Shaping the future of geriatrics and clinical gerontology research at NIA

Evan Hadley

Evan HADLEY,
Director,
Division of Geriatrics and Clinical Gerontology (DGCG)
.

For the past 34 years, it’s been my great privilege to lead the dedicated and talented team in NIA’s Division of Geriatrics and Clinical Gerontology (DGCG). DGCG focuses on translating research from the lab to the clinic to help older adults maintain health, mobility, and independence. This includes developing new interventions for age-related conditions, investigating the prevention and treatment of multiple chronic conditions, and conducting other studies to promote evidence-based geriatric care.

As we mark NIA’s 50th anniversary, I’d like to reflect on a few key achievements of NIA’s geriatrics and clinical gerontology efforts to date and spotlight opportunities on the horizon for our field and the scientists and clinicians we support.

Looking back

We pride ourselves on rigorous research that has the potential to help improve quality of life for older adults. Highlights of NIA’s recent achievements in geriatrics and clinical gerontology include:

  • Improved understanding of lifestyle interventions and therapies for common age-related conditions: Through the development of robust, large-scale clinical trials, we’ve helped clarify effects of various age-related health interventions. For example, findings from the ASPirin in Reducing Events in the Elderly (ASPREE) trial contributed to the U.S. Preventive Services Task Force 2022 recommendation against initiating low-dose aspirin for prevention of cardiovascular disease in adults over age 60. Other large-scale trials have offered important insights and clinical guidance around testosterone supplementation and postmenopausal estrogen therapy. In addition, we’ve conducted large-scale trials to test the impact of lifestyle interventions on aging. For example, the Comprehensive Assessment of Long Term Effects of Reducing Intake of Energy (CALERIE) study found that two years of reducing caloric intake by 12% in healthy young and middle-aged people had favorable effects on risk factors for a variety of aging-related conditions.
  • Building infrastructure: NIA has developed critical research infrastructure and training opportunities for clinician-scientists from all career stages. In 1988, Congress passed legislation leading to the development of the Claude D. Pepper Older Americans Independence Centers (OAICs). Today, NIA funds 15 OAICs across the nation that serve as hubs of excellence in geriatrics research. These centers provide aging scientists with multiple resources including access to specimens, data, collaboration, and mentorship. In addition, the AgingResearchBiobank provides specimens and data from NIA-supported studies to other researchers, thus expanding these studies’ contributions into new domains.
  • Recruiting the next generation of clinical aging researchers: To help increase the number of clinicians trained in geriatrics and foster the development of the next generation of clinician-scientists in aging, NIA established the Grants for Early Medical/Surgical Specialists’ Transition to Aging Research (GEMSSTAR) program. Through GEMSSTAR, NIA offers crucial early-career support for physician-scientists who have recently completed medical, surgical, or dental training in another discipline and are pursuing a clinical aging research path within their specialty area.

New explorations ahead

As our knowledge of the underlying mechanisms of aging expand, we remain committed to our focus on clinical and translational research that has the potential to help older adults live longer, healthier, and more independent lives. One key area of interest is exploring the causes of healthy aging and age-related conditions over the lifespan. For example, the causes of anemia in a substantial proportion of older patients remain unclear, and this needs to be a focus of future research.

Future research also must clarify the prospects of interventions starting well before old age to improve healthy aging over the lifespan, including effects of sustained reduction and specific schedules of caloric intake. The NIH Molecular Transducers of Physical Activity Consortium (MoTrPAC) project is another example of our efforts to understand the causal mechanisms at play in promising areas of interest. Through MoTrPAC, scientists will map molecular changes that occur in the body as a result of physical activity that could help us better understand how exercise plays a role in maintaining health as we age.

Moreover, developing and testing promising new strategies for patients with multiple conditions remains crucial. This includes palliative care to improve quality of life by alleviating symptoms and reducing functional limitations, as well as building evidence for medication prescribing that maximizes benefits and minimizes adverse effects. Importantly, these strategies must also be tested for real-world health care setting implementation. More broadly, we need to learn more about similarities and differences among diverse groups in risk factors for aging-related conditions and responses to interventions for them. This knowledge will help in personalizing health care to meet individuals’ needs as they age.

Excited for the future

There is much to look forward to in the coming decades, from exploring the role of new technologies, including artificial intelligence, to collaboration with disciplines such as evolutionary and developmental biology. In parallel, NIA will continue to emphasize training and career development in aging research for current and future clinician scientists — from many health career specialties — who contribute to better care of older persons.

I‘m confident the ensuing years will bring continued progress in our quest for healthier aging. Stay connected with NIA to keep in touch on the latest opportunities, or leave a comment below!

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