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Title: To Pay for Health Care, Treat Aging
Source: [None]
URL Source: [None]
Published: Aug 7, 2009
Author: wired
Post Date: 2009-08-07 20:56:33 by tom007
Keywords: None
Views: 20

To Pay for Health Care, Treat Aging

* By Brandon Keim Email Author * August 7, 2009 | * 2:07 pm | * Categories: Government, Health, Medicine *

nursinghome

As politicians try to reform a health care system that could swallow one-fifth of the nation’s economic output by 2020, they should consider making a small bet with a potentially huge payoff: research that could slow the process of aging.

“There will never be enough money for the federal government to pay for the demands of health care, because of chronic age-related diseases,” said Doug Wallace, a cell biologist at the University of California, Irvine.

Wallace specializes in mitochondria — cellular power plants that float outside the cell nucleus, turn glucose into usable energy, and wear down over time. He thinks their malfunction underlies nearly every disease whose risks spike after middle age, from cancer to heart disease to dementia.

A decade ago, Wallace’s was a lonely, evangelical voice. But research from multiple groups suggests he might be on to something. Broken-down mitochondria have been found in diseased hearts, brain cells from people with Alzheimer’s, and cancer cells.

This could be an effect rather than a cause of disease, but drugs that target a family of mitochondria-regulating genes called sirtuins have shown promise in preventing age-related diseases, albeit in laboratory mice. One such drug is now in clinical trials for diabetes. Another mitochondria-linked drug has dramatically extended mouse lifespans, and it was given to them during the mouse equivalent of old age.

“There might be a totally different way of treating disease, in which you’re treating the body as a system,” said Wallace. “The idea is that you could have a treatment for Alzheimer’s disease that would also be good for cardiac disease, and that’s exactly what we find with mitochondrial medicine.”

None of these drugs have proved effective in humans, and they might never. But scientists say there’s a chance. And they offer the possibility of not simply holding off one disease until another emerges, or extending life by a few months at tremendous cost, but of nipping age-related disease at the root.

That should be especially appealing as the nation confronts the swelling monster of health care spending, which by 2020 could cost more than $4 trillion. According to a Robert Wood Johnson Foundation report, chronic diseases — many of them age-related — now already account for three-quarters of U.S. health care spending.

Much of that cost reflects waste and excess, but even were it repaired, a fundamental problem would remain.

“We’re concerned that the disease-specific approach will not only run out of steam, but will in the end prolong the period of disability and frailty,” said Jay Olshansky, a longevity and aging specialist at the University of Illinois School of Public Health.

“Say you come up with a treatment for heart disease, and an individual lives for an extra ten years, but most of that time is spent with Alzheimer’s disease. You’ve purchased survival time that is expensive and unhealthy,” he said.

Olshansky is a member of a MacArthur Foundation-supported network of researchers who are studying the social and economic implications of a society that’s living longer, but not becoming healthier. (He’s also a vocal proponent of another broad-spectrum disease prevention strategy: basic education. “Education has been shown to have an extraordinarily powerful beneficial effect on health. That’s something that’s immediately available,” he said. “Some of the greatest benefits are available to us without improvements in technology.”)

In papers published in The Scientist and British Medical Journal, Olshanksy and International Longevity Center president Robert Butler wrote that drugs that delay aging’s onset by seven years are now a realistic possibility.

They’re currently in the process of calculating this longevity dividend’s economic benefits. Even if the figures aren’t finalized, however, they’re likely to be massive. For Alzheimer’s disease alone, they estimate that the cost of care will rise to $1 trillion by 2050. The Robert Wood Johnson foundation estimates two-thirds of rising health costs come from chronic diseases.

“We need a method of molecular pre-emption. If we’re going to be able to afford health care, that’s what we’ve got to do. That’s going to provide the maximum cost savings, not managing symptoms or curative treatment,” said former National Institutes of Health chief Elias Zerhouni at a symposium held last Friday by the Jackson Laboratory.

The NIH channels almost all U.S. governmental support for age-delaying research through the National Institute on Aging, but its $1 billion budget is a pittance by federal standards. Nearly $5 billion is earmarked for the National Cancer Institute, and that’s just one disease of aging. Of the NIA’s $1 billion, just $180 million is set aside for research on the biology of aging. That figure has barely changed since 2006.

President Obama’s stimulus package did allot $273 million for the National Institute on Aging, but only a small fraction will likely go to potentially age-delaying research, said Peter Rabinovitch, a University of Washington gerontologist. By contrast, the stimulus plan contains $37 billion for electronic health records.

According to Rabinovitch, biology of aging research also doesn’t appear in any of the proposed federal health care plans.

“It’s been an uphill battle to realize that basic research on the biology of aging can have an impact on health care in the long run. You have to be able to look at the longer picture, and that’s a job for politicians and policymakers,” he said. “Just half a billion dollars would transform this field.”

See Also:

* Anti-Aging Drugs Could Change the Nature of Death * New Longevity Drugs Poised to Tackle Diseases of Aging * Pharmaceutical Fountain of Youth Could Cost Pennies * Cancer Drug Delays Aging in Mice

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