The elderly comprise the fastest growing segment of our population, and aging itself is the largest single risk factor for most chronic diseases. The geroscience hypothesis posits that since aging physiology plays a role in many – if not all – chronic diseases, addressing aging physiology will allow a reduction or delay in the appearance of multiple chronic diseases. The elderly are often afflicted by multiple comorbidities and while recent progress in addressing individual diseases has led to an increase in life expectancy, this has not always been accompanied by a parallel increase in healthspan, the portion of life spent in good health. Thus, the proportion of sick elderly has been rising steadily, posing a significant burden on individuals, society and the health care system.
Advances in medical care which allow individuals to reach old age are advancing more quickly than our ability to provide age-related healthcare. Thus, the proportion of healthcare-related resources which are used to treat the elderly is increasing rapidly. The global population is aging and the economic impacts are dire. It is imperative to accelerate efforts to fulfill the needs of our growing elderly population. However, together with palliative actions, there is also an urgent need to develop preventative measures that can reduce the burden of age-related diseases and disabilities.
Aging itself is by far the greatest risk factor for most chronic diseases and disabilities which affect the elderly. However, there is still a widespread perception that aging is immutable, and thus we often focus our research and clinical trials on curing specific diseases without addressing the contribution of aging physiology to the onset or severity of those diseases. However, in the last few decades we have made impressive progress in understanding the genetics, biology, and physiology of aging, using a veritable zoo of laboratory animals to model human aging. Basic research in animal models has demonstrated the plasticity of lifespan. More importantly, we’ve been able to apply that knowledge to extend, in laboratory animals, not only the lifespan but also simultaneously increase their healthspan. That is, a slower rate of aging leads not only to a longer life, but also to a delay in the appearance and progression of most diseases of aging, as well as a slowing in age-related functional decline. What was thought to be disparate is now understood to be connected.
Progress in aging research has made possible the emergence of the field of geroscience, the intersection between basic aging biology and disease. The aims of geroscience are to understand how aging enables diseases and to exploit that knowledge to slow the appearance and progression of age-related diseases and disabilities. In addition, it is well established that some diseases (and/or their treatments) can accelerate the loss of function and resilience normally associated with aging, thus leading to an early susceptibility to disease. Therefore, we need to recognize that the complex relationships between aging, loss of function and susceptibility to disease operate in both directions. By developing a deeper understanding of the major underlying cause of our age-related increase in vulnerability to most cancers, dementias, stroke, heart attacks, vascular disease, diabetes and many other chronic diseases, geroscience aims to improve overall health in our later years. In fact, one of the goals of geroscience includes a more holistic interpretation of elderly health, to include optimizing function and resilience, elements that affect quality of life even in the absence of overt disease. Interventions that slow the aging process would dramatically lower health care costs and have societal benefits that are unmatched by the cure of any single disease.