The Fourth Summit: Geroscience for the Next Generation

SUMMIT AGENDA - DAY ONE

9:00 a.m.

Framing the Summit: Welcome and Introduction

Richard J. Hodes
Director
National Institute on Aging
National Institutes of Health

Ronald A. Kohanski
Director, Division of Aging Biology
National Institute on Aging
National Institutes of Health


SESSION I: Biological Determinants of Health and Disparities in Aging
Health disparities related to aging are the result of complex biological, environmental, sociocultural, and behavioral factors. Many open questions and gaps in knowledge remain with regard to how these factors impact an individual’s health over their life course. The overarching goal of this session is to consider ways in which research on geroscience and the biology of aging can provide important new information about disparities in aging, and ultimately improve the health status of older adults in diverse populations. This session will provide an introduction and overview of health disparity frameworks for research which identify key domains of influence over the life course and how those domains impact individuals and communities at different levels. The session will also include a presentation on the impacts of structural disadvantages on aging related health outcomes, an overview of basic and translational cancer biology research for understanding and reducing cancer health disparities, and perspectives on framing fundamental biological research to expand progress in addressing health disparities of aging.

Session Chair: Roland Thorpe, Jr., Johns Hopkins Bloomberg School of Public Health
Session Facilitator: Jessica Smith, National Institute on Aging

9:30 a.m.

Introduction – Health Disparities Frameworks

Eliseo J. Pérez-Stable
Director

National Institute of Minority Health and Health Disparities (NIMHD)
National Institutes of Health

10:00 a.m.

Structural Disadvantages and Health Disparities

Shannon Zenk
Director

National Institute of Nursing Research (NINR)
National Institutes of Health

10:30 a.m.

Health Disparities and Cancers

Tiffany Wallace
Program Director
Center to Reduce Health Disparities (CRCHD)
National Cancer Institute (NCI)
National Institutes of Health 

11:00 a.m.

Addressing Health Disparities in the Biology of Aging

Stacy Carrington Lawrence
Deputy Director

Division of Aging Biology
National Institute on Aging

 11:30 a.m.

Panel Discussion

Jamaine Davis
Assistant Professor of Biochemistry and Cancer Biology

Meharry Medical College
Vanderbilt University

Roland Thorpe, Jr.
Co-Director DRPH Concentration in Health, Equity, and Social Justice
Professor of Medicine
Johns Hopkins Bloomberg School of Public Health

 12:00 p.m. Lunch Break (on your own)


SESSION II: Populations for Geroscience: High and Low Burdens of Functional Deficits and Morbidities

Populations may be selected to participate in studies based on some special characteristics, such as familial lifespan, early disease or chronic infection, or as a birth cohort independent of other features. These studies reveal differences related to those characteristics, and within-population heterogeneity in apparent rates of aging. Reports of major findings from these well-studied populations will be presented during this session, to emphasize what has been learned about rates of aging and explore how these might inform biological research on health disparities.

Session Chair: VJ Periyakoil, Stanford University
Session Facilitator: De’Larrian Knight, National Institute on Aging

12:45 p.m.

Centenarians – Exceptional Aging

Sofiya Milman
Associate Professor, Department of Medicine

Albert Einstein College of Medicine

1:00 p.m.

Aging in Non-Industrialized Contexts: Lessons from Indigenous Populations

Michael Gurven
Professor, Department of Anthropology

Co-Director, Tsimane Life History and Health Project
University of California Santa Barbara (UCSB)

1:15 p.m.

HIV and Accelerated Aging

Kristine Erlandson
Associate Professor, Medicine-Infectious Disease

University of Colorado Anschutz Medical Campus

1:30 p.m.

Cancer and Accelerated Aging

Mina Sedrak
Medical Oncologist

Deputy Director of Clinical Trials, Center for Cancer and Aging
City of Hope

1:45 p.m.

ICU Survivors and Accelerated Aging

Nathan Brummel
Clinical Associate Professor of Internal Medicine
Physician, Pulmonary Disease
The Ohio State University

2:00 p.m.

