Select Committee on Science and Technology Minutes of Evidence

Memorandum submitted by AgeNet


  1.  AgeNet is an initiative sponsored and funded by the Medical Research Council, BUPA, Research into Ageing, SmithKline Beecham and Westminster Health Care. Funding is also received from the Office of Science and Technology's Foresight Challenge. AgeNet's purpose is to stimulate multidisciplinary and multisector research partnerships which will have beneficial outcomes for the health and quality of life of older people.

  2.  Over the initial three year phase of activity, starting in April 1997, AgeNet will have arranged some 20 multidisciplinary workshop meetings, developed databases, and established a website where information on its activities can be found ( AgeNet is in touch with over 1,000 researchers and others interested in ageing, and in age-associated conditions and issues, across the whole range of relevant scientific and professional disciplines. The responses to the Committee's questions that follow are intended to reflect the views of this community as assessed by the Director of AgeNet. They are not intended to reflect the views of the sponsors of AgeNet, some of whom have been invited to submit evidence by the Committee.


  3.  Public support for ageing research in the UK is fragmented and arguably insufficient, given the challenge of the ageing population. The EQUAL initiative has made a start in stimulating relevant new research activity. However, under present arrangements there can be no assurance that the scale and balance of effort is appropriate, nor is there vision and leadership. There would be a good case for developing the EQUAL initiative, under the auspices of the Office of Science and Technology, to constitute a mechanism for taking a Government-wide view of research strategy relevant to population ageing.

AgeNet's involvement in the EQUAL initiative

  4.  AgeNet has kept in close touch with the four Research Councils that are active in support of research on ageing and age-associated conditions and issues, with a view to participating in joint activities. Joint activities within the EQUAL initiative are outlined in the Annex. These Research Councils, and the Office of Science and Technology (OST), have been represented on AgeNet's Management Committee.

How well has EQUAL gained the support and participation of the most appropriate organisations and individuals?

  5.  OST's EQUAL initiative in effect comprises the research programmes formulated in response to the initiative by the Engineering & Physical Sciences Research Council (EPSRC, whose programme is also designated EQUAL), the Biotechnology & Biological Sciences Research Council (BBSRC; Science of Ageing—SAGE), the Medical Research Council (MRC; LINK Integrated Approaches to Healthy Ageing), and the Economic and Social Research Council (ESRC: Growing Older). Beyond this, EQUAL has virtually no profile in the research community and hence no support as such.

  6.  The significant new programmes of the EPSRC, BBSRC and ESRC have made a start in drawing the attention of the wider scientific community to the research agenda that follows from the prospect of population ageing over the coming half century.

  7.  The BBSRC and ESRC programmes each employed a single call for proposals, and each runs for about three years with the component projects (32 and 24 respectively) commencing at about the same time. There is no reason to suppose that the selection process did not pick the best proposals from amongst those submitted. However, programmes operated in this way tend to disfavour proposals from new research collaborations crossing disciplinary boundaries, particularly when there is a relatively short interval between the announcement of the call for proposals and the deadline for submissions.

  8.  In contrast, the approach adopted by the EPSRC features scoping workshops leading to annual calls for proposals, with each topic repeated in successive years; encouragement for one-year feasibility studies as well as standard grants; deliberate effort to employ referees and Panel members from a wide background; and obligatory involvement of organisations that can represent the interests of the ultimate users of the innovation. This approach is well designed to foster new multidisciplinary research partnerships, which is particularly desirable given the broad range of disciplines and professions relevant to the ageing process.

  9.  The MRC supports a wide range of research relevant to ageing and age-associated disease, and has introduced new funding schemes that promote multidisciplinary research. Although the health of older people is one of 11 topics identified by the Health Departments as a research priority for the MRC, research proposals in this area have to compete with the generality of proposals for the funding available. In these circumstances, it is hard to judge to what extent the MRC's programme of research relevant to the EQUAL initiative has gained the support and participation of the most appropriate organisations and individuals.

  10.  It is noteworthy that the four Research Councils have adopted three distinct responses to the EQUAL initiative, consistent with their differing approaches to research support generally. It would be worthwhile commissioning a comparative evaluation at an appropriate time to see if lessons could be learned about relative effectiveness.

Has the initiative identified and supported the most appropriate research areas for confronting the challenges of an ageing population?

