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Overview

This conference explored fundamental science of healthy ageing and social considerations (including the NHS).

Read the conference report here (PDF).

Healthy ageing was a two-day conference held by the Royal Society and the Academy of Medical Sciences' FORUM. The UK Government has set the Grand Challenge of achieving five extra years of healthy older age by 2035, but achieving this will be reliant on innovations in research and health and social care systems that benefit people of all ages and backgrounds. Speakers discussed scientific advances across ageing research, from basic mechanisms that drive ageing through to novel treatments and other interventions - considering how we define healthy ageing and prioritise the most effective research and innovations. The meeting addressed the implications of our ageing population for society, policy, and the health and social care systems. Finally, it considered how healthier older age can be realised through research, policy and other initiatives, exploring the ethical, social and economic frameworks that will be needed to ensure sustainable and fair benefit for all.

Attending this event

This open event was free to attend and was intended for participants with an interest in the life sciences sector from a variety of backgrounds including academia, industry, government, as well as regulatory and other scientific bodies.

Contact the Industry team for more information.

About the conference series

This meeting forms part of the Royal Society's Transforming our Future series and the Academy of Medical Sciences' FORUM programme.

The Transforming our Future meetings are unique, high-level events that address scientific and technical challenges of the next decade and bring together leading experts from wider scientific community, industry, government and charities. The meetings are organised with the support of the Royal Society Science, Industry and Translation Committee.

The Academy's FORUM programme brings together industry, academia and the NHS, and the charity, regulatory and wider healthcare sectors. It provides an independent platform to bring together leaders from across the life sciences sector to discuss scientific opportunities, technology trends, translational challenges and strategic choices in healthcare.

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Organisers

Schedule

09:00-09:15
Welcome

Speakers

09:15-09:50
Keynote - Can We Prevent Ageing?

Abstract

Human life expectancy in many parts of the world has increased substantially. Unfortunately healthy lifespan has not kept up and there is a growing period of disability and ill health at the end of life. The ageing population is therefore often seen as an increasingly alarming burden for society. Because ageing is the major risk factor for so many chronic and killer diseases, scientific attention has turned to the underlying ageing process itself, and the mechanisms by which it leads to disability and illness. The characteristic hallmarks of ageing are largely identified and are conserved in evolution. They have turned out to be remarkably malleable to environmental, genetic and pharmacological interventions, which also prevent age-related diseases. These discoveries are moving forward into the commercial sector and clinical trials, and it is now realistic to foresee medical interventions into the ageing process that will prevent more than one age-related disease. We may thus be able to maintain health until closer to the end of life.

Speakers

09:50-10:25
Keynote - The Challenge of Healthy Ageing: Social science issues and perspectives

Abstract

The way in which health, social circumstances and economic factors evolve over people's lives is inexorably intertwined. Only by understanding all three, and the dynamic interrelationships between them, can we really understand the evolution of health and lifestyles as people age. Even then, many policy issues associated with population ageing, whether these are challenges or opportunities, cannot be adequately understood by studying individual ageing processes in isolation, a more general economy-wide perspective is required. This talk will discuss these issues, with specific reference to recent UK evidence and the current debate surrounding the Grand Challenge on Healthy Ageing.

Speakers


Chair

10:55-11:20
Targeting the biology of ageing to prevent or treat ageing-related diseases

Abstract

Ageing is a biology regulated in part by a protein complex called target of rapamycin complex 1 (TORC1). Inhibition of TORC1 has extended lifespan and health span in every preclinical species studied to date. These data raise the possibility that drugs that inhibit TORC1 may have therapeutic benefit in ageing-related conditions in humans. One of the mechanisms by which TORC1 inhibition may have benefit in ageing-related diseases is by upregulating autophagy. Autophagy is a process by which cells breakdown and recycle protein aggregates and dysfunctional organelles. Declines in cellular autophagy occur with age and may contribute to the accumulation of damaged misfolded proteins in neurodegenerative diseases such as Parkinson's disease. Based on these findings, a Phase 1b/2a study is ongoing to evaluate whether oral doses of TORC1 inhibitors are well-tolerated in Parkinson's disease patients and achieve central nervous system concentrations predicted to induce autophagy.

