Select Committee on Science and Technology First Report



    Lord Drayson
    Baroness Emerton
    Baroness Hilton of Eggardon
    Lord May of Oxford
    Lord Mitchell
    Baroness Murphy
    Lord Oxburgh
    Lord Soulsby of Swaffham Prior
    Lord Sutherland of Houndwood (Chairman)
    Lord Turnberg
    Baroness Walmsley
    Michael Collon (Clerk)
    Dr Jonathan Radcliffe (Specialist Assistant)
    Professor Tom Kirkwood (Professor of Medicine, University of Newcastle, Specialist Adviser to the Sub-Committee)
    Dr Alison Austin (Assistant Director, Office of Science and Technology, OST)
    Steve Brown (BT - Martlesham Heath)
    Professor Roger Coleman (Professor of Inclusive Design and Co-director of the Helen Hamlyn Research Centre at the Royal College of Art)
    Professor David Cope (Parliamentary Office for Science and Technology)
    Professor Peter Crome (President-elect, British Geriatrics Society)
    Dr Deborah Dunn-Walters (British Society for Research on Ageing, BSRA)
    Dr Diana Dunstan (Medical Research Council, MRC)
    Doug Emery (Innovation Fellow, University of Sheffield)
    Sir John Grimley Evans (Emeritus Professor of Clinical Geratology, Oxford University)
    Dr James Goodwin (Head of Research, Help the Aged)
    Ms Shabnam Khan (Economic and Social Research Council, ESRC)
    Professor Steve Jackson (The Gurdon Institute, Cambridge University)
    Professor Peter Lansley (Reading University)
    Dr Lorna Layward (Research Manager, Help the Aged)
    Mrs Mary Manning (Executive Director, Academy of Medical Sciences)
    Dr Brian Merry (Liverpool University)
    Dr Colin Miles (Biotechnology and Biological Sciences Research Council, BBSRC)
    Ms Elizabeth Mills (former director, Research into Ageing)
    Dr Helen Munn (Academy of Medical Sciences)
    Dr Kedar Pandya (Engineering and Physical Sciences Research Council, EPSRC)
    Professor Linda Partridge (University College London)
    Martin Rumsey (Office of Science and Technology, OST)
    Dr Jacob Sweiry (Wellcome Trust Science Funding Division)
    Professor Alan Walker (Professor of Social Policy, University of Sheffield)

1. Professor Kirkwood opened the seminar, speaking on the timeliness of the inquiry, with an overview of ageing research in the UK.

2. A number of factors combined to make this an appropriate time for the inquiry: demographic changes, scientific progress, economic factors such as the cost of pensions and health care, rising expectations, and growing opportunities in an ageing world for exploiting the UK science base in age-related research.

3. The proportion of the global population aged 65 and over in 1900 was 1% (UK 5%); in 2000 it was 7% (UK 16%); and by 2050 it was estimated to be 20%, a figure the UK would reach in 2020. . Life expectancy continued to increase by about two years per decade. Translating this rate of increase into the immediate context, it meant that by the end of the seminar, for each hour of our life spans that would be used for this purpose, 12 minutes could be "recouped" through the ongoing increase in life expectancy.

4. From studies in Sweden, where statistics had been kept since 1860, it was clear that the maximum life-span, far from reaching a plateau, was accelerating.

5. Life expectancy was influenced by a number of factors. Genetic heritability accounted for about 25% of the differences between individuals. The ageing process was not genetically programmed, but was caused by an accumulation of cellular defects resulting from random molecular damage, with genes influencing cellular repair. Other factors affecting ageing were nutrition, lifestyle and environment. These were influenced by socio-economic factors, as could be seen from variations in life span recorded by different local authorities.

6. An important question concerned the relationship between intrinsic ageing and the development of age-related diseases such as osteoporosis, osteoarthritis and dementia.

7. A great deal of research was being carried out in the UK, sponsored mainly by charities, by the research councils, and by the EU. This was still fragmented, but some efforts at co-ordination had been undertaken by the Funders Forum for Research on Ageing, and recently by the National Collaboration on Ageing Research, which had been sponsored by several of the research councils. The challenges were that much of the science was new and poorly understood. There was a lack of clarity in the objectives, and in particular in the relationship between ageing and disease.

8. An example was established by Jeanne Calment, the longest-living person (122 years), who enjoyed good health through most of her life span. She retained a mischievous sense of humour as, in her words to a journalist in her later years, "I only ever had one wrinkle, and I am sitting on it".

