This blog post is a cross post with Silverevolution. Silverevolution is an ACCESS Health blog devoted entirely to innovations and issues related to care of the elderly and chronically ill. Click here to visit the Silverevolution blog.
This week is a special week in Stockholm. The Nobel Laureates of 2014 have come to Stockholm for a week full of events. Some of the events, like the Nobel Week Dialogue, are open to the public. This year, the topic of the dialogue was aging, so I could not stay away. I would like to share some of the impressions from the Nobel Week Dialogue.
I listened to the panel “Diseases of Aging.” For information on the panelists and to view the program of the Nobel Week Dialogue, please visit the Nobel Week Dialogue website.
The panelists and the audience discussed how the burden of disease changes as our population ages. More people suffer from stroke, from cancer, and from cardiovascular diseases. Many older people suffer from several diseases at the same time. One disease, such as obesity, is a risk factor for other diseases. Can we afford to treat these diseases in the future? Are there effective ways to prevent these diseases?
You can watch the panel discussion here. The discussion yielded some useful insights: We have not slowed the development of age related diseases like dementia. We have postponed the onset of age related diseases. We do not age more slowly. We age later in life.
When we stay physically active, we help our bodies and our minds to stay young. When we remain socially connected, we slow down the aging processes. When we learn, we activate parts of the brain that prevent us from aging. We ought to remain students throughout our lives.
Some age related diseases have common causes. If we can identify the common causes, we can prevent or delay several diseases at the same time. Once a person develops diseases, we must treat each disease separately. Professor Miia Kivipelto, a geriatric epidemiologist at the Karolinska Institute, argued that prevention is partly a political issue. We must make it easier for people to lead healthy lifestyles. Linda Partridge, Director of the University College London Institute of Health Aging, disagreed. She argued that raising taxes on unhealthy food would not prevent people from consuming sugary and fatty foods. We must persuade people to lead healthy lifestyles. We must educate people.
Professor Ingmar Skoog of the University of Gothenburg highlighted another important point. He talked about early diagnosis. Most studies of dementia follow patients for a period of twenty years. What if the early signs of dementia are visible earlier than twenty years prior to the development of dementia? What if prevention as we see it today, such as exercise and cognitive training, are retarders of the disease? What if what we call prevention is not prevention? Perhaps we must understand the fundamental mechanics of the disease better. Perhaps we must learn how to diagnose dementia earlier than twenty years before the onset of the disease. Perhaps we must rethink prevention.
Sweden spends below five percent of healthcare costs on prevention, according to a recent report from the Forum for Welfare (Forum för välfärd). It is costly to screen people for diseases. We may need to screen one hundred thousand individuals to find the disease in one person who can benefit from an early treatment. The panelists and the audience talked about the importance of preventing diseases. What I missed from the lecture today was a discussion on cost effective prevention. The gains of prevention seem to be large. If we can reduce the costs of prevention, we could lower healthcare costs. We could offer early treatment.
The moderator, Göran Hansson, Professor at Karolinska Institutet asked the panelists if they believe we could repeat the success story of the reduction in smoking. Can we reduce obesity like we reduced smoking? Nobel Laureate Eric Kandel offered a positive view. We made it trendy not to smoke. Many people stopped smoking because it was no longer trendy to smoke. But Ms. Partridge countered with a pessimistic view. We were never made to smoke, but we were made to eat. Historically, the more we ate, the greater our chance of survival was. Evolution has equipped us with few tools to resist fatty foods. We have lived in abundance for a short period of time. Repeating the success story of smoking will be a challenge. Are you an optimist or a pessimist when it comes to reducing obesity in the world?
The discussions stimulated my curiosity. I want to learn about common causes of diseases related to old age. I want to know more about prevention of diabetes and early detection of dementia. The topics at Nobel Week Dialogue were relevant because the panelists discussed diseases that affect large groups of people. In Sweden, one hundred and fifty thousand individuals suffer from dementia, and two thirds of these people also suffer from Alzheimer´s Disease, according to the Swedish Dementia Register. There are over four hundred thousand individuals who suffer from diabetes in Sweden. And almost four hundred million people in the world suffer from diabetes, according to the International Diabetes Federation. These figures are growing.
I was happy to note that many young people attended the Nobel Week Dialogue. I am also grateful that Nobel Week Dialogue chose to focus on aging this year. ACCESS Health works actively to support young entrepreneurs who are interested in aging. Entrepreneurs in different countries participate in ACCESS Health incubator programs.
As previous authors of this blog have described, Modern Aging is an ACCESS Health project designed to encourage entrepreneurs to create new businesses to serve the needs of the elderly and the chronically ill. The Modern Aging project was first conceived and implemented in Sweden. Young entrepreneurs were selected to participate in a fourteen week educational program. The winner received money to start a company. ACCESS Health plans to replicate and expand the Modern Aging project in Europe, the United States, and Asia. Check out www.accessh.org for updates on the program and the Modern Aging Innovation Laboratory.