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Aging experts say healthcare incentives reward treatment rather than prevention

Readers will note a deviation from the usual Q&A format to focus on this timely report from a trio of aging experts that appeared in the July 24 issue of the journal Nature:

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Consistent with arguments promoted by this author for the past 25 years, these experts are calling for a change in the mindset of how to best cope with the healthcare needs of our aging population. They are asking for more efforts to promote interventions that have the potential to prevent multiple chronic diseases and extend healthy lifespans rather than just treating the symptoms.

The experts assert that, by treating the causes of aging, it may be easier to help people stay healthier in their old age. More than 70 percent of people over age 65 already have two or more chronic diseases, but little is being encouraged to prevent these diseases in the first place.

“Heart failure doesn’t happen all at once,” according to first author Luigi Fontana , MD, PhD, professor of medicine and nutrition at Washington University and Brescia University. “It takes 30 or 40 years of an unhealthy lifestyle and activation of aging-related pathways from metabolic abnormalities such as high blood pressure, high cholesterol and type 2 diabetes to give a person heart failure in his 60s. So we propose using lifestyle interventions — such as a personalized healthy diet and exercise program — to down-regulate aging pathways so the patient avoids heart failure in the first place.”

“You don’t have to be a mathematician or an economist to understand that our current health care approach is not sustainable,” says Fontana. “As targeting diseases has helped people live longer, they are spending more years being sick with multiple disorders related to aging, and that’s expensive.”

“But public money must be invested in extending healthy lifespan by slowing aging. Otherwise, we will founder in a demographic crisis of increased disability and escalating health care costs,” write the researchers in Nature.

“The combination of an aging population with an increased burden of chronic diseases and the epidemic of obesity and type 2 diabetes could soon make health care unaffordable for all but the richest people,” added Fontana.

The experts are reiterating what we already know but which we mostly ignore to our own detriment. It is time to face the reality that most of what ails us is largely preventable by living a healthier lifestyle and it isn’t how long we live as how well we live that is most important.

(Readers can read the entire article at Fontana, L. Kennedy BK, Longo V. Treat ageing: prepare for human testing. Nature, vol. 511 (7510), pp. 405-406. July 24, 2014)

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