  11.  The challenges of an ageing population follow from the projected increase in the numbers of older people over the next half century, together with the desire to improve their health and quality of life beyond present levels. The purpose of research is to generate the knowledge necessary (a) to intervene effectively in the processes which start with biological ageing, lead on to age-associated impairment of function and thence disability, and result in loss of social capability and thence dependence; and (b) to promote active, successful ageing. The research agenda may be outlined as follows:

    —  biology of ageing, an area of great current interest and activity. The BBSRC's SAGE programme is contributing;

    —  age-associated disease, where the paradigm is the world-wide effort in academia and industry to understand the basis of Alzheimer's disease at molecular level and thence to devise rational, effective therapeutic interventions. Other age-associated diseases which have an equally big impact on quality of life receive less attention, however, for instance osteoarthritis and loss of vision through macular degeneration;

    —  "frailty", shorthand for all those chronic conditions of older people which are not capable of consideration as a single pathology and which require long-term care and complex interventions (including rehabilitation). There is increasing concern on the part of geriatricians, gerontological nurses and practitioners of the various therapy disciplines to move towards evidence-based practice underpinned by methodologically sound research findings. It is not clear that we are devoting enough effort here;

    —  healthy ageing, the phenomenon whereby many people manage to avoid ill-health in old age (at least until close to death), requires close study to identify the determinants of healthy ageing and the interventions—both medical and social—best designed to promote this. The research agenda needs to be developed;

    —  health services research relevant to the needs of older people is now beginning to be recognised as important in relation to the cost-effective employment of the 40 per cent of NHS expenditure that is incurred on behalf of those over the age of 65. It is very welcome that the MRC's new Health Services Research Collaboration has chosen to focus on the chronic health problems of older people;

    —  modifying the physical environment, to reduce the handicap experienced by people with disabilities. The EPSRC's EQUAL research programme has made a start in addressing the possibilities;

    —  modifying the social environment to foster well-being and to lessen the loss of capability that is experienced in old age, whether on account of physical or mental disability, or poverty or loneliness. The ESRC's Growing Older programme bears on this.

  12.  There is at least some coverage of the elements of this research agenda from the programmes comprising the EQUAL initiative. However, there seems to have been no attempt systematically to consider the balance of effort.

  13.  Balance of research effort has to take into account the needs of society for the new knowledge generated by research, both to advance basic understanding and to underpin innovative practice. It also has to take account of potential scientific fruitfulness, since there is a well justified reluctance to throw resources at a problem, however important and interesting, before the concepts and tools are in place to allow progress. However, it is arguable that with the enormous advances currently being made in our understanding of the genome and of cell structure generally, and in our ability to elucidate metabolic pathways and control processes, we might feel less constrained than hitherto in targeting the chronic diseases of old age which have the biggest adverse impact on quality of life.

Is research in this area receiving sufficient Government funding?

  14.  As well as the balance of effort, discussed above, there is the overall scale of effort to consider. In general terms, ageing research has been something of a Cinderella, at least until the developments in funding programmes outlined above. The medical research charities have generally funded work on the diseases of early and mid-life, with the notable exceptions of Research into Ageing, a small but expanding source of funding, and the new PPP Medical Healthcare Trust which has recently initiated a funding programme. Beyond the medical research charities, the Nuffield Foundation last year commenced a programme to support relevant social sciences research, but otherwise there is little dedicated support for research on ageing issues.

  15.  It is understood that the National Health Service is reviewing its support of research relevant to the needs of an ageing population. The outcome could be significant in the context of judgements about the sufficiency of Government funding of research in this area.

  16.  Given the magnitude of the projected demographic trend of population ageing, the burden of chronic age-associated disease, the need to develop new societal roles in the increasingly long period that follows mid-life, and the developments in the underpinning science that will allow progress to be made, there is a strong prima facie case for considering additional Government funding for research.

  17.  There is also a good case for directing specific support to aspects of ageing research which present particular institutional difficulties. Studying the process of human ageing requires that subjects be followed over considerable periods of time in what are known as longitudinal studies. Such studies require more commitment and administrative support than does the generality of biomedical or social science research. Analogous studies with animal models require the maintenance of colonies of rodents, for instance, to substantially greater ages than would be normal for non-ageing research—incurring substantially greater costs.

What should be the priority areas of research for the EQUAL initiative?

  18.  In principle, the scope of the EQUAL initiative covers the full range of research on ageing and age-associated conditions and issues. This is the only viewpoint within Government which has such a synoptic perspective, since there is no Government Department which has lead responsibility for ageing or for the research requirements for policy development (unlike the position for nearly all other areas of policy-relevant research).

  19.  It is noteworthy that some counties manage the public support of ageing research substantially through the aegis of a lead institution. The US National Institute on Ageing is a notable example. The arrangements in the Netherlands and in the European Union under the Fifth Framework Programme are others. Such arrangements naturally facilitate a strategy approach to research programme development, unlike the position in the UK.

  20.  The priorities, scale and balance of research on ageing in the UK should reflect national needs and scientific potential, not administrative mechanisms and institutional boundaries for the publicly funded support of research. Under present arrangements, there is no assurance that this is the case. Nor is there any source of vision and leadership.

  21.  There would therefore be a good case for developing the EQUAL initiative, under the auspices of the OST, to constitute a mechanism for taking a Government-wide view of research strategy relevant to population ageing. This mechanism would address research priorities, as these evolve over time, and the scale and balance of research effort. The mechanism should be able to address research needs within single disciplines as well as the multidisciplinary approaches that are becoming increasingly important in improving the quality of life of older people. The means whereby research findings are translated into practice ought also to be considered.

  22.  AgeNet, as the one organisation whose remit covers all aspects of ageing research, stands ready to play its part in future developments.

January 2000

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