Asking the Big Questions in Dublin’s Fair City – Part 1

Mary Ni Lochlainn is an Academic Clinical Fellow in Geriatric Medicine. She works at King’s College Hospital NHS Foundation Trust.

This February marked the first, hopefully of many, Biogerontology for Clinicians International Conference, held at the state-of-the-art Mercer Institute of Successful Ageing (MISA) at St. James’ Hospital, Dublin. Hosted by the inimitable Professor Rose Anne Kenny, of Trinity College Dublin, and staff of The Irish Longitudinal Study of Ageing (TILDA), the programme boasted twelve expert speakers across a day and a half, with the aim of putting recent advances in biology in context with the pathology of ageing. The idea was to bring together leaders in ageing from various backgrounds, to ‘generate meaningful collaborative, translational approaches with significant potential strategic value to service users.’ And it certainly achieved those aims.

Prof Kenny kicked off proceedings giving a brief address on successful ageing, and the enormous heterogeneity amongst people, noting that this heterogeneity starts early, referencing the well-known Dunedin Study of 1000 38 year olds, which showed ‘biological age’ ranges from 30-60. She reminded us candidly that ‘there are two options for everyone here and one of them in ageing’.

Prof Tom Kirkwood, from Newcastle University, went for the big questions in his talk ‘Why and How we Age’. Again variability and heterogeneity came up, Prof Kirkwood noting that nematode worms, simple hermaphrodites, have a very variable age of death, even when genetic and environmental variables are removed. Prof Kirkwood gave the attendees plenty of food for thought in terms of targets for the future, or rather not so much food, when he highlighted the growing research behind intermittent fasting and caloric restriction. Personally I’m waiting for the human trials to really prove this….

Prof Eline Slagboom of Leiden University in the Netherlands gave a compelling talk on the metabolome, highlighting the use of a standardised metabolite platform in predicting common diseases and mortality. Perhaps these markers will be added to future frailty scores? She also noted that some of these biomarkers are more amenable to intervention than others and could be targets for future interventions. An example is this study: ‘Metabolic effects of a 13-weeks lifestyle intervention in older adults: The Growing Old Together Study’. One has to wonder whether we should be focusing more on biomarkers of health status rather than biomarkers of age. Could more specific markers of health status motivate patients to engage with treatments and lifestyle changes?

The staggering effects of socioeconomic status (SES) on health were highlighted by Dr. Cathal McCrory of TILDA. Did you know that social class affects both walking speed and heart rate variability? Dr. Frederick Sheedy had our brains ticking over, asking can we induce trained immunity via administration of the right nutrients. Metabolites play a role in training our immune system, so the work being done on the metabolome in TILDA and elsewhere could lead to a whole new world in therapeutics.

Dr. Nollaig Bourke of TILDA gave an impressive talk on the role of gender in biogerontology. We know Parkinson’s has a bias towards men, and Alzheimer’s towards women, but what does that mean for research into causes and treatments of these diseases? We know the X-chromosome has the highest density of immune-related genes. Could mechanisms of overcoming X-linked activation be related to the high prevalence of autoimmune disease in women? What role do sex hormones play too? Sadly we also learned that there is some truth in the dreaded man flu. I’m keeping that one quiet.

Dr. James Murray delivered an informative and accessible talk on autophagy, the process where a cell recycles nutrients and eliminates other materials that are excessive and/or damaged. Up and down-regulation of autophagy can lead to cell death, hence its appeal to cancer researchers, however it is also of interest in other areas such as neurodegenerative diseases. Sadly, for those of us who enjoy frequent meals, autophagy pathways have also been postulated to benefit from intermittent fasting.

The gut microbiome was obviously going to feature and Professor Paul O’Toole from University College Cork kept everyone engaged with his impressive talk. Work done within ELDERMET, an Irish microbiome project focused on older adults, has shown that gut microbiota composition correlates with diet and health in older people, notably changing significantly according to place of residence. He is currently leading a multi-centre dietary intervention trial so watch this space.

NB: Part 2 will be published tomorrow.

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