9. Professor Steve Jackson discussed the biological determinants of ageing and longevity. He addressed what ageing was; why and how we aged; whether we could slow down or prevent ageing; and if so, whether this would be a good thing for society.

10. Ageing consisted of a loss of vigour; in skin, a loss of the subcutaneous fat cell layer leading to loss of suppleness and wrinkling; connective tissue changes; greying hair and loss of hair; impairment of the senses; osteoporosis; and cardiovascular and neurological degeneration. The underlying changes were cellular damage leading to impaired cell function; accumulated tissue and organ damage leading to dysfunction; and the loss of ability for tissue renewal.

11. Longevity, while influenced by the environment, was pre-ordained by genes. Identical twins tended to have similar life-spans. There were startling differences between species: people lived seven times longer than cats, which lived five times longer than mice, which in turn lived 25 times longer than fruit-flies. But selections for longer-lived laboratory animals revealed that certain mutations could dramatically increase life-span without apparent detrimental effects.

12. The rate of ageing was not fixed. The reason we had not evolved to live longer was that evolution acted to maximise reproductive success, so that there was little selective pressure to retain genes which might allow an individual to live significantly longer than its reproductive phase. On the contrary, evolution would select genetic factors which increased reproductive fitness even though this might cause accelerated ageing.

13. Oxidative stress was a major factor causing ageing, and a major target for oxidative damage was DNA. Laboratory animals selected to live longer were more resistant to oxidative stress. The reason calorie restriction enhanced the life-span of many organisms was related to its effects on oxidative metabolism and stress-resistance.

14. Most human cells could divide only a limited number of times, and when they reached the end of their replication capacity, they entered into senescence. There was evidence that cell senescence also took place during the ageing of a person. Telomeres in cells provided a cell-division clock: when they became too short, senescence was induced. There were strong links to DNA damage. Another link to DNA damage was Werner's syndrome, an autosomal recessive disorder which led to death in the fourth to sixth decade of life.

15. In principle, it was possible that damaged DNA could be better repaired, rates of cell death reduced, and hence ageing slowed down, using drugs, but this led to the questions whether extending human life-span was desirable for the individual or for society.

16. Ageing research was not an isolated discipline, but was closely connected to research into diseases such as Alzheimer's, Parkinson's, cancer and cardiovascular diseases.

17. Sir John Grimley Evans spoke about the impacts of ageing on human health, and the prospects for science-based intervention.

18. Biologically, ageing was characterised by a loss of adaptability manifested in age-specific mortality rates. Between birth and age 10, mortality rates decreased with age, but from age 11 onwards they increased. For effective prevention of late-life disability ageing had to be seen as a life-long process, with some determinants of late life trajectory acting in childhood and in utero. Biological ageing was the result of interaction between intrinsic (genetic) and extrinsic (environmental and lifestyle) factors, but was modulated by non-ageing effects: selective survival, cohort effects such as education, and the differential challenge exemplified in the many aspects of cultural ageism.

19. Science wanted to know why ageing came about, but there were two sorts of questions relating to causes and to mechanisms. Epidemiology sought causes, but needed biological, physiological and social sciences to elucidate mechanisms. In coping with human ills it was possible to remove causes or to interrupt mechanisms. Neither approach was generally better than the other.

20. In the UK, medical, social and biological geratology had followed separate traditions; the time had come to try in particular to bring medical and biological developments closer together. The impediments included different career structures and funding sources, and difficulties in extrapolating from the short-lived animals studied by biologists to the human being. Developments in molecular biology had now made such extrapolation more reliable. The focus of biologists on longevity contrasted with the medical concern with disability. There was a need for greater complementarity between the work of the three traditions of geratology.

21. There was a divergence between projected rates of disability and the rates found in practice. In a US study of the period 1982 to 2001, it had been expected that the numbers of people over age 65 who were disabled would increase steadily over time as life expectancy was lengthened. In fact, in the US there were now 2 million fewer older people with disability than would have been expected if disability rates of 1982 had continued. The trend was "live longer, die faster".

22. There was thus encouraging evidence that the present pattern of age-associated disability could be improved. Age-associated loss of adaptability meant that the older one was when first suffering potentially disabling disease (such as heart attack or stroke), the more likely one was to die rather than linger with disability. This was the principle of "postponement as prevention". Disability arose when there was an "ecological gap" between what an individual needed or reasonably wished to do and what his or her environment required for this to be achieved. Technological approaches could improve a person's range of function and reduce the demands of the environment. There were problems associated with the development and deployment of technological approaches to the prevention and management of disability. Areas of particular need included technologies to help people with cognitive impairment and those suffering trauma or undergoing surgery.

