global life expectancy is expected to continue to...
TRANSCRIPT
#MIGlobal
Global life expectancy is expected to continue to increase
Sources: United Nations.
Years
79.6
81.8
84.1
76.9
79.2
82.0
76.078.1
80.5
71.0
73.7
76.6
60
65
70
75
80
85
90
2015 2030 2050
U.S.
Europe
China
World
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By 2050, the U.S. older adult population will increase 76 percent and globally it will increase 146 percent
Sources: U.S. United Nations.
Million people aged 65+
50 75 88131 167 193134 237
333
606
975
1,491
0
200
400
600
800
1,000
1,200
1,400
1,600
2015 2030 2050
U.S.
Europe
China
World
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Globally, the 80+ year-old population will grow the most from current levels among older adults
213
336
447
152
256
358
114
189
293
125
192
392
0
50
100
150
200
250
300
350
400
450
500
2015 2030 2050
Million people
65-69 Yrs
70-74 Yrs
80+ Yrs
75-79 Yrs
Sources: United Nations.
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Larger portions of populations aged 65+ going forward
2015 2030 2050
World 8% 12% 16%
India 5% 8% 13%
Brazil 8% 14% 23%
China 9% 16% 24%
Russia 13% 18% 21%
United States 15% 20% 21%
United Kingdom 18% 22% 25%
Germany 21% 28% 33%
Japan 26% 31% 37%
Source: United Nations.
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While other major countries curb interest, Chinese consumption of cigarettes is expected to increase
27 27
16 16
28
31
0
5
10
15
20
25
30
35
2015 2030
U.S. India China
Source: University of Denver.
Percent of adults 30 years and older
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Obesity rates are expected to rise in populous countries outside the U.S.
53 52
3 458
0
10
20
30
40
50
60
2015 2030
U.S.
India China
Source: University of Denver.
Percent of adults 30 years and older
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Spending on top 6 chronic diseases in the U.S. will grow over 70 percent by 2020
Source: Centers for Disease Control and Prevention.
2010 Total = US$ 887 billion2020 Total = US$ 1.5 trillion
3472 133 141 155
351
55118
225 244273
611
$0$100$200$300$400$500$600$700
2010
2020
US$ billions
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U.S. safety net health insurance expenditure is expected to increase, with growth in Medicaid outpacing Medicare
Sources: Centers for Medicare & Medicaid Services, Kaiser Family Foundation.
432
746
480
686
$0
$100
$200
$300
$400
$500
$600
$700
$800
2011 2020
Medicaid Medicare
US$ billions
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The shrinking cost of sequencing a genome From $3 billion for the first genome to less than $1 thousand today
Source: National Institutes of Health.
0
20
40
60
80
100
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
US$ millions
Next generation
technology adoption
$95.3 million
$1 thousand
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Our mission to change aging requires more than a compelling narrative
Source: Milken Institute.
“Population aging is one of the great
global developments of the 21st century.
The vast potential of longer lives, made
possible by remarkable advances in
medical science and public health,
demands fresh thinking and action.”
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What is “personalized” medicine
• Uses information about a person’s genes, proteins, and cellular environment for prevention, diagnosis, and treatment
• Treatment strategies with greater specificity
Source: Columbia University Medical Center.
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A multi-sector, multi-strategy approach is crucial to making lasting change.
• Interventions need to complement each other.
• The effects and effectiveness of these interventions vary from disease to disease.
Source: Milken Institute.
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Older adults with a greater sense of purpose are less likely to develop adverse health outcomes
Source: Stroke.
Mortality
Decline in physical function
Frailty
DisabilityAlzheimer’s disease
Clinical stroke
Vs.
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Purpose in life is associated with substantially reduced risk of Alzheimer’s disease (AD)
• Provides neural reserve by protecting against harmful effects of AD pathologic changes on cognitive function in elderly persons
• AD has a long preclinical phase• Purpose in life may be modifiable:
• Self-reflection
• Synthesis of experiences
• Awareness of role and potential
• Establish goals and priorities
Sources: Archives of General Psychiatry.
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Purpose in life is associated with substantially reduced risk of Alzheimer’s disease (AD)
Effect of purpose in life on the relation between A lzheimer disease pathologic changes on cognitive fun ction in advanced age.Boyle PA1, Buchman AS, Wilson RS, Yu L, Schneider JA, Bennett DA.Author informationAbstractCONTEXT:Purpose in life is associated with a substantially reduced risk of Alzheimer disease (AD), but the neurobiologic basis of this protective effect remains unknown.OBJECTIVE:To test the hypothesis that purpose in life reduces the deleterious effects of AD pathologic changes on cognition in advanced age.DESIGN:A longitudinal, epidemiologic, clinicopathologic study of aging was conducted that included detailed annual clinical evaluations and brain autopsy.PARTICIPANTS:Two hundred forty-six community-based older persons from the Rush Memory and Aging Project participated.MAIN OUTCOME MEASURES:Purpose in life was assessed via structured interview, and cognitive function was evaluated annually and proximate to death. On postmortem examination, 3 indexes of AD pathologic features were quantified: global AD pathologic changes, amyloid, and tangles. The associations of disease pathologic changes and purpose in life with cognition were examined using linear regressionand mixed models.
Sources: Archives of General Psychiatry.
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Considering all the factors that can cause obesity
Nutrition and risk behavior
Lifestyle and workplace activities
Demographics and family structure
Geographic variations
Source: Milken Institute.
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A modest reduction in sugar-sweetened beverage consumption can lead to substantial improvements
Source: Milken Institute.
