The Australian Ageing Research Agenda

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The Australian Ageing Research Agenda

• Prof G A (Tony) Broe
• Prince of Wales Ageing Research Centre
• Prince of Wales Medical Research Institute
• President Elect
• Australian Association of Gerontology

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Serious Ageing
Oeppen and Vaupal, Broken Limits to Life
Expectancy. Science (2002)
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Serious ageing should be be incorporated into
the Ageing Research Agenda

• Vaupel (Science 2002) is likely to be correct
  an average life expectancy of 100 yrs by 2060
• Malthus was wrong wealthy populations age get
  richer, rather than multiply get poorer
• Demographers age limits have been very wrong
  Dublin (65y), Omran (70), Fries Olshansky (85)
• Politicians blame the baby boomers. But they will
  be little more than a blip on our future ageing
• Australia will have 1.3 M. people 85 by 2051 (a
  400 increase as the population grows by 30)

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The Ageing Research AgendaQuestions

• What is the difference, or relative value, in
  pursuing ageing research vs more general
  research acknowledging age differentials?
• How can ageing research contribute to the
  general Australian Research Agenda?

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The Ageing Research AgendaQuestions

• What is the difference, or relative value, in
  pursuing ageing research vs more general
  research acknowledging age differentials?
• What characterises human ageing as a topic
  worthy of its own research agenda?
• What characterises general scientific research?

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What characterises Human Ageing?

• Very serious - the ageing of the aged 80
• Very rapid - so it has a recognition time-lag
• Very recent - so it has lack of acceptance
• Poorly understood - distal proximal causes
• Extremely complex - accumulated genetic/
  environment interactions across the life-span
• Multifactorial - we should embrace diversity

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Population Ageing - England 1541-1981 Ageing is
very rapid, very recent v. complex
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20
15

over 60
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5
0
1541
1751
1921
1981
1800
Era
Laslett P. Ageing Soc 1984 4379-89
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Ageing of the aged from 1970 on (Vaupel,
Science 1998)
Mortality declines with advancing age over 80
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What characterises Human Ageing?

• Serious ageing - the ageing of the aged 80
• Very rapid - so it has a recognition time-lag
• Very recent - so it has lack of acceptance
• Poorly understood - distal proximal causes
• Extremely complex - an accumulation of life- long
  genetic/environment interactions
• Multifactorial - we must embrace complexity

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Human Ageing MedicineLack of acceptance of a
new discipline

• The Australian Association of Gerontology was
  formed in 1964 now has about 1000 members -
  however
• Geriatric Medicine Old Age Psychiatry training
  were accepted by our colleges only after 1976
• We look after old people - Syndrome of the
  1970s-80s when we set up our multidisciplinary
  clinical units
• We do ageing research - Syndrome of the
  1980-90s when we set up our multidisciplinary
  research units
• Keep your old people out of our acute hospitals
  Syndrome of 2000-03

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The Ageing Research Agenda

• What is the difference, or relative value, in
  pursuing ageing research vs more general
  research acknowledging age differentials?
• What characterises human ageing as a topic
  worthy of its own research agenda?
• What characterises general scientific research?

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The Ageing Research Agenda

• Ageing Research
• Very recent
• Very new
• Tackles serious ageing
• New questions abound
• Complexity rules
• Multi-factorial

• General Research
• Comparatively old
• Pretty establishment
• Defines midlife as aging
• An aura of dogma
• Ockhams razor rules
• Reductionist

Can these 2 agendas be merged?
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Q. What is the difference, or relative value, in
pursuing ageing research vs more general
research acknowledging age differentials?

• A. Both are legitimate and both are essential.
• 1. Nutrition, exercise, cancer, cardio-vascular
  other system-based (vs general) researchers
  can do piggy-back age-related research onto
  older cohorts with important advances in ageing
• 2. Gerontologists should drive complex,
  multi-factorial, across discipline, across
  life-span research on serious ageing that links
  social environmental biological risk factors.
  Ageing research needs to cross current
  restrictive boundaries set up by funding bodies
  such as ARC, NHMRC, NHF etc

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Q.2. How can ageing research contribute to the
general Australian Research Agenda?

• The principles intrinsic to Ageing Research
  (complexity diversity multifactorial causation
  a life-span approach and multidisciplinary
  approach) apply increasingly to many other
  research fields
• The Information Revolution has transformed social
  and epidemiological research. Combined with
  advances in genetics, imaging, I.T. and other
  technologies we have the tools to bring ageing
  research principles to any research area

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Q 3.Can investigator driven, hypothesis testing,
ageing research assist aged policy/services?

• Appropriate population-based studies are a
  scientific equivalent of the more PC consumer
  consultation (RCS randomized controlled
  surveys)
• Kilsyth, Dubbo, SOPS, Canberra, and other studies
  have made many direct indirect contributions
  to ageing and health services in Australia

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Sydney Older Persons Study 1992-2003 Summary of
topics - Publications from 1995
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Conclusions

• Population Ageing is a good product of 200 yrs of
  wealth, health and salubrity - creating a
  majority of healthy older people, who dont throw
  bombs
• Average life-span will increase relentlessly but
  our very old arent dying - their brains simply
  fade away
• We need to delay and reduce late-life decline and
  disability and to support failing old their
  carers
• Ageing Research is the key. Longitudinal, cross
  discipline, socio-epidemiological studies w.
  biological correlates - is a good methodology to
  answer the Qs.