Speakers

11:20-11:45
Creating medicines that eliminate senescent cells for the treatment of diseases of ageing

Abstract

UNITY, a healthspan company, is initially focused on eliminating accumulated senescent cells (SnCs), which are a fundamental mechanism of ageing, a driver of many common age-associated diseases and one of the root causes of ageing. UNITY is pioneering the discovery and development of senolytic therapeutics allowing us to halt, slow or reverse age-associated disease and restore tissue to a more functionally healthy state.

UNITY has built a unique discovery and development engine that first builds the senescence disease hypothesis in preclinical studies and then evaluates the clinical translation of this hypothesis to patients.

UBX0101, a potent senolytic small molecule inhibitor of the MDM2/p53 protein interaction, is being evaluated for the treatment of OA of the knee. Initial results from a Phase 1 clinical trial demonstrated that UBX0101 improved pain and function and modulated SASP factors. UBX1967 and UBX1325, a BCL-2 family inhibitor, are being evaluated for the potential treatment of age-related diseases of the eye, including age-related macular degeneration and diabetic retinopathy.

Speakers

11:45-12:10
Innate immune ageing: Consequences and corrections

Abstract

The immune system is remodelled with age resulting in increased risk of infections, reduced vaccination responses and increased risk of autoimmune disease and cancer. This lecture will discuss changes to neutrophil and natural killer cell function with age, the underlying mechanisms involved, the contribution of these changes to the aged phenotype and interventions to correct the deficits.

Speakers

12:10-12:35
Stemming the Tide of Time

Abstract

Resident stem cells are the key to healthy organ functional homeostasis. They respond to metabolic demand with increased cell production and regeneration at times following injury and acute disease onset. Quiescence, a state of reversible cell cycle arrest typifies tissue resident stem cells; it preserves their integrity and numbers until physiological stemness is required. Stem cell activity is orchestrated in an interplay between them and the niche they occupy. A consequence of the deregulated choreography between stem cells, their specialised ECM and satellite cells is a rundown of functional tissue integrity observed in ageing. As exemplified by well-defined stem cells of the gut, blood, muscle, skin and brain. Radical strategies in stem cell medicine that target rejuvenation of the niche will be required in order to slow the ageing phenotype, prolonging organ vitality. If successful, the potential could be huge and transformative for future management of age-related conditions.

Speakers

12:35-13:00
Twins Omics and longevity

Abstract

The microbiota is the community of around 100 trillion microbes that live in our colon that are like a virtual organ. This organ is key to our digestion, appetite, mood, metabolism, and control of our immune system. It is also key to how we respond to most drugs and foods. The TwinsUK cohort of 12,000+ twins has been running for nearly 25 years and is now the most intensively studied group of humans on the planet (www.twinsuk.ac.uk). We are currently using the microbiome data to provide novel measures of health, such as the level of microbial diversity and how this impacts overall health outcomes and ageing. We have demonstrated a modest genetic influence on microbial composition and metabolic function. Our new PREDICT study of over 1100 people is the largest nutrition study of its kind and shows we all react differently to the same foods, even identical twins. Understanding these unique aspects and our unique microbiome profiles are paving the way for the new era of personalised nutrition, which will break the mould of "one size fits all" advice and advance our understanding of ageing.

Speakers

Professor Tim Spector FMedSci

King's College London and Zoe Health


Chair

14:00-14:25
A single-cell view of the ageing somatic genome

Abstract

Loss of genome sequence integrity due to accumulating somatic mutations has been recognized as a possible causal factor in ageing since the 1950s. As a stochastic process this has been difficult to analyze in a quantitative manner in bulk tissues due to the random occurrence of somatic mutations, resulting in genome mosaics across cell populations. We developed an accurate single-cell approach to quantitatively assess multiple types of mutations, e.g., base substitutions, insertions and deletions, copy number variation, retrotranspositions, in single cells isolated from humans at different time points during normal ageing. Data will be presented on the frequency and spectrum of such mutations in human primary cells as a function of age, as well as the potential functional impact of such mutations.

