We are living through a defining moment in history. The staggering COVID-19 mortality rates for older adults make improving these outcomes an exigent goal. This pressing priority can be achieved through research focused on keeping disease and decline at bay as we age. In a time of great global uncertainty, what matters most is clearer now than ever before: Health matters. Older adults matter. Science, and especially geroscience, matter.
In the United States, provisional death counts from the Centers for Disease Control and Prevention show that almost 80 percent of COVID-19 deaths occur in adults age 65 and over. In Europe, adults age 60 and over account for 95 percent of deaths, according to the World Health Organization, and a recent paper in The Lancet found that the risk of dying from COVID-19 increases with each decade of age. Furthermore, at the peak of the pandemic, COVID-19 has become the leading cause of death in affected countries exceeding heart disease and cancer.
Of course, many older adults contract the novel coronavirus and remain symptom-free, experience only mild disease, and/or fully recover. It is the presence of underlying conditions, including diabetes and lung and cardiovascular disease, that puts patients, young and old, at greater risk for severe COVID-19 disease. Yet, the fact of the matter is that a majority of older adults in the US today have at least one chronic disease. It is for this reason that we must work to improve health and delay the onset of these conditions as we age. This is the goal of geroscience, an emerging field that offers the promise of delaying the onset of age-related diseases by delaying aging processes.
As Hans Henri P. Kluge, the World Health Organization’s regional director for Europe recently stated: “It is becoming clearer that the healthier you were before the pandemic plays a crucial role. People who age healthily are less at risk.”
In a time of great global uncertainty, what matters most is clearer now than ever before: Health matters. Older adults matter. Science, and especially geroscience, matter.
This clarity provides a course for addressing this crisis. In addition to universally beneficial measures like increasing the availability of masks, sanitizers, ventilators, and testing, research and commercialization investments in two key areas can provide opportunities to improve outcomes. The first involves intensifying health promotion and disease prevention efforts in areas that are directly related to older adults. The second is in accelerating discoveries in geroscience. Our collective aim must be to help people grow older in better health. Here are some measures that can address this goal.
Vaccine and Vaccine-Efficacy Improvements
The research development agenda in this area includes identifying an effective COVID-19 vaccine and ensuring its broad availability and administration. On the geroscience front, a gradual decline in the immune system, known as immunosenescence, is associated with vaccine failure rates in older adults. Studies have shown that the drug Rapamycin, a potentially promising anti-aging therapy, can help combat immunosenescence and improve vaccine response rates.
We need to explore additional targeted ways to improve the vaccine response rate, which, in the case of the seasonal flu, sits not much above 50 percent for older adults.
Pharmacological Treatments for All Disease Levels
To date, COVID-19 has no known cure. Some preliminary studies point to the possibility that anti-malarial medications chloroquine and hydroxychloroquine can treat the disease, but more research, including large, randomized clinical trials, is needed to determine if they are safe and effective, and if so, at which phase of the disease progression.
Cytokine storm, a term denoting hyper-reactive immune responses that trigger excessive inflammation, appears to be responsible for severe illness and death in many patients, including previously healthy individuals with COVID-19. This is an area where geroscience research, including studies to better understand the role of inflammation in fighting disease, can provide potential direction toward the development of safe and effective treatments. Targeting a key inflammatory cytokine known as IL-6 showed promise in a small Chinese study and is currently being tested in additional studies.
We must also consider the need to treat health sequelae, like lung and brain damage, that reportedly occur in some COVID-19 survivors. Existing and future investigations into lung fibrosis and forms of dementia may prove beneficial in treating these ailments and underscore the need for sustained research into the processes involved in the development of diseases of aging.
It is important to consider that scientific endeavors have benefits that extend beyond health. A recent analysis in Science found that federal research increasingly appears to fuel innovation that develops new jobs, industrial competitiveness, and entrepreneurial success. The study authors “urge policymakers to consider these newly observable benefits of federal research when they formulate tax policy and science research budgets.”
Around the world, we are witnessing heroic efforts to cure and care for people and to put lives before livelihoods, confirming that protecting everyone from COVID-19, no matter their age, is the most valuable investment of all. From nation to nation and neighbor to neighbor, we must prioritize improving health and health care, advancing geroscience, and sharing knowledge to benefit members of all generations. Our mission to promote healthy aging has never seemed so vital.