Understanding Aging Through Research

1
Understanding Aging Through Research

• Judith A. Salerno, M.D., M.S.
• Deputy Director,
• National Institute on Aging/
• August 1, 2006
• National Institutes of Health
• U.S. Department of Health and Human Services

2
NIA Mission

• Established in 1974 to support and conduct
  research on
  
• aging processes
• age-related diseases
• special problems and needs of the aged
• Train and develop research scientists
• Provide research resources
• Disseminate information on health and research
  advances

3
Other Federal AgenciesSupporting Aging Research

• DHHS
• Administration on Aging
• Agency for Healthcare Research and Quality
• Centers for Disease Control and Prevention
• National Center for Health Statistics
• Centers for Medicare and Medicaid Services
• Other Agencies
• Department of Veteran Affairs
• Department of Commerce, Bureau of the Census
• Social Security Administration

4

• 65 in the United States

5
(No Transcript)
6
Primary Causes of Disability
Osteoporosis and Fractures Cardiovascular Disease
Diabetes Arthritis Vision Hearing Cognitiv
e Impairments
7
Number of Chronically Disabled
Americans Age 65 and Over
(In Millions)
12
If disability rate did not change since 1982
10.0
10
9.5
9.2
8.3
8
7.5
7.4
6.4
7.1
7.1
7.0
7.0
6
Based on declining disability rate since 1982
4
1982
1989
1994
1999
2005
(estimated)
Source National Long Term Care Survey 1982-1999
(Kenneth Manton, Ph.D.)
8
Seeing the Future Through Aging Research NIA
Extramural Programs

• Biology of Aging (BAP)
• Behavioral and Social Research (BSR)
• Neuroscience and Neuropsychology of Aging (NNA)
• Geriatrics and Clinical Gerontology (GCG)

9
Biology of Aging Program Areas of Emphasis

• Fundamental molecular, cellular, genetic and
  physiological mechanisms underlying normal
  aging
  
• The role of aging on the susceptibility to
  age-related pathologies and disabilities
  
• Comparative biology of aging across species
• Genetic control of lifespan and healthspan
• Molecular mechanisms of caloric restriction
• Director Dr. Felipe Sierra [phone]
• EMAIL sierraf_at_nia.nih.gov

10
Behavioral and Social Research Program Areas of
Emphasis

• Interventions to reduce health disparities US
  and Global
  
• Demography and Economics Health, Work and
  Retirement
  
• Aging Minds Cognition, Affective and Social
  Neuroscience
  
• The Burden of Illness and Comparative Health
  Systems
  
• Increasing Health Expectancy
• Genetics, Behavior and the Social Environment
• Director Dr.
  Richard Suzman [phone]
  
• EMAIL rsuzman_at_nih.gov

11
Geriatrics and Clinical Gerontology Program
Areas of Emphasis

• Geriatric conditions and functional problems
  (e.g., frailty, incontinence, auto driving
  disabilities)
  
• Age-related issues in disease diagnosis,
  prevention, and treatment, including the effects
  of comorbidity
  
• New diseases of old age (vascular stiffening,
  sarcopenia)
  
• Hormonal therapies (estrogen, testosterone,
  growth hormone)
  
• Effects of physical activity in aging. 
• Exceptional longevity and exceptionally healthy
  aging
  
• Health implications and translation of findings
  from basic aging research
  
• Director Dr. Evan Hadley [phone]
• Email ehadley_at_nih.gov

12
GB and CCB foci
Shared foci Disease/disability prevention in
old age, progression of aging pathologies in late
life
13
Neuroscience and Neuropsychology of Aging
Program Areas of Emphasis

• Basic Neurobiology Age-related structural and
  functional changes particular interest on the
  selective vulnerability of neural cells in
  neurodegeneration and aging
• Sensory Motor Processes Broad range, from
  epidemiological studies through molecular and
  cellular aspects both peripheral and central
  mechanisms.
• Cognitive Neuroscience (Learning and Memory)
  Characteristics and underlying mechanisms, both
  biological and psychological, of changes in
  cognition and affect in normal aging.
• Sleep Epidemiology, pathogenesis, diagnosis,
  treatment, and prevention of sleep disorders in
  older people
  
• Director Dr. Marcelle Morrison-Bogorad
  [phone] EMAIL MorrisoM_at_nia.nih.gov
  

14
Major Area of Emphasis Alzheimers Disease and
Dementia

• Basic, clinical, and epidemiological studies of
  the etiology, diagnosis, and prevention and
  treatment of
  
• - Alzheimer's disease (AD),
• - Mild Cognitive Impairment (MCI), and
• - Other dementias and treatable brain
• disorders affecting older people

15
Projected Number of Persons with Alzheimers
Disease
In 2000, there were 4.5 million Americans with
AD annual cost of care estimated at 1 billion.
By 2050, the number of Americans with AD will
increase to 13.2 million (middle series
projection).
Source Evans, et al. Arch Neurol 2003 60
1119-1122.
16
From Bench to Bedside
Clinical Trials
Pre-Clinical Testing
Drug Development
Pre-clinical drug discovery
AD Neuroimaging
AD Genetics
Basic, Clinical, and Epidemiologic Research in
Alzheimers Disease
17
Progress in AD Research
Then (1990)
Now (2006)

• Genes unknown that could cause AD and no known
  biological pathways that involved development of
  damage to the brain in AD
  
• AD could not be modeled in animals
• NIH did not fund any AD clinical trials
• No method for identifying people at high risk of
  AD
  
• No way of visualizing plaques in the brain of a
  living AD patient

• 3 genes identified for early-onset and 1 risk
  factor gene for late-onset AD and more known
  about the pathways leading to beta-amyloid
  plaques and tangles development
• Developed transgenic mice that produce
  beta-amyloid plaques and tangles
  
• Over 25 clinical trials funded to look at ways to
  prevent AD, slow progression or provide
  symptomatic benefit
  
• New ways suggested to identify people at early
  stages of AD and imaging accelerates study in
  this area
  
• New imaging method can visualize plaques and be
  one way to identify early stages and track
  progression.
  

18
NIH Neuroscience Blueprint

• 15 NIH Institutes and Centers participating in
  Blueprint
  
• Pooled resources, expertise and collaborative
  initiatives
  
• About 100 million over 5 years

19
Turning 65 in 2006

• Politics Dick Cheney, Trent Lott, Dick
  Gephardt, Jesse Jackson
  
• Singers Paul Simon, Art Garfunkel, Bob
  Dylan, Neil Diamond,
  
• Joan Baez, Helen Reddy,
  Paul Anka, Eddie Rabbitt,
  
• Chubby Checker
• Sports Pete Rose, Bill Parcells
• Actors Nick Nolte, Faye Dunaway, Ryan
  ONeal,
  
• Ann-Margaret, Beau
  Bridges, Chuck Woolery
  
• TV/Authors Ed Bradley, Martha Stewart, Robin
  Leach,
  
• George Will, Anne Rice

20
The Future of Aging?