Success in Delaying Aging Has Better Return Than
Focus on Cancer, Heart Disease
Even modest success in slowing aging would increase
number of non-disabled older adults by five percent every year from 2030
to 2060
Oct. 8, 2013 A new study shows that research to
delay aging and the infirmities of old age would have better population
health and economic returns than advances in individual fatal diseases
such as cancer or heart disease. The research shows significantly lower
and declining returns for continuing the current research "disease
model," which seeks to treat fatal diseases independently, rather than
tackling the shared, underlying cause of frailty and disability: aging
itself.
With even modest gains in our scientific
understanding of how to slow the aging process, an additional 5 percent
of adults over the age of 65 would be healthy rather than disabled every
year from 2030 to 2060, reveals the a study in the October issue of
Health Affairs.
Put another way, an investment in delayed aging
would mean 11.7 million more healthy adults over the age of 65 in 2060.
The analysis, from top scientists at USC, Harvard,
Columbia, the University of Illinois at Chicago and other institutions,
assumes research investment leading to a 1.25 percent reduction in the
likelihood of age-related diseases. In contrast to treatments for fatal
diseases, slowing aging would have no health returns initially, but
would have significant benefits over the long term.
In the United States, the number of people aged 65
and over is expected to more than double in the next 50 years, from 43
million in 2010 to 106 million in 2060. About 28 percent of the current
population over 65 is disabled.
"In the last half-century, major life expectancy
gains were driven by finding ways to reduce mortality from fatal
diseases," said lead author Dana Goldman, Leonard D. Schaeffer
Director's Chair at the USC Schaeffer Center for Health Policy and
Economics.
"But now disabled life expectancy is rising faster
than total life expectancy, leaving the number of years that one can
expect to live in good health unchanged or diminished. If we can age
more slowly, we can delay the onset and progression of many disabling
diseases simultaneously."
Number of Disabled Elderly
Americans 2010-2060
An investment in delayed aging would mean 11.7 million more healthy
adults over the age of 65 in 2060 -- far more than even optimistic
advances in cancer or heart disease research, which would barely improve
on the baseline of not doing anything. Graphy courtesy Health Affairs
Lowering the incidence of cancer by 25 percent in
the next few decades in line with the most favorable historical trends
would barely improve population health over not doing anything at all,
the analysis showed.
The same is true of heart disease, the leading
cause of death worldwide: About the same number of older adults would be
alive but disabled in 2060 whether we do nothing or continue to combat
cancer and heart disease individually. The findings are in line with
earlier research showing that curing cancer completely would only
increase life expectancy by about three years.
"Even a marginal success in slowing aging is going
to have a huge impact on health and quality of life. This is a
fundamentally new approach to public health that would attack the
underlying risk factors for all fatal and disabling diseases," said
corresponding author S. Jay Olshansky of the School of Public Health at
the University of Illinois-Chicago.
"We need to begin the research now. We don't know
which mechanisms are going to work to actually delay aging, and there
are probably a variety of ways this could be accomplished, but we need
to decide now that this is worth pursuing."
Several lines of scientific inquiry have already
shown how we might age more slowly, including studies of the genetics of
"centenarians" and other long-lived people. Slowing the signs of
biological aging has also been achieved in animal models, using
pharmaceuticals or interventions such as caloric restriction.
But until now, no assessment has been made of the
costs and health returns on developing therapies for delayed aging: "We
would be affecting every generation. This study is a benchmark in the
world of public health," Olshansky said.
The study shows that, with major advances in cancer
treatment or heart disease, a 51-year-old can expect to live about one
more year. A modest improvement in delaying aging would double this to
two additional years and those years are much more likely to be spent
in good health.
The increase in healthy years of life would have an
economic benefit of approximately $7.1 trillion over the next five
decades, the researchers find. Their analysis did not account for the
potential cognitive benefits for older adults with research in delayed
aging.
However, the results of the study also show that
improving the population of healthy, older adults will not lower overall
health care spending. With research advances in delayed aging, more
people would be alive past the age of 65, which means significantly
higher outlays for Medicare and Medicaid despite less per-person
spending on medical costs.
"Shifting the focus of medical investment to
delayed aging instead of targeting diseases individually would lead to
significant gains in physical health and social engagement," Goldman
said. "We see extremely large population health benefits, and the
benefits will extend to future generations. There are major fiscal
challenges, but these are manageable with reasonable policy changes, and
the economic value of such a shift is too large to ignore."
Notes:
David Cutler of Harvard University, John Rowe of
the Mailman School of Public Health at Columbia University, Pierre-Carl
Michaud of the University of Quebec at Montreal, and Jeffrey Sullivan
and Desi Peneva of Precision Health Economics are co-authors on the
study.
This research was supported by the MetLife
Foundation through the MetLife Foundation Silver Scholar Award,
administered by the Alliance for Aging Research. Additional support for
this research came from the Ellison Medical Foundation and the American
Federation for Aging Research. The development of the Future Elderly
Model was supported by the National Institute of Aging of the National
Institutes of Health (grants: P30AG024968, RC4AG039036) and the
MacArthur Research Network on an Aging Society.
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