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Grand Challenges of Our Aging Society Workshop Summary (2010) / Chapter Skim
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2 Biological Research, Medical Advances, and Ethical Considerations
Pages 5-14

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From page 5...
... EXTENDING THE LIFE SPAN Richard A Miller Geriatrics Center Uniersity of Michigan Richard Miller addressed biological research on the life span by proposing to ask a hypothetical 50-year-old: Would you rather spend the next 30 years turning into an 80-year-old, or would you like to stay 50 years old for 30 years, and only then resume aging?
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From page 6...
... An intermediary research agenda involves the study of worms and flies that use the same gene to extend their life span, the study of cells from bats and birds that live on average three times longer than mammals of the same size, and comparisons of people to shorter lived marmosets. Research should also take advantage of what biologists have discovered regarding stress resistance pathways, developmental "switches," and long-lived mouse mutants.
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From page 7...
... To characterize the scientific consensus, controversy, and ignorance on the biology of aging, a parallel may be drawn from the history of infectious disease. The study of how to slow the aging process is at about the same stage as the study of infectious disease after Edward Jenner pio neered a vaccine against smallpox, but before Louis Pasteur, John Snow, and Robert Koch documented why the vaccine worked and developed the germ theory of disease.
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From page 8...
... Many of these systems affect each other, creating a biological safety net that provides reserves and resilience. In frailty, multisystem dysregulation and interactions may result in loss of physiological networking and mutual regulation, loss of reserves, and decreased homeostatic regulation.
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From page 9...
... Interventions at the first level, phenotype, include ways to increase physical activity and social engagement by redesigning community opportunities and environment. Maintaining physical activity ensures functioning on many levels, from muscle mass and strength to regulating mitochondrial function and energy production.
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From page 10...
... A final advantage of large-scale public health interventions is that they confer social benefit on everyone. As Fried concluded, "If we can redesign societal approaches so that they are both great for people as they get older and great for society because they help bring the wisdom and experience of an aging population to bear on unmet social needs, then we could have a new kind of social compact." ALLOCATING SCARCE HEALTH CARE RESOuRCES Daid B
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From page 11...
... If the country continues in this manner, health care costs will become com pletely unaffordable. Garrett Hardin's well-known 1968 essay, "The Tragedy of the Commons," describes the dilemma of multiple individuals acting indepen dently in their own self-interest and thereby destroying a shared limited resource, through no intent of their own and against their own long-term interest.
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From page 12...
... It would be a welcome means to deny unrestrained use of health care in futile situations. Providing an illustration from his own practice, Reuben mentioned the case of an elderly individual with severe dementia and metastatic breast cancer being kept in an intensive care unit for 130 days at the insistence of her family.
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From page 13...
... A defined system for allocating health care resources would address only direct costs of health care, and not the substantial indirect economic impact of lost productivity of patients and their informal caregivers. Reuben closed with a three-part research agenda: 1.
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Key Terms

  • aging process
  • care resources
  • biological research
  • aging society
  • physical activity

  • allocating health
  • intensive care
  • care services
  • healthy life
  • proper limits

  • health interventions
  • care unit
  • physiological dysregulation
  • little funding
  • defined medicare

  • social engagement
  • medicare benefit
  • experience corps
  • distributive justice
  • costly health

  • health approaches
  • poorer health
  • common health
  • health intervention
  • scarce health

  • conventional health
  • health status
  • care requires
  • care costs
  • care raises


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