Global Roadmap for Healthy Longevity (2022) / Chapter Skim
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Pages 210-221
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From page 210... ...
Although geroscience has the potential to extend the life span, the commission chose to emphasize the "healthy" part of "healthy longevity"; thus, the goal is to improve the percentage of life in good health, not to further prolong the life span, recognizing that major disparities in life span exist globally. In its focus on the underlying drivers of aging, geroscience differs from traditional biomedical research, which focuses on one disease at a time and often is conducted with carefully constructed study samples that are not representative of the larger population.
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Care Delivery Technology Digital technologies have the potential to play an important role in integrated care delivery for older people by enabling early detection and management of chronic diseases and functional impairments. Digital care technology is most effective when experts across sectors, such as engineers, medical professionals, and scientists, use human-centered design techniques to engage older adults throughout the design process.
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Older adults thereby have a visible reminder to increase physical activity that supports healthy longevity and enables self-monitoring and feedback (Kononova et al., 2019)
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Consequently, while unstructured AI can be highly effective for generating hypotheses to be tested, findings must be validated using hypothesis-driven research before they can be used to create algorithms to support precision medicine or precision public health (Hulsen et al., 2019)
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Research Questions In addition to the efficacy and acceptability of AI use and interventions across health systems, Kennedy and colleagues (2014) suggest the following research goals for geroscience: • "Continuum from psychological to molecular stresses • Differentiate hormesis from toxic stress • Better align human and animal studies • Biomarker development: chronologic versus biologic aging • Link age-related environmental inputs to epigenetic signatures • Test small molecules that regulate enzymes controlling epigenetic events • Differentiate adaptive and maladaptive inflammatory responses • Define age-related inflammatory sources and their systemic effects • Determine how obesity and metabolic dysfunction alter inflammation with age • Generate systems-level understanding of the types of macromolecular damage and their roles in chronic disease states • Understand how stochastic damage influences the variability of aging • Define role of signal transduction pathways linked to metabolism in the aging process • Understand contribution of circadian clocks to aging and metabolism • Connect metabolic dysfunction with tissue-specific decline in aging • Identify proteostatic pathways that are overwhelmed in specific chronic disease states • Examine crosstalk between proteostasis machineries • Understand non-cell-autonomous signaling and activation of proteosta sis pathways • Determine whether declining adult stem cell function drives aging and chronic disease • Examine how aging and associated disease impair adult stem cell function
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While for many people, interventions and recommendations discussed in Chapters 4 and 5 can ideally delay biological aging and increase years of healthy life, others will continue to rely on public health, health care, and long-term care for support as they age and experience the onset of chronic conditions. Current care systems are disjointed, however, and a rebalancing of investment across the care spectrum will be necessary to ensure that adequate support and priority are given to preventing disease and promoting health, not just responding to illness.
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2018. The global burden of multiple chronic conditions: A narrative review.
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and comparable countries? Health spending.
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2017. Return on investment of public health interventions: A systematic review.
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2012. Common values in assessing health outcomes from disease and injury: Disability weights measurement study for the Global Burden of Disease Study 2010.
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2019. Life expectancy and healthy life expectancy by World Bank Income Group.
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Moreover, for younger people to have optimism about their futures, they need to see that their later years can be characterized by well-being, engagement, meaning, and purpose. These investments, combined with the assets and prosocial goals of unprecedented numbers of older adults, can achieve healthy longevity for individuals and societies.
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