The future of ageing

The aims of research and innovation in this field – and how they are prioritised

Processes for setting priorities

Research funding comes from many different sources – public funders such as research councils and governments; charities and foundations; and the commercial sector. Each of these funders will have different remits and drivers (including in some cases commercial considerations) that affect the areas of research and innovation that they choose to fund. For example the remit of many charitable medical research funders is limited to one or more specific diseases.

However, there are a number of ethical challenges in making decisions about what to prioritise that are common to all funders. These include, for example, questions of who is involved in setting priorities (whose voice is seen to have value); and the values and assumptions that underpin those priorities, whether explicitly or implicitly.

One example of a national-level organisation taking an explicitly inclusive approach to identifying priority areas for research and innovation in ageing is AgeWell Canada. In 2018, AgeWell Canada published eight challenge areas for the future of technology and ageing research in Canada, based on an extensive public consultation process across over 1,000 stakeholders – including input from many older Canadians and carers, as well as its own network of members and partner organisations. As a publicly-funded body, AgeWell also seeks to influence the focus of private sector innovation – for example through supporting start-ups working in these priority areas of research.

Question 3

What priority-setting processes in ageing research / innovation are you familiar with? How do you think they should change, if it all?

Issues you might wish to touch on in your response include (but are not limited to):

• who should be involved in setting priorities for research/innovation in this field;
• what might be the advantages / disadvantages of greater involvement by older people and/or by broader intergenerational public input;
• who, in your experience, is unheard in decisions about priorities;
• what you regard as good practice in designing procedures for priority setting – for example what criteria such procedures should meet;
• whether issues of equity should be built into prioritisation decisions – and if so, how;
• examples of what you regard as existing good practice in this field, including any examples of initiatives that have supported a wide diversity of involvement.

Overarching research aims

In the UK, the ‘Ageing Society Grand Challenge’ (one of four themes in the Government’s 2017 Industrial strategy) aimed to “harness the power of innovation to help meet the needs of an ageing society” with a “mission [to] ensure that people can enjoy at least five extra healthy, independent years of life by 2035, while narrowing the gap between the experience of the richest and poorest.” It is suggested that “success in this mission will help people remain independent for longer, continue to participate through work and within their communities, and stay connected to others to counter the epidemic of loneliness”. These indicators of success overlap to a degree with the eight ‘challenge areas’ identified by AgeWell Canada in 2018: supportive homes and communities; health care and health service delivery; autonomy and independence; cognitive health and dementia; mobility and transportation; healthy lifestyles and wellness; staying connected; and financial wellness and employment.

The House of Lords Science and Technology Committee 2021 report, Ageing: science, technology and healthy living, supports the mission of the Ageing Society Grand Challenge but expresses some doubt as to whether it will be achievable on the basis of current approaches. The Committee cites concerns expressed by researchers about the adequacy of the funding available to basic ageing research, compared with that dedicated to technology and data-driven approaches. It further highlights the wider challenges for the funding of basic ageing research in the UK, given that so much biomedical research funding is disease-specific. This picture was contrasted with the situation in the US, with funding for ageing research more readily available both through public means (through the National Institute of Aging) and through much better access to private capital to support translation.

The important role of private finance in supporting the translation of breakthroughs in basic research in geroscience to clinical trials also highlights how priorities in research are likely to be influenced by commercial considerations. Some leading funders of geroscience research place a strong emphasis on the scope of research to increase lifespan as well as healthspan. This contrasts with approaches that focus on improving the life expectancy of the most disadvantaged (‘levelling up’ within existing understanding of human life-span), and/or on improving healthspan across a population.

Question 4

Which ageing challenges should medical and technological developments prioritise – and why?

Issues you might wish to touch on in your response include (but are not limited to):

• whether the aims and outcomes set out in the UK’s Healthy Ageing Challenge are the right ones to target (and why/why not?);
• whether there are other aspects of ‘ageing well’ that are not covered by these aims / outcomes, where you believe biomedical science or technological innovation has an important part to play (and why?)
• to what extent considerable life extension is possible or desirable (and why / why not?)
• what relative priority should be given to different ways of tackling these challenges – for example through developments in assistive technologies vs investments in basic and translational science?