23. In discussion of these topics a number of points were raised.

24. Lord Turnberg asked about the relation between genes and environment. Matters such as status in society and marital status affected longevity. Sir John Grimley Evans agreed that there was a relationship, but it was complex. It was clear from US studies that education was highly significant. It gave the ability to earn more and to control the pace of working; educated persons were better able to respond to progress in scientific knowledge, and to balance present pleasure against future happiness.

25. Lord Sutherland asked why it was necessary to make a distinction between ageing and disease, and wondered if this was caused only by the structure of research. Professor Kirkwood said that there was agreement on the need for research to combat disease, but not on the need for research to combat ageing, as had become clear when Alzheimer's was classified as a disease. It was more difficult to raise funding for research into ageing. Dr Goodwin agreed that the pragmatic distinction did affect fundraising from donors and the general public. Dr Dunstan said that the MRC was concerned only with the quality of research.

26. There was general agreement on the lack of dialogue between medical and biological researchers. It occurred in all areas, but was pronounced in gerontology. Lord Oxburgh pointed out that the design of the Norman Foster building at Imperial College encouraged interaction between the disciplines.

27. Professor Lansley thought it was easier for researchers to focus on diseases. Professor Partridge said that attempts were made to focus on basic biology (diet and health) rather than specific diseases. The increased understanding of biological interventions had led to an explosion of research. Dr Dunn-Walters said that the three research societies had carved up the research territory and moved further apart. The BSRA welcomed medical researchers, but they were not keen to join. Medical and biological researchers were pulled apart by the imperatives of their jobs.

28. Professor Peter Lansley introduced the topic of better environments for healthy ageing.

29. The EPSRC supported the EQUAL Initiative, aimed at Extending the Quality of Life. It was concerned with creating better home environments (adapting buildings for older people); creating better hospital environments (using colour coding to facilitate use by older people, and colour and lighting to promote recovery and well-being); creating better urban environments (e.g. by designing dementia friendly streets); and creating better consumer products.

30. The EQUAL Initiative had started in 1997, since when it had spent £8.6m funding 48 research teams in 33 universities. It was multidisciplinary, bringing together scientists concerned with the physical sciences, design and engineering with those involved with social, health and medical research. They designed new technologies for use in existing homes, in shops, and in transport, and promoted new approaches for designing better environments and products. These reduced the effects of physical impairment, vision and hearing loss, dementia and other cognitive impairment.

31. There was practical evidence of the value of this research, which was designed to be close to the end user rather than an academic talking shop. Of the contacts of the EQUAL Network, which supported dissemination of the findings from the EQUAL Initiative, only one third were researchers; one third were professionals and practitioners, the remainder older and disabled people. In the words on one of these, "Leading-edge of research meets sharp-end of practice tempered by the realities of ageing and disability".

32. Lately however support for research had been tailing off. There was little political support, and it was not even clear which government department had responsibility.

33. Steve Brown looked at design and assistive technology for older people.

34. Telecare was the use of information and communication technology (ICT) to support independent living for older, frail and disabled people. The existing first generation telecare systems were community alarm systems, such as pull-cords and pendants linked to auto-dialling phones. The technology was proven; it was low cost, and used by all local authorities. It was non-invasive, requiring the client to initiate an alarm and alert a remote carer.

35. The second generation consisted of emerging telecare systems; "smart systems" incorporating "smart sensors". These were capable of alerting a carer when the client was disabled, and could incorporate safety and security applications, but they were still based on response to an alarm, though in this case an alarm created by the system rather than the client. They were invasive, monitoring people in their own homes. They were currently being trialled by local authorities.

36. Finally, future third generation telecare systems involved highly complex data processing and novel sensors, designed not to react to events but to prevent them occurring. They were still at the design stage, but with some early trials. They were designed to be used in conjunction with first and second stage telecare.

37. Professor Alan Walker explained the work of the Research Councils.

38. Four of the Research Councils (MRC, ESRC, EPSRC, BBSRC) all sponsored major research programmes or portfolios relevant to ageing. One of the most important of these was the ESRC Growing Older programme, launched in 1999 and the largest social sciences research programme on ageing ever mounted in the UK.

39. In 2001 these four Research Councils set up the UK National Collaboration on Ageing Research (NCAR) to stimulate inter-disciplinary research and develop a new cross-Council approach to ageing research. A broader overview of ageing research was maintained by the Funders Forum for Research on Ageing, which brought together the four Research Councils, six leading charities, the OST and the Department of Health. The NCAR was responsible for creating the European Forum on Population Ageing Research. It was also leading ERA-AGE, a European Union initiative coordinating research into ageing in nine EU countries. UK research, while behind the US in terms of coordination and strategic thinking, was the leader in Europe.

