1 00:00:05,640 --> 00:00:08,080 WELCOME TO THE FOURTH 2 00:00:08,080 --> 00:00:10,680 GEROSCIENCE SCIENCE SUMMIT. 3 00:00:10,680 --> 00:00:15,280 AND IN THE INTEREST OF TIME AND 4 00:00:15,280 --> 00:00:22,440 SIMPLICITY, PLEASE WELCOME Dr. 5 00:00:22,440 --> 00:00:23,160 HODES. 6 00:00:23,160 --> 00:00:24,000 DIRECTOR OF THE NATIONAL 7 00:00:24,000 --> 00:00:27,360 INSTITUTE ON AGING. 8 00:00:27,360 --> 00:00:28,680 >>THANK YOU, IT'S A GREAT 9 00:00:28,680 --> 00:00:29,880 PLEASURE TO BE HERE. 10 00:00:29,880 --> 00:00:31,800 I THINK MY FIRST TIME IN THIS 11 00:00:31,800 --> 00:00:32,600 AUDITORIUM SINCE THE PANDEMIC 12 00:00:32,600 --> 00:00:34,240 AND IT'S A GREAT OCCASION TO 13 00:00:34,240 --> 00:00:35,360 HAVE EVERYBODY BACK. 14 00:00:35,360 --> 00:00:36,400 SO MANY IN-PERSON AS WELL AS 15 00:00:36,400 --> 00:00:39,720 THOSE LISTEN IN REMOTELY. 16 00:00:39,720 --> 00:00:41,000 THE FOURTH GEROSCIENCE SUMMIT IS 17 00:00:41,000 --> 00:00:44,320 A PRODUCT IN SOME SENSE, OF THE 18 00:00:44,320 --> 00:00:46,080 FORMATION OF THE GEROSCIENCE 19 00:00:46,080 --> 00:00:46,560 SCIENCE INTEREST GROUP. 20 00:00:46,560 --> 00:00:49,080 BACK IN 2012 NOW SO TIME HAS 21 00:00:49,080 --> 00:00:51,680 FLOWN. 22 00:00:51,680 --> 00:00:56,000 IT BEGAN WITHIN NIA, EVOLVED 23 00:00:56,000 --> 00:01:00,120 WITH DISCUSSION AMONG A NUMBER 24 00:01:00,120 --> 00:01:02,360 OF INSTITUTE DIRECTORS WHO SAW 25 00:01:02,360 --> 00:01:10,400 IT ACROSS NIH SO IT'S GROWN TO 26 00:01:10,400 --> 00:01:11,120 AND VERY BROAD. 27 00:01:11,120 --> 00:01:15,200 IN THE PAST, THE EARLY 28 00:01:15,200 --> 00:01:15,840 GEROSCIENCE SUMMITS INTRODUCED 29 00:01:15,840 --> 00:01:17,760 RESEARCH AND BROADER PUBLIC. 30 00:01:17,760 --> 00:01:18,480 THAT'S WHAT GEROSCIENCE WAS ALL 31 00:01:18,480 --> 00:01:20,960 ABOUT. 32 00:01:20,960 --> 00:01:21,880 WE LOOKED AT THE INTRODUCTION OF 33 00:01:21,880 --> 00:01:22,920 GEROSCIENCE AND MAJOR DISEASE 34 00:01:22,920 --> 00:01:23,720 AND THEIR TREATMENT AND 35 00:01:23,720 --> 00:01:24,920 INTRODUCED THE CONCEPT TO LARGER 36 00:01:24,920 --> 00:01:26,800 GROUPS OF ADVOCATES AND SPECIAL 37 00:01:26,800 --> 00:01:29,920 ORGANIZATIONS WHO WERE LESS 38 00:01:29,920 --> 00:01:30,680 FAMILIAR. 39 00:01:30,680 --> 00:01:31,800 TODAY, YOU WILL SEE AN OUT 40 00:01:31,800 --> 00:01:33,720 STANDING SYMPOSIUM PLANNED. 41 00:01:33,720 --> 00:01:35,360 SPEAKERS WHICH INVOLVE THIS 42 00:01:35,360 --> 00:01:37,200 MORNING DIRECTORS OF TWO OTHER 43 00:01:37,200 --> 00:01:39,120 INSTITUTES AT NIH REFLECTING 44 00:01:39,120 --> 00:01:42,440 THAT LEADERSHIP. 45 00:01:42,440 --> 00:01:44,440 MULTIPLE REPRESENTATIVE SIGN 46 00:01:44,440 --> 00:01:52,720 SCIENTIST AND NOTABLY,INCLUDINGE 47 00:01:52,720 --> 00:01:56,880 ASSURANCE THE RESEARCH CONDUCTED 48 00:01:56,880 --> 00:01:57,480 IN GEROSCIENCE IS APP PUBLIC 49 00:01:57,480 --> 00:01:59,720 ABLE TO A BROAD AND DIVERSE 50 00:01:59,720 --> 00:02:00,200 COMMUNITY. 51 00:02:00,200 --> 00:02:02,440 ALSO OVER THE YEARS WITH THE 52 00:02:02,440 --> 00:02:04,720 EMERGING COMPUTATIONAL 53 00:02:04,720 --> 00:02:06,760 TECHNOLOGY AND ASSURANCE WE 54 00:02:06,760 --> 00:02:08,160 MAXIMIZE THE USE OF THESE 55 00:02:08,160 --> 00:02:10,600 CURRENT AND CUTTING EDGE 56 00:02:10,600 --> 00:02:11,600 TECHNOLOGIES IN GEROSCIENCE AND 57 00:02:11,600 --> 00:02:14,240 CARRY OUT WITH AN EYE TOWARDS 58 00:02:14,240 --> 00:02:15,320 APPLICATION TO IMPROVING THE 59 00:02:15,320 --> 00:02:17,600 QUALITY OF LIFE IN OLDER 60 00:02:17,600 --> 00:02:18,120 INDIVIDUALS. 61 00:02:18,120 --> 00:02:20,240 I SHARE THE ANTICIPATION OF A 62 00:02:20,240 --> 00:02:21,160 FANTASTIC THREE DAYS OF SCIENCE 63 00:02:21,160 --> 00:02:28,920 AND TURN IT BACK TO RON KOHAN 64 00:02:28,920 --> 00:02:29,200 KOHANSKI. 65 00:02:29,200 --> 00:02:33,760 >>THANK YOU, RICHARD. 66 00:02:33,760 --> 00:02:36,000 >>I'M THE DIRECTOR AT THE 67 00:02:36,000 --> 00:02:43,120 NATIONAL INSTITUTE ON AGING. 68 00:02:43,120 --> 00:02:48,400 MY PREDECESSOR HAS NOTED WAS IN 69 00:02:48,400 --> 00:02:49,880 DEVELOPING IDEAS ABOUT 70 00:02:49,880 --> 00:03:00,080 GEROSCIENCE. 71 00:03:05,360 --> 00:03:07,360 ROSALIE AND ASSOCIATES AND MY 72 00:03:07,360 --> 00:03:08,320 THANKS GO TO THEM. 73 00:03:08,320 --> 00:03:11,960 I BELIEVE THAT THIS SUMMIT WOULD 74 00:03:11,960 --> 00:03:13,640 NOT HAVE HAPPEN WITHOUT THEIR 75 00:03:13,640 --> 00:03:23,960 DAILY ENGAGEMENT. 76 00:03:25,880 --> 00:03:29,360 SO PETER HORNSBY, SPEAKING OF 77 00:03:29,360 --> 00:03:31,640 EVERYTHING IN THE UNIVERSE, SAID 78 00:03:31,640 --> 00:03:33,280 THAT THINGS AGE EVENTUALLY 79 00:03:33,280 --> 00:03:35,520 DETERIORATE AND BECOME NON 80 00:03:35,520 --> 00:03:35,880 FUNCTIONAL. 81 00:03:35,880 --> 00:03:38,120 AND THERE ARE MANY ASPECTS OF 82 00:03:38,120 --> 00:03:40,200 AGING THAT ARE NOT DETERIORATION 83 00:03:40,200 --> 00:03:41,960 BUT THE PARTS THAT WE ARE 84 00:03:41,960 --> 00:03:43,640 INTERESTED IN SUPPORTING ARE 85 00:03:43,640 --> 00:03:45,600 THOSE THAT ARE MAINTAIN ABLE AND 86 00:03:45,600 --> 00:03:47,560 THE PARTS THAT WE'RE INTERESTED 87 00:03:47,560 --> 00:03:55,360 IN FINDING WAYS TO AMELIORATE 88 00:03:55,360 --> 00:03:57,680 THE THOSE ARE DESCRIBED IN THE 89 00:03:57,680 --> 00:03:59,040 OUTLOOK ON AGING. 90 00:03:59,040 --> 00:04:02,040 BUT THEN, WE COME ALONG WITH THE 91 00:04:02,040 --> 00:04:08,360 GEROSCIENCE SIGH PHYPOTHESIS INT 92 00:04:08,360 --> 00:04:09,880 PHILLIPPE ORGANIZED AND WE 93 00:04:09,880 --> 00:04:10,960 EDITED. 94 00:04:10,960 --> 00:04:11,560 THE GEROSCIENCE HYPOTHESIS. 95 00:04:11,560 --> 00:04:13,520 ANY INTERCEPTIONS THAT READDRESS 96 00:04:13,520 --> 00:04:15,440 IT THE AGING PROCESS WILL 97 00:04:15,440 --> 00:04:18,080 SIMULTANEOUSLY DELAY THE ON SET 98 00:04:18,080 --> 00:04:20,040 OF MULTIPLE DISEASES. 99 00:04:20,040 --> 00:04:21,440 THIS IS ROUGHLY SPEAKING 10 100 00:04:21,440 --> 00:04:24,000 YEARS AGO WHEN THE EMPHASIS WAS 101 00:04:24,000 --> 00:04:27,480 ON DISEASES AND HE WOULD 102 00:04:27,480 --> 00:04:29,120 OBSERVE, FREQUENTLY, THAT WE'RE 103 00:04:29,120 --> 00:04:31,400 AT NATIONAL INSTITUTES OF HEALTH 104 00:04:31,400 --> 00:04:35,000 AND WE SEEM TO BE FOCUSED VERY 105 00:04:35,000 --> 00:04:36,400 SPECIFICALLY ON CLUSTERS OF 106 00:04:36,400 --> 00:04:38,960 DISEASES AND SPECIFIC DISEASES 107 00:04:38,960 --> 00:04:43,040 AND IT'S TRUE AND IT'S 108 00:04:43,040 --> 00:04:47,480 JUSTIFIABLE BECAUSE IT'S ONE WAY 109 00:04:47,480 --> 00:04:49,560 OF LOOKING AT HEALTH. 110 00:04:49,560 --> 00:04:51,200 IT'S SUGGESTED BY THE DISEASES 111 00:04:51,200 --> 00:04:52,960 OR DYSFUNCTIONS THAT ARE CARRY. 112 00:04:52,960 --> 00:04:55,360 WE THINK WE SHOULD EXPAND 113 00:04:55,360 --> 00:04:57,640 GEROSCIENCE A LITTLE BIT TO 114 00:04:57,640 --> 00:05:01,400 THINK ABOUT NOT JUST DISEASES, 115 00:05:01,400 --> 00:05:03,080 AGING AND MULTIPLE CONDITIONS 116 00:05:03,080 --> 00:05:03,800 RELATED TO AGE. 117 00:05:03,800 --> 00:05:05,360 EYE TRY TO EXPLAIN A LITTLE BIT 118 00:05:05,360 --> 00:05:07,240 OF SOME OF THE BACKGROUND OF 119 00:05:07,240 --> 00:05:08,000 WHERE WE WERE. 120 00:05:08,000 --> 00:05:19,000 BACK IN 2008, THIS 2008 THIS PS 121 00:05:19,920 --> 00:05:21,880 PUBLISHED AND THIS WAS LOOKING 122 00:05:21,880 --> 00:05:23,440 FOR CARDIOVASCULAR RISK 123 00:05:23,440 --> 00:05:23,960 PROFILES. 124 00:05:23,960 --> 00:05:34,520 THE WAY THIS IS LAID OUT, IS YOU 125 00:05:35,720 --> 00:05:37,640 GET A SCORE, HIGHER THE SCORE 126 00:05:37,640 --> 00:05:39,160 THE GREATER OF RISK AND THE 127 00:05:39,160 --> 00:05:42,680 DEVELOPING A CARDIOVASCULAR 128 00:05:42,680 --> 00:05:43,160 ILLNESS. 129 00:05:43,160 --> 00:05:46,600 AND THERE ARE SOME WELL-KNOWN 130 00:05:46,600 --> 00:05:50,080 MARKERS THAT ARE MOLECULAR OR 131 00:05:50,080 --> 00:05:52,720 CLINICALLY DIAGNOSTIC OR 132 00:05:52,720 --> 00:05:55,440 BEHAVIORAL OR FUNCTIONS OF 133 00:05:55,440 --> 00:06:00,760 METABOLISM, FOR EXAMPLE. 134 00:06:00,760 --> 00:06:04,000 SO, HIGH DENSITY CHOLESTEROL IS 135 00:06:04,000 --> 00:06:07,120 GOOD AND YOU CAN HAVE EFFECT BY 136 00:06:07,120 --> 00:06:09,000 THE NEGATIVE NUMBER. 137 00:06:09,000 --> 00:06:10,400 LOW BLOOD PRESSURE IS A GOOD 138 00:06:10,400 --> 00:06:12,440 IDEA, NOT TOO LOW OF COURSE. 139 00:06:12,440 --> 00:06:15,240 HIGH BLOOD PRESSURE IS 140 00:06:15,240 --> 00:06:16,760 INCREASINGLY A RISK WITH THE 141 00:06:16,760 --> 00:06:17,960 INCREASING NUMBERS. 142 00:06:17,960 --> 00:06:20,280 TOTAL CHOLESTEROL GOES TOO HIGH 143 00:06:20,280 --> 00:06:24,480 BIGGER RISK AND SMOKER, RISK FOR 144 00:06:24,480 --> 00:06:26,560 EVERYTHING DELETERIOUS AND 145 00:06:26,560 --> 00:06:27,960 DIABETES, NOT A GOOD CONDITION 146 00:06:27,960 --> 00:06:30,200 TO HAVE BUT CAN BE TREATED. 147 00:06:30,200 --> 00:06:34,080 YOU CANNOT TREAT THE PASSAGE OF 148 00:06:34,080 --> 00:06:34,560 TIME. 149 00:06:34,560 --> 00:06:37,440 IF YOU ARE OLDER, YOUR RISK IS 150 00:06:37,440 --> 00:06:39,200 MUCH GREATER THAN IF YOU ARE 151 00:06:39,200 --> 00:06:43,520 YOUNGER AND YOUR AGE IS GREATER 152 00:06:43,520 --> 00:06:45,280 RISK THAN ANY OTHER FACTOR 153 00:06:45,280 --> 00:06:47,360 INDIVIDUALLY AND YOU CAN GET OLD 154 00:06:47,360 --> 00:06:50,040 ENOUGH, COMBINED. 155 00:06:50,040 --> 00:06:52,920 SO, THE QUESTION IS, IF IT'S 156 00:06:52,920 --> 00:06:58,400 AGE, WHAT CAN YOU DO? 157 00:06:58,400 --> 00:06:59,240 NOT MUCH. 158 00:06:59,240 --> 00:07:00,760 CHECK YOUR WATCH FREQUENTLY. 159 00:07:00,760 --> 00:07:05,040 BUT IF YOU THINK OF IT AS THE 160 00:07:05,040 --> 00:07:06,200 PROCESS'S THAT OCCUR OVER THE 161 00:07:06,200 --> 00:07:11,360 COURSE OF A LIFETIME, THAT WOULD 162 00:07:11,360 --> 00:07:13,600 BE AGING AND IT COULD BE 163 00:07:13,600 --> 00:07:15,000 ADDRESSED FROM A BIOLOGICAL 164 00:07:15,000 --> 00:07:16,880 POINT OF VIEW AS WELL AS HAVE 165 00:07:16,880 --> 00:07:18,600 CLINICAL IMPLICATIONS FOR 166 00:07:18,600 --> 00:07:21,280 IMPROVING HEALTH AT OLDER AGES. 167 00:07:21,280 --> 00:07:26,480 IN EFFECT, IT MIGHT BE 75 OR 65 168 00:07:26,480 --> 00:07:28,720 BUT MAYBE THESE NUMBERS COULD BE 169 00:07:28,720 --> 00:07:31,000 REDUCED IN TERMS OF WHAT IS 170 00:07:31,000 --> 00:07:33,200 THEIR RELATIVE CONTRIBUTION TO 171 00:07:33,200 --> 00:07:36,120 YOUR RISK FOR CARDIOVASCULAR 172 00:07:36,120 --> 00:07:36,720 DISEASE. 173 00:07:36,720 --> 00:07:37,960 SO WE THOUGHT WE WOULD TALK 174 00:07:37,960 --> 00:07:42,760 ABOUT AGING AND IN THE CONTEXT 175 00:07:42,760 --> 00:07:44,440 OF GEROSCIENCE, HOW WOULD THAT 176 00:07:44,440 --> 00:07:46,200 PLAY OUT? 177 00:07:46,200 --> 00:07:53,720 SO, YOU COULD THINK THAT IF YOU 178 00:07:53,720 --> 00:07:55,240 TAKE THE GEROSCIENCE HYPOTHESIS 179 00:07:55,240 --> 00:07:59,480 TO A MATHEMATICAL VIEW, YOU 180 00:07:59,480 --> 00:08:01,840 WOULD THINK THAT YOU WOULD HAVE 181 00:08:01,840 --> 00:08:03,360 DIFFERENTIAL IMPACTS ON AGE 182 00:08:03,360 --> 00:08:05,280 RELATED DISEASES BECAUSE THE AGE 183 00:08:05,280 --> 00:08:08,320 RELATED DISEASES HAVE DIFFERENT 184 00:08:08,320 --> 00:08:09,040 PATTERNS. 185 00:08:09,040 --> 00:08:17,800 SO, HYPERTENSION HAS INCIDENTS 186 00:08:17,800 --> 00:08:20,240 THAT SEEMS TO -- IF YOU WERE TO 187 00:08:20,240 --> 00:08:21,600 EXTRAPOLATE THIS LINE DOWN IT 188 00:08:21,600 --> 00:08:25,000 MIGHT INTERSECT AT AROUND 45 OR 189 00:08:25,000 --> 00:08:27,400 SO BUT IF YOU LOOK AT CON GUESS 190 00:08:27,400 --> 00:08:31,160 TIVE HEART FAILURE, THE 191 00:08:31,160 --> 00:08:34,080 INCIDENTS MIGHT EXTRAPOLATE DOWN 192 00:08:34,080 --> 00:08:37,480 TO 70 OR 60 BUT THE RISKS SEEM 193 00:08:37,480 --> 00:08:39,320 TO BE DIFFERENT IN SOME CASES 194 00:08:39,320 --> 00:08:48,040 BETWEEN MEN AND WOMEN. 195 00:08:48,040 --> 00:08:49,560 IT'S NOT CLEAR IF YOU LOOKED THE 196 00:08:49,560 --> 00:08:51,840 A SINGLE ORGAN SYSTEM OR 197 00:08:51,840 --> 00:08:53,080 PHYSIOLOGICAL SYSTEM DOES AGING 198 00:08:53,080 --> 00:08:54,800 HAVE THE SAME IMPACT? 199 00:08:54,800 --> 00:08:56,320 EVEN WITHIN A SINGLE ORGAN 200 00:08:56,320 --> 00:08:57,000 SYSTEM. 201 00:08:57,000 --> 00:09:00,120 WITH THE BRAIN, IN TERMS OF 202 00:09:00,120 --> 00:09:05,160 LET'S SAY THESE TWO CONDITIONS, 203 00:09:05,160 --> 00:09:08,040 DEMENTIA AND SCHIZOPHRENIA HAVE 204 00:09:08,040 --> 00:09:09,680 A HIGHER INCIDENTS -- THIS IS 205 00:09:09,680 --> 00:09:12,520 INCIDENTS VERSUS AGE. 206 00:09:12,520 --> 00:09:13,720 SO THERE'S A HIGHER INCIDENTS 207 00:09:13,720 --> 00:09:15,320 BUT IT'S THE ONSET SEEMS TO BE 208 00:09:15,320 --> 00:09:17,320 MUCH LATER IN LIFE. 209 00:09:17,320 --> 00:09:18,760 SIMILARLY FOR STROKE BUT IF YOU 210 00:09:18,760 --> 00:09:20,800 LOOK AT DEPRESSION, WHICH 211 00:09:20,800 --> 00:09:22,720 DOESN'T SEEM TO HAVE A BIG AGE 212 00:09:22,720 --> 00:09:27,640 RELATED FACTOR TO IT, AT LEAST 213 00:09:27,640 --> 00:09:29,280 AS FAR AS WE CAN SEE FROM THIS 214 00:09:29,280 --> 00:09:29,640 INCIDENTS PLOT. 215 00:09:29,640 --> 00:09:32,360 THIS IS A SINGLE STUDY OF 216 00:09:32,360 --> 00:09:34,800 126,000 PEOPLE IN ONE COUNTY IN 217 00:09:34,800 --> 00:09:36,440 MINNESOTA SO IT MAY NOT BE 218 00:09:36,440 --> 00:09:37,480 APPLICABLE ALL THE WAY ACROSS 219 00:09:37,480 --> 00:09:40,480 BUT IT DOES ILLUSTRATE THAT EVEN 220 00:09:40,480 --> 00:09:42,800 WITHIN A SINGLE POPULATION 221 00:09:42,800 --> 00:09:45,280 STUDY, YOU WILL FIND MULTIPLE 222 00:09:45,280 --> 00:09:46,840 CHARACTERISTICS IN TERMS OF HOW 223 00:09:46,840 --> 00:09:49,240 THESE AGE RELATED DISEASES PLAY 224 00:09:49,240 --> 00:09:51,320 OUT ACROSS AGE. 225 00:09:51,320 --> 00:09:55,400 AND THEN THEY'RE NOT ALL 226 00:09:55,400 --> 00:09:57,600 MONATONIC IN THE SENSE THAT 227 00:09:57,600 --> 00:10:00,120 DIABETES, WHICH YOU CAN THINK OF 228 00:10:00,120 --> 00:10:01,400 AS METABOLIC CONDITIONS OR 229 00:10:01,400 --> 00:10:03,600 CONDITIONS OF METABOLISM, THEY 230 00:10:03,600 --> 00:10:04,640 SHOW A DIFFERENT PATTERN AND 231 00:10:04,640 --> 00:10:06,720 SINCE IT'S THE SAME POPULATION, 232 00:10:06,720 --> 00:10:08,480 YOU ARE PROBABLY NOT LOOKING AT 233 00:10:08,480 --> 00:10:11,320 DIFFERENCES DUE TO SURVIVAL BIAS 234 00:10:11,320 --> 00:10:13,680 AND THEN IF YOU LOOK AT A SINGLE 235 00:10:13,680 --> 00:10:15,080 SYSTEM SUCH AS BONE, MAYBE IT'S 236 00:10:15,080 --> 00:10:23,480 NOT REALLY A SINGLE SYSTEM. 237 00:10:23,480 --> 00:10:25,840 OSTEOPOROSIS EFFECT A DIFFERENT 238 00:10:25,840 --> 00:10:26,800 PART OF THE POINT FROM ARTHRITIS 239 00:10:26,800 --> 00:10:36,560 BONE -- THE PHYSIOLOGY OFWHAT IT 240 00:10:36,560 --> 00:10:40,040 LEADS TO THESE INCREASES WITH 241 00:10:40,040 --> 00:10:42,040 AGE ARE POSSIBLY INFORMATIVE BUT 242 00:10:42,040 --> 00:10:42,920 THEY HAVE TO BE DEALT WITH 243 00:10:42,920 --> 00:10:46,040 BECAUSE IT'S A QUESTION OF 244 00:10:46,040 --> 00:10:47,800 HETEROGENEITY IN PHYSIOLOGICAL 245 00:10:47,800 --> 00:10:48,400 SYSTEMS. 246 00:10:48,400 --> 00:10:49,600 SO, IT LEADS YOU TO THE 247 00:10:49,600 --> 00:10:50,880 QUESTION, IF APPROXIMATE YOU 248 00:10:50,880 --> 00:10:52,640 WANTED TO THINK ABOUT AGING AND 249 00:10:52,640 --> 00:10:53,840 HOW IF YOU HAD SOME TREATMENT 250 00:10:53,840 --> 00:10:55,600 THAT WOULD SLOW THE RATE OF 251 00:10:55,600 --> 00:10:56,920 AGING, HOW WOULD THAT PLAY OUT 252 00:10:56,920 --> 00:10:58,440 IN THE INCIDENTS OF DISEASE SO 253 00:10:58,440 --> 00:11:01,640 THE HYPOTHESIS STATES THAT THERE 254 00:11:01,640 --> 00:11:04,760 WOULD BE LATER ONSET AND LESS 255 00:11:04,760 --> 00:11:05,400 SEVERITY. 256 00:11:05,400 --> 00:11:07,000 SO, YOU CAN THEN LOOK FOR THE 257 00:11:07,000 --> 00:11:08,400 INCIDENTS OF DISEASE IN THE 258 00:11:08,400 --> 00:11:11,400 PRESENCE OF AN INTERVENTION THAT 259 00:11:11,400 --> 00:11:12,640 YOU HAVE GOOD REASON TO THINK 260 00:11:12,640 --> 00:11:16,160 WILL SLOW THE RATE OF AGING. 261 00:11:16,160 --> 00:11:18,040 FOR ANY DISEASE THERE'S AN 262 00:11:18,040 --> 00:11:19,680 INTERACTION BETWEEN THE GENES 263 00:11:19,680 --> 00:11:20,680 AND THE ENVIRONMENT AND THE 264 00:11:20,680 --> 00:11:22,320 QUESTION IS, WHAT CAN YOU 265 00:11:22,320 --> 00:11:29,760 EXTRACT ABOUT AGING OF INCIDENTS 266 00:11:29,760 --> 00:11:35,920 VERSUS AGE? 267 00:11:35,920 --> 00:11:36,960 SO, HOW WOULD YOU INTERPRET THIS 268 00:11:36,960 --> 00:11:39,200 BEFORE YOU EXTRACT BIOMARKERS OF 269 00:11:39,200 --> 00:11:39,920 AGING. 270 00:11:39,920 --> 00:11:41,760 IF THIS IS ALL AGING AND WE KNOW 271 00:11:41,760 --> 00:11:44,000 IT ISN'T BECAUSE OF THESE 272 00:11:44,000 --> 00:11:45,200 INTERACTIONS LET'S JUST SUPPOSE 273 00:11:45,200 --> 00:11:47,080 IT WAS ALL AGING OR IT'S 274 00:11:47,080 --> 00:11:48,240 DOMINATED BY AGING SO THIS IS 275 00:11:48,240 --> 00:11:56,640 THE BIGGEST CIRCLE, UNLIKELY, 276 00:11:56,640 --> 00:11:58,160 BUT AS A THOUGHT EXPERIMENT IS 277 00:11:58,160 --> 00:11:59,720 THIS FASTER AGING BECAUSE THE 278 00:11:59,720 --> 00:12:01,880 AGE RELATED CONDITION OCCURS 279 00:12:01,880 --> 00:12:03,160 EARLIER AND IS IT SLOWER AGING 280 00:12:03,160 --> 00:12:06,280 BECAUSE THE AGE OF ONSET OR THE 281 00:12:06,280 --> 00:12:09,880 INCIDENTS IS LATER? 282 00:12:09,880 --> 00:12:11,920 OR IS THIS REALLY LITTLE 283 00:12:11,920 --> 00:12:16,240 EFFECTED BY AGING AND IT IS MORE 284 00:12:16,240 --> 00:12:17,200 BY GENES AND ENVIRONMENT HOW DO 285 00:12:17,200 --> 00:12:21,640 YOU KNOW IT'S NOT THE CASE 286 00:12:21,640 --> 00:12:23,160 THERE? 287 00:12:23,160 --> 00:12:25,920 IT'S A PROBLEM TO COME TO TERMS 288 00:12:25,920 --> 00:12:27,480 DIS TINGEING IF YOU ARE LOOKING 289 00:12:27,480 --> 00:12:28,960 AT INCIDENTS OF AND AGING 290 00:12:28,960 --> 00:12:30,720 FACTORS AND WHAT ARE THE NON 291 00:12:30,720 --> 00:12:33,800 AGING FACTORS AND WITH YOUR 292 00:12:33,800 --> 00:12:35,080 LOCAL EPIDEMIOLOGIST THEY SHOULD 293 00:12:35,080 --> 00:12:38,640 BE ABLE TO HELP YOU PARSE THAT. 294 00:12:38,640 --> 00:12:40,320 LET'S JUST TAKE ANOTHER EXAMPLE. 295 00:12:40,320 --> 00:12:46,280 IF YOU LOOK AT THE INCIDENTS 296 00:12:46,280 --> 00:12:47,600 PULMONARY FIBRO SIS OVER TIME 297 00:12:47,600 --> 00:12:49,400 YOU HAVE A LOT OF COMPLEXITY IN 298 00:12:49,400 --> 00:12:51,000 THE RELATIVELY SIMPLE QUESTION 299 00:12:51,000 --> 00:12:53,680 WHAT IS THE CONTRIBUTION OF AGE 300 00:12:53,680 --> 00:13:01,560 TO FIBROTIC DISEASE IN THE LUNG 301 00:13:01,560 --> 00:13:03,800 SO FROM THIS STUDY THERE'S A 302 00:13:03,800 --> 00:13:04,520 DRIFT UPWARDS IN THE INCIDENTS 303 00:13:04,520 --> 00:13:06,400 OF THE DISEASE SO OVER THAT 304 00:13:06,400 --> 00:13:08,680 TIMEFRAME IT'S NOT GENETICS 305 00:13:08,680 --> 00:13:09,960 UNLESS IT'S PEOPLE MOVING INTO 306 00:13:09,960 --> 00:13:11,920 THE POPULATION WHO ARE OF A 307 00:13:11,920 --> 00:13:13,120 DIFFERENT GENETIC BACKGROUND. 308 00:13:13,120 --> 00:13:15,360 BUT IT'S NOT THE CASE, BECAUSE 309 00:13:15,360 --> 00:13:20,640 IT'S NOT ISOLATED GROUP AND OR A 310 00:13:20,640 --> 00:13:22,040 RELATIVELY STABLE POPULATION BUT 311 00:13:22,040 --> 00:13:23,600 SOMETIMES IT GOES UP AS IN THESE 312 00:13:23,600 --> 00:13:28,040 TWO STUDIES BUT SOMETIMES IT 313 00:13:28,040 --> 00:13:28,760 GOES DOWN. 314 00:13:28,760 --> 00:13:30,560 WHY THAT WOULD BE IS NOT QUITE 315 00:13:30,560 --> 00:13:31,680 CLEAR. 316 00:13:31,680 --> 00:13:33,120 IT COULD BE POPULATION 317 00:13:33,120 --> 00:13:34,680 COMPETITION, ENVIRONMENTAL 318 00:13:34,680 --> 00:13:37,120 FACTORS ARE LIKELY CULPRIT BUT 319 00:13:37,120 --> 00:13:40,560 MAYBE IT REFLECTS A HIGHER RATE 320 00:13:40,560 --> 00:13:42,280 OF AGING BECAUSE THINGS MIGHT BE 321 00:13:42,280 --> 00:13:43,920 MORE STRESSFUL OVER THAT DECADE 322 00:13:43,920 --> 00:13:46,960 OR THE DIAGNOSTIC PARAMETERS MAY 323 00:13:46,960 --> 00:13:48,120 HAVE CHANGED. 324 00:13:48,120 --> 00:13:52,920 AND THAT IN A SENSE OF -- ALL OF 325 00:13:52,920 --> 00:13:54,800 THESE ARE ILLUSTRATED HERE WERE 326 00:13:54,800 --> 00:13:56,680 IN A STUDY OF A POPULATION IN 327 00:13:56,680 --> 00:13:58,800 NEW MEXICO BACK IN 1994, THIS 328 00:13:58,800 --> 00:14:00,240 WAS THE AGE DISTRIBUTION AND YOU 329 00:14:00,240 --> 00:14:06,840 CAN SEE, IPF, DEFINITELY MORE 330 00:14:06,840 --> 00:14:08,480 FREQUENTLY FOUND AT OLDER AGES 331 00:14:08,480 --> 00:14:12,040 THAT'S TRUE ALL THE WAY ACROSS 332 00:14:12,040 --> 00:14:15,200 AND IT TENDS TO BE MORE 333 00:14:15,200 --> 00:14:16,000 PROMINENT AMONG MALES THAN 334 00:14:16,000 --> 00:14:18,760 FEMALES AND THAT IS NEW MEXICO, 335 00:14:18,760 --> 00:14:21,160 NORWAY, U.S. HEALTH RECORDS, AND 336 00:14:21,160 --> 00:14:22,960 THAT POPULATION IN MINNESOTA 337 00:14:22,960 --> 00:14:25,600 THTHAT I MENTIONED BEFORE. 338 00:14:25,600 --> 00:14:27,720 THIS IS IMPORTANT IN THE SENSE 339 00:14:27,720 --> 00:14:30,120 THAT IF YOU WANT TO LOOK AT 340 00:14:30,120 --> 00:14:32,360 INCIDENTS, YOU NEED TO CONSIDER 341 00:14:32,360 --> 00:14:34,480 WHETHER THE DISEASES RARE WHICH 342 00:14:34,480 --> 00:14:35,640 WOULD SUGGEST THAT YOU HAVE TO 343 00:14:35,640 --> 00:14:38,200 WORK WITH A SPECIFIC POPULATION 344 00:14:38,200 --> 00:14:40,480 BUT RARE DISEASES OFTEN ARE 345 00:14:40,480 --> 00:14:45,320 DOMINATED BY GENETIC PRE DOES 346 00:14:45,320 --> 00:14:47,320 POSITION. 347 00:14:47,320 --> 00:14:49,920 SO HOW MUCH IS AGING? 348 00:14:49,920 --> 00:14:51,920 YOU MIGHT WANTS TO LOOK AT A 349 00:14:51,920 --> 00:14:52,960 POPULATION WHERE THE INCIDENTS 350 00:14:52,960 --> 00:14:54,280 IS HIGHER FOR NO OTHER REASON 351 00:14:54,280 --> 00:14:55,800 THAN THE BIOLOGY GOING ON WITH 352 00:14:55,800 --> 00:14:56,440 THE PRESENT. 353 00:14:56,440 --> 00:14:57,840 BUT THAT WOULD ALSO BE THE SAME 354 00:14:57,840 --> 00:14:59,800 FOR THE GENOTYPE BUT AGAIN, IF 355 00:14:59,800 --> 00:15:01,440 IT'S JUST GENOTYPE, IT'S NOT 356 00:15:01,440 --> 00:15:03,800 CLEAR WHY IT WOULD OCCUR LATER 357 00:15:03,800 --> 00:15:06,000 WITH AGE SO YOUR TWO OTHER 358 00:15:06,000 --> 00:15:10,760 PLACES TO LOOK ARE GOING TO BE 359 00:15:10,760 --> 00:15:21,280 THE ENVIRONMENT AND EVERYBODY 360 00:15:27,480 --> 00:15:28,480 HAS DIFFERENT SIDES HANDS, YOU 361 00:15:28,480 --> 00:15:31,240 DON'T WANT TO MANAGE GRIP 362 00:15:31,240 --> 00:15:32,240 STRENGTH AND A HAND. 363 00:15:32,240 --> 00:15:34,200 THEIR HANDS ARE GOING TO BE BE 364 00:15:34,200 --> 00:15:38,600 DIFFERENT SIZES BUT IF YOU HAVE 365 00:15:38,600 --> 00:15:39,560 YOUR EQUIPMENT GEARED TO THE 366 00:15:39,560 --> 00:15:41,440 SIZE OF THE PERSON THAT YOU ARE 367 00:15:41,440 --> 00:15:44,200 EXAMINING AND IT'S CALIBRATED, 368 00:15:44,200 --> 00:15:46,280 YOU CAN GET VERY ACCURATE 369 00:15:46,280 --> 00:15:47,000 MEASUREMENTS OF GRIP STRENGTH 370 00:15:47,000 --> 00:15:48,920 AND IT'S ADD GUY PREDICT OR 371 00:15:48,920 --> 00:15:51,280 ALONG WITH WALKING SPEED, FOR 372 00:15:51,280 --> 00:15:52,880 EXAMPLE. 373 00:15:52,880 --> 00:15:55,320 OF CONTINUED HEALTH SO THE 374 00:15:55,320 --> 00:15:59,360 DECLINE IN GRIP STRENGTH. 375 00:15:59,360 --> 00:16:03,480 THERE'S A RISE IN MUZZ MUSCLE AD 376 00:16:03,480 --> 00:16:07,800 BONE AND THERE'S PLATEAU AND THE 377 00:16:07,800 --> 00:16:08,920 DECLINE. 378 00:16:08,920 --> 00:16:10,600 WHAT IS ILLUSTRATED HERE IS THE 379 00:16:10,600 --> 00:16:13,240 SET ITER OWE GENEITY OF THE 380 00:16:13,240 --> 00:16:17,040 EXAMINING VARIABLE WHICH IS 381 00:16:17,040 --> 00:16:17,560 STRENGTH. 382 00:16:17,560 --> 00:16:19,440 BUT THAT CAN BE HANDLED NOW. 383 00:16:19,440 --> 00:16:21,600 THE TOOLS TO HANDLE 384 00:16:21,600 --> 00:16:23,640 HETEROGENEITY IS AVAILABLE BUT 385 00:16:23,640 --> 00:16:25,640 IT UNDERSCORES THE PRECISION 386 00:16:25,640 --> 00:16:26,800 MEDICINE FOR MEDICINE GEARED TO 387 00:16:26,800 --> 00:16:28,920 THE INDIVIDUAL AS WELL AS AT THE 388 00:16:28,920 --> 00:16:31,800 POPULATION LEVEL BOTH NEED TO BE 389 00:16:31,800 --> 00:16:35,280 ADDRESSED TO UNDERSTAND HOW 390 00:16:35,280 --> 00:16:35,960 AGING TAKES PLACE AND WHAT WE 391 00:16:35,960 --> 00:16:37,760 CAN DO ABOUT IT AND WHAT METRICS 392 00:16:37,760 --> 00:16:48,200 WE MIGHT BRING TO BEAR. 393 00:16:48,560 --> 00:16:49,240 WALKING SPEED. 394 00:16:49,240 --> 00:16:50,040 THE RECORD HERE. 395 00:16:50,040 --> 00:16:52,280 MOST OF US ARE BELOW THAT AND WE 396 00:16:52,280 --> 00:16:57,880 COULDN'T SUSTAIN IT FOR 24 MILES 397 00:16:57,880 --> 00:17:08,200 OR 50 KILOMETRES. 398 00:17:19,000 --> 00:17:24,680 IF YOU LOOK AT DISEASES THERE'S 399 00:17:24,680 --> 00:17:28,120 INCIDENTS IN CANCERS, ALL KINDS, 400 00:17:28,120 --> 00:17:31,280 AND IT'S NOT MONATONIC IT'S 401 00:17:31,280 --> 00:17:33,480 EXPONENTIAL UP TO THIS POINT AND 402 00:17:33,480 --> 00:17:39,960 THEN IT SEEMS TO LEVEL OFF AND 403 00:17:39,960 --> 00:17:41,440 SO YOU HAVE TO TAKE INTO ACCOUNT 404 00:17:41,440 --> 00:17:43,920 WHEN YOU THINK ABOUT HOW TO 405 00:17:43,920 --> 00:17:46,000 MEASURE AGING OF THE 406 00:17:46,000 --> 00:17:48,440 CHARACTERISTICS OF HOW THINGS 407 00:17:48,440 --> 00:17:49,840 CHANGE WITH AGE. 408 00:17:49,840 --> 00:17:52,160 AND THEY BE MONATONIC OR NOT, 409 00:17:52,160 --> 00:17:53,960 THEY MAY BE LINEAR OR NOT. 410 00:17:53,960 --> 00:17:59,640 GENERALLY SPEAKING, FOR LOSSES 411 00:17:59,640 --> 00:18:00,880 OF FUNCTION THEY'RE EXPONENTIAL 412 00:18:00,880 --> 00:18:02,880 OR INCIDENTS OF DISEASE. 413 00:18:02,880 --> 00:18:04,280 SO WE HAVE THE QUESTION OF 414 00:18:04,280 --> 00:18:04,880 AGING. 415 00:18:04,880 --> 00:18:06,640 THERE'S ARE TWO THAT IS TO SAY 416 00:18:06,640 --> 00:18:07,560 IN GENERAL HOW DO YOU MEASURE 417 00:18:07,560 --> 00:18:10,400 THE RATE OF AGING? 418 00:18:10,400 --> 00:18:12,760 SO, THESE ARE TWO THAT CAME OUT 419 00:18:12,760 --> 00:18:15,000 IN 2013 ALTHOUGH STEVE HORVATH 420 00:18:15,000 --> 00:18:17,040 DID PUBLISH IN 2011 WHAT SHOULD 421 00:18:17,040 --> 00:18:19,360 BE CONSIDERED THE FIRST AGING 422 00:18:19,360 --> 00:18:19,960 PLOT. 423 00:18:19,960 --> 00:18:25,360 BUT THE GENERAL IDEA HERE IS YOU 424 00:18:25,360 --> 00:18:30,440 HAVE FROM AT THE TIME, 600 425 00:18:30,440 --> 00:18:31,440 SOMETHING THOUSAND DNA 426 00:18:31,440 --> 00:18:33,600 METHYLATION MARKS. 427 00:18:33,600 --> 00:18:35,800 THAT'S METHAL CYTISINICLINE THAT 428 00:18:35,800 --> 00:18:38,760 COULD BE MEASURED AND YOU FEED 429 00:18:38,760 --> 00:18:42,120 THAT INTO A COMPUTER SO YOU HAVE 430 00:18:42,120 --> 00:18:44,000 POPULATION OF DIFFERENT AGES AND 431 00:18:44,000 --> 00:18:45,840 METH LAYING IN BLOOD CELLS AND 432 00:18:45,840 --> 00:18:50,400 YOU ASK THE CUESER COMPUTER TO T 433 00:18:50,400 --> 00:18:54,080 IF THAT LARGE MOUNTAIN OF 434 00:18:54,080 --> 00:19:04,280 INFORMATION. 435 00:19:09,800 --> 00:19:11,040 SO THE INTERPRETATION APPLIES TO 436 00:19:11,040 --> 00:19:11,640 ANY OF THESE. 437 00:19:11,640 --> 00:19:13,200 IF YOU ARE ABOVE THE LINE, YOUR 438 00:19:13,200 --> 00:19:14,920 RATE OF AGING MAY BE FASTER. 439 00:19:14,920 --> 00:19:16,480 IF YOU ARE BELOW THE LINE, YOUR 440 00:19:16,480 --> 00:19:18,360 RATE OF AGING WOULD BE SLOWER 441 00:19:18,360 --> 00:19:20,040 AND IF YOU ARE TRYING TO DEVELOP 442 00:19:20,040 --> 00:19:21,720 AN INTERVENTION THAT SLOWS THE 443 00:19:21,720 --> 00:19:25,800 RATE OF AGING, YOU MIGHT USE 444 00:19:25,800 --> 00:19:27,280 SUCH DNA METHYLATION CLOCK IN 445 00:19:27,280 --> 00:19:34,960 THE ORIGINAL PAPER, THEY HAD 446 00:19:34,960 --> 00:19:41,200 T -- YOU COULDFIND IT IN THE BOA 447 00:19:41,200 --> 00:19:41,480 CRIME SCENE. 448 00:19:41,480 --> 00:19:42,880 IT'S THE BEST APPLICATION BUT 449 00:19:42,880 --> 00:19:44,520 IT'S CHANGED SINCE THEN AND 450 00:19:44,520 --> 00:19:45,960 THESE HAVE BECOME A BENCHMARK 451 00:19:45,960 --> 00:19:48,800 WAY OF ANALYZING AGING ALONG 452 00:19:48,800 --> 00:19:53,280 WITH SOME OTHER BIOCHEMICAL 453 00:19:53,280 --> 00:19:55,320 CHANGES SUCH AS TILA MERE 454 00:19:55,320 --> 00:19:56,840 SHORTENING OR THE HALLMARKS OF 455 00:19:56,840 --> 00:19:57,160 AGING. 456 00:19:57,160 --> 00:19:58,840 THIS IS A HIGHLY ACCESSIBLE AND 457 00:19:58,840 --> 00:20:01,800 IT'S ACCESSIBLE IN LABORATORY 458 00:20:01,800 --> 00:20:03,360 ORGANISMS, WILD POPULATIONS, 459 00:20:03,360 --> 00:20:06,080 DOMESTIC ANIMALS AND US. 460 00:20:06,080 --> 00:20:08,280 AND IT'S -- IT HAS A LOT OF 461 00:20:08,280 --> 00:20:09,720 UTILITY BECAUSE BLOOD DRAWS ARE 462 00:20:09,720 --> 00:20:10,920 QUITE FAMILIAR TO EVERYONE WHO 463 00:20:10,920 --> 00:20:13,240 GOES TO THE DOCTOR. 464 00:20:13,240 --> 00:20:15,080 SO, THERE ARE SOME QUESTIONS 465 00:20:15,080 --> 00:20:16,600 THAT GO ALONG WITH THIS. 466 00:20:16,600 --> 00:20:18,880 IS THERE A SINGLE RATE OF AGING? 467 00:20:18,880 --> 00:20:23,440 SO IF YOU LOOKED AT THIS WAS A 468 00:20:23,440 --> 00:20:24,240 BROAD POPULATION. 469 00:20:24,240 --> 00:20:26,240 IF YOU LOOKED AT THE COMPONENTS 470 00:20:26,240 --> 00:20:28,800 OF THE POPULATION YOU MIGHT SEE 471 00:20:28,800 --> 00:20:30,480 ETHNIC GROUP OR SOCIOECONOMIC 472 00:20:30,480 --> 00:20:33,440 STATUS OR ANY OTHER PARAMETERS 473 00:20:33,440 --> 00:20:35,240 THAT YOU WOULD CARE TO PUT IN 474 00:20:35,240 --> 00:20:36,560 YOU MIGHT SEE DIFFERENT RATES OF 475 00:20:36,560 --> 00:20:37,160 AGING. 476 00:20:37,160 --> 00:20:38,680 THAT'S THE LINE LOOKS DIFFERENT. 477 00:20:38,680 --> 00:20:39,920 SO IF THIS IS YOUR REFERENCE 478 00:20:39,920 --> 00:20:42,440 LINE OF THE WHOLE POPULATION, 479 00:20:42,440 --> 00:20:43,840 SUB PARTS WILL ACTUALLY APPEAR 480 00:20:43,840 --> 00:20:45,280 TO BE AGING SLOWER AND SOME 481 00:20:45,280 --> 00:20:47,360 MIGHT APPEAR TO BE AGING MORE 482 00:20:47,360 --> 00:20:47,960 QUICKLY. 483 00:20:47,960 --> 00:20:52,400 AND IT'S NOT OBVIOUS WHICH WAY 484 00:20:52,400 --> 00:21:02,880 THE PREDICTIONS SOME PEOPLE 485 00:21:08,400 --> 00:21:08,880 MAINTAIN GREAT ROBUSTNESS IN 486 00:21:08,880 --> 00:21:10,760 PHYSICAL ABILITY TO PERFORM BUT 487 00:21:10,760 --> 00:21:12,680 MAY HAVE COGNITIVE IMPAIRMENTS 488 00:21:12,680 --> 00:21:15,400 OR VICE VERSA AND SO IT'S NOT 489 00:21:15,400 --> 00:21:16,840 CLEAR THAT THERE'S A SINGLE RATE 490 00:21:16,840 --> 00:21:25,640 OF AGING. 491 00:21:25,640 --> 00:21:28,520 THIS DELTA MIGHT INDICATE FASTER 492 00:21:28,520 --> 00:21:30,440 AGING BUT DOES IT HAVE THE SAME 493 00:21:30,440 --> 00:21:32,640 MEANING BIOLOGICALLY IF THAT 494 00:21:32,640 --> 00:21:34,760 DELTA SAY 10 YEARS AT AGE 40 OR 495 00:21:34,760 --> 00:21:37,800 10 YEARS AT AGE 60 OR 10 YEARS 496 00:21:37,800 --> 00:21:38,280 AT AGE 80. 497 00:21:38,280 --> 00:21:40,000 IF YOU ARE AN OPTIMIST, WHAT 498 00:21:40,000 --> 00:21:42,680 DOES IT MEAN IF A PERSON IS 100. 499 00:21:42,680 --> 00:21:45,160 SO, IT'S NOT CLEAR WHAT THE 500 00:21:45,160 --> 00:21:46,400 DELTA AGE WOULD MEAN WHETHER 501 00:21:46,400 --> 00:21:47,880 IT'S ACCELERATION OR 502 00:21:47,880 --> 00:21:58,280 DECELERATION OF AGING. 503 00:22:04,600 --> 00:22:06,360 THESE BLOOD CELLS ARE RESPONDING 504 00:22:06,360 --> 00:22:08,280 BY CHANGING THEIR DNA 505 00:22:08,280 --> 00:22:10,760 METHYLATION SO THAT'S ONE WAY OF 506 00:22:10,760 --> 00:22:16,600 VIEWING THE MEANING OF CHANGES 507 00:22:16,600 --> 00:22:17,600 IN DNA METHYLATION IN CELLS THAT 508 00:22:17,600 --> 00:22:19,200 ARE NOT ORGAN SYSTEMS ON THE 509 00:22:19,200 --> 00:22:24,840 OTHER HAND, AND TALKING TO 510 00:22:24,840 --> 00:22:26,280 ISABEL PUREMAN SHE POINTED OUT 511 00:22:26,280 --> 00:22:27,640 IT COULD WORK THE OTHER WAY 512 00:22:27,640 --> 00:22:28,080 AROUND. 513 00:22:28,080 --> 00:22:30,040 THAT IS THE BLOOD CELLS ARE 514 00:22:30,040 --> 00:22:31,560 AGING AND BLOOD INTERACTS WITH 515 00:22:31,560 --> 00:22:33,520 ALL THE ORGAN SYSTEMS SO THE 516 00:22:33,520 --> 00:22:35,080 BLOOD CELLS ARE CONVEYING TO THE 517 00:22:35,080 --> 00:22:41,320 ORGAN SYSTEMS, INFORMATION ABOUT 518 00:22:41,320 --> 00:22:44,160 AGING, PROMOTING AIMING, OR 519 00:22:44,160 --> 00:22:45,720 DECELERATING AGING AND THAT'S 520 00:22:45,720 --> 00:22:47,400 THE OTHER WAY OF LOOK AGENT IT 521 00:22:47,400 --> 00:22:51,840 AND BOTH POSSIBILITIES ARE 522 00:22:51,840 --> 00:23:02,320 REALISTIC AND SOME FACTORS AND 523 00:23:13,960 --> 00:23:16,160 OLD BLOOD TRANSFER TO YOUNG 524 00:23:16,160 --> 00:23:19,960 ORGANISM AND VICE VERSA YOU CAN 525 00:23:19,960 --> 00:23:21,520 DECELERATE AGING DEPENDING ON 526 00:23:21,520 --> 00:23:22,480 THE PHENOTYPE THAT YOU ARE 527 00:23:22,480 --> 00:23:22,880 MEASURING. 528 00:23:22,880 --> 00:23:25,440 WE WOULD LIKE TO KNOW WHAT ALL 529 00:23:25,440 --> 00:23:29,400 OF THESE DNA METHYLATION MARKS 530 00:23:29,400 --> 00:23:30,840 MEAN. 531 00:23:30,840 --> 00:23:35,320 IN TERMS ARE THEY VALID SUPPO 532 00:23:35,320 --> 00:23:44,800 SUPPORTERS OF WHERE ARE THE 533 00:23:44,800 --> 00:23:45,560 BOUNDARY CONDITIONS BECAUSE 534 00:23:45,560 --> 00:23:47,160 THESE ARE STRAIGHT LINES THAT GO 535 00:23:47,160 --> 00:23:52,680 ON FOREVER AND MAYBE THEY WERE 536 00:23:52,680 --> 00:23:55,000 NOT AS EXTREME AND THAT REMAINS 537 00:23:55,000 --> 00:23:59,680 TO BE SCENE SEEN SO IT'S A QUICK 538 00:23:59,680 --> 00:24:04,440 OVERVIEW OF WHAT THE SUMMIT WILL 539 00:24:04,440 --> 00:24:05,760 BE BASED ON THESE QUESTIONS HOW 540 00:24:05,760 --> 00:24:07,440 WE THINK ABOUT AGING AND HOW WE 541 00:24:07,440 --> 00:24:10,840 THINK ABOUT HEALTH AND WE'LL 542 00:24:10,840 --> 00:24:12,800 START WITH A SET OF PRESENTATION 543 00:24:12,800 --> 00:24:16,720 ONLYPREN ONHEALTH DISPARITIES. 544 00:24:16,720 --> 00:24:17,360 IF GEROSCIENCE APPLIES WE HAVE 545 00:24:17,360 --> 00:24:19,320 TO BEGIN WITH THE VIEW POINT 546 00:24:19,320 --> 00:24:22,520 THAT GEROSCIENCE WILL APPLY TO 547 00:24:22,520 --> 00:24:25,240 EVERYONE. 548 00:24:25,240 --> 00:24:26,680 SO WE'LL ASK ABOUT HEALTH 549 00:24:26,680 --> 00:24:27,920 DISPARITIES AND HOW IT PLAYS OUT 550 00:24:27,920 --> 00:24:30,960 AND IT WILL LEAD INTO WHAT 551 00:24:30,960 --> 00:24:32,160 POPULATIONS ARE ENGAGE IN THE 552 00:24:32,160 --> 00:24:39,480 STUDY OF AGING. 553 00:24:39,480 --> 00:24:41,360 THERE ARE MULTI MORBID TEASE 554 00:24:41,360 --> 00:24:44,680 THAT ARE OLDER AGES AND MULTI 555 00:24:44,680 --> 00:24:46,640 MORBIDITY AND THE POLY PHARMACY 556 00:24:46,640 --> 00:24:50,520 INCREASES AND THOSE ARE AND 557 00:24:50,520 --> 00:24:51,760 THOSE ARE PRESSING PROBLEMS. 558 00:24:51,760 --> 00:25:00,840 NOT ONLY THE -- IF ONE CAN 559 00:25:00,840 --> 00:25:02,480 ANTICIPATE WHAT IS NEXT FOR YOUR 560 00:25:02,480 --> 00:25:03,400 PATIENT, THAT WOULD CERTAINLY 561 00:25:03,400 --> 00:25:07,240 HELP THE PATIENT. 562 00:25:07,240 --> 00:25:14,360 IT'S GUIDANCE ON THINGS WE COULD 563 00:25:14,360 --> 00:25:24,880 DO WHAT METRICS DO YOU USE TO 564 00:25:25,560 --> 00:25:27,520 EXAMINE AGING AND HOW DO YOU USE 565 00:25:27,520 --> 00:25:30,640 THOSE TO MODEL AGING BECAUSE 566 00:25:30,640 --> 00:25:32,800 MODELING OF BIOLOGICAL 567 00:25:32,800 --> 00:25:36,520 PHENOMENON HAS BEEN FACILITATED 568 00:25:36,520 --> 00:25:42,840 BY COMPUTER ADVANCES IN COMPUTEN 569 00:25:42,840 --> 00:25:44,680 ABILITIES BUT HOW YOU MODEL IT 570 00:25:44,680 --> 00:25:47,680 IS REALLY NOT ALWAYS CLEAR AND 571 00:25:47,680 --> 00:25:49,640 TALKS I'VE HEARD AT VARIOUS 572 00:25:49,640 --> 00:25:51,400 MEETINGS, THERE'S BEEN A GOOD 573 00:25:51,400 --> 00:26:00,360 INTERCHANGE BETWEEN THE -- WE'RE 574 00:26:00,360 --> 00:26:01,600 CONVERGING NOW ON BETTER WAYS TO 575 00:26:01,600 --> 00:26:02,480 UNDERSTAND AGING. 576 00:26:02,480 --> 00:26:03,960 IT TELLS YOU WHAT CAN YOU FIND 577 00:26:03,960 --> 00:26:08,200 AND WHAT YOU SHOULD STILL BE 578 00:26:08,200 --> 00:26:14,000 LOOKING FOR. 579 00:26:14,000 --> 00:26:17,600 AND CAN YOU ASSEMBLE TOGETHER TO 580 00:26:17,600 --> 00:26:22,280 GIVE YOU A BETTER PICTURE IN 581 00:26:22,280 --> 00:26:23,640 ABOUT A PERSON'S HEALTH AS 582 00:26:23,640 --> 00:26:27,320 THEY'RE AGING AND THERE'S THE 583 00:26:27,320 --> 00:26:32,240 PRACTICE OF GERIATRICS AND HOW 584 00:26:32,240 --> 00:26:33,400 IT'S INFORMED BY GEROSCIENCE AND 585 00:26:33,400 --> 00:26:34,280 UNDERLYING THE PRACTICE AND 586 00:26:34,280 --> 00:26:35,240 PULLING A LOT OF THIS TOGETHER 587 00:26:35,240 --> 00:26:36,520 WOULD BE THE CLINICAL TRIALS 588 00:26:36,520 --> 00:26:39,400 THAT CAN BE DONE IN ORDER TO 589 00:26:39,400 --> 00:26:40,600 DETERMINE WHETHER AN 590 00:26:40,600 --> 00:26:43,400 INTERCEPTIONS IS EFFECTIVE IN 591 00:26:43,400 --> 00:26:44,960 PRODUCING GREATER HEALTH AT 592 00:26:44,960 --> 00:26:45,680 OLDER AGES. 593 00:26:45,680 --> 00:26:50,800 AND THAT'S REALLY THE KEY. 594 00:26:50,800 --> 00:26:54,200 IS TO PRODUCE -- TO AID THE 595 00:26:54,200 --> 00:27:02,000 POPULATION TO AGE BETTER. 596 00:27:02,000 --> 00:27:02,320 THANK YOU. 597 00:27:02,320 --> 00:27:04,120 WELCOME TO THE FOURTH 598 00:27:04,120 --> 00:27:04,760 GEROSCIENCE SCIENCE SUMMIT AND 599 00:27:04,760 --> 00:27:08,120 I'LL TURN IT OVER. 600 00:27:08,120 --> 00:27:18,320 [APPLAUSE] 601 00:27:23,720 --> 00:27:24,400 >>ALL RIGHT. 602 00:27:24,400 --> 00:27:31,080 GOOD MORNING, EVERYONE. 603 00:27:31,080 --> 00:27:33,120 I CAN ACT UP, I'M AT HOME, 604 00:27:33,120 --> 00:27:33,360 RIGHT. 605 00:27:33,360 --> 00:27:36,000 GOOD MORNING, EVERYONE. 606 00:27:36,000 --> 00:27:38,520 SO, YOU KNOW, I'M SO EXCITED 607 00:27:38,520 --> 00:27:40,400 ABOUT THE OPPORTUNITY TO SERVE 608 00:27:40,400 --> 00:27:44,960 AS YOUR CHAIR AT A PANELIST ON 609 00:27:44,960 --> 00:27:48,280 THE FIRST SESSION. 610 00:27:48,280 --> 00:27:50,560 I WANTED TO SAY THANK YOU TO THE 611 00:27:50,560 --> 00:27:54,680 ORGANIZERS AND JUST JOIN ME IN 612 00:27:54,680 --> 00:27:57,360 GIVING Dr. KOHANSKI ANNA 613 00:27:57,360 --> 00:28:00,720 PLOWS. 614 00:28:00,720 --> 00:28:02,120 A ROUND OF 615 00:28:02,120 --> 00:28:02,400 APPLAUSE. 