European consultation synthesis

Biogerontology

Unfortunately, more than three main themes emerged. However, there are some similarities in the key themes between the Partner reports which form a sound basis upon which to commence working towards the Road Map. These can be condensed down to the following:

• Development of an understanding of the basic biology of healthy ageing

• The measurement and development of a scientific understanding of the determinants of healthy ageing at the level of the population

• Translating advances in the basic biological science of ageing into effective interventions to promote healthy ageing.

• Neurodegenerative disease, dementias including Alzheimer’s disease and cognitive decline

• Longitudinal cohort studies

• Multi-morbidity

• Medication during the ageing process, pharmacokinetics and dynamics

• Determination of biological markers of ageing and frailty and genetic disposition of ageing models

• Nutrition, metabolism, strengthening of immunology and immune systems

• Cellular and Micro-RNA at senescence

• Longevity genetics

• Personalised, predictive and preventive geriatric research

• Bioethics research

• Specific research (using IT&C instruments) needed for obtaining and maintaining bio-medical databases

• Ageing genetics and the study of gene-environment interactions in the context of population ageing

• History of biology of ageing

Social and Economic Resources

• Socio-economic inequalities in later life and the inter- and intra-generational dynamics of income inequality over the life course

• Social and civic engagement, advocacy and the participation of older adults in social and public policy.

• Investigations into to the improvements in the ‘quality’ of older adults’ lives through the application of scientifically derived instruments and use of new technologies (e.g. ITC, eHealth, Telecare and Intelligent Ambient Assistance Platforms)

• Socio-political, financial and cultural consequences of an ageing population (e.g. Ageism; the institutional and structural aspects of ageing; changes in the retirement system; employment and retirement; health care systems and networks; institutional responses to the needs of older people and their costs; intergenerational solidarity).

• Ageing and migration.

• Pension and social-security system models and welfare issues, Insurance especially long term care insurance and nursing care insurance.

• Ethics and especially inequality problems.

• Life-course perspectives on ageing and social inequalities in health.

• Social sustainability of care and social integration of very old and frail adults.

• Research regarding the mathematical and informational modelling of ageing and its associated pathologies.

• Family and family caregivers.

• Mobility for older people.

• Psycho-social problems.

Environments of Ageing

There was less general agreement and understanding of what this area of research covered. This may because fewer of the respondents in each of the 11 countries have scientists working in this newer area of work. Hence some of the themes mentioned have their proper place within the answers to the ‘Social and Economic Resources’ question and have been placed there. A good working definition of the area was given within the Swedish report as,

The overarching aim of environmental gerontology is to describe and explain the relationship be­tween the ageing person and his/her physical-social environment...

The main research themes to emerge include:

• The social and economic impact of assistive and other new technologies to the quality of older adults’ lives.

• Work environments, ageing and the quality of life and quality of care. This includes the study of workplace design and the impact of employment upon the current and future quality of life of older employees.

• How to enhance quality of life and quality of care in the variety of environments in which older adults reside through the lens of improved spatial planning/city design and sustainability of design for all ages. Cognisance of the wider framework of global climatic change in this work is imperative.

• Rural ageing as the key environment with raw data disaggregated to allow the scientific analysis of the situation in rural areas to be examined. Longitudinal studies are needed to identify migration cycles and to monitor rural conditions and characteristics.

• Age-based public transport, adequate living structures and age-dependent communication. This includes handicap accessibility, technical adaptations of elevators, doors, etc. and lightening concepts.

Healthy Ageing

Many see the two areas of Biogerontology and Healthy ageing as inextricably linked. The main themes reported within the national reports include:

• The development of scientifically based health promotion strategies. These should include translational health advice; discussion on cognitive health; sexuality and physical expression in older life; falls prevention; healthy eating; exercise and the implications of obesity and sedentary lifestyles on health.

• Interdisciplinary research on all aspects of mental health in old age.

• Development of life-course approaches to healthy ageing.

• Age-associated dysfunctions and diseases and the prevention of those, e.g. arteriosclerosis-prevention, diabetes, hypertension, and dementia problems.

• Definition of ageing as both a biological and social phenomenon and its evolution.

• Prevention of neurodegenerative diseases and the decline in cognitive functions.

• Elaboration of typology and definitions of healthy ageing and well-being in relation to the concept of “active ageing”.

• Prevention of depression and cognitive illnesses.

• Fundamental and applicative bio-medical and social research aimed at the prevention of age related pathologies.

The comments range from a desire to improve both the process of inter- and multi-disciplinary research collaboration and knowledge transfer (e.g. ‘...qualitative development of the health care system’; ‘...translation of research into practice’; ‘Moving from laboratory bench to social and clinical settings’; ‘the ‘mainstreaming’ of the ageing agenda within government’; ‘adoption of a Life course approach’; ‘Ageing as a social and cultural phenomenon’; ‘Work and working life’) through to more philosophical questions (e.g. ‘does ‘old’ have to be negative?’; ‘the relevance of actual healthy aging has to be analyzed’; a ‘cultural construction of old age across history and society’) to the more mainstream research areas already documented above (e.g. ‘whether years added to life are healthy years or years of disease).

Nevertheless, these latter examples are also supplemented by some important suggestions for future scientific enquiry and multidisciplinary collaboration employing a variety of methods They include for example, ‘The ageing of immigrant populations in Europe’; ‘(the) Methodology of measuring, statistical estimates and mathematical models of studying and forecasting of ageing processes and issues’; ‘Ties between body image and identity’; ‘Ageing in developing countries’; ‘Intergenerational issues’ and ‘Abuse, neglect and exploitation (includes mistreatment): human rights violations of older people’. Yet again all these, it could be argued should be included within the key themes already identified in Question 1. All these points aside there is a stated uniformity of purpose and significant support of the view that European multidisciplinary collaboration is essential but is dependent upon adequate funding.

As this summary has already made clear, there is almost universal support for European collaboration across all the key themes. No single priority emerged, simply because as one national report suggested ‘Many of the answers to this question were included in the priority themes’.

The collective view from this Partnership seems to focus around the importance of a) methodological refinement and b) the power of the comparative cross-national study for advancing both scientific understanding and policy development as the key priorities for European collaboration.

Only one national report suggested that it was inappropriate at this stage of the process to ask this question, claiming that it should wait until there is clear agreement about the research priorities first. Nevertheless, a majority stressed the necessity of European level coordination for the success of the Road Map.