We can do more to help the elderly cope with the COVID-19 crisis
There is now a broad social realization that the elderly are the main risk group that needs to be protected.
By ILIA STAMBLERTHERE IS now a broad social realization that the elderly are the main risk group that needs to be protected. (photo credit: OLIVIER FITOUSSI/FLASH90)
Does the society really wish to help the elderly cope with the COVID-19 crisis? If so, why does not it address the problem at the root?There is a lot of uncertainty about the COVID-19 statistics. Yet, at least one piece of evidence is clear: older persons are at the greatest risk. And this simply means that the aging process and its resulting multiple aging-related diseases (multimorbidity) are the main determinants for disability, hospitalizations, severe clinical outcomes and deaths with COVID-19 – and thus are responsible for the devastating damages to the economy and the entire society. There is now a broad social realization that the elderly are the main risk group that needs to be protected.Then why not make the next logical step and realize the crucial role of the degenerative aging processes, the diminishing resilience and immunity of the aging persons, and the corresponding vital need to therapeutically ameliorate these degenerative aging processes to improve immunity and resilience? This could help mitigate the present crisis and avert future ones. This is the essence of the geroscience approach to the COVID-19 crisis that aims to therapeutically improve multiple aging-related diseases by intervening into their underlying aging processes, such as the process of immunosenescence. A recent position paper “Geroscience in the Age of COVID-19” published in the prestigious scientific journal Aging and Disease by some of the leading figures in the field of geroscience, from the US and Israel, promotes the geroscience-based preventive interventions.In addition to the healthy lifestyle (such as exercise, sufficient sleep and balanced nutrition) known to improve immunity in older persons, the geroscientists advocate for expanding the testing of existing drugs with established safety profiles that can potentially improve the biology of aging, immune mechanisms and resilience (the so called “geroprotectors”). These include such medications as metformin, rapamycin and their analogues, as well as NAD boosters, senolytics, biological immuno-modulatorors and other prospective geroprotective agents. These interventions showed promise in animal studies and some emerging human trials, though the scientists caution that so far no such treatments have yet been approved as geroprotectors for use in humans. Hence, self-medication with any of these substances is highly discouraged. Yet, the broader clinical testing of the existing, potentially geroprotective drugs, as well as developing new drugs targeting the aging processes, can be an effective long-term line of defense. Alongside the therapies, the geroscientists also advocate for the broader introduction of measurements (biomarkers) of aging, especially measurements of the deteriorating immune system, as potentially powerful means to predict the risks for the elderly, improve treatments and allocate resources for the protection of those who are most in need of it.THEN WHY not support and advance this research? Experience shows that it is not sufficiently supported. Vast funding is now allocated to researching and developing treatments for COVID-19, including some rather unorthodox and uncertain treatments. The calls for research proposals on COVID-19 now mainly focus on reactive treatments and vaccines. But there is insufficient realization that many reactive treatments and vaccines for COVID-19, whenever they are developed, will likely have diminished safety and efficacy in elderly patients who are at the highest risk, precisely because of their impaired immunity and resilience that geroscience aims to enhance.Yet very little support is explicitly announced for developing preventive geroscience-based interventions for improving the underlying aging health. Just compare the over $3.6 billion allocated by the NIH for the COVID-19 response, with only a few million for geroscience-oriented approaches called for by the National Institute on Aging within the NIH. In other places, such as the EU and Israel, such calls for preventive aging interventions are even more difficult, next to impossible, to find. The public awareness and support of such preventive interventions are also comparatively minuscule, compared to some of the massively publicized research directions such as vaccine development.Is the lack of attention to this approach due to our entrenched psychological reluctance to face our aging process that spills over to science? Is it due to “ageism” in healthcare that generally discriminates against or ignores the special concerns and needs of older persons? Is it the reluctance to think holistically and for the long term? Whatever the psychological impediments, the scientific community and the wide public should think rationally and proactively and give a strong focus and support for aging health interventions.If there is a lesson to be learned from this crisis, it is arguably the realization of the need to therapeutically address degenerative aging processes to prevent aging-related ill health as a whole. This understanding should translate to public health and research policies supportive of geroscience research, development and clinical application, improving the funding, incentives, education and institutional and public support for the field. Public advocacy should play an essential role for the realization of these goals. An example of such an advocacy effort is the public initiative for “Enhancing research, development and education for promoting healthy longevity and preventing aging-related diseases” advocated by the associations “Vetek (Seniority) – the Movement for Longevity and Quality of Life” and “Disabled, Not Half a Person.” With sufficient support and deployment, the preventive geroscience approach may help avoid or mitigate the effects of devastating crises of aging-related ill health – presently and for the future.The writer, a PhD, is the chief science officer of “Vetek (Seniority) Association – the Movement for Longevity and Quality of Life” and “Disabled, Not Half a Person,” Israel.