616 00:28:02,400 --> 00:28:02,680 [APPLAUSE] 617 00:28:02,680 --> 00:28:04,360 >>I WANT TO SHARE HOW WE'RE 618 00:28:04,360 --> 00:28:08,520 ORGANIZED IN THIS NEXT -- UP 619 00:28:08,520 --> 00:28:09,160 UNTIL NOON. 620 00:28:09,160 --> 00:28:10,880 WHAT WE'RE GOING TO DO HERE IS 621 00:28:10,880 --> 00:28:13,120 WE'RE GOING TO HEAR FOUR 622 00:28:13,120 --> 00:28:14,480 PRESENTATIONS AND WE'LL HEAR 623 00:28:14,480 --> 00:28:17,200 FROM TWO PANELISTS AND WHAT 624 00:28:17,200 --> 00:28:18,840 WE'VE DECIDED TO DO IS WE'RE 625 00:28:18,840 --> 00:28:21,400 GOING TO HEAR ALL OF THE 626 00:28:21,400 --> 00:28:23,480 PRESENTATIONS, THEN THE TWO 627 00:28:23,480 --> 00:28:24,920 PANELISTS AND THEN WE'LL OPEN IT 628 00:28:24,920 --> 00:28:26,440 UP FOR QUESTION AND ANSWER. 629 00:28:26,440 --> 00:28:28,680 SO PLEASE HOLD ON TO YOUR 630 00:28:28,680 --> 00:28:29,720 QUESTIONS BECAUSE WE WANT TO 631 00:28:29,720 --> 00:28:31,520 HAVE A GROUP -- WE FEEL IT WOULD 632 00:28:31,520 --> 00:28:33,400 BE BETTER TO HAVE A MORE ROBUST 633 00:28:33,400 --> 00:28:34,760 AND GROUP DISCUSSION IN THE END 634 00:28:34,760 --> 00:28:36,680 AFTER YOU HEAR ALL OF THE TALKS. 635 00:28:36,680 --> 00:28:39,880 SO OUR GOAL HERE TODAY IS TO 636 00:28:39,880 --> 00:28:44,400 THINK ABOUT, TO BE ABLE TO THINK 637 00:28:44,400 --> 00:28:45,360 ABOUT HOW WAYS GEROSCIENCE AND 638 00:28:45,360 --> 00:28:47,240 THE BIOLOGY OF AGING CAN PROVIDE 639 00:28:47,240 --> 00:28:53,520 IMPORTANT AND NEW INSIGHTS INTO 640 00:28:53,520 --> 00:28:55,080 UNDERSTANDING THE DISPARITIES OF 641 00:28:55,080 --> 00:28:57,200 AGING OF OLDER ADULTS IN LATER 642 00:28:57,200 --> 00:28:58,840 LIFE AS WELL AS DIVERSE 643 00:28:58,840 --> 00:28:59,640 POPULATIONS. 644 00:28:59,640 --> 00:29:02,160 AS YOU MAY KNOW, ONE OF THE KEY 645 00:29:02,160 --> 00:29:04,160 THINGS AS IT RELATES TO HEALTH 646 00:29:04,160 --> 00:29:05,680 DISPARITY WE'VE COME TO LEARN 647 00:29:05,680 --> 00:29:07,360 OVER THE LAST TWO DECADES, 648 00:29:07,360 --> 00:29:09,080 HEALTH DISPARITIES IS A RESULT 649 00:29:09,080 --> 00:29:11,120 OF THE SYNERGISTIC EFFECTS OF A 650 00:29:11,120 --> 00:29:13,560 NUMBER OF DIFFERENT FACTORS 651 00:29:13,560 --> 00:29:14,000 OPERATING. 652 00:29:14,000 --> 00:29:16,760 WE HAVE CYCLE SOCIAL FACTORS, 653 00:29:16,760 --> 00:29:18,640 CULTURAL FACTORS, BIOLOGICAL 654 00:29:18,640 --> 00:29:23,160 FACTORS AND UP WIT ONE OF THE TN 655 00:29:23,160 --> 00:29:23,960 IMPROVE UPON AND WE HAVE AN 656 00:29:23,960 --> 00:29:25,040 OPPORTUNITY IN THIS SPACE THE 657 00:29:25,040 --> 00:29:28,280 NEXT THREE DAYS IS THINK HOW TO 658 00:29:28,280 --> 00:29:29,160 BETTER SITUATE AND INTERNET 659 00:29:29,160 --> 00:29:32,560 OPINTEGRATETHIS. 660 00:29:32,560 --> 00:29:34,440 WE HAVE SUCCESS IN OTHER FACTORS 661 00:29:34,440 --> 00:29:36,720 BUT THINKING ABOUT HOW TO 662 00:29:36,720 --> 00:29:38,320 INGRATE IN BIOLOGY AND A LIFE 663 00:29:38,320 --> 00:29:39,880 COURSE PERSPECTIVE IS IMPORTANT. 664 00:29:39,880 --> 00:29:46,680 I WANT TO INTRODUCE ALL OF OUR 665 00:29:46,680 --> 00:29:49,360 SPEAKERS AND THEN HAVE THEM COME 666 00:29:49,360 --> 00:29:53,160 UP AND WE'LL ENGAGE IN FRUITFUL 667 00:29:53,160 --> 00:29:54,520 DISCUSSION. 668 00:29:54,520 --> 00:30:05,640 OUR FIRST SPEAKER IS Dr. FIRST . 669 00:30:06,720 --> 00:30:07,120 PEREZ-STABLE. 670 00:30:07,120 --> 00:30:09,040 HE IS RECOGNIZED AS A LEADER IN 671 00:30:09,040 --> 00:30:10,200 LATINO HEALTHCARE AND 672 00:30:10,200 --> 00:30:12,480 DISPARITIES AND HE SPENT PRIOR 673 00:30:12,480 --> 00:30:16,880 TO COME TO NIH HE SPENT 32 YEARS 674 00:30:16,880 --> 00:30:18,640 LEADING RESEARCH ON TOBACCO 675 00:30:18,640 --> 00:30:19,920 CONTROL AND IN LATIN AMERICAN 676 00:30:19,920 --> 00:30:23,120 AND THE UNITED STATES AND 677 00:30:23,120 --> 00:30:24,320 FOLLOWING Dr. PEREZ-STABLE WE 678 00:30:24,320 --> 00:30:26,160 WILL HEAR FROM Dr. SHANNON 679 00:30:26,160 --> 00:30:28,240 ZENK WHO IS THE DIRECTOR OF THE 680 00:30:28,240 --> 00:30:30,960 NATIONAL INSTITUTE ON NURSING -- 681 00:30:30,960 --> 00:30:32,760 OF NURSING RESEARCH. 682 00:30:32,760 --> 00:30:36,960 SHE WAS PREVIOUSLY A NURSING 683 00:30:36,960 --> 00:30:38,440 COLLEGIATE PROFESSOR AT THE 684 00:30:38,440 --> 00:30:41,680 UNIVERSITY OF ILLINOIS CHICAGO. 685 00:30:41,680 --> 00:30:44,080 HER OWN RESEARCH FOCUSES ON 686 00:30:44,080 --> 00:30:44,800 SOCIAL INEQUITIES IN HEALTH WITH 687 00:30:44,800 --> 00:30:48,280 A GOAL OF IDENTIFYING EFFECTIVE 688 00:30:48,280 --> 00:30:49,280 MULTI-LEVEL APPROACHES TIME 689 00:30:49,280 --> 00:30:51,680 PROVE HEALTH AND ELIMINATE 690 00:30:51,680 --> 00:30:55,000 RACIAL ETHNIC SOCIAL ECONOMIC 691 00:30:55,000 --> 00:30:55,840 DISPARITIES. 692 00:30:55,840 --> 00:30:58,120 AFTER WE'LL HAVE FROM Dr. 693 00:30:58,120 --> 00:30:59,440 WALLACE FROM THE OFFICE OF THE 694 00:30:59,440 --> 00:31:01,360 DIRECTOR OF THE NATIONAL CANCER 695 00:31:01,360 --> 00:31:03,680 INSTITUTE AND CENTER TO REDUCE 696 00:31:03,680 --> 00:31:05,160 CANCER HEALTH DISPARITIES AND 697 00:31:05,160 --> 00:31:07,960 PRIOR TO JOINING NCI, SHE WAS AN 698 00:31:07,960 --> 00:31:09,240 ONCOLOGIST SCIENTIST AT THE 699 00:31:09,240 --> 00:31:12,240 HUMAN GENOME SCIENCES A 700 00:31:12,240 --> 00:31:16,000 BIOMEDICAL PHARMACEUTICAL 701 00:31:16,000 --> 00:31:16,600 CORPORATION. 702 00:31:16,600 --> 00:31:18,600 AND CLOSING OUT OUR SPEAKER IS 703 00:31:18,600 --> 00:31:21,480 Dr. STACEY CARRINGTON 704 00:31:21,480 --> 00:31:24,480 LAWRENCE, WHO IS A DEPOSIT YOU 705 00:31:24,480 --> 00:31:25,400 AT THE DIRECTOR OF DIVISION OF 706 00:31:25,400 --> 00:31:28,320 AGE AND BIOLOGY AND PRIOR TO 707 00:31:28,320 --> 00:31:30,960 JOINING NIA IN 201, SHE WAS A 708 00:31:30,960 --> 00:31:32,400 SENIOR SCIENTIFIC ADVISER IN THE 709 00:31:32,400 --> 00:31:33,960 OFFICE OF AGING RESEARCH. 710 00:31:33,960 --> 00:31:36,560 HER EXPERTISE ENCOMPASSES AREAS 711 00:31:36,560 --> 00:31:38,160 INCLUDING HEALTH DISPARITIES 712 00:31:38,160 --> 00:31:40,040 RESEARCH, HIV RELATE CODE 713 00:31:40,040 --> 00:31:41,680 MORBIDITY AND CO INFECTION AND 714 00:31:41,680 --> 00:31:43,520 STRUCTURAL BIOLOGY, SYSTEM 715 00:31:43,520 --> 00:31:47,240 BIOLOGY AND IMMUNOLOGY AND BASIC 716 00:31:47,240 --> 00:31:49,560 VIROLOGY AND AFTER WE HEAR THOSE 717 00:31:49,560 --> 00:31:51,440 FOUR PRESENTATIONS, WE'LL HAVE 718 00:31:51,440 --> 00:31:56,640 TWO PANELISTS, THE FIRST WILL BE 719 00:31:56,640 --> 00:32:00,320 Dr. JERMAINE DAVIS AND 720 00:32:00,320 --> 00:32:03,560 BIOPHYSICAL CYST AND AND HIS 721 00:32:03,560 --> 00:32:07,560 RESEARCH AIMS TO DETERMINE HOW 722 00:32:07,560 --> 00:32:11,720 GENETIC VARIANTS OF PROTEIN 723 00:32:11,720 --> 00:32:15,520 ABCCA7 CONFER RISK FOR 724 00:32:15,520 --> 00:32:16,760 ALZHEIMER'S FOR AFRICAN 725 00:32:16,760 --> 00:32:20,440 AMERICANS AND I'M ROLLAND THORP 726 00:32:20,440 --> 00:32:24,560 I'M A PROFESSOR AT THE PLOOM 727 00:32:24,560 --> 00:32:26,360 BURG SCHOOL OF PUBLIC-HEALTH AND 728 00:32:26,360 --> 00:32:28,400 MINORITY AGING RESEARCH. 729 00:32:28,400 --> 00:32:34,200 PLEASE HELP ME JOIN Dr. 730 00:32:34,200 --> 00:32:34,720 PEREZ-STABLE. 731 00:32:34,720 --> 00:32:44,920 [APPLAUSE] 732 00:33:00,200 --> 00:33:00,760 >>Eliseo J. Perez-Stable: GOOD 733 00:33:00,760 --> 00:33:01,200 MORNING, EVERYBODY. 734 00:33:01,200 --> 00:33:05,760 I WANT TO THANK RICHARD HODES 735 00:33:05,760 --> 00:33:07,000 AND RON FOR PUTTING THIS ON. 736 00:33:07,000 --> 00:33:09,280 I HAVE A LOT OF ROOTS IN NIA, AS 737 00:33:09,280 --> 00:33:10,160 YOU WILL SEE. 738 00:33:10,160 --> 00:33:13,000 I'VE BEEN HERE AT NIH NOW FOR 739 00:33:13,000 --> 00:33:14,200 OVER SEVEN AND A HALF YEARS. 740 00:33:14,200 --> 00:33:16,840 SO I'M GOING TO TRY TO PUT IN 741 00:33:16,840 --> 00:33:18,760 CONTEXT THE IDEA OF HEALTH DIS 742 00:33:18,760 --> 00:33:25,200 PDISPARITIES FRAMEWORK AND 743 00:33:25,200 --> 00:33:29,360 SHANNON WILL ADD MORE ON THE 744 00:33:29,360 --> 00:33:39,680 STRUCTURAL ISSUES. 745 00:33:40,440 --> 00:33:40,960 . 746 00:33:40,960 --> 00:33:43,520 SO MY GOALS FOR YOU IN THE NEXT 747 00:33:43,520 --> 00:33:46,160 20 MINUTES OR SO WILL BE TO LOOK 748 00:33:46,160 --> 00:33:47,960 AT WHAT THIS WORKING DEFINITION 749 00:33:47,960 --> 00:33:53,080 TO FACILITATE INTER DISCIPLINARY 750 00:33:53,080 --> 00:33:53,760 COLLABORATION. 751 00:33:53,760 --> 00:33:55,560 IT'S CRITICAL FOR US TO ADVANCE 752 00:33:55,560 --> 00:33:57,080 IN THIS AUDIENCE. 753 00:33:57,080 --> 00:33:59,360 THAT WOULD BE MY MAIN GOAL. 754 00:33:59,360 --> 00:34:01,760 I'LL SHARE A LITTLE BIT OF A 755 00:34:01,760 --> 00:34:02,800 CONCEPTUAL FRAMEWORK PROCESS. 756 00:34:02,800 --> 00:34:05,880 I'M A GENERAL INTERNIST SO I'M 757 00:34:05,880 --> 00:34:07,600 NOT A SOCIAL SCIENTIST OR 758 00:34:07,600 --> 00:34:08,600 THINKING IN THOSE TERMS. 759 00:34:08,600 --> 00:34:11,080 I LEARNED IT THIS ALONG THE WAY 760 00:34:11,080 --> 00:34:14,160 OF MY RESEARCH, PARTICULARLY 761 00:34:14,160 --> 00:34:17,280 THROUGHOUT THE LATTER PART OF 762 00:34:17,280 --> 00:34:18,840 THE '90s AND IN 2000s. 763 00:34:18,840 --> 00:34:21,680 I WILL TRY TO DWELL ON THE 764 00:34:21,680 --> 00:34:23,600 EMPHASIS OF INDIVIDUAL FACTORS 765 00:34:23,600 --> 00:34:27,840 UNDERSTANDING THAT Dr. ZENK 766 00:34:27,840 --> 00:34:31,360 WILL COVER MORE ON THE 767 00:34:31,360 --> 00:34:39,880 STRUCTURAL SIDE. 768 00:34:39,880 --> 00:34:42,680 I'LL START WITH DEFINITIONS. 769 00:34:42,680 --> 00:34:44,200 THESE ARE THE POPULATION WITH 770 00:34:44,200 --> 00:34:46,760 HEALTH DISPARITIES. 771 00:34:46,760 --> 00:34:48,200 THERE MIGHT BE A DIFFERENT 772 00:34:48,200 --> 00:34:48,720 PERSPECTIVE. 773 00:34:48,720 --> 00:34:53,440 THIS IS OFFICIALLY WHAT NIH 774 00:34:53,440 --> 00:34:53,760 ACKNOWLEDGES. 775 00:34:53,760 --> 00:34:55,840 WE LEAD THIS EFFORT AT NIMHD AND 776 00:34:55,840 --> 00:34:57,400 IT'S IN OUR CONGRESSIONAL 777 00:34:57,400 --> 00:34:59,640 MANDATE FROM THE YEAR 2000. 778 00:34:59,640 --> 00:35:02,160 THOSE FIRST THREE BULLETS ARE 779 00:35:02,160 --> 00:35:03,600 THERE, RACIAL AND ETHNIC 780 00:35:03,600 --> 00:35:05,720 MINORITY POPULATIONS AS DEFINED 781 00:35:05,720 --> 00:35:09,040 IN THE CENSUS. 782 00:35:09,040 --> 00:35:11,000 FOR PEOPLE OF ANY RACE, 783 00:35:11,000 --> 00:35:13,000 ETHNICITY AND UNDERSERVED ROLE 784 00:35:13,000 --> 00:35:13,640 RESIDENTS. 785 00:35:13,640 --> 00:35:18,640 BRIEFLY IF YOU LOOK AT ORIGINAL 786 00:35:18,640 --> 00:35:21,320 LEGISLATION, WHICH WAS REDONE IN 787 00:35:21,320 --> 00:35:24,000 2010 WITH THE AFFORDABLE CARE 788 00:35:24,000 --> 00:35:27,360 ACT, 90% OF THE 'E EMPHASIS IS N 789 00:35:27,360 --> 00:35:28,760 RACIAL AND ETHNIC GROUPS. 790 00:35:28,760 --> 00:35:30,560 THERE'S LANGUAGE THAT SAYS IF IF 791 00:35:30,560 --> 00:35:32,200 THERE ISN'T A PROVEN DISPARITY 792 00:35:32,200 --> 00:35:33,600 NOT ALL MINORITY GROUPS NEED TO 793 00:35:33,600 --> 00:35:35,160 BE INCLUDED. 794 00:35:35,160 --> 00:35:37,240 CLEARLY, FROM OUR PERSPECTIVE, 795 00:35:37,240 --> 00:35:40,600 RACE ETHNICITY, THIS IS 796 00:35:40,600 --> 00:35:42,640 SELF-IDENTIFIED SOCIAL CONSTRUCT 797 00:35:42,640 --> 00:35:45,280 THAT EXPLAINS SO MUCH THAT WE 798 00:35:45,280 --> 00:35:46,240 DON'T UNDERSTAND AND SOCIAL 799 00:35:46,240 --> 00:35:47,640 ECONOMIC STATUS, SOCIAL CLASS, 800 00:35:47,640 --> 00:35:54,080 THE TWO PILLARS OF OUR SCIENCE. 801 00:35:54,080 --> 00:35:55,960 AND INTERACTIONS WITH OTHER 802 00:35:55,960 --> 00:35:56,960 POPULATIONS UNDER SERVE 803 00:35:56,960 --> 00:35:58,480 RESIDENTS OR SEXUAL AND GENDER 804 00:35:58,480 --> 00:36:04,320 MINORITIES LOOKING AT THAT 805 00:36:04,320 --> 00:36:05,760 INTERSECTION KEEP IN MIND THESE 806 00:36:05,760 --> 00:36:06,920 POPULATIONS WITHOUT DISPARITIES 807 00:36:06,920 --> 00:36:09,640 APPLY TO THE ENTIRE AGING AND 808 00:36:09,640 --> 00:36:12,000 THIS IS NOT AN DOMAIN ONLY. 809 00:36:12,000 --> 00:36:13,440 AND SO ALL INTERNET STUDENTS AND 810 00:36:13,440 --> 00:36:15,080 CENTERS ARE EXPECTED TO DO 811 00:36:15,080 --> 00:36:16,640 RESEARCH AND SOME RESEARCH ON 812 00:36:16,640 --> 00:36:19,240 HEALTH DISPARITIES AS IT APPLIES 813 00:36:19,240 --> 00:36:21,080 TO THEIR AGENDA AND WE ENDORSE 814 00:36:21,080 --> 00:36:22,920 THIS CONCEPT THAT EVERY 815 00:36:22,920 --> 00:36:25,280 POPULATION WE SAY HAS HELPED 816 00:36:25,280 --> 00:36:27,120 DISPARITIES HAS A SOCIAL 817 00:36:27,120 --> 00:36:32,600 DISADVANTAGE THAT RESULTS IN 818 00:36:32,600 --> 00:36:35,600 PART OF THIS IS A CENTRAL PART 819 00:36:35,600 --> 00:36:36,880 OF THIS DEFINITION AND THEN ALSO 820 00:36:36,880 --> 00:36:39,560 IN ADDITION IN CLINICAL CARE, 821 00:36:39,560 --> 00:36:40,600 ALMOST ALWAYS FOLLOWED WITH 822 00:36:40,600 --> 00:36:45,480 BEING UNDERSERVED IN HEALTHCARE? 823 00:36:45,480 --> 00:36:45,960 SOMEWAY. 824 00:36:45,960 --> 00:36:47,720 WE HAVE USED A HEALTH OUTCOME 825 00:36:47,720 --> 00:36:49,960 WORSE IN THESE POPULATIONS 826 00:36:49,960 --> 00:36:51,720 COMPARED TO A EVERYONE GROUP AND 827 00:36:51,720 --> 00:36:53,840 THE MAJORITY POPULATION AND IT 828 00:36:53,840 --> 00:36:58,320 DEFINES THE HEALTH DISPARITIES. 829 00:36:58,320 --> 00:37:00,720 WE'RE THINKING WE MIGHT WANT TO 830 00:37:00,720 --> 00:37:03,040 RETHINK THAT THIS YEAR AND 831 00:37:03,040 --> 00:37:04,520 CREATE MORE ASPIRATIONAL 832 00:37:04,520 --> 00:37:05,720 CONTROLS OF WHERE WE SHOULD BE 833 00:37:05,720 --> 00:37:07,280 AT A POPULATION AND I'LL SHOW 834 00:37:07,280 --> 00:37:13,960 YOU A REASON WHY. 835 00:37:13,960 --> 00:37:16,640 TO RERATE THE FUNDAMENTAL THEY 836 00:37:16,640 --> 00:37:20,640 EXPLAINS SO MUCH THAT IN OUR 837 00:37:20,640 --> 00:37:22,240 PERSPECTIVE, EVERY CLINICAL 838 00:37:22,240 --> 00:37:24,200 STUDY, EVERY STUDY WITH HUMAN 839 00:37:24,200 --> 00:37:29,840 BEINGS NEEDS TO CONSIDER THESE 840 00:37:29,840 --> 00:37:31,320 FACTORS WITH MECHANISMS AND 841 00:37:31,320 --> 00:37:31,880 OUTCOMES. 842 00:37:31,880 --> 00:37:33,120 IT DOESN'T MEAN YOU HAVE TO 843 00:37:33,120 --> 00:37:34,520 POWER EVERY STUDY TO LOOK AT 844 00:37:34,520 --> 00:37:35,840 DIFFERENCES AND IT DOESN'T MEAN 845 00:37:35,840 --> 00:37:41,120 IT WILL ALWAYS BE AN IMPORTANT 846 00:37:41,120 --> 00:37:42,280 CONTRIBUTE OR BUT BECAUSE WE 847 00:37:42,280 --> 00:37:46,600 DON'T UNDERSTAND THE WAYS TO 848 00:37:46,600 --> 00:37:57,080 IMPACT HEATH AND TWICE AS MANY 849 00:38:02,040 --> 00:38:03,280 STROKES AND WHEN COMPARED TO 850 00:38:03,280 --> 00:38:06,520 THEIR WHITE COUNTERPARTS FOR THE 851 00:38:06,520 --> 00:38:08,880 EXACT BLOOD PRESSURE AND THE 45 852 00:38:08,880 --> 00:38:13,920 AND 64 AND THIS IS SYSTEM I CAN 853 00:38:13,920 --> 00:38:24,400 BLOOD PRESSURE AND AND IF YOU 854 00:38:25,080 --> 00:38:30,520 LOOK AT THE RACE OF ALL TIMES 855 00:38:30,520 --> 00:38:37,720 DISEASE AND REEMPHASIZE THE 856 00:38:37,720 --> 00:38:41,560 IMPORTANCE OF BOTH OF THESE 857 00:38:41,560 --> 00:38:42,040 FACTORS. 858 00:38:42,040 --> 00:38:44,720 THESE ARE, AS A PICTURE FROM A 859 00:38:44,720 --> 00:38:47,040 PAPER THAT WAS PUB LASHED LAST 860 00:38:47,040 --> 00:38:48,760 SUMMER IN LANCE ITS, 861 00:38:48,760 --> 00:38:49,760 COLLABORATION, WE HAD WITH THE 862 00:38:49,760 --> 00:38:51,280 INSTITUTE FOR HEALTH METRIC 863 00:38:51,280 --> 00:38:55,400 EVALUATION AND THE SAME GROUP 864 00:38:55,400 --> 00:39:00,520 THAT PRODUCES A LOOKING AT THE 865 00:39:00,520 --> 00:39:02,240 UNITED STATES BY SUB POPULATION 866 00:39:02,240 --> 00:39:04,400 BY RACE AND ETHNICITY AND IT'S 867 00:39:04,400 --> 00:39:08,920 COMPARING THE LIFE EXPECTANCY TO 868 00:39:08,920 --> 00:39:10,080 WHITES BY BLACKS OR AFRICAN 869 00:39:10,080 --> 00:39:11,320 AMERICANS AND AMERICAN INDIANS 870 00:39:11,320 --> 00:39:13,320 AND ALASKA NATIVES AND ASIANS 871 00:39:13,320 --> 00:39:15,240 ALTHOUGH IT DOES SAY PACIFIC 872 00:39:15,240 --> 00:39:19,200 ISLANDERS IT'S ONLY ASIANS IN 873 00:39:19,200 --> 00:39:25,760 THAT PICTURED HERE AND IF YOU 874 00:39:25,760 --> 00:39:28,320 WERE BLUE PURPLE YOU ARE BETTER 875 00:39:28,320 --> 00:39:30,080 THAN WHITES IF YOU ARE IN THE 876 00:39:30,080 --> 00:39:31,480 FELLOW BROWN RANGE YOU ARE DOING 877 00:39:31,480 --> 00:39:41,640 AND WE SEE IN THIS SLIDE THIS 878 00:39:41,640 --> 00:39:43,480 LATINOS AND ASIAN HAVE LONGER 879 00:39:43,480 --> 00:39:49,560 LIFE EXACTLIFE EXPECTANCY THAN . 880 00:39:49,560 --> 00:39:51,520 WE'VE KNOWN THIS FOR A LONG TIME 881 00:39:51,520 --> 00:39:57,360 IN LATINO AND PROVEN FOR ASIANS 882 00:39:57,360 --> 00:40:01,000 AS WELL AND GEOGRAPHY MAY 883 00:40:01,000 --> 00:40:01,640 MATTER. 884 00:40:01,640 --> 00:40:04,520 NORTHERN ARIZONA, THE RIO GRANDE 885 00:40:04,520 --> 00:40:08,680 VALLEY IN TEXAS AND EVEN IN 886 00:40:08,680 --> 00:40:11,640 HAWAII, THE OUTCOMES ARE NOT 887 00:40:11,640 --> 00:40:12,640 GOOD. 888 00:40:12,640 --> 00:40:13,280 WITH BLACKS OR AFRICAN AMERICANS 889 00:40:13,280 --> 00:40:14,160 WE SEE AREAS OF THE UNITED 890 00:40:14,160 --> 00:40:15,640 STATES WHERE AFRICAN AMERICANS 891 00:40:15,640 --> 00:40:18,720 ACTUALLY DO BETTER THAN WHITES 892 00:40:18,720 --> 00:40:20,000 ALTHOUGH IN GENERAL IN THE CORE 893 00:40:20,000 --> 00:40:22,440 PART OF THE SOUTHEAST WE SEE 894 00:40:22,440 --> 00:40:26,960 WORSE OUTCOMES AND IN AMERICAN 895 00:40:26,960 --> 00:40:29,240 INDIANS AND ALASKA NATIVES THEY 896 00:40:29,240 --> 00:40:30,600 HAVE WORSE OUTCOMES SO THERE ARE 897 00:40:30,600 --> 00:40:33,000 AREAS WHERE THEY MAY BE EQUAL OR 898 00:40:33,000 --> 00:40:34,640 BETTER BUT OVER ALL, THEY HAVE 899 00:40:34,640 --> 00:40:37,000 THE WORST OUTCOMES OF ANY OF THE 900 00:40:37,000 --> 00:40:40,000 RACIAL AND ETHNIC GROUPS. 901 00:40:40,000 --> 00:40:44,840 WE LOOK AT ISSUES RELATED SO AND 902 00:40:44,840 --> 00:40:46,120 USING HOUSEHOLD INCOME AND THESE 903 00:40:46,120 --> 00:40:47,800 ARE DATED 10 YEARS AGO AND YOU 904 00:40:47,800 --> 00:40:50,440 ARE UNDER THE POPPER TEE LEVEL 905 00:40:50,440 --> 00:40:51,160 ROUGHLY TASK THOUSAND DOLLARS 906 00:40:51,160 --> 00:40:53,280 FOR HOUSEHOLD OF FOUR AND THE 907 00:40:53,280 --> 00:40:57,480 THREE TIMES MORE LIKELY TO DIE 908 00:40:57,480 --> 00:40:58,840 FROM ANY CAUSE COMPARED TO 909 00:40:58,840 --> 00:40:59,760 SOMEONE'S HOUSEHOLD WITH A 910 00:40:59,760 --> 00:41:02,160 INCOME OF $115,000 WHICH IS WELL 911 00:41:02,160 --> 00:41:05,800 OFF BUT IT'S NOT WEALTHY AND SO 912 00:41:05,800 --> 00:41:07,600 THIS LYNN YEAR RELATIONSHIP WITH 913 00:41:07,600 --> 00:41:12,280 OUTCOME OF LIFE EXPECT SCAN SEE 914 00:41:12,280 --> 00:41:15,000 IS ROBUST AND PERHAPS OTHER THAN 915 00:41:15,000 --> 00:41:17,480 AGE THIS WAS PREVIOUSLY SHOWN 916 00:41:17,480 --> 00:41:20,200 NOT TOO MANY PHYSIOLOGICAL 917 00:41:20,200 --> 00:41:22,560 MEASURES THAT WE TAKE HAVE THIS 918 00:41:22,560 --> 00:41:25,280 KIND OF LINEAR AND ROBUST 919 00:41:25,280 --> 00:41:26,840 RELATIONSHIP MAYBE TOBACCO 920 00:41:26,840 --> 00:41:31,960 SMOKING, MAYBE BODY MASK INDEX 921 00:41:31,960 --> 00:41:35,160 AND SYSTEM I CAN BLOOD PRESSURE 922 00:41:35,160 --> 00:41:36,440 AND HOW MANY KNOW THE SOCIAL 923 00:41:36,440 --> 00:41:40,200 ECONOMIC STATUS OF THEIR 924 00:41:40,200 --> 00:41:45,760 PATIENTS. 925 00:41:45,760 --> 00:41:49,040 THERE WAS A PUBLICATION FROM THE 926 00:41:49,040 --> 00:41:50,440 SURVEY LESS SYSTEM AND YOU CAN 927 00:41:50,440 --> 00:41:53,280 SEE THE DISTRIBUTION 928 00:41:53,280 --> 00:41:55,080 PREDOMINANTLY WHITE AND 60% OF 929 00:41:55,080 --> 00:41:57,520 THE U.S. POPULATION IN 2020 WAS 930 00:41:57,520 --> 00:41:59,520 IDENTIFIED AS WHITE. 931 00:41:59,520 --> 00:42:02,160 BUT REGARDLESS, ALMOST 10% 932 00:42:02,160 --> 00:42:03,720 REPORTED SOME LEVEL OF 933 00:42:03,720 --> 00:42:05,920 SUBJECTIVE KIND OF DECLINE 934 00:42:05,920 --> 00:42:12,240 WITHIN THE PRIOR YEAR AND THIS 935 00:42:12,240 --> 00:42:14,000 WAS HIGHER FOR AMERICAN INDIAN 936 00:42:14,000 --> 00:42:16,920 AND ALASKA NATIVES AND LATINO 937 00:42:16,920 --> 00:42:18,800 HISPANICS AS WELL AND LOWER FOR 938 00:42:18,800 --> 00:42:20,000 ASIANS AND WHITES AND BLACKS IN 939 00:42:20,000 --> 00:42:21,440 THIS STUDY WERE NOT THAT 940 00:42:21,440 --> 00:42:22,400 DIFFERENT. 941 00:42:22,400 --> 00:42:25,040 WE SEE THE INFLUENCE OF AGE, OF 942 00:42:25,040 --> 00:42:27,880 COURSE, AND EDUCATION AS WELL AS 943 00:42:27,880 --> 00:42:33,840 SOCIAL SUPPORT AND SO THE 944 00:42:33,840 --> 00:42:35,000 FACTORS OF OF WHAT THE 945 00:42:35,000 --> 00:42:36,920 INDIVIDUALS BRING TO THE TABLE, 946 00:42:36,920 --> 00:42:39,560 BY DESIGN, SO YOU ARE RACE 947 00:42:39,560 --> 00:42:44,440 ETHNICITY YOUR SOCIAL CON TRUCK 948 00:42:44,440 --> 00:42:48,320 AND OTHER ASPECTS OF SOCIAL AND 949 00:42:48,320 --> 00:42:53,240 BEHAVIORAL SCIENCE, INTERACTING 950 00:42:53,240 --> 00:42:56,520 WITH BIOLOGY TO DETERMINE 951 00:42:56,520 --> 00:42:58,320 OUTCOME AND AND WITH OTHER 952 00:42:58,320 --> 00:42:59,880 INSTITUTES WE HAVE SET UP A 953 00:42:59,880 --> 00:43:02,000 SOCIAL DETERMINANTS OF HEALTH 954 00:43:02,000 --> 00:43:04,760 MEASURES AT THE PHOENIX TOOLKIT. 955 00:43:04,760 --> 00:43:09,240 THIS IS A PROCESS THAT BEGAN IN 956 00:43:09,240 --> 00:43:11,080 2018 AND WE'VE HAD TWO SICK 957 00:43:11,080 --> 00:43:14,520 CYCLES AND MOST OF THE EFFORTS 958 00:43:14,520 --> 00:43:16,200 HAS BEEN VETTING STRUCTURAL 959 00:43:16,200 --> 00:43:18,680 SOCIAL DETERMINANTS OF HEALTH 960 00:43:18,680 --> 00:43:21,800 PROTOCOLS AND IN PHOENIX THESE 961 00:43:21,800 --> 00:43:25,960 CON TRUCKS OR SURVEYS ARE CALLED 962 00:43:25,960 --> 00:43:28,680 PROTOCOLS ARE MEASURES THE PAST 963 00:43:28,680 --> 00:43:33,960 SET WAS DES OF 2022 AND THE 964 00:43:33,960 --> 00:43:35,240 DEMOGRAPHICS AND INDIVIDUAL 965 00:43:35,240 --> 00:43:37,880 PERMANENT WERE MOSTLY ALREADY 966 00:43:37,880 --> 00:43:39,680 THERE GATHERED TOGETHER AND SOME 967 00:43:39,680 --> 00:43:42,800 OF THEM WERE EVALUATED IN OUR 968 00:43:42,800 --> 00:43:43,480 FIRST EICHEL BUT MOST WERE 969 00:43:43,480 --> 00:43:45,480 PRESENT AND HAD BEEN PUT ON THE 970 00:43:45,480 --> 00:43:48,880 PHOENIX WEBSITE BY OTHER 971 00:43:48,880 --> 00:43:50,960 INSTITUTES IN THEIR ESPECIALLY 972 00:43:50,960 --> 00:43:55,200 NCI AND NIADA AND WE'RE GOING TO 973 00:43:55,200 --> 00:43:58,040 RETHINK OR REWALL WAIT SOME 974 00:43:58,040 --> 00:44:00,440 GIVEN THE PROPOSAL FOR CHANGING 975 00:44:00,440 --> 00:44:03,480 THE WAY RACE AND ETHNICITY IS 976 00:44:03,480 --> 00:44:05,680 QUARRIED IN THE CENSUS AND IT'S 977 00:44:05,680 --> 00:44:12,400 OUT FOR PUBLIC COMMENT NOW. 978 00:44:12,400 --> 00:44:13,720 SO LET'S TALK ABOUT FRAMEWORK. 979 00:44:13,720 --> 00:44:18,240 I WOULD LIKE TO TALK ABOUT THIS 980 00:44:18,240 --> 00:44:22,080 MODEL. 981 00:44:22,080 --> 00:44:24,240 IT IT'S USED BY SCIENTISTS IN 982 00:44:24,240 --> 00:44:26,120 GENERAL INTERNAL MEDICINE AND 983 00:44:26,120 --> 00:44:27,600 POPULATION SCIENCE TO EMPHASIS 984 00:44:27,600 --> 00:44:30,320 HOW LITTLE IMPORTANCE HEALTHCARE 985 00:44:30,320 --> 00:44:32,680 HAS TO YOUR HEALTH OUTCOMES. 986 00:44:32,680 --> 00:44:36,960 AND IT'S ONLY ABOUT 10% OF 987 00:44:36,960 --> 00:44:41,320 OUTCOMES AND WE SEE A BEHAVIOR 988 00:44:41,320 --> 00:44:44,520 OVER 20 YEARS AGO McGINNIS 989 00:44:44,520 --> 00:44:45,840 ADDRESSING PREMATURE MORTALITY. 990 00:44:45,840 --> 00:44:48,320 THE GENETIC QUADRANT OF 30% IS 991 00:44:48,320 --> 00:44:50,040 BECAUSE WE DON'T REALLY KNOW. 992 00:44:50,040 --> 00:44:54,360 ESPECIALLY BACK THEN, WHEN THIS 993 00:44:54,360 --> 00:44:55,560 WAS DESIGNED SOCIAL 994 00:44:55,560 --> 00:44:56,960 INCOMPETENTER ACTIONS AND I 995 00:44:56,960 --> 00:44:59,160 WOULD EMPHASIZE THAT THINKING 996 00:44:59,160 --> 00:45:01,360 ABOUT THIS KIND OF PIE CHART, 997 00:45:01,360 --> 00:45:04,920 THIS IS FOR SOMEONE WHO COMES 998 00:45:04,920 --> 00:45:09,560 HEALTHY TO O THE QUESTIONS SO 999 00:45:09,560 --> 00:45:11,400 SOMEONE WHO DOES NOT TAKE A 1000 00:45:11,400 --> 00:45:12,240 CHRONIC MEDICATION. 1001 00:45:12,240 --> 00:45:21,840 AS WE AGE, THOSE FACTORS ARE AND 1002 00:45:21,840 --> 00:45:24,280 MORE COMMON 30% HAVE MORE THAN 1003 00:45:24,280 --> 00:45:27,320 ONE CHRONIC DISEASE AND IN A 1004 00:45:27,320 --> 00:45:30,000 RECENT REPORT THAT I LOOKED AT 1005 00:45:30,000 --> 00:45:31,880 ALMOST 60% OF ADULTS OVER THE 1006 00:45:31,880 --> 00:45:37,440 AGE OF 65 TAKE A PRESCRIPTION 1007 00:45:37,440 --> 00:45:40,160 MEDICINE AND SO WHAT IS NORMAL 1008 00:45:40,160 --> 00:45:45,160 HAPPENS AS WE AGE AND THE ROLE 1009 00:45:45,160 --> 00:45:48,400 OF HEALTHCARE SYSTEMS INCREASES 1010 00:45:48,400 --> 00:45:49,800 SIGNIFICANTLY. 1011 00:45:49,800 --> 00:45:54,040 THIS WAS MY CRUDE ATTEMPT WHEN I 1012 00:45:54,040 --> 00:45:55,600 TAUGHT HEATH DISPARITIES COURSE 1013 00:45:55,600 --> 00:45:57,280 IN THE EARLY PART OF THE 2000s 1014 00:45:57,280 --> 00:46:02,960 AT UC SAN FRANCISCO, AS PART OF 1015 00:46:02,960 --> 00:46:05,560 THE CTSA PROGRAM AFTER IT WAS 1016 00:46:05,560 --> 00:46:07,680 FUNDED TO LOOK AT MULTI-LEVEL 1017 00:46:07,680 --> 00:46:09,120 DETERMINANTS OF DISPARITIES SO 1018 00:46:09,120 --> 00:46:11,840 WHAT GOES IN FACTORS THAT 1019 00:46:11,840 --> 00:46:13,800 INFLUENCE HEALTH AND HEALTHCARE 1020 00:46:13,800 --> 00:46:15,360 DISPARITIES AND ALL OF THESE 1021 00:46:15,360 --> 00:46:16,840 ELEMENTS ARE LISTED AND THEY'RE 1022 00:46:16,840 --> 00:46:21,000 CAPTURED AND THERE'S NO REAL 1023 00:46:21,000 --> 00:46:23,480 LEADERSHIP HERE AND IT WAS 1024 00:46:23,480 --> 00:46:25,680 TRANSMIT TAG WE WORRY ABOUT 1025 00:46:25,680 --> 00:46:26,480 INDIVIDUAL FACTORS THAT PEOPLE 1026 00:46:26,480 --> 00:46:28,720 BRING ON THE DEMOGRAPHIC AND THE 1027 00:46:28,720 --> 00:46:30,160 PSYCHOSOCIAL AND BEHAVIOR AND 1028 00:46:30,160 --> 00:46:32,960 THE BIOLOGICAL FEAR BUT ALSO 1029 00:46:32,960 --> 00:46:35,600 THERE ARE THESE OTHER CONTEXTUAL 1030 00:46:35,600 --> 00:46:39,960 FACTORS THAT REALLY MATTER 1031 00:46:39,960 --> 00:46:42,440 INCLUDING THE HEALTH-CARE 1032 00:46:42,440 --> 00:46:43,200 SYSTEM. 1033 00:46:43,200 --> 00:46:46,360 AT THE TIME, THE INFORMATION 1034 00:46:46,360 --> 00:46:47,840 ABOUT THE BIOLOGICAL FACTORS 1035 00:46:47,840 --> 00:46:48,920 PARTICULARLY INITIALLY WITH THE 1036 00:46:48,920 --> 00:46:51,400 GENOME PROJECT AND GENETICS, WAS 1037 00:46:51,400 --> 00:46:54,280 JUST REALLY ON AN ASTRO KNOT I 1038 00:46:54,280 --> 00:46:56,040 CANAL RISE AND WHERE THE ROLE 1039 00:46:56,040 --> 00:46:57,920 WAS WITH REGARDS TO WHAT WE KNEW 1040 00:46:57,920 --> 00:47:05,840 FROM POPULATIONS AND CLINICAL 1041 00:47:05,840 --> 00:47:14,400 SCIENCE, REALLY 1042 00:47:14,400 --> 00:47:16,080 BROUGHT HOME THE IMPORTANCE OF 1043 00:47:16,080 --> 00:47:18,480 STRUCTURAL FACTORS AND 1044 00:47:18,480 --> 00:47:19,840 INDIVIDUAL HEALTH AND WHEN THEY 1045 00:47:19,840 --> 00:47:21,880 WENT THROUGH A VISIONING 1046 00:47:21,880 --> 00:47:26,080 PROCESS, AND A NUMBER OF YEARS 1047 00:47:26,080 --> 00:47:31,280 AGO, IT WAS BEFORE I A RIDE AT 1048 00:47:31,280 --> 00:47:32,800 NIH CAN Dr. MADDOX LEADING 1049 00:47:32,800 --> 00:47:34,240 THAT EFFORT THESE WERE FACTORS 1050 00:47:34,240 --> 00:47:35,880 THAT WERE EXTRACTED FROM THAT 1051 00:47:35,880 --> 00:47:41,560 AND IT REALLY HAVE INFORMED OUR 1052 00:47:41,560 --> 00:47:43,160 FRAMEWORK. 1053 00:47:43,160 --> 00:47:45,760 NOTICE ON THE LEFT THESE SAME 1054 00:47:45,760 --> 00:47:46,600 CATEGORIES OF INDIVIDUAL FACTORS 1055 00:47:46,600 --> 00:47:48,360 WITH BEHAVIOR AND BIOLOGY AND 1056 00:47:48,360 --> 00:47:51,200 THE IMPORTANCE OF THE PHYSICAL 1057 00:47:51,200 --> 00:47:53,000 ENVIRONMENT HAD BECOME OBVIOUS 1058 00:47:53,000 --> 00:47:54,960 BY THEN AND YET THE SOCIAL 1059 00:47:54,960 --> 00:48:01,160 ENVIRONMENT HOW WE INTERACT WITH 1060 00:48:01,160 --> 00:48:02,880 PEOPLE AS VICTIMS OR FAMILY 1061 00:48:02,880 --> 00:48:04,840 UNITS OR GROUPS OF PEOPLE AS 1062 00:48:04,840 --> 00:48:05,720 WELL AS COMMUNITIES HAVE BEEN 1063 00:48:05,720 --> 00:48:12,760 KNOWN FOR DECADES TO BE 1064 00:48:12,760 --> 00:48:13,960 INFLUENTIAL IN HEALTH AND 1065 00:48:13,960 --> 00:48:15,160 INTERACTIONS BEING PROTECTIVE 1066 00:48:15,160 --> 00:48:20,320 AND OTHERS NOT BEING PROTECTED. 1067 00:48:20,320 --> 00:48:22,040 THE IMPORTANCE OF HEALTH AND 1068 00:48:22,040 --> 00:48:23,400 PUBLIC HEATH CARE SYSTEMS SHOULD 1069 00:48:23,400 --> 00:48:28,160 NOT BE UNDER EMPHASIZED FOR MANY 1070 00:48:28,160 --> 00:48:34,000 REASONS AND ESPECIALLY AS WE GET 1071 00:48:34,000 --> 00:48:35,680 OLDER AND CLINICIANS HAVE A 1072 00:48:35,680 --> 00:48:37,720 MAJOR ROLE TO PLAY IN ALL OF 1073 00:48:37,720 --> 00:48:38,200 THIS. 1074 00:48:38,200 --> 00:48:43,520 FROM NIMHD FILES, I FOUND THIS 1075 00:48:43,520 --> 00:48:45,080 CONCEPTUAL FRAMEWORK THAT WAS 1076 00:48:45,080 --> 00:48:47,920 USED IN TEACHING ABOUT HEATH 1077 00:48:47,920 --> 00:48:52,000 DISPARITIES BEFORE I ARRIVED AT 1078 00:48:52,000 --> 00:48:56,520 NIMHD AND THIS WAS 2013 IN THE 1079 00:48:56,520 --> 00:48:58,960 COURSE AND ALL OF THESE FACTORS 1080 00:48:58,960 --> 00:49:01,080 WERE INCLUDED DO NOTE, HOWEVER, 1081 00:49:01,080 --> 00:49:03,520 THE EMPHASIS ON RACISM. 1082 00:49:03,520 --> 00:49:06,160 AND I WOULD SAY COME BACK TO 1083 00:49:06,160 --> 00:49:07,840 THIS AS A CENTRAL FACTOR IN 1084 00:49:07,840 --> 00:49:11,040 HEALTH DISPARITIES, RAISES 1085 00:49:11,040 --> 00:49:15,840 DISCRIMINATION, IN THE U.S. 1086 00:49:15,840 --> 00:49:17,720 WHEN I WAS ON THE NATIONAL 1087 00:49:17,720 --> 00:49:20,720 INSTITUTE ON AGING COUNCIL, 1088 00:49:20,720 --> 00:49:23,520 THERE WAS A REVIEW OF THE HEALTH 1089 00:49:23,520 --> 00:49:24,280 DISPARITIES PORTFOLIO. 1090 00:49:24,280 --> 00:49:27,720 I DIDN'T REALLY UNDERSTAND THE 1091 00:49:27,720 --> 00:49:29,880 REASONS OR WHY I WAS PUT IN THAT 1092 00:49:29,880 --> 00:49:33,200 ROLE BUT I WAS IN MY FIRST YEAR 1093 00:49:33,200 --> 00:49:35,520 ON COUNCIL WITH Dr. BERNARD 1094 00:49:35,520 --> 00:49:38,160 BEING THE MAIN DRIVER OF IT AND 1095 00:49:38,160 --> 00:49:40,000 AFTER REVIEWING THE PORTFOLIO 1096 00:49:40,000 --> 00:49:41,280 AND UNDERSTANDING A LITTLE BIT 1097 00:49:41,280 --> 00:49:43,440 MORE OF WHAT NIA WAS DOING AND 1098 00:49:43,440 --> 00:49:45,600 HOW DISPARITIES, ONE OF THE 1099 00:49:45,600 --> 00:49:46,800 RECOMMENDATIONS WAS THAT THERE 1100 00:49:46,800 --> 00:49:50,760 SHOULD BE A PERSON HIGHER FOR 1101 00:49:50,760 --> 00:49:54,960 SPECIAL POPULATIONS THERE AND 1102 00:49:54,960 --> 00:49:58,360 UNDERSTAND THE INFLUENCE OF 1103 00:49:58,360 --> 00:50:00,200 COUNCIL ADVISE AND DID HODES 1104 00:50:00,200 --> 00:50:01,200 WOULD HIRE SOMEONE. 1105 00:50:01,200 --> 00:50:03,240 WE WERE SUPPOSED TO DEVELOP A 1106 00:50:03,240 --> 00:50:07,360 FRAMEWORK, A FRAMEWORK OF HEALTH 1107 00:50:07,360 --> 00:50:09,600 DISPARITIES. 1108 00:50:09,600 --> 00:50:09,800 RAATZ. 1109 00:50:09,800 --> 00:50:18,960 MODIFIED AND EXPANDED AND WITH 1110 00:50:18,960 --> 00:50:23,240 CARL HILL, MARIE BERNARD AND 1111 00:50:23,240 --> 00:50:25,120 Dr. KAPLAN WHO WAS ON COUNCIL 1112 00:50:25,120 --> 00:50:27,120 AS WELL. 1113 00:50:27,120 --> 00:50:28,880 AND CAPTURING THE DIFFERENT 1114 00:50:28,880 --> 00:50:31,680 COMPONENTS, ENVIRONMENT, SOCIAL, 1115 00:50:31,680 --> 00:50:33,840 CULTURAL, BEHAVIORAL AND 1116 00:50:33,840 --> 00:50:34,640 BIOLOGICAL. 1117 00:50:34,640 --> 00:50:35,760 THIS PROCESS, THINKING ABOUT 1118 00:50:35,760 --> 00:50:40,680 THIS IN A SORT OF A ROADMAP KIND 1119 00:50:40,680 --> 00:50:45,760 OF WAY, MADE ME ASK STAFF AT 1120 00:50:45,760 --> 00:50:47,200 NIHMD TO DEVELOP A FRAMEWORK 1121 00:50:47,200 --> 00:50:52,280 WHEN I ARRIVED NIA A IN 2015 ANS 1122 00:50:52,280 --> 00:50:52,880 WHAT WAS PRODUCED. 1123 00:50:52,880 --> 00:50:54,920 IT NEEDS TO BE RE-EVALUATE AND 1124 00:50:54,920 --> 00:50:56,320 RETHOUGHT OF AND IT HAD 1125 00:50:56,320 --> 00:50:57,520 SUGGESTION AND RECENT 1126 00:50:57,520 --> 00:50:58,680 PUBLICATION ADDING A BAND 1127 00:50:58,680 --> 00:51:00,120 BETWEEN THE PHYSICAL AND THE 1128 00:51:00,120 --> 00:51:03,520 SOCIAL CULTURAL ENVIRONMENT 1129 00:51:03,520 --> 00:51:04,800 FOCUSED ON THE DIGITAL 1130 00:51:04,800 --> 00:51:09,400 ENVIRONMENT WHICH I THOUGHT WAS 1131 00:51:09,400 --> 00:51:09,920 INTERESTING. 1132 00:51:09,920 --> 00:51:11,200 OTHERS HAVE ARGUED FOR THE ONE 1133 00:51:11,200 --> 00:51:15,200 HEALTH APPROACH AND WHAT ABOUT 1134 00:51:15,200 --> 00:51:16,640 THE ANIMAL AND PLANT WORLD AND 1135 00:51:16,640 --> 00:51:18,960 HOW IT INTER FACTS WITH HUMANS 1136 00:51:18,960 --> 00:51:26,720 AND IN FACT I WAS PART OF 1137 00:51:26,720 --> 00:51:28,520 WRITING UP A PROCESS FROM A 1138 00:51:28,520 --> 00:51:30,720 FORMER MENTEE OF MINE BUT I 1139 00:51:30,720 --> 00:51:32,360 THINK THE EMPHASIS IS HERE. 1140 00:51:32,360 --> 00:51:39,360 WE LOOK AT THE INDIVIDUAL 1141 00:51:39,360 --> 00:51:43,240 COLUMN, GOING TO SOCIETAL POLICY 1142 00:51:43,240 --> 00:51:46,680 CHANGES THAT INFLUENCE HOW A 1143 00:51:46,680 --> 00:51:50,280 MAJORITY OF OUR RESEARCH AT 1144 00:51:50,280 --> 00:51:54,760 NIMHD REMAINS IN THAT FIRST 1145 00:51:54,760 --> 00:51:56,120 COLUMN AND I HAVE TO SEE WHAT 1146 00:51:56,120 --> 00:51:58,440 THE LAST YEAR PORTFOLIO ANALYSIS 1147 00:51:58,440 --> 00:52:00,400 WOULD SHOW AND IT ISN'T AS 1148 00:52:00,400 --> 00:52:01,120 STRAIGHT FORWARD AS SAYING WELL 1149 00:52:01,120 --> 00:52:03,720 THIS IS A DISTRIBUTION AND SO WE 1150 00:52:03,720 --> 00:52:08,920 HAVE OUR RO1 AND ACROSS THE 1151 00:52:08,920 --> 00:52:12,960 SPECTRUM KNOW AND FOCUS ON 1152 00:52:12,960 --> 00:52:14,400 INDIVIDUAL RESEARCH AND PUSHING 1153 00:52:14,400 --> 00:52:15,160 THINGS TO BE RIGHT WILL BE 1154 00:52:15,160 --> 00:52:16,440 IMPORTANT IF YOU ASK ME WHAT'S 1155 00:52:16,440 --> 00:52:18,360 THE CAUSAL PATHWAY HERE? 1156 00:52:18,360 --> 00:52:20,360 THERE IS NONE DEPICTED IN THIS 1157 00:52:20,360 --> 00:52:22,800 FRAMEWORK NOR IS THIS INTENDED 1158 00:52:22,800 --> 00:52:24,440 TO BE COMPREHENSIVE AND I WOULD 1159 00:52:24,440 --> 00:52:26,040 SAY IT'S PROBABLY RIGHT TO LEFT 1160 00:52:26,040 --> 00:52:28,400 AND I WOULD GENRE EMPHASIZE THE 1161 00:52:28,400 --> 00:52:30,920 IMPORTANCE OF THE HEALTH-CARE 1162 00:52:30,920 --> 00:52:33,120 SYSTEM FOR 50% OF THE U.S. 1163 00:52:33,120 --> 00:52:34,160 POPULATION AND MAYBE EVEN A 1164 00:52:34,160 --> 00:52:35,440 THIRD OF THE U.S. POPULATION 1165 00:52:35,440 --> 00:52:40,280 WHERE IT BECOMES CRITICAL FOR 1166 00:52:40,280 --> 00:52:42,280 HALF OF THE ADULTS IN THE U.S. 1167 00:52:42,280 --> 00:52:45,040 IS IT'S A RELATIVELY SMALL OR 1168 00:52:45,040 --> 00:52:47,360 VERY MODEST RELEVANCE SINCE ONE 1169 00:52:47,360 --> 00:52:50,600 CAN GET MOST PREVENTATIVE 1170 00:52:50,600 --> 00:52:51,680 INTERVENTIONS NOW INTERACTION 1171 00:52:51,680 --> 00:52:53,160 WITH MINIMAL INTERACTION S WITH 1172 00:52:53,160 --> 00:52:54,720 A CLINICIAN. 1173 00:52:54,720 --> 00:52:59,960 IN TERMS OF VACCINATION OR TESTS 1174 00:52:59,960 --> 00:53:04,480 THAT ARE RECOMMENDED. 1175 00:53:04,480 --> 00:53:07,320 OUR COLLEAGUE, JAMES JACKSON WHO 1176 00:53:07,320 --> 00:53:08,880 WE LOST A FEW YEARS AGO 1177 00:53:08,880 --> 00:53:10,400 DEVELOPED A THEORY ABOUT CHRONIC 1178 00:53:10,400 --> 00:53:12,440 STRESS RACE AND UNHEALTHY 1179 00:53:12,440 --> 00:53:13,600 BEHAVIOR AND SOME OF YOU 1180 00:53:13,600 --> 00:53:15,520 FAMILIAR WITH THIS AND IT WAS 1181 00:53:15,520 --> 00:53:18,760 VERY CONTROVERSIAL WHEN JAMES 1182 00:53:18,760 --> 00:53:19,360 PUBLISHED THIS. 1183 00:53:19,360 --> 00:53:21,240 I DON'T WANT TO GO INTO DETAILS 1184 00:53:21,240 --> 00:53:23,920 WHAT THE VALUE OF THIS AND IT'S 1185 00:53:23,920 --> 00:53:25,800 THE THINKING THAT WENT INTO IT 1186 00:53:25,800 --> 00:53:27,080 SO, THE GROUPS SAID WELL 1187 00:53:27,080 --> 00:53:32,440 DEPRESSION AND SUICIDE IN WHITES 1188 00:53:32,440 --> 00:53:34,280 ARE MUCH HIGHER AND EVEN OVER 1189 00:53:34,280 --> 00:53:36,960 ALL YOU SEE AFRICAN AMERICANS 1190 00:53:36,960 --> 00:53:39,040 HAVING WORSE HEALTH. 1191 00:53:39,040 --> 00:53:42,880 HOWEVER, SUBSTANCE USE AND 1192 00:53:42,880 --> 00:53:45,280 REFLECTELLED BY EXTREME OR 1193 00:53:45,280 --> 00:53:47,360 MODERATE OBESITY AS WELL ARE 1194 00:53:47,360 --> 00:53:49,840 MORE COMMON AMONG AFRICAN 1195 00:53:49,840 --> 00:53:51,400 AMERICANS AND DIFFERENCES HAVE 1196 00:53:51,400 --> 00:53:58,400 REALLY ATTENUATED AND FROM THE 1197 00:53:58,400 --> 00:54:00,240 LATE 80 AND LOOKING AT CHRONIC 1198 00:54:00,240 --> 00:54:01,960 STRESS AND CHRONIC CONDITIONS IN 1199 00:54:01,960 --> 00:54:05,640 TWO YEARS OF FOLLOW-UP AND THEY 1200 00:54:05,640 --> 00:54:07,000 CONCLUDED ON STRENGTHEN 1201 00:54:07,000 --> 00:54:09,240 STRESSORS AND LEADING TO MORE 1202 00:54:09,240 --> 00:54:10,960 DEPRESSION DIAGNOSIS AMONG 1203 00:54:10,960 --> 00:54:11,840 WHITES. 