Thursday, July 24, 2014

Treat Ageing not Disease

An interesting commentary in NATURE provides an overview of the concept that modern medicine should be seeking to increase the ‘healthspan’ rather than addressing individual diseases one by one. Since many diseases are linked to the gradual debilitation associated with old age, the thought is that by blocking those degenerative changes overall health, and perhaps even lifespan, will be enhanced.

Certainly studies in animals have begun to reveal the molecular underpinnings of degeneration during ageing. Thus the mTOR signaling system, telomerase, and damage mediated by free radical triggered inflammation are all clearly important. Drugs such as rapamycin that affect the mTOR system have been shown to extend lifetimes and ‘healthspans’ in animals. Despite this progress at the laboratory level there are many obstacles to implementing these concepts and approaches in clinical practice.

One is funding. Research on ageing per se receives a tiny fraction of that received by cancer or cardiovascular disease research. Another is the lack of good tools and models that would allow study of ageing processes in animals in a manner parallel to the approaches used to evaluate ageing in humans. Since ageing studies can obviously be of very long duration, good surrogate markers would also be important. Finally our entire health care system is set up to be disease and procedure oriented rather than focusing on promoting the overall health of the individual.

It seems to this observer that pursuing the ‘healthspan’ concept will be vital in addressing the health needs of our rapidly ageing population. Some of the exciting findings on life- and health-extension in animals need to be carefully validated and then gradually extended into clinical trials in humans. I am sure that many otherwise healthy older people would be interested in participating in tests of drugs or other approaches that might provide a measure of rejuvenation. I know I would.    

1 comment:

  1. Another missing but in my opinion desperately needed direction of work in moving aging research forward is establishing the link between scientists and laymen. To my surprise I discovered that most people still view aging as some kind of "natural" process one shouldn't even think of modifying. This might partly explain the scarcity of funding of aging studies. I sure hope you are right about many healthy older folks willing to lend a hand to aging researchers, but knowing the views of people whose life is not related to science in any way I unfortunately find it doubtful.