Professor Claire Stewart – Written evidence (INQ0046)
We are currently scratching the surface in terms of our understanding of the biological process of ageing. The few human studies, which exist have very focussed questions and are either in healthy older people (generally males) or older people with e.g. obesity/diabetes/CV disease. Therefore to think we understand the biology of ageing on a basal level is worrying. The notion that ageing is a single process to be cured, is also going to delay our capability of developing interventions. We need to accept that ageing is a complex process that requires population specific investigations, is we are to develop effective pharma interventions. We do, however, know that lifestyle/environmental factors accelerate/decelerate unhealthy/healthy ageing. Nutrition and physical activity are known to improve functional, health, cognitive indices, regardless of the individual – however, lifestyle changes are difficult to implement, regardless of the benefits.
It is clear that those in deprived parts of the world have shortened healthspan vs. those in wealthier environments. Further, the incidence of sedentary behaviour/overweight/obesity inclined in a parallel manner to the number of televisions and cars in houses – associated comorbidities of sedentary lifestyles are documented and evidenced, but mindset change is difficult to achieve. In a sense we are tackling the problem after the horse has bolted – education and facilities to support physical activity and healthy eating need to be instilled from a young age, not once we have aged. Education and support are key.
b. Are there examples of good practice in the UK/devolved nations, or elsewhere?
Five more years of healthy independent living by 2035, is a fantastic goal, but not achievable in 15 years. Increased lifespan is very different to increased healthspan and unless individuals engage with healthy lifestyles and these are supported by government and big pharma, the likelihood of having new/repositioned drugs on the market and working for all, in 15 years, is unlikely, given the underpinning mechanisms are not yet known.
Key areas that may improve health, however are:
• Treatment of co-morbidities and polypharmacy : Needs modelling
• Diagnostics, particularly early diagnostics for ageing-related diseases : Needs investment
• Biomarkers for diagnostics and for monitoring effectiveness of treatments: From what samples and attained how?
• Personalised medicine for ageing-related diseases and multi-morbidities: While medicines are being developed, effective lifestyle interventions should be fostered. Coaching/mentoring/support for the general public should be developed and implemented.
19 September 2019