1204 00:54:11,840 --> 00:54:12,960 AMONG BLACKS ON HEALTHY 1205 00:54:12,960 --> 00:54:16,680 BEHAVIORS WERE SOMEWHAT 1206 00:54:16,680 --> 00:54:18,800 PROTECTED FOR MENTAL HEALTH 1207 00:54:18,800 --> 00:54:20,240 CONDITIONS IT INCREASED BECAUSE 1208 00:54:20,240 --> 00:54:24,960 OF OTHER UNHEALTHY BEHAVIORS 1209 00:54:24,960 --> 00:54:27,920 OPPOSED TO MEMBER HEALTH AND THE 1210 00:54:27,920 --> 00:54:30,880 DEPRESSION AND SUICIDE AND I 1211 00:54:30,880 --> 00:54:34,320 FREQUENTLY THAT'S HOW MANY OF US 1212 00:54:34,320 --> 00:54:35,840 APPROACH THESE ISSUES AND NUMBER 1213 00:54:35,840 --> 00:54:37,520 OF BIOLOGICAL MEASURES WITH 1214 00:54:37,520 --> 00:54:39,080 CHRONIC STRESS AND RESEARCH HAS 1215 00:54:39,080 --> 00:54:40,360 BEEN USED AND WE'LL GO THROUGH 1216 00:54:40,360 --> 00:54:42,480 THEM IN DETAIL HERE AND MOST OF 1217 00:54:42,480 --> 00:54:44,480 THE ONES THAT PEOPLE ARE 1218 00:54:44,480 --> 00:54:48,720 FAMILIAR WORKING WITH HAVE 1219 00:54:48,720 --> 00:54:51,000 GATHERING OF WHAT IS CALLED 1220 00:54:51,000 --> 00:54:55,440 ALICE STATIC LOAD FOLLOWING THE 1221 00:54:55,440 --> 00:54:58,080 WEATHERING HYPOTHESIS THAT ARE 1222 00:54:58,080 --> 00:55:00,160 GENERATED OUT OF UNIVERSITY OF 1223 00:55:00,160 --> 00:55:02,080 MICHIGAN LOOKING AT 1224 00:55:02,080 --> 00:55:03,760 PHYSIOLOGICAL RESPONSE TO 1225 00:55:03,760 --> 00:55:06,960 CHRONIC STRESS AND OR CORTISOL 1226 00:55:06,960 --> 00:55:09,000 AND FLAM TORI ACCESS AND OTHER 1227 00:55:09,000 --> 00:55:12,040 INFLAMMATORY MARKERS AND THIS 1228 00:55:12,040 --> 00:55:15,480 LOOKED AT AND SLEEP AND A REALLY 1229 00:55:15,480 --> 00:55:16,960 IMPORTANT ACTIVITY AND SUPPOSED 1230 00:55:16,960 --> 00:55:21,920 TO SPEND UP TO A THIRD OF OUR 1231 00:55:21,920 --> 00:55:23,920 TIME IN SLEEP HAS BEEN EVALUATED 1232 00:55:23,920 --> 00:55:25,640 ALTHOUGH MEASUREMENT IS A 1233 00:55:25,640 --> 00:55:28,520 CHALLENGE AND THE FUNCTIONAL MRI 1234 00:55:28,520 --> 00:55:30,760 AS ANOTHER MEASURE AND PEOPLE 1235 00:55:30,760 --> 00:55:35,720 HAVE TO USE AND LET ME TRY TO 1236 00:55:35,720 --> 00:55:39,080 WIND DOWN WITH DISCUSSION ABOUT 1237 00:55:39,080 --> 00:55:43,200 RACISM AND DISCRIMINATION. 1238 00:55:43,200 --> 00:55:47,600 THESE ARE DATA FROM ABOUT 10 1239 00:55:47,600 --> 00:55:49,760 YEARS AGO AND FROM THE KAISER 1240 00:55:49,760 --> 00:55:51,680 FAMILY FOUNDATION OF AMERICANS 1241 00:55:51,680 --> 00:55:53,320 AND OVER THIRD OF LATINO AND 1242 00:55:53,320 --> 00:55:55,160 OVER HALF OF AFRICAN AMERICANS 1243 00:55:55,160 --> 00:55:56,920 SAID YES TO THE QUESTION OF HAVE 1244 00:55:56,920 --> 00:55:58,640 YOU BEEN TREATED UNFAIRLY 1245 00:55:58,640 --> 00:56:00,880 BECAUSE OF RACE OR ETHNIC 1246 00:56:00,880 --> 00:56:02,920 BACKGROUND IN A VARIETY OF 1247 00:56:02,920 --> 00:56:06,240 SETTINGS INCLUDING HEALTHCARE. 1248 00:56:06,240 --> 00:56:07,920 THIS IS BEFORE THE PANDEMIC AND 1249 00:56:07,920 --> 00:56:11,680 THIS IS BEFORE THE MURDER OF 1250 00:56:11,680 --> 00:56:12,000 GEORGE FLOYD. 1251 00:56:12,000 --> 00:56:15,360 THIS IS A TIME WHEN IT WAS MAYBE 1252 00:56:15,360 --> 00:56:17,400 NOT SCIENTIFIC TO TALK ABOUT 1253 00:56:17,400 --> 00:56:21,400 RESEARCH ON RACISM AND AS MUCH 1254 00:56:21,400 --> 00:56:23,200 AND I REMEMBER A CONVERSATION 1255 00:56:23,200 --> 00:56:24,960 WITH DR. TABAK WHEN I GOT HERE 1256 00:56:24,960 --> 00:56:25,560 ABOUT THIS ISSUE. 1257 00:56:25,560 --> 00:56:27,720 THIS WAS A TIME WHEN TALKING 1258 00:56:27,720 --> 00:56:29,280 ABOUT RACISM OR DISCRIMINATION 1259 00:56:29,280 --> 00:56:34,240 WAS CLEARLY NOT POLITE 1260 00:56:34,240 --> 00:56:35,200 CONVERSATION. 1261 00:56:35,200 --> 00:56:38,840 WITHIN EVERYONE EVEN AMONG 1262 00:56:38,840 --> 00:56:40,160 BETWEEN DIFFERENT RACIAL AND 1263 00:56:40,160 --> 00:56:41,720 ETHNIC GROUPS AND THINKING ABOUT 1264 00:56:41,720 --> 00:56:43,400 RACISM AS A RESEARCH CONSTRUCT 1265 00:56:43,400 --> 00:56:47,240 IS REALLY IMPORTANT IF WE 1266 00:56:47,240 --> 00:56:48,320 OPERATIONALIZE AND EVALUATE IT 1267 00:56:48,320 --> 00:56:50,000 AND INFLUENCE ON OUTCOMES AND 1268 00:56:50,000 --> 00:56:52,000 ALMOST ALL OF THE WORK THAT YOU 1269 00:56:52,000 --> 00:56:54,240 HAVE HEARD ABOUT, OR READ, HAS 1270 00:56:54,240 --> 00:56:56,640 BEEN ON INTRA PERSONAL ACCESS 1271 00:56:56,640 --> 00:57:00,000 WITH MEASURES THAT HAVE BEEN 1272 00:57:00,000 --> 00:57:02,960 WELL DEVELOPED AND SOUND. 1273 00:57:02,960 --> 00:57:05,440 THERE ARE SOME ASPECTS THAT ARE 1274 00:57:05,440 --> 00:57:06,960 INTERNALIZED WHICH IS WHAT THE 1275 00:57:06,960 --> 00:57:09,320 MEASURES OF LOAD AND OTHER 1276 00:57:09,320 --> 00:57:10,920 COGNITIVE MEASURES TRY TO GET AT 1277 00:57:10,920 --> 00:57:12,120 SO INDIVIDUALS SAY I'M NOT A 1278 00:57:12,120 --> 00:57:13,560 VICTIM AND I'VE NEVER HAD 1279 00:57:13,560 --> 00:57:16,880 EXPERIENCED ANY RACISM AND THEY 1280 00:57:16,880 --> 00:57:19,400 HAVE A ADOPTED THE RESPONSE AND 1281 00:57:19,400 --> 00:57:22,360 COG IN THEY'VELY OR 1282 00:57:22,360 --> 00:57:23,080 PHYSIOLOGICALLY. 1283 00:57:23,080 --> 00:57:24,640 THERE ARE OTHER ASPECTS THAT ARE 1284 00:57:24,640 --> 00:57:25,680 MUCH LESS WELL STUDIED. 1285 00:57:25,680 --> 00:57:28,520 IT WAS A STUDY FROM AMONG YOUTH 1286 00:57:28,520 --> 00:57:30,480 IN LOS ANGELES AND LOOKED AT 1287 00:57:30,480 --> 00:57:37,360 PERCEIVED SOCIETAL SO 14, 15 AND 1288 00:57:37,360 --> 00:57:38,800 DON'T HAVE MUCH EXPERIENCE TO 1289 00:57:38,800 --> 00:57:40,120 VERBALIZE WHAT THEY WOULD CALL 1290 00:57:40,120 --> 00:57:41,360 RACISM OR DISCRIMINATION BUT 1291 00:57:41,360 --> 00:57:43,040 THEY CAN SEE WHAT THEY HAVE 1292 00:57:43,040 --> 00:57:47,160 OPINIONS ABOUT SOCIETY AND THIS 1293 00:57:47,160 --> 00:57:54,320 IS BEYOND RACE ETHNICITY SO IT 1294 00:57:54,320 --> 00:57:55,960 INCLUDES BODY WEIGHT AND OTHER 1295 00:57:55,960 --> 00:57:58,000 ASPECTED ASKED IN THAT STUDY AND 1296 00:57:58,000 --> 00:58:00,000 A PROSPECT DESIGN AND INFLUENCE 1297 00:58:00,000 --> 00:58:09,040 AND BEHAVIOR AND I DON'T KNOW IF 1298 00:58:09,040 --> 00:58:10,440 ANYONE HAS DONE ENOUGH WORK ON 1299 00:58:10,440 --> 00:58:11,960 THE SECONDHAND EFFECTS OF RACISM 1300 00:58:11,960 --> 00:58:13,320 SO INDIVIDUALS WHO ARE EXPOSED 1301 00:58:13,320 --> 00:58:16,280 TO SOMEONE WHO IS TRAUMATIZED BY 1302 00:58:16,280 --> 00:58:18,160 BEING AROUND RACISTS. 1303 00:58:18,160 --> 00:58:25,040 THIS IS A MAP OF WASHINGTON D.C. 1304 00:58:25,040 --> 00:58:28,040 AND I EXPECT Dr. ZENK WILL 1305 00:58:28,040 --> 00:58:29,800 COVER MORE BUT TO BRING HOME THE 1306 00:58:29,800 --> 00:58:31,080 POINT ABOUT RED LINING. 1307 00:58:31,080 --> 00:58:35,560 PEOPLE DID NOT CHOSE NECESSARILY 1308 00:58:35,560 --> 00:58:37,800 TO LIVE IN SEGREGATED 1309 00:58:37,800 --> 00:58:38,480 NEIGHBORHOODS. 1310 00:58:38,480 --> 00:58:41,720 THIS WAS A POLICY DESIGNED BY 1311 00:58:41,720 --> 00:58:46,560 THE GOVERNMENT TO SEPARATE OUT 1312 00:58:46,560 --> 00:58:47,720 BLACKS OR NEGROES CALLED AT THE 1313 00:58:47,720 --> 00:58:49,400 TIME, WHICH WAS A REPRESENTED 1314 00:58:49,400 --> 00:58:50,960 LOW GRADE PROPERTIES SO THE 1315 00:58:50,960 --> 00:58:53,360 MECHANISM WAS TO BANKING SYSTEM 1316 00:58:53,360 --> 00:58:56,040 AND BANKS WOULD NOT LOAN MONEY 1317 00:58:56,040 --> 00:59:00,400 TO FAMILIES IN THESE AREAS TO 1318 00:59:00,400 --> 00:59:01,840 BUY PROPERTY OR WOULD MAKE IT 1319 00:59:01,840 --> 00:59:03,840 MUCH HARDER TO LOAN MONEY. 1320 00:59:03,840 --> 00:59:06,840 SO, THE WAY FAMILIES IN THE U.S. 1321 00:59:06,840 --> 00:59:18,720 BUILD EQUITY, MUCU.S. TO OWNSO N 1322 00:59:20,760 --> 00:59:23,040 THOUGH IT WAS LEGAL TODAY, IT 1323 00:59:23,040 --> 00:59:25,280 HAS HAD ITS EFFECTS IN THE U.S. 1324 00:59:25,280 --> 00:59:27,640 THIS IS ONE EXAMPLE OF AN 1325 00:59:27,640 --> 00:59:31,200 INTERVENTION WHERE WE MAY SEE 1326 00:59:31,200 --> 00:59:34,040 AND I KNOW NIA HAS FUNDED A 1327 00:59:34,040 --> 00:59:39,200 NUMBER OF BEHAVIORAL ECONOMIC 1328 00:59:39,200 --> 00:59:45,120 STUDIES, THIS WAS FUNDED BY 1329 00:59:45,120 --> 00:59:46,560 LOOKING AT DIABETES AND 60 1330 00:59:46,560 --> 00:59:49,040 AFRICAN AMERICAN WITH MILWAUKEE 1331 00:59:49,040 --> 00:59:50,240 WITH POOR CONTROL OF DIABETES 1332 00:59:50,240 --> 00:59:52,320 AND DEPENDING ON THE INCENTIVES 1333 00:59:52,320 --> 00:59:55,840 YOU SEE DROPS IN HEMOGLOBIN A1C 1334 00:59:55,840 --> 00:59:57,400 OVER THE COURSE OF THREE MONTHS 1335 00:59:57,400 --> 00:59:59,680 THAT WERE ALL SIGNIFICANT BUT 1336 00:59:59,680 --> 01:00:02,400 MODERATE OR HIGH FREQUENCY BEING 1337 01:00:02,400 --> 01:00:02,920 BETTER. 1338 01:00:02,920 --> 01:00:07,640 LET ME END WITH JUST SOME GLOBAL 1339 01:00:07,640 --> 01:00:09,480 THOUGHTS. 1340 01:00:09,480 --> 01:00:11,400 INTERVENTIONS TO ADDRESS 1341 01:00:11,400 --> 01:00:12,280 DISPARITIES NEED TO BE THOUGHT 1342 01:00:12,280 --> 01:00:14,320 OF FROM THE START AS MULTI 1343 01:00:14,320 --> 01:00:15,080 LEVEL. 1344 01:00:15,080 --> 01:00:18,040 WE'RE NOT GOING TO FIND THE 1345 01:00:18,040 --> 01:00:19,080 MAGIC PILL HERE THAT IS GOING TO 1346 01:00:19,080 --> 01:00:21,320 SOLVE DISPARITIES OR THE 1347 01:00:21,320 --> 01:00:22,360 BEHAVIOR CHANGES THAT IS GOING 1348 01:00:22,360 --> 01:00:24,200 TO TAKE ARE KAY OF IT OR THE 1349 01:00:24,200 --> 01:00:25,960 POLICY CHANGE FOR THAT MATTER. 1350 01:00:25,960 --> 01:00:28,480 WE REALLY NEED TO THINK IN 1351 01:00:28,480 --> 01:00:30,160 MULTIPLE LEVELS AND MULTIPLE 1352 01:00:30,160 --> 01:00:31,520 DOMAINS OF INFLUENCE. 1353 01:00:31,520 --> 01:00:33,640 I WANT TO EMPHASIZE THE 1354 01:00:33,640 --> 01:00:35,080 IMPORTANCE OF INTERSECTIONALITY 1355 01:00:35,080 --> 01:00:37,360 FROM OUR PERSPECTIVE, RACE 1356 01:00:37,360 --> 01:00:40,520 ETHNICITY AND SOCIOECONOMIC 1357 01:00:40,520 --> 01:00:43,080 STATUS ARE THE TWO FUNDAMENTAL 1358 01:00:43,080 --> 01:00:44,040 MILL ARREST AND YOU SEE THIS 1359 01:00:44,040 --> 01:00:45,840 ACROSS OTHER CONDITIONS OF WHICH 1360 01:00:45,840 --> 01:00:49,120 AGE IS ANOTHER ONE AND AS WELL 1361 01:00:49,120 --> 01:00:51,880 AS OF COURSE AS SEX AND 1362 01:00:51,880 --> 01:00:53,520 GEOGRAPHY AND SEXUAL ORIENTATION 1363 01:00:53,520 --> 01:00:57,080 AND GENDER IDENTITY IN MANY, 1364 01:00:57,080 --> 01:01:00,280 MANY CHRONIC COMPAN CONDITIONS E 1365 01:01:00,280 --> 01:01:01,960 ALL FAMILIAR WITH. 1366 01:01:01,960 --> 01:01:05,040 IDENTIFYING MECHANISMS IS REALLY 1367 01:01:05,040 --> 01:01:05,640 CRITICAL. 1368 01:01:05,640 --> 01:01:07,880 THEY'RE NOT RESTRICTED TO ONE 1369 01:01:07,880 --> 01:01:09,560 DOMAIN. 1370 01:01:09,560 --> 01:01:11,920 BIOLOGY, SOCIAL INTERACTIONS, 1371 01:01:11,920 --> 01:01:13,000 INDIVIDUAL BEHAVIOR AND THE 1372 01:01:13,000 --> 01:01:14,440 ENVIRONMENT AND THE HEALTH 1373 01:01:14,440 --> 01:01:16,080 SYSTEM ARE JUST GLOBAL 1374 01:01:16,080 --> 01:01:17,040 CATEGORIES WE USE. 1375 01:01:17,040 --> 01:01:18,640 THERE MAY BE OTHERS. 1376 01:01:18,640 --> 01:01:21,560 I HAVE A STRONG BELIEF IN THE 1377 01:01:21,560 --> 01:01:25,720 IMPORTANCE OF COMMUNICATION AND 1378 01:01:25,720 --> 01:01:28,480 COMMUNICATION SCIENCE IN THE 1379 01:01:28,480 --> 01:01:33,920 MICRO ASPECT, THERE'S A MINI 1380 01:01:33,920 --> 01:01:35,760 ASPECTS THERE'S A POWER OF 1381 01:01:35,760 --> 01:01:37,840 PATIENT CLINICIAN INTERACTIONS 1382 01:01:37,840 --> 01:01:39,960 THAT NEED TO BE STUDIED AND 1383 01:01:39,960 --> 01:01:42,120 CAPTURED IN DEVELOPED FURTHER. 1384 01:01:42,120 --> 01:01:44,280 THIS NOT JUST PHYSICIAN, THIS IS 1385 01:01:44,280 --> 01:01:46,840 INCLUDES ALL HEALTHCARE 1386 01:01:46,840 --> 01:01:49,200 PROVIDERS AT ALL LEVELS AND THIS 1387 01:01:49,200 --> 01:01:53,360 IDEA OF BUILDING TRUST THAT 1388 01:01:53,360 --> 01:01:55,480 SUSTAINABLE OVER TIME AND NOT A 1389 01:01:55,480 --> 01:01:59,160 ONE-TIME VISIT OR A ONE-TIME 1390 01:01:59,160 --> 01:02:01,320 HOSPITALIZATION THAT ONE HAS A 1391 01:02:01,320 --> 01:02:04,280 CRISIS AND THIS IS OVER A PERIOD 1392 01:02:04,280 --> 01:02:04,880 OF TIME. 1393 01:02:04,880 --> 01:02:07,240 WE HAVE AN OPPORTUNITY TO 1394 01:02:07,240 --> 01:02:08,560 FURTHER DEVELOP THAT. 1395 01:02:08,560 --> 01:02:10,560 THE IMPLEMENTING STRUCTURE 1396 01:02:10,560 --> 01:02:12,800 CHANGE TO MODIFY INDIVIDUALS AND 1397 01:02:12,800 --> 01:02:15,120 GROUP BEHAVIORS NOT ONLY WOULD 1398 01:02:15,120 --> 01:02:17,160 IT BE LIKE CREATING GREEN SPACE 1399 01:02:17,160 --> 01:02:18,360 WHERE PEOPLE FEEL LIKE THEY CAN 1400 01:02:18,360 --> 01:02:22,440 GO OUTDOORS AND HAVE A SAFE 1401 01:02:22,440 --> 01:02:23,880 ENVIRONMENT SO AGAIN, PEOPLE CAN 1402 01:02:23,880 --> 01:02:29,480 BE OUTDOORS AND WALK OR HAVE 1403 01:02:29,480 --> 01:02:31,480 STAIRS THAT ARE EASY TO ACCESS 1404 01:02:31,480 --> 01:02:33,520 SO THAT IF YOU ARE ABLE TO, YOU 1405 01:02:33,520 --> 01:02:35,200 CAN WALK UP TO THE SECOND FLOOR 1406 01:02:35,200 --> 01:02:37,000 INSTEAD OF TAKING THE ELEVATOR 1407 01:02:37,000 --> 01:02:38,280 ALL THE TIME SO THANK YOU FOR 1408 01:02:38,280 --> 01:02:41,960 YOUR ATTENTION AND I APOLOGIZE I 1409 01:02:41,960 --> 01:02:43,240 WOULDN'T STAY FOR THE PANEL. 1410 01:02:43,240 --> 01:02:45,960 I HAVE ANOTHER MEETING TO 1411 01:02:45,960 --> 01:02:46,640 ANOTHER SITE. 1412 01:02:46,640 --> 01:02:48,840 I'M SURE MY COLLEAGUES WILL HAVE 1413 01:02:48,840 --> 01:02:49,800 A GREAT CONVERSATION WITH YOU. 1414 01:02:49,800 --> 01:02:50,680 THANK YOU. 1415 01:02:50,680 --> 01:02:51,320 >>Shannon Zenk: GOOD MORNING TO 1416 01:02:51,320 --> 01:02:51,920 EVERYONE. 1417 01:02:51,920 --> 01:02:52,720 IT'S A PLEASURE TO BE HERE. 1418 01:02:52,720 --> 01:02:54,560 THANK YOU SO MUCH FOR THE 1419 01:02:54,560 --> 01:02:56,920 INVITATION AND IT'S ALWAYS GREAT 1420 01:02:56,920 --> 01:02:59,280 TO BE IN THE ROOM WITH Dr. 1421 01:02:59,280 --> 01:03:00,600 HODES AND GREAT TO FOLLOW MY 1422 01:03:00,600 --> 01:03:04,280 COLLEAGUE Dr. PEREZ-STABLE. 1423 01:03:04,280 --> 01:03:06,400 SO, I AM DELIGHTED TO BE WITH 1424 01:03:06,400 --> 01:03:07,000 YOU. 1425 01:03:07,000 --> 01:03:08,640 AS WE ALL KNOW, HEALTH 1426 01:03:08,640 --> 01:03:10,920 DISPARITIES RELATED TO AGING ARE 1427 01:03:10,920 --> 01:03:15,440 THE RESULT OF A COMPLEX 1428 01:03:15,440 --> 01:03:18,080 COMBINATION OF BIOLOGICAL, 1429 01:03:18,080 --> 01:03:20,200 BEHAVIORAL, PSYCHOLOGICAL, AND 1430 01:03:20,200 --> 01:03:21,880 ENVIRONMENTAL AND SOCIAL 1431 01:03:21,880 --> 01:03:23,160 FACTORS. 1432 01:03:23,160 --> 01:03:25,600 NOW, PARTICULARLY THE PANELIST 1433 01:03:25,600 --> 01:03:27,000 WHO'S WILL FOLLOW WILL FOCUS ON 1434 01:03:27,000 --> 01:03:28,600 THE BIOLOGICAL FACTORS BUT I'M 1435 01:03:28,600 --> 01:03:32,120 GOING TO FOCUS ON SOCIAL AND 1436 01:03:32,120 --> 01:03:35,960 STRUCTURAL DRIVERS OF HEALTH AND 1437 01:03:35,960 --> 01:03:37,960 OF HEALTH DISPARITIES ALSO KNOWN 1438 01:03:37,960 --> 01:03:39,040 AS SOCIAL DETERMINANTS OF 1439 01:03:39,040 --> 01:03:39,560 HEALTH. 1440 01:03:39,560 --> 01:03:41,800 SO I'M GOING TO COVER FOUR MAIN 1441 01:03:41,800 --> 01:03:42,680 TOPICS. 1442 01:03:42,680 --> 01:03:44,840 FIRST, WHAT DO WE MEAN WHEN WE 1443 01:03:44,840 --> 01:03:46,600 SAY STRUCTURAL AND SOCIAL 1444 01:03:46,600 --> 01:03:48,040 DETERMINANTS OF HEALTH AND 1445 01:03:48,040 --> 01:03:49,880 STRUCTURAL INTERVENTIONS? 1446 01:03:49,880 --> 01:03:52,160 SECOND, WHAT ARE THE 1447 01:03:52,160 --> 01:03:53,880 IMPLICATIONS OF SOCIAL 1448 01:03:53,880 --> 01:03:55,400 DETERMINANTS OF HEALTH ON AGING 1449 01:03:55,400 --> 01:03:57,080 RELATED HEALTH OUTCOMES? 1450 01:03:57,080 --> 01:03:58,760 I'LL HIGHLIGHT WHY DIFFERENCES 1451 01:03:58,760 --> 01:04:01,640 IN AGING OUTCOMES THAT MAY HAVE 1452 01:04:01,640 --> 01:04:04,360 BEEN ATTRIBUTED TO BIOLOGY OR 1453 01:04:04,360 --> 01:04:07,240 BEHAVIOR MAY ACTUALLY BE THE 1454 01:04:07,240 --> 01:04:14,480 CONSEQUENCES OF INEQUITABLE 1455 01:04:14,480 --> 01:04:14,800 SYSTEMS. 1456 01:04:14,800 --> 01:04:17,520 LASTLY, I'LL SHARE EXAMPLES OF 1457 01:04:17,520 --> 01:04:20,840 NIH INITIATIVES FOCUSED ON 1458 01:04:20,840 --> 01:04:22,960 STRUCTURAL AND SOCIAL 1459 01:04:22,960 --> 01:04:24,040 DETERMINANTS OF HEALTH. 1460 01:04:24,040 --> 01:04:27,000 SO FIRST, LET'S DEFINE A FEW KEY 1461 01:04:27,000 --> 01:04:29,120 TERMS TO HELP LAY THE FOUNDATION 1462 01:04:29,120 --> 01:04:31,120 FOR THE DISCUSSION. 1463 01:04:31,120 --> 01:04:33,880 THERE ARE MULTIPLE 1464 01:04:33,880 --> 01:04:34,920 CONCEPTUALIZATIONS OF SOCIAL 1465 01:04:34,920 --> 01:04:37,120 DETERMINANTS OF HEALTH ON THE 1466 01:04:37,120 --> 01:04:39,360 LITERATURE SO I'LL SHARE ONE 1467 01:04:39,360 --> 01:04:43,760 PERSPECTIVE ON THE DETERMINANTS. 1468 01:04:43,760 --> 01:04:45,200 SO WHEN I SAY SOCIAL 1469 01:04:45,200 --> 01:04:46,640 DETERMINANTS OF HEALTH I'M 1470 01:04:46,640 --> 01:04:47,800 REFERRING TO CONDITIONS WHICH 1471 01:04:47,800 --> 01:04:50,280 PEOPLE ARE BORN, GROW, LIVE, 1472 01:04:50,280 --> 01:04:52,640 LEARN, PLAY AND AGE. 1473 01:04:52,640 --> 01:04:54,920 AS WELL AS THE WIDER SET OF 1474 01:04:54,920 --> 01:04:56,960 FORCES AND SYSTEMS THAT SHAPE 1475 01:04:56,960 --> 01:05:05,920 THE DISTRIBUTION OF POWER AS 1476 01:05:05,920 --> 01:05:07,040 WELL AS PEOPLE'S SOCIAL POSITION 1477 01:05:07,040 --> 01:05:08,680 WITHIN SOCIETY. 1478 01:05:08,680 --> 01:05:12,120 NOW THESE ECONOMIC, LEGAL, 1479 01:05:12,120 --> 01:05:14,920 REGULATORY AND SOCIAL FORCES AND 1480 01:05:14,920 --> 01:05:16,360 SYSTEM ARE OFTEN REFERRED TO AS 1481 01:05:16,360 --> 01:05:18,560 STRUCTURAL FACTORS. 1482 01:05:18,560 --> 01:05:20,080 EXAMPLES INCLUDE SOCIAL AND 1483 01:05:20,080 --> 01:05:24,160 ECONOMIC POLICIES, GOVERNANCE, 1484 01:05:24,160 --> 01:05:26,480 SOCIAL VALUES AND RACISM AS 1485 01:05:26,480 --> 01:05:28,400 EXPRESSED IN POLICIES AND 1486 01:05:28,400 --> 01:05:29,440 REGULATIONS ARE ANOTHER EXAMPLE 1487 01:05:29,440 --> 01:05:34,520 OF A STRUCTURAL FACTOR. 1488 01:05:34,520 --> 01:05:36,080 THEY SHAPE WHETHER RESOURCES AND 1489 01:05:36,080 --> 01:05:37,600 OPPORTUNITIES NECESSARY FOR 1490 01:05:37,600 --> 01:05:39,960 HEALTH ARE EQUALLY DISTRIBUTED 1491 01:05:39,960 --> 01:05:43,040 AND SOCIETY OR WHETHER THEY ARE 1492 01:05:43,040 --> 01:05:44,760 UNJUSTLY DISTRIBUTED BASED ON 1493 01:05:44,760 --> 01:05:47,440 FACTORS SUCH AS RACE, ETHNICITY, 1494 01:05:47,440 --> 01:05:50,240 GENDER IDENTITY, SEXUAL 1495 01:05:50,240 --> 01:05:51,720 ORIENTATION, SOCIOECONOMIC 1496 01:05:51,720 --> 01:05:54,960 POSITIONS OR GEOGRAPHY. 1497 01:05:54,960 --> 01:05:56,000 NOW SOME SOCIAL DETERMINANTS OF 1498 01:05:56,000 --> 01:05:58,840 HEALTH ARE PROTECT TIVE WHERE AS 1499 01:05:58,840 --> 01:06:02,400 OTHERS ARE HARMFUL, INCRUISING 1500 01:06:02,400 --> 01:06:03,360 RISK OF POOR HEALTH. 1501 01:06:03,360 --> 01:06:04,920 WE THINK OF SOCIAL DETERMINANTS 1502 01:06:04,920 --> 01:06:07,080 AS NEGATIVE BUT THEY'RE POSITIVE 1503 01:06:07,080 --> 01:06:09,680 AND NEGATIVE SOCIAL DETERMINANTS 1504 01:06:09,680 --> 01:06:11,320 AND SOCIAL DETERMINANTS OF 1505 01:06:11,320 --> 01:06:14,200 HEALTH IMPACT NOT ONLY 1506 01:06:14,200 --> 01:06:15,880 INDIVIDUAL HEALTH BUT POPULATION 1507 01:06:15,880 --> 01:06:17,400 HEALTH AS WELL AND THIS APPLIES 1508 01:06:17,400 --> 01:06:20,840 ACROSS DISEASES AND CONDITIONS, 1509 01:06:20,840 --> 01:06:22,520 POPULATION GROUPS AND STAGES OF 1510 01:06:22,520 --> 01:06:25,080 THE LIFE COURSE. 1511 01:06:25,080 --> 01:06:27,680 SO LET ME FOCUS ON WHAT WE MEAN 1512 01:06:27,680 --> 01:06:29,360 BY STRUCTURAL INTERVENTIONS. 1513 01:06:29,360 --> 01:06:31,440 SO HERE IS HOW I WOULD 1514 01:06:31,440 --> 01:06:32,040 SUMMARIZE. 1515 01:06:32,040 --> 01:06:33,480 STRUCTURAL INTERVENTIONS ARE 1516 01:06:33,480 --> 01:06:35,960 MACRO LEVEL OR MAY SO LEVEL 1517 01:06:35,960 --> 01:06:37,880 STRATEGIES THAT TARGET THESE 1518 01:06:37,880 --> 01:06:39,480 ECONOMIC LEGAL, POLITICAL, AND 1519 01:06:39,480 --> 01:06:41,880 SOCIAL SYSTEMS AND FORCES. 1520 01:06:41,880 --> 01:06:44,320 OFTEN POLICIES TO EXAMINE THEIR 1521 01:06:44,320 --> 01:06:46,240 IMPACTS ON HEALTH. 1522 01:06:46,240 --> 01:06:47,600 STRUCTURAL INTERVENTION SPAN A 1523 01:06:47,600 --> 01:06:49,600 NUMBER OF SECTORS THAT CAN 1524 01:06:49,600 --> 01:06:52,720 INCLUDE ECONOMIC, EDUCATION, 1525 01:06:52,720 --> 01:06:53,680 HOUSING AND TRANSPORTATION TO 1526 01:06:53,680 --> 01:06:56,240 NAME JUST A FEW. 1527 01:06:56,240 --> 01:06:58,840 THESE APPROACHES OFTEN EFFECT 1528 01:06:58,840 --> 01:07:01,360 THESE DAILY LIVING CONDITIONS. 1529 01:07:01,360 --> 01:07:04,040 SO, ALL THE CONTEXT WHERE PEOPLE 1530 01:07:04,040 --> 01:07:05,240 THEIR LIVES. 1531 01:07:05,240 --> 01:07:06,760 COMMUNITIES, WORKPLACES, 1532 01:07:06,760 --> 01:07:08,640 SCHOOLS, AND THE HEALTH-CARE 1533 01:07:08,640 --> 01:07:11,720 SYSTEM THAT Dr. PEREZ-STABLE 1534 01:07:11,720 --> 01:07:12,360 HIGHLIGHTED. 1535 01:07:12,360 --> 01:07:14,160 NOW IT'S IMPORTANT TO KNOW THAT 1536 01:07:14,160 --> 01:07:15,480 STRUCTURE INTERVENTIONS ARE 1537 01:07:15,480 --> 01:07:19,560 GENERALLY DISEASE AGNOSTIC. 1538 01:07:19,560 --> 01:07:22,520 WHICH ENABLES THEM TO TACKLE THE 1539 01:07:22,520 --> 01:07:23,800 COMMON UPSTREAM RISK FACTORS 1540 01:07:23,800 --> 01:07:25,840 THAT HAVE IMPACTED MULTIPLE 1541 01:07:25,840 --> 01:07:27,360 HEALTH OUTCOMES AND THIS ABILITY 1542 01:07:27,360 --> 01:07:29,000 TO IMPACT MULTIPLE HEALTH 1543 01:07:29,000 --> 01:07:32,920 OUTCOMES WAS HIGHLIGHTED THIS 1544 01:07:32,920 --> 01:07:35,000 MORNING UNDER THE GEROSCIENCE 1545 01:07:35,000 --> 01:07:35,840 HYPOTHESIS. 1546 01:07:35,840 --> 01:07:37,840 NOW, INCREASINGLY DISCUSSING THE 1547 01:07:37,840 --> 01:07:39,160 LITERATURE, ESPECIALLY RELATED 1548 01:07:39,160 --> 01:07:40,920 TO HEALTHCARE ARE SOCIAL NEEDS 1549 01:07:40,920 --> 01:07:43,640 OR HEALTH RELATED SOCIAL NEEDS. 1550 01:07:43,640 --> 01:07:45,400 THE TERMS SOCIAL NEEDS IS OFTEN 1551 01:07:45,400 --> 01:07:48,440 USED TO REFER TO AN ADVERSE 1552 01:07:48,440 --> 01:07:49,640 INDIVIDUAL OR FAMILY LEVEL 1553 01:07:49,640 --> 01:07:53,720 SOCIAL RISK FACTORS SUCH AS LOW 1554 01:07:53,720 --> 01:07:55,520 INCOME, FOOD INSECURITY OR 1555 01:07:55,520 --> 01:07:57,160 HOUSING INSTABILITY. 1556 01:07:57,160 --> 01:07:58,760 SOME CONSIDER SOCIAL NEEDS AS 1557 01:07:58,760 --> 01:08:00,200 SOCIAL DETERMINANTS OF HEALTH 1558 01:08:00,200 --> 01:08:02,360 AND OTHER TIMES, THESE 1559 01:08:02,360 --> 01:08:04,360 INDIVIDUAL OR FAMILY LEVEL 1560 01:08:04,360 --> 01:08:06,440 FACTORS ARE CONSIDERED A MORE 1561 01:08:06,440 --> 01:08:08,560 DOWNSTREAM MANIFESTATION OF THE 1562 01:08:08,560 --> 01:08:10,000 IMPACT OF STRUCTURAL AND OTHER 1563 01:08:10,000 --> 01:08:12,360 SOCIAL DETERMINANTS OF HEALTH. 1564 01:08:12,360 --> 01:08:17,840 NOW REGARDLESS OF WHETHER 1565 01:08:17,840 --> 01:08:19,280 THEY'RE UNDER THE UMBRELLA IT'S 1566 01:08:19,280 --> 01:08:20,960 REALLY IMPORTANT TO NOTE THAT WE 1567 01:08:20,960 --> 01:08:23,080 NEED RESEARCH ON SOCIAL AND 1568 01:08:23,080 --> 01:08:25,120 ECONOMIC FACTORS AT THE 1569 01:08:25,120 --> 01:08:29,760 SOCIETAL, COMMUNITY, FAMILY, AND 1570 01:08:29,760 --> 01:08:34,600 INDIVIDUAL LEVELS. 1571 01:08:34,600 --> 01:08:36,160 WE NEED RESEARCH TO IDENTIFY 1572 01:08:36,160 --> 01:08:38,240 HEALTH SOLUTIONS AT ALL OF THESE 1573 01:08:38,240 --> 01:08:38,600 LEVELS. 1574 01:08:38,600 --> 01:08:40,120 WHEN WE DESCRIBE THE DIFFERENCES 1575 01:08:40,120 --> 01:08:42,160 AND HEALTH OUTCOMES, DUE TO 1576 01:08:42,160 --> 01:08:43,920 STRUCTURAL AND SOCIAL 1577 01:08:43,920 --> 01:08:45,240 DETERMINANTS OF HEALTH WE OFTEN 1578 01:08:45,240 --> 01:08:48,000 THINK ABOUT HEALTH DISPARITIES 1579 01:08:48,000 --> 01:08:50,400 WHICH ELISEO ADDRESSED IN HIS 1580 01:08:50,400 --> 01:08:50,960 TALK. 1581 01:08:50,960 --> 01:08:52,760 MANY PEOPLE BELIEVE ADDRESSING 1582 01:08:52,760 --> 01:08:53,680 THE SOCIAL DETERMINANTS OF 1583 01:08:53,680 --> 01:08:55,880 HEALTH IS A PRIMARY APPROACH TO 1584 01:08:55,880 --> 01:08:56,960 ACHIEVE HEALTH EQUITY. 1585 01:08:56,960 --> 01:08:58,080 AND I BELIEVE THAT THIS IS AS 1586 01:08:58,080 --> 01:08:58,440 WELL. 1587 01:08:58,440 --> 01:09:00,920 I WANT TO STRESS THAT WE CANNOT 1588 01:09:00,920 --> 01:09:03,120 UNDERSTAND AND ADDRESS HEALTH 1589 01:09:03,120 --> 01:09:04,160 DISPARITIES WITHOUT CONSIDERING 1590 01:09:04,160 --> 01:09:07,360 THE STRUCTURAL AND SOCIAL 1591 01:09:07,360 --> 01:09:10,360 FACTORS. 1592 01:09:10,360 --> 01:09:11,800 INEQUITABLE DISTRIBUTION OF 1593 01:09:11,800 --> 01:09:15,480 ADVERSE DAILY LIFE AND RESOURCES 1594 01:09:15,480 --> 01:09:17,600 ARE FUNDAMENTAL DRIVERS OF 1595 01:09:17,600 --> 01:09:18,040 HEALTH INEQUITIES. 1596 01:09:18,040 --> 01:09:19,720 SO NOW THAT WE HAVE A SHARED 1597 01:09:19,720 --> 01:09:21,360 UNDERSTANDING OF WHAT WE MEAN BY 1598 01:09:21,360 --> 01:09:23,080 SOCIAL DETERMINANTS OF HEALTH 1599 01:09:23,080 --> 01:09:23,920 AND ESPECIALLY STRUCTURAL 1600 01:09:23,920 --> 01:09:25,680 FACTORS AND INTERVENTIONS LET'S 1601 01:09:25,680 --> 01:09:27,080 TURN TO THEIR CRITICAL 1602 01:09:27,080 --> 01:09:28,640 IMPORTANCE FOR AGING RELATED 1603 01:09:28,640 --> 01:09:38,920 HEALTH OUTCOMES. 1604 01:09:44,080 --> 01:09:46,640 WE KNOW EXPOSURE TO VIS 1605 01:09:46,640 --> 01:09:47,840 ADVANTAGE CAN A COUPLE LATE OVER 1606 01:09:47,840 --> 01:09:52,160 TIME TO IMPACT HEALTH. 1607 01:09:52,160 --> 01:09:54,000 A LIFE COURSE PERSPECTIVE 1608 01:09:54,000 --> 01:09:55,080 RELATED TO SOCIAL DETERMINANTS 1609 01:09:55,080 --> 01:09:58,080 OF HEALTH IS HIGHLY RELEVANT FOR 1610 01:09:58,080 --> 01:09:59,520 UNDERSTANDING AND ADDRESSING 1611 01:09:59,520 --> 01:10:02,640 AGING RELATED HEALTH OUTCOMES. 1612 01:10:02,640 --> 01:10:05,360 ALSO RELEVANT FOR THIS SESSION, 1613 01:10:05,360 --> 01:10:07,720 WHICH I'LL LEAVE TO MY FELLOW 1614 01:10:07,720 --> 01:10:10,960 PANELIST TO EXPOUND UPON IS 1615 01:10:10,960 --> 01:10:12,040 STRUCTURAL AND OTHER SOCIAL 1616 01:10:12,040 --> 01:10:13,960 DETERMINANTS OF HEALTH ARE 1617 01:10:13,960 --> 01:10:15,160 BIOLOGICALLY EMBEDDED THAT'S 1618 01:10:15,160 --> 01:10:17,600 THEY INITIATE AND SUSTAIN 1619 01:10:17,600 --> 01:10:18,880 BIOLOGICAL CHANGES THAT CAN LEAD 1620 01:10:18,880 --> 01:10:21,440 TO DISPARITIES AND WEATHERING OR 1621 01:10:21,440 --> 01:10:22,880 ACCELERATED AGING AND HEALTH 1622 01:10:22,880 --> 01:10:24,880 STATUS LATER IN LIFE AND LIFE 1623 01:10:24,880 --> 01:10:26,880 EXPECT APP SEE AND I WOULD LIKE 1624 01:10:26,880 --> 01:10:30,600 TO ACKNOWLEDGE THIS FIGURE FROM 1625 01:10:30,600 --> 01:10:32,840 Dr. MICHELLE EVANS AT NIA AND 1626 01:10:32,840 --> 01:10:36,800 HER COLLEAGUES SHOWING THESE 1627 01:10:36,800 --> 01:10:37,800 RELATIONSHIPS. 1628 01:10:37,800 --> 01:10:39,640 SO, WHAT SOCIAL DETERMINANTS AND 1629 01:10:39,640 --> 01:10:41,440 SOCIAL NEEDS ARE RELEVANT FOR 1630 01:10:41,440 --> 01:10:42,920 AGING RESEARCH. 1631 01:10:42,920 --> 01:10:45,400 IN FACT, WE HAVE DECADES OF 1632 01:10:45,400 --> 01:10:46,840 RESEARCH ON SOCIAL DETERMINANTS 1633 01:10:46,840 --> 01:10:48,760 OF HEALTH, SOCIAL NEEDS, AND 1634 01:10:48,760 --> 01:10:51,400 AGING RELATED HEALTH OUTCOMES. 1635 01:10:51,400 --> 01:10:53,240 FOR EXAMPLE, THIS PAPER 1636 01:10:53,240 --> 01:10:54,680 DISCUSSED EVIDENCE ON SOCIAL 1637 01:10:54,680 --> 01:10:58,040 DETERMINANTS AND OLDER ADULTS 1638 01:10:58,040 --> 01:10:59,400 ACROSS TEN SOCIAL DETERMINANTS 1639 01:10:59,400 --> 01:11:00,960 AND NEEDS IDENTIFIED BY THE 1640 01:11:00,960 --> 01:11:03,080 WORLD HEALTH ORGANIZATION. 1641 01:11:03,080 --> 01:11:05,240 NOW ALL WERE RELEVANT FOR HEALTH 1642 01:11:05,240 --> 01:11:07,960 OF OLDER ADULTS. 1643 01:11:07,960 --> 01:11:09,760 IN GENERAL, THOUGH, SOCIAL 1644 01:11:09,760 --> 01:11:11,080 DETERMINANTS AND SOCIAL NEEDS 1645 01:11:11,080 --> 01:11:12,520 THAT ARE RELEVANT FOR THE HEALTH 1646 01:11:12,520 --> 01:11:15,240 OF OLDER ADULTS, ARE THE SAME AS 1647 01:11:15,240 --> 01:11:17,120 THOSE THAT WE SEE AT OTHER LIFE 1648 01:11:17,120 --> 01:11:17,760 STAGES. 1649 01:11:17,760 --> 01:11:21,240 WITH SOME DIFFERENCES. 1650 01:11:21,240 --> 01:11:23,040 BUT, DO THEIR CUMULATIVE EFFECT 1651 01:11:23,040 --> 01:11:27,960 OVER THE LIFE COURSE, IT'S MUCH 1652 01:11:27,960 --> 01:11:31,960 MAGNIFIED CONSIDERABLY AS PEOPLE 1653 01:11:31,960 --> 01:11:36,360 AGE. 1654 01:11:36,360 --> 01:11:39,080 SO LET'S CONSIDER THE 1655 01:11:39,080 --> 01:11:43,360 RELATIONSHIPS BETWEEN SOCIAL 1656 01:11:43,360 --> 01:11:44,080 DETERMINE ADULTS. 1657 01:11:44,080 --> 01:11:46,040 OLDER ADULTS FOUND THAT SEVERAL 1658 01:11:46,040 --> 01:11:47,440 DOMAINS OF THE NEIGHBORHOOD 1659 01:11:47,440 --> 01:11:49,720 BUILT ENVIRONMENT INCLUDING LAND 1660 01:11:49,720 --> 01:11:52,360 USE, PHYSICAL DISORDERS, WALK 1661 01:11:52,360 --> 01:11:53,960 ACT AND GREEN SPACE, WERE 1662 01:11:53,960 --> 01:11:55,720 ASSOCIATED WITH MEASURES OF 1663 01:11:55,720 --> 01:11:58,960 COGNITIVE FUNCTION AND DEMENTIA 1664 01:11:58,960 --> 01:11:59,600 RISK. 1665 01:11:59,600 --> 01:12:01,000 RELATIONSHIPS WELL COGNITIVE 1666 01:12:01,000 --> 01:12:03,280 FUNCTION WERE STRONGER, AMONG 1667 01:12:03,280 --> 01:12:07,200 OLDER WOMEN AND THOSE WITH DIS A 1668 01:12:07,200 --> 01:12:11,120 DISABILITY AS WELL AS THOSE WITH 1669 01:12:11,120 --> 01:12:14,080 LOWER SOCIOECONOMIC STATUS. 1670 01:12:14,080 --> 01:12:17,280 BLACK OLDER ADULT AND BIRTH IN A 1671 01:12:17,280 --> 01:12:18,720 JIM CROW STATE USED AS A MEASURE 1672 01:12:18,720 --> 01:12:20,760 OF STRUCTURAL RACISM WAS HAVING 1673 01:12:20,760 --> 01:12:23,280 MORE AGGRESSIVE BREAST CANCER 1674 01:12:23,280 --> 01:12:26,200 SUBTYPES AS WELL AS PREMATURE 1675 01:12:26,200 --> 01:12:26,920 MORTALITY. 1676 01:12:26,920 --> 01:12:28,200 NOW INTERESTINGLY THE 1677 01:12:28,200 --> 01:12:30,360 RELATIONSHIP WITH PREMATURE 1678 01:12:30,360 --> 01:12:31,800 MORTALITY WAS STRONGEST AMONG 1679 01:12:31,800 --> 01:12:34,400 THOSE WHO WERE OLDEST DURING THE 1680 01:12:34,400 --> 01:12:35,640 JIM CROW ERA. 1681 01:12:35,640 --> 01:12:37,160 THAT MEANS THEY HAD GREATER 1682 01:12:37,160 --> 01:12:39,480 DEGREE OF EXPOSURE TO JIM CROW 1683 01:12:39,480 --> 01:12:42,320 POLICIES OVER TIME. 1684 01:12:42,320 --> 01:12:44,880 ONE OF THE MOST STRIKING SOCIAL 1685 01:12:44,880 --> 01:12:47,200 INEQUITIES IS THE RACIAL WEALTH 1686 01:12:47,200 --> 01:12:48,840 GAP WHICH HAS BEEN LINKED TO 1687 01:12:48,840 --> 01:12:50,280 HEALTH OUTCOMES AND HEALTH 1688 01:12:50,280 --> 01:13:01,440 INDDISPARITIES.THEY WERE THREE R 1689 01:13:01,680 --> 01:13:03,080 THE LEAST WEALTHY COMPARED TO 1690 01:13:03,080 --> 01:13:06,720 THE MOST WEALTHY INDIVIDUALS. 1691 01:13:06,720 --> 01:13:08,840 THE RECENT ANALYSIS FOUND THAT 1692 01:13:08,840 --> 01:13:10,080 DIFFERENCES IN WEALTH WERE 1693 01:13:10,080 --> 01:13:11,760 ASSOCIATED WITH THE LONGEVITY 1694 01:13:11,760 --> 01:13:13,640 GAP BETWEEN BLACK AND WHITE 1695 01:13:13,640 --> 01:13:16,640 OLDER ADULT AND MORE OVER, 1696 01:13:16,640 --> 01:13:17,640 SIMULATIONS IN THAT STUDY SHOWED 1697 01:13:17,640 --> 01:13:19,520 THAT REPARATIONS PAYMENTS, 1698 01:13:19,520 --> 01:13:21,680 GREATLY REDUCED THE RACIAL GAP 1699 01:13:21,680 --> 01:13:24,680 AND LONGEVITY AND FROM BETWEEN 1700 01:13:24,680 --> 01:13:27,480 65 AND OVER 100 PERCENT. 1701 01:13:27,480 --> 01:13:29,560 AGAIN, HIGHLIGHTING THE ROLE OF 1702 01:13:29,560 --> 01:13:31,120 POLICIES AND IDENTIFYING 1703 01:13:31,120 --> 01:13:34,440 SOLUTIONS FOR HEALTH 1704 01:13:34,440 --> 01:13:34,880 DISPARITIES. 1705 01:13:34,880 --> 01:13:37,960 SO WHAT ARE THE IMPLICATIONS OF 1706 01:13:37,960 --> 01:13:39,120 STRUCTURAL AND SOCIAL 1707 01:13:39,120 --> 01:13:40,200 DETERMINANTS FOR AGING RESEARCH? 1708 01:13:40,200 --> 01:13:42,280 I WOULD ARGUE THAT IF WE ARE 1709 01:13:42,280 --> 01:13:44,840 CONDUCTING HEALTH DISPARITIES 1710 01:13:44,840 --> 01:13:47,000 RESEARCH BUT IGNORING STRUCTURAL 1711 01:13:47,000 --> 01:13:49,400 AND SOCIAL FACTORS THAT WE RISK 1712 01:13:49,400 --> 01:13:53,720 AN INCOMPLETE OR INACCURATE 1713 01:13:53,720 --> 01:13:55,880 UNDERSTANDING AND MISGUIDED 1714 01:13:55,880 --> 01:13:57,360 CONCLUSIONS ON THE UNDERLYING 1715 01:13:57,360 --> 01:13:59,560 DRIVERS OF AGING RELATED HEALTH 1716 01:13:59,560 --> 01:14:00,760 DISPARITIES AND OUTCOME. 1717 01:14:00,760 --> 01:14:03,400 I WOULD ARGUE IGNORING 1718 01:14:03,400 --> 01:14:04,560 STRUCTURAL AND SOCIAL 1719 01:14:04,560 --> 01:14:05,840 DETERMINANTS RISKS INTERVENTIONS 1720 01:14:05,840 --> 01:14:09,040 THAT ARE LESS EFFECTIVE. 1721 01:14:09,040 --> 01:14:11,080 AND SHORT TERM HEALTH 1722 01:14:11,080 --> 01:14:12,400 IMPROVEMENTS THAT ARE NOT 1723 01:14:12,400 --> 01:14:14,600 SUSTAINABLE OR TRANSLATABLE. 1724 01:14:14,600 --> 01:14:16,080 AND THIS IS BECAUSE STRUCTURAL 1725 01:14:16,080 --> 01:14:17,640 FACTORS ARE FUNDAMENTAL CAUSES 1726 01:14:17,640 --> 01:14:18,960 OF DISEASE. 1727 01:14:18,960 --> 01:14:20,440 THEY CONTRIBUTE TO MULTIPLE 1728 01:14:20,440 --> 01:14:22,000 HEALTH DISPARITIES THROUGH 1729 01:14:22,000 --> 01:14:24,120 MULTIPLE MECHANISMS AND 1730 01:14:24,120 --> 01:14:24,880 PATHWAYS. 1731 01:14:24,880 --> 01:14:27,320 AND AS NEW TREATMENTS OR 1732 01:14:27,320 --> 01:14:29,480 DISEASES OR HEALTH SOLUTIONS ARE 1733 01:14:29,480 --> 01:14:30,560 AVAILABLE TO ADDRESS ONE OF 1734 01:14:30,560 --> 01:14:36,120 THESE MECHANISMS, SOCIAL 1735 01:14:36,120 --> 01:14:38,400 INEQUALITIES EMERGE OR ARE 1736 01:14:38,400 --> 01:14:39,720 REPLICATEDDED BECAUSE THEY HAVE 1737 01:14:39,720 --> 01:14:41,160 RESOURCES NEEDED TO EXPLOIT THEM 1738 01:14:41,160 --> 01:14:44,200 AND WE SAW THIS IN COVID. 1739 01:14:44,200 --> 01:14:45,720 IDENTIFYING EFFECTIVE 1740 01:14:45,720 --> 01:14:47,520 INTERVENTIONS FOR PROXIMAL RISK 1741 01:14:47,520 --> 01:14:49,560 FACTORS OR MECHANISMS AND NOT 1742 01:14:49,560 --> 01:14:53,680 THE UPSTREAM DRIVERS IS NOT 1743 01:14:53,680 --> 01:14:55,600 ENOUGH. 1744 01:14:55,600 --> 01:14:57,240 WE MUST ADDRESS UPSTREAM 1745 01:14:57,240 --> 01:14:58,800 SOCIETAL DRIVERS TO ELIMINATE 1746 01:14:58,800 --> 01:15:02,080 HEALTH DISPARITIES. 1747 01:15:02,080 --> 01:15:04,960 SO, HOW SHOULD RESEARCHERS 1748 01:15:04,960 --> 01:15:05,880 INCORPORATE SOCIAL AND 1749 01:15:05,880 --> 01:15:07,480 STRUCTURAL FACTORS INTO THEIR 1750 01:15:07,480 --> 01:15:08,760 WORK AND WHAT DOES IT ALL HAVE 1751 01:15:08,760 --> 01:15:12,440 TO DO WITH THE NATIONAL 1752 01:15:12,440 --> 01:15:14,200 INSTITUTE OF NURSING RESEARCH. 1753 01:15:14,200 --> 01:15:15,800 AS OUR NAME SUGGESTS, NURSES ARE 1754 01:15:15,800 --> 01:15:17,800 AT THE HEART OF EVERYTHING WE 1755 01:15:17,800 --> 01:15:20,320 DO. 1756 01:15:20,320 --> 01:15:21,640 NURSES INTER AGENT WITH 1757 01:15:21,640 --> 01:15:23,080 INDIVIDUALS AND FAMILIES ACROSS 1758 01:15:23,080 --> 01:15:26,240 A WIDE VARIETY OF SETTINGS. 1759 01:15:26,240 --> 01:15:27,800 HOSPITALS AND CLINICS TO BE SURE 1760 01:15:27,800 --> 01:15:29,800 AND SCHOOLS AND WORKPLACES AND 1761 01:15:29,800 --> 01:15:31,920 HOMES AND LONG-TERM CARE 1762 01:15:31,920 --> 01:15:34,680 FACILITIES, AND IN POLICY 1763 01:15:34,680 --> 01:15:36,280 SETTINGS AND IN JUSTICE SETTINGS 1764 01:15:36,280 --> 01:15:38,720 AND COMMUNITIES FROM URBAN TO 1765 01:15:38,720 --> 01:15:39,680 SUBURBAN TO RURAL. 1766 01:15:39,680 --> 01:15:42,560 OUR WORK GIVES US A DEEP 1767 01:15:42,560 --> 01:15:45,920 UNDERSTANDING OF EYE WIDE ARRAY 1768 01:15:45,920 --> 01:15:49,120 OF FACTORS FROM PERSONAL TO 1769 01:15:49,120 --> 01:15:50,760 SOCIETAL THAT LEAD TO HEALTH 1770 01:15:50,760 --> 01:15:52,000 AMONG SOME AND ILLNESS AMONG 1771 01:15:52,000 --> 01:15:52,520 OTHERS. 1772 01:15:52,520 --> 01:15:54,400 WE'RE HIGHLY WELL POSITIONED TO 1773 01:15:54,400 --> 01:15:56,920 CONDUCT RESEARCH ON SOCIAL 1774 01:15:56,920 --> 01:15:58,240 DETERMINANTS OF HEALTH THAT PLAY 1775 01:15:58,240 --> 01:16:00,200 SUCH AN IMPORTANT ROLE IN 1776 01:16:00,200 --> 01:16:03,720 ADVANCING HEALTH EQUITY AND FOR 1777 01:16:03,720 --> 01:16:06,280 ALL AMERICANS INCLUDING OLDER 1778 01:16:06,280 --> 01:16:06,680 ADULTS. 1779 01:16:06,680 --> 01:16:09,000 AS LAID OUT IN OUR STRATEGIC 1780 01:16:09,000 --> 01:16:11,400 PLAN WHICH WE RELEASED LAST MAY 1781 01:16:11,400 --> 01:16:13,360 OUR RESEARCH WITH NURSING 1782 01:16:13,360 --> 01:16:14,720 PERSPECTIVE AT ITS CORE IS 1783 01:16:14,720 --> 01:16:16,120 HEALTH SOLUTIONS FOR PEOPLE IN 1784 01:16:16,120 --> 01:16:20,440 THE CONTEXT OF THEIR LIVES AND 1785 01:16:20,440 --> 01:16:23,480 LIVING CONDITIONS. 1786 01:16:23,480 --> 01:16:24,680 ACROSS SETTINGS WHERE NURSES 1787 01:16:24,680 --> 01:16:25,400 PRACTICE. 1788 01:16:25,400 --> 01:16:27,400 IT INCLUDES FIVE RESEARCH LENSES 1789 01:16:27,400 --> 01:16:30,560 WHICH REALLY ARE DESCRIBING A 1790 01:16:30,560 --> 01:16:31,360 PERSPECTIVE THROUGH WHICH TO 1791 01:16:31,360 --> 01:16:34,560 ADDRESS A HEALTH CHALLENGE. 1792 01:16:34,560 --> 01:16:36,440 WE HAVE FIVE RESEARCH LENSES 1793 01:16:36,440 --> 01:16:38,080 THAT WE THINK LEVERAGE THE 1794 01:16:38,080 --> 01:16:41,840 STRENGTHS OF NURSING SCIENCE TO 1795 01:16:41,840 --> 01:16:42,840 INNOVATE, THINK BIGGER AND 1796 01:16:42,840 --> 01:16:44,880 INCREASE OUR IMPACT. 1797 01:16:44,880 --> 01:16:47,720 THEY'RE HEALTH EQUITY, 1798 01:16:47,720 --> 01:16:49,760 POPULATION IN COMMUNITY HEALTH, 1799 01:16:49,760 --> 01:16:52,360 PREVENTION AND HEALTH PROMOTION 1800 01:16:52,360 --> 01:16:54,520 AND SYSTEMS AND MODELS OF CARE. 1801 01:16:54,520 --> 01:16:59,840 THESE RESEARCH LENSES ARE 1802 01:16:59,840 --> 01:17:00,800 COMPLIMENTARY, THEY LEVERAGE 1803 01:17:00,800 --> 01:17:02,840 STREP AND PROMOTE MULTI LEVEL 1804 01:17:02,840 --> 01:17:04,160 APPROACHES CROSS DISCIPLINARY 1805 01:17:04,160 --> 01:17:10,800 AND CROSS SECTORAL CO SECTOR CON 1806 01:17:10,800 --> 01:17:12,600 ALL WITH THE GOAL OF INFORMING 1807 01:17:12,600 --> 01:17:14,000 PRACTICE AND POLICY. 1808 01:17:14,000 --> 01:17:16,880 SO AS SHOWN IN THIS FRAMEWORK, 1809 01:17:16,880 --> 01:17:18,440 NINR SUPPORTED INVESTIGATORS 1810 01:17:18,440 --> 01:17:20,440 HAVE THE FLEXIBILITY TO APPLY A 1811 01:17:20,440 --> 01:17:22,480 SINGLE LENS OR A COMBINATION OF 1812 01:17:22,480 --> 01:17:29,960 LENSES IN LENSES AND WE ENCOURAE 1813 01:17:29,960 --> 01:17:31,480 HEALTH ECONOMIC AND SOCIAL 1814 01:17:31,480 --> 01:17:34,360 DETERMINANTS OF HEALTH LENSES 1815 01:17:34,360 --> 01:17:36,480 THROUGH WHICH TO CONSIDER THE 1816 01:17:36,480 --> 01:17:36,760 OTHERS. 1817 01:17:36,760 --> 01:17:40,520 IN OUR STRATEGIC PLAN, WE CALL 1818 01:17:40,520 --> 01:17:42,040 FOR BOTH MIGHT LEVEL AND 1819 01:17:42,040 --> 01:17:44,000 STRUCTURAL APPROACHES TO 1820 01:17:44,000 --> 01:17:45,280 OPTIMIZE HEALTH AND ADVANCE 1821 01:17:45,280 --> 01:17:46,280 HEALTH EQUITY. 