The Need to Promote Research of Aging and Aging-related Diseases as a Way to Improve Health of the Global Elderly Population.
Resolution of the International Conference on Aging and Disease of the International Society on Aging and Disease - ICAD 2014, November 1-2, 2014, Beijing, China
Aging and the Burden of Disease
The degenerative aging processes and associated diseases are the gravest challenge to global public health. Aging-related degenerative processes do not necessarily cause a particular disease but rather combine to produce a large set of non-communicable chronic diseases.
Degenerative aging processes are the major underlying cause of non-communicable diseases (NCDs), including cancer, ischemic heart disease, stroke, type 2 diabetes, Alzheimer's disease, etc. Mental health deterioration due to chronic neurodegenerative diseases forms the largest cause of disability in the world, responsible for over 20% of years lived with disability.
Aging-related NCDs are the greatest cause of mortality in the world, yearly claiming more than 34.5 million lives worldwide (66% or 2/3 of global deaths, or nearly 100.000 deaths daily). Hence major efforts must be directed toward their alleviation. According to the World Health Organization’s “Draft Twelfth General Programme of Work” (April 13, 2013), one of WHO’s leadership priorities is “Addressing the challenge of non-communicable diseases.”
Aging also increases the risk of morbidity and mortality from infectious diseases like pneumonia and influenza. Moreover, the susceptibility to injury and trauma (such as falls and concussions), due to the impairment of balance and mental state, and even falling victim to violence, are strongly increased by the aging process. Also, the processes of aging exacerbate and reinforce the effects of other risk factors of non-communicable diseases (tobacco use, unhealthy diet, physical inactivity, and harmful use of alcohol). In sum, aging-related health decline is the major cause of mortality and morbidity worldwide and should be addressed according to the severity of the problem.
Global Aging and the Forthcoming Global Health Crisis
The crisis of non-communicable diseases is exacerbated by the fact that the world population is rapidly aging. Between 2000 and 2050, the proportion of the world's population over 60 years will double from about 11% to 22%. The absolute number of people aged 60 years and over is expected to increase from 605 million to 2 billion over the same period. The problem is more pressing for the developed world, which is characterized by a higher life expectancy and an older population. Thus, while 2/3 of deaths in the world occur from chronic age-related diseases, in industrialized nations this proportion reaches 90%. Yet, age-related diseases and deaths are by no means just a problem of the industrialized world. In fact, in absolute terms, about 80% of deaths from chronic age-related diseases occur in low- and middle-income countries. The proportion of the aged all across the developing world is growing rapidly. By 2050, the proportion of people above 60 living in what are currently low and middle income countries, is expected to grow from 64 to 80%. This will globally enhance the impact of the biological aging process on the prevalence of non-communicable disease patterns.
The effect of degenerative aging processes can be modified by social and economic factors, as well as lifestyles (diet, exercise, etc.), but only to a modest extent. Hence, there is a need to promote research into the biology of aging and aging-related diseases as the way to improve the health of the elderly more substantially.
Policies to Promote Research of Aging and Aging-related Diseases
Addressing aging-related debilitating processes through biomedical means should become a new and powerful approach to the prevention of non-communicable diseases which affect most people at the later stages of life. The purpose of preventive medicine for the elderly is to preserve health of an aging individual so as to prevent functional decline.
Governments should ensure the following policies to promote research into the biology of aging and aging-related diseases, for improving the health of the global elderly population:
1) Ensuring a significant increase of governmental funding for goal-directed (translational) progress in preventing the degenerative aging processes, and the associated chronic non-communicable diseases and disabilities, and for extending healthy and productive life, during the entire life course.
2) Developing and adopting legal and regulatory frameworks that give incentives for goal-directed research and development designed to specifically address the development, registration, administration and accessibility of drugs, medical technologies and other therapies that will ameliorate the aging processes and associated diseases and extend healthy life.
3) Establishing national and international coordination structures to steer promotion of research and education on the biology of aging and associated diseases and the development of clinical guidelines to modulate the aging processes and associated aging-related diseases and to extend the healthy and productive lifespan for the population.