Living Long and Well: Prospects for a Personalized Approach to the Medicine of Ageing.

Abstract

Research into ageing and its underlying molecular basis enables us to develop and implement targeted interventions to ameliorate or cure its consequences. However, the efficacy of interventions often differs widely between individuals, suggesting that populations should be stratified or even individualized. Large-scale cohort studies in humans, similar systematic 56 studies in model organisms, and detailed investigations into the biology of ageing can provide individual validated biomarkers and mechanisms, leading to recommendations for targeted interventions. Human cohort studies are already ongoing, and can be supplemented by in silico simulations. Systematic studies in animal models are made possible by the use of inbred strains, or genetic reference populations of mice. Combining both, the comprehensive picture of the various determinants of ageing and healthspan can be studied in detail, and an appreciation of the relevance of results from model organisms to humans emerges. The interactions between genotype and environment, particularly the psychosocial environment, are poorly studied in both humans and model organisms, presenting serious challenges to any approach to a personalized medicine of ageing. To increase success of preventive interventions, we argue that there is a pressing need for an individualized evaluation of interventions such as physical exercise, nutrition, nutraceuticals and calorie restriction mimetics as well as psychosocial and environmental factors, separately and in combination. The expected extension of healthspan enables us to refocus healthcare spending on individual prevention starting in late adulthood, and on the brief period of morbidity at very old age.This is the peer-reviewed but unedited manuscript version of the following article: Fuellen G, Schofield PN, Flatt T, Schulz RJ, Boege F, Kraft K, Rimbach G, Ibrahim S, Tietz A, Schmidt C, Köhling R, Simm S. Living long and well: prospects for a personalized approach to the medicine of ageing. Gerontology. The final, published version is available at https://www.karger.com/Article/FullText/442746