1822 01:17:46,280 --> 01:17:48,840 I AGREE WITH Dr. PEREZ-STABLE 1823 01:17:48,840 --> 01:17:51,480 THAT MULTI LEVEL INTERCEPTIONS 1824 01:17:51,480 --> 01:17:53,520 ARE IMPORTANT AND WE NEED TO 1825 01:17:53,520 --> 01:17:55,480 ADDRESS SOCIAL DETERMINANTS AT 1826 01:17:55,480 --> 01:17:57,000 MULTIPLE LEVELS AS WELL A 1827 01:17:57,000 --> 01:17:58,880 COMBINATION OF SOCIAL FACTORS 1828 01:17:58,880 --> 01:18:01,240 WITH OTHER FACTORS SUCH AS THE 1829 01:18:01,240 --> 01:18:02,840 HEALTH-CARE SYSTEM AND BEHAVIOR 1830 01:18:02,840 --> 01:18:10,840 TO NAME A COUPLE. 1831 01:18:10,840 --> 01:18:12,360 RESEARCH HAS APPROACHES AT 1832 01:18:12,360 --> 01:18:13,440 MULTIPLE LEVELS THAT ARE AIMED 1833 01:18:13,440 --> 01:18:23,960 AT OFFSETTING EXPOSURE YOU WITH 1834 01:18:24,800 --> 01:18:25,800 YOU WILL HE ALSO NEED RESEARCH 1835 01:18:25,800 --> 01:18:29,280 ON STRUCTURAL INTERVENTIONS TO 1836 01:18:29,280 --> 01:18:31,960 IDENTIFY WHAT POLICIES AND 1837 01:18:31,960 --> 01:18:36,560 APPROACHES AND EFFECTIVE AND 1838 01:18:36,560 --> 01:18:38,000 ECONOMIC LEGAL REGULATORY AND 1839 01:18:38,000 --> 01:18:46,240 DRIVERS OF HEALTH DISPARITIES A 1840 01:18:46,240 --> 01:18:48,400 FAIR AND JUST OPPORTUNITY TO A 1841 01:18:48,400 --> 01:18:50,160 FEIGN THEIR FULL HEALTH AND 1842 01:18:50,160 --> 01:19:00,720 REQUIRES ADDRESSING SYSTEMS AND 1843 01:19:06,360 --> 01:19:09,160 DOES MY APPROACH AT A MINIMUM 1844 01:19:09,160 --> 01:19:11,560 ACKNOWLEDGE OR IDEALLY ADDRESS 1845 01:19:11,560 --> 01:19:14,640 HISTORIC AND PERSISTENT 1846 01:19:14,640 --> 01:19:15,280 STRUCTURAL INEQUITIES THAT COULD 1847 01:19:15,280 --> 01:19:17,000 BE TRIBUTE TO DISPARITIES AND 1848 01:19:17,000 --> 01:19:18,800 ACCELERATED BY A BIOLOGICAL 1849 01:19:18,800 --> 01:19:20,680 AGING THE HEALTH OF OLDER ADULT 1850 01:19:20,680 --> 01:19:25,120 AND LIFE EXPECTANCY. 1851 01:19:25,120 --> 01:19:27,440 SO WE HAVE FUNDING CONTINUES AT 1852 01:19:27,440 --> 01:19:37,960 NINR WHERE INVESTIGATORS CAN AND 1853 01:19:48,960 --> 01:19:56,320 THE FIRST IS COMPASS WHICH IS 1854 01:19:56,320 --> 01:19:58,440 IT'S ALSO INNOVATIVE FOR NIH AND 1855 01:19:58,440 --> 01:20:05,680 IT AIMS TO FUND DIRECTLY THERE 1856 01:20:05,680 --> 01:20:07,920 ARE TWO GOALS FOR THE COMPASS 1857 01:20:07,920 --> 01:20:09,320 PROGRAM TO CHAT ALLIES DEPLOY 1858 01:20:09,320 --> 01:20:11,080 AND EVALUATE COMMUNITY LED 1859 01:20:11,080 --> 01:20:15,160 HEALTH EQUITY STRUCTURAL 1860 01:20:15,160 --> 01:20:21,440 INTERVENTIONS AND A 10 YEAR 1861 01:20:21,440 --> 01:20:23,240 PROGRAM IS TO DEVELOP A NEW 1862 01:20:23,240 --> 01:20:25,080 HEALTH EQUITY RESEARCH MODEL AND 1863 01:20:25,080 --> 01:20:27,960 FOR THIS TYPE OF RESEARCH FOR 1864 01:20:27,960 --> 01:20:31,320 NIH AS WELL AS OTHER FEDERAL 1865 01:20:31,320 --> 01:20:33,280 AGENCIES AND ANOTHER INITIATIVE 1866 01:20:33,280 --> 01:20:37,080 IS THE TRANSFORMATIVE HEALTH 1867 01:20:37,080 --> 01:20:38,360 DISPARITIES RESEARCH THAT 1868 01:20:38,360 --> 01:20:40,720 SUPPORTS TRANSLATIONAL RESEARCH 1869 01:20:40,720 --> 01:20:41,720 PROJECTS TO REDUCE HEALTH 1870 01:20:41,720 --> 01:20:43,160 DISPARITIES AND ADVANCE HEALTH 1871 01:20:43,160 --> 01:20:44,240 EQUITY. 1872 01:20:44,240 --> 01:20:45,960 SO THIS PROGRAM STRONGLY 1873 01:20:45,960 --> 01:20:47,520 ENCOURAGES INTERVENTIONS ON 1874 01:20:47,520 --> 01:20:53,120 SOCIAL DETERMINANTS AND REQUIRES 1875 01:20:53,120 --> 01:21:03,520 COMMUNITY PARTNERSHIPS. 1876 01:21:07,320 --> 01:21:10,680 AND WE ARE COMMITTED AT NIH TO 1877 01:21:10,680 --> 01:21:11,680 ACCELERATE SOCIAL DETERMINANTS 1878 01:21:11,680 --> 01:21:13,360 OF HEALTH RESEARCH ACROSS THE 1879 01:21:13,360 --> 01:21:14,160 AGENCY. 1880 01:21:14,160 --> 01:21:15,880 THIS IS ACROSS DISEASES AND 1881 01:21:15,880 --> 01:21:17,680 CONDITIONS POPULATIONS, STAGES 1882 01:21:17,680 --> 01:21:19,960 OF THE LIFE COURSE, AND SOCIAL 1883 01:21:19,960 --> 01:21:22,040 DETERMINANTS OF HEALTH DOMAINS. 1884 01:21:22,040 --> 01:21:24,840 SO THIS RESEARCH COORDINATING 1885 01:21:24,840 --> 01:21:26,800 COMMITTEE THAT WAS FORMED ONE 1886 01:21:26,800 --> 01:21:28,680 YEAR HAS SEVERAL AMBITIOUS 1887 01:21:28,680 --> 01:21:29,840 OBJECTIVES AND THIS AIM SHOWN 1888 01:21:29,840 --> 01:21:32,080 HERE AND I WANT TO THANK NIA WHO 1889 01:21:32,080 --> 01:21:36,120 PLAYED SUCH AN IMPORTANT ROLE 1890 01:21:36,120 --> 01:21:43,600 LAUNCH NORTH EFFORLAWNING THIS S 1891 01:21:43,600 --> 01:21:46,320 ENGAGE 18 ON THE EXECUTIVE 1892 01:21:46,320 --> 01:21:48,680 COMMIT AND MORE OPT COORDINATING 1893 01:21:48,680 --> 01:21:49,240 COMMITTEE. 1894 01:21:49,240 --> 01:21:51,160 THANK YOU FOR IN INVITING ME. 1895 01:21:51,160 --> 01:21:52,480 IF YOU HAVE HAVE QUESTIONS OR 1896 01:21:52,480 --> 01:21:55,360 WANT TO REACH OUT, DO SO AT THE 1897 01:21:55,360 --> 01:21:56,200 E-MAIL ADDRESS DOWN HIGHER. 1898 01:21:56,200 --> 01:21:56,920 THANK YOU SO MUCH. 1899 01:21:56,920 --> 01:22:46,400 [APPLAUSE] 1900 01:22:46,400 --> 01:22:48,200 BEFORE WE BEGIN, I WANT TO 1901 01:22:48,200 --> 01:22:50,320 EMPHASIZE WHAT A PRIORITY 1902 01:22:50,320 --> 01:22:51,480 ADDRESSING HEALTH DISPARITIES 1903 01:22:51,480 --> 01:22:53,320 AND PROMOTING HEALTH EQUITY ARE 1904 01:22:53,320 --> 01:22:54,760 FOR NCI. 1905 01:22:54,760 --> 01:22:55,960 IF YOU HAVEN'T SEEN THIS MONTH 1906 01:22:55,960 --> 01:23:03,920 OUR DIRECTOR AT NCI RELEASED THE 1907 01:23:03,920 --> 01:23:06,160 NATIONAL CANCER PLAN. 1908 01:23:06,160 --> 01:23:08,160 AND THIS BUILDS UPON WORK THAT'S 1909 01:23:08,160 --> 01:23:10,640 BEEN DONE ACROSS NCI AND THE 1910 01:23:10,640 --> 01:23:12,000 ENTIRE NCI RESEARCH ENTERPRISE 1911 01:23:12,000 --> 01:23:18,720 OVER THE YEARS TO REALLY 1912 01:23:18,720 --> 01:23:23,000 RECOGNIZE EIGHT GOALS ARE 1913 01:23:23,000 --> 01:23:23,960 DESCRIBED THROUGH THIS PLAN 1914 01:23:23,960 --> 01:23:28,840 HOWEVER YOU CAN SEE OVERLAP TO 1915 01:23:28,840 --> 01:23:29,920 FIRST ELIMINATE INEQUALITY AND 1916 01:23:29,920 --> 01:23:36,280 SECOND TO ENGAGE EVERY PERSON. 1917 01:23:36,280 --> 01:23:38,560 I WANT TO TALK ABOUT HOW WE 1918 01:23:38,560 --> 01:23:39,920 DEFINE CANCER DISPARITIES AND 1919 01:23:39,920 --> 01:23:42,640 THIS VARIES ACROSS NCI AND NIH 1920 01:23:42,640 --> 01:23:46,360 AND NHHS AND IN OUR FUNDING 1921 01:23:46,360 --> 01:23:47,160 OPPORTUNITIES, WHEN WE TALK 1922 01:23:47,160 --> 01:23:49,880 ABOUT DISPARITIES, WE'RE 1923 01:23:49,880 --> 01:23:51,160 REFERRING TO ADVERSE DIFFERENCES 1924 01:23:51,160 --> 01:24:01,640 BETWEEN POPULATION GROUPS WHEN 1925 01:24:11,280 --> 01:24:12,920 WE TALK ABOUT POPULATION GROUPS, 1926 01:24:12,920 --> 01:24:14,120 THIS IS VERY BROAD. 1927 01:24:14,120 --> 01:24:16,480 WE TYPICALLY WILL FOCUS ON 1928 01:24:16,480 --> 01:24:18,360 POPULATION GROUPS THAT HAVE 1929 01:24:18,360 --> 01:24:22,640 SYSTEMICALLY EXPERIENCED GREATER 1930 01:24:22,640 --> 01:24:24,640 OBSTACLES IN HEALTH AND AS WE'VE 1931 01:24:24,640 --> 01:24:26,560 HEARD THESE ARE LINKED TO 1932 01:24:26,560 --> 01:24:27,720 DISCRIMINATION AND EXCLUSION. 1933 01:24:27,720 --> 01:24:29,480 AND SO MANY OF THE POPULATIONS 1934 01:24:29,480 --> 01:24:31,440 THAT WE'VE SUPPORTED IN OUR 1935 01:24:31,440 --> 01:24:33,440 FUNDING, ARE BASED UPON RACE AND 1936 01:24:33,440 --> 01:24:35,360 ETHNICITY AND DISABILITY, SEXUAL 1937 01:24:35,360 --> 01:24:38,880 GENDER MINORITY, GEOGRAPHIC 1938 01:24:38,880 --> 01:24:43,680 LOCATION AND VARIOUS OTHER SES 1939 01:24:43,680 --> 01:24:50,640 CHARACTERISTICS. 1940 01:24:50,640 --> 01:24:54,760 MANY OF THESE FACTORS ARE INTER 1941 01:24:54,760 --> 01:24:55,960 RELATED AND THIS IS SCHEMATIC 1942 01:24:55,960 --> 01:24:57,160 AND YOU CAN SEE IT FROM THE 1943 01:24:57,160 --> 01:24:59,080 AMERICAN ASSOCIATION OF CANCER 1944 01:24:59,080 --> 01:25:03,000 RESEARCH IN THEIR CANCER 1945 01:25:03,000 --> 01:25:04,040 DISPARITIES PROGRESS REPORT 1946 01:25:04,040 --> 01:25:05,080 RELEASED IN 2022. 1947 01:25:05,080 --> 01:25:06,600 WE KNOW ALL OF THESE FACTORS ARE 1948 01:25:06,600 --> 01:25:09,040 AT LEAST PARTIALLY AND DIRECTLY 1949 01:25:09,040 --> 01:25:11,120 INFLUENCED BY STRUCTURAL AND 1950 01:25:11,120 --> 01:25:13,280 SYSTEMIC RACISM AND SOCIAL 1951 01:25:13,280 --> 01:25:14,000 INJUSTICES. 1952 01:25:14,000 --> 01:25:15,800 AND THESE FACTORS ARE INTER 1953 01:25:15,800 --> 01:25:17,320 RELATED AND SOCIAL DETERMINANTS 1954 01:25:17,320 --> 01:25:19,960 ARE AT THE MIDDLE OTHER 1955 01:25:19,960 --> 01:25:21,920 CONTRIBUTORS SUCH AS BIOLOGY 1956 01:25:21,920 --> 01:25:23,120 BEHAVIOR AND ENVIRONMENT ARE ALL 1957 01:25:23,120 --> 01:25:26,800 PLAYING A ROLE AND NCI, WE WERE 1958 01:25:26,800 --> 01:25:27,360 INTERESTED IN LEARNING MORE 1959 01:25:27,360 --> 01:25:28,760 ABOUT ALL OF THESE FACTORS AND 1960 01:25:28,760 --> 01:25:32,080 ALL OF THE CANCER DISPARITIES 1961 01:25:32,080 --> 01:25:35,640 WE'VE IDENTIFIED IN THE UNITED 1962 01:25:35,640 --> 01:25:36,680 STATES. 1963 01:25:36,680 --> 01:25:38,160 SO WE HAVE A NUMBER OF FUNDING 1964 01:25:38,160 --> 01:25:38,440 INITIATIVES. 1965 01:25:38,440 --> 01:25:39,840 THIS IS JUST A VERY SMALL 1966 01:25:39,840 --> 01:25:42,440 SLITHER OF WHAT WE OFFER AT NCI 1967 01:25:42,440 --> 01:25:45,000 IN THE SPACE OF DISPARITIES 1968 01:25:45,000 --> 01:25:46,480 RESEARCH AND THEY HAVE DIFFERENT 1969 01:25:46,480 --> 01:25:48,000 RESEARCH DISCIPLINES SO AS YOU 1970 01:25:48,000 --> 01:25:49,200 CAN SEE HERE, WE HAVE 1971 01:25:49,200 --> 01:25:50,280 OPPORTUNITIES IN BASIC RESEARCH 1972 01:25:50,280 --> 01:25:53,400 AND SOME MORE IN TRANSLATIONAL 1973 01:25:53,400 --> 01:25:55,440 AND CLINICAL RESEARCH AND SOCIAL 1974 01:25:55,440 --> 01:25:58,960 SCIENCES AND POPULATIONS 1975 01:25:58,960 --> 01:26:04,080 SCIENCES AND A MOUNTING NUMBER 1976 01:26:04,080 --> 01:26:05,520 IN MULTI-DISCIPLINARY RESEARCH 1977 01:26:05,520 --> 01:26:07,400 IN TEAM SCIENCE BUT I'M GOING TO 1978 01:26:07,400 --> 01:26:09,320 FOCUS PRIMARILY ON SOME OF THE 1979 01:26:09,320 --> 01:26:10,840 FUNDING AND SOME OF THE RESEARCH 1980 01:26:10,840 --> 01:26:13,200 WE'VE SUPPORTED POWER IN THE 1981 01:26:13,200 --> 01:26:16,160 SPACE OF BASIC AND TRANCAL. 1982 01:26:16,160 --> 01:26:19,600 SO WHEN WE TALK ABOUT 1983 01:26:19,600 --> 01:26:20,680 TRANSLATIONAL RESEARCH, WE'RE 1984 01:26:20,680 --> 01:26:21,760 TALKING ABOUT RESEARCH THAT 1985 01:26:21,760 --> 01:26:23,840 STARTS AT THE BENCH. 1986 01:26:23,840 --> 01:26:28,520 TRANSLATED INTO THE CLINIC AND 1987 01:26:28,520 --> 01:26:29,360 OFTEN TIMES FURTHER INTO THE 1988 01:26:29,360 --> 01:26:31,120 COMMUNITY WHERE WE SEE AN 1989 01:26:31,120 --> 01:26:31,880 IMPROVEMENT OF PUBLIC-HEALTH. 1990 01:26:31,880 --> 01:26:33,480 THIS IS NOT JUST ONE DIRECTIONAL 1991 01:26:33,480 --> 01:26:34,840 IT'S BIDIRECTIONAL AND WE 1992 01:26:34,840 --> 01:26:37,600 SUPPORT WORK THAT IS OBSERVED IN 1993 01:26:37,600 --> 01:26:38,400 THE COMMUNITY OR THE CLIP I CAN 1994 01:26:38,400 --> 01:26:40,800 AND WORK BACK TO THE BENCH TO 1995 01:26:40,800 --> 01:26:41,160 BORE EXPLAIN. 1996 01:26:41,160 --> 01:26:42,480 BUT DOING THIS TYPE OF RESEARCH 1997 01:26:42,480 --> 01:26:44,240 AND DISPARITIES CAN BE VERY 1998 01:26:44,240 --> 01:26:45,040 CHALLENGES. 1999 01:26:45,040 --> 01:26:47,880 FIRST WE KNOW THAT THERE'S POOR 2000 01:26:47,880 --> 01:26:49,840 REPRESENTATION OF RACIAL AND 2001 01:26:49,840 --> 01:26:51,000 ETHNIC AND UNDERSERVED 2002 01:26:51,000 --> 01:26:52,560 POPULATIONS IN THERAPEUTIC 2003 01:26:52,560 --> 01:26:53,680 CLINICAL TRIALS AND WE'RE 2004 01:26:53,680 --> 01:26:57,760 WORKING HARD TO ADDRESS THIS. 2005 01:26:57,760 --> 01:26:59,520 THERE ARE RESERVATIONS TO 2006 01:26:59,520 --> 01:27:01,920 PATIENTS TO DONATE BIOSPECIMEN 2007 01:27:01,920 --> 01:27:03,120 OR SHARE CLINICAL DATA AND IT'S 2008 01:27:03,120 --> 01:27:05,960 A GENERAL LACK OF DIVERSITY AND 2009 01:27:05,960 --> 01:27:08,920 BIO REPOSITORY AND OTHER PATIENT 2010 01:27:08,920 --> 01:27:11,400 COHORTS AND WHEN THEY DO 2011 01:27:11,400 --> 01:27:12,760 CONTRIBUTE TO THESE COHORTS 2012 01:27:12,760 --> 01:27:17,320 THERE'S A LACK OF OF 2013 01:27:17,320 --> 01:27:18,240 STANDARDIZATION AND THIS CAN 2014 01:27:18,240 --> 01:27:22,280 MAKE SECONDARY DATA ANALYSIS 2015 01:27:22,280 --> 01:27:23,440 CHALLENGING IF THE RIGHT 2016 01:27:23,440 --> 01:27:24,080 INFORMATION WASN'T COLLECTED 2017 01:27:24,080 --> 01:27:26,000 FROM THE PATIENT AND LASTLY, 2018 01:27:26,000 --> 01:27:29,880 THERE'S A DEBATE ON GOING ON IF 2019 01:27:29,880 --> 01:27:36,800 BIOLOGIBIOLOGICAL ARE ENOUGH TON 2020 01:27:36,800 --> 01:27:40,960 TRIB TO THE DISPARI DISPARITIES. 2021 01:27:40,960 --> 01:27:45,360 THERE ARE CHALLENGES WE ARE 2022 01:27:45,360 --> 01:27:49,240 CREDITS RESEARCH AS ONE OF THE 2023 01:27:49,240 --> 01:27:51,200 PRIORITY AREAS AND THIS BECAUSE 2024 01:27:51,200 --> 01:27:53,680 WE RECOGNIZE ACHIEVING DIVERSE 2025 01:27:53,680 --> 01:27:55,080 REPRESENTATION IN ALL OF OUR 2026 01:27:55,080 --> 01:27:57,000 CANCER RESEARCH ACTIVITIES IS 2027 01:27:57,000 --> 01:27:58,920 ABSOLUTELY CRITICAL TO ENSURING 2028 01:27:58,920 --> 01:28:00,680 THAT THE ADVANCEMENTS BEING MADE 2029 01:28:00,680 --> 01:28:03,400 ARE EQUITABLE TO ALL PATIENT 2030 01:28:03,400 --> 01:28:05,160 POPULATIONS SO WE'RE SEEING SOME 2031 01:28:05,160 --> 01:28:06,480 ADVANCEMENTS AND FUNDING MORE 2032 01:28:06,480 --> 01:28:10,040 RESEARCH AND WE'RE DEVELOPING 2033 01:28:10,040 --> 01:28:12,360 MORE MODELS USEFUL FOR THE REECE 2034 01:28:12,360 --> 01:28:13,960 SEARCH COMMUNITY AND WE'RE 2035 01:28:13,960 --> 01:28:16,040 SEEING PUBLICATIONS AND 2036 01:28:16,040 --> 01:28:19,240 PRESENTATIONS THAT ARE SCREENING 2037 01:28:19,240 --> 01:28:21,000 DESCRIBING EVIDENCE IN THIS 2038 01:28:21,000 --> 01:28:21,480 SPACE. 2039 01:28:21,480 --> 01:28:23,040 WE HAVE THREE RESEARCH 2040 01:28:23,040 --> 01:28:25,000 INITIATIVES THAT ARE OPEN REALLY 2041 01:28:25,000 --> 01:28:28,560 FOCUSED IN ON THIS BASIC AND 2042 01:28:28,560 --> 01:28:32,880 TRANSLATITRANSLATIONAL AND I'LLW 2043 01:28:32,880 --> 01:28:35,400 THE PROGRAMS WE HAVE AND I'LL 2044 01:28:35,400 --> 01:28:37,160 TALK ABOUT THE DATA AND RESEARCH 2045 01:28:37,160 --> 01:28:38,280 WE'RE COMING OUT OF THESE. 2046 01:28:38,280 --> 01:28:41,200 THE FIRST PROGRAM IS ON BASIC 2047 01:28:41,200 --> 01:28:42,960 RESEARCH IN CANCER HEALTH 2048 01:28:42,960 --> 01:28:46,600 DISPARITIES. 2049 01:28:46,600 --> 01:28:54,040 IT'S BEEN AROUND SINCE 2010 AND 2050 01:28:54,040 --> 01:28:59,840 THE PURPOSE OF THIS IS TO 2051 01:28:59,840 --> 01:29:02,320 PROVIDE INVESTIGATIONs AND YOU 2052 01:29:02,320 --> 01:29:03,800 PROBABLY WON'T BE SURPRISED TO 2053 01:29:03,800 --> 01:29:05,280 HEAR THAT MORE AND MORE 2054 01:29:05,280 --> 01:29:06,600 APPLICATIONS AND PROJECTS WE'RE 2055 01:29:06,600 --> 01:29:08,680 FUNDING ARE FOCUSING ON HOW 2056 01:29:08,680 --> 01:29:10,080 SOCIAL DETERMINANTS ARE 2057 01:29:10,080 --> 01:29:11,520 INFLUENCING BIOLOGY TO 2058 01:29:11,520 --> 01:29:19,160 CONTRIBUTE TO THOSE DIFFERENCES. 2059 01:29:19,160 --> 01:29:22,640 THEY DEVELOP METHODS AND MODELS 2060 01:29:22,640 --> 01:29:30,200 ON SECONDARY ANALYSIS SO HE WE 2061 01:29:30,200 --> 01:29:31,240 FUNDED 150 GRANTS ACROSS 17 2062 01:29:31,240 --> 01:29:35,000 DIFFERENT CANCER SITES AND HAVE 2063 01:29:35,000 --> 01:29:36,440 1100 PUBLICATIONS THAT HAVE 2064 01:29:36,440 --> 01:29:38,000 RESULTED FROM THIS AND JUST LAST 2065 01:29:38,000 --> 01:29:40,240 YEAR WHEN WE LOOKED AT OR ACTIVE 2066 01:29:40,240 --> 01:29:41,800 PORTFOLIO, WE SEE THE MAJORITY 2067 01:29:41,800 --> 01:29:45,240 OF STUDIES ARE IN PROSTATE, 2068 01:29:45,240 --> 01:29:47,040 BREAST AND COLORECTAL CANCER AND 2069 01:29:47,040 --> 01:29:48,400 THIS IS NOT SURPRISING MOST OF 2070 01:29:48,400 --> 01:29:51,080 THE EVIDENCE FALLS WITHIN THOSE 2071 01:29:51,080 --> 01:29:52,840 CANCER SITES AND WE LOOK AT 2072 01:29:52,840 --> 01:29:54,600 POPULATIONS THE MAJORITY OF THE 2073 01:29:54,600 --> 01:29:56,320 PORTFOLIO IS AFRICAN AMERICAN OR 2074 01:29:56,320 --> 01:30:00,320 BLACK PATIENTS WITH A CHUNK 2075 01:30:00,320 --> 01:30:02,960 FOCUSED ON HISPANIC AND LATINO 2076 01:30:02,960 --> 01:30:04,560 AND OTHERS INCLUDED AS WELL. 2077 01:30:04,560 --> 01:30:05,760 ANOTHER PROGRAM WE'VE BEEN 2078 01:30:05,760 --> 01:30:07,560 LARGELY FOCUSED ON ARE THE 2079 01:30:07,560 --> 01:30:09,800 SPORTS AND THESE ARE SPECIALIZED 2080 01:30:09,800 --> 01:30:20,160 PROGRAMS OF RESEARCH. 2081 01:30:24,360 --> 01:30:25,240 THOSE ARE LARGE PROGRAMS AND 2082 01:30:25,240 --> 01:30:33,320 THEY FOCUS ON RESEARCH AND I 2083 01:30:33,320 --> 01:30:41,040 MIGHT BE FAMILIAR WITH A 2084 01:30:41,040 --> 01:30:43,320 PROSTATE SPORE BUT THEY HAVE 2085 01:30:43,320 --> 01:30:44,960 MORE THEMES CROSS CUTTING THEMES 2086 01:30:44,960 --> 01:30:46,880 SO CANCER DISPARITIES IS ONE 2087 01:30:46,880 --> 01:30:51,320 ADDRESSING MINORITY HEALTH WOULD 2088 01:30:51,320 --> 01:30:53,360 BE ANOTHER AND TO DATE THEY ARE 2089 01:30:53,360 --> 01:30:59,960 NOT FOCUSED IN ADDRESSING HEALTH 2090 01:30:59,960 --> 01:31:00,800 DISPARITIES OR MINORITY HEALTH. 2091 01:31:00,800 --> 01:31:02,800 TO REDUCE CANCER HEALTH 2092 01:31:02,800 --> 01:31:04,400 DISPARITIES WHERE I WORK, WE 2093 01:31:04,400 --> 01:31:06,640 TEAMED UP WITH THE TRANSLATIONAL 2094 01:31:06,640 --> 01:31:11,720 RESEARCH PROGRAM TO HAVE A 2095 01:31:11,720 --> 01:31:13,800 PLANNING GRANT OPPORTUNITY AND 2096 01:31:13,800 --> 01:31:15,240 THIS WAYS DESIGNED TO HELP THE 2097 01:31:15,240 --> 01:31:17,360 LARGE TEAMS GET UP TO SPEED, GET 2098 01:31:17,360 --> 01:31:20,040 THEIR INFRASTRUCTURE TOGETHER, 2099 01:31:20,040 --> 01:31:22,680 GET THEIR PRELIMINARY DATA 2100 01:31:22,680 --> 01:31:25,000 TOGETHER AND COME IN FOR A FULL 2101 01:31:25,000 --> 01:31:28,160 SPORE SO WE AWARDED 12 GRANTS 2102 01:31:28,160 --> 01:31:28,760 AND THEY WERE ACROSS A WIDE 2103 01:31:28,760 --> 01:31:30,800 NUMBER OF CANCER SITES AND 2104 01:31:30,800 --> 01:31:32,840 ACROSS A WIDE NUMBER OF 2105 01:31:32,840 --> 01:31:35,720 POPULATION GROUPS AND A LOT OF 2106 01:31:35,720 --> 01:31:36,920 DATA HAS RED LIGHTED FROM THIS. 2107 01:31:36,920 --> 01:31:38,760 A LOT OF DATA WILL COME FROM 2108 01:31:38,760 --> 01:31:39,360 THIS PROGRAM. 2109 01:31:39,360 --> 01:31:41,240 THE LAST PROGRAM I WANTED TO 2110 01:31:41,240 --> 01:31:43,600 MENTION DEALS WITH OR EFFORTS IN 2111 01:31:43,600 --> 01:31:46,160 TRYING TO DEVELOP MORE CANCER 2112 01:31:46,160 --> 01:31:48,240 MODEL THAT REFLECT DIVERSITY OF 2113 01:31:48,240 --> 01:31:57,560 PATIENT POPULATION AND WE HAVE 2114 01:31:57,560 --> 01:32:01,680 MODELS AND OF WE ARE ADDING ONE 2115 01:32:01,680 --> 01:32:03,520 CELL LINE HERE EX ORGANIZE 2116 01:32:03,520 --> 01:32:15,240 ANNOYED THERORGANOIDS ANDTHEY VA 2117 01:32:15,240 --> 01:32:18,240 PIECE OF TUMOR AND IT YOU GRAFT 2118 01:32:18,240 --> 01:32:21,080 IT IN A MOUSE AND IT BETTER 2119 01:32:21,080 --> 01:32:22,960 REFLECTS THE HETEROGENEITY SO WE 2120 01:32:22,960 --> 01:32:25,240 HAVE THE PDX DEVELOPMENT IT 2121 01:32:25,240 --> 01:32:27,240 TRIALS RESEARCH NETWORK AND THIS 2122 01:32:27,240 --> 01:32:28,600 WAYS STARTED IN 2017 BY THE 2123 01:32:28,600 --> 01:32:33,040 DIVISION OF CANCER TREATMENT AND 2124 01:32:33,040 --> 01:32:44,040 DIAGNOSISDIAGNOSIS AND THOSE WID 2125 01:32:49,600 --> 01:32:51,200 TO CONDUCT PRECLINICAL TESTING 2126 01:32:51,200 --> 01:32:52,880 OF THERAPEUTIC TARGETED AGENTS 2127 01:32:52,880 --> 01:32:58,040 AND THE HOPE IS THAT IT WILL 2128 01:32:58,040 --> 01:33:00,040 LEAD FOR WHAT THERAPEUTICS 2129 01:33:00,040 --> 01:33:04,800 SHOULD GO INTO EARLY PHASE 2130 01:33:04,800 --> 01:33:05,040 TRIALS. 2131 01:33:05,040 --> 01:33:06,840 WE NOTICED THE DIVERSITY OF THE 2132 01:33:06,840 --> 01:33:10,120 MODELING BEING MADE WAS NOT VERY 2133 01:33:10,120 --> 01:33:11,640 PRONOUNCED SO THROUGH THE CENTER 2134 01:33:11,640 --> 01:33:13,600 THROUGH REDUCE CANCER HEALTH 2135 01:33:13,600 --> 01:33:14,760 DISPARITIES WE ADDED TWO CENTERS 2136 01:33:14,760 --> 01:33:16,480 TO THIS AND THESE CENTERS FOR HE 2137 01:33:16,480 --> 01:33:22,400 CAN USED ON DEVELOPING MODEL 0 S 2138 01:33:22,400 --> 01:33:23,800 FROM UNDERSERVED POPULATIONS AND 2139 01:33:23,800 --> 01:33:25,680 THEIR RESEARCH QUESTIONS ARE 2140 01:33:25,680 --> 01:33:28,320 BETTER UNDERSTANDING THERAPEUTIC 2141 01:33:28,320 --> 01:33:29,320 OUTCOME DISPARITIES SO THIS IS 2142 01:33:29,320 --> 01:33:33,680 CONTINUING ON EX IT'S BEEN 2143 01:33:33,680 --> 01:33:35,280 REISSUED AND NEW AWARDS ARE 2144 01:33:35,280 --> 01:33:35,680 PENDING. 2145 01:33:35,680 --> 01:33:37,280 THOSE ARE THE THREE PROGRAMS 2146 01:33:37,280 --> 01:33:38,720 THAT WE'VE BEEN FUNDING OVER 2147 01:33:38,720 --> 01:33:40,120 RECENT YEARS AND I WANT TO TALK 2148 01:33:40,120 --> 01:33:41,920 ABOUT SOME OF THE FINDINGS THAT 2149 01:33:41,920 --> 01:33:43,000 ARE COMING OUT. 2150 01:33:43,000 --> 01:33:46,880 THIS IS NOT MEANT TO BE READ 2151 01:33:46,880 --> 01:33:48,640 INDIVIDUALLY BUT TO GIVE YOU AN 2152 01:33:48,640 --> 01:33:49,960 IDEA OF HOW PROCEED SOME OF THE 2153 01:33:49,960 --> 01:33:51,680 DATA THAT HAS RESULTED IS AND 2154 01:33:51,680 --> 01:33:53,360 I'M GOING TO TALK ABOUT SPECIFIC 2155 01:33:53,360 --> 01:33:55,600 THEMES AS A FEW SPECIFIC 2156 01:33:55,600 --> 01:33:55,800 STUDIES. 2157 01:33:55,800 --> 01:33:57,120 BUT AS YOU CAN SEE A LOT OF THIS 2158 01:33:57,120 --> 01:33:59,560 IS FOCUSED IN ON RISK ALLELES 2159 01:33:59,560 --> 01:34:01,960 AND LOOKING AT LARGE-SCALE 2160 01:34:01,960 --> 01:34:04,440 GENETIC PROFILING TO UNDERSTAND 2161 01:34:04,440 --> 01:34:07,800 DIFFERENCES BETWEEN POPULATION 2162 01:34:07,800 --> 01:34:10,280 GROUPS, LOOKING AT RED MEAT 2163 01:34:10,280 --> 01:34:11,360 CONSUMPTION AND COORDINATION 2164 01:34:11,360 --> 01:34:13,920 WITH GENOTYPES AND HOW THAT 2165 01:34:13,920 --> 01:34:15,320 INCREASES PAN CREE OT TICK 2166 01:34:15,320 --> 01:34:16,520 CANCER RISK AND SO ON. 2167 01:34:16,520 --> 01:34:19,560 THESE ARE JUST SOME MORE OF THE 2168 01:34:19,560 --> 01:34:21,160 STUDIES OF BEING RELEASED AND 2169 01:34:21,160 --> 01:34:22,880 THIS IS THE FIRST ONE HERE AND 2170 01:34:22,880 --> 01:34:25,280 LOOKING AT GENETIC ANCESTRY. 2171 01:34:25,280 --> 01:34:26,880 IT WAS INTERESTING AS IT WAS 2172 01:34:26,880 --> 01:34:28,960 LOOKING AT PEDIATRIC PATIENTS 2173 01:34:28,960 --> 01:34:31,440 AND LOOKING AT THEIR GENETIC 2174 01:34:31,440 --> 01:34:33,800 ANCESTRY WERE ABLE TO FIND 2175 01:34:33,800 --> 01:34:35,280 MOLECULAR SUBTYPES CAN PREDICT 2176 01:34:35,280 --> 01:34:37,240 WHETHER A CHILD WOULD HAVE 2177 01:34:37,240 --> 01:34:38,320 ADVERSE EVENTS OR RESPOND TO 2178 01:34:38,320 --> 01:34:40,560 TREATMENT SO REALLY ADVANCING 2179 01:34:40,560 --> 01:34:47,760 SOME OF OUR PRECISION EFFORTS. 2180 01:34:47,760 --> 01:34:49,320 WE HAD PRESS RELEASED OVER THE 2181 01:34:49,320 --> 01:34:50,080 STUDIES OVER THE YEARS. 2182 01:34:50,080 --> 01:34:52,280 I WANT TO FOCUS ON SOME OF THE 2183 01:34:52,280 --> 01:34:54,480 THEMES THAT MIGHT BE RELEVANT 2184 01:34:54,480 --> 01:34:55,000 FOYER AGING. 2185 01:34:55,000 --> 01:34:57,760 WE'VE HAD STUDIES LOOKING AT 2186 01:34:57,760 --> 01:34:59,640 DISPARITIES AND EPIGENETIC AGING 2187 01:34:59,640 --> 01:35:00,360 AND CANCER. 2188 01:35:00,360 --> 01:35:02,800 THIS IS ONE STUDY FROM A GROUP 2189 01:35:02,800 --> 01:35:06,840 THROUGH OUR P20 SPORES MOVED TO 2190 01:35:06,840 --> 01:35:08,240 THE UNIVERSITY OF VIRGINIA 2191 01:35:08,240 --> 01:35:10,160 HEALTH SERVICES SYSTEMS AND IN 2192 01:35:10,160 --> 01:35:13,000 THIS STUDY THEY'RE LOOKING AT 2193 01:35:13,000 --> 01:35:14,400 RACIAL DISPARITIES AND 2194 01:35:14,400 --> 01:35:15,840 EPIGENETIC AGING SO BETTER 2195 01:35:15,840 --> 01:35:17,440 UNDERSTAND WHY WE SEE 2196 01:35:17,440 --> 01:35:19,320 DISPARITIES IN COLORECTAL CANCER 2197 01:35:19,320 --> 01:35:22,520 AND THIS IS BASED ON THE AFRICAN 2198 01:35:22,520 --> 01:35:24,640 AMERICANS TYPICALLY GET EARLIER 2199 01:35:24,640 --> 01:35:26,760 ONSET COLORECTAL CANCER AND IN 2200 01:35:26,760 --> 01:35:28,640 ADDITION, TYPICALLY GET MORE 2201 01:35:28,640 --> 01:35:30,920 RIGHT-SIDED COLON CANCER WHICH 2202 01:35:30,920 --> 01:35:33,400 HAS BEEN ASSOCIATED WITH POORER 2203 01:35:33,400 --> 01:35:34,720 PROGNOSIS SO THIS IS A QUICK 2204 01:35:34,720 --> 01:35:36,320 LOOK AT SOME OF THE DATA WHERE 2205 01:35:36,320 --> 01:35:39,240 THEY LOOKED AT METHYLATION 2206 01:35:39,240 --> 01:35:41,400 STUDIES AND THEY DID EPIGENETIC 2207 01:35:41,400 --> 01:35:43,200 AGE AND LOOKED AT CORRELATION 2208 01:35:43,200 --> 01:35:44,720 WITH CHRONOLOGICAL AGE AND THEY 2209 01:35:44,720 --> 01:35:46,160 SAW THE CORRELATION WAS VERY 2210 01:35:46,160 --> 01:35:48,760 GOOD IN EUROPEAN AMERICAN OR 2211 01:35:48,760 --> 01:35:51,120 WHITE PATIENTS BUT NOT 2212 01:35:51,120 --> 01:35:52,200 CORRELATED IN OUR AFRICAN 2213 01:35:52,200 --> 01:35:53,160 AMERICAN PATIENTS. 2214 01:35:53,160 --> 01:35:55,080 THEY LOOKED AT AGE ACCELERATION 2215 01:35:55,080 --> 01:35:57,200 ON THIS NEXT CHART AND THEY SAW 2216 01:35:57,200 --> 01:35:59,800 THAT IN THE AFRICAN AMERICANS, 2217 01:35:59,800 --> 01:36:01,120 AGE ACCELERATION WAS HIGHER ON 2218 01:36:01,120 --> 01:36:02,840 THE RIGHT SIDE OF THE COLON BUT 2219 01:36:02,840 --> 01:36:05,040 WHEN THEY LOOKED IN EUROPEAN 2220 01:36:05,040 --> 01:36:06,080 AMERICANS IT WAS OPPOSITE AND IT 2221 01:36:06,080 --> 01:36:11,440 WAS LOWER IN THE RIGHT SIDE. 2222 01:36:11,440 --> 01:36:13,440 THIS LOWER TABLE REINFORCES THAT 2223 01:36:13,440 --> 01:36:16,280 THE ACCELERATION EPIEN GET TICK 2224 01:36:16,280 --> 01:36:17,400 AGING WAS HIGHER ON THE RIGHT 2225 01:36:17,400 --> 01:36:18,800 SIDE OF THE AFRICAN AMERICAN 2226 01:36:18,800 --> 01:36:20,560 COLON'S LEADING POTENTIALLY TO 2227 01:36:20,560 --> 01:36:21,760 SOME OF THE REASONS WHY WE MAY 2228 01:36:21,760 --> 01:36:32,240 BE SEEING SOME DISPARITIES. 2229 01:36:34,600 --> 01:36:38,080 AND FINDING DNA THAT WERE 2230 01:36:38,080 --> 01:36:39,880 DISTINCT BETWEEN RACES AND 2231 01:36:39,880 --> 01:36:42,120 HINTING TO THE PREDISPOSITION TO 2232 01:36:42,120 --> 01:36:44,200 HAVING MORE COL OWE WRECK CALL 2233 01:36:44,200 --> 01:36:45,840 CANCER EX THAT POPULATION AND 2234 01:36:45,840 --> 01:36:48,280 THIS BOTTOM STUDY HERE, IT'S NOT 2235 01:36:48,280 --> 01:36:50,480 EVEN IN CANCER AND IT'S NOT 2236 01:36:50,480 --> 01:36:53,760 SUPPORTED BY US BUT LOOKING AT 2237 01:36:53,760 --> 01:36:55,800 EPIGENETIC AGING AND A COLDER 2238 01:36:55,800 --> 01:36:57,800 COHORT OF WOMEN AND POST 2239 01:36:57,800 --> 01:37:00,120 MENOPAUSING WOMAN AND THEY 2240 01:37:00,120 --> 01:37:01,840 LINKED INCREASED EPIGENETIC AGE 2241 01:37:01,840 --> 01:37:03,320 WITH LOW EDUCATION AND AS WELL 2242 01:37:03,320 --> 01:37:05,960 AS THE AFRICAN AMERICAN WOMEN IN 2243 01:37:05,960 --> 01:37:07,560 THAT STUDY AND END INDICATING 2244 01:37:07,560 --> 01:37:09,400 THIS COULD BE A SIGN FOR SOME OF 2245 01:37:09,400 --> 01:37:12,560 THE DISPARITIES AND HEALTH 2246 01:37:12,560 --> 01:37:13,080 OUTCOMES. 2247 01:37:13,080 --> 01:37:14,640 AND THESE ARE TWO STUD SKIS I 2248 01:37:14,640 --> 01:37:21,880 DON'T HAVE ANY DATA TO SHOW FOR 2249 01:37:21,880 --> 01:37:30,560 YOU AND HEART DISEASE AND THE 2250 01:37:30,560 --> 01:37:31,800 DIFFERENCES IN MECHANISMS 2251 01:37:31,800 --> 01:37:33,560 BETWEEN THOSE POPULATION GROUPS 2252 01:37:33,560 --> 01:37:44,080 AND IN THE FINAL LOWER PROJECT 2253 01:37:53,840 --> 01:37:56,120 HOW THIS CONTRIBUTES TO ONSET 2254 01:37:56,120 --> 01:37:58,880 AND AFRICAN AMERICAN PATIENTS. 2255 01:37:58,880 --> 01:38:00,480 AND ANOTHER THEME THAT REALLY 2256 01:38:00,480 --> 01:38:02,480 ARISES A LOT IN OUR STUDIES ARE 2257 01:38:02,480 --> 01:38:04,080 LOOKING AT GENETIC DIFFERENCES 2258 01:38:04,080 --> 01:38:06,640 SO THIS IS A STUDY RELEASED FROM 2259 01:38:06,640 --> 01:38:09,200 THIS IS FROM OUR P20 PORTFOLIO A 2260 01:38:09,200 --> 01:38:13,000 GROUP LED BY A DOCTOR WHO IS A 2261 01:38:13,000 --> 01:38:19,080 PIONEER IN BREAST CANCER 2262 01:38:19,080 --> 01:38:21,400 DISPARITIES AND HER CO AIs AND 2263 01:38:21,400 --> 01:38:23,760 THEY'VE DONE A LOT IN GENETIC 2264 01:38:23,760 --> 01:38:26,680 DISPARITIES BUT A PAPER SHOWS 2265 01:38:26,680 --> 01:38:29,880 THERE WERE RACIAL DISPARITIES IN 2266 01:38:29,880 --> 01:38:31,320 PATHOLOGICAL COMPLETE RESPONSE 2267 01:38:31,320 --> 01:38:33,680 IN RESPONSE TO CHEMOTHERAPY AND 2268 01:38:33,680 --> 01:38:35,880 EARLY STAGE BREAST CANCER AND SO 2269 01:38:35,880 --> 01:38:38,160 THIS IS A QUICK LOOK AT DATA BUT 2270 01:38:38,160 --> 01:38:40,080 IN SHORT, THEY HAD A LARGE MULTI 2271 01:38:40,080 --> 01:38:42,960 ETHNIC COHORT AND THEY LOOKED AT 2272 01:38:42,960 --> 01:38:44,200 690 PATIENTS ALL WITH EARLY 2273 01:38:44,200 --> 01:38:46,000 STAGE BREAST CANCER AND FOUND 2274 01:38:46,000 --> 01:38:48,000 OUT THE BLACK PATIENTS 2275 01:38:48,000 --> 01:38:50,720 SPECIFICALLY PATIENTS WITH HR 2276 01:38:50,720 --> 01:38:52,600 NEGATIVE H HER 2 POSITIVE TUMORS 2277 01:38:52,600 --> 01:38:56,200 HAD A SLOWER CHANCE OF GETTING A 2278 01:38:56,200 --> 01:38:57,040 PATHOLOGICAL COMPLETE RESPONSE 2279 01:38:57,040 --> 01:38:58,560 WHEN COMPARED TO THE WHITE 2280 01:38:58,560 --> 01:38:59,720 PATIENTS AND FURTHERMORE, THEY 2281 01:38:59,720 --> 01:39:01,040 FOUND THAT OF THOSE PATIENTS 2282 01:39:01,040 --> 01:39:03,240 THAT DID NOT HAVE A PATHOLOGICAL 2283 01:39:03,240 --> 01:39:05,000 COMPLETE RESPONSE, THAT THE 2284 01:39:05,000 --> 01:39:07,440 AFRICAN AMERICANS OR BLACK 2285 01:39:07,440 --> 01:39:09,240 PATIENTS HAD MUCH WORSE IN LOWER 2286 01:39:09,240 --> 01:39:10,680 SURVIVAL SO THEY LOOKED FURTHER 2287 01:39:10,680 --> 01:39:11,720 TO UNDERSTAND WHY THESE 2288 01:39:11,720 --> 01:39:14,480 DIFFERENCES EXIST AND THEY DID 2289 01:39:14,480 --> 01:39:16,240 SOME NEXGEN SEQUENCES AND IN THE 2290 01:39:16,240 --> 01:39:20,280 BLACK PATIENTS WITH POSITIVE 2291 01:39:20,280 --> 01:39:30,800 TUMORS THEY FOUND EVIDENCE OF 2292 01:39:31,440 --> 01:39:33,040 I'M GOING TO END TALKING ABOUT 2293 01:39:33,040 --> 01:39:34,240 IMMUNE RESPONSE AND 2294 01:39:34,240 --> 01:39:34,560 INFLAMMATION. 2295 01:39:34,560 --> 01:39:36,240 THIS IS A WIDELY DISCUSSED TOPIC 2296 01:39:36,240 --> 01:39:37,680 IN CANCER DISPARITIES AND I'M 2297 01:39:37,680 --> 01:39:39,200 GOING TO FOCUS ON SOME OF THE 2298 01:39:39,200 --> 01:39:49,720 WORK BEING DONE HERE AT NCI AND 2299 01:40:07,800 --> 01:40:08,600 THROUGH DIFFERENT GROUPS AND 2300 01:40:08,600 --> 01:40:10,480 THERE'S INCREASED INFLAMMATION 2301 01:40:10,480 --> 01:40:11,800 AND IMMUNE RESPONSE IN THE 2302 01:40:11,800 --> 01:40:18,520 AFRICAN AMERICAN PATIENTS AND 2303 01:40:18,520 --> 01:40:21,320 THEY SEE A SIMILAR AND SYSTEMIC 2304 01:40:21,320 --> 01:40:22,320 INFLAMMATION AND FINDING THE 2305 01:40:22,320 --> 01:40:24,120 SAME THING BUT WHAT HASN'T BEEN 2306 01:40:24,120 --> 01:40:29,280 KNOWN IS EXACTLY WHY THIS 2307 01:40:29,280 --> 01:40:36,360 INCREASED NOT THEY LOOKED AT 2308 01:40:36,360 --> 01:40:37,440 THESE MULTI LEVEL DRIVERS THAT 2309 01:40:37,440 --> 01:40:38,840 COULD BE CONTRIBUTE TO GO RACIAL 2310 01:40:38,840 --> 01:40:42,440 AND ETHNIC DISPARITIES AND KANG 2311 01:40:42,440 --> 01:40:44,440 SER AND LOOKING ACROSS 2312 01:40:44,440 --> 01:40:45,720 INDIVIDUAL LEVELS AND FOR THIS 2313 01:40:45,720 --> 01:40:47,880 THEY REALLY HONED IN ON 2314 01:40:47,880 --> 01:40:49,040 ENVIRONMENTS AND NEIGHBORHOOD 2315 01:40:49,040 --> 01:40:51,560 INFLUENCE TO SEE IF THIS COULD 2316 01:40:51,560 --> 01:40:53,120 CONTRIBUTING AND INTERACTING SO 2317 01:40:53,120 --> 01:40:55,040 THERE'S A HYPOTHESIS THAT 2318 01:40:55,040 --> 01:40:56,360 NEIGHBORHOOD DEPRIVATION IS A 2319 01:40:56,360 --> 01:41:05,880 RISK FACTOR FOR PROCESS INDICATE 2320 01:41:05,880 --> 01:41:07,080 EUROPEAN AMERICAN OR WHITE MEN 2321 01:41:07,080 --> 01:41:08,520 SO WHEN THEY DID THEIR 2322 01:41:08,520 --> 01:41:12,000 NEIGHBORHOOD DEPRIVATION INDEX 2323 01:41:12,000 --> 01:41:14,200 THERE WAS A ESTABLISHED BY 2324 01:41:14,200 --> 01:41:18,040 MESSER AND USING CENSUS TRACK 2325 01:41:18,040 --> 01:41:23,560 DATA LEVEL THAT WAS DRAWN FROM 2326 01:41:23,560 --> 01:41:25,600 THE THEY FOCUSED ON MODEL WITH 2327 01:41:25,600 --> 01:41:27,200 SIX VARIABLES SHOWN HERE BUT YOU 2328 01:41:27,200 --> 01:41:29,800 KNOW AT THE END IT'S LOWER NDI 2329 01:41:29,800 --> 01:41:31,960 VALUES AND IT MEANS LESS 2330 01:41:31,960 --> 01:41:33,720 DEPRIVATION AND HIGHER NDI 2331 01:41:33,720 --> 01:41:35,640 VALUES MEANS GREATER DEPRIVATION 2332 01:41:35,640 --> 01:41:37,960 AND THIS IS THE RAPE PUBLISHED 2333 01:41:37,960 --> 01:41:40,400 THIS YEAR IN JAM A AND WHAT THEY 2334 01:41:40,400 --> 01:41:41,720 FIND IN SURE IS THAT IN THEIR 2335 01:41:41,720 --> 01:41:47,280 CASE CONTROL STUDY, IT WAS 2336 01:41:47,280 --> 01:41:49,600 ASSOCIATED WITH A 55% OF ODDS OF 2337 01:41:49,600 --> 01:41:53,280 HAVING PROSTATE CANCER AND BUT 2338 01:41:53,280 --> 01:41:55,920 THIS WAS NOT SEEN IN EUROPEAN 2339 01:41:55,920 --> 01:41:57,120 AMERICAN MEN AND THEN WHEN THEY 2340 01:41:57,120 --> 01:41:59,400 LOOKED IN JUST THEIR CONTROLS, 2341 01:41:59,400 --> 01:42:01,360 THEY FOUND THAT NEIGHBORHOOD 2342 01:42:01,360 --> 01:42:04,320 DEPRIVATION WAS ASSOCIATED WITH 2343 01:42:04,320 --> 01:42:06,160 MARKERS THAT WERE LINKED TO 2344 01:42:06,160 --> 01:42:08,960 CHEMO TAX IS, TUMOR IMMUNE FEE 2345 01:42:08,960 --> 01:42:13,600 AND INFLAMMATION SO THIS DATA 2346 01:42:13,600 --> 01:42:16,360 SUGGESTS THAT WHAT WE KNOW IS 2347 01:42:16,360 --> 01:42:17,280 DERIVED NEIGHBORHOOD RESIDENCY 2348 01:42:17,280 --> 01:42:19,800 IS ALSO A RISK FACTORS AND THIS 2349 01:42:19,800 --> 01:42:22,960 IS NOT STRIC STRICTLY BIOLOGICAL 2350 01:42:22,960 --> 01:42:24,360 ORIGIN ET TICK AND THIS IS IN 2351 01:42:24,360 --> 01:42:25,960 AFRICAN AMERICAN MEN WITH 2352 01:42:25,960 --> 01:42:27,720 PROSTATE CANCER AND LINKED TO 2353 01:42:27,720 --> 01:42:32,120 SYSTEMIC INFLAMMATION AND 2354 01:42:32,120 --> 01:42:33,200 IMMUNITY. 2355 01:42:33,200 --> 01:42:34,760 SO I'LL END ON THIS SLIDE IT'S 2356 01:42:34,760 --> 01:42:36,080 DONE THROUGH THE GROUP WITH 2357 01:42:36,080 --> 01:42:37,840 ELITE AUTHOR OF BRITTANY LORD 2358 01:42:37,840 --> 01:42:40,840 AND IT NICELY DETAILS SOME 2359 01:42:40,840 --> 01:42:43,480 RECENT STUDIES THAT LINK 2360 01:42:43,480 --> 01:42:45,360 BIOLOGICAL EFFECTS THERE ARE 2361 01:42:45,360 --> 01:42:47,280 ASSOCIATED WITH BOTH 2362 01:42:47,280 --> 01:42:48,960 ENVIRONMENTAL AND SOCIAL FACTORS 2363 01:42:48,960 --> 01:42:50,560 AND SO YOU KNOW, FOR 2364 01:42:50,560 --> 01:42:52,280 ENVIRONMENTAL FACTORS, BOTH AIR 2365 01:42:52,280 --> 01:42:53,600 POLLUTION AND NEIGHBORHOOD 2366 01:42:53,600 --> 01:42:57,240 DEPRIVATION ARE KNOWN TO 2367 01:42:57,240 --> 01:42:58,280 DISPARITIES EFFECT COMMUNITIES 2368 01:42:58,280 --> 01:42:59,480 OF COLORS AND THERE'S A LONG 2369 01:42:59,480 --> 01:43:01,040 LIST OF BIOLOGICAL EFFECT THAT'S 2370 01:43:01,040 --> 01:43:04,840 RESULT FROM THIS INCLUDING 2371 01:43:04,840 --> 01:43:15,080 THINGS LIKE STUDIES HAVE SHOWN A 2372 01:43:15,080 --> 01:43:16,840 DIRECT LINK TO MANY BIOLOGICAL 2373 01:43:16,840 --> 01:43:19,200 EFFECTS OF THIS AND COLLECTIVELY 2374 01:43:19,200 --> 01:43:20,320 THEY BELIEVE THIS IS HAVING AN 2375 01:43:20,320 --> 01:43:22,160 EFFECT ON THE OUTCOMES OF THE 2376 01:43:22,160 --> 01:43:25,840 BLACK INDIVIDUALS AND THEIR 2377 01:43:25,840 --> 01:43:36,320 STUDIES AND SO WITH THIS I AM 2378 01:43:40,800 --> 01:43:41,840 HAPPY TO TAKE QUESTIONS AND 2379 01:43:41,840 --> 01:43:43,080 ADDRESS THEM IN THE PANEL. 2380 01:43:43,080 --> 01:43:45,600 [APPLAUSE] 2381 01:43:45,600 --> 01:43:48,240 >>OUR LAST SPEAKER IS 2382 01:43:48,240 --> 01:43:52,000 Dr. CARRINGTON LAWRENCE. 2383 01:43:52,000 --> 01:43:53,800 I APOLOGIZE FOR NOT BEING 2384 01:43:53,800 --> 01:43:55,040 THERE IN-PERSON THIS MORNING BUT 2385 01:43:55,040 --> 01:43:56,520 I WILL BE THERE IN THE 2386 01:43:56,520 --> 01:43:57,920 AFTERNOON. 2387 01:43:57,920 --> 01:44:02,840 I'LL BE ADDRESSING HEALTH 2388 01:44:02,840 --> 01:44:05,080 DISPARITIES AND IT'S INTERESTING 2389 01:44:05,080 --> 01:44:07,120 HOW EVERYTHING CONVERGES AND IT 2390 01:44:07,120 --> 01:44:08,560 SEEMS THERE ARE MUCH 2391 01:44:08,560 --> 01:44:09,520 SIMILARITIES ACROSS THE SPECTRUM 2392 01:44:09,520 --> 01:44:16,600 WHEN IT COMES TO HELP 2393 01:44:16,600 --> 01:44:17,720 DISPARITIES, I'LL GIVE A 2394 01:44:17,720 --> 01:44:19,440 BACKGROUND ON AGING. 2395 01:44:19,440 --> 01:44:21,640 AND THE DEMOGRAPHICS AROUND 2396 01:44:21,640 --> 01:44:23,200 AGING AND HEALTH DISPARITIES. 2397 01:44:23,200 --> 01:44:25,680 AND THEN I'LL LEAD INTO SOME 2398 01:44:25,680 --> 01:44:27,560 DISCUSSIONS ABOUT APPROACHES FOR 2399 01:44:27,560 --> 01:44:28,280 EXAMINING BIOLOGICAL 2400 01:44:28,280 --> 01:44:29,440 DETERMINANTS OF HEALTH. 2401 01:44:29,440 --> 01:44:33,360 SO OLDER ADULTS OVER THE AGE OF 2402 01:44:33,360 --> 01:44:34,760 65 REPRESENT 16% OF THE U.S. 2403 01:44:34,760 --> 01:44:35,560 POPULATION. 2404 01:44:35,560 --> 01:44:36,760 OVER THE NEXT DECADE THIS NUMBER 2405 01:44:36,760 --> 01:44:40,240 IS EXPECTED TO GROW TO DECREASES 2406 01:44:40,240 --> 01:44:41,880 IN THE BIRTH WEIGHT AS WELL AS 2407 01:44:41,880 --> 01:44:43,000 ADVANCES IN HEALTHCARE LEADING 2408 01:44:43,000 --> 01:44:47,040 TO INCREASED LONGEVITY IN THIS 2409 01:44:47,040 --> 01:44:47,720 POPULATION. 2410 01:44:47,720 --> 01:44:50,040 THIS IS GOING TO RESULT IN OLDER 2411 01:44:50,040 --> 01:44:51,000 ADULTS AND CHILDREN FOR THE 2412 01:44:51,000 --> 01:44:53,520 FIRST TIME IN HISTORY BY 2034 SO 2413 01:44:53,520 --> 01:44:58,840 NOT THAT FAR OFF 1/4 ADULTS OVER 2414 01:44:58,840 --> 01:45:00,960 65 ARE MEMBERS OF RATE AND 2415 01:45:00,960 --> 01:45:03,520 ETHNIC POPULATION AND BY 2040, 2416 01:45:03,520 --> 01:45:05,320 IT IT'S ESTIMATED THAT 23% OF 2417 01:45:05,320 --> 01:45:07,040 OLDER ADULTS WILL BE MEMBERS OF 2418 01:45:07,040 --> 01:45:10,360 RACIAL AND ETHNIC MINORITY 2419 01:45:10,360 --> 01:45:11,560 GROUPS. 