughtful people take seriously — and rightly so. It deserves the same deliberate attention as financial planning or health, not the passivity of default.

The governing reality for most people, however, is affordability. Where and how you can afford to live is frequently the determining factor, and there is little to be gained from retirement planning literature that ignores this. The practical question is how to make the best available choice within real constraints — and that question is worth engaging with honestly and early.

Early is the operative word. This is a decision best made by around the age of sixty, while the full range of options remains open and the capacity to implement a considered choice is intact. Decisions about where to live that are made significantly later tend to be reactive — driven by health events, bereavement, financial pressure, or diminishing mobility rather than genuine preference. The difference between a chosen environment and an imposed one is important and it affects everything from mood to independence to how long a person can remain active in the world.

Three considerations deserve particular care. The first is mobility — not merely whether you can get around your immediate environment, but whether the broader location supports independence as physical capacity changes over time.

The second is social connection — whether the place you live makes it easy or difficult to maintain existing relationships, encounter new people, and remain or become, part of a community.

The third is the environment itself — the immediate physical surroundings, access to nature, to amenities, to the small daily pleasures that make a place feel like home rather than simply a residence.

These three are not independent of each other. A place that scores well on all of them is worth effort to find and, where necessary and possible, to afford.

Jack Lack’s Listening Chair is always here, as is your welcome.