federal research on aging, memory, alzheimer’s, and brain health
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National Press Foundation TrainingAging and Retirement: Understanding Generational Changes
Richard J. Hodes, M.D.
Director
National Institute on Aging
June 14, 2016
An Aging Population:
esearch Loos to the Futur
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Looing to the Future
Current trends in demographics,health, and costs
What ill the tra!ectories "e #ordisease$ ellness$ % where arewe achieving success?
Aging "iolog& %Can we increaselifespan? healthspan?
Current and #uture directions
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Looing to the Future
!urrent trends in de"ographics,health, and costs
What ill the tra!ectories "e #or
disease$ ellness$ % where are weachieving success?
Aging "iolog& %Can we increase
lifespan? healthspan? Current and #uture directions
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or s er opu a onis &ro'ing
'e et al( U()( Census *ureau, +nternational opulationReports, -./161,
Americas 6.and
oer population ispro!ected to nearl&dou"le, #rom 43 millto 33 mill "& 20.0
Glo"al li#eepectanc& ispro!ected toincrease "& almosteight &ears, #rom63(6 &ears in 201.to 56(2 &ears in20.0
he glo"alpopulation o# people
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Li(e e)pectanc* (alling (or thepoor, rising (or the rich
7rom 8+A 'ealthand Retirement
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7rom 1-502019, mortalit&rates #or those aged 4.%.4hae decreased "& 44(
Allcause mortalit& o#
middleaged hite non'ispanic men and omenincreased in the United)tates "eteen 1---2019
% this trend is uni;ue tothe U)(
+ncreases in drug andalcohol poisonings,
suicide, and chronic lier
Midli(eMor+idit*Mortalit* Trends
Case A and A PNAS112=4->:
Allcause mortalit&, ages4.%.4
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Ages .-64 3933 .-64 3933 .-64 39330(00
0(.0
1(00
1(.0
2(00
2(.0
0(29
1(00
0(15
1(06
0(32
1(35
0(2-
0(35
0(24
1(01 0(--
2(02
Actiities o#
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Pre3alence o( De"entia in the4.5.
'e"ert, ? et al( =2019> Neurolog"30=1-'e"ert, ? et al( =2009>Arch Neurol 60=3
1226data
12-6
data
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The &ro'ing !ost o( De"entia
pro!ections in 2010 dollars
'urd, @< et al( =2019> N#$% 963=14>:19
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he .&ear age/sead!usted cumulatie haFardrates #or dementia ere:
9(6/100 persons % 1st epoch =late 50s earl&30s>
2(3/100 persons % 2nd epoch =late 30s earl&-0s>
2(2/100 persons % 9rd epoch =late -0s earl&00s>
2(0/100 persons % 4th epoch =late 00s earl&
10s>
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=uestions>
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Looing to the Future
Current trends in demographics,health, and costs
#hat 'ill the tra?ectories +e
(or disease> 'ellness> @ whereare we achieving success?
Aging "iolog& %Can we increase
lifespan? healthspan? Current and #uture directions
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Leading !auses o( Death,Adults /B Cears, 12-6
Ran !ause o( Death
1 'eart disease
2 Cancer
9 Chronic loer respirator& diseases
4 )troHe
. AlFheimers disease
6
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e an or )erc se o reaHeart Failure #ith Preser3ed
?ection Fraction
itFman, $A%A91.=
R d i d T i l ( Fi i l
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Rando"iEed Trial o( Financial0Incenti3e Progra"s (or 5"oing
!essation
'alpern, )< et al(=201.>N#$%
Re'ardG
and!o""it"entGparticipantsuit "oreo(ten thantreat"ent asusual
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5*stolic 8lood Pressure Inter3ention
TrialPri"ar* %utco"e
he )R+8 Research Grou 201. N# %959 22
5PRINT 5tud*
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8io"arers In(or" %ur 4nderstanding o(AlEhei"er$s Progression
acH CR et al( 2019 &ancet Neurol 12
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=uestions>
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Looing to the Future
Current trends in demographics,health, and costs
What ill the tra!ectories "e #or
disease$ ellness$ % where are weachieving success?
Aging +iolog* @Can we
increase lifespan? healthspan? Current and #uture directions
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7/26/2019 Federal research on aging, memory, Alzheimers, and brain health
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!hronic
idne*
Disease
5troe %steoporosis!ong.Heart
Failure
!%PD
H*perlipid.
HTN Depression
Dia+etes
Arthritis
!ancer
!ardiacArrh*th"
ias
!AD
Disease Pre3alence as aFunction o( Age
5chiEophrenia
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Epigenetics
MetabolismInflammation
Damage(Repair)
Stress(Adaptation)
Genetics
StemCells
Immunity
Proteostasis
Arthritis
Sarcopenia CD
C!PD "eartDisease
Immunity
$ascularDisease%eurological
Disease
Cancer
MacularDegeneration
"earing
&iology
ofDisease
&iologyof
Aging
Proteostasis
Epigenetics
MacromolecularDamage
Inflammation
!ther&iology
Metabolism
StemCells
StressResponse
*urch, J* et al( =2014>$ )erontol A 'iol Sci %edSci JunK 6- )uppl 1:)19K enned&, * et al(
&eroscienceG is the!on3ergence o(
T'o Fields o( 5tud*
Li( i Pl ti
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Rapam&cin +
Aspirin % + Acar"ose %
15a estradiol +
Li(espan is Plastic 00Inter3entions in "ice
Ad Libitum
Restricted
Calorie
I i F i
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Inter"ittent Fasting:A Pro"ising Lead
*randhorst, ) et al( =201.> Cell %eta*olis+ 22,
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Comprehensive Assessment of Long-term
Effects of Reducing Intake of Energy
7irst humantrial o# longterm CR oneLects onagingrelated
outcomes
ested
#easi"ilit& and
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CALERIE Results
Raussin, et al($ )erontol A 'iol Sci %ed Sci 201.
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=uestions>
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Looing to the Future
Current trends in demographics,health, and costs
What ill the tra!ectories "e #ordisease$ ellness$ % where arewe achieving success?
Aging "iolog& %Can we increaselifespan? healthspan?
!urrent and (uture directions
P ti i % & l
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For e)a"ple, a(a"il* in!olo"+ia that
de3elops ADearl* isgenerousl*
'oring 'ithresearchers
Pre3ention is %ne &oalo( NIA$s AlEhei"er$s
Trials
Fleisher AS et al. 2012 Lancet Neurolo 11 12 :1057-65.
Gene Carriers, late 3!s
"eta-amyloid, late #!s
$ementia onset is in late %!s
&on-Carriers, late 3!s
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0Trials )plore ManyDierent
Disease Path'a*s
+n addition to antiam&loid therapies, 8+Ais stud&ing:
o Compounds ith other actions, such as
reenting loss o# nere connections Restoring #unction o# damaged s&napses
romoting ne neuron groth
o
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%ther Pro?ects in the ADPipeline
A consortium to looH at ho ascular risH #actors
inIuence A PilotStud"
)tud& o Understand 7all
P ti i ti i R h i
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Participation in Research isssentialK
8+A, C
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ncourages sedentar&older adults to "eactie eer& da&
*ased on the science
+ncludes
people ith chronic
health conditions older people ho
traditionall& hae notem"raced eercise
=shos them ho to do
00 Putting Researchin Action
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Get #ree in#o on aging, health O
AlFheimers disease ?earn a"out research O training
opportunities
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=uestions>
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