2420 01:45:11,560 --> 01:45:13,200 BY 2050 THE U.S. POPULATION OVER 2421 01:45:13,200 --> 01:45:15,120 ALL WILL BE MORE RACIALLY AND 2422 01:45:15,120 --> 01:45:17,120 ETHNICALLY DIVERSE WITH THE 2423 01:45:17,120 --> 01:45:19,080 BIGGEST IN ADULT IDENTIFYING IS 2424 01:45:19,080 --> 01:45:23,000 TWO OR MORE ETH NICE TEASE AND 2425 01:45:23,000 --> 01:45:24,880 IN 2016, AFRICAN AMERICANS ARE 2426 01:45:24,880 --> 01:45:26,720 PROJECTED TO BE 13% OF THE U.S. 2427 01:45:26,720 --> 01:45:31,240 OLDER ADULT POPULATION. 2428 01:45:31,240 --> 01:45:32,840 WHILE THE PERCENTAGE OF AMERICAN 2429 01:45:32,840 --> 01:45:35,720 INDIAN AND ALASKA NATIVE 2430 01:45:35,720 --> 01:45:37,960 INDIVIDUALS WILL INCREASE 2431 01:45:37,960 --> 01:45:48,240 SLIGHTLY TO .7%. 2432 01:45:52,280 --> 01:45:54,320 WHICH WE'LL SEE AN INCREASE FROM 2433 01:45:54,320 --> 01:45:59,080 8% TO 21%. 2434 01:45:59,080 --> 01:46:01,360 IN ADDITION, AGING AND IN OF 2435 01:46:01,360 --> 01:46:03,600 ITSELF IS CONSIDERED A HEALTH 2436 01:46:03,600 --> 01:46:04,800 DISPARITIES AND OLDER ADULTS 2437 01:46:04,800 --> 01:46:06,520 HAVE PREPORTION AND BURDEN OF 2438 01:46:06,520 --> 01:46:08,080 CHRONIC DISEASES INCLUDING 2439 01:46:08,080 --> 01:46:10,440 CANCER AND HYPERTENSION AND 2440 01:46:10,440 --> 01:46:12,320 CARDIOVASCULAR DISEASE AND 2441 01:46:12,320 --> 01:46:22,720 DIABETES AND ET CETERA. 2442 01:46:29,840 --> 01:46:33,000 AS WELL AS THEIR SOCIOECONOMIC 2443 01:46:33,000 --> 01:46:35,880 STATUS, SEX, AGE AND SEXUAL 2444 01:46:35,880 --> 01:46:36,760 ORIENTATION, GEOGRAPHIC 2445 01:46:36,760 --> 01:46:38,440 LOCATION, AND OTHER 2446 01:46:38,440 --> 01:46:39,400 CHARACTERISTICS HISTORICALLY 2447 01:46:39,400 --> 01:46:41,040 LINKED TO DISCRIMINATION AND EX 2448 01:46:41,040 --> 01:46:43,280 CLUES AND WE HEARD A BIT ABOUT 2449 01:46:43,280 --> 01:46:48,000 THIS FROM BOTH Dr. 2450 01:46:48,000 --> 01:46:53,000 PEREZ-STABLE AND Dr. ZENK THIS 2451 01:46:53,000 --> 01:47:00,040 MORNING. 2452 01:47:00,040 --> 01:47:01,920 SO FOR OLDER ADULTS WHO ARE 2453 01:47:01,920 --> 01:47:06,120 MEMBERS OF ETHNIC MINORITIES AND 2454 01:47:06,120 --> 01:47:08,400 INDIVIDUALS WHO HAVE LOWER 2455 01:47:08,400 --> 01:47:09,960 SOCIOECONOMIC STATUS ARE MORE 2456 01:47:09,960 --> 01:47:13,800 LIKELY TO EXPERIENCE CHRONIC 2457 01:47:13,800 --> 01:47:16,360 DISEASES AND HAVE MULTI 2458 01:47:16,360 --> 01:47:19,560 MORBIDITY AND SEVERITY OF THOSE 2459 01:47:19,560 --> 01:47:20,600 DISEASES AND IN ADDITION THEY 2460 01:47:20,600 --> 01:47:25,480 HAVE HIGHER MORTALITY AND SOME 2461 01:47:25,480 --> 01:47:28,600 OF THE MOST COMMON OCCURRING AGE 2462 01:47:28,600 --> 01:47:32,360 ASSOCIATED CHRONIC DISEASES AND 2463 01:47:32,360 --> 01:47:34,720 MANY ARE SIGNIFICANT HEALTH 2464 01:47:34,720 --> 01:47:36,280 DISPARITIES WITHIN AFRICAN 2465 01:47:36,280 --> 01:47:40,280 AMERICAN, AMERICAN INDIAN, AND 2466 01:47:40,280 --> 01:47:41,760 HISPANIC INDIVIDUALS. 2467 01:47:41,760 --> 01:47:43,040 AMERICAN INDIANS, ALASKA 2468 01:47:43,040 --> 01:47:44,320 NATIVES, HAVE THE HIGHEST 2469 01:47:44,320 --> 01:47:46,320 PREFERENCE OF DIABETES FOLLOWED 2470 01:47:46,320 --> 01:47:50,680 BY HISPANIC AND AFRICAN AMERICAN 2471 01:47:50,680 --> 01:47:52,400 AND AFRICAN AMERICANS HAVE 2472 01:47:52,400 --> 01:47:55,840 HYPERTENSION MORE LIKELY AND 2473 01:47:55,840 --> 01:47:57,000 HISPANIC AMERICANS AND AFRICAN 2474 01:47:57,000 --> 01:48:01,000 AMERICANS ARE MORE LIKELY TO BE 2475 01:48:01,000 --> 01:48:04,520 OBESE. 2476 01:48:04,520 --> 01:48:05,800 INTERESTINGLY, NON-HISPANIC 2477 01:48:05,800 --> 01:48:07,320 WHITE INDIVIDUALS HAVE 2478 01:48:07,320 --> 01:48:09,000 CARDIOVASCULAR DISEASE BUT 2479 01:48:09,000 --> 01:48:10,160 AFRICAN AMERICANS HAVE THE 2480 01:48:10,160 --> 01:48:12,720 HIGHEST AGE ADJUSTED DEATH RATE 2481 01:48:12,720 --> 01:48:15,240 FROM CARDIOVASCULAR DISEASE. 2482 01:48:15,240 --> 01:48:17,400 OLDER ADULTS LIVING IN RURAL 2483 01:48:17,400 --> 01:48:18,080 COMMUNITIES ALSO EXPERIENCE 2484 01:48:18,080 --> 01:48:19,400 SIGNIFICANT CHALLENGES AND 2485 01:48:19,400 --> 01:48:20,840 INCLUDING HIGHER RATES OF 2486 01:48:20,840 --> 01:48:23,760 OBESITY AND HIGHER PREVALENCE OF 2487 01:48:23,760 --> 01:48:24,680 CHRONIC DISEASE AND LESS ACCESS 2488 01:48:24,680 --> 01:48:26,440 TO SERVICES. 2489 01:48:26,440 --> 01:48:28,000 AND IN ADDITION, PEOPLE ARE 2490 01:48:28,000 --> 01:48:30,360 AGING WITH THE DISABILITY, OF 2491 01:48:30,360 --> 01:48:34,040 HIGHER PREPORTION OF HEALTH RISK 2492 01:48:34,040 --> 01:48:35,840 FACTORS AND PHYSICAL INACTIVITY 2493 01:48:35,840 --> 01:48:44,600 AND HYPERTENSION AND OBESITY. 2494 01:48:44,600 --> 01:48:47,600 NEXT SLIDE. 2495 01:48:47,600 --> 01:48:49,720 SO THE NIA IS COMMITTED TO 2496 01:48:49,720 --> 01:48:52,840 SUPPORTING RESEARCH THAT 2497 01:48:52,840 --> 01:48:54,960 ADDRESSES HEALTH DISPARITY. 2498 01:48:54,960 --> 01:48:57,440 NIH SEEKS TO UNDERSTAND THE 2499 01:48:57,440 --> 01:48:59,600 ENVIRONMENTAL SOCIOCULTURAL 2500 01:48:59,600 --> 01:49:01,480 BEHAVIORAL AND BIOLOGICAL OF 2501 01:49:01,480 --> 01:49:02,920 HEALTH DISPARITIES AND 2502 01:49:02,920 --> 01:49:05,600 DISPARITIES RELATED TO AGING AND 2503 01:49:05,600 --> 01:49:07,040 DISEASES SUCH AS ALZHEIMER'S AND 2504 01:49:07,040 --> 01:49:11,040 RELATED DEMENTIA. 2505 01:49:11,040 --> 01:49:12,800 WE ALSO SUPPORT RESEARCH TO 2506 01:49:12,800 --> 01:49:15,520 DEVELOP STRATEGIES FOR IMPROVING 2507 01:49:15,520 --> 01:49:17,640 HEALTH AMONG MID LIFE AND OLDER 2508 01:49:17,640 --> 01:49:19,840 ADULTS IN UNDER REPRESENTED 2509 01:49:19,840 --> 01:49:22,640 GROUPS EXPERIENCE DISPARITIES. 2510 01:49:22,640 --> 01:49:24,200 AND THESE PRIORITIES ARE 2511 01:49:24,200 --> 01:49:26,080 OUTLINED IN THE NIA STRATEGIC 2512 01:49:26,080 --> 01:49:28,440 DIRECTIONS FOR RESEARCH AND ALSO 2513 01:49:28,440 --> 01:49:30,320 REFLECTED WITHIN THE NIA HEALTH 2514 01:49:30,320 --> 01:49:33,920 DISPARITY RESEARCH FRAMEWORK. 2515 01:49:33,920 --> 01:49:35,960 THE NIA STRATEGIC GOALS FOR 2516 01:49:35,960 --> 01:49:40,600 HEALTH DISPARITIES WHICH IS GOAL 2517 01:49:40,600 --> 01:49:42,560 F, AND OUR OVER ALL DOCUMENT 2518 01:49:42,560 --> 01:49:44,200 AIMS TO UNDERSTAND HEALTH 2519 01:49:44,200 --> 01:49:45,240 DISPARITIES AND DEVELOPS 2520 01:49:45,240 --> 01:49:46,560 STRATEGIES TO IMPROVE THE HEALTH 2521 01:49:46,560 --> 01:49:50,000 STATUS OF OLDER ADULT AND 2522 01:49:50,000 --> 01:49:52,920 DIVERSE POPULATIONS. 2523 01:49:52,920 --> 01:50:00,560 POPULATION POPULATIONS.THE GOALH 2524 01:50:00,560 --> 01:50:01,200 F-4. 2525 01:50:01,200 --> 01:50:02,920 UNDERSTAND AND IDENTIFY OF 2526 01:50:02,920 --> 01:50:04,800 ENVIRONMENTAL, SOCIAL, CULTURAL, 2527 01:50:04,800 --> 01:50:06,120 BEHAVIORAL AND BIOLOGICAL 2528 01:50:06,120 --> 01:50:09,360 FACTORS THAT CREATE AND SUSTAIN 2529 01:50:09,360 --> 01:50:13,760 HEALTH DISPARITIES AMONG OLDER 2530 01:50:13,760 --> 01:50:15,760 ADULTS AND WE DO THIS BY 2531 01:50:15,760 --> 01:50:17,680 SUPPORTING RESEARCH TO GATHER 2532 01:50:17,680 --> 01:50:19,920 DATA AND PATTERNS OF HEALTH 2533 01:50:19,920 --> 01:50:22,640 DISPARITIES AND TO TRACK AND THE 2534 01:50:22,640 --> 01:50:24,680 ANALYZE AND REDUCE LIFE 2535 01:50:24,680 --> 01:50:26,000 EXPECTANCY AND DIVERSE OLDER 2536 01:50:26,000 --> 01:50:28,560 ADULT POPULATIONS AND WE ALSO 2537 01:50:28,560 --> 01:50:29,480 STRIVE TO UNDERSTAND THE 2538 01:50:29,480 --> 01:50:31,560 DIFFERENCES IN AGING PROCESSES 2539 01:50:31,560 --> 01:50:35,520 ACROSS AND DIVERSE POPULATIONS 2540 01:50:35,520 --> 01:50:37,880 AND IN ADDITION IT'S IMPORTANT 2541 01:50:37,880 --> 01:50:42,200 TO UNDERSTAND HOW ENVIRONMENTAL 2542 01:50:42,200 --> 01:50:43,280 SOCIOCULTURAL BEHAVIORAL AS WELL 2543 01:50:43,280 --> 01:50:46,200 AS BIOLOGICAL FACTORS LEAD TO 2544 01:50:46,200 --> 01:50:47,560 DISPARITIES AND HEALTH AT OLDER 2545 01:50:47,560 --> 01:50:51,400 AGES AND TO DEVELOP 2546 01:50:51,400 --> 01:50:56,360 INTERVENTIONS THAT RADIO DUCE 2547 01:50:56,360 --> 01:50:57,680 THOUGH AND I WOULD LIKE TO 2548 01:50:57,680 --> 01:51:00,080 UNDERSTAND AND DETERMINE HOW 2549 01:51:00,080 --> 01:51:01,400 ENVIRONMENTAL SCIO AND 2550 01:51:01,400 --> 01:51:02,680 BIOLOGICAL DETERMINANTS INTERACT 2551 01:51:02,680 --> 01:51:04,280 TO INCREASE THE RISK OF DISEASE 2552 01:51:04,280 --> 01:51:07,520 AND CIVILITY AND TO DETERMINE 2553 01:51:07,520 --> 01:51:10,400 THE EFFECTS OF EARLY LIFE 2554 01:51:10,400 --> 01:51:12,120 FACTORS OF HEALTH DISPARITIES 2555 01:51:12,120 --> 01:51:14,280 AMONG OLDER ADULTS. 2556 01:51:14,280 --> 01:51:16,520 AIM F-2. 2557 01:51:16,520 --> 01:51:18,600 AIMS TO DEVELOP STRATEGIES TO 2558 01:51:18,600 --> 01:51:20,800 PROMOTE ACTIVE LIFE EXPECTANCY 2559 01:51:20,800 --> 01:51:23,000 AND IMPROVE THE HEALTH, STATUS 2560 01:51:23,000 --> 01:51:27,520 OF OLDER ADULTS AND DIVERSE 2561 01:51:27,520 --> 01:51:29,960 POPULATIONS AND LIFE EXPECTANCY 2562 01:51:29,960 --> 01:51:34,440 HAS INCREASED AMONG ALL 2563 01:51:34,440 --> 01:51:35,400 POPULATION GROUPS HOWEVER 2564 01:51:35,400 --> 01:51:37,160 AFRICAN AMERICAN MEN HAVE THE 2565 01:51:37,160 --> 01:51:41,640 LOWEST LIFE EXPECTED OF ALL LIFE 2566 01:51:41,640 --> 01:51:43,080 GROUPS IN THE U.S. SO IT'S 2567 01:51:43,080 --> 01:51:46,040 IMPORTANT TO NOTE THAT 2568 01:51:46,040 --> 01:51:49,920 DISPARITIES STILL EXIST IN LIFE 2569 01:51:49,920 --> 01:51:55,200 EXPECTANCY IN CERTAIN GROUPS. 2570 01:51:55,200 --> 01:51:56,840 F-3 AIMS TO DEVELOP AND 2571 01:51:56,840 --> 01:51:59,200 IMPLEMENT STRATEGIES TO INCREASE 2572 01:51:59,200 --> 01:52:01,760 INCLUSION OF DIVERSE POPULATIONS 2573 01:52:01,760 --> 01:52:06,000 AND RESEARCH. 2574 01:52:06,000 --> 01:52:09,880 UNDERSTANDING OR IMPROVING THE 2575 01:52:09,880 --> 01:52:11,760 ABILITY OF NIA INVESTIGATORS TO 2576 01:52:11,760 --> 01:52:13,720 RECRUIT AND RETAIN RESEARCH 2577 01:52:13,720 --> 01:52:15,720 PARTICIPANTS THAT ARE 2578 01:52:15,720 --> 01:52:17,600 REPRESENTATIVE OF THE TOTAL U.S. 2579 01:52:17,600 --> 01:52:19,720 POPULATION IS ESSENTIAL IN ORDER 2580 01:52:19,720 --> 01:52:21,240 TO CONDUCT RIGOROUS HEALTH 2581 01:52:21,240 --> 01:52:24,160 DISPARITIES RESEARCH RELATED TO 2582 01:52:24,160 --> 01:52:24,360 AGING. 2583 01:52:24,360 --> 01:52:26,800 AND FINALLY F-4 SUPPORTS 2584 01:52:26,800 --> 01:52:28,320 RESEARCH ON WOMEN'S HEALTH 2585 01:52:28,320 --> 01:52:30,000 INCLUDING STUDIES OF HOW SEX AND 2586 01:52:30,000 --> 01:52:31,880 GENDER INFLUENCE AGING PROCESSES 2587 01:52:31,880 --> 01:52:33,200 AND OUTCOMES. 2588 01:52:33,200 --> 01:52:35,440 AND NIA SUPPORTS A DIVERSE 2589 01:52:35,440 --> 01:52:38,480 PORTFOLIO OF RESEARCH AND OLDER 2590 01:52:38,480 --> 01:52:40,040 WOMEN'S HEALTH AND INCLUDING 2591 01:52:40,040 --> 01:52:41,240 STUDIES ON SEX DIFFERENCES AND 2592 01:52:41,240 --> 01:52:44,040 THE BASIC BIOLOGY OF AGING. 2593 01:52:44,040 --> 01:52:46,760 AND RON HIGHLIGHTED SOME OF THE 2594 01:52:46,760 --> 01:52:50,720 DIFFERENCES THAT ARE SEEN ACROSS 2595 01:52:50,720 --> 01:52:55,320 THE SEXES IN HIS PRESENTATION 2596 01:52:55,320 --> 01:52:57,160 EARLIER THIS MORNING AND WE ALSO 2597 01:52:57,160 --> 01:52:59,600 ARE INTERESTED IN HORMONAL 2598 01:52:59,600 --> 01:53:05,800 INFLUENINFLUENCES ON COGNITIVE . 2599 01:53:05,800 --> 01:53:07,680 WE LOOK AT RESEARCH ACROSS THE 2600 01:53:07,680 --> 01:53:09,760 LIFESPAN AND INCLUDING THE 2601 01:53:09,760 --> 01:53:20,280 MENOPAUSAL TRANSITION AND AND 2602 01:53:23,160 --> 01:53:27,240 INCLUDING OF SEX AND GENDER 2603 01:53:27,240 --> 01:53:34,480 OLDER AGES AND NEXT SLIDE, 2604 01:53:34,480 --> 01:53:34,800 PLEASE. 2605 01:53:34,800 --> 01:53:37,200 THE NIA HEALTH DISPARITIES 2606 01:53:37,200 --> 01:53:39,480 RESEARCH FRAMEWORK WHICH IS A 2607 01:53:39,480 --> 01:53:43,240 COMPANION TO THE GOALS, WAS 2608 01:53:43,240 --> 01:53:45,240 DEVELOPED IN 2015 SO BEFORE OUR 2609 01:53:45,240 --> 01:53:52,160 GOALS DOCUMENT AND INTEREST IN 2610 01:53:52,160 --> 01:53:56,840 DOING HEALTH DISPARITIES AND 2611 01:53:56,840 --> 01:53:59,160 RESEARCHES AND THE FRAMEWORK CAN 2612 01:53:59,160 --> 01:54:01,960 BE FOUND AT OUR NIA WEBSITE AND 2613 01:54:01,960 --> 01:54:03,320 IT IDENTIFIES PRIORITY 2614 01:54:03,320 --> 01:54:04,400 POPULATIONS FOR HEALTH 2615 01:54:04,400 --> 01:54:08,520 DISPARITIES RESEARCH AND IT IS 2616 01:54:08,520 --> 01:54:14,680 SHOWCASING AND IT HAS FOUR KEY 2617 01:54:14,680 --> 01:54:16,640 LEVELS OF ANALYSIS RELATED TO 2618 01:54:16,640 --> 01:54:17,720 DISPARITIES RESEARCH AND THOSE 2619 01:54:17,720 --> 01:54:20,160 CAN BE SEEN HERE AS 2620 01:54:20,160 --> 01:54:21,560 ENVIRONMENTAL, SCIO, CULTURAL 2621 01:54:21,560 --> 01:54:32,080 AND BEHAVIORAL AND BIOLOGICAL 2622 01:54:48,520 --> 01:54:50,040 INCORPORATING LIFESPAN THAT 2623 01:54:50,040 --> 01:54:52,000 DETERMINE THE TRAJECTORY OF 2624 01:54:52,000 --> 01:54:53,120 HEALTH AND DETERMINE HEALTH 2625 01:54:53,120 --> 01:54:56,280 DISPARITIES. 2626 01:54:56,280 --> 01:55:06,520 NEXT SLIGHT. 2627 01:55:50,320 --> 01:56:00,800 SOCIOCULTURAL LEVEL OF ANALYSIS 2628 01:56:06,160 --> 01:56:10,920 THAT INCLUDES STIGMA, BIAS AND 2629 01:56:10,920 --> 01:56:11,400 LONELINESS. 2630 01:56:11,400 --> 01:56:15,960 AND THE BEHAVIORAL LEVEL OF 2631 01:56:15,960 --> 01:56:20,000 ANALYSIS, PRIORITIZES COPING 2632 01:56:20,000 --> 01:56:21,640 MECHANISMS AND HEALTH BEHAVIOR 2633 01:56:21,640 --> 01:56:23,280 INCLUDING SUBSTANCE USE AND 2634 01:56:23,280 --> 01:56:24,200 NUTRITION AND PHYSICAL ACTIVITY 2635 01:56:24,200 --> 01:56:25,920 AND FINALLY THE BIOLOGICAL LEVEL 2636 01:56:25,920 --> 01:56:36,480 OF ANALYSIS SUPPORTS AREAS AND I 2637 01:56:39,240 --> 01:56:45,320 WILL DISCUSS AND AS YOU CAN SEE 2638 01:56:45,320 --> 01:56:47,720 THE RESEARCH WITHIN THE 2639 01:56:47,720 --> 01:56:50,200 FRAMEWORK AND RESEARCH SUPPORTED 2640 01:56:50,200 --> 01:56:53,880 AT NI A AND HEALTH DISPARITIES 2641 01:56:53,880 --> 01:56:55,520 WHICH ARE PARTICULARLY AN 2642 01:56:55,520 --> 01:56:57,200 IMPORTANT FACTOR INFLUENCING OR 2643 01:56:57,200 --> 01:57:07,680 DRIVING HEALTH DISPARITIES AND 2644 01:57:07,960 --> 01:57:10,040 THEY NEED TO BE FURTHER DEFINED 2645 01:57:10,040 --> 01:57:12,960 AND NOT LISTED HERE ARE OTHER 2646 01:57:12,960 --> 01:57:14,520 FACTORS INCLUDING INFECTIOUS 2647 01:57:14,520 --> 01:57:15,840 DISEASE AND PATHOGEN BURDEN 2648 01:57:15,840 --> 01:57:17,720 WHICH IS SOMETHING WE'VE 2649 01:57:17,720 --> 01:57:19,520 OBSERVED DURING COVID OR 2650 01:57:19,520 --> 01:57:20,760 IMPORTANT AREAS TO UNDERSTAND 2651 01:57:20,760 --> 01:57:24,760 FOR HEALTH DISPARITIES AND 2652 01:57:24,760 --> 01:57:28,440 AGING. 2653 01:57:28,440 --> 01:57:32,880 SO, IN ADDITION TO THE FRAMEWORK 2654 01:57:32,880 --> 01:57:34,560 AND THE STRATEGIC PLAN WE REACH 2655 01:57:34,560 --> 01:57:36,640 OUT TO OUR NATIONAL ADVISORY 2656 01:57:36,640 --> 01:57:41,280 COUNCIL ON AGING TO GET ADVICE 2657 01:57:41,280 --> 01:57:44,560 ON AREAS TO PRIORITIZE FOR AGING 2658 01:57:44,560 --> 01:57:47,920 RESEARCH AND THE NATIONAL CONSUL 2659 01:57:47,920 --> 01:57:49,720 ON AGING, PROVIDED 2660 01:57:49,720 --> 01:57:51,480 RECOMMENDATIONS TO NIA AND ASKED 2661 01:57:51,480 --> 01:57:54,960 THAT WE CONSIDER THE FOLLOWING. 2662 01:57:54,960 --> 01:57:57,080 TO REEXAM PRIORITY AREAS THAT 2663 01:57:57,080 --> 01:57:58,840 GUIDE THE RESEARCH AND ALL 2664 01:57:58,840 --> 01:58:00,480 DIVISIONS AT NIH RELATED TO 2665 01:58:00,480 --> 01:58:01,960 HEALTH DISPARITIES ISSUES AND 2666 01:58:01,960 --> 01:58:03,840 SUPPORT MORE RESEARCH ON SOCIAL 2667 01:58:03,840 --> 01:58:05,160 AND ECONOMIC FACTORS THAT 2668 01:58:05,160 --> 01:58:06,240 PREDICT HEALTH AND WELL-BEING 2669 01:58:06,240 --> 01:58:09,400 AND VULNERABLE DIVERSE 2670 01:58:09,400 --> 01:58:11,840 POPULATION GROUPS. 2671 01:58:11,840 --> 01:58:13,080 AND INTERESTINGLY OR I SHOULD 2672 01:58:13,080 --> 01:58:16,640 SAY ENCOURAGINGLY, THEY WANT 2673 01:58:16,640 --> 01:58:18,400 TO -- THEY ASKED US TO ENCOURAGE 2674 01:58:18,400 --> 01:58:20,520 AGING BIOLOGY RESEARCH AND 2675 01:58:20,520 --> 01:58:22,280 CONTRIBUTE TO GO DEFINING THE 2676 01:58:22,280 --> 01:58:24,240 BIOLOGICAL BASIS OF HEALTH 2677 01:58:24,240 --> 01:58:25,920 DISPARITIES AND ENHANCING 2678 01:58:25,920 --> 01:58:27,360 AWARENESS OF HEALTH DISPARITIES 2679 01:58:27,360 --> 01:58:28,640 AMONG BASIC BIOLOGY 2680 01:58:28,640 --> 01:58:29,600 INVESTIGATORS ENGAGE IN THE 2681 01:58:29,600 --> 01:58:31,960 STUDY OF AGING RELATED DISEASES. 2682 01:58:31,960 --> 01:58:33,320 THEY ALSO WOULD LIKE US TO 2683 01:58:33,320 --> 01:58:35,000 DEVELOP AND SUSTAIN LEADERSHIP 2684 01:58:35,000 --> 01:58:37,000 TO FURTHER WORKFORCE DIVERSITY 2685 01:58:37,000 --> 01:58:44,840 AND HEALTH DISPARITIES RESEARCH. 2686 01:58:44,840 --> 01:58:46,800 SO THERE ARE, THERE'S QUITE A 2687 01:58:46,800 --> 01:58:48,840 BIT KNOWN ABOUT THE DETERMINANTS 2688 01:58:48,840 --> 01:58:51,280 OF HEALTH AND INFLUENCE HEALTH 2689 01:58:51,280 --> 01:58:52,800 DISPARITIES AND WE'RE ALSO QUITE 2690 01:58:52,800 --> 01:58:54,760 AWARE OF THE DISPARITIES IN 2691 01:58:54,760 --> 01:58:58,720 AGING CLINICAL OUTCOMES AS I 2692 01:58:58,720 --> 01:59:05,840 REFER TO EARLIER IN MY TALK. 2693 01:59:05,840 --> 01:59:09,600 NEXT SLIDE. 2694 01:59:09,600 --> 01:59:12,000 WHAT ARE THE MEDIATOR THAT TIE 2695 01:59:12,000 --> 01:59:14,600 THE INPUTS AND THE OUT PUTS, THE 2696 01:59:14,600 --> 01:59:16,240 MOLECULAR AND PHYSIOLOGICAL 2697 01:59:16,240 --> 01:59:17,400 INCOMPETENTER ACTIONS THAT ARE 2698 01:59:17,400 --> 01:59:19,640 INFLUENCED BY SOCIAL 2699 01:59:19,640 --> 01:59:20,600 DETERMINANTS OF HEALTH THAT 2700 01:59:20,600 --> 01:59:24,400 IMPACT RATES OF AGING, AGING 2701 01:59:24,400 --> 01:59:30,320 HEALTH AND LIFESPAN. 2702 01:59:30,320 --> 01:59:31,600 THERE'S BEEN SEVERAL STUDIES 2703 01:59:31,600 --> 01:59:33,240 SUPPORTED BY NIA AIMING TO 2704 01:59:33,240 --> 01:59:35,040 UNDERSTAND WHAT THE BIOLOGICAL 2705 01:59:35,040 --> 01:59:36,480 MECHANISMS UNDERLINE HEALTH 2706 01:59:36,480 --> 01:59:37,440 DISPARITIES IN THE CON SEX OF 2707 01:59:37,440 --> 01:59:45,560 SCONTEXTSOCIAL DISPARITIES OF H. 2708 01:59:45,560 --> 01:59:48,120 MAINLY BY EXAMINING THE ROLE OF 2709 01:59:48,120 --> 01:59:49,400 EPIGENETIC MODIFICATIONS AND 2710 01:59:49,400 --> 01:59:53,840 WE'VE HEARD A BIT ABOUT THAT 2711 01:59:53,840 --> 01:59:54,280 TODAY. 2712 01:59:54,280 --> 01:59:56,760 RON GAVE HIS PRESENTATION 2713 01:59:56,760 --> 01:59:57,920 MOLECULAR CLOCKS AND TIFFANY 2714 01:59:57,920 --> 02:00:00,120 HIGHLIGHTED STUDIES RELATED TO 2715 02:00:00,120 --> 02:00:03,720 LOOKING AT EPIGENETICS TO 2716 02:00:03,720 --> 02:00:05,320 MEASURE ACCELERATED BIOLOGICAL 2717 02:00:05,320 --> 02:00:06,960 AGE AMONG POPULATIONS 2718 02:00:06,960 --> 02:00:10,080 EXPERIENCING HEALTH DISPARITIES. 2719 02:00:10,080 --> 02:00:11,400 AND THERE'S BEEN A SMALL NUMBER 2720 02:00:11,400 --> 02:00:13,800 OF STUDIES EXAMINING THE ROLE OF 2721 02:00:13,800 --> 02:00:18,720 GENOMIC INSTABILITY AND 2722 02:00:18,720 --> 02:00:20,760 SHORTENING ATTRITION AND 2723 02:00:20,760 --> 02:00:22,040 CELLULOSE AND MEASURE RATES OF 2724 02:00:22,040 --> 02:00:24,200 AGING AND HEALTH DISPARITIES 2725 02:00:24,200 --> 02:00:26,040 POPULATIONS. 2726 02:00:26,040 --> 02:00:26,880 HOWEVER, THERE'S STEL A 2727 02:00:26,880 --> 02:00:29,280 SIGNIFICANT GAP IN OUR 2728 02:00:29,280 --> 02:00:30,960 UNDERSTANDING OF THE BIOLOGICAL 2729 02:00:30,960 --> 02:00:32,880 AND PHYSIOLOGICAL MECHANISMS 2730 02:00:32,880 --> 02:00:37,200 INVOLVED IN DIFFERENTIAL HEALTH 2731 02:00:37,200 --> 02:00:40,640 OUTCOMES. 2732 02:00:40,640 --> 02:00:43,080 SO THERE'S A CRITICAL NEED TO 2733 02:00:43,080 --> 02:00:44,720 DISCOVER THE FUNDAMENTAL 2734 02:00:44,720 --> 02:00:47,840 BIOLOGICAL MECHANISMS OF AGING. 2735 02:00:47,840 --> 02:00:50,120 AND IF WE HOPE TO DESIGN 2736 02:00:50,120 --> 02:00:50,840 INTERVENTIONS AND TREATMENTS 2737 02:00:50,840 --> 02:00:55,080 THAT PREVENT OR AMELIORATE AGING 2738 02:00:55,080 --> 02:00:56,760 RELATED DISEASES AND ARE 2739 02:00:56,760 --> 02:00:58,800 EFFECTIVE FOR EVERYONE. 2740 02:00:58,800 --> 02:01:00,080 IT WILL BE IMPORTANT TO 2741 02:01:00,080 --> 02:01:02,440 RECOGNIZE THE BIOLOGY LINKED TO 2742 02:01:02,440 --> 02:01:03,280 HEALTH DISPARITIES IN THE 2743 02:01:03,280 --> 02:01:05,720 CONTEXT OF MULTIPLE DETERMINANTS 2744 02:01:05,720 --> 02:01:08,320 OF HEALTH AS BEING CRITICAL TO 2745 02:01:08,320 --> 02:01:13,000 DESIGNING INTERVENTIONS THAT 2746 02:01:13,000 --> 02:01:17,360 PREVENT AND TREAT AGING RELATED 2747 02:01:17,360 --> 02:01:21,680 DISEASES. 2748 02:01:21,680 --> 02:01:25,240 AND IT WILL ALSO BE IMPORTANT TO 2749 02:01:25,240 --> 02:01:27,280 RECOGNIZE OR TO UNDERSTAND THE 2750 02:01:27,280 --> 02:01:30,320 ACCELERATED AGING PHENOTYPE 2751 02:01:30,320 --> 02:01:31,840 DESCRIBED BY MY NIA COLLEAGUES 2752 02:01:31,840 --> 02:01:34,280 AND THE INTRAMURAL PROGRAM LEAD 2753 02:01:34,280 --> 02:01:36,960 BY Dr. MICHELLE EVANS AND 2754 02:01:36,960 --> 02:01:39,040 ANOTHER OFTEN UNDER LOOKED 2755 02:01:39,040 --> 02:01:39,920 OVERLOOKED AREA IN MANY STUDIES 2756 02:01:39,920 --> 02:01:43,000 OF HEALTH DISPARITIES IS 2757 02:01:43,000 --> 02:01:44,840 HETEROGENEITY AND SO HETERO 2758 02:01:44,840 --> 02:01:46,400 BEGIN A TEE IS A FUNDAMENTAL 2759 02:01:46,400 --> 02:01:47,920 PROPERTY OF BIOLOGICAL SYSTEMS 2760 02:01:47,920 --> 02:01:52,240 THAT CONTRIBUTES TO THE 2761 02:01:52,240 --> 02:01:53,640 DEVELOPMENT, DIFFERENTIATION, 2762 02:01:53,640 --> 02:01:54,640 IMMUNE MEDIATED RESPONSES AND 2763 02:01:54,640 --> 02:01:57,200 MANY OTHER CELLULAR TISSUE ORGAN 2764 02:01:57,200 --> 02:01:59,160 AND ORGANISMS FUNCTIONS AS WELL 2765 02:01:59,160 --> 02:02:01,160 AS DISEASE AND DISEASE 2766 02:02:01,160 --> 02:02:02,840 PROGRESSION AND THIS 2767 02:02:02,840 --> 02:02:08,160 HETEROGENEITY INCREASES WITH 2768 02:02:08,160 --> 02:02:11,880 AGE. 2769 02:02:11,880 --> 02:02:13,520 SO A LITTLE BIT ABOUT THE 2770 02:02:13,520 --> 02:02:15,960 ACCELERATED AGING PHENOTYPE AND 2771 02:02:15,960 --> 02:02:18,760 WE'VE SEEN THIS PICTURE EARLIER 2772 02:02:18,760 --> 02:02:23,000 IN Dr. ZENK'S PRESENTATION. 2773 02:02:23,000 --> 02:02:25,960 AND THIS PHENOTYPE IS A RESULT 2774 02:02:25,960 --> 02:02:27,920 OF THE INNER PLAY OF SOCIAL 2775 02:02:27,920 --> 02:02:29,160 DETERMINANTS OF HEALTH WITH 2776 02:02:29,160 --> 02:02:31,360 COMPLEX BIOLOGICAL FACTORS AND 2777 02:02:31,360 --> 02:02:33,000 PATHWAYS WHICH ARE THE ROOT 2778 02:02:33,000 --> 02:02:34,560 CAUSES OF DISPARATE HEALTH 2779 02:02:34,560 --> 02:02:36,440 OUTCOMES WITH AGING. 2780 02:02:36,440 --> 02:02:37,880 AGING AND HEALTH DISPARITIES 2781 02:02:37,880 --> 02:02:39,640 OPERATE THROUGH COMMON 2782 02:02:39,640 --> 02:02:41,480 CONVERGING PATHWAYS. 2783 02:02:41,480 --> 02:02:42,680 ULTIMATELY RESULT IN SIMILAR 2784 02:02:42,680 --> 02:02:45,880 HEALTH OUTCOMES WITH DIFFERENT 2785 02:02:45,880 --> 02:02:46,600 TRAJECTORIES. 2786 02:02:46,600 --> 02:02:47,720 THE DIFFERENT TRAJECTORIES MAY 2787 02:02:47,720 --> 02:02:49,600 BE INFLUENCED BY MANY FACTORS 2788 02:02:49,600 --> 02:02:52,200 INCLUDING DYSFUNCTIONAL GENE 2789 02:02:52,200 --> 02:02:53,760 ENVIRONMENT INTERACTs AND 2790 02:02:53,760 --> 02:02:55,120 SOCIAL AND POLITICAL 2791 02:02:55,120 --> 02:02:57,040 DETERMINANTS OF HEALTH AND 2792 02:02:57,040 --> 02:03:00,000 BIOLOGICAL PATHWAYS THAT CAN BE 2793 02:03:00,000 --> 02:03:04,400 SEEN HERE RESULTING IN HEALTH 2794 02:03:04,400 --> 02:03:08,840 DISPARITIES AND SHORTENED LIFE 2795 02:03:08,840 --> 02:03:10,720 EXPECTANCY. 2796 02:03:10,720 --> 02:03:13,080 ALTHOUGH THERE'S EVIDENCE THAT 2797 02:03:13,080 --> 02:03:15,640 INFLAMMATION STRESS AND IMMUNE 2798 02:03:15,640 --> 02:03:17,160 FUNCTION AND DNA REPAIR PLAY A 2799 02:03:17,160 --> 02:03:19,160 ROLE IN THE DEVELOPMENT OF AN 2800 02:03:19,160 --> 02:03:20,600 ACCELERATED AGING PHENOTYPE OF 2801 02:03:20,600 --> 02:03:22,880 HEALTH DISPARITIES, THE 2802 02:03:22,880 --> 02:03:25,600 MULTI-LEVEL INTERACTING FACTORS 2803 02:03:25,600 --> 02:03:31,760 AND PATHWAYS ARE NOT FULLY 2804 02:03:31,760 --> 02:03:38,160 UNDERSTOOD. 2805 02:03:38,160 --> 02:03:40,680 MUCH OF THE DIVERSITY AND LATE 2806 02:03:40,680 --> 02:03:44,000 LIFE HEALTH OUTCOMES FROM AGE 2807 02:03:44,000 --> 02:03:50,240 RELATED FLUCTUATIONS OVER TIME, 2808 02:03:50,240 --> 02:03:54,880 COMES FROM WITHIN INDIVIDUALS, 2809 02:03:54,880 --> 02:03:59,040 CELL, TISSUE, ORGANS AGE AT 2810 02:03:59,040 --> 02:04:00,960 DIFFERENT RATES AND INCREASES 2811 02:04:00,960 --> 02:04:03,400 VARIABILITY AND BECAUSE BIOLOGY 2812 02:04:03,400 --> 02:04:08,360 DEMANDS ROBUSTNESS, TO ENSURE 2813 02:04:08,360 --> 02:04:11,920 SURVIVAL, IS LIKELY THAT 2814 02:04:11,920 --> 02:04:13,320 SIGNIFICANT REDUNDANCY EXISTS 2815 02:04:13,320 --> 02:04:14,960 BETWEEN GENES PROTEINS AND 2816 02:04:14,960 --> 02:04:19,040 PATHWAYS AND BIOLOGICAL 2817 02:04:19,040 --> 02:04:21,640 NETWORKS. 2818 02:04:21,640 --> 02:04:23,760 THESE NETWORKS ARE VARIABLE AND 2819 02:04:23,760 --> 02:04:27,440 DEPENDS ON MULTI -- MULTIPLE 2820 02:04:27,440 --> 02:04:31,640 DETERMINANTS OF HEALTH INCLUDING 2821 02:04:31,640 --> 02:04:33,040 STRESS AND LOAD WHICH WE HEARD 2822 02:04:33,040 --> 02:04:35,600 ABOUT EARLIER AS WELL. 2823 02:04:35,600 --> 02:04:38,040 AND DISPARATE HEALTH OUTCOMES 2824 02:04:38,040 --> 02:04:41,600 ARE LIKELY CORAL RATED BY 2825 02:04:41,600 --> 02:04:47,760 BIOLOGICAL HETEROGENEITY. 2826 02:04:47,760 --> 02:04:49,400 SO STUDYING HEALTH DISPARITIES 2827 02:04:49,400 --> 02:04:51,200 FROM THE BIOLOGICAL PERSPECTIVE 2828 02:04:51,200 --> 02:04:52,840 MAY PROVIDE TARGETS AND PATHWAYS 2829 02:04:52,840 --> 02:04:55,040 FOR DEVELOPING INTERVENTIONS TO 2830 02:04:55,040 --> 02:04:56,840 TREAT AGE AND RELATED CONDITIONS 2831 02:04:56,840 --> 02:04:58,360 AND IT'S IMPORTANT TO LINK THE 2832 02:04:58,360 --> 02:05:01,560 DRIVERS OF DISPARITIES WITH 2833 02:05:01,560 --> 02:05:03,400 BIOLOGICAL EFFECTORS THAT RESULT 2834 02:05:03,400 --> 02:05:05,560 IN CLINICAL OUTCOMES AS THIS IS 2835 02:05:05,560 --> 02:05:08,360 EXTREMELY COMPLEX. 2836 02:05:08,360 --> 02:05:10,520 MANY STUDIES EXAMINING THE 2837 02:05:10,520 --> 02:05:13,440 EFFECT OF STRESSORS ON CHANGES 2838 02:05:13,440 --> 02:05:15,520 IN BIOLOGICAL PRESSES SUCH AS 2839 02:05:15,520 --> 02:05:17,000 DNA METHYLATION, TO MEASURE 2840 02:05:17,000 --> 02:05:22,960 IMPACTS ON AGING, BUT MOST OF 2841 02:05:22,960 --> 02:05:33,400 THESE STUDIES AND IN MANY 2842 02:05:35,280 --> 02:05:36,840 STUDIES THE POPULATION ARE 2843 02:05:36,840 --> 02:05:38,640 STRATIFIED ACCORDING TO 2844 02:05:38,640 --> 02:05:40,160 CHRONOLOGICAL AGE, SOCIOECONOMIC 2845 02:05:40,160 --> 02:05:44,760 STATUS, RACE, ETHNICITY, GENDER, 2846 02:05:44,760 --> 02:05:46,160 IDENTITY, GEOGRAPHY AND THE SAME 2847 02:05:46,160 --> 02:05:48,240 POLL SIZES ARE REALLY SMALL FOR 2848 02:05:48,240 --> 02:05:56,320 MOST OF THE STUDIES AND CAN 2849 02:05:56,320 --> 02:05:57,720 IMPACT THE SIGNIFICANCE OF THE 2850 02:05:57,720 --> 02:06:01,800 BINDINGS AND SO, WHAT IF WE EXAM 2851 02:06:01,800 --> 02:06:05,680 THE BIOLOGY BY STRATIFYING 2852 02:06:05,680 --> 02:06:08,160 HEALTH STATUS AND TRACKING THE 2853 02:06:08,160 --> 02:06:10,120 DIVERGENCE AND HEALTH OVER TIME 2854 02:06:10,120 --> 02:06:13,760 WITHOUT REGARD TO THE INPUTS FOR 2855 02:06:13,760 --> 02:06:15,760 INFLUENCES OF HEALTH AND LARGE 2856 02:06:15,760 --> 02:06:18,600 DIVERSE WELL CHARACTERIZED 2857 02:06:18,600 --> 02:06:21,840 COHORTS. 2858 02:06:21,840 --> 02:06:26,240 NEXT SLIDE. 2859 02:06:26,240 --> 02:06:28,040 SO APPROACHING STUDIES OF HEALTH 2860 02:06:28,040 --> 02:06:29,560 DISPARITIES USING A STANDARD 2861 02:06:29,560 --> 02:06:31,880 METRIC OF HEALTH, COULD ALLOW 2862 02:06:31,880 --> 02:06:35,680 FOR AN UN BIAS IDENTIFICATION OF 2863 02:06:35,680 --> 02:06:39,640 BIOLOGICAL UN BIASES AND I 2864 02:06:39,640 --> 02:06:44,240 SHOULD SAY WELL POWERED STUDY TO 2865 02:06:44,240 --> 02:06:45,200 IDENTIFY INVOLVED IN DIFFERENT 2866 02:06:45,200 --> 02:06:55,720 HEALTH OUTCOMES DURING AGING. 2867 02:06:56,280 --> 02:06:59,000 IT'S HEALTH STATUS AND AGING AND 2868 02:06:59,000 --> 02:07:00,800 A DEFICIT ACCUMULATION INDEX 2869 02:07:00,800 --> 02:07:02,200 CANNING USED TO PREDICTED 2870 02:07:02,200 --> 02:07:03,960 SURVIVAL AS IT HAS A STRONG 2871 02:07:03,960 --> 02:07:05,440 RELATIONSHIP TO MORTALITY AND 2872 02:07:05,440 --> 02:07:10,080 THIS WAS OBSERVED IN CANCER 2873 02:07:10,080 --> 02:07:13,440 STUDIES WOMEN UNDERGOING 2874 02:07:13,440 --> 02:07:17,480 TREATMENTS FOR GYNECOLOGICAL 2875 02:07:17,480 --> 02:07:22,560 CANCERS AND DEFICIT ACCUMULATION 2876 02:07:22,560 --> 02:07:28,000 INDEXES INCLUDES VARIOUS METRICS 2877 02:07:28,000 --> 02:07:30,360 WITH SCORE AND THOSE METRICS 2878 02:07:30,360 --> 02:07:32,360 INCLUDED LABORATORY FINDINGS, 2879 02:07:32,360 --> 02:07:34,080 PHYSICAL FUNCTIONS, ASSESSMENTS 2880 02:07:34,080 --> 02:07:37,640 OF DISABILITIES, DISEASE, 2881 02:07:37,640 --> 02:07:39,520 SYMPTOMS, AND SENSORY AND 2882 02:07:39,520 --> 02:07:40,920 COGNITIVE FUNCTIONS SO IT'S SORT 2883 02:07:40,920 --> 02:07:47,800 OF GOT A WHOLE LOT OF METRICS 2884 02:07:47,800 --> 02:07:48,920 INCLUDED IN ORDER TO GIVE SORT 2885 02:07:48,920 --> 02:07:54,240 OF A COMPREHENSIVE SENSE OF WHAT 2886 02:07:54,240 --> 02:07:58,360 AN INDIVIDUAL'S HEALTH STATUS 2887 02:07:58,360 --> 02:08:00,360 IS. 2888 02:08:00,360 --> 02:08:01,560 IN ADDITION, DEFICIT 2889 02:08:01,560 --> 02:08:03,080 ACCUMULATION INDEXES CAN BE 2890 02:08:03,080 --> 02:08:05,080 USEFUL ESPECIALLY IN THE 2891 02:08:05,080 --> 02:08:07,040 CIRCUMSTANCE BECAUSE YOU CAN 2892 02:08:07,040 --> 02:08:12,800 MEASURE THE SAME DEFICITS 2893 02:08:12,800 --> 02:08:21,520 SERIALLY IN THE SAME INDIVIDUAL. 2894 02:08:21,520 --> 02:08:30,000 SO COHORTS CAN BE BEND BE BINNEE 2895 02:08:30,000 --> 02:08:31,960 GRAPH AND TRACKED OVER AN 2896 02:08:31,960 --> 02:08:33,800 EXTENDED PERIOD OF TIME. 2897 02:08:33,800 --> 02:08:35,760 BIOLOGICAL SAMPLES CAN BE 2898 02:08:35,760 --> 02:08:36,960 OBTAINED AT BASELINE AND EACH 2899 02:08:36,960 --> 02:08:40,960 POINT WHERE THERE'S A DIVERGENCE 2900 02:08:40,960 --> 02:08:42,200 AND THE DEFICIT ACCUMULATION 2901 02:08:42,200 --> 02:08:45,240 SCORE AND THE MEASURES OF THE 2902 02:08:45,240 --> 02:08:47,080 HALLMARKS AND SIGNALING MODEL IS 2903 02:08:47,080 --> 02:08:49,200 INDICATIVE OF ALTER INTRA ORGAN 2904 02:08:49,200 --> 02:08:51,080 COMMUNICATION AND BE ASSESSED TO 2905 02:08:51,080 --> 02:08:54,120 UNDERSTAND MORE ABOUT MOLECULAR 2906 02:08:54,120 --> 02:08:54,960 MECHANISMS INVOLVED IN THOSE 2907 02:08:54,960 --> 02:09:02,760 POINTS OF DIVERSION. 2908 02:09:02,760 --> 02:09:06,000 SO JUST TO SAY A LITTLE BIT 2909 02:09:06,000 --> 02:09:06,920 ABOUT THE HALLMARKS OF AGING AND 2910 02:09:06,920 --> 02:09:12,680 HEALTH DISPARITIES, THEY'RE 2911 02:09:12,680 --> 02:09:15,440 DEFINED AS FACTORS THAT ARE 2912 02:09:15,440 --> 02:09:18,520 DEPENDENT, HAVE A TIME DEPENDENT 2913 02:09:18,520 --> 02:09:20,480 MANIFESTATION OF ALTERATIONS 2914 02:09:20,480 --> 02:09:24,440 ACCOMPANYING THE AGING PROCESS. 2915 02:09:24,440 --> 02:09:26,600 THEY HAVE THE POS ABILITY TO 2916 02:09:26,600 --> 02:09:29,040 ACCELERATE AGING BY 2917 02:09:29,040 --> 02:09:31,560 EXPERIMENTALLY ACCENTUATING 2918 02:09:31,560 --> 02:09:32,200 HALLMARK AND THEY HAVE THE 2919 02:09:32,200 --> 02:09:33,960 ABILITY TO REDUCE OR REVERSE 2920 02:09:33,960 --> 02:09:35,720 AGING BY THERAPEUTIC 2921 02:09:35,720 --> 02:09:37,440 INTERVENTIONS TARGETING THE 2922 02:09:37,440 --> 02:09:40,920 HALLMARKS AND THERE ARE 2923 02:09:40,920 --> 02:09:42,360 CURRENTLY 12 HALLMARKS INCLUDING 2924 02:09:42,360 --> 02:09:46,000 GENOMIC INSTABILITY AND 2925 02:09:46,000 --> 02:09:48,920 EPIGENETIC ALTERATIONS AND LOSS 2926 02:09:48,920 --> 02:09:51,160 OF PROTEO STAY IS AND 2927 02:09:51,160 --> 02:09:53,880 DEREGULATED NUTRIENT SENSEING 2928 02:09:53,880 --> 02:09:56,800 AND CELLULAR AND CREM STEL 2929 02:09:56,800 --> 02:10:02,480 EXHAUSTION AND CHRONIC 2930 02:10:02,480 --> 02:10:05,840 INFLAMMATION AND MICROBIAL DIS 2931 02:10:05,840 --> 02:10:10,560 BIOS SIS AND CHANGES IN THESE 2932 02:10:10,560 --> 02:10:12,520 BUY LODGE PATHWAYS MAY BE 2933 02:10:12,520 --> 02:10:15,120 INDICATING AGE ACCELERATION OR 2934 02:10:15,120 --> 02:10:16,640 THE RISK OF ADVERSE HEALTH 2935 02:10:16,640 --> 02:10:17,800 OUTCOMES AND THEY COULD BE 2936 02:10:17,800 --> 02:10:19,680 TARGETS OF EARLY INTERVENTIONS 2937 02:10:19,680 --> 02:10:22,960 FOR HEALTH DISPARITIES AND THEY 2938 02:10:22,960 --> 02:10:25,560 MAY BE IDENTIFIED BY EXCESSING 2939 02:10:25,560 --> 02:10:33,880 TIME POINTS OF DIVERGENCE. 2940 02:10:33,880 --> 02:10:35,640 SO ALL 12 HALLMARKS ARE RELATE 2941 02:10:35,640 --> 02:10:39,120 TO ONE ANOTHER AND THEY INTERACT 2942 02:10:39,120 --> 02:10:43,680 ACROSS AND WITHIN AND BETWEEN 2943 02:10:43,680 --> 02:10:44,400 EACH OTHER. 2944 02:10:44,400 --> 02:10:46,760 THEY'RE ALSO INTERCONNECTED WITH 2945 02:10:46,760 --> 02:10:48,600 THE EIGHT HALLMARKS OF HEALTH 2946 02:10:48,600 --> 02:10:51,200 ALONG WITH ORGANISMAL -- 2947 02:10:51,200 --> 02:10:52,680 ORGANIZATION THAT CREATES A 2948 02:10:52,680 --> 02:10:55,200 MULTI DIMENSIONAL CASCADE OF 2949 02:10:55,200 --> 02:10:56,880 INTERACTIONS THAT MAY FURTHER 2950 02:10:56,880 --> 02:10:57,880 EXPLAIN IMPORTANT FEATURES OF 2951 02:10:57,880 --> 02:11:00,160 THE AGING PROCESS. 2952 02:11:00,160 --> 02:11:04,000 AND AS YOU CAN SEE, SOME OF 2953 02:11:04,000 --> 02:11:05,680 THESE HALLMARKS OF HEALTH 2954 02:11:05,680 --> 02:11:11,840 INCLUDE BARRIER INTEGRITY, 2955 02:11:11,840 --> 02:11:16,560 MAINTENANCE HOME YO HOME YO STN 2956 02:11:16,560 --> 02:11:19,160 AND REPAIR AND REGENERATION 2957 02:11:19,160 --> 02:11:20,800 WHICH IS THINGS WE'VE HEARD 2958 02:11:20,800 --> 02:11:25,240 EARLIER TODAY RELATED TO HEALTH 2959 02:11:25,240 --> 02:11:30,000 DISPARITIES. 2960 02:11:30,000 --> 02:11:31,680 AND JUST TO SAY A LITTLE BIT 2961 02:11:31,680 --> 02:11:33,760 ABOUT INTERIM COMMUNICATION AS 2962 02:11:33,760 --> 02:11:36,520 ANOTHER, POTENTIAL BIOMARKER 2963 02:11:36,520 --> 02:11:38,720 LOOKING AT DIVERGENCE AND HEALTH 2964 02:11:38,720 --> 02:11:42,720 STATUS AND TO COMMUNICATION ARE 2965 02:11:42,720 --> 02:11:43,760 CONSIDERED A HALLMARK OF AGING 2966 02:11:43,760 --> 02:11:45,600 IS ASSOCIATED WITH HALLMARK HATH 2967 02:11:45,600 --> 02:11:47,600 WAYS AND TO ORGAN COMMUNICATION 2968 02:11:47,600 --> 02:11:53,200 IS THE GATEKEEPER OF METABOLIC 2969 02:11:53,200 --> 02:11:56,600 HEALTH AND TRAVEL 2970 02:11:56,600 --> 02:12:03,840 FROM ORGANS TO ORGAN THE 2971 02:12:03,840 --> 02:12:07,800 CIRCULATION, THERE ARE NEW 2972 02:12:07,800 --> 02:12:09,320 AVENUES THAT HAVE BEEN 2973 02:12:09,320 --> 02:12:10,640 DISCOVERED IN PARTICULAR IN THE 2974 02:12:10,640 --> 02:12:13,360 MIDDLE PANEL HERE SHOWN 2975 02:12:13,360 --> 02:12:14,680 NEURAL-IMMUNE INTERACTIONS THAT 2976 02:12:14,680 --> 02:12:16,800 MAINTAIN TISSUE HOME YO STAY IS 2977 02:12:16,800 --> 02:12:18,640 AND INVOLVE THE RAIN AND 2978 02:12:18,640 --> 02:12:20,880 PERIPHERAL NERVOUS SYSTEM AND 2979 02:12:20,880 --> 02:12:22,840 THEIR AN ATOMICALLY LINKED TO 2980 02:12:22,840 --> 02:12:27,680 VARIOUS ORGANS AND ALSO, ON THE 2981 02:12:27,680 --> 02:12:30,400 RIGHT, YOU WILL SEE VES KELS 2982 02:12:30,400 --> 02:12:31,760 INVOLVED SIGNALING IN BETWEEN 2983 02:12:31,760 --> 02:12:33,840 CELLS, TISSUES, ORGANS, 2984 02:12:33,840 --> 02:12:35,280 PHYSIOLOGICAL SYSTEMS AND BODY 2985 02:12:35,280 --> 02:12:38,000 DEPARTMENTS SUCH AS BETWEEN THE 2986 02:12:38,000 --> 02:12:39,320 BLOOD BRAIN BARRIER SO INCREASE 2987 02:12:39,320 --> 02:12:40,920 OUR UNDERSTANDING OF THESE 2988 02:12:40,920 --> 02:12:43,040 PROCESSES AND AGING AND HOW THEY 2989 02:12:43,040 --> 02:12:44,560 RELATE TO DIVERGENCE AND HEALTH 2990 02:12:44,560 --> 02:12:46,120 OUTCOMES WE'LL BE IMPORTANT FOR 2991 02:12:46,120 --> 02:12:56,640 ADDRESSING HEALTH DISPARITIES. 2992 02:13:09,320 --> 02:13:11,800 AND THEY CAN BE IDENTIFIED AND 2993 02:13:11,800 --> 02:13:13,960 MANIPULATED IN HUMANS AND ANIMAL 2994 02:13:13,960 --> 02:13:16,680 MODELS WHICH MAKES IT 2995 02:13:16,680 --> 02:13:17,800 BIOMARKERS. 2996 02:13:17,800 --> 02:13:18,920 BUY IDENTIFYING SPECIFIC 2997 02:13:18,920 --> 02:13:22,640 PATHWAYS AND THE APPROACH TO 2998 02:13:22,640 --> 02:13:23,920 ASSESSING HEALTH DISPARITIES WE 2999 02:13:23,920 --> 02:13:25,080 CAN DEVELOP TO DEPARTMENT AND 3000 02:13:25,080 --> 02:13:27,200 HEALTH STATUS AND PREDICT HEALTH 3001 02:13:27,200 --> 02:13:29,160 OUTCOMES AND TO INDICATE 3002 02:13:29,160 --> 02:13:31,320 EFFECTIVENESS OF INTERVENTIONS. 3003 02:13:31,320 --> 02:13:35,440 IN FACT CURRENTLY AS YOU CAN SEE 3004 02:13:35,440 --> 02:13:37,480 THERE ARE SEVERAL IDENTIFIED 3005 02:13:37,480 --> 02:13:40,440 POTENTIAL MOLECULAR BIOMARKERS 3006 02:13:40,440 --> 02:13:44,400 FOCUSED ON THE HALLMARKS OF 3007 02:13:44,400 --> 02:13:47,680 AGING AS WELL AS OTHER PATHWAYS 3008 02:13:47,680 --> 02:13:50,520 THAT INCREASE OR DECREASE AGING 3009 02:13:50,520 --> 02:13:52,360 PARAMETERS IN BOTH HUMAN AND 3010 02:13:52,360 --> 02:13:58,320 ANIMAL STUDIES. 3011 02:13:58,320 --> 02:14:03,600 NEXT SLIDE. 3012 02:14:03,600 --> 02:14:05,800 THE PROCESS OF AGING IS COMPLEX. 3013 02:14:05,800 --> 02:14:08,520 AGING IS INFLUENCED BY THE 3014 02:14:08,520 --> 02:14:11,400 BIOLOGICAL, PHYSICAL, AND SOCIAL 3015 02:14:11,400 --> 02:14:13,440 DETERMINANTS OF HEALTH. 