'Research on the ageing phenotypes: toward a translational perspective'
Dr Luigi Ferruci, Scientific Director of the National Institute on Aging & Director of the Baltimore Longitudinal Study of Aging.
Over the last few years research on the biology of aging has made unprecedented progress. Up to 20 years ago, the appearance of a scientific report on the biology of aging in one of the top rank biological journals was a rare event, almost considered a curiosity or a singularity. More recently, research on the biological mechanisms that underlie aging has grown into a critical branch of science. Research in cell and animal models of mechanisms that may affect aging or modulate its progression is now the main focus of entire laboratories and research institutions around the world. Candidate mechanisms include epigenetic modifications, DNA repair, cell senescence, telomere shortening, impaired proteostasis, impaired mitochondrial function and others.
Unfortunately, very little of such new wealth of knowledge has been translated into better care for older persons and to the development of interventions that can slow down aging and prevent or delay the decline in health and physical function that is unavoidably associated with the aging process. Indeed, it is still unclear whether candidate aging mechanisms and the development of the susceptibility phenotypes typical of aging are in any way related. Promoting aging well will require delaying major diseases and disabilities and their consequences. Medical research has been successful in controlling and preventing specific diseases in persons that were otherwise relatively healthy. However, as the population ages, such disease specific approaches start showing limitations and need to be supplemented by a more global approach that takes into account measures of susceptibility and resilience that may strongly affect competing risks. As people live longer and develop susceptibility, they are more likely to fall victim to multiple diseases and preventing or treating one disease is increasingly likely to result in an alternative cause of death or disability with limited gain in healthy or total life expectancy. This view is consistent with recent findings suggesting that unrelated morbidities cluster in the same individuals and that mild chronic inflammation and hyper-metabolism are strong independent predictors of multi-morbidity.
Technology is now available that allows assessing candidate biological mechanisms of aging. At the same time, geriatricians, population scientists and gerontologists are developing robust measures of susceptibility and resilience that can be collected in clinical populations. In most cases, these research fields work as separate entities and are unlikely to collide. Progress will require biologists, gerontologists, population scientists and geriatricians to find a common language and start operating as a multidisciplinary team.
Scientific Director of the National Institute on Aging & Director of the Baltimore Longitudinal Study of Aging
Dr. Luigi Ferrucci is a geriatrician and an epidemiologist who conducts research on the causal pathways leading to progressive physical and cognitive decline in older persons. In September 2002, he became the Chief of the Longitudinal Studies Section at the National Institute on Aging (NIA) and the Director of the Baltimore Longitudinal Study on Aging.
Dr. Ferrucci received a Medical Degree and Board Certification in 1980, a Board Certification in Geriatrics in 1982 and Ph.D. in Biology and Pathophysiology of Aging in 1998 at the University of Florence, Italy. He spent a 2-year internship at the Intensive Care Unit of the Florence Institute of Gerontology and Geriatrics, and was for many years Associate Professor of Biology, Human Physiology and Statistics at the University of Florence. Between 1985 and 2002 he was Chief of Geriatric Rehabilitation at the Department of Geriatric Medicine and Director of the Laboratory of Clinical Epidemiology at the Italian National Institute of Aging. During the same period, he collaborated with the United States National Institute of Aging (NIA), Laboratory of Epidemiology, Demography, and Biometry where he spent several periods as Visiting Scientist.
Dr. Ferrucci has made major contributions in the design of many epidemiological studies conducted in the U.S. and in Europe, including the European Longitudinal Study on Aging, the “ICare Dicomano Study,” the AKEA study of Centenarians in Sardinia and the Women’s Health and Aging Study. He was also the Principal Investigator of the InCHIANTI study, a longitudinal study conducted in the Chianti Geographical area (Tuscany, Italy) looking at risk factors for mobility disability in older persons.
Dr. Ferrucci has redesigned the Baltimore Longitudinal Study on Aging to retain the wealth of data collected over more than 50 years while introducing new questions on the nature of aging emerged in the recent literature. Dr. Ferrucci is Scientific Director of NIA, since May 2011.