Memorandum by the Biosciences Federation
INTRODUCTION
1. The Biosciences Federation was founded
in 2002 in order to create a single authority within the life
sciences that decision-makers are able to consult for opinion
and information to assist the formulation of public policy. It
brings together the strengths of 33 member organisations, including
the Institute of Biology, which represents 45 additional affiliated
societies (see Appendix). The organisations that have already
joined the Biosciences Federation represent a cumulative membership
of some 70,000 bioscientists and cover the whole spectrum from
physiology and neuroscience, biochemistry and microbiology to
ecology and agriculture. The Biosciences Federation is a registered
charity (no 1103894).
2. This submission was informed in particular
by a contribution from the British Society for Research on Ageing.
As a consequence of the expertise on which the Federation was
able to call, the submission focuses on how advances in the knowledge
of biological processes of ageing can improve the quality of life
of older people, rather than on developments in technology and
design.
THE BIOLOGICAL
PROCESS OF
AGEING
3. Ageing is a normal biological process
that is distinct from, but is a primary risk factor for, many
late life degenerative diseases such as cancer and cardiovascular
disease. The ageing process also imposes physiological deficits
on the organism that are potent causes of the increased mortality
and morbidity seen in the elderly population, including cognitive
decline, decline in muscle and bone strength and balance, decreased
efficiency of the immune system, sensory impairments, incontinence,
and dermatological problems. Thus, as a result of damage and disordered
function at the cell and tissue levels, ageing produces increased
frailty of the whole organism. Evidence suggests that many of
the degenerative effects of the process will be ameliorated through
appropriate environmental interventions, including improved nutrition
and other lifestyle changes such as avoiding UV exposure. Genetic
therapies might also become more relevant in the future.
Promising avenues of research
4. A high priority for research should be
to understand how ageing is a risk factor for multiple diseases.
This requires a deep understanding of the basic processes of cell
biology, including cell division and processes leading to cell
death, and the mechanisms of continued control of gene expression.
Research in simple organisms has identified genes that have an
important influence on life span. Genetic research will open up
new approaches to prolonging healthy life.
5. Work with model organisms is revealing
that interventions such as dietary restriction and reduced signalling
through the insulin/insulin-like growth factor pathway can extend
lifespan and delay the onset of ageing-related pathologies. The
organism is kept in a youthful state for longer, and the effect
appears to be conserved across the animal kingdom. The challenge
in future years is to understand how this pathway determines lifespan
so that physiological insights obtained can be harnessed to improve
human well-being.
6. Patients with a rare genetic disease,
Werner's syndrome, show the accelerated development of many classical
age-related diseases. The syndrome is now known to be caused by
the premature accumulation of "senescent" cells. Future
research will focus on determining the scale of the contribution
that such cells make to normal ageing, and developing treatments
aimed at preventing their degenerative effects.
7. UK research has demonstrated that a loss
of the ability to produce new T cells is a significant cause of
the failure of the immune system to fight off infection. This
decline in T cell production can be prevented in several types
of elderly mammal by treatment with the hormone interleukin 7
(IL-7). It has also been shown that changes in the neuroendocrine
axis, primarily a decline in level of the hormone dehydroepiandrosterone
(DHEA), predispose the elderly immune system to infection. The
immune system is particularly vulnerable immediately after serious
physical or emotional trauma such as a fall. Therapeutic intervention
with IL-7 or DHEA could benefit older people within 5-10 years
if suitably supported and translated into clinical practice.
8. The cognitive decline that accompanies
normal ageing has a different etiology to that of senile dementia
and remains poorly understood. Pharmaceutical companies have focused
considerable research effort to developing medicines to treat
senile dementia, but much less attention has been paid to the
cognitive decline of ageing. What factors could counteract this?
Is mental exercise as important as physical exercise in this regard?
Could "smart drugs" help the elderly improve their mental
performance? These are all important avenues for improving the
well being of the population.
9. An important contributor to the reduced
quality of life, and loss of independence, among the elderly is
the decrease in muscle mass and reduced functional capacity of
muscle. Because muscles lose their strength and bones their ability
to heal, falls often lead to bone fracture, which can result in
permanent immobility. Hip fracture is predisposed to by nutritional
deficit, and is a major drain on the NHS and a social cost to
the individuals concerned, and their families or other carers.
Recent evidence has shown that community-based exercise training
programmes in the healthy elderly and chronic age-related disease
states can have profound effects in reversing muscle wasting and
the accompanying functional deficit. Further work is required
to elucidate the signalling events in muscle that result from
exercise interventions.
Differences between sexes, and between different
social and ethnic groups
10. Some differences would be expected between
groups since longevity is recognised to be familial and to have
a genetic predisposition. The sex hormones oestrogen and testosterone
have important roles in the maintenance of effective skeletal
muscle, while recent research has demonstrated that the immune
system ages differently in men and women. The key organ responsible
for the output of new T cells is the thymus, and this organ atrophies
more rapidly in men than women. This appears to correlate with
the increased rate of death from infection seen in elderly men,
and the increased frequency of autoimmune diseases seen in elderly
women. Ethnicity, environment and cultural practice are difficult
to separate but all clearly influence ageing. Both diet (paragraph
5) and exercise (paragraph 9) affect ageing-related pathologies
and a healthy lifestyle is more difficult for disadvantaged social
groups to achieve.
