Image from National Cancer Institute on Unsplash.
Recently I gave a talk to a small group. One question I got was, “How would research and treatment option changed if the medical system recognized the realities of age and aging?”
I love this question! If I could influence medical research spending, I would encourage 3 crucial topics topics.
Of course, it’s not likely to happen in real life because a lot of research gets funded by drug companies. These studies would show we need less medication, not more.
If you’re reading this article and you know about articles I’ve missed, please post the citations in the comments. I’ve had people say, “Oh no – there are lots of studies in this area!” but they can’t produce a single citation.
1 – Separating the influence of chronological age from covariates, such as comorbidities and residence in nursing homes.
Look at all the discussions of “aging and Covid19.” Few if any actually separate aging effects from comorbidities and residence in a nursing home.
A lot of “older” people have comorbidities, but not everyone does. If you happen to be healthy, you’re still shoved into the category of “old and sick.”
Lots of times you’ll see, “Older people experience increased risk” associated with a medical condition. I’ve never seen this statement modified to, “Older people who also have these comorbidities…” When I’ve asked why age has been identified as a predictor, I’ve gotten shrugs.
It’s like that old joke about the elderly man who complains of knee pain.
The doctor says, “At your age, what do you expect?”
The man says, “My other knee’s the same age and it’s doing just fine.”
On a broader scale, some people in their 80s and 90s are doing just fine, too.
2 – Impact of late-onset versus early-onset medical issues.
I came across a study comparing late-onset hypertension with early-onset hypertension. Not surprisingly, there was a significant difference in predicting the impact on cardiovascular outcomes.
Why was there just ONE study? Of course, it wasn’t in the US: think of the implications for the lucrative market for anti-hypertension drugs.
So when you see a 70-year-old with hypertension, why not ascertain when it started? Sometimes there’s no way to know but usually you can.
I suspect we’d find similar results for late-onset cholesterol levels and diabetes. But who’s looking? All those “older” people would stop taking drugs and then where would we be?
3 – Evaluate the impact of fitness on markers of aging.
One study found that immunosenescence was influenced by exercise. Older people who exercised had markers showing their immune systems were as strong as those of younger people who didn’t exercise.
Another study published in Frontiers in Immunology concluded:
“Despite the immune system’s vulnerability to prodigious exercise training, the overall anti-inflammatory effect of exercise may reduce the risk of age-related chronic disease characterized by chronic low-grade inflammation (e.g., cancer, type 2 diabetes, heart, and Alzheimer’s disease).”
They conclude that “Many studies show the positive effect of exercise on the immune system such as elevation in T-cell proliferative capacity, increased neutrophil function, and NK cell cytotoxic activity.”
Anecdotally, a surgeon told me it’s easier to operate on fit people. Muscle behaves differently from fat, he says, when you’ve got someone open under anesthesia.
If I ruled the world (or just the funding for medical research), I’d say we need to explore these areas. Even more important, we need to get the results into guidelines for treatment of anyone over 50.
Related article: Forget Everything You’ve Heard About Aging and Coronavirus
