Healthy Aging Summit Unites Medical Center in Shared Goals
Thanks in great part to public health investments, since 1900 life expectancy has roughly doubled. Around the globe, there are now more people aged 65 and older than under age 5. By 2050, the number of people aged 80 years or older is expected to triple. Society now faces the challenge of optimizing our longer lives by extending our “healthspan”—defined as years of life lived free of disease and disability.
To address this challenge, on April 19, the Healthspan Extension Summit brought together researchers from across the medical center to present findings in basic science, clinical medicine, and public health, and to discuss how these fields can ensure healthier long lives. The event was organized by the CUIMC Healthy Aging Initiative (CHAI) and supported by the Four Deans Fund and the Robert N. Butler Columbia Aging Center, which is based at Columbia Mailman School of Public Health at Columbia University Irving Medical Center (CUIMC). It drew over 300 members of the research community to the Vagelos Education Center for an afternoon symposium capped by a poster session and reception. (Watch a video of the event below.)
In opening remarks, Dean Linda P. Fried spoke about the Initiative’s inception under Anil Rustgi, director of the Herbert Irving Comprehensive Cancer Center, when he served as the interim CEO of CUIMC several years ago. Chaired by Dean Fried, CHAI officially launched last spring when incoming CUIMC CEO, Dean Katrina Armstrong, called for the creation of a medical center-wide steering committee to be led by Dean Fried with the enthusiastic support of Deans Lorraine Frazier and Roseanna Graham. Over the past year, 16 committee members have worked to define a new vision for the future of aging research at Columbia, and created activities to serve CHAI’s mission: extend the healthspan and create healthy longevity for everyone. “We need to dedicate our science to ensuring that those longer years are lived with the maximum possible health,” Dean Fried said, adding that it is possible to shape healthy aging trajectories, even later in life, with a huge potential upside for all generations by harnessing the unique capabilities of older people, including their desire to improve the world.
Biological Mechanisms of Aging
Presentations by CUIMC scientists who work in laboratory settings highlighted state-of-the-art techniques that measure and can potentially intervene on aging processes, as well as aging-related illness. Xuebing Wu in the Department of Systems Biology, revealed how aging may be a feedback loop of errors in DNA and RNA translation. His goal: “to see whether we can break this feedback loop and slow down aging.” In a similar vein, Shan Zha in the Department of Microbiology & Immunology, presented her work on ribosomal DNA instability as a marker of aging. Stephen Tsang in Ophthalmology, Pathology, and Cell Biology explained how gene editing could serve as precision medicine to prevent and treat aging-related macular degeneration. Hans-Willem Snoeck in Microbiology & Immunology introduced his work on stress hormones and mechanisms undermining the function of aging blood stem cells, with the goal of protecting the aging immune system and preventing hematologic malignancies.
Allison E. Aiello of the Columbia Aging Center led a discussion that examined the need to translate basic science insights from animal models to human health. Emmanuelle Passegué said this kind of translation-minded approach is central to the work she does at the Columbia Stem Cell Initiative. The Columbia Aging Center’s Alan Cohen said animal models are important but cautioned that mice with short lifespans are substantially different than humans. Research can help reveal the factors behind illness linked to our longer lives, added Gérard Karsenty who chairs the Department of Genetics and Development.
Age-Related Illness
CUIMC clinicians presented findings on diseases and conditions that disproportionally affect older people. One example: the bidirectional relationship between aging and poor sleep. Marie-Pierre St-Onge who directs CUIMC’s Center of Excellence for Sleep & Circadian Research explained that poor sleep is not only linked to illness, but also to measures of aging. “Individuals that had more variable sleep schedules had a worsening of epigenetic aging,” she said. Adam M. Brickman in Neurology presented evidence on the link between cerebrovascular disease and onset of Alzheimer’s disease. Meghan Reading Turchioe in Nursing spoke on promoting informed decisions that optimize quality of life and patient satisfaction related to treatment for atrial fibrillation. Matthew Baldwin in Pulmonology presented on recovery from acute respiratory distress syndrome and insights into biological mechanisms that may inform treatments.
Jennifer Manly in Neurology led the panel discussion on clinical aging research. Scott Small in Neurology drew a distinction between “aging pathophysiology versus diseases that occur as we age,” saying it’s a complicated picture. For example, Alzheimer’s is associated with aging but is also seen in people at younger ages. Addressing the question of research priorities, Ian Kronish in Cardiology and Associate Director, Center For Behavioral Cardiovascular Health, said disparities in aging were important to consider, and Columbia Mailman’s Thalia Porteny concurred on the impact that social determinants of health have on aging outcomes. Manly encouraged colleagues to focus on communities that are most affected by disease and decline and “to identify sources of resilience” in those communities.
Public Health
Population health research is shedding light on new health challenges in older adults, as well as risk factors, and potential interventions. Columbia Mailman’s Katherine Keyes pointed to spikes in suicide and binge drinking among older adults in the U.S. A new initiative she leads called SPIRIT is encouraging research across CUIMC on mental health at all ages. “If you want to understand older adult mental health you need to understand their health all throughout development,” she said. Along these lines, Columbia Mailman’s Allison Kupsco explained that prenatal environmental exposures raise the risk for health problems later in life. Billy Caceres in Nursing presented his research on stigma which found that anticipation of discrimination alone is linked to risk for heart disease and aging. Keith Diaz in Cardiology presented on strategies to promote physical activity. Finally, to prevent serious falls among older adults, Columbia Mailman’s Andrew Rundle offered a novel idea: planting shade trees to protect against the destabilizing physiological impacts on people and heat damage to sidewalks.
Muredach Reilly, Vice Dean for Clinical and Translational Research at the Vagelos College of Physicians and Surgeons, led the discussion on population health science in aging. The presentations made clear that it is possible to intervene to achieve healthy aging, noted José Luchsinger in Medicine. Carol Kunzel in the College of Dental Medicine raised the question of how public health incorporates insights from basic science, such as in the consideration of biological mechanisms. Columbia Mailman’s Dan Belsky—a co-lead on the symposium planning committee with Greg Alexander of Nursing and Caitlin Hawke of the Aging Center—added that scientists need to both “translate up from the basic sciences, but also translate back down,” from clinical and population health findings to make sure mechanisms identified in the lab are still present in communities of people.
Concluding Remarks
Dean Fried summarized the wide-ranging aging research activities across CUIMC revealed by the Summit. “I couldn’t be more excited about the science,” she said, adding that the Summit shows the potential “to reach together for the opportunity to reverse the increase in ill health across the life-course and expand the opportunity for an increased healthspan.”
Dean Katrina Armstrong concluded the plenary by announcing a new CUIMC investment in aging research. CHAI will launch $240,000 in pilot funds immediately following the Summit to foster new teams and innovative collaborations across departments and schools. “There’s never been a more important time for us to figure out how to preserve our health and well-being,” she said. “I feel a sense of optimism coming from the people in this room and what we are going to take on together but also an incredible sense of urgency. We need to get this work done.”
(To learn more about CHAI and the pilot funding program, contact Caitlin Hawke: columbiaagingcenter@cumc.columbia.edu.)
Photos by Brooke Slezak.