A Pragmatic Approach to Introducing Translational Geroscience Into the Clinic: A Paradigm Based on the Incremental Progression of Aging-Related Clinical Research

Aug 10, 2024The journals of gerontology. Series A, Biological sciences and medical sciences

A Practical Way to Bring Aging Research into Medical Care Using Gradual Clinical Studies

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Abstract

Geroscience explores how molecular mechanisms drive aging and its associated diseases.

Gerotherapeutics aim to counteract molecular drivers of aging to reduce chronic diseases and geriatric syndromes.
Concerns about safety and valid endpoints have delayed the prescription of potentially harmful medications to healthy older adults.
Trials of gerotherapeutic medications are more readily implemented when their benefits outweigh the risks associated with treating diseases.
Metrics for effective disease treatments are often considered more reliable than those for prolonging health.
Clarifying the mechanisms of geroscience in therapeutic contexts may enhance the advancement of translational geroscience.

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Geroscience posits that molecular drivers underlie the aging process. Gerotherapeutics entail strategies to counter molecular drivers of aging to reduce the chronic diseases and geriatric syndromes they trigger. Although the concept of gerotherapeutics for prevention has generated much excitement, the implications of prescribing potentially harmful medications to older adults who are "healthy" have been associated with many delays. Concerns regarding safety and valid endpoints have contributed to holdups. In contrast, it has been relatively easier to implement trials of medications with gerotherapeutic properties as novel approaches to remedy disease. In these applications, the risks of the medications are easier to justify when therapeutic benefits are perceived as outweighing the harms of the disease. Likewise, metrics of effective disease treatments are often seen as more reliable and quantifiable than metrics of health prolongation. Overall, clarifying geroscience mechanisms in disease therapeutic applications provides key opportunities to advance translational geroscience, especially as preventive geroscience trials are often encumbered. In this review, gerotherapeutic benefits of canakinumab, cholchicine, and zoledronic acid as parts of disease management are considered. Longevity Clinics and other opportunities to advance translational geroscience as parts of contemporary care are also discussed.

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A Pragmatic Approach to Introducing Translational Geroscience Into the Clinic: A Paradigm Based on the Incremental Progression of Aging-Related Clinical Research

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