Speakers

14:25-14:50
Understanding and manipulating mitochondrial redox metabolism in ageing

Abstract

Over the past few years myself and collaborators have developed mitochondria-targeted bioactive and probe molecules. These have included antioxidants that selectively block mitochondrial oxidative damage. Among these molecules are derivatives of the natural antioxidants ubiquinone (MitoQ) and Vitamin E. The antioxidant efficacy of these molecules was increased considerably by targeting them to mitochondria, which are the major source of oxidative stress in mammalian cells. This was achieved by covalent attachment of the antioxidant to a lipophilic cation. Due to the large mitochondrial membrane potential, these cations accumulate several hundred fold within mitochondria, protecting them from oxidative damage far more effectively than untargeted antioxidants. This was extended to develop the related mitochondria-targeted nitric oxide donor, MitoSNO, which is protective against cardiac ischemia-reperfusion injury. In parallel work we have developed the mitochondria-targeted hydrogen peroxide probe MitoB, that enables us to utilise ex vivo mass spectrometry to assess mitochondrial hydrogen peroxide production in vivo. Here I will focus on how the used of these probes and bioactive molecules in helping to understand the role of mitochondrial redox processes in ageing.

Speakers

14:50-15:15
Nutrient-specific appetites and the nutritional ecology of healthy ageing

Abstract

Appetite is not a unitary phenomenon, rather there are nutrient-specific appetite systems, which have evolved to cooperate to help animals achieve a balanced diet. These specific appetites manage the vastly multidimensional challenge of balancing an animal's simultaneous and changing requirements for dozens of different macro and micro-nutrients and other food components (e.g. fibre). However, nutrient-specific appetites will compete rather than cooperate in an imbalanced nutritional environment, leading to the expression of regulatory priorities for some nutrients (e.g. protein) over others, with profound impacts on energy intake, health and ageing. I will explore these concepts using the Nutritional Geometry Framework, introducing data from a range of species, from slime moulds to humans.

Speakers

15:15-15:40
Protein misfolding in the human brain in ageing and disease

Abstract

Brain ageing is the major risk factor for common neurodegenerative diseases, Alzheimer's disease, Parkinson's disease, frontotemporal dementia and dementia with Lewy Bodies. The pathological hallmark of these diseases is the accumulation of misfolded protein aggregates that cause cellular toxicity and neuronal death. Under conditions of cellular ageing, proteotoxic stress or disease-causing mutations, certain native proteins escape the cell quality control system and begin to aggregate into non-native structures ranging from oligomers to highly ordered assemblies. Here I address how we can define the different structures and conformations of an aggregating protein in health and disease using highly sensitive single molecule approaches. As a protein aggregates, it acquires biological properties that interact with several cellular processes including calcium signaling, oxidative stress, mitochondrial dysfunction, and inflammation. Such cellular processes are vulnerable to age related decline, further exacerbating the toxic effects of protein misfolding. Finally I address the therapeutic opportunities and challenges presented by targeting protein misfolding in neurodegenerative disease.

Speakers


Chair

16:00-17:00
Panel discussion: how do we effectively prioritise and translate promising research into real world interventions?

Speakers

09:00-09:05
Welcome

Speakers


Chair

09:05-09:30
The Prevention of Alzheimer’s Disease: Life-course Brain Health Initiatives in Science and Practice

Abstract

Over the last 10-15 years, major research initiatives led from within the UK are highlighting that the degenerative brain diseases which lead to dementia in late life have their genesis (at least) as early as midlife. This creates opportunities for early detection, risk profiling and implementation of personal prevention plans.