40. "New Dynamics of Ageing" was a cross-Research Council initiative launched in 2004, and the largest UK programme of interdisciplinary research on ageing to date. Among its aims were to ensure that science fed into policy and practice, to cross the boundaries of disciplines, and to bring young scientists into the topic. It was looking at ageing across the whole lifespan, and not just among older people.

41. In summary, the Research Councils working in partnership were coordinating different scientific approaches, stimulating inter-disciplinary research, leading Europe, increasing investment in research, and bridging the gap between research and policy.

42. Dr James Goodwin discussed research by charities.

43. Help the Aged was a leading member of the Association of Medical Research Charities (AMRC) which brought together 112 members to provide guidance on research governance, ethics, policies and processes. In 2002/03 £660m had been spent on biomedical research, £578m by the top five members. A very large proportion of this involved research into diseases which were prevalent among the elderly. There were an increasing number of applications for funding, 19 out of 20 of which had to be refused. However there were only six charities in the Funders Forum on Ageing Research, four of which supported ageing research in science and technology areas.

44. An international comparison across the four UN regions revealed three strategic problems applicable to the UK: low relative investment; fragmentation and lack of capacity; and absence of strategic direction. The European Union approach was particularly disappointing; ageing research was a low priority. In 2002 expenditure on research into ageing in the UK was considerably higher than in the whole of the rest of the EU. The EU Sixth Framework Programme made only limited reference to ageing as a priority. In the USA, by contrast, the National Institute of Aging combined high order strategic organisation with enviable levels of funding; this paradigm should be considered by the Committee.

45. In summary, there were a number of matters the Committee should consider. There were numerous biomedical charities with age-related disease well represented, but few entirely dedicated to ageing research. The comparative expenditure on ageing was moderate, but quality assurance mechanisms ensured that it had a high impact. The priorities went beyond funding: charities were well placed to work with Government to increase funding levels, improve strategic direction, and maximise the benefits of new research.

46. In subsequent discussion the following points were made.

47. Professor Kirkwood stressed that an issue for the Committee would be how far an inquiry into scientific aspects of ageing could extend into questions of disability. Professor Coleman thought disability was largely created by the impact of the environment on ageing. Lord Sutherland said that the Committee should concentrate on how different contexts affected disability.

48. Professor Lansley said that the EQUAL Initiative provided strong evidence of the return of investment in the new technologies. A cost/benefit analysis must involve economists and business schools. Professor Kirkwood instanced the large benefits derived by the NHS from a minimal investment in ensuring that the elderly were provided with walking sticks of the right length.

49. In relation to third generation assistive technology, Lord Oxburgh asked why individuals were reluctant to wear devices. Mr Brown said the reason was not known; there had been no research into what older people wanted.

50. Professor Kirkwood suggested that there was a need to look at the differences between the sexes, and between different social and ethnic groups. Dr Sweiry, agreeing, said that the Biobank Project, funded jointly by the Wellcome Trust, the MRC and the Department of Health, would provide enormous quantities of data to assist in uncovering genetic and environmental factors affecting ageing and leading to diseases prevalent among the elderly. Professor Walker agreed with Baroness Walmsley that there was not enough research into the cultural aspects of ageing. However there was a huge database, and the ESRC was a significant investor, for example through the Growing Older programme.

51. Discussion turned to the direction and funding of research. Lord Sutherland said that the Treasury regarded young people as producers, but the elderly only as consumers, which might be a reason why research tended to focus on infants and the young. He asked how effective it was to attempt to drive research strategies by targeted calls for grant applications in particular areas. Professor Partridge explained that the National Institute for Aging in Washington DC regularly invited research proposals on specific topics. Lord May thought there was scope for programmes calling for responses in particular areas provided these were chosen by people with the right attitudes.

52. Professor Kirkwood wondered why the Department of Health was not represented at the seminar, and whether they were put off by the word "scientific" in the title of the inquiry. Lord Sutherland thought that there was a radical divide in the Department between research and its application. For them the vital question seemed to be, not whether research would reduce expenditure generally, but whose budget was affected? Was the benefit going to accrue to the body whose budget bore the cost of the research?

53. Lord Sutherland concluded by thanking all those who had attended the seminar, and in particular those who had made presentations, for their contributions to a very valuable debate. It would be of great assistance in focusing the work of the inquiry.

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