Panel Discussion

Leon McDougle
Professor, Family Medicine, The Ohio State University

Past President, National Medical Association

VJ Periyakoil
Professor of Medicine (Primary Care and Population Health)

Stanford University

2:45 p.m.Break


SESSION III: Multimorbidities and Geriatric Syndromes
Although geroscience is rooted in the discovery of the biological mechanisms of aging, this emerging field is also intently focused on translation, with the goal of improving health and quality of life for older individuals. Multimorbidity (the co-occurrence of two or more chronic conditions in the same individual) and geriatric syndromes (common health issues observed in older individuals that do not fall into discrete disease categories) are two pressing issues facing geriatricians and their patients. Over the past several years, the identification of the molecular causes and regulatory networks associated with “interesting biological phenomena” (e.g., development) have led to a better understanding of the molecular basis of human physiologic and pathologic conditions – and suggested new strategies to ameliorate deleterious conditions (e.g., diseases, infections, depression, etc.).

This session will explore the idea that both multimorbidity and geriatric syndromes are emergent properties of underlying global instability intrinsically connected with the biology of aging. Thus, multimorbidity and geriatric syndromes should be considered as fundamental and guiding outcomes when developing a “geroscience toolbox” for geriatricians and their patients. The ideal geroscience toolbox would contain ways to quantify aging and methods to improve health and quality of life for older people. Although most basic research with laboratory animals has focused on specific diseases or individual conditions, the geroscience hypothesis postulates that the biology of aging causes multiple diseases and conditions. Thus, a critical question to be addressed in this session is “How can we use other mammals for geroscience research on multimorbidities and geriatric syndromes?” For basic and translational research, is it helpful to model experimental approaches using naturally occurring multimorbidities in other mammals, or do we need common (overlapping) multimorbidities to advance the geroscience concept beyond single diseases of aging?

Session Chair: Alessandro Bartolomucci, University of Minnesota
Session Facilitator: Richard Oppong, National Institute on Aging

3:15 p.m.

Multimorbidities and Geriatric Syndromes in Humans

Luigi Ferrucci
Scientific Director

National Institute on Aging
National Institutes of Health

3:30 p.m.

Multimorbidities and Geriatric Syndromes in Non-Human Primates

Ellen Quillen
Assistant Professor, Molecular Medicine

Wake Forest University School of Medicine

3:45 p.m.

Multimorbidities and Geriatric Syndromes in Companion Dogs

Natasha Olby
The Dr. Kady M. Gjessing and Rahna M. Davidson Distinguished Chair in Gerontology

Professor, Neurology and Neurosurgery
NC State University

4:00 p.m.

Morbidities in Diverse Species

Caroline Zeiss
Professor, Pathology

Yale University

4:15 p.m.

Panel Discussion

Noah Snyder-Mackler
Assistant Professor, Center for Evolution & Medicine

Arizona State University

Alessandro Bartolomucci
Professor and Ancel Keys Biomedical Scholar in Physiology and Metabolism 
University of Minnesota 

5:00 p.m.End of Summit Day One

SUMMIT AGENDA - DAY TWO

9:00 a.m.

Welcome and Opening Remarks – Summit Day Two

Luigi Ferrucci 
Scientific Director 
National Institute on Aging  
National Institutes of Health 


SESSION IV: Methods for Measuring Health
This session proposes to explore different methods for “measuring health” across the lifespan. The identification of independent variables for aging and health other than years-since-birth would represent a major advance for the field of geroscience. Ideally, such measures would serve as quantitative measures of aging (and health) as a dynamic process, and their diagnostic utility would allow people, or other animals, to be grouped by physiological and/or biochemical characteristics. Furthermore, this type of measure should be predictive of changes in response to deleterious or beneficial changes in circumstances (e.g., stressors or therapies).

Session Chair: Lolita Sai Nidadavolu, Johns Hopkins University
Session Facilitator: Michael Duggan, National Institute on Aging

9:15 a.m.

Deficit Accumulation Index

Susan Howlett
Professor, Department of Pharmacology

Division of Geriatric Medicine
Dalhousie University

9:35 a.m.

Geriatric Assessment

Thomas Gill
Professor of Medicine, Epidemiology, and Investigative Medicine

Director, Yale Program on Aging
Yale University

9:55 a.m.

Frailty and Resilience

Jeremy Walston 
Raymond and Anna Lublin Professor of Geriatric Medicine & Gerontology

Johns Hopkins University

10:15 a.m.

Multisystem/Multilevel Biomarker Associations with Human Aging

Eileen Crimmins
AARP Chair in Gerontology

Director, USC/UCLA Center on Biodemography and Population Health
USC Leonard Davis School of Gerontology

10:35 a.m.

The Aging Intervention Pipeline

Gordon Lithgow
Professor and Vice President, Academic Affairs

Buck Institute for Research on Aging

10:55 a.m.