Cohort Data from projects like EPAD and the PREVENT Dementia Program combined with real world data as contained within the Scottish Brain Health Register can be explored to provide the empirical basis for accurate risk prediction decades before dementia develops. The implementation of these approaches will be through Brain Health Clinical Services being established outside the traditional memory clinics across the UK.

Novel and evidence based approaches to providing both individual and public health interventions to optimise brain health will yield tangible reductions in dementia incidence in the years ahead irrespective of the success or otherwise of developing new pharmacological interventions.

Speakers

09:30-09:55
Cognitive Ageing and Dementia: A Life-Span Perspective

Abstract

In this presentation I review empirical findings and theoretical concepts in cognitive ageing and late-life dementia research, with emphases on (a) person-to-person heterogeneity in trajectories of cognitive change over time, (b) how trajectories of child cognitive development determine peak levels of adult cognitive function from which ageing-related cognitive declines occur, and (c) how lifelong trajectories of cognitive function relate to the timing of severe cognitive impairments characteristic of dementia. I consider conceptual issues surrounding categorical versus dimensional models of late-life dementia and discuss how current diagnostic approaches affect inferences in the empirical study of disease progression. Together, the incomplete current understanding of the biological foundations of ageing-related cognitive declines and the continuous nature of many biomarkers commonly used in dementia diagnosis and classification pose both opportunities and challenges in the current research landscape.

Speakers

09:55-10:20
Insights towards the development of new medicines for dementia

Abstract

There are approximately 47 million people living with dementia globally for which there are currently no disease‐modifying treatments. Despite over 125 clinical trials in Alzheimer's Disease (AD), the largest group of dementia patients, there are still only 4 approved symptomatic agents. With age being the biggest risk factor, the number of patients suffering with AD is expected to reach over 130 million by 2050 and so the unmet need will grow substantially over the coming decades. Whilst previous clinical failures have questioned the basic understanding of the biology of the disease, there have been new advances in the field from genetic studies, use of human cells and major improvements in imaging technologies. Using this information, a collaborative effort from the pharmaceutical, biotechnology and academic sectors is now required to translate this basic research to the delivery of new treatments in the most appropriate stratified clinical population.

Speakers

10:20-10:45
AI-driven approaches for preventative healthcare

Abstract

The last decade has seen major advances in artificial intelligence that are now being translated into real world impact. In healthcare dozens of research papers have now been published that demonstrate how AI systems can make sense of complex health data and match and even exceed the performance of expert clinicians. This presentation will cover the promise from using AI to move care from reactive to proactive and preventative but also the major barriers and challenges that need to be overcome to be successful.

Speakers


Chair

11:15-11:40
Multimorbidity: a life course approach to intervention

Abstract

Multimorbidity, the existence of two or more chronic conditions, increases with age, affecting two thirds of people aged 65 plus. This has significant adverse consequences for frailty, hospital admission, loss of independence and mortality. Care guidelines focus on interventions for high risk individuals with established, advanced disease. Yet few evidence-based interventions are available, and at this late stage can only briefly postpone the inevitable consequences. A life course approach to understand social and biomedical determinants of multimorbidity, identify sensitive or critical periods, and discover measures to enhance resilience to its ill effects, should provide a more effective means of intervention and risk reduction.

Speakers

11:40-12:05
Designing new trials in inflammation: The Arthritis Therapy Acceleration Programme

Abstract

The Arthritis Therapy Acceleration Programme (A-TAP) is an alliance between the University of Oxford and Birmingham. Its aim is to use Basket trials, Bayesian statistics and Cell Based Outcome Measures to determine efficacy and de-risk early stage trials of drugs that target immune mediated inflammatory diseases. Working with seven different NHS Trusts along the M40 corridor, the A-TAP delivers "stratified pathology" namely process driven, pathway focused, studies to deliver the right drug for the right disease indication. This complements the current drive for "stratified medicine", which aims to deliver the right drug for the right patient. The A-TAP strategy has potential to be adopted in other areas such as ageing and multi-morbidity.

