Greg M. Cole Assoc. Director, GRECC GLA VA Assoc. Director, Alzheimer Center UCLA

1. Current and planned strategies to establish academic programs of aging and longevity across the US Greg M. Cole Assoc. Director, GRECC GLA VA Assoc. Director, Alzheimer Center UCLA Professor, Medicine and Neurology, UCLA

2. Multiple Aging and Related Programs at UCLA • Center on Aging • Multi-campus Gerontology Program • Minor in Gerontology - ~130 undergraduates • Claude Pepper Center (OAIC) • Affiliated GRECCs • MacArthur Foundation- Healthy Aging Study • Hilbloom-Diabetes • 2 Alzheimer Centers (Federal and State) • 2 Parkinson’s Centers ( NIH and VA) • Atherosclerosis Research Unit (~80 investigators)

3. GRECCs- VA based Geriatic Research Education and Clinical Centers • Founded 1975, 16 in 1995, grown to 21-22 GRECCs across the country, (~$100 million in research/ year) • The research mission at each site consists of funded, peer-reviewed investigations within one or more circumscribed focus areas in the basic biomedical, applied clinical, and health services/rehabilitative issues surrounding aging, the aged, and their health care and functional needs; • Education mission - training of health providers in the care of the elderly, at undergraduate and postgraduate levels; among both VA staff and community providers, and in partnership with academic affiliates • Clinical mission - advance the practice of geriatric care through the development and evaluation of new approaches - which when demonstrated as effective, are to become integrated into the fabric of, and supported by, the parent health care system; and then, ideally, exported elsewhere within the VA and beyond.

4. GRECCs-2007

5. GRECC Research Areas

6. Centers of Excellence in Basic Biology of Aging • 1991 – In a major report “Extending Life, Enhancing Life, a National Research Agenda on Aging”, the Institute of Medicine (IOM) calls for the establishment of at least 10 Centers of Excellence to undertake the multi-disciplinary study of aging. • Nathan Shock Centers of Excellence in Basic Biology of Aging- NIA founded with 3 centers in 1995-$1.2M ( U Michigan-J. Faulkner, Washington- P. Rabinovitch, UT San Antonio-A. Richardson) • 1996 – Construction of the Buck Institute for Age Research begins. Throughout the planning period, a prestigious Board of Scientific Advisors advised the Institute on its initial scientific program • 2001-Barshop Institute for Longevity and Aging Studies- U Texas San Antonio (Masoro> A Richardson) • .

7. NIA Supports 77 Centers • Alzheimer Centers (28) • Claude D. Pepper Older Americans Independence Centers-(~11 OAICs, Harvard, Yale, Hopkins,Duke, UCLA, Michigan, U Conn,Kansas, Maryland, UT, Wake Forest)- Geriatrics

8. Harvard • Harvard Medical School-The Paul F. Glenn Laboratories for the Biological Mechanisms of Aging (2003)- David Sinclair (part of planned Institute for Aging Research at HMS) PPG- Yankner, Sinclair (Nature 2006, Tsai (Nature 2007) • Harvard Cooperative Program on Aging (HCPOA), a program of the Hebrew SeniorLife Institute for Aging Research with funds from the Harvard Older Americans Independence Center, HMS Division on Aging and the Massachusetts Alzheimer's Disease Research Center • Reinventing aging-Sch Pub Health/MetLife

9. Stanford/ SRI • Stanford VA GRECC and VA / NIA Aging Clinical Research Center • CRIA-CENTER FOR RESEARCH on INDEPENDENT AGING (SRI) “will explore a wide variety of opportunities in innovations to detect, prevent and mitigate the loss of cognitive and physical function associated with or resulting from the aging process. The elderly segment of the population is increasing twice as fast as the remainder of the population. The results of this shift are dramatically increasing healthcare costs, ranging from medications for chronic illness to high-end services such as nursing home care. New technologies can play an important role in helping elders maintain their independence and reducing healthcare costs, which are shouldered not only by individuals but family members and the population at large. In addition to improving quality of life, the market demand and financial incentives for research and products in this arena are significant. The current market for assistive devices through Medicare alone is $31B. “

10. Draws on Policy, Biosciences, Engineering, Advanced Materials, and Computing and Information Sciences. • The objectives for CRIA programs are defined as: • 1) Characterize and predict deficits and conditions that impede • independent aging. • 2) Prevent or treat conditions that impede independent aging. • 3) For deficits that cannot be prevented or treated, provide adaptive assistance • to maintain independence.

11. Mandate for more geriatric training • Florida State University College of Medicine was created by legislative act in June 2000 with a mandate to provide a special emphasis on preparing students to care for elderly patients • University of Arizona will develop the Arizona Reynolds Program of Applied Geriatrics • UCSF and many other medical schools are launching new Geriatrics Efforts

12. Where we are going IF NOTHING IS DONE- Expect 14 Million US Cases, ~$300 billion/yr High Median Millions Low Year

13. Why build up aging research? • Current alternative program is for very expensive drugs, devices and procedures for multiple diseases of aging. Corporations and government are already struggling to pay now. Wait till the future. • Avoid bank-breaking medical care costs by preventing/ delaying/mitigating chronic diseases of aging • Gerontology is no longer a backwater. Recent animal research shows breakthrough promise.

14. Examples of Programs and Institutes with Aging Focus • Andrus Gerontology • Institute on Aging - U Penn • IBAD - UC Irvine • Stein Institute for Research on Aging (SIRA) celebrates 20 yrs with 83 investigators. • Sun Health Research - Arizona (Alzheimer’s, Parkinson’s, Prostate cancer) • Stanford • Gladstone - (almost aging-Cardiovascular, Alzheimer’s, Stroke) • Buck Institute - Nationally, Internationally recognized researchers