THE APPLICATION
OF RESEARCH
IN TECHNOLOGY
AND DESIGN
TO IMPROVE
QUALITY OF
LIFE
11. More work is needed on materials used
in joint prostheses to make the replacements last longer. Cross-disciplinary
work in electronics and mechanics is required to develop robotics
linking nerve function and muscle control. Functional electrical
stimulation, that currently enables some stroke victims to be
more mobile and hence less dependent, should be extended to facilitate
upper body functions in the ageing.
CAPABILITY AND
CAPACITY OF
UK RESEARCH
How effectively is research coordinated?
12. National coordination to date has been
largely ineffective at the research level, despite the creation
of the National Collaboration on Ageing Research. There are two
types of deficiencies: translating research discoveries made under
the remit of one Research Council to clinical research sponsored
by a second Research Council; and securing funding for work that
currently falls between the remits of two Councils. BBSRC and
EPSRC have had some success in integrating their research programmes
with those of the major charities funding ageing research. The
BBSRC's Experimental Research on Ageing programme, for instance,
includes observers from the charity Research into Ageing. To achieve
effective cooperation with this sector government must recognise
that charities are mission focused and so only a small proportion
of the available ageing research will be of value to any particular
organisation, and that even an interested charity has only limited
funds available for research.
13. To maximise the UK's return on international
coordination requires recognition that (a) effective national
coordination must be in place, (b) a national strategy for ageing
research must have been agreed with the research community and
underpinned with adequate resources, and (c) the international
situation itself is highly dynamic so the UK must be opportunistic
in finding partners. Within European Framework programmes there
have been some notable triumphs for individual researchers, and
some valuable networking activities have been undertaken (eg the
IMAGINE network on immune ageing research in Europe). However,
it is probably fair to say that the UK has not obtained full value
from EU funding instruments. The impending requirement for UK
institutions to secure the full economic cost of research currently
threatens future UK involvement in European funding programmes.
14. At the community level, too, there is
scope for translating the outcome of research much more effectively
into clinical practice. Osteoporosis is a major cause of incapacity
among the elderly, yet a recent EU report found that the UK has
the lowest provision for bone densitometry of any member state.
Likewise, vitamin D deficiency is known to be an important cause
of skeletal morbidity in the elderly, and several studies have
shown that giving vitamin D and calcium supplementation to elderly
institutionalised individuals is associated with a significant
reduction in the occurrence of fractures. Existing recommendations
from expert groups including the Royal College of Physicians and
the Committee on Medical Aspects of Food and Nutrition Policy
remain largely unknown by the health professional community, and
are yet to be translated into effective policy in spite of national
service frameworks.
15. Attitudes of the elderly to lifestyle
and nutrition impinge so much on the effectiveness of health promotion
issues that any ambitions for an increased healthy life expectancy
will require a good deal of effective, real-time communication
between science researchers, health practitioners and customer
representatives on such matters as target setting, resource allocation
and modes of delivery.
Have the correct research priorities been identified?
16. Following the identification in 1994-95
of the ageing population as a Foresight priority area BBSRC has
run two successive special initiatives, the Science of Ageing
(SAGE) and Experimental Research on Ageing (ERA) programmes. The
British Society for Research on Ageing considers that the areas
selected for support under these programmes have captured much
that basic biology has to offer in meeting the challenge posed
by the ageing population.
17. However, at the awards stage of SAGE
it became clear that the UK lacked a strong base in demographic
analysis as applied to ageing research, and at that of ERA it
was apparent that linkages between biological chemistry and gerontology
could be usefully developed.
Is there sufficient research capability in the
UK?
18. The Biosciences Federation is confident
that the UK has sufficient research expertise to tackle all aspects
of ageing research, but funding is a major problem. While the
BBSRC programmes identified the right priorities, the mode of
special initiative support made it difficult to sustain delivery
of research in particular areas for longer than three years. Of
the 28 SAGE principal investigators only 10 were able to progress
their research subsequently under the ERA application criteria.
This could allow gaps in UK research to develop. The capacity
to conduct national research cannot be grown and sustained through
this type of funding instrument. Some of the promising research
highlighted in paragraphs 4-9 will require sustained investment
over an extended time period. In general terms, ageing-related
research receives only a fraction of the funding that goes into
cancer and cardiovascular disease.
19. The largest US sponsor of ageing research,
the National Institute on Ageing, has a budget four times the
current per capita annual expenditure on biological ageing
research in the UK. To match US per capita spending in
the UK would require an additional annual investment of about
£5 million per annum, which would support a research community
of about 40-60 research groups working in all areas endorsed by
SAGE and ERA. The multi-disciplinary nature of ageing research
requires that this should be cross-Council funding.
Is the research being used to inform policy?
20. The Federation believes that research
is not being used effectively to inform policy. There is no over-arching
body taking responsibility for research specifically aimed at
increasing or extending healthy life-span. The greatest missing
element is a unifying research environment that brings all ideas
together. The extreme complexity of the issues, and limited funding,
mean that there is a requirement to prioritise approaches.
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