3016 02:14:13,440 --> 02:14:14,760 BECAUSE BIOLOGY IS MOST PROM I 3017 02:14:14,760 --> 02:14:15,720 GUESSAL TO HEALTH THE 3018 02:14:15,720 --> 02:14:17,560 CONTRIBUTION OF BIOLOGY OR 3019 02:14:17,560 --> 02:14:18,840 UNDERSTANDING RATES OF AGING, 3020 02:14:18,840 --> 02:14:21,080 AND THE ROLE OF THE HALLMARKS OF 3021 02:14:21,080 --> 02:14:23,840 AGING IN COMMUNICATION AND 3022 02:14:23,840 --> 02:14:25,600 HETEROGENEITY MUST BE CLARIFIED 3023 02:14:25,600 --> 02:14:27,040 TO BETTER UNDERSTAND AGING 3024 02:14:27,040 --> 02:14:27,920 HEALTH DISPARITIES AND 3025 02:14:27,920 --> 02:14:31,600 UNDERSERVED AND DISADVANTAGED 3026 02:14:31,600 --> 02:14:41,800 POPULATIONS. 3027 02:14:42,560 --> 02:14:43,800 TRANSLATE BASIC BIOLOGICAL 3028 02:14:43,800 --> 02:14:45,200 FINDING TO CLINICAL 3029 02:14:45,200 --> 02:14:46,760 INTERVENTIONS FOR TREATING AGE 3030 02:14:46,760 --> 02:14:49,040 RELATED DISEASES AND CONDITIONS 3031 02:14:49,040 --> 02:14:56,880 AND LASTLY, AND RONNA LEWD TOD Y 3032 02:14:56,880 --> 02:14:58,760 THIS AS WELL, GIVEN THE 3033 02:14:58,760 --> 02:15:00,080 COMPLEXITY AND THE PRECISION 3034 02:15:00,080 --> 02:15:02,240 MEDICINE MAY BE REQUIRED. 3035 02:15:02,240 --> 02:15:03,320 ONE-SIZE-FITS-ALL INTERVENTION 3036 02:15:03,320 --> 02:15:07,000 WILL BE DIFFICULT IF NOT 3037 02:15:07,000 --> 02:15:10,360 IMPOSSIBLE. 3038 02:15:10,360 --> 02:15:13,720 THANK YOU. 3039 02:15:13,720 --> 02:15:17,600 AND I GUESS WE CAN GO TO THE 3040 02:15:17,600 --> 02:15:25,240 PANEL AND TAKE QUESTIONS. 3041 02:15:25,240 --> 02:15:27,600 >>IF YOU HOLD ON, WE'RE GETTING 3042 02:15:27,600 --> 02:15:29,560 READY TO MOVE INTO THE PART OF 3043 02:15:29,560 --> 02:15:30,880 THE PROGRAM WHERE WE'RE GOING TO 3044 02:15:30,880 --> 02:15:32,760 HEAR FROM THE TWO PANELIST AND 3045 02:15:32,760 --> 02:15:35,160 AFTER WE HEAR FROM THE TWO 3046 02:15:35,160 --> 02:15:36,200 PANELISTS WE'LL BRING THE 3047 02:15:36,200 --> 02:15:38,520 SPEAKER UP AND ENGAGE IN AN 3048 02:15:38,520 --> 02:15:39,400 ALL-INCLUSIVE DISCUSSION. 3049 02:15:39,400 --> 02:15:41,360 NEXT, THE FIRST PANELIST WE'LL 3050 02:15:41,360 --> 02:15:51,760 HEAR FROM IS Dr. DAVIS. 3051 02:16:01,520 --> 02:16:03,440 >>GOOD MORNING. 3052 02:16:03,440 --> 02:16:06,880 I AM EXCITED TO BE HERE AND I'M 3053 02:16:06,880 --> 02:16:08,040 LEARNING A LOT AND SEEING A LOT 3054 02:16:08,040 --> 02:16:10,640 OF OVERLAP IN MANY AREAS. 3055 02:16:10,640 --> 02:16:12,760 AND SO AS OUR LAST SPEAKER KIND 3056 02:16:12,760 --> 02:16:17,040 OF CONCLUDED WITH, SHE MENTIONED 3057 02:16:17,040 --> 02:16:18,000 PRECISION MEDICINE. 3058 02:16:18,000 --> 02:16:20,080 SO I THOUGHT INITIALLY I WOULD 3059 02:16:20,080 --> 02:16:21,960 TALK ABOUT SOME APPROACHES TO 3060 02:16:21,960 --> 02:16:23,480 ACHIEVING PRECISION MEDICINE 3061 02:16:23,480 --> 02:16:25,080 BECAUSE AS WE THINK ABOUT WHAT 3062 02:16:25,080 --> 02:16:27,440 HAS BEEN PRESENTED, WE 3063 02:16:27,440 --> 02:16:28,840 UNDERSTAND THAT THERE ARE 3064 02:16:28,840 --> 02:16:31,360 SOCIETAL FACTORS AND 3065 02:16:31,360 --> 02:16:33,480 ENVIRONMENTAL AND BIOLOGICAL 3066 02:16:33,480 --> 02:16:35,200 FACTORS AND THESE CAN ALL LEAD 3067 02:16:35,200 --> 02:16:37,800 TO DIFFERENT DISEASE 3068 02:16:37,800 --> 02:16:39,440 MANIFESTATIONS SO WE NEED TO 3069 02:16:39,440 --> 02:16:40,720 REALLY UNDERSTAND HOW THESE 3070 02:16:40,720 --> 02:16:44,120 DISEASES AND EVEN TREATMENT 3071 02:16:44,120 --> 02:16:45,320 RESPONSES ACTIVATE CERTAIN 3072 02:16:45,320 --> 02:16:47,120 PATHWAYS TO ACTUALLY ACHIEVE 3073 02:16:47,120 --> 02:16:49,480 PRECISION MEDICINE FOR ALL. 3074 02:16:49,480 --> 02:16:50,560 BUT ONE OF THE THINGS THAT I 3075 02:16:50,560 --> 02:16:56,360 THOUGHT I WOULD TALK ABOUT IS 3076 02:16:56,360 --> 02:16:58,160 SOME OF THE LIMITATIONS TO THIS 3077 02:16:58,160 --> 02:17:08,640 SO WE NEED DATASETS FROM AND 3078 02:17:09,480 --> 02:17:16,320 EVERY ENGAGE WE NEED THEM TO 3079 02:17:16,320 --> 02:17:17,960 PARTICIPATE IN RESEARCH EX 3080 02:17:17,960 --> 02:17:20,880 CLINICAL TRIALS AND TO DO THAT A 3081 02:17:20,880 --> 02:17:25,240 MAN BEAR YEAR IS TRUST AND SO 3082 02:17:25,240 --> 02:17:28,600 HOW DO WE INCREASE TRUST IN 3083 02:17:28,600 --> 02:17:29,920 POPULATIONS THAT HAVE 3084 02:17:29,920 --> 02:17:31,120 HISTORICALLY BEEN EX LAWSUITED 3085 02:17:31,120 --> 02:17:38,560 AND DISADVANTAGED. 3086 02:17:38,560 --> 02:17:40,240 I THOUGHT I WOULD GO BACK TO 3087 02:17:40,240 --> 02:17:41,960 Dr. WALLACE WHEN SHE SHOWED 3088 02:17:41,960 --> 02:17:49,440 THE TRANSLATIONAL SPECTRUM AND A 3089 02:17:49,440 --> 02:17:52,120 LOOP TO COMMUNITY TO BASIC 3090 02:17:52,120 --> 02:17:55,680 SCIENCE AND THIS APPROACH 3091 02:17:55,680 --> 02:17:57,200 ACTUALLY SPEARHEADED BY WHAT 3092 02:17:57,200 --> 02:18:06,760 WE'VE LEARNED IN COVID. 3093 02:18:06,760 --> 02:18:09,000 ONE OF THE KEY BARRIERS WAS 3094 02:18:09,000 --> 02:18:13,160 ACCESS TO INFORMATION AND AS YOU 3095 02:18:13,160 --> 02:18:16,400 ALL KNOW, MISINFORMATION AND 3096 02:18:16,400 --> 02:18:19,000 DISINFORMATION WAS RAMPANT SO IT 3097 02:18:19,000 --> 02:18:20,400 LEAD TO POOR HEALTH OUTCOMES 3098 02:18:20,400 --> 02:18:21,600 BECAUSE PEOPLE COULD NOT MAKE 3099 02:18:21,600 --> 02:18:24,920 INFORMED DECISIONS. 3100 02:18:24,920 --> 02:18:26,480 WHEN WE STARTED, PART OF ONE 3101 02:18:26,480 --> 02:18:28,200 I'VE DONE, I'M A BASIC SCIENTIST 3102 02:18:28,200 --> 02:18:29,960 AND I THINK AS A Dr. 3103 02:18:29,960 --> 02:18:31,760 PEREZ-STABLE MENTIONED THAT WE 3104 02:18:31,760 --> 02:18:35,760 NEED INTER DISCIPLINE AR 3105 02:18:35,760 --> 02:18:38,560 COLLABORATIONS AND I RESEARCH AT 3106 02:18:38,560 --> 02:18:39,760 MEHARRY MEDICAL COLLEGE AND WE 3107 02:18:39,760 --> 02:18:41,040 LOOKED AT HOW WE CAN WORK 3108 02:18:41,040 --> 02:18:43,640 TOGETHER AND TO BUILD TRUST AND 3109 02:18:43,640 --> 02:18:45,360 TO PARTICULARLY FOR COVID 3110 02:18:45,360 --> 02:18:49,080 INCREASE VACCINATION RATES. 3111 02:18:49,080 --> 02:18:51,560 ONE OF THE KEY THINGS AND THE 3112 02:18:51,560 --> 02:18:56,120 PUBLIC WANTS ACCESS TO SO HOW DO 3113 02:18:56,120 --> 02:19:00,920 WE DO THAT. 3114 02:19:00,920 --> 02:19:02,400 BASIC SCIENTIST AND POPULATION 3115 02:19:02,400 --> 02:19:05,160 SCIENTISTS CAN HELP INCREASE 3116 02:19:05,160 --> 02:19:05,920 THIS TRUST. 3117 02:19:05,920 --> 02:19:07,600 SO IN ORDER TO ACHIEVE HEALTH 3118 02:19:07,600 --> 02:19:09,600 EQUITY, THE PUBLIC NEEDS MORE 3119 02:19:09,600 --> 02:19:14,200 ACCESS TO RESEARCHERS AND 3120 02:19:14,200 --> 02:19:15,440 SCIENTISTS. 3121 02:19:15,440 --> 02:19:17,000 WHAT WE STARTED TO DO, WE HAVE 3122 02:19:17,000 --> 02:19:18,560 COMMUNITY ENGAGEMENT CORE SO WE 3123 02:19:18,560 --> 02:19:20,000 STARTED TO USE THIS CORE TO 3124 02:19:20,000 --> 02:19:23,760 UNDERSTAND SOME OF THESE 3125 02:19:23,760 --> 02:19:27,560 BARRIERS. 3126 02:19:27,560 --> 02:19:28,960 THEY WERE WORKING WITH FACULTY 3127 02:19:28,960 --> 02:19:30,120 TO ADDRESS SOME OF THE KEY 3128 02:19:30,120 --> 02:19:31,240 THINGS WE THOUGHT WOULD BE 3129 02:19:31,240 --> 02:19:35,440 IMPORTANT IN ACHIEVING 3130 02:19:35,440 --> 02:19:37,120 IMPROVEMENT INFORMATION SO WE 3131 02:19:37,120 --> 02:19:38,440 CREATED DIFFERENT ACTIVITIES TO 3132 02:19:38,440 --> 02:19:43,160 HELP DISSEMINATE INFORMATION AND 3133 02:19:43,160 --> 02:19:46,600 WE GAVE DISSEMINATION TO FACULTY 3134 02:19:46,600 --> 02:19:49,320 AND WE HAD LISTENING SESSIONS TO 3135 02:19:49,320 --> 02:19:53,080 LISTEN TO BASIC SCIENCE 3136 02:19:53,080 --> 02:19:54,840 RESEARCH, WE DID Facebook LIVE 3137 02:19:54,840 --> 02:19:55,880 SEGMENT AS WELL AS TOWN HALL 3138 02:19:55,880 --> 02:19:58,280 MEETINGS NEWSPAPER ADDS AND 3139 02:19:58,280 --> 02:20:02,840 ON-LINE NEWSLETTER ABSTRACTS. 3140 02:20:02,840 --> 02:20:04,520 WE HELPED THESE BASIC SCIENTISTS 3141 02:20:04,520 --> 02:20:08,360 WRITE IT IN LAY MEN TERMS AND 3142 02:20:08,360 --> 02:20:09,960 FROM THIS, EACH ACTIVITY 3143 02:20:09,960 --> 02:20:11,320 RESEARCHER WAS PAID WITH A 3144 02:20:11,320 --> 02:20:14,200 MEMBER OF THE COMMUNITY 3145 02:20:14,200 --> 02:20:15,200 ENGAGEMENT CORE WHICH HELPED 3146 02:20:15,200 --> 02:20:19,080 THEM GUIDE THEM THROUGH THE 3147 02:20:19,080 --> 02:20:20,080 PROCESS. 3148 02:20:20,080 --> 02:20:22,080 SOME OF THESE ACTIVITIES 3149 02:20:22,080 --> 02:20:25,680 ENLISTED IN THIS TABLE HERE AND 3150 02:20:25,680 --> 02:20:27,080 THEN WE HAD COMPETENCY WE 3151 02:20:27,080 --> 02:20:28,840 DEVELOPED TO RESEARCH THE 3152 02:20:28,840 --> 02:20:29,920 ACTIVITIES AND RECOMMENDATIONS 3153 02:20:29,920 --> 02:20:32,680 FOR EVALUATION AND WE ALSO HAD A 3154 02:20:32,680 --> 02:20:36,280 POST TRAINING DISSEMINATION, 3155 02:20:36,280 --> 02:20:37,240 DISSEMINATION TRAINING WHERE WE 3156 02:20:37,240 --> 02:20:41,680 LOOKED AT THE RESULTS OF THE 3157 02:20:41,680 --> 02:20:42,400 PARTICIPANTS THE SIDE SO THROUGH 3158 02:20:42,400 --> 02:20:49,280 THESE ACTIVITIES, THESE CAN BE 3159 02:20:49,280 --> 02:20:51,120 USED BY POPULATION SCIENTISTS 3160 02:20:51,120 --> 02:20:54,200 AND THEN ACADEMIC INSTITUTIONS A 3161 02:20:54,200 --> 02:20:55,240 ADD MOL MODEL TO GUIDE THE 3162 02:20:55,240 --> 02:20:57,840 COMMUNITY AND ENGAGE RESEARCH 3163 02:20:57,840 --> 02:20:59,040 DISSEMINATION ACTIVITIES SO SOME 3164 02:20:59,040 --> 02:21:00,480 OF OUR NEXT STEPS ARE TO CONDUCT 3165 02:21:00,480 --> 02:21:03,080 MORE RESEARCHER TRAININGS AND 3166 02:21:03,080 --> 02:21:06,520 FURTHER DEVELOPED STRATEGIES 3167 02:21:06,520 --> 02:21:08,040 WITH INPUT FROM ESTABLISHED 3168 02:21:08,040 --> 02:21:09,840 COMMUNITY ADVISORY BOARDS TO 3169 02:21:09,840 --> 02:21:11,720 ENHANCE THE SCIENCE OF 3170 02:21:11,720 --> 02:21:12,840 DISSEMINATION WITH AN EMPHASIS 3171 02:21:12,840 --> 02:21:23,360 ON THE COMMUNITY PERSPECTIVE. 3172 02:21:24,600 --> 02:21:33,200 [APPLAUSE] 3173 02:21:33,200 --> 02:21:33,840 > 3174 02:21:33,840 --> 02:21:35,040 MINUTES GOES BY FAST. 3175 02:21:35,040 --> 02:21:38,320 MY JOB NOW IS THE SECOND 3176 02:21:38,320 --> 02:21:40,680 PANELIST TO PULL TOGETHER ALL 3177 02:21:40,680 --> 02:21:41,920 THESE GREAT TALKS OF WHAT WE 3178 02:21:41,920 --> 02:21:43,760 HEARD AND THEN LEAD US INTO THE 3179 02:21:43,760 --> 02:21:45,240 QUESTION AND ANSWER PERIOD. 3180 02:21:45,240 --> 02:21:48,440 SO I JUST WANT TO REFLECT ON 3181 02:21:48,440 --> 02:21:49,560 WHAT I LEARNED AND HEARD THIS 3182 02:21:49,560 --> 02:21:50,760 MORNING. 3183 02:21:50,760 --> 02:21:55,000 WE HAD FOUR OUTSTANDING 3184 02:21:55,000 --> 02:21:55,840 PRESENTATIONS WHICH EACH OF 3185 02:21:55,840 --> 02:21:58,080 THOSE PRESENTATIONS IN MY 3186 02:21:58,080 --> 02:22:00,920 REFLECTION, TALKS ABOUT THE 3187 02:22:00,920 --> 02:22:02,960 ROBUST APPROACHES THAT HAVE BEEN 3188 02:22:02,960 --> 02:22:04,640 TAKEN NOW TO ADDRESS HEALTH 3189 02:22:04,640 --> 02:22:08,400 DISPARITIES AND WHAT NEEDS TO BE 3190 02:22:08,400 --> 02:22:11,400 TAKEN TO ACHIEVE HEALTH EQUITY 3191 02:22:11,400 --> 02:22:15,080 AND ALSO THE OTHER THING IS, HOW 3192 02:22:15,080 --> 02:22:16,320 GEROSCIENCE CAN POSITION ITSELF 3193 02:22:16,320 --> 02:22:19,040 TO BE THE LEAD IN ONE IN THE 3194 02:22:19,040 --> 02:22:21,400 AREA OF ACHIEVING HEALTH EQUITY 3195 02:22:21,400 --> 02:22:24,160 AND THAT'S SUSTAINING AND 3196 02:22:24,160 --> 02:22:24,800 TESTING THIS GEROSCIENCE 3197 02:22:24,800 --> 02:22:26,120 HYPOTHESIS SO ONE OF THE KEY 3198 02:22:26,120 --> 02:22:29,320 THINGS I LEARNED FROM Dr. 3199 02:22:29,320 --> 02:22:30,280 PEREZ-STABLE'S PRESENTATION IS 3200 02:22:30,280 --> 02:22:31,600 THAT IT'S GOING TO BE IMPORTANT 3201 02:22:31,600 --> 02:22:36,920 FOR US TO TAKE THIS INTER 3202 02:22:36,920 --> 02:22:39,640 DISCIPLINARY COLLABORATION IN 3203 02:22:39,640 --> 02:22:41,440 ORDER TO ADDRESS THE INDIVIDUAL 3204 02:22:41,440 --> 02:22:42,960 LEVEL HEALTH DISPARITIES THAT 3205 02:22:42,960 --> 02:22:44,720 EXIST AND TO UNDERSTAND THAT 3206 02:22:44,720 --> 02:22:46,200 RACISM AND DISCRIMINATION ARE 3207 02:22:46,200 --> 02:22:47,280 KEY DRIVERS OF THOSE AND IN 3208 02:22:47,280 --> 02:22:48,920 ORDER FOR US TO BE ABLE TO 3209 02:22:48,920 --> 02:22:50,600 REALLY MOVE FORWARD, WE HAVE TO 3210 02:22:50,600 --> 02:22:53,120 PUT SOME CONCERTED EFFORT NOT 3211 02:22:53,120 --> 02:22:55,160 ONLY IN JUST TALKING ABOUT IT 3212 02:22:55,160 --> 02:22:56,560 BUT WHAT DOES IT MEAN TO MEASURE 3213 02:22:56,560 --> 02:22:58,200 IT AND MEASURE IT APPROPRIATELY 3214 02:22:58,200 --> 02:23:00,240 AND PUT IT IN DIFFERENT TYPES OF 3215 02:23:00,240 --> 02:23:01,960 STUDY DESIGNS. 3216 02:23:01,960 --> 02:23:04,600 NEXT I LEARNED FROM Dr. ZENK 3217 02:23:04,600 --> 02:23:06,960 THAT THE KEY MESSAGE I LEARNED 3218 02:23:06,960 --> 02:23:12,120 THERE IS THAT THE INDIVIDUALS' 3219 02:23:12,120 --> 02:23:13,520 CHOICES ARE CON TRAINED BY THE 3220 02:23:13,520 --> 02:23:15,200 SOCIAL STRUCTURES THAT THEY LIVE 3221 02:23:15,200 --> 02:23:15,680 IN. 3222 02:23:15,680 --> 02:23:17,240 THAT'S THE BIGGEST ONE I TOOK 3223 02:23:17,240 --> 02:23:20,480 FROM THERE AND THAT THERE ARE 3224 02:23:20,480 --> 02:23:22,240 THESE SEVERAL DIFFERENT SOCIAL 3225 02:23:22,240 --> 02:23:23,640 DETERMINANTS OF HEALTH THAT 3226 02:23:23,640 --> 02:23:24,480 IMPACT THESE INDIVIDUAL CHOICES 3227 02:23:24,480 --> 02:23:26,480 AND TO BE ABLE TO DISENTANGLE 3228 02:23:26,480 --> 02:23:27,760 THOSE AND SEPARATE THOSE MIGHT 3229 02:23:27,760 --> 02:23:30,040 NOT BE OPTIMAL AND WE NEED TO 3230 02:23:30,040 --> 02:23:31,360 UNDERSTAND HOW PEOPLE OPERATE IN 3231 02:23:31,360 --> 02:23:33,560 THEIR SPACES TO BE ABLE TO 3232 02:23:33,560 --> 02:23:35,760 CREATE MULTI LEVEL INTERVENTIONS 3233 02:23:35,760 --> 02:23:38,440 TO MOVE FORWARD SO WE CAN MEET 3234 02:23:38,440 --> 02:23:41,280 PEOPLE WHERE THEY ARE AND Dr. 3235 02:23:41,280 --> 02:23:44,480 WALLACE'S PRESENTATION, I REALLY 3236 02:23:44,480 --> 02:23:47,720 UNDERSTAND AND LEARNED THAT 3237 02:23:47,720 --> 02:23:49,160 THERE'S THIS DROVE HOME THE 3238 02:23:49,160 --> 02:23:51,520 POINT WITH MR. IS TO THINK ABOUT 3239 02:23:51,520 --> 02:23:52,920 THIS POOR REPRESENTATION WE HAVE 3240 02:23:52,920 --> 02:23:54,880 IN CLINICAL RESEARCH AND HOW DO 3241 02:23:54,880 --> 02:23:57,840 WE MOVE AND A ADVANCE TO 3242 02:23:57,840 --> 02:23:59,480 ACHIEVING THESE STUDIES WHERE WE 3243 02:23:59,480 --> 02:24:00,720 HAVE ALL DIFFERENT RACE 3244 02:24:00,720 --> 02:24:02,440 ETHNICITY AND NOT JUST RACE AND 3245 02:24:02,440 --> 02:24:03,560 ETHNICITY I KNOW A LOT OF TIMES 3246 02:24:03,560 --> 02:24:10,920 WE TALK ABOUT RACE AND ETHNICITY 3247 02:24:10,920 --> 02:24:16,200 AND AND THEY ARE A AT THE TIMER 3248 02:24:16,200 --> 02:24:20,640 OWE GIN TEE ACCESS AND THEN, 3249 02:24:20,640 --> 02:24:26,680 FINALLY. 3250 02:24:26,680 --> 02:24:28,080 THEY ADDRESS SOME OF THE THINGS 3251 02:24:28,080 --> 02:24:30,800 THAT ARE AT THE CRUX OF WHAT I 3252 02:24:30,800 --> 02:24:32,280 BELIEVE WILL TAKE FOR US TO BE 3253 02:24:32,280 --> 02:24:34,000 ABLE TO MOVE FROM HEALTH 3254 02:24:34,000 --> 02:24:38,560 DISPARITIES AND RESEARCH TO 3255 02:24:38,560 --> 02:24:39,840 ADVANCE HEALTH EQUITY AND TO DO 3256 02:24:39,840 --> 02:24:43,840 THAT IN A MEANINGFUL WAY WHICH 3257 02:24:43,840 --> 02:24:45,480 WE'RE NO LONGER DOING SILO 3258 02:24:45,480 --> 02:24:46,400 RESEARCH AND WE'RE UNDERSTANDING 3259 02:24:46,400 --> 02:24:47,600 AND THINKING ABOUT THOSE 3260 02:24:47,600 --> 02:24:48,800 DIFFERENT LEVELS OF A DOMAINS 3261 02:24:48,800 --> 02:24:54,040 THAT WERE SHOWN IN THE EARLIER 3262 02:24:54,040 --> 02:24:56,160 RESEARCH FRAMEWORK AND I WANTED 3263 02:24:56,160 --> 02:25:00,040 TO SAY THAT Dr. DAVIS HIS 3264 02:25:00,040 --> 02:25:01,360 COMMENTS REGARDING ENGAGING THE 3265 02:25:01,360 --> 02:25:05,320 COMMUNITY IS IMPORTANT WITH 3266 02:25:05,320 --> 02:25:08,520 RESPECT TO BUILDING TRUST AND 3267 02:25:08,520 --> 02:25:10,400 MAKING SURE THAT WE HAVE THIS 3268 02:25:10,400 --> 02:25:11,480 DIALOGUE AND IT'S BUY 3269 02:25:11,480 --> 02:25:12,640 DIRECTIONAL WHEN WE GO INTO THE 3270 02:25:12,640 --> 02:25:14,960 COMMUNITY AND ENGAGE IN SOME 3271 02:25:14,960 --> 02:25:16,280 DECISION-MAKING AND THEY OFTEN 3272 02:25:16,280 --> 02:25:18,040 TIMES WHAT WE MISS OUT IS WE GO 3273 02:25:18,040 --> 02:25:19,720 IN WITH THINGS WE WANT TO DO IN 3274 02:25:19,720 --> 02:25:24,400 MIND AND NOT NECESSARILY ASK OR 3275 02:25:24,400 --> 02:25:25,680 YOU COME WITH IDEA AND WE WANT 3276 02:25:25,680 --> 02:25:27,120 TO BE OPEN TO GOING INTO 3277 02:25:27,120 --> 02:25:28,200 PARTICULARLY IF WE'RE ASKING 3278 02:25:28,200 --> 02:25:30,240 PEOPLE, PEOPLE OF COLOR, TO GIVE 3279 02:25:30,240 --> 02:25:34,080 US BIOSPECIMENS THERE'S A WHOLE 3280 02:25:34,080 --> 02:25:35,640 STORY HISTORY OF DISTRUST AND WE 3281 02:25:35,640 --> 02:25:37,120 WANT TO BE ABLE TO DO THAT AND 3282 02:25:37,120 --> 02:25:38,160 BUILD A RELATIONSHIP THAT 3283 02:25:38,160 --> 02:25:39,960 INVOLVES INTO A PARTNERSHIP AND 3284 02:25:39,960 --> 02:25:41,040 I THINK THAT'S GOING TO BE 3285 02:25:41,040 --> 02:25:45,840 IMPORTANT AND I WANT TO CLOSE 3286 02:25:45,840 --> 02:25:47,240 WITH TWO QUESTIONS THAT COME TO 3287 02:25:47,240 --> 02:25:50,520 MIND AFTER HEARING THESE GREAT 3288 02:25:50,520 --> 02:25:51,280 PRESENTATIONS. 3289 02:25:51,280 --> 02:25:52,720 I'VE ALWAYS WONDERED THIS AND I 3290 02:25:52,720 --> 02:25:55,040 LOVE TO TALK ABOUT IT AND I ALSO 3291 02:25:55,040 --> 02:25:56,240 WONDERED, WE TALK ABOUT 3292 02:25:56,240 --> 02:25:57,640 ACCELERATED AGING PHENOTYPE. 3293 02:25:57,640 --> 02:25:59,800 HOW DO WE KNOW IT'S ACCELERATED 3294 02:25:59,800 --> 02:26:00,760 COMPARED TO WHOM? 3295 02:26:00,760 --> 02:26:02,720 IT MAY BE NORMAL BASED ON THE 3296 02:26:02,720 --> 02:26:06,560 LIVING CONDITIONS FOR WHICH 3297 02:26:06,560 --> 02:26:07,920 PEOPLE LIVE. 3298 02:26:07,920 --> 02:26:08,960 PUT THE REFERENCE GROUP IN THE 3299 02:26:08,960 --> 02:26:10,040 LIVED EXPERIENCE OF THE PEOPLE 3300 02:26:10,040 --> 02:26:11,560 THAT WE'RE SAYING ACCELERATED 3301 02:26:11,560 --> 02:26:14,400 AND DO WE SIT ACCELERATED IN 3302 02:26:14,400 --> 02:26:15,800 THEM AND THEY WILL CALL IT A 3303 02:26:15,800 --> 02:26:17,400 COUNTER FACTUAL BUT YOU KNOW, 3304 02:26:17,400 --> 02:26:19,920 LET'S THINK ABOUT THAT SO WE'RE 3305 02:26:19,920 --> 02:26:20,840 SAYING WE'RE AT THE TIMING AN 3306 02:26:20,840 --> 02:26:32,640 ACTESTING A AN ACCELERATEDPHENOT 3307 02:26:33,200 --> 02:26:34,280 HEAR BUT I KNOW IT'S THERE 3308 02:26:34,280 --> 02:26:36,880 BECAUSE I SA IT IN Dr. ZENK'S 3309 02:26:36,880 --> 02:26:38,160 SLIDE I WOULD LOVE TO ELEVATE 3310 02:26:38,160 --> 02:26:39,040 THE CONVERSATION ON HOW WE'RE 3311 02:26:39,040 --> 02:26:43,280 GOING TO TRAIN THE NEXT 3312 02:26:43,280 --> 02:26:44,480 GENERATION OF SCIENTIST TO DO 3313 02:26:44,480 --> 02:26:45,920 THIS WORK FOR THE BETTERMENT OF 3314 02:26:45,920 --> 02:26:48,040 ALL HUMANS AND TO IMPROVE THE 3315 02:26:48,040 --> 02:26:51,640 HEALTH OF NOT ONLY OLDER ADULTS 3316 02:26:51,640 --> 02:26:53,160 BUT ACROSS THE BOARD. 3317 02:26:53,160 --> 02:26:55,120 I'LL CLOSE ASK MY COLLEAGUES TO 3318 02:26:55,120 --> 02:26:56,720 JIN ME UP AT THE PODIUM AND SO 3319 02:26:56,720 --> 02:26:58,080 WE CAN OPEN IT UP FOR QUESTION 3320 02:26:58,080 --> 02:27:00,200 AND ANSWERS. 3321 02:27:00,200 --> 02:27:06,560 [APPLAUSE] 3322 02:27:06,560 --> 02:27:08,320 IS IT POSSIBLE TO GET Dr. 3323 02:27:08,320 --> 02:27:12,280 CARRINGTON UP ON THE SCREEN, 3324 02:27:12,280 --> 02:27:22,440 PLEASE? 3325 02:27:25,880 --> 02:27:28,880 AS YOU MAY RECALL, Dr. 3326 02:27:28,880 --> 02:27:29,720 PEREZ-STABLE SHARED WITH US HE 3327 02:27:29,720 --> 02:27:39,960 HAD TO LEAVE. 3328 02:27:50,640 --> 02:27:52,720 WE'RE NOW OPEN FOR QUESTIONS. 3329 02:27:52,720 --> 02:27:53,160 WE'LL TAKE QUESTIONS. 3330 02:27:53,160 --> 02:27:55,960 IF APPROXIMATE YOU HAVE A 3331 02:27:55,960 --> 02:27:57,280 QUESTION, PLEASE, APPROACH THE 3332 02:27:57,280 --> 02:27:59,600 MICROPHONE AND IDENTIFY. 3333 02:27:59,600 --> 02:28:00,800 YOUR NAME AND INSTITUTION, 3334 02:28:00,800 --> 02:28:04,200 PLEASE. 3335 02:28:04,200 --> 02:28:08,040 HELLO, THIS IS MANUAL NORAH. 3336 02:28:08,040 --> 02:28:10,440 I HAVE A BROAD -- I DON'T KNOW 3337 02:28:10,440 --> 02:28:12,040 WHAT TO SAY NAIVE QUESTION BUT 3338 02:28:12,040 --> 02:28:14,320 IT'S A BROAD QUESTION REGARDING 3339 02:28:14,320 --> 02:28:15,280 HEALTH DISPARITIES AND MY 3340 02:28:15,280 --> 02:28:18,640 QUESTION IS THIS, ALL THE 3341 02:28:18,640 --> 02:28:21,600 SPEAKERS HAVE DONE A GREAT JOB 3342 02:28:21,600 --> 02:28:22,320 IDENTIFYING HEALTH DISPARITIES 3343 02:28:22,320 --> 02:28:23,880 AND THE DIFFERENCE BETWEEN THE 3344 02:28:23,880 --> 02:28:27,040 CHALLENGES AND MY QUESTION IS, 3345 02:28:27,040 --> 02:28:28,880 NOT ABOUT THE ROLE OF NIH. 3346 02:28:28,880 --> 02:28:30,360 THINK WE'RE DOING A GREAT JOB. 3347 02:28:30,360 --> 02:28:32,320 WE'RE DOING A GREAT JOB BUT MY 3348 02:28:32,320 --> 02:28:36,000 QUESTION IS MORE ABOUT THE ARE 3349 02:28:36,000 --> 02:28:38,600 WE GOING THE RIGHT DIRECTION IN 3350 02:28:38,600 --> 02:28:39,920 HEALTH DISPARITIES. 3351 02:28:39,920 --> 02:28:43,160 WE KNOW THE FRAMEWORK IS COMPLEX 3352 02:28:43,160 --> 02:28:44,880 AND I DON'T EXPECT THE PANEL TO 3353 02:28:44,880 --> 02:28:46,640 KNOW ALL THAT BUT CAN WE SAY 3354 02:28:46,640 --> 02:28:48,400 THAT FIRST OF ALL, ARE WE GOING 3355 02:28:48,400 --> 02:28:52,280 IN THE RIGHT DIRECTION TO TRY TO 3356 02:28:52,280 --> 02:28:55,000 10, 20, 50 YEARS FROM NOW WE'LL 3357 02:28:55,000 --> 02:28:56,920 NOT HAVE THESE WE ARE SEEING 3358 02:28:56,920 --> 02:28:57,840 BETWEEN FOR EXAMPLE BETWEEN THE 3359 02:28:57,840 --> 02:29:00,320 DIFFERENT ETHNIC GROUPS, RACES, 3360 02:29:00,320 --> 02:29:03,560 SOCIOECONOMIC STATUS, THIS IS A 3361 02:29:03,560 --> 02:29:04,960 COMPLEX QUESTION BECAUSE 3362 02:29:04,960 --> 02:29:06,480 ECONOMICS PLAYS A BIG ROLL AND 3363 02:29:06,480 --> 02:29:07,920 POLITICS PLAY A BIG ROLE BUT ARE 3364 02:29:07,920 --> 02:29:09,280 WE GOING IN THE RIGHT DIRECTION 3365 02:29:09,280 --> 02:29:10,680 AS A COUNTRY OF OUR OWN? 3366 02:29:10,680 --> 02:29:14,400 THAT'S MY STARTING QUESTION. 3367 02:29:14,400 --> 02:29:16,840 THANK YOU. 3368 02:29:16,840 --> 02:29:18,720 >>ANYONE ON THE PANEL WANT TO 3369 02:29:18,720 --> 02:29:19,760 TAKE A SHOT AT THAT. 3370 02:29:19,760 --> 02:29:25,680 >>SO, IT'S AN INTERESTING AND A 3371 02:29:25,680 --> 02:29:26,080 GREAT QUESTION. 3372 02:29:26,080 --> 02:29:28,120 I WILL SAY OVER THE YEARS I'VE 3373 02:29:28,120 --> 02:29:29,520 BEEN INVOLVED IN HEALTH 3374 02:29:29,520 --> 02:29:30,720 DISPARITIES RESEARCH, I'VE SEEN 3375 02:29:30,720 --> 02:29:38,040 A BIT OF A CHANGE FROM TRYING TO 3376 02:29:38,040 --> 02:29:39,360 DESCRIBE WHAT HEALTH DISPARITIES 3377 02:29:39,360 --> 02:29:41,640 ARE AND UNDERSTANDING, YOU KNOW, 3378 02:29:41,640 --> 02:29:44,120 WHAT IS CONTRIBUTING TO IT TO 3379 02:29:44,120 --> 02:29:48,440 MORE TRYING TO ADDRESS THE ROOT 3380 02:29:48,440 --> 02:29:50,240 CAUSES AND WE'RE SHIFTING OUR 3381 02:29:50,240 --> 02:29:51,400 FOCUS AND DESCRIBING THEM TO 3382 02:29:51,400 --> 02:29:53,880 MAYBE TRYING TO FIGURE OUT 3383 02:29:53,880 --> 02:29:55,200 INTERVENTIONS AND WAYS THAT WE 3384 02:29:55,200 --> 02:30:01,520 CAN GET TO THOSE ROOT CAUSES OF 3385 02:30:01,520 --> 02:30:03,400 IT SO, I HOPE THAT WE'RE MOVING 3386 02:30:03,400 --> 02:30:05,960 IN A DIRECTION WHERE ELIMINATING 3387 02:30:05,960 --> 02:30:08,200 DISPARITIES IS A REALITY AND I 3388 02:30:08,200 --> 02:30:09,760 DON'T THINK IT'S GOING TO BE 3389 02:30:09,760 --> 02:30:12,720 OVERNIGHT AS THERE'S A LOT OF 3390 02:30:12,720 --> 02:30:13,440 CONTRIBUTORS THAT WILL BE 3391 02:30:13,440 --> 02:30:18,640 DIFFICULT TO ADDRESS AND WE ARE 3392 02:30:18,640 --> 02:30:20,600 CHANGING OUR MIND SET FROM 3393 02:30:20,600 --> 02:30:22,360 ADDRESSING AND I DON'T KNOW IN 3394 02:30:22,360 --> 02:30:23,560 YOUR EXPERIENCE IF YOU ARE ALSO 3395 02:30:23,560 --> 02:30:26,800 SEEING THAT CHANGE. 3396 02:30:26,800 --> 02:30:27,040 >> 3397 02:30:27,040 --> 02:30:34,400 >>YEAH, I DEGREE. 3398 02:30:34,400 --> 02:30:35,920 THERE'S A MOVEMENT OF BLAMING 3399 02:30:35,920 --> 02:30:37,520 INDIVIDUALS TO RECOGNIZING THE 3400 02:30:37,520 --> 02:30:48,000 FACTORS THAT MANY LEVELS AND 3401 02:31:01,120 --> 02:31:02,600 UNLESS WE GET AS THOSE WE WON'T 3402 02:31:02,600 --> 02:31:05,240 BE AS EFFECTIVE AS WE CAN BE AT 3403 02:31:05,240 --> 02:31:07,000 ELIMINATING HEALTH DISPARITIES. 3404 02:31:07,000 --> 02:31:09,760 >>AND ONE THING SMALL THING TO 3405 02:31:09,760 --> 02:31:12,800 ADD IS WHAT ROLLAND ENDED WITH 3406 02:31:12,800 --> 02:31:14,880 IS TRAINING THE NEXT GENERATION 3407 02:31:14,880 --> 02:31:16,960 OF SCIENTISTS TO ADDRESS THESE 3408 02:31:16,960 --> 02:31:19,200 PROBLEMS AND THERE WAS A TIME 3409 02:31:19,200 --> 02:31:20,560 WHERE A LOT OF HEALTH 3410 02:31:20,560 --> 02:31:22,000 DISPARITIES WORK WAS NOT FUNDED 3411 02:31:22,000 --> 02:31:25,800 AND SO NOW WE'RE SEEING MORE 3412 02:31:25,800 --> 02:31:27,200 PEOPLE ENGAGING IN HEALTH 3413 02:31:27,200 --> 02:31:28,680 DISPARITY AND THINKING ABOUT 3414 02:31:28,680 --> 02:31:31,160 HEALTH DISPARITIES FROM 3415 02:31:31,160 --> 02:31:33,320 DIFFERENT PERSPECTIVES. 3416 02:31:33,320 --> 02:31:35,440 >>I THINK THAT THE REAL POINT, 3417 02:31:35,440 --> 02:31:36,720 I AGREE WITH EVERYONE. 3418 02:31:36,720 --> 02:31:39,000 I THINK ONE INDICATION THAT WE 3419 02:31:39,000 --> 02:31:40,040 MADE PROGRESS IS WHEN THE 3420 02:31:40,040 --> 02:31:42,080 DEPARTMENT OF HEALTH AND HUMAN 3421 02:31:42,080 --> 02:31:43,560 SERVICES NAME RACISM IS A 3422 02:31:43,560 --> 02:31:45,680 PUBLIC-HEALTH ISSUE AND AFTER 3423 02:31:45,680 --> 02:31:47,360 THAT, NIH IMMEDIATELY, 3424 02:31:47,360 --> 02:31:49,040 IMMEDIATELY WEPT AND PUT OUT 3425 02:31:49,040 --> 02:31:51,200 CALLS AND ALLOCATED RESOURCES SO 3426 02:31:51,200 --> 02:31:53,560 I ABSOLUTELY CERTAINLY THINK 3427 02:31:53,560 --> 02:31:54,640 THAT WE ARE MOVING IN A RIGHT 3428 02:31:54,640 --> 02:31:55,200 DIRECTION. 3429 02:31:55,200 --> 02:31:57,000 I THINK WE'RE IN THE RIDE PACE 3430 02:31:57,000 --> 02:31:59,400 AND WE'RE ON THE RIGHT PLACE. 3431 02:31:59,400 --> 02:32:01,600 I DO AGREE WITH Dr. ZENK WE 3432 02:32:01,600 --> 02:32:04,480 COULD HAVE MOVED A LITTLE MORE 3433 02:32:04,480 --> 02:32:05,840 ABREAST BUT IT MIGHT BE THE 3434 02:32:05,840 --> 02:32:07,280 NATURE OF SCIENCE AND THE 3435 02:32:07,280 --> 02:32:08,200 IMPLICATION OF SCIENCE. 3436 02:32:08,200 --> 02:32:10,200 BUT I DO BELIEVE THAT WE ARE IN 3437 02:32:10,200 --> 02:32:11,440 THE RIGHT AREA. 3438 02:32:11,440 --> 02:32:13,160 REMEMBER, THIS DIDN'T HAPPEN 3439 02:32:13,160 --> 02:32:13,520 OVERNIGHT. 3440 02:32:13,520 --> 02:32:16,160 TO REVERSE IT OVERNIGHT IS 3441 02:32:16,160 --> 02:32:17,720 UNTHINKABLE SO WE WANT TO BE 3442 02:32:17,720 --> 02:32:19,120 MINDFUL OF THAT. 3443 02:32:19,120 --> 02:32:19,440 YES, MA'AM. 3444 02:32:19,440 --> 02:32:20,920 >>SO THESE QUESTIONS ACTUALLY 3445 02:32:20,920 --> 02:32:24,400 CAME IN FROM THE ZOOM AUDIENCE. 3446 02:32:24,400 --> 02:32:26,560 WHAT IS THE PROCESS TO DETERMINE 3447 02:32:26,560 --> 02:32:28,600 AND HIGHLIGHT PRIORITY HEALTH 3448 02:32:28,600 --> 02:32:30,920 DISPARITIES POPULATIONS FOR HIGH 3449 02:32:30,920 --> 02:32:32,600 PRIORITY RESEARCH SUPPORTED BY 3450 02:32:32,600 --> 02:32:32,760 NIH? 3451 02:32:32,760 --> 02:32:34,440 >>WHAT IS THE PROCESS -- 3452 02:32:34,440 --> 02:32:37,440 >>TO DETERMINE AND HIGHLIGHT 3453 02:32:37,440 --> 02:32:41,040 PRIORITY HEALTH DISPARITIES 3454 02:32:41,040 --> 02:32:41,560 POPULATIONS. 3455 02:32:41,560 --> 02:32:46,480 >>IF I REMEMBER CORRECTLY, THAT 3456 02:32:46,480 --> 02:32:47,840 WAS ON Dr. PEREZ-STABLE SLIDE 3457 02:32:47,840 --> 02:32:50,840 AND HE IS NOT WITH US. 3458 02:32:50,840 --> 02:32:52,360 I'M NOT SURE WHAT THE PROCESS 3459 02:32:52,360 --> 02:32:53,800 WOULD BE WITH THEM. 3460 02:32:53,800 --> 02:32:55,320 BUT DOES ANYBODY WANT TO TAKE A 3461 02:32:55,320 --> 02:32:55,800 STAB AT IT? 3462 02:32:55,800 --> 02:33:00,320 I KNOW THAT WAS ON HIS 3463 02:33:00,320 --> 02:33:01,560 PRESENTATION. 3464 02:33:01,560 --> 02:33:10,520 >>Dr. LOOKED HOD HODES IT JOI. 3465 02:33:10,520 --> 02:33:12,880 LEGISLATIVE REQUIREMENTS OR 3466 02:33:12,880 --> 02:33:14,080 MANDATES WERE PART OF HOW THEY 3467 02:33:14,080 --> 02:33:15,280 WERE DEFINED AND I THINK BASED 3468 02:33:15,280 --> 02:33:17,440 ON THE CHANGING LANDSCAPE AS HE 3469 02:33:17,440 --> 02:33:19,440 ALLUDED TO THEY'RE REVISITING 3470 02:33:19,440 --> 02:33:23,880 THOSE PRIORITY GROUPS NOW. 3471 02:33:23,880 --> 02:33:26,680 >>WHEN I THINK OF AGING 3472 02:33:26,680 --> 02:33:27,800 RESEARCH, I THINK IT'S SO 3473 02:33:27,800 --> 02:33:28,880 IMPORTANT TO UNDERSTAND THE 3474 02:33:28,880 --> 02:33:30,920 GLOBAL PERSPECTIVE AND THERE'S 3475 02:33:30,920 --> 02:33:33,040 GREAT STUDIES OF COURSE FROM 3476 02:33:33,040 --> 02:33:36,720 ITALY AND JAPAN ABOUT LONGEVITY. 3477 02:33:36,720 --> 02:33:38,480 ARE THERE HEALTH DISPARITY 3478 02:33:38,480 --> 02:33:40,040 STUDIES FROM OTHER COUNTRIES 3479 02:33:40,040 --> 02:33:41,840 WHERE PEOPLE ARE MARGINALIZED 3480 02:33:41,840 --> 02:33:45,640 ALL THROUGH EUROPE OF COURSE AND 3481 02:33:45,640 --> 02:33:46,720 SOUTHEAST ASIA? 3482 02:33:46,720 --> 02:33:52,760 ANYTHING TO COMPARE TO? 3483 02:33:52,760 --> 02:33:56,720 >>I BELIEVE THERE ARE SOME 3484 02:33:56,720 --> 02:33:58,120 COMPARATIVE STUDIES. 3485 02:33:58,120 --> 02:34:01,720 MY PERSPECTIVE AS IT RELATES TO 3486 02:34:01,720 --> 02:34:02,960 COMPARING IT WITH HEALTH 3487 02:34:02,960 --> 02:34:03,920 DISPARITIES IT'S NOT THE RIGHT 3488 02:34:03,920 --> 02:34:06,360 BECAUSE IT'S APPLES TO ORANGES 3489 02:34:06,360 --> 02:34:07,280 BECAUSE PEOPLE'S CONTEXT ARE 3490 02:34:07,280 --> 02:34:07,560 DIFFERENT. 3491 02:34:07,560 --> 02:34:09,040 TO GIVE YOU A BRIEF EXAMPLE. 3492 02:34:09,040 --> 02:34:11,400 WHEN WE STUDY BLACK AND WHITE 3493 02:34:11,400 --> 02:34:12,320 DISPARITIES IN THE UNITED STATES 3494 02:34:12,320 --> 02:34:13,800 AND WE'RE THINKING ABOUT ACROSS 3495 02:34:13,800 --> 02:34:15,240 THE LIFE OR PARTICULAR OLDER 3496 02:34:15,240 --> 02:34:17,960 ADULTS WE CANNOT NOT UNDERSTAND 3497 02:34:17,960 --> 02:34:20,040 THE IMPACT, THE SLATE RE, JIM 3498 02:34:20,040 --> 02:34:23,480 CROW AND ALL THOSE THINGS THAT 3499 02:34:23,480 --> 02:34:25,040 HAVE OCCURRED WHEREAS IF WE 3500 02:34:25,040 --> 02:34:26,280 COMPARE IT IN SWEDEN THEY DON'T 3501 02:34:26,280 --> 02:34:26,880 HAVE THOSE. 3502 02:34:26,880 --> 02:34:28,600 WHEN WE THINK ABOUT MAKING 3503 02:34:28,600 --> 02:34:30,120 COMPARISONS IT NEEDS TO BE AS 3504 02:34:30,120 --> 02:34:31,400 COMPARABLE AS POSSIBLE BUT THERE 3505 02:34:31,400 --> 02:34:33,960 ARE SOME STUDIES THAT HAVE DONE 3506 02:34:33,960 --> 02:34:37,560 SOME COMPARATIVE STUFF AND 3507 02:34:37,560 --> 02:34:42,600 THERE'S NIA HAS FUND AID NUMBER 3508 02:34:42,600 --> 02:34:44,000 OF SISTER STUDIES WITH THE 3509 02:34:44,000 --> 02:34:45,600 HEALTH AND RETIREMENT SURVEY AND 3510 02:34:45,600 --> 02:34:47,080 A COUPLE OTHER SURVEYS THAT ARE 3511 02:34:47,080 --> 02:34:49,240 VERY SIMILAR TO IT AROUND THE 3512 02:34:49,240 --> 02:34:51,920 COUNTRY AND THEY DO PROVIDE SOME 3513 02:34:51,920 --> 02:34:54,760 COMPARATIVE RESEARCH ON THE 3514 02:34:54,760 --> 02:34:58,920 INDICATORS I THINK SEEM TO BE 3515 02:34:58,920 --> 02:35:01,280 APPROPRIATE. 3516 02:35:01,280 --> 02:35:01,720 ANYBODY ELSE? 3517 02:35:01,720 --> 02:35:06,720 >>WE HAVE A CENTER FOR GLOBAL 3518 02:35:06,720 --> 02:35:08,960 HEALTH AT NCI THAT'S GROWING IN 3519 02:35:08,960 --> 02:35:11,000 THE SPACE OF UNDERSTANDING AND 3520 02:35:11,000 --> 02:35:11,760 ADDRESSING HEALTH DISPARITIES 3521 02:35:11,760 --> 02:35:13,760 AND THE HOPE IS SOME OF THE 3522 02:35:13,760 --> 02:35:15,080 LESSONS LEARNED IN LOW AND 3523 02:35:15,080 --> 02:35:17,440 MIDDLE INCOME COUNTRIES AND 3524 02:35:17,440 --> 02:35:19,400 OTHER AREAS EXPERIENCING 3525 02:35:19,400 --> 02:35:21,280 DISPARITIES COULD POTENTIALLY BE 3526 02:35:21,280 --> 02:35:22,840 APPLIED BACK HERE IN CERTAIN 3527 02:35:22,840 --> 02:35:24,640 SCENARIOS BUT I COULDN'T AGREE 3528 02:35:24,640 --> 02:35:28,480 MORE THAT THE CONTEXT IS VERY 3529 02:35:28,480 --> 02:35:29,280 DISTINCT AND DIFFERENT AND IT'S 3530 02:35:29,280 --> 02:35:33,520 NOT A DIRECT COMPARISON SO, I 3531 02:35:33,520 --> 02:35:34,120 THINK CERTAINLY LEARNING MORE 3532 02:35:34,120 --> 02:35:36,400 AND LOOKING AT WHAT WE CAN 3533 02:35:36,400 --> 02:35:39,200 POTENTIALLY APPLY BACK HERE WILL 3534 02:35:39,200 --> 02:35:40,520 BE AVAILABLE BUT I DON'T THINK 3535 02:35:40,520 --> 02:35:42,960 IT WILL BE IN ALL CASES. 3536 02:35:42,960 --> 02:35:46,520 >>DID YOU HAVE ANYTHING? 3537 02:35:46,520 --> 02:35:49,200 >>I WAS JUST GOING TO ECHO WHAT 3538 02:35:49,200 --> 02:35:50,400 TIFFANY SAID. 3539 02:35:50,400 --> 02:35:53,000 THERE'S A LOT OF STUDIES 3540 02:35:53,000 --> 02:35:57,040 SUPPORTED NIA LOOKING AT 3541 02:35:57,040 --> 02:35:59,360 DISPARITIES AND OTHER SORT OF A 3542 02:35:59,360 --> 02:36:02,280 GLOBAL CONTEXT AND THERE'S SOME 3543 02:36:02,280 --> 02:36:03,880 NEW INITIATIVES LOOKING AT 3544 02:36:03,880 --> 02:36:05,960 ALZHEIMER'S DISEASE AND RELATED 3545 02:36:05,960 --> 02:36:11,320 DEMENTIA AND INTERNATIONALLY SO 3546 02:36:11,320 --> 02:36:15,080 I THINK THERE'S THIS INTEREST IN 3547 02:36:15,080 --> 02:36:16,280 LOOKING AT HEALTH DISPARITIES 3548 02:36:16,280 --> 02:36:17,800 FROM A GLOBAL PERSPECTIVE AND 3549 02:36:17,800 --> 02:36:20,720 SEEING ABOUT WHAT THINGS CAN BE 3550 02:36:20,720 --> 02:36:23,000 BACK TO COMPANIES IN THE U.S. 3551 02:36:23,000 --> 02:36:26,760 BUT CERTAINLY CONTEXT MATTERS. 3552 02:36:26,760 --> 02:36:31,680 >>THANK YOU. 3553 02:36:31,680 --> 02:36:34,280 >>DO YOU WANT TO COME FORWARD. 3554 02:36:34,280 --> 02:36:36,600 YOU CAN COMMENT ON THIS AS WELL. 3555 02:36:36,600 --> 02:36:37,400 >>SURE. 3556 02:36:37,400 --> 02:36:37,960 SURE. 3557 02:36:37,960 --> 02:36:39,280 VERY BRIEFLY. 3558 02:36:39,280 --> 02:36:40,960 SO LIZ NEIL SON FROM THE 3559 02:36:40,960 --> 02:36:43,240 DIVISION OF BEHAVIOR RESEARCH. 3560 02:36:43,240 --> 02:36:48,480 THERE'S AN INTERNATIONAL FAMI 3561 02:36:48,480 --> 02:36:50,480 FAMILY -- LIZ KNEELSON DIVISION 3562 02:36:50,480 --> 02:36:52,240 OF BEHAVE. 3563 02:36:52,240 --> 02:36:53,400 THERE'S AN INTERNATIONAL FAMILY 3564 02:36:53,400 --> 02:36:54,760 OF STUDIES LINKED TO THE HEALTH 3565 02:36:54,760 --> 02:36:56,640 AND RETIREMENT STUDY THAT LOOKED 3566 02:36:56,640 --> 02:36:59,600 AT THE SOCIAL BEHAVIORAL POLICY 3567 02:36:59,600 --> 02:37:02,600 ENVIRONMENTAL EXPOSURE THAT ARE 3568 02:37:02,600 --> 02:37:03,640 DRIVING HEALTH IN THESE 3569 02:37:03,640 --> 02:37:05,280 POPULATION REPRESENTATIVE GROUPS 3570 02:37:05,280 --> 02:37:07,440 AND I THINK JUST ALLUDING TO THE 3571 02:37:07,440 --> 02:37:09,240 SORT OF DEFINITION OF A HEALTH 3572 02:37:09,240 --> 02:37:10,280 DISPARITY THAT IS SOMETHING THAT 3573 02:37:10,280 --> 02:37:13,280 IS DRIVEN BY UNEQUAL ACCESS AND 3574 02:37:13,280 --> 02:37:14,920 RESOURCES AND OR DISADVANTAGE 3575 02:37:14,920 --> 02:37:16,120 WITHIN THE POPULATION THAT'S 3576 02:37:16,120 --> 02:37:17,520 GOING TO BE VERY DIFFERENT BY 3577 02:37:17,520 --> 02:37:19,120 THE DIFFERENT CONTEXT IN WHICH 3578 02:37:19,120 --> 02:37:24,080 PEOPLE ARE LIVING SO YOU KNOW, 3579 02:37:24,080 --> 02:37:25,360 RACE IS CONDUCTED SOCIALLY HERE 3580 02:37:25,360 --> 02:37:27,280 AND DIFFERENTLY IN ANOTHER 3581 02:37:27,280 --> 02:37:29,400 COUNTRY SO THOSE HAVE RICH 3582 02:37:29,400 --> 02:37:30,680 PUBLICLY AVAILABLE DATA 3583 02:37:30,680 --> 02:37:32,000 RESOURCES TO SHARE TO TACKLE 3584 02:37:32,000 --> 02:37:34,920 THESE QUESTIONS ACROSS THE 3585 02:37:34,920 --> 02:37:36,360 INTERNATIONAL ARENA. 3586 02:37:36,360 --> 02:37:39,800 >>THANK YOU. 3587 02:37:39,800 --> 02:37:42,640 >>YES, HI, THANK YOU VERY MUCH 3588 02:37:42,640 --> 02:37:44,800 FOR THIS INTERESTING SESSION. 3589 02:37:44,800 --> 02:37:47,080 I JUST WANTED TO ASK A GENERAL 3590 02:37:47,080 --> 02:37:49,160 QUESTION, THE EMPHASIS ON 3591 02:37:49,160 --> 02:37:51,080 DISADVANTAGED, SOURCES OF 3592 02:37:51,080 --> 02:37:52,160 ADVERSITY, MAKES A LOT OF SENSE 3593 02:37:52,160 --> 02:37:53,600 AND THINKING ABOUT HEALTH 3594 02:37:53,600 --> 02:37:55,000 DISPARITIES BUT THE WHOLE KIND 3595 02:37:55,000 --> 02:37:57,640 OF FLIP SIDE ABOUT ADVANTAGE AND 3596 02:37:57,640 --> 02:38:00,440 BUFFERING AND RESILIENCE, KIND 3597 02:38:00,440 --> 02:38:01,960 OF GOES HAND AND HAND BUT IT'S 3598 02:38:01,960 --> 02:38:04,280 NOT REALLY SEEMS TO BE GIVEN THE 3599 02:38:04,280 --> 02:38:06,200 EXPLICIT ATTENTION AND SO I'M 3600 02:38:06,200 --> 02:38:07,000 WONDERING EITHER ABOUT 3601 02:38:07,000 --> 02:38:07,840 INITIATIVES THAT ARE 3602 02:38:07,840 --> 02:38:10,320 SPECIFICALLY FOCUSING ON THE 3603 02:38:10,320 --> 02:38:12,600 POSITIVE ASPECTS THAT LEADS TO 3604 02:38:12,600 --> 02:38:15,040 DISPARITIES, WHY DO SOME GROUPS 3605 02:38:15,040 --> 02:38:17,360 HAVE MORE ADVANTAGE AND EVEN 3606 02:38:17,360 --> 02:38:18,320 MARGINALIZED GROUPS WITH 3607 02:38:18,320 --> 02:38:20,680 HISPANIC MORTALITY PARADOX FLEX 3608 02:38:20,680 --> 02:38:25,640 THETHATTHERE'S CERTAIN AGES SO S 3609 02:38:25,640 --> 02:38:27,760 EXPLICIT FOCUS ON RESILIENCE AND 3610 02:38:27,760 --> 02:38:30,720 BUFFERING IS THAT PART OF NIH 3611 02:38:30,720 --> 02:38:32,520 THE MULTIPLE INSTITUTES IS THERE 3612 02:38:32,520 --> 02:38:33,720 A FOCUS ON THAT? 3613 02:38:33,720 --> 02:38:34,160 THANK YOU. 3614 02:38:34,160 --> 02:38:36,280 >>UH-HUH. 3615 02:38:36,280 --> 02:38:38,240 >>DO YOU WANT TO TAKE THAT ONE. 3616 02:38:38,240 --> 02:38:39,560 >>I THOUGHT I SAW IT. 3617 02:38:39,560 --> 02:38:41,200 >>I'LL START, YEAH. 3618 02:38:41,200 --> 02:38:43,040 THANK YOU FOR THE QUESTION. 