With old age comes an increased risk of diabetes, which can cause high blood pressure, which ups your chances for heart failure. It sounds like an unavoidable, unpleasant reality, but a local researcher sees it another way. If we can delay the first domino from falling, can we put the brakes on everything else too?
In a commentary published in Nature this week, researchers, including Luigi Fontana, research associate professor of medicine and co-director of the Longevity Research Program at Washington University School of Medicine, suggest shifting medicine’s focus to prevention.
Instead of treating diseases individually, they suggest pouring more resources into altering the way our bodies allow diseases to develop. This, they say, is the ultimate need for a flawed healthcare system.
“The old system that is so disease-centered, it’s going to fail because there are too many elderly people that are sick. There will be no resources unless we do something to change the system, to pay for it for all these people” says Fontana.
Today, almost 90 percent of Americans over the age of 65 have one or more chronic diseases. The elderly population has dramatically increased in the past century, as has the average lifespan of Americans. As we age, our bodies change in chains of events known as molecular pathways, which Fontana and his colleagues study. These pathways cause our cells to change; for example, when we eat, a molecular pathway triggers the creation of fat molecules, which are then stored.
These daily changes cause wear and tear on our pathways, leading to those common diseases. But our bodies don’t need to degrade at the speed they naturally do, Fontana says.
“Diet and certain drugs in combination can work on these pathways and promote health,” Fontana says. “It’s not just the story ‘eat better and exercise and everything’s gonna go well.’” Rather, he says, it’s about “personalizing” these treatments to an individual to manipulate their particular pathways. Give those predisposed to diabetes a nutrition and exercise plan and a metformin regimen, for example, which can stave off blood sugar problems.
Though the evidence in animal trials shows these tailored treatments can increase healthy lifespan, funding for such research is negligible and must be increased to make an impact, Fontana says.
“We need more research and more funding and a different mindset to move from a disease-centered approach,” he explains.
If such research is funded for clinical trials on people and improvements could be made, implementation will likely remain an issue. The strategy is contingent on the basic factors that govern healthcare: a doctor’s ability to find the right answer and a patient’s ability to pay for and follow a treatment plan. Still, Fontana says, he is confident that restructuring the treatment process of aging earlier on in life will improve the healthcare system overall.
