By 2030, there will be some 72 million Americans ages 65 or older – more than double the number in that age group in 2000. The number of “oldest old” – people age 85 or older – is expected to more than triple between 2010 and 2050. (Federal Interagency Forum on Aging-Related Statistics. Older Americans 2012: Key Indicators of Well-Being. Federal Interagency Forum on Aging-Related Statistics. Washington, DC: U.S. Government Printing Office. 2012. http://www.agingstats.gov.) Age is a primary risk factor for many disabling diseases and conditions, and recent demographic studies have shown a modest increase in activity limitations among members of the enormous baby boom cohort. For these reasons it is imperative that we discover new and effective ways to make added years as healthy and productive as possible.
The National Institute on Aging (NIA) leads a national scientific effort to understand the nature of aging in order to promote the health and well-being of older adults. NIA’s mission is to support and conduct genetic, biological, clinical, behavioral, social, and economic research related to the aging process, diseases and conditions associated with aging, and other special problems and needs of older Americans; foster the development of research and clinician-scientists for research on aging; and communicate information about aging and advances in research on aging with the scientific community, health care providers, and the public. We carry out our mission by supporting extramural research at universities, research centers, and medical centers across the United States and around the world as well as a vibrant intramural research program at NIA laboratories in Baltimore and Bethesda, Maryland.
A major priority for NIA is investment in research on the aging process at its most fundamental levels. Exciting basic research findings, such as the discovery that removing small populations of senescent cells, which have lost their capacity to divide but continue to send and receive signals within the body, delayed onset of disease-related changes in skeletal muscle, fat, and eye tissues in mice and that removing senescent cells later in life slowed progression of established age-related disorders, are suggesting new avenues for the development of interventions for age-related diseases and conditions. The establishment of the trans-NIH Geroscience Interest Group, which was formed to accelerate and coordinate efforts to promote further discoveries on the common risks and mechanisms behind age-related diseases and conditions, is expected to stimulate an increased research interest in the basic biology of aging.
NIA also maintains an ongoing commitment to supporting basic behavioral and social research in aging. Ongoing initiatives in social neuroscience, behavioral and social consequences of natural and man-made disasters on the elderly, and effects of the economic downturn on older individuals will be active into FY 2014, and NIA remains an active participant in the trans-NIH Basic Behavioral and Social Science Opportunity Network (OppNet). In addition, NIA recently began to solicit research applications to use newly-available genetic data in the Health and Retirement Study, the nation’s premier study of health, retirement, pensions, and Social Security, to advance our understanding of how genetic, behavioral, and psychosocial factors affect the health and well-being of older Americans.
The translation of new interventions to clinical practice is another area of focus at NIA. NIA supports 13 Edward R. Roybal Centers for Translation Research in the Behavioral and Social Sciences of Aging; the Centers currently support research on health and mobility, disease and pain management, decision making and behavior change. Center investigators are also developing better data collection and measurement techniques and working to forecast the consequences of medical breakthroughs on health and health care spending. NIA also continues to support 13 Claude D. Pepper Older Americans Independence Centers, which investigate ways to maintain or restore independence in older adults. Ongoing studies such as Lifestyle Interventions and Independence for Elders (LIFE), in which researchers are testing an intervention to preserve mobility in older people, and the ASPirin in Reducing Events in the Elderly (ASPREE) trial, designed to determine whether the benefits of aspirin outweigh the risks in people over 70, further exemplify NIA’s commitment to reducing disease and disability in the elderly. NIA also initiated 17 clinical trials on a variety of conditions in FY 2012.
NIA’s comprehensive Alzheimer’s disease (AD) research program spans the spectrum of discovery, from basic neuroscience through translational research and clinical application. In 2012, the National Alzheimer’s Plan and Research Summit, as well as additional funding provided for FY 2012, generated new momentum in this field. Under four new funding opportunity announcements, projects covering development and validation of new therapeutics and prevention and treatment trials will be active in FY 2014. In addition, over 40 compounds are currently under development as part of the NIH AD Translational Initiative, and NIH supports over 35 AD-related clinical trials.
Recent AD-related advances include the discovery that misfolded tau protein, a pathological hallmark of the disease, spreads among neurons in a predictable pattern throughout vulnerable brain regions and the development of technology to convert skin cells from patients with familial AD into functional neurons. Separately, in a highly promising pilot trial, a nasal-spray form of insulin delayed memory loss and preserved cognition in people with cognitive deficits ranging from mild cognitive impairment to moderate AD. A larger-scale study to confirm and extend these results began in 2012 and will continue through 2014. In addition, a five-year study of whether crenezumab, which is designed to bind to and possibly clear abnormal amounts of amyloid protein in the brains of people with Alzheimer’s, can prevent cognitive decline in familial (early-onset) AD will continue through 2014.
Finally, NIA supports several innovative programs dedicated to the critical task of training the next generation of aging researchers. For example, the prestigious Paul B. Beeson Career Development Awards in Aging Research, co-funded by NIA and several philanthropic concerns, support outstanding junior and mid-career faculty committed to academic careers in aging-related research, training, and practice. Beeson scholars are emerging as leaders in the field of aging research. NIA’s new Grants for Early Medical/Surgical Specialists Transition to Aging Research (GEMSSTAR) program provides support for early stage clinician-scientists who have recently completed their clinical training and are embarking on a career in aging research in their specialty area. Recognizing the urgent need to promote diversity in the research workforce, in 2012 NIA established the Advancing Diversity in Aging Research through Undergraduate Education Program, which supports academic institutions that propose creative and innovative research education programs to diversify the workforce in aging at the undergraduate level.
For a comprehensive overview of NIA’s plans and priorities, see Living Long and Well in the 21st Century: Strategic Directions for Research on Aging, at http://www.nia.nih.gov/about/living-long-well-21st-century-strategic-directions-research-aging