It is Time to Embrace 21st-Century Medicine / Matt Kaeberlein, It is Time to Embrace 21st-Century Medicine, Public Policy & Aging Report, Volume 29, Issue 4, 2019, Pages 111–115. EXTRACT: Biomedical research and clinical practice have traditionally been focused on disease rather than health. We typically wait until people are sick before trying to cure their disease or alleviate their symptoms, rather than actively supporting health and wellbeing in the absence of disease. Current demographic trends toward older populations make this approach problematic. Instead of improving the quality of life, we may be extending the period of morbidity and frailty for millions of people. Twenty-first century medicine should adopt the strategy of directly targeting the molecular mechanisms that cause biological aging. Only in this way will it be possible to slow the onset and progression of multiple age-related diseases simultaneously, in order to extend the healthspan proportionately with the lifespan.
The Longevity Dividend: A Brief Update / S Jay Olshansky, The Longevity Dividend: A Brief Update, Public Policy & Aging Report, Volume 29, Issue 4, 2019, Pages 116–118. EXTRACT: The language of the longevity dividend as we know it today originated in 2006 (Olshansky et al., 2006), but its intellectual origins are not new. Clive McKay et al. (1956) suggested the successful life extension that had already been achieved in laboratory animals by then (without knowing whether changes in the healthspan also occurred in these animals) justified the experimental manipulation of the lifespan in humans. Bernie Strehler (1975) coined the term “gerontogeny” to describe future interventions designed to extend the healthspan, but he warned us that societies are not yet prepared for the scientific windfalls that would follow from delayed aging. As part of an National Science Foundation publication devoted to the public policy and ethical considerations involving lifespan interventions, Hayflick (1977) suggested that being old and being aged are not the same, and that research designed to slow aging should proceed with the sole purpose of helping us to get older without becoming aged.
Time for a New Strategy in the War on Alzheimer’s Disease / Matt Kaeberlein, Time for a New Strategy in the War on Alzheimer’s Disease, Public Policy & Aging Report, Volume 29, Issue 4, 2019, Pages 119–122. ABSTRACT: Alzheimer’s disease is a growing threat to the economic and social well-being of developed countries around the globe, but efforts to delay, prevent, or cure this disorder have yet to yield success. I believe the lack of progress largely results from approaches that ignore the most important component of Alzheimer’s disease: biological aging. Major advances have been made in understanding the molecular mechanisms that link biological aging to disease. These mechanisms have been formalized as nine hallmarks, or pillars, of aging. Here, I discuss the barriers that have impaired progress and propose specific steps that can be taken to overcome these barriers. The time has come to adopt bold new strategies that tackle biological aging as the root cause of Alzheimer’s disease.
A Regulatory Pathway for Medicines That Target Aging / G Alexander Fleming, Jennifer H Zhao, Thomas C Seoh, Nir Barzilai, A Regulatory Pathway for Medicines That Target Aging, Public Policy & Aging Report, Volume 29, Issue 4, 2019, Pages 128–133. EXTRACT: With the world’s population growing older and the primary causes of death shifting to noncommunicable, chronic diseases, there is a high unmet need for interventions that delay or prevent chronic disease. The emerging science of biological aging (geroscience) has demonstrated the feasibility of slowing biological aging, delaying chronic diseases, and spending more time living free from chronic disease, also known as increasing the “healthspan.” Despite these scientific advances, the Food and Drug Administration (FDA) and other major authorities have not articulated a regulatory pathway for licensing products with age-related claims. Regulation of the development of medicines has traditionally focused on the treatment of specific diseases and functional impairments. The perception is that a gap is expanding between what science may offer as age-related interventions and what drug regulation can provide in response. An approach that is consistent with FDA policy and practice is exemplified by the primary efficacy endpoint and proposed analysis of the Targeting Aging with Metformin (TAME) trial. Efficacy in this trial has been defined by reducing the time to the first occurrence of any one of several chronic diseases.
International Investment in Geroscience / Sean X Leng, Brian K Kennedy, International Investment in Geroscience, Public Policy & Aging Report, Volume 29, Issue 4, 2019, Pages 134–138. EXTRACT: Progress in the field of aging biology has been evident for several decades. Perhaps a forerunner for progress was the widespread adoption of non-vertebrate model organisms (predominantly flies, worms, and yeast). These organisms are inexpensive for research, relatively short-lived, and amenable to discovery-based science (Kennedy, 2008). As such, many genetic screens have been performed, identifying hundreds of genes associated with aging (https://genomics.senescence.info/genes/). Mutations in many of these genes leads to lifespan extension and, perhaps more importantly, some of the same genes and pathways have emerged from different organisms (Taormina et al., 2019), implying that the pathways modifying aging are widely conserved. Indeed, many of the same pathways modulate aging in mice and initial studies point to conservation in humans (Singh, Demmitt, Nath, & Brunet, 2019).
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