Panel Discussion

Lolita Sai Nidadavolu
Assistant Professor of Medicine

Johns Hopkins University

12:00 p.m. Lunch Break (on your own)


SESSION V: Mathematical Modeling of Aging and Health for Geroscience

A major ongoing challenge for the field of geroscience is how to measure overall health and rates of aging. It is important to know whether conditions in life or interventions slow or accelerate aging, especially in the context of clinical outcomes. Mathematical modeling of aging could inform which parameters to measure to achieve useful information on rates of aging and may indicate which interventions – targeted to specific hallmarks of aging or molecular pathways – may be most effective to change the rate of aging. Modeling aging should illuminate causal connections between environments or therapies and aging outcomes. To date, molecular clocks (e.g., methylation clocks) have been put forward as key metrics for the rate of aging. This session will explore the current state-of-the-science in this area and consider the importance of modeling for basic and translational research.

Session Chair: Chia-Ling Kuo, Senior Biostatistician, UConn Center on Aging
Session Facilitator: Zhaoyuan Gong, National Institute on Aging

   
1:00 p.m.

Modeling Multiple Aspects of Aging

Trey Ideker
Division Chief, Medical Genetics

Professor of Bioengineering and Medicine
UC San Diego School of Medicine

1:20 p.m.

Input Parameters to Model Aging

Dan Ehninger
Group Leader and Professor
German Center for Neurodegenerative Diseases (DZNE)

1:40 p.m.

Selecting and Extracting Features Relevant to Aging

Alex Zhavoronkov
Founder and CEO

Insilico Medicine

2:00 p.m.

Rejuvenation to Model Aging

Irina Conboy
Professor of Bioengineering

UC Berkeley

2:20 p.m.

Panel Discussion

Brian Chen
Chief Science Officer

FOXO Technologies

Alan Cohen
Associate Professor and Chair in Biological Complexity and Healthy Longevity

Department of Environmental Health Sciences
Butler Columbia Aging Center
Mailman School of Public Health
Columbia University

Chia-Ling Kuo
Senior Biostatistician, Connecticut Convergence Institute for Translation in Regenerative Engineering

UConn Center on Aging
University of Connecticut

3:00 p.m. Break


SESSION VI: Biomarkers for Geroscience

The development of biomarkers for aging and geroscience faces several challenging issues, which include wide variation in any health metric when measured against age; variation in organ and tissue function compared between individuals, and variations in life histories that impact health (at any age) in ways that may be adaptive or maladaptive. The underlying biology of aging studied in other animals will share some important common features with humans, but important species- and strain-specific differences need to be addressed. For example, the identification of biomarkers may be influenced by conditions of accelerated aging – notably in human progeroid syndromes and in laboratory animals genetically engineered to accumulate deficits at accelerated rates. Conversely, interventions that yield improved health are expected to be reported in biomarkers of aging. Biomarkers are important research tools for geroscience, but ultimately need to have clinical utility; their complexity should be handled to be on par or close to biomarkers for other clinical conditions encountered by geriatricians.

Session Chair: Jamie Justice, Assistant Professor, Gerontology and Geriatric Medicine, Wake Forest University
Session Facilitator: Dimitrios Tsitsipatis, National Institute on Aging

3:15 p.m.

Fundamental Considerations for Biomarkers of Aging

Stephen Kritchevsky
Professor, Gerontology and Geriatric Medicine

Wake Forest University

3:30 p.m.

Biomarkers from the Dunedin Study

Daniel Belsky
Associate Professor, Epidemiology

Columbia University

3:45 p.m.

Organ-specific Biomarkers of Aging

Albert Higgins-Chen
Assistant Professor, Department of Psychiatry

Yale University

4:00 p.m.

Bridging Biomarkers of Aging from Model Organisms to Humans

Martin Picard
Associate Professor of Behavioral Medicine

Columbia University

4:15 p.m.

Frailty and Epigenetic Biomarkers

Alice Kane
Assistant Professor

Institute for Systems Biology

4:30 p.m.

Panel Discussion       

Nathan Basisty
Investigator and Head of the Translational Geroproteomics Unit

National Institute on Aging
National Institutes of Health

Jamie Justice
Assistant Professor, Gerontology and Geriatric Medicine

Wake Forest University School of Medicine

Lauren Gaydosh
Assistant Professor of Sociology
The University of Texas at Austin

5:15 p.m. End of Summit Day Two

SUMMIT AGENDA - DAY THREE

9:00 a.m.

