Changing Age – Changing Expectations of Life
Tom KirkwoodInstitute for Ageing and HealthNewcastle University
The Continuing Increase in Life Expectancy
UN estimate 1980
UN estimate 1990
UN estimate 2000
Oeppen & Vaupel Science 2002
Declining early/mid-life mortality Declining later-life mortality
The Traditional View of Ageing
The ageing process is biologically determined (we are programmed to die) with an inbuilt limit to lifespan
The ageing process is one of progressive, irreversible loss of functional capacity and of quality of life
Ageing is something that only concerns people in the later years of life
Increasing human longevity threatens to impose an intolerable burden on societies around the world
What happened? Why??
The “Disposable Soma”
Ageing – Historically a Rarity, Now Routine
1900
2000
20 8040 60 Age
Implications of the Disposable Soma
We are not programmed to die.
We are programmed for survival but in our ancestral environment investments in reproduction were a higher priority than long-term survival.
Ageing is caused by the build-up of faults.
Ageing and Development
Senescent Cell (human fibroblast)
●DNA damage foci●Telomeres●Overlap of damage foci with telomeres●Mitochondria with high membrane potential (good)●Mitochondria with low membrane potential (bad)
BBSRC/EPSRC Centre for Integrated Systems Biology of Ageing and Nutrition
Centre for Integrated Systems Biology of Ageing and Nutrition
Disease A
Disease B
Disease C
‘Upstream’ ‘Downstream’
Multi-Stage Progression of Age-Related Disease
Dementia and Neurodegenerative Diseases1960s
First survey of prevalence in the community (Kay)First psychometric test for diagnosing dementia (Hopkins)
Alzheimer’s disease recognised as the most common cause of dementia in older people (Blessed,Tomlinson,
Roth)
1970sCholinergic deficit in AD discovered leading to development of first symptomatic treatments (Perry E)
1990sDiscovery of dementia with Lewy bodies (DLB) as the second most common cause of dementia in older people (Perry R, McKeith)
Establishment of Newcastle Brain Tissue Resource with MRC support
2000s Vascular cognitive impairment characterised as a major determinant of dementia in old age (Kalaria, O’Brien)
Work starts to determine the causes of dementia in Parkinson’s disease (Burn)
Demonstration of links between mitochondrial mutations and neurodegeneration and establishment of RCUK Centre for Brain Ageing and Vitality (Turnbull)
Establishment (with UCL) of national Clinical Research Network on Dementia and Neurodegenerative Diseases (McKeith)
Centre for Brain Ageing and Vitality
• Stem cell ageing• Sarcopenia• Nutritional effects on DNA repair and DNA
methylation• Vascular ageing• Protein metabolism• Mitochondria• Exercise
– Muscle Assessment and Training Laboratory (MRC Translational Funding £760k)
Working with the NHS
Our partnership with the NHS is essential: The NHS as a research environment. Partnership in NIHR Biomedical Research Centre on
Ageing and Age-related Diseases. Business opportunities in partnership with the Newcastle
upon Tyne Hospitals NHS Foundation Trust.
Other NHS links: Strategic Health Authority. Primary Care Trusts. Mental Health Trust. Other regional NHS Trusts.
What Accounts for the Individuality of Human
Ageing?
Factors Influencing Health Trajectories in Old Age
Genes Nutrition Lifestyle Environment Socioeconomic status Attitude
These factors and their interactions are being studied in the Newcastle 85+ Study; a 5-year prospective study in more than 1000 individuals born in 1921 of the biological, clinical and psychosocial factors associated with healthy ageing.
The LIVEWELL Programme
Objectives:
•To develop and pilot an integrated suite of pragmatic interventions to promote health and well-being in later life
• To define a panel of outcome measures, including biomarkers of the healthy ageing phenotype
• Use retirement as the “window of opportunity” for interventions
Academic ‘quarter’Wolfson Research Centre (1999)Wellcome Biogerontology Building (2003)Newcastle MR Centre (2005)Edwardson Building (2008)Clinical Ageing Research Unit (2008)Translational Research Building (2010)
Clinical ‘quarter’Centre for Health of the Elderly (NHS)Old Age PsychiatryNIHR Biomedical Research Centre on AgeingRehabilitation/Primary Care
Business and Engagement ‘quarter’Teaching and Engagement CentreResearch and Innovation Care FacilityCentre for Assistive TechnologyFood Research CentreIndustry Buildings
Retail ‘quarter’Retail outlet(s) attracting cross-section of publicFlagship store with pioneering facilities/services
The Campus for Ageing and Vitality
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BBC Reith Lectures 2001
House of Lords Select Committee on Science and Technology, 2005
EU AgeAction: ‘Changing Expectations of Life’, 2007 (http://ageaction.ncl.ac.uk)
Foresight Project on Mental Capital and Wellbeing, 2008
Developing the Agenda
Foresight Challenge Project: Mental Capital Through Life
The Traditional View of Ageing
The ageing process is biologically determined (we are programmed to die) with an inbuilt limit to lifespan
The ageing process is one of progressive, irreversible loss of functional capacity and of quality of life
Ageing is something that only concerns people in the later years of life
Increasing human longevity threatens to impose an intolerable burden on societies around the world
We are programmed for survival not death.
Increasing longevity is a resounding success bringing major opportunities as well as challenges.
Youth and age are a continuum
Ageing is intrinsically malleable
A New View of Age
•Within the US, the economic benefit of the increase in life span since 1970 is estimated to have been worth $73,000,000,000,000.
Barriers to Changing the Status Quo
Fatalism – “I can’t change it anyway”. Negative stereotyping – “Old people are
losers”. Tunnel vision – “This is how it has to be” Youth bias – “We must invest in the future!” Restrictive accounting of costs and benefits –
“Why should I pay when it’s not me that benefits?”
Lack of hard evidence – “I won’t consider it until it’s proved to work”
Short-term’ism – “I’ll deal with it when I’ve fixed the immediate crisis”.
Changing Age- Waking up to the 29-hour day!
• Each day we have 24 hours for now, and 5 hours for later.
• How good will those 5 hours be when we come to use them?
• Can we make them better?
Research – Training – Engagement