Understand how hallmarks of biological aging contribute to age-related diseases and conditions in older adults.
Understand that since advances in aging research show that aging is modifiable, geroscience research focuses on preventing and delaying age-related diseases and conditions through interventions that target aging mechanisms.
Discuss use of biomarkers of aging for clinical geroscience trials.
Understand the principles of translational geroscience as they apply to clinical trials studying interventions in fundamental aging processes.
Key Clinical Points
Aging is a universal human experience that looms large in popular and commercial culture. Geroscience is a new field, and some of the early interventions being studied include repurposed drugs or over-the-counter agents that target aging mechanisms.
Common sense clinical judgment should prevail when providers are asked about using such substances ahead of rigorous clinical data and Food and Drug Administration (FDA) approvals. A plausible link to mechanisms of aging does not mean an intervention will be effective or risk-free. Unregulated clinics are not the same thing as carefully controlled and regulated clinical trials.
Attempting to reverse the many ways our bodies change as we age is not always appropriate or helpful, as some changes may be adaptive, or represent consequences rather than causes of aging.
Providers and consumers should remember that most investigational drugs and therapies fail, and that typically older adults are at greater risk for harm by the misuse of medications or procedures.
Geriatricians will need to gain knowledge in geroscience so that they can function as content experts in geroscience-guided therapies as they are developed and approved for clinical use.
“There is nothing more deceptive than an obvious fact. Besides, we may chance to hit upon some other obvious facts which may have been by no means obvious.”
Sherlock Holmes in The Adventures of Sherlock Holmes. Arthur Conan Doyle (1892)
WHAT IS THE GEROSCIENCE HYPOTHESIS?
Geroscience is a relatively new field in aging that focuses on understanding the relationships between biological aging and age-related diseases. Key terms and language in this new discipline are shown in Table 40-1. The geroscience hypothesis states that fundamental biological mechanisms of aging drive the susceptibility of aged individuals to not just one, but multiple chronic diseases, such as cardiovascular disease, type 2 diabetes, malignancy, and dementia.
TABLE 40-1GEROSCIENCE GLOSSARY ||Download (.pdf) TABLE 40-1 GEROSCIENCE GLOSSARY
Geroscience. Posits that fundamental biological mechanisms play important roles in the susceptibility of aged individuals to multiple chronic diseases
Healthspan. Duration of healthy, active life before the occurrence of functional limitation and dependence
Lifespan. Normal duration of life of members of a given species, typically as median lifespan
Hallmarks or pillars of aging: Interrelated cellular biologic processes that are manifest with aging and could be potential targets to extend healthspan