Speakers

12:05-12:30
Technology to increase patient compliance

Abstract

This talk summarises the issues with adherence and explores the reasons why patients are non-adherent. It will also explore the technologies available to improve adherence and provide reasons why so many solutions fail, as well as providing examples of successful solutions and the characteristics they share. Finally, Matt will show how designing technology solutions for an ageing population maximises the impact of these solutions in improving adherence and delivering improved clinical outcomes.

Speakers


Chair

13:20-13:45
AI and Technology for Dementia Care

Abstract

We are living in an increasingly interconnected world, in which technology allows us to access information and services to interact with people, objects and devices remotely. Advanced connected technologies and Artificial Intelligence (AI) allow us to tackle some of the key challenges faced by our communities. With growing environmental challenges and an ageing population, we need to find effective solutions to make our living environment more sustainable and develop services to provide more effective health and care support. This talk will discuss part of our research in Care Research and Technology Centre at the UK Dementia Research Institute. We will discuss the development of a digital platform using AI and connected in-home sensors to enable remote monitoring and timely interventions to support people affected with dementia.

Speakers

13:45-14:10
The Determinants and Effects of Meaning and Purpose in Ageing

Abstract

The presentation will give an overview of recent research on the role of meaning and purpose in ageing. Analyses from the Health and Retirement Study and the Nurses' Health Study on the determinants and effects of meaning and purpose will be described. These analyses will include assessments of the effects of purpose on health, longevity, alleviating depression, and life satisfaction. Further attention will be given to what factors in a person's life create a sense of meaning and purpose. Various approaches on how to better track meaning and purpose throughout the life course will be presented, and discussion will be given to how "meaning" and "purpose", while often used interchangeably, in fact represent distinct constructs and may have different determinants and effects.

Speakers

14:10-14:35
Social prescribing for prevention and management of illness in older age: findings from clinical trials, cohort studies and electronic patient data

Abstract

Over the past few years, referrals to non-medical treatments ("social prescribing") have become increasingly popular in various countries globally. This talk will explore the pathways involved in social prescribing referrals and describe the roll-out of the scheme in the UK within the National Health Service. It will present data from clinical trials and observational data on the potential efficacy of these programmes for the prevention and management of different mental and physical health conditions in older adults and explore the theory behind social prescribing as a complex adaptive health intervention and some of the primary mechanisms of action. It will also present preliminary data on the cost effectiveness of the scheme gathered from UK evaluations and consider the demographic and health characteristics of individuals who have been receiving and refusing social prescribing in the first six months of the scheme in the UK.

Speakers

14:35-15:00
The opportunities in Dementia

Abstract

Dementia is the biggest challenge facing health and social care. It affects some 850,000 people in the UK and is unique in the effect it has on carers of people with the condition. Costs are in the order of £26 billion per year and are divided between health and social care. Dementia is the leading cause of death in England and significant successes have been achieved over the last few years in terms of raising awareness of dementia, investment in research and increasing the number of people receiving a formal diagnosis.

Treatments for dementia and one of its commonest causes, Alzheimer's disease, have so far eluded science but advances are taking place. A large body of research directed at symptomatic improvement in people with the condition, support for them and importantly, for their carers and families, has been carried out.

The National Health Service's Long Term Plan provides the opportunity to significantly continue the improvement in terms of diagnosis and post diagnostic care.

Speakers


Chair

15:30-16:00
Keynote - Current research directions and population need, contexts and futures for our ageing populations

Abstract

This talk will attempt to bring together some of the implications of research and evidence presented at this conference. This will be contextualised drawing on relevant existing population representative and derived studies and broader multidisciplinary sources. In particular there will be a focus on changing life expectancies, Sustainable Development Goals and rapidly rising concern about our ability to address own own species impact on climate and environmental integrity. An ageing focus throws up a different perspective on these, including how we review and assess the evidence base to address current challenges and future scenarios.

Speakers

16:00-17:00
Panel discussion: Inequalities and avoiding harm

Speakers

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