Related Specialty: Gerontology

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n most advanced countries the proportion of the population aged 65 years and older is responsible for a high proportion of the nation’s expenditure on health and social services.  In many countries this age group is the fastest growing demographic subgroup, driven both by reducing mortality in middle-age and an ongoing improvement in survival in the older age groups. 

 

A substantial fraction of the lifespan of the elderly is spent with moderate to severe disability.  The impact on quality of life is frequently compounded by a reduced access to the social networks typically available to previous generations.  These factors are combining to produce an economic burden on younger generations and major  national health challenge.

 

These changes are leading to growing appreciation of the need for new preventive approaches aimed at improving disability free survival amongst older adults and reducing the time required for institutional care.  Achieving this goal will require a better understanding of the reasons for physical decline in older adults and the development of new and innovative strategies to delay the onset and slow the progress of chronic disease.

 

Progress towards this goal will be underpinned by high-quality epidemiological studies capable of assessing contributions of genetic, lifestyle and environmental influences on age-related decline in physical and mental function.  These must be accompanied by mechanistic exploring the role of factors such as low grade inflammation and altered immunological responses.

 

Examples of the type of resource required include the ASPREE clinical trial and cohort study led jointly by Monash University and the Berman Center for Health Outcomes Research in Minneapolis USA.  This unique resource has followed the progress of over 19,000 individuals aged 70 years and above with extensive cognitive testing and clinical examinations.  Over 12,000 individuals have provided biospecimens (blood and urine).  This and other similar unique platforms will provide exceptional opportunities to study new strategies for the protection and early diagnosis multiple diseases of the elderly.

 

1. MCNEIL JJ, Woods RL, Nelson MR, et al. For the ASPREE Investigator Group. Effect of aspirin on disability-free survival in the healthy elderly. N Engl J Med. 2018; 379: 1499-1508.  

2. MCNEIL JJ, Wolfe R, Woods RL, et al. For the ASPREE Investigator Group. Effect of Aspirin on Cardiovascular Events and Bleeding in the Healthy Elderly. N Engl J Med 2018; 379: 1509-18. 

3. MCNEIL JJ, Nelson MR, Woods RL, et al. For the ASPREE Investigator Group. Effect of aspirin on all-cause mortality in the healthy elderly. N Engl J Med 2018; 379: 1519-28.

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