The high-profile failures of several Alzheimer’s drug trials in recent years have pushed researchers to examine whether intervention needs to come earlier in the course of the disease. The amyloid plaques that characterize Alzheimer’s accumulate a decade or more before symptoms occur, Hodes said, and trials are beginning to explore whether earlier intervention can be more effective.
The government has been urged to undertake a public health campaign to advise people how to avoid cognitive decline, Hodes said, but a two-year review of the science showed that no intervention has evidence compelling enough to support such a campaign. Still, he said there have been promising indications that exercise, certain kinds of cognitive training, and controlling blood pressure in midlife can have positive impacts on Alzheimer’s risk. Even absent government pronouncements, he said, individuals can take into account the latest evidence to make smart lifestyle decisions.
Though mainly still in the lab, work to understand the biological mechanisms of aging has made significant progress recently, Church said. Scientists have identified nine or 10 pathways that play roles in aging, and research is underway to develop interventions to head off and even reverse age-related physiological changes.
Experiments in animals have extended longevity or reversed some of aging’s effects, and Church said his lab is at work on gene therapies that aim to affect all or most of the identified pathways active in aging. He said recent work has proven successful at addressing five age-related diseases: Type 2 diabetes, obesity, osteoarthritis, cardiac damage, and kidney damage.
Despite the new drugs and emerging therapeutics, the health care business model to deliver them is broken, according to Sachin Jain, president and chief executive officer of CareMore Health.
It’s undeniable, Jain said, that aging has become big business in America, with a plethora of products and services marketed to people hoping to stave off or treat aging’s decline. The problem, he said, is that a lot of the products miss the market of the needy elderly, who aren’t technologically savvy, don’t have disposable income, but nonetheless have rising needs.
Jain said the current health care system’s incentives are misaligned from its consumers’. Hospitals, for example, make more money if their beds are full, while providers looking to contain costs, not to mention consumers who want to stay healthy, would like beds to be empty.
CareMore Health, based in California, is designed to have a patient-centered focus, Jain said. The provider accepts all risk for the cost of its customers’ care and has designed its system to support people’s health. That means the system emphasizes preventive care, coordinates specialists for those who fall ill, and saves when patients stay out of the hospital.
“It’s undeniable that aging has been good for business, but has business been good for aging?” Jain said.