3619 02:38:43,040 --> 02:38:45,760 I AGREE, NOT ONLY DOES 3620 02:38:45,760 --> 02:38:47,840 DISADVANTAGE ACCUMULATE BUT SO 3621 02:38:47,840 --> 02:38:48,960 DOES ADVANTAGE AND THAT PLAYS 3622 02:38:48,960 --> 02:38:50,280 OUT IN DIFFERENT WAYS IN TERMS 3623 02:38:50,280 --> 02:38:51,800 OF HEALTHY AGING. 3624 02:38:51,800 --> 02:38:53,680 BUT I AGREE WITH YOU IN TERMS OF 3625 02:38:53,680 --> 02:38:55,720 THINKING ABOUT RESILIENCE AND 3626 02:38:55,720 --> 02:38:56,760 STRENGTH BASED STRATEGIES THOSE 3627 02:38:56,760 --> 02:38:58,480 ARE REALLY IMPORTANT AND I 3628 02:38:58,480 --> 02:39:01,120 TOUCHED ON IT BRIEFLY IN MY 3629 02:39:01,120 --> 02:39:03,280 PRESENTATION. 3630 02:39:03,280 --> 02:39:06,600 I THINK RESILIENT STRATEGIES, 3631 02:39:06,600 --> 02:39:08,040 STRENGTH BASED STRATEGY THAT 3632 02:39:08,040 --> 02:39:10,880 BUFFER THE IMPACT OF EXPOSURE TO 3633 02:39:10,880 --> 02:39:15,440 A DISADVANTAGE INEQUITABLE 3634 02:39:15,440 --> 02:39:19,040 SYSTEMS AND WE CAN DO A LOT 3635 02:39:19,040 --> 02:39:20,920 MORE IN TERMS OF IDENTIFYING 3636 02:39:20,920 --> 02:39:24,200 EFFECTIVE INTERVENTIONS. 3637 02:39:24,200 --> 02:39:28,040 >>ANYONE ELSE? 3638 02:39:28,040 --> 02:39:29,000 >>THANK YOU. 3639 02:39:29,000 --> 02:39:31,960 MY NAME IS RAGA I'M A GRADUATE 3640 02:39:31,960 --> 02:39:33,400 STUDENT FROM YALE. 3641 02:39:33,400 --> 02:39:34,920 SO, THERE WAS A REALLY 3642 02:39:34,920 --> 02:39:37,080 INTERESTING SLIDE IN Dr. 3643 02:39:37,080 --> 02:39:39,680 LAWRENCE'S PRESENTATION AROUND 3644 02:39:39,680 --> 02:39:43,200 SORT OF THE HEALTH DISPARITIES 3645 02:39:43,200 --> 02:39:44,520 FRAMEWORK WITH SPECIFICALLY WENT 3646 02:39:44,520 --> 02:39:46,360 THROUGH SOCIAL FACTORS AND 3647 02:39:46,360 --> 02:39:48,000 PSYCHOLOGICAL FACTORS. 3648 02:39:48,000 --> 02:39:50,040 MY QUESTION WAS MORE AROUND 3649 02:39:50,040 --> 02:39:51,680 SPECIFICALLY SOME OF THE SOCIAL 3650 02:39:51,680 --> 02:39:52,480 FACTORS THAT WERE POINTED OUT 3651 02:39:52,480 --> 02:39:53,960 AND THE DIFFERENT FORMS OF 3652 02:39:53,960 --> 02:39:55,600 STRESS THAT ARE THERE. 3653 02:39:55,600 --> 02:39:58,320 AND HOW THEY RELATE TO SORT OF 3654 02:39:58,320 --> 02:39:59,160 HEALTH DISPARITIES THAT ARE 3655 02:39:59,160 --> 02:40:02,080 THERE SO A LOT OF WORK SEEMS TO 3656 02:40:02,080 --> 02:40:06,720 BE DONE IN SORT OF LINKING STUFF 3657 02:40:06,720 --> 02:40:17,000 LIKE DEPRESSION. 3658 02:41:13,000 --> 02:41:17,160 >>BY RACIAL ETHNIC GROUPS AND 3659 02:41:17,160 --> 02:41:19,520 THEY NOW HAVE BEEN ABLE TO 3660 02:41:19,520 --> 02:41:23,520 IDENTIFY THEM USING THE STRESS 3661 02:41:23,520 --> 02:41:24,880 BIOMARKERS THEY HAVE. 3662 02:41:24,880 --> 02:41:26,480 I KNOW THERE'S WORK THERE AND 3663 02:41:26,480 --> 02:41:31,640 THERE'S BEEN DONE AND TO ADDRESS 3664 02:41:31,640 --> 02:41:33,240 THAT ISSUE BUT WE HAVE MORE WORK 3665 02:41:33,240 --> 02:41:34,720 TO DO IN THAT AREA BUT I KNOW 3666 02:41:34,720 --> 02:41:40,920 Dr. CRIMCRIMONS IS DOING THAT WE 3667 02:41:40,920 --> 02:41:50,680 USE OF THE HRS DATASET. 3668 02:41:50,680 --> 02:41:53,520 >>I HAVE A QUESTION. 3669 02:41:53,520 --> 02:41:58,440 STACEY HIGHLIGHTED IN YOUR TALK 3670 02:41:58,440 --> 02:42:08,400 TALKING ABOUT RATHER THAN 3671 02:42:08,400 --> 02:42:09,440 PREDICTORS OF HEALTH DISPARITIES 3672 02:42:09,440 --> 02:42:11,080 AND LOOK AT PEOPLE AND BINNED 3673 02:42:11,080 --> 02:42:15,200 THEM BY THEREBY LOGICAL PROFILES 3674 02:42:15,200 --> 02:42:17,680 AND I WAS RECONCILING WITH THE 3675 02:42:17,680 --> 02:42:19,960 IMPORTANCE OF A REPRESENTATIVE 3676 02:42:19,960 --> 02:42:21,400 SCIENCE AND MAKING SURE THAT WE 3677 02:42:21,400 --> 02:42:23,480 HAD THE INCLUSION OF ALL THE 3678 02:42:23,480 --> 02:42:26,200 RELEVANT POPULATIONS AND 3679 02:42:26,200 --> 02:42:28,640 ADEQUATELY TO GET THE VARIATION 3680 02:42:28,640 --> 02:42:36,240 IN THE POPULATION AND ALSO WITH 3681 02:42:36,240 --> 02:42:37,720 THE FUNDAMENTAL POINTS AND THE 3682 02:42:37,720 --> 02:42:39,840 DRIVERS ARE IN THESE SOURCES OF 3683 02:42:39,840 --> 02:42:41,400 DISADVANTAGE SO I WAS WONDERING 3684 02:42:41,400 --> 02:42:44,280 IF YOU CAN ELABORATE ON HOW YOU 3685 02:42:44,280 --> 02:42:46,200 DIFFERENTIATE THIS SORT OF 3686 02:42:46,200 --> 02:42:48,440 BINNING BY BIOLOGICAL STATUS VIA 3687 02:42:48,440 --> 02:42:54,880 V THE SORT OF STANDARD AND 3688 02:42:54,880 --> 02:42:56,760 GROUPING AND WHERE THOSE 3689 02:42:56,760 --> 02:42:59,120 APPROACHES HAVE COMPLIMENTARY 3690 02:42:59,120 --> 02:43:09,640 AND STRENGTH OR WEAKNESSES AN 3691 02:43:19,280 --> 02:43:20,000 AND -- I'M OFF MUTE. 3692 02:43:20,000 --> 02:43:21,120 >>WE CAN HEAR YOU NOW. 3693 02:43:21,120 --> 02:43:26,640 >>SO, MAYBE I DIDN'T EXPRESS IT 3694 02:43:26,640 --> 02:43:30,160 COMPLETELY RIGHT BUT THOSE 3695 02:43:30,160 --> 02:43:32,040 BINNING BY HEALTH STATUS IS FROM 3696 02:43:32,040 --> 02:43:35,920 A DIVERSE COHORT THAT HAS SORT 3697 02:43:35,920 --> 02:43:37,600 OF THE REPRESENTATIVE SAMPLES 3698 02:43:37,600 --> 02:43:39,840 THAT YOU WOULD EXPECT AND WANT 3699 02:43:39,840 --> 02:43:43,520 AND A COHORT. 3700 02:43:43,520 --> 02:43:46,640 BUT INSTEAD OF TAKING THE COHORT 3701 02:43:46,640 --> 02:43:50,880 AND SEPARATING PEOPLE OUT BY AGE 3702 02:43:50,880 --> 02:43:53,480 OR RACE OR SOCIOECONOMIC STATUS 3703 02:43:53,480 --> 02:43:55,480 OR WHATEVER CATEGORY YOU WANT TO 3704 02:43:55,480 --> 02:44:05,560 PLACE ON IT, YOU LOOK MORE 3705 02:44:05,560 --> 02:44:07,080 BROADLY AT HEALTH STATUS AND THE 3706 02:44:07,080 --> 02:44:08,760 MEASURE OF HEALTH STATUS MAY 3707 02:44:08,760 --> 02:44:09,960 INCLUDE THE SOCIAL DETERMINANTS 3708 02:44:09,960 --> 02:44:12,800 OF HEALTH AND IT DEPENDS ON WHAT 3709 02:44:12,800 --> 02:44:14,240 STATUS WE THINK WOULD WORK WELL 3710 02:44:14,240 --> 02:44:16,000 FOR WHAT YOU ARE TRYING TO SEE 3711 02:44:16,000 --> 02:44:19,200 AND I THINK SOME OF THOSE 3712 02:44:19,200 --> 02:44:21,840 FACTORS SUCH AS FUNCTION AND 3713 02:44:21,840 --> 02:44:23,240 DISABILITY AND THINGS IN THE 3714 02:44:23,240 --> 02:44:25,920 DEFICIT ACCUMULATION INDEX COULD 3715 02:44:25,920 --> 02:44:30,960 PLAY INTO THAT A LITTLE BIT AS 3716 02:44:30,960 --> 02:44:31,400 WELL. 3717 02:44:31,400 --> 02:44:35,280 SO ARE JUST LOOKING TO SEE ANY 3718 02:44:35,280 --> 02:44:45,800 PARTICULAR GROUP OF PEOPLE MAYBE 3719 02:45:04,320 --> 02:45:06,640 STARTING FROM A DIFFERENT POINT, 3720 02:45:06,640 --> 02:45:10,320 IN THAT MAKES SENSE. 3721 02:45:10,320 --> 02:45:12,360 >>THANK YOU TO ALL THE SPEAKERS 3722 02:45:12,360 --> 02:45:20,360 AND PANELISTS. 3723 02:45:20,360 --> 02:45:22,000 LISTENING TO ALL THE TALKS, I 3724 02:45:22,000 --> 02:45:24,840 REALIZE THERE'S SOME IMPLICIT 3725 02:45:24,840 --> 02:45:26,280 BIOLOGICAL HYPOTHESIS WE CAN 3726 02:45:26,280 --> 02:45:27,880 MAKE EXPLICIT IN WHAT WE'RE 3727 02:45:27,880 --> 02:45:30,520 TALKING ABOUT AND I THINK THE 3728 02:45:30,520 --> 02:45:35,320 PROMINENCE OF HEALTH DISPARITIES 3729 02:45:35,320 --> 02:45:41,320 AT THE GEROSCIENCE THAT AGING IS 3730 02:45:41,320 --> 02:45:43,880 A ROOT CAUSE OF MANY CHRONIC 3731 02:45:43,880 --> 02:45:46,160 DISEASES AND IF WE'RE WORKING AT 3732 02:45:46,160 --> 02:45:48,200 HEALTH DISPARITIES, MAYBE THE 3733 02:45:48,200 --> 02:45:50,640 HIGH POTH IS THAT HEALTH 3734 02:45:50,640 --> 02:45:52,400 DISPARITIES OR SOCIAL 3735 02:45:52,400 --> 02:45:55,160 DISPARITIES ARE ACCELERATING 3736 02:45:55,160 --> 02:46:05,680 AGING AND IT'S ONE HYPOTHESIS 3737 02:46:06,600 --> 02:46:09,320 THERE ARE THAT SET OF STREETORS 3738 02:46:09,320 --> 02:46:10,320 AND SOCIAL DETERMINANTS OF 3739 02:46:10,320 --> 02:46:12,320 HEALTH IS INFLUENCING A LOT OF 3740 02:46:12,320 --> 02:46:14,120 BIOLOGICAL PROCESSES, NOT 3741 02:46:14,120 --> 02:46:16,120 NECESSARILY AGING THAT ARE 3742 02:46:16,120 --> 02:46:17,080 THROUGH VARIOUS CHAINS IMPACTING 3743 02:46:17,080 --> 02:46:18,520 A WIDE RANGE OF DISEASES AND 3744 02:46:18,520 --> 02:46:21,040 MIGHT BE A SEPARATE PATHWAY 3745 02:46:21,040 --> 02:46:23,040 UNRELATED TO AGING OR THOSE TWO 3746 02:46:23,040 --> 02:46:24,520 THINGS MIGHT INTERACT PERHAPS 3747 02:46:24,520 --> 02:46:26,800 IT'S THE MOST LIKELY BUT I JUST 3748 02:46:26,800 --> 02:46:27,840 THOUGHT IT WOULD BE INTERESTING 3749 02:46:27,840 --> 02:46:29,880 TO FRAME THE HYPOTHESIS IMPLICIT 3750 02:46:29,880 --> 02:46:31,280 IN THINKING ABOUT IT AND I WOULD 3751 02:46:31,280 --> 02:46:41,080 LOVE TO GET YOUR REACTIONS. 3752 02:46:41,080 --> 02:46:45,040 YOU ARE LOOKING AT ME. 3753 02:46:45,040 --> 02:46:45,440 [LAUGHTER] 3754 02:46:45,440 --> 02:46:49,640 >>THANK YOU FOR THE QUESTION. 3755 02:46:49,640 --> 02:46:55,560 I THINK IT'S SIMILAR TO WHAT YOU 3756 02:46:55,560 --> 02:46:56,080 ARE SAYING. 3757 02:46:56,080 --> 02:47:01,240 YOU WANT TO KNOW, DOES AGING 3758 02:47:01,240 --> 02:47:03,160 PROCESS DOES HEALTH DISPARITIES 3759 02:47:03,160 --> 02:47:06,480 EX EXASPERATE THE AGING. 3760 02:47:06,480 --> 02:47:08,520 FROM USING IT GEROSCIENCE 3761 02:47:08,520 --> 02:47:08,960 ASPECT. 3762 02:47:08,960 --> 02:47:10,160 I STILL DON'T KNOW THE ANSWER TO 3763 02:47:10,160 --> 02:47:10,680 IT. 3764 02:47:10,680 --> 02:47:14,480 I PROBABLY CAN ARGUE BOTH SIDES 3765 02:47:14,480 --> 02:47:14,760 OF THE COIN. 3766 02:47:14,760 --> 02:47:15,600 PRESS ON IT. 3767 02:47:15,600 --> 02:47:18,520 BUT IT'S AN IMPORTANT QUESTION 3768 02:47:18,520 --> 02:47:22,080 TO ASK AND FOR THIS COMMUNITY 3769 02:47:22,080 --> 02:47:23,600 GEROSCIENCE I THINK MOVING 3770 02:47:23,600 --> 02:47:26,600 FORWARD IF WE START WITH 3771 02:47:26,600 --> 02:47:27,840 DISPARITIES WAS OUTSTANDING IDEA 3772 02:47:27,840 --> 02:47:30,600 BECAUSE IT CUTS ACROSS OR 3773 02:47:30,600 --> 02:47:33,320 IMPACTS THE OTHER SEVEN OR EIGHT 3774 02:47:33,320 --> 02:47:35,120 TOTAL, THE OTHER SEVEN AREAS AND 3775 02:47:35,120 --> 02:47:39,200 I THINK IT PROVIDES US AN 3776 02:47:39,200 --> 02:47:40,600 OPPORTUNITY TO THINK ABOUT THIS 3777 02:47:40,600 --> 02:47:41,960 PARTICULARLY AS WE GET TO DAY 3778 02:47:41,960 --> 02:47:43,480 THREE WHERE WE HEARD ALL THE 3779 02:47:43,480 --> 02:47:45,400 PRESENTATIONS AND THINK ABOUT 3780 02:47:45,400 --> 02:47:48,880 HOW WE AS A COMMUNITY CAN SET 3781 02:47:48,880 --> 02:47:50,920 THESE HYPOTHESIS UP AND TO TEST 3782 02:47:50,920 --> 02:47:53,520 THEM AND MAYBE, YOU KNOW, THE 3783 02:47:53,520 --> 02:47:55,080 SCIENTIFIC WAY IS TO TEST BOTH 3784 02:47:55,080 --> 02:47:56,960 OF THEM AND IT MAY BE IT BUT YOU 3785 02:47:56,960 --> 02:48:01,640 HAVE TO SEE, YOU SHOULD THINK 3786 02:48:01,640 --> 02:48:03,320 ABOUT WHAT IT IS YOU ARE TRYING 3787 02:48:03,320 --> 02:48:05,640 THINK AND HOW YOU CAN FIT EITHER 3788 02:48:05,640 --> 02:48:16,200 ONE OF THESE WITHIN SOME OF THE 3789 02:48:25,480 --> 02:48:26,600 WITHOUT STIGMATIZING THE PEOPLE 3790 02:48:26,600 --> 02:48:28,040 TO IMPROVE THEIR HEALTH. 3791 02:48:28,040 --> 02:48:29,000 THAT'S ALL I'VE GOT FOR YOU 3792 02:48:29,000 --> 02:48:29,840 RIGHT NOW. 3793 02:48:29,840 --> 02:48:31,360 I'M NOT GOING TO LOOK OVER AND 3794 02:48:31,360 --> 02:48:33,120 ASK IF THEY HAVE ANYTHING I KNOW 3795 02:48:33,120 --> 02:48:34,400 THEY DO BECAUSE DOES ANYBODY 3796 02:48:34,400 --> 02:48:36,000 HAVE ANYTHING ELSE TO ADD? 3797 02:48:36,000 --> 02:48:37,560 >>I MIGHT ANSWER. 3798 02:48:37,560 --> 02:48:38,840 IT'S AN INTERESTING QUESTION. 3799 02:48:38,840 --> 02:48:40,880 I'M TRYING TO WRAP MY BRAIN 3800 02:48:40,880 --> 02:48:43,720 AROUND HOW IT WOULD GO DIFFERENT 3801 02:48:43,720 --> 02:48:46,040 IN TERMS OF WHAT THE OUTCOMES OF 3802 02:48:46,040 --> 02:48:49,320 THE RESEARCH WOULD DIFFER. 3803 02:48:49,320 --> 02:48:50,720 ONE THING I WANT TO SAY IS MORE 3804 02:48:50,720 --> 02:48:54,480 AND MORE AT NCI WE'RE TRYING TO 3805 02:48:54,480 --> 02:48:55,680 STEER AWAY FROM DOING HEALTH 3806 02:48:55,680 --> 02:48:57,200 DISPARITIES RESEARCH. 3807 02:48:57,200 --> 02:48:58,120 RIGHT. 3808 02:48:58,120 --> 02:49:01,040 IT'S A SILOED KIND OF APPROACH 3809 02:49:01,040 --> 02:49:03,320 AND ONLY IN RESPONSE TO A 3810 02:49:03,320 --> 02:49:07,640 SPECIFIC RFA OR PAR AND GET ALL 3811 02:49:07,640 --> 02:49:09,600 RESEARCH TO CONSIDER DISPARITIES 3812 02:49:09,600 --> 02:49:11,840 AND UNDERSERVED POPULATIONS IT'S 3813 02:49:11,840 --> 02:49:14,120 JUST RESEARCH AND SO YOU KNOW, 3814 02:49:14,120 --> 02:49:16,480 ALONG THIS LINE EVENTUALLY WE'RE 3815 02:49:16,480 --> 02:49:18,440 GOING TO START -- STOP THINKING 3816 02:49:18,440 --> 02:49:20,920 ABOUT HOW DISPARITIES INTERVENE 3817 02:49:20,920 --> 02:49:23,080 AND JUST INCLUDE THEM FROM THE 3818 02:49:23,080 --> 02:49:24,000 BEGINNING AND SO I DON'T KNOW IF 3819 02:49:24,000 --> 02:49:31,160 I'M MAKING SENSE AS MUCHS -- ALL 3820 02:49:31,160 --> 02:49:31,960 RESEARCH SHOULD CONSIDER 3821 02:49:31,960 --> 02:49:33,080 UNDERSERVED POPULATION AND IF WE 3822 02:49:33,080 --> 02:49:34,440 CAN COMPARE AND LOOK FOR THINGS 3823 02:49:34,440 --> 02:49:35,760 THAT WOULD CONTRIBUTE TO 3824 02:49:35,760 --> 02:49:37,160 DISPARITIES AND IT WOULD BE A 3825 02:49:37,160 --> 02:49:38,200 RESULT OF SOMETHING IT SHOULD BE 3826 02:49:38,200 --> 02:49:42,560 DONE AND ORGANICALLY AND ALL 3827 02:49:42,560 --> 02:49:44,760 RESEARCH BEING DONE. 3828 02:49:44,760 --> 02:49:47,040 >>JUST IN CASE WE DON'T KNOW, 3829 02:49:47,040 --> 02:49:48,960 THERE'S DEMOGRAPHICS TRANSITION 3830 02:49:48,960 --> 02:49:50,520 THAT'S OCCUR IN AMERICA RIGHT 3831 02:49:50,520 --> 02:49:51,240 NOW. 3832 02:49:51,240 --> 02:49:53,320 WE'RE NOW A NATION WHERE THE 3833 02:49:53,320 --> 02:49:54,840 MINORITY ARE THE MAJORITIES AND 3834 02:49:54,840 --> 02:49:57,480 WE'RE A NATION WHERE OUR OLDER 3835 02:49:57,480 --> 02:49:58,920 SEGMENT POPULATION CONTINUES TO 3836 02:49:58,920 --> 02:50:00,600 LIVE LONGER AND LONGER THAT'S 3837 02:50:00,600 --> 02:50:01,680 BECAUSE OF THE ADVANCES WE HAVE 3838 02:50:01,680 --> 02:50:05,240 AND IF YOU PUT AT THE NEXUS OF 3839 02:50:05,240 --> 02:50:06,800 BOTH OF THOSE, WE'LL SEE THE 3840 02:50:06,800 --> 02:50:12,400 NATION EVENING HEAL'S HEALTH ISE 3841 02:50:12,400 --> 02:50:12,880 MINORITIES. 3842 02:50:12,880 --> 02:50:15,240 TO MOVE FORWARD AND THINK ABOUT 3843 02:50:15,240 --> 02:50:17,360 DISPARITIES, BY DEFAULT WE THINK 3844 02:50:17,360 --> 02:50:18,840 THERE'S A COMPARISON AND WE WANT 3845 02:50:18,840 --> 02:50:22,040 TO THINK BROADER AND WE WANT TO 3846 02:50:22,040 --> 02:50:24,440 THINK ABOUT HAVING INCLUSIVE 3847 02:50:24,440 --> 02:50:26,040 POPULATIONS TO BE ABLE TO 3848 02:50:26,040 --> 02:50:27,320 UNDERSTAND AND BE ABLE TO 3849 02:50:27,320 --> 02:50:31,400 SUFFICIENT SAMPLE SIZE TO STUDY 3850 02:50:31,400 --> 02:50:40,320 GROUPS AND SO WE NEED TO AND WE 3851 02:50:40,320 --> 02:50:41,640 WANT TO HAVE ALL MARKERS AND ALL 3852 02:50:41,640 --> 02:50:44,320 GROUPS SO WE DON'T JUST WANT ONE 3853 02:50:44,320 --> 02:50:46,240 GROUP WHERE THEY'RE HIGH AND 3854 02:50:46,240 --> 02:50:47,560 BIOSPECIMENS AND WE WANT A 3855 02:50:47,560 --> 02:50:48,960 BIOMEDICAL BANK WITH EQUAL 3856 02:50:48,960 --> 02:50:50,440 REPRESENTATION AND IT'S POWER TO 3857 02:50:50,440 --> 02:50:54,680 ANSWER ANY SCIENTIFIC INQUIRY IY 3858 02:50:54,680 --> 02:50:56,080 THAT WE WANT. 3859 02:50:56,080 --> 02:50:57,640 >>THOMAS. 3860 02:50:57,640 --> 02:51:00,240 WE ARE PART OF A GROUP THAT IS 3861 02:51:00,240 --> 02:51:03,520 TRYING TO DEVELOP A TRIPLET OF 3862 02:51:03,520 --> 02:51:05,480 GENERIC DRUGS AND AN ESSENTIAL 3863 02:51:05,480 --> 02:51:08,880 AMINO ACID SO IT COULD BE 3864 02:51:08,880 --> 02:51:13,000 ACCESSIBLE AND CHEAP FOR VARIOUS 3865 02:51:13,000 --> 02:51:14,760 CARDIOMETABOLIC BENEFITS. 3866 02:51:14,760 --> 02:51:18,160 WE HAVE PHASE 2 DATA ON OBESITY 3867 02:51:18,160 --> 02:51:20,680 AND BLOOD PRESSURE, 3868 02:51:20,680 --> 02:51:22,960 HYPERTENSION, VERY INTRIGUINGLY, 3869 02:51:22,960 --> 02:51:26,600 OUR PHASE 2 DATA SHOWED IT TO BE 3870 02:51:26,600 --> 02:51:27,760 DOUBLE LEE EFFECTIVE IN AFRICAN 3871 02:51:27,760 --> 02:51:28,480 AMERICANS. 3872 02:51:28,480 --> 02:51:30,240 WE DON'T HAVE GENOMIC DATA ON 3873 02:51:30,240 --> 02:51:31,800 THIS BUT WE'RE HAVING AN 3874 02:51:31,800 --> 02:51:32,760 INTERNAL DEBATE ABOUT HOW MUCH 3875 02:51:32,760 --> 02:51:35,800 TO FOCUS ON THIS FEATURE, PEOPLE 3876 02:51:35,800 --> 02:51:38,280 REFLECT BACK ON THE BUY 3877 02:51:38,280 --> 02:51:40,400 EXPERIENCE AND IT COULD BE 3878 02:51:40,400 --> 02:51:41,640 SOMEWHAT CONTROVERSIAL AND I'M 3879 02:51:41,640 --> 02:51:45,760 JUST CURIOUS TO ASK THIS PANEL, 3880 02:51:45,760 --> 02:51:47,120 ABOUT THE HEALTH EQUITY AND 3881 02:51:47,120 --> 02:51:49,440 ACCESS AND HEALTHY LONGEVITY ARE 3882 02:51:49,440 --> 02:51:51,560 MORE INFLUENTIAL AND MORE 3883 02:51:51,560 --> 02:51:52,960 PREVALENT IN THE COMMON 3884 02:51:52,960 --> 02:51:55,600 DISCOURSE, DO YOU THINK THAT 3885 02:51:55,600 --> 02:51:57,480 THIS FEATURE IN OUR DEVELOPMENT 3886 02:51:57,480 --> 02:51:59,160 PROGRAM IS SOMETHING THAT 3887 02:51:59,160 --> 02:52:02,840 DESERVES SPECIAL MENTION OR 3888 02:52:02,840 --> 02:52:08,880 FOCUS? 3889 02:52:08,880 --> 02:52:11,640 >>I THINK CERTAINLY IF YOU ARE 3890 02:52:11,640 --> 02:52:12,280 OBSERVE NORTH MARKED DIFFERENCE 3891 02:52:12,280 --> 02:52:17,040 THAN FURTHER INTERROGATION IS 3892 02:52:17,040 --> 02:52:19,080 WARRANTED. 3893 02:52:19,080 --> 02:52:19,720 ANYTHING THAT GETS PUT OUT INTO 3894 02:52:19,720 --> 02:52:26,280 A CLINICAL TRIAL OR OUT INTO THE 3895 02:52:26,280 --> 02:52:28,440 COMMUNITY PATIENTS SHOULD KNOW 3896 02:52:28,440 --> 02:52:32,040 WHAT THE DATA SUPPORTED AND HOW 3897 02:52:32,040 --> 02:52:32,760 THEY'LL RESPOND. 3898 02:52:32,760 --> 02:52:34,400 IT'S AN INTERESTING FINDING SO 3899 02:52:34,400 --> 02:52:36,360 JUST FOR THAT ALONE, I THINK 3900 02:52:36,360 --> 02:52:38,160 LOOKING INTO IT MORE. 3901 02:52:38,160 --> 02:52:40,360 I WOULD CAUTION WE'RE CERTAINLY 3902 02:52:40,360 --> 02:52:42,440 NOT SUPPORTIVE OF RACE BASED 3903 02:52:42,440 --> 02:52:44,080 MEDICINE. 3904 02:52:44,080 --> 02:52:45,760 WE DON'T GO INTO ANY STUDIES 3905 02:52:45,760 --> 02:52:46,920 WITH THAT INTENTION THAT WE'RE 3906 02:52:46,920 --> 02:52:48,800 GOING TO FIND A MEDICATION THAT 3907 02:52:48,800 --> 02:52:50,800 WILL WORK BETTER OR WORSE AND 3908 02:52:50,800 --> 02:52:52,320 ONE POPULATION BUT WE WANT TO 3909 02:52:52,320 --> 02:52:54,360 KNOW HOW THEY ALL WORK AND ALL 3910 02:52:54,360 --> 02:52:56,160 POPULATIONS TO MAKE SURE THAT 3911 02:52:56,160 --> 02:52:57,480 PERSONALIZED MEDICINE IS REALLY 3912 02:52:57,480 --> 02:52:58,200 ADVANCED. 3913 02:52:58,200 --> 02:52:59,760 SO, I WOULD FOLLOW-UP ON IT JUST 3914 02:52:59,760 --> 02:53:05,680 TO SEE IF IT'S REAL AND I DON'T 3915 02:53:05,680 --> 02:53:07,000 KNOW IF APPROXIMATE OTHERS HAVE 3916 02:53:07,000 --> 02:53:07,280 ANYTHING. 3917 02:53:07,280 --> 02:53:08,480 >>YEAH, JUST THE CAUTION, 3918 02:53:08,480 --> 02:53:08,960 RIGHT. 3919 02:53:08,960 --> 02:53:11,440 I THINK A NEW REPORT FROM THE 3920 02:53:11,440 --> 02:53:14,240 NATIONAL ACADEMY OF MEDICINE OF 3921 02:53:14,240 --> 02:53:15,880 PARTIALLY SUPPORTED BY THE NIH 3922 02:53:15,880 --> 02:53:19,320 MOVING AWAY FROM RACE, 3923 02:53:19,320 --> 02:53:22,520 SELF-REPORTED RACE TO GENETIC 3924 02:53:22,520 --> 02:53:23,960 MARKERS BECAUSE IT IS, WE DO 3925 02:53:23,960 --> 02:53:25,760 WANT TO CAUTION AGAINST, WE KNOW 3926 02:53:25,760 --> 02:53:28,760 RACE IS A SOCIAL CONSTRUCT AND 3927 02:53:28,760 --> 02:53:30,640 DOES NOT ADEQUATELY CAPTURE 3928 02:53:30,640 --> 02:53:32,480 GENETIC VARIABILITIES SO I WOULD 3929 02:53:32,480 --> 02:53:34,360 BE CAUTIOUS IN TERMS OF 3930 02:53:34,360 --> 02:53:35,720 INTERPRETATION BUT AGREE WITH 3931 02:53:35,720 --> 02:53:42,440 LOOKING INTO IT FURTHER. 3932 02:53:42,440 --> 02:53:43,400 >>DO YOU HAVE ANYTHING Dr. 3933 02:53:43,400 --> 02:53:43,640 LAWRENCE? 3934 02:53:43,640 --> 02:53:44,960 >>NOTHING MORE TO ADD. 3935 02:53:44,960 --> 02:53:48,760 I THINK Dr. ZENK HAD IT ALL. 3936 02:53:48,760 --> 02:53:50,320 I'M HAVING TROUBLE HEARING YOU. 3937 02:53:50,320 --> 02:53:51,840 I DON'T KNOW IF YOU ARE HAVING 3938 02:53:51,840 --> 02:53:52,480 TROUBLE HEARING ME. 3939 02:53:52,480 --> 02:53:54,240 I WAS GOING TO ACTUALLY MAKE A 3940 02:53:54,240 --> 02:53:57,960 COMMENT ABOUT THE NATIONAL 3941 02:53:57,960 --> 02:54:04,520 ACADEMY AND NEWLY LINKING 3942 02:54:04,520 --> 02:54:06,840 AGAINST TO GENETICS RATHER THAN 3943 02:54:06,840 --> 02:54:07,440 RACE. 3944 02:54:07,440 --> 02:54:11,120 HAVING SERVED ON THE H3 AFRICA 3945 02:54:11,120 --> 02:54:15,600 PANEL IT'S CLEAR THAT RACE IS A 3946 02:54:15,600 --> 02:54:17,120 SOCIAL CONSTRUCT AND GENETICS 3947 02:54:17,120 --> 02:54:19,240 TELLS A VERY DIFFERENT STORY 3948 02:54:19,240 --> 02:54:22,040 SOMETIMES SO I WOULD JUST ECHO 3949 02:54:22,040 --> 02:54:25,560 WHAT SHE SAID AND EXPLORE IT BUT 3950 02:54:25,560 --> 02:54:27,840 BE CAUTIOUS. 3951 02:54:27,840 --> 02:54:29,240 >>THANK YOU SO MUCH. 3952 02:54:29,240 --> 02:54:30,200 WE'RE AT TIME NOW. 3953 02:54:30,200 --> 02:54:33,760 I WANT TO THANK ALL THE 3954 02:54:33,760 --> 02:54:34,720 PANELISTS, THANK THE SPEAKERS 3955 02:54:34,720 --> 02:54:38,000 AND THE PAN PANELISTS FOR A JOB 3956 02:54:38,000 --> 02:54:39,120 WELL DONE. 3957 02:54:39,120 --> 02:54:44,800 JOIN ME IN A ROUND OF APPLAUSE 3958 02:54:44,800 --> 02:54:46,440 FOR THEM. 3959 02:54:46,440 --> 02:54:48,600 LUNCH OR YOUR OWN AND I START 3960 02:54:48,600 --> 02:54:52,040 SESSION 2 AT 12:45. 3961 02:54:52,040 --> 02:54:52,560 12:45. 3962 02:54:52,560 --> 02:54:53,960 BE BACK HERE READY TO GO. 3963 02:54:53,960 --> 02:54:54,240 BON APPETITE. 3964 02:54:54,240 --> 02:54:57,720 WELCOME BACK. 3965 02:54:57,720 --> 02:55:00,520 IT'S HARD TO MEETING OF THE 3966 02:55:00,520 --> 02:55:02,080 COLLEAGUES SO I APPRECIATE YOU 3967 02:55:02,080 --> 02:55:07,160 BEING HERE. 3968 02:55:07,160 --> 02:55:11,280 IT'S MY GREAT PLEASURE TO BE 3969 02:55:11,280 --> 02:55:14,840 HERE AND CHAIR THIS SESSION ON 3970 02:55:14,840 --> 02:55:16,160 HIGH AND LOW BURDENS OF 3971 02:55:16,160 --> 02:55:18,840 FUNCTIONAL DEFICITS AND 3972 02:55:18,840 --> 02:55:19,640 MORBIDITIES. 3973 02:55:19,640 --> 02:55:20,760 WHAT I THOUGHT I WOULD DO IS 3974 02:55:20,760 --> 02:55:21,960 INTRODUCE ALL THE AMAZING 3975 02:55:21,960 --> 02:55:24,880 SPEAKERS WE HAVE LINED UP TODAY 3976 02:55:24,880 --> 02:55:26,440 AND THEN I WILL HAND OFF TO THEM 3977 02:55:26,440 --> 02:55:27,960 AND WE'LL COME BACK AND DO A 3978 02:55:27,960 --> 02:55:29,480 LITTLE PANEL DISCUSSION. 3979 02:55:29,480 --> 02:55:33,680 OUR SPEAKERS FOR TODAY ARE Dr. 3980 02:55:33,680 --> 02:55:37,480 SOFIYA MILMAN THE ASSOCIATE 3981 02:55:37,480 --> 02:55:38,520 PROFESSOR DEPARTMENT OF MEDICINE 3982 02:55:38,520 --> 02:55:41,720 AT ALBERT EINSTEIN COLLEGE OF 3983 02:55:41,720 --> 02:55:45,160 MEDICINE AND SHE'S GOING TO TALK 3984 02:55:45,160 --> 02:55:46,200 ABOUT SEN NAN ARYANS AND THOSE 3985 02:55:46,200 --> 02:55:48,800 WITH EXCEPTIONAL AGING AND THOSE 3986 02:55:48,800 --> 02:55:49,480 WHO HIT 100. 3987 02:55:49,480 --> 02:55:53,040 I HAVE A FEW PATIENTS WHO ARE 3988 02:55:53,040 --> 02:55:55,600 LIKE THAT AND Dr. IS MICHAEL 3989 02:55:55,600 --> 02:55:57,480 GURVEN A PROFESSOR IN THE 3990 02:55:57,480 --> 02:56:00,920 DEPARTMENT OF ANTHROPOLOGY AT 3991 02:56:00,920 --> 02:56:03,080 UCSB IN SANTA BARBARA AND HE 3992 02:56:03,080 --> 02:56:06,360 WILL TALK ABOUT AGING IN 3993 02:56:06,360 --> 02:56:07,640 NON-INDUSTRY AMIZED CONTEXT AND 3994 02:56:07,640 --> 02:56:11,760 THE LESSONS WE CAN LEARN FROM 3995 02:56:11,760 --> 02:56:12,640 INDIGENOUS POPULATIONS. 3996 02:56:12,640 --> 02:56:16,160 FOLLOWING IS CHRISTINE ERLANDSON 3997 02:56:16,160 --> 02:56:17,760 SHE'S AN ASSOCIATE PROFESSOR OF 3998 02:56:17,760 --> 02:56:19,600 MEDICINE AND INFECTIOUS DISEASES 3999 02:56:19,600 --> 02:56:20,800 AT UNIVERSITY OF COLORADO AND 4000 02:56:20,800 --> 02:56:26,240 SHE WILL TALK ABOUT THE IMPACT 4001 02:56:26,240 --> 02:56:28,240 OF HIV AND AGING. 4002 02:56:28,240 --> 02:56:31,880 AFTER CHRISTINE IS MINA SEDRAK A 4003 02:56:31,880 --> 02:56:34,720 MEDICAL ONCOLOGIST AND THE 4004 02:56:34,720 --> 02:56:35,800 DEPUTY DIRECTOR OF CLINICAL 4005 02:56:35,800 --> 02:56:38,040 TRIALS AT THE CITY OF HOPE AND 4006 02:56:38,040 --> 02:56:40,520 HE IS GOING TO TALK ABOUT CANCER 4007 02:56:40,520 --> 02:56:42,680 AND ACCELERATED AGING AND HOW 4008 02:56:42,680 --> 02:56:45,040 CANCER AND THE CANCER TREATMENT 4009 02:56:45,040 --> 02:56:47,080 IMPACT ON MODERATING THE AGING 4010 02:56:47,080 --> 02:56:52,000 PROCESS AND THEN WE HAVE Dr. 4011 02:56:52,000 --> 02:56:54,720 NATHAN BRUMMEL A PULL 4012 02:56:54,720 --> 02:56:56,160 MINUTOLOGIST WHO IS GOING TO 4013 02:56:56,160 --> 02:57:00,440 TALK ABOUT THE POST ICU SYNDROME 4014 02:57:00,440 --> 02:57:03,680 AND ICU SE SUR RIVER AND THE IMT 4015 02:57:03,680 --> 02:57:06,440 OF A LONGER STAY LIFE AT AGING 4016 02:57:06,440 --> 02:57:06,920 PROCESS. 4017 02:57:06,920 --> 02:57:08,840 AFTER THE SPEAKERS WE HAVE DID 4018 02:57:08,840 --> 02:57:11,720 LEON MCDOOGLE WHO IS THE PAST 4019 02:57:11,720 --> 02:57:13,240 PRESIDENT OF THE NATIONAL 4020 02:57:13,240 --> 02:57:14,560 MEDICAL ASSOCIATION WHO IS GOING 4021 02:57:14,560 --> 02:57:19,360 TO GIVE US AN OVERVIEW OF 4022 02:57:19,360 --> 02:57:19,960 HOLISTIC GEROSCIENCE SCIENCE 4023 02:57:19,960 --> 02:57:20,960 APPROACHES AND INTERSECTIONAL 4024 02:57:20,960 --> 02:57:23,840 DIMENSIONS OF HEALTH AND 4025 02:57:23,840 --> 02:57:24,880 WELL-BEING. 4026 02:57:24,880 --> 02:57:26,920 USE USING THE 5A FRAMEWORK OF 4027 02:57:26,920 --> 02:57:28,600 AVAILABILITY ACCESSIBILITY, 4028 02:57:28,600 --> 02:57:30,840 ACCOMMODATION, AFFORDABILITY AND 4029 02:57:30,840 --> 02:57:31,640 ACCEPTABILITY. 4030 02:57:31,640 --> 02:57:35,040 AND AFTER THAT I WILL DO A 4031 02:57:35,040 --> 02:57:36,040 SUMMARY DISCUSSION. 4032 02:57:36,040 --> 02:57:42,760 MY NAME IS VY PERIYAKOIL FROM 4033 02:57:42,760 --> 02:57:44,440 SANFORD WHERE I SERVE AS THE 4034 02:57:44,440 --> 02:57:48,280 ASSOCIATE DEAN OF RESEARCH AND I 4035 02:57:48,280 --> 02:57:50,480 ALSO WORK AT THE PALO ALTO 4036 02:57:50,480 --> 02:57:51,720 HEALTH-CARE SYSTEM AS A CHIEF 4037 02:57:51,720 --> 02:57:52,040 STAFF. 4038 02:57:52,040 --> 02:57:57,280 I'M SO PLEASED TO BE HERE AND 4039 02:57:57,280 --> 02:58:00,760 IT'S OFF SO SOFIYA. 4040 02:58:00,760 --> 02:58:02,520 >>GOOD AFTERNOON, EVERYONE, I'M 4041 02:58:02,520 --> 02:58:04,800 REALLY EXCITED TO BE HERE. 4042 02:58:04,800 --> 02:58:05,240 I ENJOYED THE TALKS THIS MORNING 4043 02:58:05,240 --> 02:58:07,520 AND I'M LOOKING FORWARD TO THE 4044 02:58:07,520 --> 02:58:08,320 TALKS COMING UP. 4045 02:58:08,320 --> 02:58:09,560 SO TODAY I'LL TELL YOU ABOUT THE 4046 02:58:09,560 --> 02:58:12,960 WORK THAT WE'VE BEEN DOING 4047 02:58:12,960 --> 02:58:15,800 FOCUSED ON CENTENARIANS THAT ARE 4048 02:58:15,800 --> 02:58:18,800 A POPULATION OF EXCEPTIONAL 4049 02:58:18,800 --> 02:58:19,200 AGING. 4050 02:58:19,200 --> 02:58:20,600 AS WE'VE HEARD THIS MORNING, AND 4051 02:58:20,600 --> 02:58:25,200 MOST OF US KNOW, AGE ASKING A 4052 02:58:25,200 --> 02:58:26,680 MAJOR RISK FACTORS AND AIMING 4053 02:58:26,680 --> 02:58:29,120 RELATED DISEASES SUCH AS THAT 4054 02:58:29,120 --> 02:58:30,560 THE INCIDENTS OF DISEASE THAT'S 4055 02:58:30,560 --> 02:58:35,160 WE ASSOCIATE WITH OLDER AGE LIKE 4056 02:58:35,160 --> 02:58:37,000 CONGESTIVE HEART DISEASE, 4057 02:58:37,000 --> 02:58:39,560 DIABETES, DEMENTIA WILL RISE 4058 02:58:39,560 --> 02:58:41,120 WITH AGING EXPONENTIALLY. 4059 02:58:41,120 --> 02:58:46,440 SO THE WAY THE STATE CURRENTLY 4060 02:58:46,440 --> 02:58:50,000 IS, IS WE FIND THAT PEOPLE OFTEN 4061 02:58:50,000 --> 02:58:51,600 HAVE TO DEAL WITH CHRONIC 4062 02:58:51,600 --> 02:58:54,560 CONDITIONS AND DISABILITY FOR 20 4063 02:58:54,560 --> 02:58:56,200 TO 30 YEARS OF THEIR LIFE. 4064 02:58:56,200 --> 02:59:01,080 AND SO, IF WE LOOK AT THE TOP 4065 02:59:01,080 --> 02:59:08,040 BAR HERE, THE ENTIRETY OF THE 4066 02:59:08,040 --> 02:59:14,800 BAR REPRESENTS IT'S THE TIME OF 4067 02:59:14,800 --> 02:59:15,440 LIFE INDIVIDUAL EVENTS FREE OF 4068 02:59:15,440 --> 02:59:17,160 DISEASE AND THE ONSET OF AGE 4069 02:59:17,160 --> 02:59:21,160 RELATED DISEASES OR CHRONIC 4070 02:59:21,160 --> 02:59:22,600 DISEASES SO WHAT WE'RE HOPING TO 4071 02:59:22,600 --> 02:59:25,440 ACHIEVE IS WE WANT TO SEE A 4072 02:59:25,440 --> 02:59:27,800 COMPRESSION OF MORBIDITY AND THE 4073 02:59:27,800 --> 02:59:29,000 PERIOD OF LIFE A INDIVIDUAL 4074 02:59:29,000 --> 02:59:30,360 SPENDS IN CHRONIC DISEASE IS 4075 02:59:30,360 --> 02:59:33,600 ACTUALLY COMPRESSED OR 4076 02:59:33,600 --> 02:59:34,040 SHORTENED. 4077 02:59:34,040 --> 02:59:35,680 WE EXTEND THE LIFESPAN TOO IN 4078 02:59:35,680 --> 02:59:36,960 THE PROCESS, I DON'T THINK WE 4079 02:59:36,960 --> 02:59:38,880 MIND AS LONG AS THE PERIOD OF 4080 02:59:38,880 --> 02:59:41,080 MORBIDITY REMAINS SHORT. 4081 02:59:41,080 --> 02:59:43,680 NOW, IS THIS A REALISTIC IDEA OR 4082 02:59:43,680 --> 02:59:47,560 IS THIS SORT OF A PIE IN THE SKY 4083 02:59:47,560 --> 02:59:49,480 AND I WOULD ARGUE AND ACTUALLY 4084 02:59:49,480 --> 02:59:52,160 PRESENT EVIDENCE THAT THIS IS A 4085 02:59:52,160 --> 02:59:55,000 VERY REALISTIC BY LOGICALLY 4086 02:59:55,000 --> 02:59:57,720 PLAUSIBLE CONCEPT AND THAT IS 4087 02:59:57,720 --> 02:59:59,760 BECAUSE WE HAVE PEOPLE AMONG US, 4088 02:59:59,760 --> 03:00:02,240 RIGHT, PEOPLE WHO LIVE VERY LONG 4089 03:00:02,240 --> 03:00:06,040 LIVES, CENTENARIANS AND SUPER 4090 03:00:06,040 --> 03:00:07,640 CENTENARIAN WHO DON'T LIVE TO 4091 03:00:07,640 --> 03:00:14,680 AGE 100 AND BEYOND BUT MAINTAIN 4092 03:00:14,680 --> 03:00:16,720 THEIR HEALTH FOR THE ENTIRETY OF 4093 03:00:16,720 --> 03:00:17,320 THEIR LIVES. 4094 03:00:17,320 --> 03:00:19,440 WE'RE LOOKING FOR DISEASE FREE 4095 03:00:19,440 --> 03:00:20,920 SURVIVAL CURVES FOR PEOPLE WITH 4096 03:00:20,920 --> 03:00:23,760 DIFFERENT LIFE SPANS AND THE 4097 03:00:23,760 --> 03:00:24,440 TEAL CURVE REPRESENTS PEOPLE WHO 4098 03:00:24,440 --> 03:00:28,080 LIVE TO AGE 110 OR OLDER. 4099 03:00:28,080 --> 03:00:30,920 THE BLUE CURVE ARE PEOPLE AGE 4100 03:00:30,920 --> 03:00:32,880 105 AND SO ON AND THEY'RE BEING 4101 03:00:32,880 --> 03:00:34,440 COMPARED TO PEOPLE WHO HAVE AN 4102 03:00:34,440 --> 03:00:36,600 AVERAGE LIFESPAN AND THAT'S THE 4103 03:00:36,600 --> 03:00:38,680 BLACK CURVE. 4104 03:00:38,680 --> 03:00:40,240 AND WHAT WE'RE SEEING HERE IS 4105 03:00:40,240 --> 03:00:43,880 THAT THESE PEOPLE DELAY THE 4106 03:00:43,880 --> 03:00:45,800 ONSET OF AGE RELATED MORBIDITY 4107 03:00:45,800 --> 03:00:48,000 AND THIS IS A COMBINATION OF ONE 4108 03:00:48,000 --> 03:00:49,440 OR MORE OF THE FOLLOWING 4109 03:00:49,440 --> 03:00:59,960 DISEASES, CANCER, DIABETES AND 4110 03:01:13,840 --> 03:01:18,000 WE HAVE TO BE CAREFUL WHEN WE DO 4111 03:01:18,000 --> 03:01:21,040 THAT BECAUSE WE'RE FINDING 4112 03:01:21,040 --> 03:01:22,120 CENTENARIANS AT THE END OF THEIR 4113 03:01:22,120 --> 03:01:24,160 LIVES SO THEY'RE 100 AND MAYBE 4114 03:01:24,160 --> 03:01:27,200 THEY HAVE 10 MORE YEARS TO LIVE, 4115 03:01:27,200 --> 03:01:27,800 RIGHT. 4116 03:01:27,800 --> 03:01:29,080 THEY'VE ALREADY LIVED 100 YEARS 4117 03:01:29,080 --> 03:01:32,160 SO IN REALITY THEY'RE CLOSER TO 4118 03:01:32,160 --> 03:01:33,440 DEATH THAN THEY ARE TO THE 4119 03:01:33,440 --> 03:01:37,400 BEGINNING OF LIFE. 4120 03:01:37,400 --> 03:01:39,600 WHEN WE'RE MEASURING DIFFERENT 4121 03:01:39,600 --> 03:01:41,080 BIOLOGICAL PARAMETERS IN THE 4122 03:01:41,080 --> 03:01:43,840 BLOOD OF CENTENARIANS WE HAVE TO 4123 03:01:43,840 --> 03:01:46,080 ASK OURSELVES, IS THIS TO 4124 03:01:46,080 --> 03:01:47,240 EXPLAIN HOW THEY GOT HERE AND IS 4125 03:01:47,240 --> 03:01:49,360 IT A LONGEVITY PARAMETER THAT 4126 03:01:49,360 --> 03:01:51,880 ALLOWS THEM TO BE A CENTENARIAN 4127 03:01:51,880 --> 03:01:54,080 OR IS IT A FACTOR THAT IS 4128 03:01:54,080 --> 03:01:56,440 PREDICTING THEIR MORTALITY AND 4129 03:01:56,440 --> 03:01:59,520 THAT'S COMING VERY SOON. 4130 03:01:59,520 --> 03:02:00,800 SO THOSE ARE THINGS WE HAVE TO 4131 03:02:00,800 --> 03:02:03,120 KEEP IN MIND. 4132 03:02:03,120 --> 03:02:06,240 AND THIS IS AN EXAMPLE OF HOW WE 4133 03:02:06,240 --> 03:02:07,920 APPROACH OUR RESEARCH. 4134 03:02:07,920 --> 03:02:10,760 WHEN WE LOOK AT PHENOTYPES IN 4135 03:02:10,760 --> 03:02:12,320 THESE POPULATIONS. 4136 03:02:12,320 --> 03:02:16,320 SO HERE WE'RE LOOKING AT AVERAGE 4137 03:02:16,320 --> 03:02:18,240 AGE OF CHOLESTEROL LEVELS AND 4138 03:02:18,240 --> 03:02:20,240 MEN AND WOMEN AND NOT 4139 03:02:20,240 --> 03:02:21,440 CENTENARIANS COMPARED TO A 4140 03:02:21,440 --> 03:02:24,240 GENERAL POPULATION AND HAINES 4141 03:02:24,240 --> 03:02:28,760 CONTROL GROUP AND THAT IS 20 TO 4142 03:02:28,760 --> 03:02:29,360 30 YEARS YOUNGER, RIGHT. 4143 03:02:29,360 --> 03:02:37,000 IF WE LOOK AT THE SE CENTENARIAS 4144 03:02:37,000 --> 03:02:47,520 AND WELL WHO WERE BORN DURING 4145 03:02:53,440 --> 03:02:54,760 THE SAME TIME AS THEY WERE BUT 4146 03:02:54,760 --> 03:02:56,520 DID NOT ACHIEVE LONGEVITY AND 4147 03:02:56,520 --> 03:02:58,360 THEY'RE NOT AVAILABLE FOR US TO 4148 03:02:58,360 --> 03:02:59,520 STUDY. 4149 03:02:59,520 --> 03:03:02,200 SO WE HAVE TO COME UP WITH THE 4150 03:03:02,200 --> 03:03:04,520 BEST NEXT APPROACH AND CAN WE 4151 03:03:04,520 --> 03:03:07,320 COMPARE THE POPULATION CONTROLS 4152 03:03:07,320 --> 03:03:10,840 TO THE CHILDREN OF CENTENARIANS 4153 03:03:10,840 --> 03:03:13,800 AND WHY DO WE DO THAT? 4154 03:03:13,800 --> 03:03:18,000 BECAUSE THE OFFSPRING ZENT HAVE 4155 03:03:18,000 --> 03:03:21,280 THE MAKE UP OF THEIR PARENTS SO 4156 03:03:21,280 --> 03:03:24,760 IF IT'S INHERITED WE SHOULD FIND 4157 03:03:24,760 --> 03:03:25,720 SOME LONGEVITY FACTORS 4158 03:03:25,720 --> 03:03:29,000 REPRESENTED IN THE OFFSPRING OF 4159 03:03:29,000 --> 03:03:30,560 OF CENTENARIANS SO THIS IS WHAT 4160 03:03:30,560 --> 03:03:31,120 WE FIND. 4161 03:03:31,120 --> 03:03:33,800 WE FIND THAT THE OFFSPRING OF 4162 03:03:33,800 --> 03:03:34,760 CENTENARIANS WHO ARE AGE 4163 03:03:34,760 --> 03:03:37,600 MATCHED, SO THAT POPULATION 4164 03:03:37,600 --> 03:03:39,720 ENHANCE CONTROL, HAS 4165 03:03:39,720 --> 03:03:43,360 SIGNIFICANTLY HIGHER HDL LEVELS, 4166 03:03:43,360 --> 03:03:44,800 COMPARED TO THESE AGE MATCHED 4167 03:03:44,800 --> 03:03:46,000 CONTROLS, SUGGESTING TO US THAT 4168 03:03:46,000 --> 03:03:49,200 THIS MAY ACTUALLY BE A PHENOTYPE 4169 03:03:49,200 --> 03:03:54,600 OF ASSOCIATED WITH LONGEVITY. 4170 03:03:54,600 --> 03:03:56,920 SO AS I MENTIONED, LONGEVITY 4171 03:03:56,920 --> 03:03:58,920 CENTERS ON IN FAMILIES AND THESE 4172 03:03:58,920 --> 03:04:00,440 ARE FOUR SIBLINGS FROM THE SAME 4173 03:04:00,440 --> 03:04:02,080 FAMILY AND THESE ARE THE SAME 4174 03:04:02,080 --> 03:04:04,120 FOUR SIBLINGS 90 YEARS EARLIER 4175 03:04:04,120 --> 03:04:06,520 AND THE YOUNGEST SISTER LIVED TO 4176 03:04:06,520 --> 03:04:09,080 101 AND THE YOUNGER BOTHER TO 4177 03:04:09,080 --> 03:04:12,120 103 AND THE OLDER SISTER TO 109 4178 03:04:12,120 --> 03:04:21,480 AND THE OLDER BROTHER TO 109. 4179 03:04:21,480 --> 03:04:24,000 IT RUNS AMONG SIBLINGS AND WE 4180 03:04:24,000 --> 03:04:27,400 SEE INHERITANCE IN THE OFFSPRING 4181 03:04:27,400 --> 03:04:29,280 OF CENTENARIANS AND I'M JUST 4182 03:04:29,280 --> 03:04:30,720 SHOWING YOU THE PREVALENCE OF 4183 03:04:30,720 --> 03:04:33,000 DIFFERENT AGE RELATED DISEASES, 4184 03:04:33,000 --> 03:04:36,360 HYPERTENSION, DIABETES AND 4185 03:04:36,360 --> 03:04:38,840 STROKE AND IN CENTENARIANS SHOWN 4186 03:04:38,840 --> 03:04:40,800 IN BLOW IN THE POPULATION 4187 03:04:40,800 --> 03:04:42,280 CONTROLS SHOWN IN RED AND THE 4188 03:04:42,280 --> 03:04:43,840 OFFSPRING OF CENTENARIANS WHO 4189 03:04:43,840 --> 03:04:49,920 ARE AGE MATCHED TO THIS ENHANCED 4190 03:04:49,920 --> 03:04:51,360 CONTROL WE SEE THE OFFSPRING 4191 03:04:51,360 --> 03:04:53,000 HAVE PREVALENCE OF THESE AGE 4192 03:04:53,000 --> 03:04:54,880 RELATED DISEASES. 4193 03:04:54,880 --> 03:04:56,320 SO THEY ARE IN DEED A GOOD 4194 03:04:56,320 --> 03:04:59,520 POPULATION FOR US TO STUDY AS A 4195 03:04:59,520 --> 03:05:04,280 SURROGATE OF CENTENARIANS AND 4196 03:05:04,280 --> 03:05:05,840 RESILIENT TO AGE RELATED 4197 03:05:05,840 --> 03:05:06,600 DISEASES. 4198 03:05:06,600 --> 03:05:08,640 NOW, FAMILIES, CHILDREN AND 4199 03:05:08,640 --> 03:05:10,240 SIBLINGS SHARE THEIR 4200 03:05:10,240 --> 03:05:11,080 ENVIRONMENT, RIGHT. 4201 03:05:11,080 --> 03:05:13,400 AND SO WE SAID WE CAN'T REALLY 4202 03:05:13,400 --> 03:05:14,680 ATTRIBUTE EVERYTHING TO GENETICS 4203 03:05:14,680 --> 03:05:16,280 IF WE DO NOT LOOK AT THE 4204 03:05:16,280 --> 03:05:22,120 ENVIRONMEENVIRONMENVIRONMENT AL. 4205 03:05:22,120 --> 03:05:25,760 HERE WE HAVE THE ENVIRONMENTAL 4206 03:05:25,760 --> 03:05:26,920 EXPOSURE IN LIFESTYLES AND 4207 03:05:26,920 --> 03:05:37,400 CENTENARIANS COMPARED TO SO 4208 03:05:39,840 --> 03:05:42,040 THERE ARE A FEW OF THEM THAT 4209 03:05:42,040 --> 03:05:44,280 BECAME CENTENARIANS AND TO OUR 4210 03:05:44,280 --> 03:05:45,840 SURPRISE, THERE WAS NO 4211 03:05:45,840 --> 03:05:47,320 DIFFERENCES IN TOBACCO USE, 4212 03:05:47,320 --> 03:05:52,320 ALCOHOL CONSUMPTION, REGULAR 4213 03:05:52,320 --> 03:05:55,720 EXERCISE, LOW CALORIE, LOW FAT 4214 03:05:55,720 --> 03:05:56,920 OR LOW SALT DIET. 4215 03:05:56,920 --> 03:05:58,800 WE WENT ON AND COMPARED THE 4216 03:05:58,800 --> 03:06:01,520 LIFESTYLE IN THE CHILDREN OF 4217 03:06:01,520 --> 03:06:04,960 CENTENARIANS TO AN AGE AND SEX 4218 03:06:04,960 --> 03:06:06,400 MATCH CONTEMPORARY CONTROL AND 4219 03:06:06,400 --> 03:06:08,000 THIS IS WORK DONE BY SOMEONE IN 4220 03:06:08,000 --> 03:06:09,560 THE AUDIENCE AND HE DID THIS 4221 03:06:09,560 --> 03:06:10,640 WHEN HE WAS A RECEIPT DEPARTMENT 4222 03:06:10,640 --> 03:06:21,160 WITH US AND NOW HE IS A FACULTY. 