Welcome and Opening Remarks – Summit Day Three

Ronald A. Kohanski
Director, Division of Aging Biology 

National Institute on Aging 
National Institutes of Health 


SESSION VII: Geroscience as Medicine in the Clinic and Community
The goal of this session is to advance the tenets of geroscience by improving crosstalk among biologists, clinicians, patients and caregivers, as a way to positively impact the care of older adults. Currently, there is not a universally accepted meaning of the concept of ‘geroscience’ by clinicians, which likely adds to underuse and misinterpretation of the term. Accordingly, clinicians and patients have yet to incorporate geroscience as a clinically helpful tool for predicting health outcomes, attempting strategies for prevention, enhancing resilience, and treating disease and/or geriatric syndromes. Speakers will highlight four areas in which geroscience could advance care of older adults, with the goals to facilitate communication among researchers and providers and their patients, and to improve understanding and integration of geroscience in their clinical practice or patient care. 

Session Chair: Debra Whitman, EVP and Chief Public Policy Officer, AARP
Session Facilitator: Vernon Kennedy, National Institute on Aging 

 

9:20 a.m.

Geroscience in Prediction

Heather Whitson
Professor of Medicine
Duke University

9:40 a.m.

Geroscience in Treatment

Robert Pignolo
Professor of Medicine
Mayo Clinic

10:00 a.m.

Geroscience in Management

Daniel Forman
Chair, Section of Geriatric Cardiology
University of Pittsburgh School of Medicine

10:20 a.m.

Creating Geroscience-Savvy Clinicians, Patients, and Caregivers

George Kuchel
Travelers Chair in Geriatrics and Gerontology
Professor of Medicine
Director, UConn Center on Aging
University of Connecticut

10:40 a.m.

Panel Discussion

Iman Al-Naggar
Assistant Professor
University of Connecticut

Daniel Parker
Assistant Professor, Medicine and Neurology

Senior Fellow of the Center for the Study of Aging and Human Development
Duke University

Erwin Tan
Director of Thought Leadership
AARP

11:45 a.m.Lunch Break (on your own)

 

SESSION VIII: Geroscience Clinical Trials
Geroscience clinical trials are based on the geroscience hypothesis – interventions against again affect multiple conditions of aging. To test anti-aging therapeutics, there appear to be at least two routes: (1) Test one therapeutic (or combination) against multiple conditions in a series of trials, or (2) Test for effects against multiple geriatric conditions and diseases but remain agnostic as to which those are. It is important to structure trials to be inclusive and incorporate social determinants of health among the parameters. This session aims to explore the challenges associated with developing and carrying out a geroscience-based clinical trial, and speakers will highlight potential paths forward.

Session Chair: Jennifer Ailshire, USC
Session Facilitator: Daisy Zamora, National Institute on Aging

 

12:45 p.m.

Translational Geroscience Network: Considerations of Parameters and Populations for Geroscience Clinical Trials

James Kirkland
Professor, General Internal Medicine

Geriatrician and Internist
Mayo Clinic

1:00 p.m.

Primary and Secondary Outcomes of a Geroscience Trial

Sara Espinoza
Associate Professor of Medicine

Director, San Antonio Geriatric Research, Education, and Clinical Center
UT Health San Antonio

1:15 p.m.

Geroscience Trial Design for Multimorbidity and Frailty

Ilaria Bellantono
Professor of Musculoskeletal Aging

Department of Oncology and Metabolism                
The University of Sheffield

1:30 p.m.

Geroscience Trial Design for Health Disparities  

Heather Allore
Professor of Medicine (Geriatrics) and of Biostatistics

Leader, Data Management and Statistics Core
Yale University School of Medicine

1:45 p.m.

Panel Discussion

Jennifer Ailshire
Associate Professor of Gerontology and Sociology

Assistant Dean of International Programs and Global Initiatives
USC

2:30 p.m.Break

SESSION IX: Looking Forward: Where Do We Go from Here?
The goal of this session will be to explore what is needed to form productive new collaborations to advance geroscience. Session facilitators will provide brief summaries of each session along with the key takeaways, and their ideas for next steps to move the field forward.
3:00 p.m.

Summaries and Key Takeaways by Session (7 minutes each)

 Session 1 Facilitator

 Session 2 Facilitator

 Session 3 Facilitator

 Session 4 Facilitator

 Session 5 Facilitator

 Session 6 Facilitator

 Session 7 Facilitator

 Session 8 Facilitator

4:00 p.m.

Final Comments and Wrap-Up

NIH Director
National Institutes of Health

4:15 p.m.Summit Adjourns