What is healthspan research?
I think the time is right for research such as this because (current treatments) are only controlling symptoms. What happens down the line? (Patients) know the drugs are only just working, but we’re potentially taking them till we die.
Medical research can often involve complex or unfamiliar terminology and the field of healthy ageing is no different. ‘Healthy ageing’ can also be used to mean different things and sometimes claims are made about how to stop or improve ageing that are not evidence-based or scientifically proven. This section explores some of the key ideas and findings that underpin healthy ageing research and the work of UK SPINE.
Geroscience
Geroscience is a relatively new term that is used to describe something that might seem quite straightforward. It is the idea that instead of treating people as they age for each illness they might develop individually, that we try to view ageing as a process that has impacts on the whole person and can lead to new problems that are seemingly unrelated to the first illness. At the moment, a patient with heart disease, diabetes and muscle weakness might be cared for by doctors in different specialities, in this case perhaps a cardiologist, an endocrinologist and a rheumatologist. These different doctors may share notes, but they might not review the patient’s care together and have chance to discuss how different illnesses might be affecting one another. Geroscientists study the biological processes that underpin ageing. The aim of Geroscience is to understand how these processes lead to different illnesses and to find ways to keep the processes working well to delay or avoid age-related illnesses from occurring.
UK SPINE is working to:
- Increase awareness of Geroscience among the public and in clinical practice
- Encourage more teaching of Geroscience to medical students and health trainees
- Change clinical policy and practice to adopt Geroscience approaches
Healthspan
If lifespan is how many years you live in total, your healthspan is how many of those years you live in good health. Lifespans in developing countries have increased rapidly over the last 200 years, but healthspan has lagged behind. In 1800, global life expectancy was around 32 years, but now the average is over 72 years old. However, not all of those additional years of life are spent in good health. In the UK, men spend an average of 16 years of life in poor health and in women this increases to 19 years (based on Office of National Statistics data). Poor healthspan doesn’t affect all people equally, it is worse in people who experience deprivation. Men living in the most deprived areas are expected to live 73.9 years, whereas those in the least deprived areas could be expected to live 83.4 years; a difference of almost a decade.
- UK SPINE wants to help increase the number of years people live in good health by developing new treatments for the underlying causes of age-related ill health.
Multimorbidity and Polypharmacy
Half of people over 65 have two or more long-term health conditions. Multimorbidity is the term used in medicine to refer to people who have two or more long-term illnesses. Different conditions can affect one another and becoming ill with one condition can make it more likely that you will develop other, related conditions. The groups that conditions occur in are called ‘clusters’, how many clusters there are and what biological processes underpin them is not fully understood, but has been identified as a priority to drive forward healthy ageing research by Chris Whitty, the Chief Medical Officer for England:
If a patient has multimorbidity, they are likely to be taking multiple medicines to control their illnesses, this is known as polypharmacy. If a patient is taking many medicines they can interact, sometimes leading to symptoms worsening or causing additional health concerns, although some interactions between medicines can be beneficial. A key problem in healthy ageing research is that clinical trials usually exclude people with multiple conditions or who are taking other medicines so new treatments don’t get tested in a population that is representative of the ‘real world’. There are calls for this to change and UK SPINE is contributing by:
- Contributing to new regulatory guidance for clinical trials to allow patients with multimorbidity and polypharmacy to take part
- Developing new types of clinical trial to test new healthy ageing medicines
Measuring and Predicting Ageing
Although we know that people age differently, and some people more successfully than others, we don’t yet have simple and reliable ways to measure this meaningfully. In medicine, any measurable indicator of disease or illness is called a biomarker. Biomarkers can be chemical, physical or biological. That means a biomarker could be a test of how well you can carry out a task, like gripping an object, or be a measure of a substance in your body or a physical measurement, like height. UK SPINE is supporting the development and testing of biomarkers for ageing through:
- Looking for biomarkers to measure effectiveness of new healthy ageing medicines
- Understanding what biomarkers could be used to monitor multimorbidity
- Holding biomarker events to collaborate and share findings
As well as needing better ways to measure ageing, we are also looking at how we can predict age-related ill health before it happens so that patients can be given preventative treatments. Preventative medicine is now an area of focus for researchers and Government because the availability of large volumes of health data is making it possible to reliably identify even very tiny warning signs of illness. Because the changes are small the most effective way to spot these changes in large amounts of data are to use computer algorithms or artificial intelligence (AI).
Find out more about how health data can be used in UK SPINE healthy ageing research.
Hallmarks of Ageing
Everyone ages differently, but although the illnesses and ailments associated with ageing can be very different in how they present and affect patients, we now know that many of them share similarities in their underlying biological causes. There are thought to be nine biological processes that contribute to ageing, which are collectively referred to as the Hallmarks of Ageing. These hallmark processes have all been shown to deteriorate during ageing and are able to speed up or slow down ageing when switched on or off in scientific experiments. A diagram representing the hallmark cellular and biological functions is shown below:
UK SPINE in healthspan research
The hallmarks and key biological processes that cause age-related disease are still being investigated. A key focus of UK SPINE is to identify, test and develop new drugs that are able to target the hallmarks of ageing to prevent age-related ill health, alleviate polypharmacy and multimorbidity and increase healthspan. Developing new medicines is extremely challenging, and can take many years of work by researchers, pharmaceutical companies, clinicians and trial staff. It can also be extremely expensive, with some new medicines costing billions to develop to the point where they can be used as a routine treatment. UK SPINE is accelerating research and development to improve healthspan by:
- Developing a network of talented people from across research, lifescience and pharmaceutical industries, funding bodies and investors, the NHS, patient groups and the public who want to collaborate to develop new healthspan medicines as quickly as possible
- Enabling the sharing of knowledge and risks across the network to create an efficient and effective drug discovery ‘pipeline’
- Ensuring healthspan treatments are fair, affordable and easy to access by helping to change funding models, drug testing and trials, and policies and regulations that currently don’t work for Geroscience or multimorbidity
- Supporting the development and testing of new types of treatments, such as supplements or vaccines to reduce age-related ill health and improve healthspan