Federal research on aging, memory, Alzheimer’s, and brain health

7/26/2019 Federal research on aging, memory, Alzheimers, 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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!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

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1(.0

2(00

2(.0

0(29

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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


10/36)atiFa"al, C? et al( =2016> N#$%954=6

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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#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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What ill the tra!ectories "e #or

disease$ ellness$ % where are weachieving success?

Aging +iolog* @Can we

increase lifespan? healthspan? Current and #uture directions


20/36)t( )auer ? et al( 201. '% ( en 7e" 9 . 2 :e00

!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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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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Federal research on aging, memory, Alzheimer’s, and brain health

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