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When the “spans” don’t match
0
10
20
30
40
50
60
70
80
90
1900 1960 2010
Years
Mean lifespan
Mean healthspan
Source: USC Davis School of Gerontology.
• Lifespan – average life expectancy
• Healthspan – age of contracting a chronic disease
• Disability-span is growing
• “Wealth-span” – age when savings begin to dwindle
#MIGlobal Source: USC Davis School of Gerontology.
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Gender and aging
Sources: USC Davis School of Gerontology, Science, OECD.
• Women
• Lived only 1-2 years longer a century ago
• Live 5 years longer than men today
• Represent >80% of centenarians
• Spend more years with “disability”
U.S. life expectancy
Men
76 years
Women
81 years
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A recent study has found that women who carry a little extra weight
live longer than the men who mention it.
Source: USC Davis School of Gerontology.
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The USC Center for Personalized Aging
Source: USC Davis School of Gerontology.
• The end of “one-size-fits-all” aging advice• This Concept is based on “genomics” and
“epigenetics”, the approach of analyzing the sequences of our DNA.
• personalized aging assumes that everybody ages differently due to many factors unique to the individual, including our genes.
• Filter out non-relevant health messaging• Allow focus on areas of personal highest risk• Help select individualized programs, diets, and
wellness strategies
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Personalized Aging Initiative
Source: USC Davis School of Gerontology.
The opportunity:• Create new approaches to individualized strategies for health maintenance
which could be referred to as "personalized aging” • Abandon 20th Century advice – “one-size fits all” • Capitalize on novel technologies and genetic counseling:
• Diet and nutrigenomics
• Health telemetry
• Develop a paradigm by which personalized longevity advice can be offered to people together with appropriate nutritional, exercise, brain training and tailored pharmacological interventions
• Recent summit with world experts
• Exercise innovation and wearable tech
• Brain Training – apps and beyond
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Caloric restriction extends lifespan?
Source: USC Davis School of Gerontology.
Only sometimes…
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Prevention of cardiovascular disease with Mediterranean diet
Sources: USC Davis School of Gerontology, The New England Journal of Medicine.
Dis-lipidemiaNoYes
PersonalizedAging!!!
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What diet should you be on?
Source: USC Davis School of Gerontology.
• Low calorie?
• Low carb?
• Low fat?
• Low protein?
• Mediterranean?
• Vegetarian?
• Vegan?
For$10 billion
And20-years,
We can tell you!
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What else can we learn from personal genomics?
Source: USC Davis School of Gerontology.
• Do you benefit from aspirin?
• Do you be benefit from 1-2 drinks a day?
• Are you at risk of skin cancer
• Are you at risk from eating “well-done” meat”
• >300 diseases and conditions
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Americans are bad at guessing how long they’ll live
Sources: USC Davis School of Gerontology, Brookings Institution, University of Michigan.
78%
83%
80%
81%
78%
75%
69%
71%
65%
60%
49%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90%
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
20 years later, the actual chance of the guesses on the left living to 75
20 years ago,
the chance people
55-60 years old
thought they had
of living to 75 years
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Incentives to improve health
Source: USC Davis School of Gerontology.
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Personalized health services
Source: USC Davis School of Gerontology.
• Nutrigenomic analysis and customized diets
• Individual exercise regimens
• Brain training exercises
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Brain training for those with dementia risk
Sources: USC Davis School of Gerontology, Center for Digital Aging.
Non-invasive brain stimulation
Brain-Challenging Video Games
• Rehabilitate and improve declining cognitive skills
• Ensure preservation of functional ability
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The economic benefits of Alzheimer’s preventionTotal medical costs for individuals with Alzheimer’s disease under delay scenarios
212 214
323
593
928
149173
254
469
765
54119
160
300
518
0
100
200
300
400
500
600
700
800
900
1000
2010 2020 2030 2040 2050
US$ billions
Total costs
Delay 1 year
Delay 5 years
Sources: USC Davis School of Gerontology, Zissimopoulos & Crimmins 2015.
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Health-adjusted life expectancy
Source: Statistics Canada.
78.383.0
68.9 71.2
0
10
20
30
40
50
60
70
80
90
Males Females
YearsLife expectancy at birth
Health adjusted life expectancy at birth
#MIGlobal Source: Alzheimer’s Society of Canada.
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Number of people with dementia in low and middle income countries compared to high income countries
Source: Alzheimer’s Disease International.
Millions of people
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The CIHR Dementia Research Strategy...
Sources: Alzheimer’s & Dementia, Lancet Neurology.
1Primary
prevention
1Primary
prevention
2Secondary
prevention
2Secondary
prevention
3Quality
Of life
3Quality
Of life
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UK call to action
• In December 2013, British PM David Cameron brought the dementia challenge to the international stage
"If we are to beat dementia, we must also work globally, with nations, business and scientists from all over the world working together as we did with cancer, and with HIV and AIDS. This is going to be a bigger and bigger issue; the key is to keep pushing.”- David Cameron, December 11, 2013
Source: BBC News.
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The innovation pipelineThe focus of the CIHR Initiative
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A life course approach to active ageing
Source: Ageing and Health Programme, World Health Organization.
Fun
ctio
nal
capa
city
Early LifeGrowth and development
Adult LifeMaintaining
highest possible level of function
Older AgeMaintaining
independence and preventing disability
Loss of Autonomy/Disability Threshold
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Staying above the “Disability Threshold”Aging in better health across the life course can reduce disease and disability in older age
Source: World Health.
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Let’s talk about FOGO**Fear of Getting Old
Sources: www.getold.com, Pfizer.
“SleepingTogether”Will ActuallyMeanSleeping Together
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Next generation health care
Source: The National Academic Press.