How to Significantly Extend Healthy Lifespan
Declaration on Aging Biomarkers and Clinical Tests
Scientists from around the world met on October 1, 2020, during the International Day of Older Persons, at the 5th Eurosymposium on Healthy Ageing (http://www.eha-heales.org/program.html), to share their research on the extension of healthy lifespan. Two topics emerged as particularly important: aging biomarkers and clinical tests.
Scientific research and technological innovation have already significantly improved the life expectancy and health of the population. Many of the biological mechanisms by which we age (“hallmarks of aging”) have been identified but require further exploration as targets for intervention. There are proofs of principle that therapeutic interventions into these mechanisms can improve healthspan in animal models and in human pilot trials. More needs to be done to improve the healthy and productive life expectancy for the aging population.
We are calling for more research and development to therapeutically treat aging as the main factor for disability and death to improve the resilience and immunity of the elderly. Staying healthy and independent for as long as possible is everyone’s wish, as well as a major public health goal as we strive to build a more resilient society. The differences observed between biological and chronological age may enable health professionals to implement targeted and personalized actions.
The goal would be to combine different biomarkers of aging to develop a generally acceptable measure of aging and degenerative processes. This is necessary in order to better understand and predict the aging process, as well as to have common metrics to evaluate the effectiveness and safety of potential geroprotective treatments. The use of the latest machine learning techniques to find even more relevant markers and predictors of aging could be an important milestone. Advances in artificial intelligence, combined with the availability of large databases, make it possible to identify and integrate many more biomarkers. These biomarkers should give reliable information about aging of all systems of the body (immune, cardiovascular, respiratory, nervous, etc.) and their integration. It is also important to have more open and collaborative databases about these biomarkers, accessible to the public while ensuring individual privacy rights.
There are emerging initiatives in this area, including databases on actionable biomarkers of aging: Mortality Predictors (http://mortalitypredictors.org/); Longevity Biomarkers (https://www.aginganalytics.com/biomarkers-of-longevity); Deep Biomarkers Of Human Aging (http://young.ai), and other relevant resources, such as Human Aging Genomics Resources (https://genomics.senescence.info/index.php) and Geroprotectors (https://geroprotectors.org/). These and analogous initiatives must be supported. The science community needs open databases including case studies, solutions, and datasets.
Another crucial point we have identified is the need to enable the validation of research on aging and geroprotective therapies by clinical studies.
To this end, the recruitment of appropriate subjects is critical. It is especially important to recruit people aged over 60 years and even 70, 80 or 90 years for clinical studies. It is important to test the therapies in the groups for whom they can produce benefits, following the International Council on Harmonization of Technical Requirements for Pharmaceuticals for Human Use (ICH) criteria for geriatric drug development. Clearly there are risks for older persons in such studies, but the risks and dangers of not developing therapies and/or applying untested therapies are much more detrimental. It should be absolutely necessary that there is an informed consent and a process of ethical review.
To accelerate decisions:
There should be an obligation for ethical committees to decide within a reasonable time on the diagnostic tests on biomarkers of aging and clinical research of geroprotective therapies (not more than one month, unless providing a justification for the delay). Deciding faster must not mean being less careful, on the contrary.
Authorizations should be more standardized, interoperable and transferable between countries.
Standards for protecting the privacy of medical data of trial participants should be established that allow easier collaboration between institutions, countries, etc.
One way to accelerate the research could be also via self tests by scientists (e.g. the Rapid Deployment Vaccine Collaborative initiative http://radvac.org).
By enhancing the evaluation of clinical aging biomarkers and testing new geroprotective therapies, it may be possible to radically reduce degenerative aging processes, and thus increase the health and economic benefits of the rapidly aging society. We must mitigate senescence processes as soon as possible to save as many lives as possible.
Full conference recording: