There a wide variety of biological theories of ageing from macro-level concepts such as evolutionary trade-offs and reliability theory to system-based theories of neuroendocrine and immune function and molecular and cellular theories such as the role of a biological clock. Animal studies can elegantly demonstrate the role of specific pathways such as insulin signalling but their relevance to human ageing remains controversial. Fundamentally, the loss of homeostatic control across a wide range of systems may suggest that no single pathway is necessary or sufficient for ageing. The new findings from GWAS studies of chronic diseases may also highlight commonality of pathways across phenotypes.
Within the context of the Halcyon programme we will present preliminary results around our work on telomeres, the hypothalamic pituitary axis and genetic variants on potential ageing traits. We will discuss future outputs as well the challenges of exploring these ideas within an epidemiological context.
In conclusion, while new biological understanding may enhance our ability to develop new targeted interventions, it is unlikely given the multi-faceted nature of ageing that any “magic bullet” will exist. Biological markers may be useful as additional predictors of frailty and as surrogate intermediary outcomes. Public health interventions are likely to be most effective if they focus across the life course in both maximising biological and psychosocial reserve as well as reducing adverse exposures that accelerate age-related decline in function.
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