4223 03:06:21,680 --> 03:06:23,400 THERE WAS IN DIFFERENCE IN THE 4224 03:06:23,400 --> 03:06:23,680 OFFSPRING. 4225 03:06:23,680 --> 03:06:24,520 THEY WERE SAME IN THE 4226 03:06:24,520 --> 03:06:26,200 EDUCATIONAL ATTAINMENT, SOCIAL 4227 03:06:26,200 --> 03:06:28,800 STRAT US SCORES, NO DIFFERENT IN 4228 03:06:28,800 --> 03:06:32,080 TOBACCO, ALCOHOL, USE OR 4229 03:06:32,080 --> 03:06:32,720 EXERCISE. 4230 03:06:32,720 --> 03:06:34,880 SO THIS REALLY THEN SUGGESTS 4231 03:06:34,880 --> 03:06:37,000 THAT TO US, WE SHOULD BE LOOKING 4232 03:06:37,000 --> 03:06:39,400 AT GENETICS CONTRIBUTORS. 4233 03:06:39,400 --> 03:06:40,920 THAT ALTHOUGH LIFESTYLE IS 4234 03:06:40,920 --> 03:06:43,320 IMPORTANT AND BY NO MEANS AM I 4235 03:06:43,320 --> 03:06:44,640 ADVOCATING FOR US TO START 4236 03:06:44,640 --> 03:06:47,840 SMOKING AND DRINKING, BUT FOR 4237 03:06:47,840 --> 03:06:48,520 THIS PARTICULAR POPULATION WHO 4238 03:06:48,520 --> 03:06:51,960 IS VERY UNIQUE, AND VERY RARE, 4239 03:06:51,960 --> 03:06:53,280 GENETIC FACTORS SEEM TO PLAY A 4240 03:06:53,280 --> 03:06:56,560 MUCH MORE IMPORTANT ROLE THAN 4241 03:06:56,560 --> 03:06:57,120 LIFESTYLE. 4242 03:06:57,120 --> 03:06:59,600 AND SO, HOW DO WE GO ABOUT 4243 03:06:59,600 --> 03:07:01,880 STUDYING GENETICS OR 4244 03:07:01,880 --> 03:07:04,000 SPECIFICALLY IDENTIFYING GENES 4245 03:07:04,000 --> 03:07:05,840 ASSOCIATED WITH LONGEVITY. 4246 03:07:05,840 --> 03:07:11,720 SO THIS IS A SCHEMATIC OF THE AN 4247 03:07:11,720 --> 03:07:16,360 IMAGINARY GENE. 4248 03:07:16,360 --> 03:07:19,840 THE RED LINE REPRESENTS AGING OR 4249 03:07:19,840 --> 03:07:22,640 GENOTYPES SO LET'S ASSUME THAT 4250 03:07:22,640 --> 03:07:24,080 IF A PERSON CARRIES THIS KIND OF 4251 03:07:24,080 --> 03:07:26,680 A GENOTYPE, THEY'RE AT HIGHER 4252 03:07:26,680 --> 03:07:29,400 RISK FOR A DISEASE AND HIGH-RISK 4253 03:07:29,400 --> 03:07:31,520 OF MORTALITY SO AT YOUNGER AGES, 4254 03:07:31,520 --> 03:07:32,520 YOU HAVE A LOT OF PEOPLE 4255 03:07:32,520 --> 03:07:34,760 CARRYING THE GENOTYPES AND IF 4256 03:07:34,760 --> 03:07:36,840 PEOPLE WITH THIS GENOTYPE DIE 4257 03:07:36,840 --> 03:07:45,200 OFF, THERE'S GOING TO BE VERY 4258 03:07:45,200 --> 03:07:47,040 FEW OF THEM WILL BE CARRIERS OF 4259 03:07:47,040 --> 03:07:49,800 THIS GENOTYPE AND ON THE OTHER 4260 03:07:49,800 --> 03:07:52,280 HAND IF YOU HAVE A GENOTYPE THAT 4261 03:07:52,280 --> 03:07:53,640 CONTRIBUTES TO LONGEVITY, YOU 4262 03:07:53,640 --> 03:07:55,960 ARE GOING TO HAVE VERY FEW 4263 03:07:55,960 --> 03:07:57,040 PEOPLE YOUNGER AGES WHO ARE 4264 03:07:57,040 --> 03:07:58,120 CARRYING THIS AGAIN OWE TYPE 4265 03:07:58,120 --> 03:07:59,960 BECAUSE IT'S A VERY RARE 4266 03:07:59,960 --> 03:08:01,760 GENOTYPE AND VERY FEW PEOPLE 4267 03:08:01,760 --> 03:08:03,920 BECOME CENTENARIANS BUT AS 4268 03:08:03,920 --> 03:08:07,120 EVERYBODY ELSE DIES OFF, THE 4269 03:08:07,120 --> 03:08:09,120 GINO TIME TYPE IS MORE AND MORE 4270 03:08:09,120 --> 03:08:10,000 PREVALENT IN THE POPULATION SO 4271 03:08:10,000 --> 03:08:15,360 WHEN YOU LOOK, THEY WILL BE MORE 4272 03:08:15,360 --> 03:08:16,560 COMMON IF YOU LOOK IN THE 4273 03:08:16,560 --> 03:08:21,200 GENERAL POPULATION. 4274 03:08:21,200 --> 03:08:25,240 SO NOW LET ME GIVE YOU A 4275 03:08:25,240 --> 03:08:26,040 SPECIFIC EXAMPLE. 4276 03:08:26,040 --> 03:08:30,280 USING THIS GROWTH HERE MONDAY ON 4277 03:08:30,280 --> 03:08:40,240 PATHWAY. 4278 03:08:40,240 --> 03:08:50,720 RODENTS THAT HAVE MUTATIONS. 4279 03:08:58,800 --> 03:09:02,160 >>WE LOOK AT DIFFERENT GENE 4280 03:09:02,160 --> 03:09:04,080 VARIANTS IN OUR CENTENARIANS 4281 03:09:04,080 --> 03:09:06,720 COMPARED TO GENERAL POPULATION 4282 03:09:06,720 --> 03:09:09,480 CONTROL IN GROWTH HOR MONDAY 4283 03:09:09,480 --> 03:09:10,840 IGF1 AND SLIM PATHWAY AND I'M 4284 03:09:10,840 --> 03:09:13,920 JUST SHOWING YOU AN EXAMPLE OF 4285 03:09:13,920 --> 03:09:15,920 THE RECEPTORS WHERE WE FOUND 4286 03:09:15,920 --> 03:09:21,040 MULTIPLE RARE GENETIC VARIANTS 4287 03:09:21,040 --> 03:09:22,480 IN DIFFERENT SITES BUT WE DID 4288 03:09:22,480 --> 03:09:26,680 THE SAME FOR OTHER PROTEINS AS 4289 03:09:26,680 --> 03:09:27,280 WELL. 4290 03:09:27,280 --> 03:09:29,880 WHEN WE TOOK AN AGO AGREE GET 4291 03:09:29,880 --> 03:09:33,440 THE RARE VARIANTS IN OUR 4292 03:09:33,440 --> 03:09:35,000 CENTENARIANS AND COMPARED IT 4293 03:09:35,000 --> 03:09:36,680 THEN PREVALENCE OF THESE 4294 03:09:36,680 --> 03:09:39,440 VARIANTS IN OUR PRO BEND 4295 03:09:39,440 --> 03:09:41,240 COMPARED TO A GENERAL POPULATION 4296 03:09:41,240 --> 03:09:45,440 CONTROL WE FOUND THAT THE 4297 03:09:45,440 --> 03:09:53,880 CENTENARIANS ARE THE OFFSPRING 4298 03:09:53,880 --> 03:09:55,240 HAVE INHERITED MANY OF THESE 4299 03:09:55,240 --> 03:10:02,000 FROM THEIR PARENTS. 4300 03:10:02,000 --> 03:10:05,920 TO SHOW THAT THESE VARIANTS ARE 4301 03:10:05,920 --> 03:10:16,120 FUNCTIONAL. 4302 03:10:28,160 --> 03:10:30,080 >>CARRYING THESE RISKS AND 4303 03:10:30,080 --> 03:10:31,520 THESE VARIANTS ARE RISK FACTORS 4304 03:10:31,520 --> 03:10:33,880 FOR LONGEVITY SO WE TOOK A 4305 03:10:33,880 --> 03:10:36,200 POPULATION OF OLDER ADULTS, AGE 4306 03:10:36,200 --> 03:10:39,520 65 AND OLDER WHOM WE FOLLOWED 4307 03:10:39,520 --> 03:10:40,960 PROSPECTIVELY AND DIVIDED THEM 4308 03:10:40,960 --> 03:10:42,160 INTO TWO GROUPS WITH VARIANT 4309 03:10:42,160 --> 03:10:44,040 WITHOUT A VARIANT AND WE FOUND 4310 03:10:44,040 --> 03:10:45,360 THAT THOSE WHO CARRIED ONE OR 4311 03:10:45,360 --> 03:10:50,640 MORE OF THESE VARIANTS, ACTUALLY 4312 03:10:50,640 --> 03:10:53,800 LIVED LONGER AND WHEN WE DID 4313 03:10:53,800 --> 03:10:55,200 ANNA JUST, WHEN WE RAN ANNA 4314 03:10:55,200 --> 03:10:57,000 JUSTED MODEL WE FOUND THAT 4315 03:10:57,000 --> 03:10:59,280 HAVING A VARIANT IN ONE OF THE 4316 03:10:59,280 --> 03:11:00,680 GENES IN THIS PATHWAY WAS 4317 03:11:00,680 --> 03:11:02,760 ACTUALLY ASSOCIATED WITH 4318 03:11:02,760 --> 03:11:04,000 SIGNIFICANT PROTECTION AND 4319 03:11:04,000 --> 03:11:06,600 REDUCTION HAZARD FOR MORTALITY 4320 03:11:06,600 --> 03:11:08,000 SUGGESTING THAT IN DEED THIS 4321 03:11:08,000 --> 03:11:10,720 PATHWAY LIKELY IS BENEFICIAL FOR 4322 03:11:10,720 --> 03:11:15,080 LONGEVITY IN HUMANS AS WELL. 4323 03:11:15,080 --> 03:11:16,960 SO WHERE DOES THAT LEAVE US? 4324 03:11:16,960 --> 03:11:18,560 WELL, NOW THAT WE KNOW THAT OR 4325 03:11:18,560 --> 03:11:21,800 AS WE FIND OTHER GENES AND 4326 03:11:21,800 --> 03:11:24,440 BIOLOGICAL PATHWAYS RELEVANT FOR 4327 03:11:24,440 --> 03:11:26,360 HEALTHY AGING AND LONGEVITY WE 4328 03:11:26,360 --> 03:11:27,640 CAN INTERVENE RIGHT. 4329 03:11:27,640 --> 03:11:30,040 WE CAN EITHER DESIGN 4330 03:11:30,040 --> 03:11:30,920 PHARMACOLOGICAL AGENTS OR 4331 03:11:30,920 --> 03:11:33,360 THOUSANDS THOSE THAT ARE READY 4332 03:11:33,360 --> 03:11:36,280 AVAILABLE AND ARE DISPOSAL TO 4333 03:11:36,280 --> 03:11:43,000 TRY AND ACT ON THOSE PATHWAYS. 4334 03:11:43,000 --> 03:11:44,520 THESE ARE DATA APPROVED DRUGS 4335 03:11:44,520 --> 03:11:48,640 THAT BLOCK THE ACCESS AND WE 4336 03:11:48,640 --> 03:11:50,320 HAVE ANNA LOGS AND TAKE THIS 4337 03:11:50,320 --> 03:11:52,320 AMOUNT WHICH BLOCKS THE GROWTH 4338 03:11:52,320 --> 03:11:53,440 HORMONE RECEPTORS AND THESE ARE 4339 03:11:53,440 --> 03:11:55,440 ALL APPROVED FOR THE USE AND A 4340 03:11:55,440 --> 03:11:57,920 CONDITION WHERE THERE'S ACCESS 4341 03:11:57,920 --> 03:12:00,000 GROWTH HORMONES SECRETION FROM 4342 03:12:00,000 --> 03:12:03,000 THE PEW TARRY AND AN ANTI GF1 4343 03:12:03,000 --> 03:12:04,960 AND A ANTIBODY THAT WAS 4344 03:12:04,960 --> 03:12:06,160 DEVELOPED BY SEVERAL 4345 03:12:06,160 --> 03:12:06,640 PHARMACEUTICAL COMPANIES 4346 03:12:06,640 --> 03:12:08,920 ALTHOUGH IT'S NOT FDA APPROVED 4347 03:12:08,920 --> 03:12:10,800 BECAUSE IT FEELS CLINICAL TRIALS 4348 03:12:10,800 --> 03:12:15,240 AS A CANCER DRUG BUT THERE WAS 4349 03:12:15,240 --> 03:12:17,040 DEVELOPMENT OF IT. 4350 03:12:17,040 --> 03:12:19,400 AND HERE IS SOME DATA FROM A 4351 03:12:19,400 --> 03:12:23,560 COLLEAGUE OF MINE, THIS WAS DONE 4352 03:12:23,560 --> 03:12:26,480 IN RODENTS NOT IN PEOPLE. 4353 03:12:26,480 --> 03:12:30,480 HE HAD ANTI-GF1 ANTIBODY TO 4354 03:12:30,480 --> 03:12:31,200 MIDDLE AGE MICE. 4355 03:12:31,200 --> 03:12:33,000 THEY WERE NOT MICE THEY WERE 4356 03:12:33,000 --> 03:12:36,960 GENETICALLY ENGINEERED TO HAVE 4357 03:12:36,960 --> 03:12:38,040 THIS IT WAS NOT EXPRESSED DURING 4358 03:12:38,040 --> 03:12:39,960 THE LIFE AND IT WAS GIVEN TO 4359 03:12:39,960 --> 03:12:41,640 THEM IN MIDDLE AGE BECAUSE WE 4360 03:12:41,640 --> 03:12:45,000 DON'T WANT TO BLOCK GROWTH 4361 03:12:45,000 --> 03:12:46,400 HORMONE BECAUSE YOU WOULDN'T 4362 03:12:46,400 --> 03:12:47,120 GROW. 4363 03:12:47,120 --> 03:12:49,560 AND HE FOUND THAT ADMINISTERING 4364 03:12:49,560 --> 03:12:51,040 THAN THIS DRUG AND BLOCKING THIS 4365 03:12:51,040 --> 03:12:55,120 PATHWAY EVEN IN MIDDLE AGE 4366 03:12:55,120 --> 03:12:57,640 EXTENDED THE LIFESPAN AND 4367 03:12:57,640 --> 03:12:59,200 SHOWING YOU CAN INTERVENE EVEN 4368 03:12:59,200 --> 03:13:09,440 IN MIDDLE AGE. 4369 03:13:17,640 --> 03:13:20,600 SO WE CAN DELAY RELATED DISEASES 4370 03:13:20,600 --> 03:13:21,800 IMPROVE QUALITY OF LIFE AND 4371 03:13:21,800 --> 03:13:25,640 PERHAPS EXTEND LIFESPAN. 4372 03:13:25,640 --> 03:13:26,120 AND BY DISCOVERING THESE 4373 03:13:26,120 --> 03:13:28,440 VARIANTS IN HUMANS, WE HOPE 4374 03:13:28,440 --> 03:13:30,680 WE'LL ACCELERATE THE DEVELOPMENT 4375 03:13:30,680 --> 03:13:37,600 OF HETHESE THERAPEUTICS AND ENHE 4376 03:13:37,600 --> 03:13:39,200 SAFETY BECAUSE WE IDENTIFY THESE 4377 03:13:39,200 --> 03:13:42,480 VARIANTS IN PEOPLE WHO LIVE TO 4378 03:13:42,480 --> 03:13:46,120 AGE 100 THEY'RE NOT HARMFUL. 4379 03:13:46,120 --> 03:13:48,280 SO WHAT DO WE KNOW ABOUT SUPER 4380 03:13:48,280 --> 03:13:50,880 AGERS ACROSS THE WORLD AND THE 4381 03:13:50,880 --> 03:13:51,400 U.S. 4382 03:13:51,400 --> 03:13:54,200 IT HAPPENS TO BE THAT JAPAN HAS 4383 03:13:54,200 --> 03:13:59,000 THE GREATEST PREPORTION THESE 4384 03:13:59,000 --> 03:14:04,680 ARE THE TWO BOUNDARIES COUNTRIE 4385 03:14:04,680 --> 03:14:07,120 GREATEST TERMS OF CENTENARIANS 4386 03:14:07,120 --> 03:14:08,160 BUT IN NUMBERS THE UNITED STATES 4387 03:14:08,160 --> 03:14:09,920 HAS MORE CENTENARIANS BECAUSE 4388 03:14:09,920 --> 03:14:11,480 OUR POPULATION IS GREATER AND 4389 03:14:11,480 --> 03:14:16,680 THERE'S SOME STATES THAT ARE 4390 03:14:16,680 --> 03:14:19,280 MORE HOS PIT ABLE TO 4391 03:14:19,280 --> 03:14:20,160 CENTENARIANS. 4392 03:14:20,160 --> 03:14:21,400 AGAIN, THESE ARE THE STATES THAT 4393 03:14:21,400 --> 03:14:25,880 HAVE A LARGE POPULATION. 4394 03:14:25,880 --> 03:14:32,720 SO IN ORDER TO INCREASE OUR 4395 03:14:32,720 --> 03:14:34,720 CENTENARIAN WITH THE DISCOVERY 4396 03:14:34,720 --> 03:14:37,440 OF THESE PROTECTIVE GENETIC 4397 03:14:37,440 --> 03:14:39,160 VARIANTS, WE LAUNCHED IN 4398 03:14:39,160 --> 03:14:40,360 COLLABORATION WITH AMERICAN 4399 03:14:40,360 --> 03:14:42,000 FEDERATION AGING RESEARCH AND 4400 03:14:42,000 --> 03:14:44,400 VIBRANT HEALTH AND REGION A RON 4401 03:14:44,400 --> 03:14:46,440 A BRAND NEW STUDY CALLED SUPER 4402 03:14:46,440 --> 03:14:50,120 AGER FAMILY STUDY WITH A GOAL OF 4403 03:14:50,120 --> 03:14:52,400 ENROLLING 10,000 SUPER AGERS OR 4404 03:14:52,400 --> 03:14:54,640 PEOPLE 95 AND OLDER SO THAT WE 4405 03:14:54,640 --> 03:14:58,360 CAN INCREASE THE NUMBER OF 4406 03:14:58,360 --> 03:15:01,480 PEOPLE IN OUR COHORT OF SUPER 4407 03:15:01,480 --> 03:15:04,080 AGERS IN ORDER TO ACCELERATE THE 4408 03:15:04,080 --> 03:15:06,000 DISCOVERY OF PROTECTIVE GENETIC 4409 03:15:06,000 --> 03:15:07,520 VARIANTS AND THIS STUDY IS ALL 4410 03:15:07,520 --> 03:15:10,160 DONE REMOTELY AND INDIVIDUALS 4411 03:15:10,160 --> 03:15:12,280 SIGN ON-LINE AND THE ANSWER 4412 03:15:12,280 --> 03:15:16,760 QUESTIONNAIRE AND WE MALE THEM A 4413 03:15:16,760 --> 03:15:20,560 SALIVA KIT AND WE EXTRACT DNA 4414 03:15:20,560 --> 03:15:23,360 AND IT'S TO ESTABLISH A 4415 03:15:23,360 --> 03:15:23,920 GEROSCIENCE RESOURCE BECAUSE 4416 03:15:23,920 --> 03:15:25,120 WHEN WE ENROLL THESE PEOPLE, 4417 03:15:25,120 --> 03:15:27,960 WE'RE GOING TO MAKE ALL THE DATA 4418 03:15:27,960 --> 03:15:30,400 AND ALL THE GENETIC INFORMATION 4419 03:15:30,400 --> 03:15:32,440 PUBLICLY AVAILABLE TO ALL THE 4420 03:15:32,440 --> 03:15:33,160 RESEARCHERS. 4421 03:15:33,160 --> 03:15:34,800 BOTH ACADEMIC AND IN THE 4422 03:15:34,800 --> 03:15:36,360 INDUSTRY. 4423 03:15:36,360 --> 03:15:37,760 SO THAT EVERYONE CAN COME 4424 03:15:37,760 --> 03:15:40,800 TOGETHER AND USE THIS DATA TO 4425 03:15:40,800 --> 03:15:41,960 MAKE DISCOVERIES. 4426 03:15:41,960 --> 03:15:44,120 IF YOU HAVE SUPER AGERS, IF YOU 4427 03:15:44,120 --> 03:15:54,560 KNOW OF, REFER THEM TO US. 4428 03:15:55,480 --> 03:15:57,200 CENTENARIANS ARE A MODEL BY AGE 4429 03:15:57,200 --> 03:15:58,720 AND THEIR OFFSPRING ARE VALUABLE 4430 03:15:58,720 --> 03:16:00,400 FOR IDENTIFYING GENETIC 4431 03:16:00,400 --> 03:16:02,920 DETERMINANTS OF DELAYED AGING 4432 03:16:02,920 --> 03:16:04,800 AND IDENTIFICATION OF GENES AND 4433 03:16:04,800 --> 03:16:06,440 BIOLOGICAL PATHWAYS THAT PROTECT 4434 03:16:06,440 --> 03:16:08,680 FROM AGING CAN BE LEVERAGED TO 4435 03:16:08,680 --> 03:16:10,800 DEVELOP THERAPEUTICS. 4436 03:16:10,800 --> 03:16:14,240 A DELAY IN AGING. 4437 03:16:14,240 --> 03:16:15,480 WITH THAT I'LL JUST THANK 4438 03:16:15,480 --> 03:16:16,800 EVERYONE WHO IS BEEN INVOLVED IN 4439 03:16:16,800 --> 03:16:18,560 OUR RESEARCH AND OUR RESEARCH 4440 03:16:18,560 --> 03:16:20,240 VOLUNTEERS AND OUR TEAMS AND OUR 4441 03:16:20,240 --> 03:16:27,080 FUNDING SOURCES. 4442 03:16:27,080 --> 03:16:27,240 [APPLAUSE] 4443 03:16:27,240 --> 03:16:29,000 HAPPY TO BE HERE AND LOOK 4444 03:16:29,000 --> 03:16:33,640 FORWARD TO FUTURE SESSIONS. 4445 03:16:33,640 --> 03:16:35,560 SO, IF WE TOOK ALL OF HUMAN 4446 03:16:35,560 --> 03:16:37,440 EXISTENCE AND MAPPED IT ACROSS 4447 03:16:37,440 --> 03:16:39,720 SINGLE CALENDER YEAR, PRETTY 4448 03:16:39,720 --> 03:16:41,400 MUCH EVERYTHING WE TAKE FOR 4449 03:16:41,400 --> 03:16:42,640 GRANTED ABOUT HOW WE LIVE OUR 4450 03:16:42,640 --> 03:16:43,960 LIVES WOULD BE SQUEEZED INTO THE 4451 03:16:43,960 --> 03:16:47,040 LAST DAY IN FACT, THE DOUGH MESS 4452 03:16:47,040 --> 03:16:48,920 INDICATION OF PLANTS AND ANIMALS 4453 03:16:48,920 --> 03:16:51,320 CALLED THE KNEW LITHE I CAN 4454 03:16:51,320 --> 03:16:52,480 REVOLUTION WON'T OCCUR UNTIL 4455 03:16:52,480 --> 03:16:55,480 6:00 A.M. ON THAT LAST DAY AND 4456 03:16:55,480 --> 03:16:56,560 THE GROWTH OF CITIES WON'T OCCUR 4457 03:16:56,560 --> 03:16:59,000 TO 3:00 P.M. ON THAT LAST DAY 4458 03:16:59,000 --> 03:17:02,160 AND INDUSTRIALIZATION JUST SHY 4459 03:17:02,160 --> 03:17:03,520 OF MIDNIGHT. 4460 03:17:03,520 --> 03:17:05,200 WE'VE BEEN HUNTER-GATHERERS AND 4461 03:17:05,200 --> 03:17:08,560 FARMERS FOR MOST OF OUR SPECIES' 4462 03:17:08,560 --> 03:17:09,920 EXISTENCE YET WE KNOW NOTHING 4463 03:17:09,920 --> 03:17:12,560 ABOUT HEALTH AND AGING OF THESE 4464 03:17:12,560 --> 03:17:13,040 POPULATIONS. 4465 03:17:13,040 --> 03:17:15,800 ALMOST ALL STUDIES OF HEALTH AND 4466 03:17:15,800 --> 03:17:18,280 AGING ARE URBAN CONTEXT OF THE 4467 03:17:18,280 --> 03:17:19,360 GLOBAL NORTH. 4468 03:17:19,360 --> 03:17:21,200 SO CONTEMPORARY HUNTER GATHERERS 4469 03:17:21,200 --> 03:17:23,680 AND FARMERS THEY'RE CERTAINLY 4470 03:17:23,680 --> 03:17:25,360 NOT LIVING RELICS OR LIVING 4471 03:17:25,360 --> 03:17:26,640 FOSSILS BUT THEY OFFER THE 4472 03:17:26,640 --> 03:17:28,200 CLOSEST GLIMPSE OF WHAT HEALTH 4473 03:17:28,200 --> 03:17:29,920 AND AGING MIGHT HAVE LOOKED LIKE 4474 03:17:29,920 --> 03:17:32,120 IN THE PAST AND THEY OFFER 4475 03:17:32,120 --> 03:17:33,880 ALTERNATIVES FOR HOW HEALTH AND 4476 03:17:33,880 --> 03:17:36,000 AGING MIGHT LOOK IN THE PRESENT. 4477 03:17:36,000 --> 03:17:37,520 AND THESE ARE INDIGENOUS 4478 03:17:37,520 --> 03:17:39,560 POPULATIONS THAT ARE LIVING IN 4479 03:17:39,560 --> 03:17:41,240 FORESTS, SAVANNAHS, THE DESERTS 4480 03:17:41,240 --> 03:17:51,640 OF AFRICA AND BY CERTAIN 4481 03:18:05,840 --> 03:18:07,440 STANDARDS AND OF AGING ARE 4482 03:18:07,440 --> 03:18:17,840 ABSENT IN THESE GROUPS. 4483 03:18:31,200 --> 03:18:33,080 LOWER LIFE EXPECTANCY AS WE 4484 03:18:33,080 --> 03:18:34,200 HEARD IN THE FIRST SESSION AND 4485 03:18:34,200 --> 03:18:35,400 WE'RE TRADITIONAL LIVELIHOODS 4486 03:18:35,400 --> 03:18:37,080 HAVE BEEN LARGELY REPLACED, 4487 03:18:37,080 --> 03:18:38,520 WHERE LAND HAS BEEN TRIPPED, 4488 03:18:38,520 --> 03:18:39,840 WHERE THERE'S DISCRIMINATION AND 4489 03:18:39,840 --> 03:18:44,480 OTHER CONSEQUENCES OF DOLL 4490 03:18:44,480 --> 03:18:46,480 ONALLISM WE SEE MORE OBESITY, 4491 03:18:46,480 --> 03:18:48,160 DIABETES, HEART DISEASE, LOWER 4492 03:18:48,160 --> 03:18:49,360 EDUCATIONAL ATTAINMENT, ET 4493 03:18:49,360 --> 03:18:50,840 CETERA AND OF COURSE HIGHER 4494 03:18:50,840 --> 03:19:00,920 DEATH RATES FROM COVID. 4495 03:19:00,920 --> 03:19:02,160 MY APPROACH WITH IF IT'S 509 4496 03:19:02,160 --> 03:19:03,240 OPPORTUNITY TO LEARN A LOT ABOUT 4497 03:19:03,240 --> 03:19:05,040 HEALTH AND AGE SEWING IN 4498 03:19:05,040 --> 03:19:06,280 PARTICULAR, AGING IN THE ABSENCE 4499 03:19:06,280 --> 03:19:08,080 OF THE USUAL COMMON CHRONIC 4500 03:19:08,080 --> 03:19:12,520 DISEASES OF AGING AND WITH WORK 4501 03:19:12,520 --> 03:19:13,560 I'LL TALK ABOUT TODAY AND OTHER 4502 03:19:13,560 --> 03:19:17,120 GROUPS I'LL COLLECT THE SAME RIN 4503 03:19:17,120 --> 03:19:19,480 PHENOTYPE DATA, SCIO DEMOGRAPHIC 4504 03:19:19,480 --> 03:19:21,520 AND AS WELL AS EPI GENOMIC DATA 4505 03:19:21,520 --> 03:19:23,880 IN THESE KINDS OF CONTEXT IS 4506 03:19:23,880 --> 03:19:29,720 VERY RARE AND RICH OPPORTUNITIES 4507 03:19:29,720 --> 03:19:39,880 AND ON THE 4508 03:19:42,280 --> 03:19:44,560 CONNECTEDNESS, COMMUNITY, 4509 03:19:44,560 --> 03:19:45,960 INFECTIOUS BURDEN AS WE'LL SEE 4510 03:19:45,960 --> 03:19:48,240 BOTH SOME POSITIVE AND NEGATIVE 4511 03:19:48,240 --> 03:19:50,680 ASPECTS, BUT HEAVY INFECTIOUS 4512 03:19:50,680 --> 03:19:51,280 BURDENS AND A VERY DIFFERENT 4513 03:19:51,280 --> 03:19:54,600 KIND OF BACKGROUND AND NATURAL 4514 03:19:54,600 --> 03:19:57,000 FERTILITY SO HIGH FERTILITY 4515 03:19:57,000 --> 03:19:58,560 POPULATIONS THAT USING EFFECTIVE 4516 03:19:58,560 --> 03:20:00,200 BIRTH CONTROL AND MORE. 4517 03:20:00,200 --> 03:20:02,120 AND SO WE CAN GET NEW INSIGHTS 4518 03:20:02,120 --> 03:20:06,320 PERHAPS EVEN NOT JUST I KNOW THE 4519 03:20:06,320 --> 03:20:07,120 GEROSCIENCE HYPOTHESIS CENTERED 4520 03:20:07,120 --> 03:20:08,600 ON AGING SPECIFICALLY BUT ON 4521 03:20:08,600 --> 03:20:10,400 ALSO THE NON COMMUNICATIVE 4522 03:20:10,400 --> 03:20:11,640 DISEASE OF AGING CAN WE GAIN 4523 03:20:11,640 --> 03:20:13,080 MORE IN SIGHT INTO THOSE 4524 03:20:13,080 --> 03:20:15,880 SPECIFIC ASPECTS, THE ROLE OF 4525 03:20:15,880 --> 03:20:17,320 MISMATCH BETWEEN OUR GENOME AND 4526 03:20:17,320 --> 03:20:18,920 OUR CURRENT ENVIRONMENTS AND 4527 03:20:18,920 --> 03:20:20,080 LIFESTYLES THAT WE FIND 4528 03:20:20,080 --> 03:20:25,440 OURSELVES IN TODAY AND SOME GENE 4529 03:20:25,440 --> 03:20:31,200 BINE AND ET CETERA AND ACROSS 4530 03:20:31,200 --> 03:20:32,360 GEOGRAPHY AND CULTURE AND ALSO 4531 03:20:32,360 --> 03:20:35,080 THERE'S A SCIENTIFIC LESSONS 4532 03:20:35,080 --> 03:20:36,560 THAT CAN BE LEARNED FROM LOOKING 4533 03:20:36,560 --> 03:20:39,600 OUTSIDE OF THE USUAL KINDS OF 4534 03:20:39,600 --> 03:20:41,600 STUDY SAMPLES AND ALSO, I WANT 4535 03:20:41,600 --> 03:20:44,800 TO MAKE EMPHASIZE THAT RAPID 4536 03:20:44,800 --> 03:20:45,960 SOCIOECONOMIC CHANGES ARE A FOOD 4537 03:20:45,960 --> 03:20:47,480 IN ALL THESE INDIGENOUS 4538 03:20:47,480 --> 03:20:49,760 POPULATIONS AND SO THAT PROVIDES 4539 03:20:49,760 --> 03:20:51,480 A RICH QUASI EXPERIMENT FOR 4540 03:20:51,480 --> 03:20:53,960 LOOKING AT THE EFFECTS OF 4541 03:20:53,960 --> 03:20:55,320 MODERNIZATION ON HEALTH AND 4542 03:20:55,320 --> 03:20:57,800 AGING AND ALSO, TRYING TO BE 4543 03:20:57,800 --> 03:21:02,480 WEARY OF THE KINDS OF CONDITIONS 4544 03:21:02,480 --> 03:21:04,200 TA INDIGENOUS POPULATIONS FIND 4545 03:21:04,200 --> 03:21:06,440 THEMSELVES TODAY, HOW TO PREVENT 4546 03:21:06,440 --> 03:21:09,000 THOSE EPIDEMIOLOGICAL ADVERSE 4547 03:21:09,000 --> 03:21:14,640 SEE ON THESE POPULATIONS AS THY 4548 03:21:14,640 --> 03:21:21,440 UNDERGO CHANGE. 4549 03:21:21,440 --> 03:21:23,600 AND NOW OPERATING OVER TWO 4550 03:21:23,600 --> 03:21:25,880 DECADES AND YOU CAN TALK ABOUT 4551 03:21:25,880 --> 03:21:27,320 THE ETHICS AND THE TRUST 4552 03:21:27,320 --> 03:21:29,120 BUILDING THAT OCCURRED OVER, IT 4553 03:21:29,120 --> 03:21:30,320 TOOK THREE YEARS OR FOUR YEARS 4554 03:21:30,320 --> 03:21:32,840 BEFORE I TOOK A SINGLE SAMPLE OF 4555 03:21:32,840 --> 03:21:34,720 BLOOD, AFTER I LEARNED THE 4556 03:21:34,720 --> 03:21:41,600 LANGUAGE AND GAINED TRUST, IT'SA 4557 03:21:41,600 --> 03:21:43,600 LARGE POPULATION, 17,000 FOR 4558 03:21:43,600 --> 03:21:45,200 EDGERS FARMERS AND WE'VE BEEN 4559 03:21:45,200 --> 03:21:47,440 FOCUSING ON AGING IN THE CONTEXT 4560 03:21:47,440 --> 03:21:48,880 OF INFECTION AND OTHER TYPES OF 4561 03:21:48,880 --> 03:21:50,640 AREAS WITH EXPOSOME AS I 4562 03:21:50,640 --> 03:21:52,880 MENTIONED AND THE PROCESS OF A 4563 03:21:52,880 --> 03:21:53,920 CULTURATION, AND MODERNIZATION 4564 03:21:53,920 --> 03:21:55,680 AND WHAT EFFECTS THAT MIGHT BE 4565 03:21:55,680 --> 03:21:57,560 HAVING IT'S A LONGITUDINAL 4566 03:21:57,560 --> 03:22:00,320 DESIGN AND I ENCOURAGE YOU IF 4567 03:22:00,320 --> 03:22:01,840 YOU ARE IN ANYTHING YOU HEAR 4568 03:22:01,840 --> 03:22:03,240 TODAY TO LOOK AT THE WEBSITE FOR 4569 03:22:03,240 --> 03:22:05,120 ACCESS TO ALL OF OUR 4570 03:22:05,120 --> 03:22:06,280 PUBLICATIONS AND THIS WORK HAS 4571 03:22:06,280 --> 03:22:09,040 BEEN FUNDED BY NIA. 4572 03:22:09,040 --> 03:22:12,280 SO JUST VERY BRIEFLY, THE 4573 03:22:12,280 --> 03:22:14,080 LIFESTYLE SO THERE'S SLASH AND 4574 03:22:14,080 --> 03:22:16,600 BURN HORTICULTURALIST. 4575 03:22:16,600 --> 03:22:18,720 NO SUPER MARKETS, NO BANK 4576 03:22:18,720 --> 03:22:20,360 ACCOUNTS, NO FORMAL INSURANCE 4577 03:22:20,360 --> 03:22:21,840 AND SO ALL THE FOOD THEY GET 4578 03:22:21,840 --> 03:22:24,440 COMES FROM THEIR FIELDS THROUGH 4579 03:22:24,440 --> 03:22:25,800 HEAVY WORK ERT AND ALSO 4580 03:22:25,800 --> 03:22:26,960 SUPPLEMENTED BY HUNTING AND 4581 03:22:26,960 --> 03:22:37,560 FISHING AND GATHERING AND SO 4582 03:22:37,560 --> 03:22:39,160 UNTREATED WATER AND WASTE. 4583 03:22:39,160 --> 03:22:40,640 AND WHAT I WANT TO DO FOR THE 4584 03:22:40,640 --> 03:22:42,400 REST OF THE TALK, JUST A FEW 4585 03:22:42,400 --> 03:22:43,040 HIGHLIGHTS. 4586 03:22:43,040 --> 03:22:45,040 SOME GREATEST HITS OF SOME OF 4587 03:22:45,040 --> 03:22:47,680 SALELY ENTER FINDINGS THAT 4588 03:22:47,680 --> 03:22:49,000 SUGGEST POTENTIALS WHEN WE LOOK 4589 03:22:49,000 --> 03:22:57,560 AT THESE POPULATIONS. 4590 03:22:57,560 --> 03:22:59,040 WE HAVE LOW INCREASES IN BLOOD 4591 03:22:59,040 --> 03:23:02,080 PRESSURE WITH AGE, NO ARTERIAL 4592 03:23:02,080 --> 03:23:04,800 DISEASE AND NO A TREAL 4593 03:23:04,800 --> 03:23:05,880 DEFIBRILLATION AND COLLABORATING 4594 03:23:05,880 --> 03:23:08,200 WITH FOLKS FROM THE HORACE STUDY 4595 03:23:08,200 --> 03:23:13,120 WE DID A CT STUDY THAT LOOKS AT 4596 03:23:13,120 --> 03:23:14,920 CALCIFICATION AND WE SAW RATES 4597 03:23:14,920 --> 03:23:18,160 OF CORONARY ARTERY CALCIFICATION 4598 03:23:18,160 --> 03:23:20,600 AND DESPITE THE CHEW MANNY 4599 03:23:20,600 --> 03:23:24,360 HAVING HIGH LEVELS OF CHRONIC 4600 03:23:24,360 --> 03:23:27,400 INFLAMMATION AND SO AGE STANDARD 4601 03:23:27,400 --> 03:23:32,840 IS ABOUT 15% COMPARED TO 86% FOR 4602 03:23:32,840 --> 03:23:35,360 ADULTS AGE 45 OR 50. 4603 03:23:35,360 --> 03:23:36,880 U.S. IS FIVE AND A HALF TIMES 4604 03:23:36,880 --> 03:23:40,480 HIGHER LEVELS THAN THE CHUMANE 4605 03:23:40,480 --> 03:23:43,640 FOR MAD RAT LEVELS IT'S 18 TIMES 4606 03:23:43,640 --> 03:23:45,280 HIGHER IN THE U.S. AND NOT THAT 4607 03:23:45,280 --> 03:23:47,880 I WEAR THAT NUMBER OF 4,000 4608 03:23:47,880 --> 03:23:51,080 BOWERS 4,000BECAUSE WE'RE GETTIL 4609 03:23:51,080 --> 03:23:52,720 NUMBERS BUT NO ONE HAD HIGH 4610 03:23:52,720 --> 03:23:57,120 LEVELS OF CORONARY LEVELS OF 4611 03:23:57,120 --> 03:23:57,680 CALCIFICATION. 4612 03:23:57,680 --> 03:23:58,200 WE LOOKED WHY. 4613 03:23:58,200 --> 03:24:00,760 THIS IS A WORK IN REGULAR. 4614 03:24:00,760 --> 03:24:02,280 THEY'RE PHYSICALLY ACTIVE AND 4615 03:24:02,280 --> 03:24:04,560 THE AVERAGE NUMBER OF STEPS IF 4616 03:24:04,560 --> 03:24:05,920 APPROXIMATE YOU LOOK AT YOUR FIT 4617 03:24:05,920 --> 03:24:07,440 BIT TODAY AND IB WE'RE ALL 4618 03:24:07,440 --> 03:24:09,280 SITTING HERE AND YOU GOT LESS 4619 03:24:09,280 --> 03:24:10,600 THAN 2 THOUGH AND ESPECIALLY IF 4620 03:24:10,600 --> 03:24:14,000 WE TOOK A SHUTTLE THIS MORNING. 4621 03:24:14,000 --> 03:24:15,560 THE AVERAGE GETS 17,000 STEPS A 4622 03:24:15,560 --> 03:24:18,520 DAY AND IT DOESN'T DIMINISH IN 4623 03:24:18,520 --> 03:24:19,440 LATER AGES. 4624 03:24:19,440 --> 03:24:20,560 THEY'RE NOT VERY VIGOROUSLY 4625 03:24:20,560 --> 03:24:21,120 ACTIVE. 4626 03:24:21,120 --> 03:24:23,200 THEY'RE NOT SEDENTARY. 4627 03:24:23,200 --> 03:24:24,880 ALSO VERY MINIMAL TOBACCO 4628 03:24:24,880 --> 03:24:29,240 SMOKING AND THE DIET FOR ALL THE 4629 03:24:29,240 --> 03:24:30,920 PALEO PEOPLE OUT THERE IN THE 4630 03:24:30,920 --> 03:24:32,840 AUDIENCE, IT'S VERY HEAVY IN 4631 03:24:32,840 --> 03:24:33,040 CARBS. 4632 03:24:33,040 --> 03:24:34,840 OVER TWO-THIRDS OF THE CALORIES 4633 03:24:34,840 --> 03:24:37,440 FROM THEIR DIET ARE COMING FROM 4634 03:24:37,440 --> 03:24:38,800 CARBS SO IT'S LOW IN SATURATED 4635 03:24:38,800 --> 03:24:41,640 FAT AND HIGHER IN PROTEIN, 4636 03:24:41,640 --> 03:24:43,560 TYPICAL BUT LOWER IN FAT AND SO 4637 03:24:43,560 --> 03:24:47,720 BY SOME OF THEIR METRICS HERE, 4638 03:24:47,720 --> 03:24:50,160 WRONG LOW LDL AND LOW BLOOD 4639 03:24:50,160 --> 03:24:52,320 PRESSURE AND LOW MORNING FASTING 4640 03:24:52,320 --> 03:25:02,800 BLOOD GLUCOSE AND THERE'S VERY 4641 03:25:08,040 --> 03:25:09,600 LITTLE IRE POLLUTION AND I LIVE 4642 03:25:09,600 --> 03:25:10,640 NOT FAR FROM L.A. 4643 03:25:10,640 --> 03:25:13,480 IN L.A. IT'S ALL SMOG, WE SAY IN 4644 03:25:13,480 --> 03:25:14,880 SANTA BARBARA IT'S FOG. 4645 03:25:14,880 --> 03:25:16,640 BUT YEAH, ALSO SOME OTHER 4646 03:25:16,640 --> 03:25:19,680 POTENTIAL PROTECTIVE EFFECTS, 4647 03:25:19,680 --> 03:25:21,120 NOT ALL INFECTIONS TREAT THE 4648 03:25:21,120 --> 03:25:23,040 BODY EQUALLY SO MAYBE HELMETS 4649 03:25:23,040 --> 03:25:25,040 MIGHT HAVE PROTECTIVE FACTORS SO 4650 03:25:25,040 --> 03:25:26,760 WE'RE DOING ON GOING STUDIES ON 4651 03:25:26,760 --> 03:25:30,480 THAT AND COMBINED, THE EXPOSOME 4652 03:25:30,480 --> 03:25:34,440 LEADS TO MINIMAL OR INARY ARTERY 4653 03:25:34,440 --> 03:25:36,120 THROUGHOUT LIFE AND OTHER 4654 03:25:36,120 --> 03:25:38,880 ASPECTS OF CARDIOMETABOLIC 4655 03:25:38,880 --> 03:25:40,440 HEALTH SO MORE RECENTLY WE'RE 4656 03:25:40,440 --> 03:25:43,040 LOOKING AT BRAIN AGING AND THEY 4657 03:25:43,040 --> 03:25:44,920 ALSO SHOW SLOWER RATES OF BRAIN 4658 03:25:44,920 --> 03:25:48,920 AGING AND MINIMALEL ALZHEIMER'S. 4659 03:25:48,920 --> 03:25:50,560 SO WE'VE LOOKED AT BOTH IN TERMS 4660 03:25:50,560 --> 03:25:52,800 OF CEREBRAL VALUE, SLOWER RATE, 4661 03:25:52,800 --> 03:25:58,440 CROSS SECTIONALLY, AND BRAIN 4662 03:25:58,440 --> 03:26:00,160 VOLUME COMPARED TO POPULATIONS 4663 03:26:00,160 --> 03:26:04,320 USING SIMILAR METHODOLOGY AND 4664 03:26:04,320 --> 03:26:06,080 THIS ALSO TRANSLATES INTO 4665 03:26:06,080 --> 03:26:08,120 COGNITIVE DEFICITS WHEN WE LOOK 4666 03:26:08,120 --> 03:26:09,560 AT COGNITIVE PERFORMANCE WITH 4667 03:26:09,560 --> 03:26:13,160 AGE ON A NUMBER OF BATTERY OF 4668 03:26:13,160 --> 03:26:15,040 DIFFERENT TYPES OF TASKS THAT 4669 03:26:15,040 --> 03:26:17,320 WE'VE DONE AND ALSO WITH 4670 03:26:17,320 --> 03:26:18,840 CONSENSUS ANALYSIS FOR 4671 03:26:18,840 --> 03:26:20,760 DIAGNOSING DEMENTIA WE HAVE 4672 03:26:20,760 --> 03:26:22,840 FOUND SIX CASES SO WHEN WE LOOK 4673 03:26:22,840 --> 03:26:25,680 AT THE COMPARABLE AGE 4674 03:26:25,680 --> 03:26:27,680 STANDARDIZED RATES IN THE 4675 03:26:27,680 --> 03:26:28,720 TSIMANE AND THE SISTER 4676 03:26:28,720 --> 03:26:30,080 POPULATION WHICH IS VERY SIMILAR 4677 03:26:30,080 --> 03:26:34,360 TO THE TSIMANE BUT CULTURATED 4678 03:26:34,360 --> 03:26:35,560 THEY HAVE SOME OF THE LOWEST 4679 03:26:35,560 --> 03:26:36,960 RATES COMPARED TO OTHER 4680 03:26:36,960 --> 03:26:39,160 POPULATIONS BOTH INDIGENOUS AND 4681 03:26:39,160 --> 03:26:42,240 OTHER COUNTRIES AND ALSO U.S., 4682 03:26:42,240 --> 03:26:45,960 EUROPE AT LARGE. 4683 03:26:45,960 --> 03:26:47,720 SO WHEN WE MOVE AWAY FROM 4684 03:26:47,720 --> 03:26:48,840 DISEASE, THEN IT GETS A LITTLE 4685 03:26:48,840 --> 03:26:50,120 BIT MORE SPECULATIVE SO 4686 03:26:50,120 --> 03:26:52,480 DIFFERENT ASPECTS OF BIOLOGICAL 4687 03:26:52,480 --> 03:26:52,960 AGE. 4688 03:26:52,960 --> 03:26:56,240 IT'S HARD TO CONCLUDE, ONE 4689 03:26:56,240 --> 03:26:58,160 INITIAL IS IN THIS AREA AND ALAN 4690 03:26:58,160 --> 03:26:59,840 IS IN THE AUDIENCE, USING 4691 03:26:59,840 --> 03:27:01,920 METRICS THAT HE POPULARIZED IN 4692 03:27:01,920 --> 03:27:03,880 THE DISTANCE AND BASICALLY IT'S 4693 03:27:03,880 --> 03:27:05,760 TO COMPOSITE OF LOTS OF 4694 03:27:05,760 --> 03:27:07,760 DIFFERENT BIOMARKERS AND MULTI 4695 03:27:07,760 --> 03:27:09,720 DIMENSIONAL SPACE TO SEE HOW 4696 03:27:09,720 --> 03:27:11,360 INDIVIDUALS DEPART FROM A 4697 03:27:11,360 --> 03:27:13,160 HEALTHY STATE WITH AGE AND 4698 03:27:13,160 --> 03:27:14,800 BASICALLY WE FIND A SIMILAR 4699 03:27:14,800 --> 03:27:17,600 LEVEL OF A SLOPE, A RATE OF 4700 03:27:17,600 --> 03:27:18,840 INCREASE OF DISREGULATION AS 4701 03:27:18,840 --> 03:27:21,200 MEASURED BY THIS METRIC WITH AGE 4702 03:27:21,200 --> 03:27:24,800 COMPARED TO THE U.S. AND 4703 03:27:24,800 --> 03:27:25,640 CANADIAN POPULATIONS BUT WHEN WE 4704 03:27:25,640 --> 03:27:30,960 LOOK AT METHYLATION, THIS IS 4705 03:27:30,960 --> 03:27:34,440 EARLIER GENERATION OF 4706 03:27:34,440 --> 03:27:37,200 METHYLATION AGE FROM THE CLOCKS 4707 03:27:37,200 --> 03:27:38,120 THAT STEVE HORVATH CAME UP WITH 4708 03:27:38,120 --> 03:27:40,280 SO BY ONE METRIC IT'S MORE 4709 03:27:40,280 --> 03:27:45,160 HOLISTIC THAT THE TSUMANE SEEMS 4710 03:27:45,160 --> 03:27:48,280 YOUNGER THAN HISPANICS AND WHITE 4711 03:27:48,280 --> 03:27:49,800 CAUCASIANS BUT ANOTHER METRIC 4712 03:27:49,800 --> 03:27:52,080 FOCUSING ON CELL TYPES, 4713 03:27:52,080 --> 03:27:54,320 ESPECIALLY IMMUNE CELL TYPES 4714 03:27:54,320 --> 03:27:58,840 LIKE CD8s, THE TSIMANE 4715 03:27:58,840 --> 03:28:01,560 APPEARED OLDER SO COR OBJECT RA 4716 03:28:01,560 --> 03:28:03,280 TIVE FROM THE FIRST SESSION THAT 4717 03:28:03,280 --> 03:28:04,800 NOT ALL CLOCKS, NOT ALL ORGANS 4718 03:28:04,800 --> 03:28:10,120 AND SYSTEMS MIGHT BE AT THE SAME 4719 03:28:10,120 --> 03:28:12,720 RATE. 4720 03:28:12,720 --> 03:28:13,400 THESE ARE INDIVIDUAL SLOPES 4721 03:28:13,400 --> 03:28:14,920 DISTANCE MEASURE FROM OUR 4722 03:28:14,920 --> 03:28:15,960 LONGITUDINAL WORK WHEN WE ASKED 4723 03:28:15,960 --> 03:28:17,840 YOU TO LOOK AT MORE RECENT 4724 03:28:17,840 --> 03:28:20,200 TIMES, THE EFFECTS OF A 4725 03:28:20,200 --> 03:28:21,320 CULTURATION, THE INTERCEPTS ARE 4726 03:28:21,320 --> 03:28:22,320 A LITTLE BIT DIFFERENT BUT THE 4727 03:28:22,320 --> 03:28:26,000 SLOPES ARE THE SAME. 4728 03:28:26,000 --> 03:28:26,960 AGING HASN'T CHANGED BUT 4729 03:28:26,960 --> 03:28:29,360 EVERYONE IS IN A BETTER 4730 03:28:29,360 --> 03:28:30,960 CONDITION COMPARED TO IN THE 4731 03:28:30,960 --> 03:28:31,240 PAST. 4732 03:28:31,240 --> 03:28:36,480 EVEN OVER THE DURATION OF THE 4733 03:28:36,480 --> 03:28:37,400 PAST 15 YEARS SO ANOTHER 4734 03:28:37,400 --> 03:28:41,880 INTERESTING STUDY WE LOOKED AT 4735 03:28:41,880 --> 03:28:44,120 E4 SO THE HIGHEST, STRONGEST 4736 03:28:44,120 --> 03:28:45,800 GENETIC RISK FACTOR FOR 4737 03:28:45,800 --> 03:28:47,640 ALZHEIMER'S DISEASE AND LINKED 4738 03:28:47,640 --> 03:28:49,040 TO COGNITIVE AGING MORE 4739 03:28:49,040 --> 03:28:52,720 GENERALLY AND CARDIOVASCULAR 4740 03:28:52,720 --> 03:28:54,400 DISEASE SO IT'S ASSOCIATED WITH 4741 03:28:54,400 --> 03:28:55,960 WORSE COGNITIVE FUNCTION BUT 4742 03:28:55,960 --> 03:28:58,680 IT'S ASSOCIATED WITH IMPROVED 4743 03:28:58,680 --> 03:29:01,040 COGNITIVE FUNCTION AMONG THOSE 4744 03:29:01,040 --> 03:29:02,600 FOLKS THAT HIGH BURDEN SO THE 4745 03:29:02,600 --> 03:29:04,360 IDEA E4 MIGHT OPERATE 4746 03:29:04,360 --> 03:29:05,520 DIFFERENTLY IN A DIFFERENT 4747 03:29:05,520 --> 03:29:07,520 CONTEXT A HIGH PATHOGEN CONTEXT, 4748 03:29:07,520 --> 03:29:09,280 IT'S SOMETHING THAT HAS BEEN 4749 03:29:09,280 --> 03:29:11,880 SUGGESTED BEFORE WHERE E4 MIGHT 4750 03:29:11,880 --> 03:29:15,840 HELP WITH CLEARANCE OF BACTERIA, 4751 03:29:15,840 --> 03:29:17,840 AND VIRAL HEPATITIS C BUT THEY 4752 03:29:17,840 --> 03:29:19,520 HADN'T BEEN LOOKED AT TOO 4753 03:29:19,520 --> 03:29:22,920 SYSTEMATICALLY BEFORE SO THE 4754 03:29:22,920 --> 03:29:33,400 IDEA THAT AND 84% OF TSIMAIN 4755 03:29:45,600 --> 03:29:49,160 HAVE EOSINO AND A NUMBER OF 4756 03:29:49,160 --> 03:29:51,520 DIFFERENT TASKS WHERE IF THEY 4757 03:29:51,520 --> 03:29:53,560 WERE WHERE THEY HAD LOW COUNTS 4758 03:29:53,560 --> 03:30:04,040 THEY WERE DOING MUCH WORSE AND 4759 03:30:08,920 --> 03:30:11,200 LIKE TWO CHILDREN MORE AND IT'S 4760 03:30:11,200 --> 03:30:15,320 A GOOD EFFECT ALL CONSIDERING. 4761 03:30:15,320 --> 03:30:19,680 AND THE LAST RESULT IS IF WE 4762 03:30:19,680 --> 03:30:21,960 LOOK AT BENIGN PROSTATE HYPER 4763 03:30:21,960 --> 03:30:23,240 PLASIA NOT LETHAL BUT A CONTINUE 4764 03:30:23,240 --> 03:30:27,240 THAT'S BEEN DEEMED UNIVERSAL MEN 4765 03:30:27,240 --> 03:30:30,320 HAVE LOW TESTOSTERONE, NO ANGIEE 4766 03:30:30,320 --> 03:30:40,840 RELATED WHEN LOOKED AT THE PATH 4767 03:31:15,880 --> 03:31:17,840 TO GET THERE AND THE BROADER 4768 03:31:17,840 --> 03:31:19,280 EXPOSOME THAT MIGHT HAVE EFFECTS 4769 03:31:19,280 --> 03:31:20,040 ON ALL THESE THINGS. 4770 03:31:20,040 --> 03:31:21,800 THANK YOU SO MUCH FOR YOUR TIME 4771 03:31:21,800 --> 03:31:24,480 AND I LOOK FORWARD TO THE 4772 03:31:24,480 --> 03:31:25,040 DISCUSSION SESSION. 4773 03:31:25,040 --> 03:31:36,080 [APPLAUSE] 4774 03:31:36,080 --> 03:31:38,560 >>I'M A MEDICAL ONCOLOGIST IN 4775 03:31:38,560 --> 03:31:43,480 LOS ANGELES AT CITY OF HOPE. 4776 03:31:43,480 --> 03:31:46,200 AND I THINK THAT THE ORGANIZERS 4777 03:31:46,200 --> 03:31:50,000 FOR HAVING ME TODAY AND I'M 4778 03:31:50,000 --> 03:31:51,960 GOING TO TALK ABOUT CANCER AND 4779 03:31:51,960 --> 03:31:53,400 ACCELERATED AGING. 4780 03:31:53,400 --> 03:31:54,240 WE START 4781 03:31:54,240 --> 03:31:55,440 WITH SOMETHING WE'VE HEARD ABOUT 4782 03:31:55,440 --> 03:31:57,560 ALREADY THAT AGING IS THE 4783 03:31:57,560 --> 03:32:02,080 LARGEST RISK FACTOR FOR ALL 4784 03:32:02,080 --> 03:32:06,720 ADULT CANCERS THERE'S BEEN A 4785 03:32:06,720 --> 03:32:08,240 DECLINE IN A NUMBER OF DEATHS 4786 03:32:08,240 --> 03:32:10,240 FROM CANCER THAT'S THE BLACK 4787 03:32:10,240 --> 03:32:12,840 LINE GOING DOWN OVER TIME. 4788 03:32:12,840 --> 03:32:18,080 BUT THAT MEANS WE ALSO HAVE AN 4789 03:32:18,080 --> 03:32:19,880 INCREASE NUMBER OF PEOPLE LIVING 4790 03:32:19,880 --> 03:32:21,680 AFTER THEIR CANCER DIAGNOSIS AND 4791 03:32:21,680 --> 03:32:23,360 THE BAR GRAPH HERE SHOWS YOU THE 4792 03:32:23,360 --> 03:32:25,240 NUMBER OF YEARS THAT PEOPLE OUT 4793 03:32:25,240 --> 03:32:29,720 ARE LIVING OUT FROM THEIR CANCER 4794 03:32:29,720 --> 03:32:30,800 DIAGNOSIS YOU CAN SEE OVER THE 4795 03:32:30,800 --> 03:32:33,760 LAST TWO DECADES, MORE AND MORE 4796 03:32:33,760 --> 03:32:36,400 PEOPLE ARE LIVING FIVE, 10, 15 4797 03:32:36,400 --> 03:32:37,800 PLUS YEARS FROM CANCER. 4798 03:32:37,800 --> 03:32:40,200 AND THIS IS A GREAT PROGRESS. 4799 03:32:40,200 --> 03:32:43,120 BUT WHAT THIS ALSO MEANS, IT'S 4800 03:32:43,120 --> 03:32:45,280 THAT A LOT OF THE CO MORBID 4801 03:32:45,280 --> 03:32:46,640 CONDITIONS THAT THE PATIENTS HAD 4802 03:32:46,640 --> 03:32:50,800 AT THE TIME OF THEIR DIAGNOSIS, 4803 03:32:50,800 --> 03:32:53,360 ARE OFTEN AMPLIFIED AFTER THE 4804 03:32:53,360 --> 03:32:55,880 EXPOSURE TO CANCER AND CANCER 4805 03:32:55,880 --> 03:32:58,080 TREATMENT AND CITY OF HOPE WE 4806 03:32:58,080 --> 03:33:01,120 HAD A COHORT OF BONE NARROW 4807 03:33:01,120 --> 03:33:02,640 TRANSPLANT PATIENTS AND WE HAD 4808 03:33:02,640 --> 03:33:04,560 THE OPPORTUNITY TO LONGITUDE 4809 03:33:04,560 --> 03:33:06,760 KNEE FOLLOW THEM OVER TIME AND 4810 03:33:06,760 --> 03:33:09,000 WHAT WE SAW IS EVEN AFTER THE 4811 03:33:09,000 --> 03:33:11,840 BONE NARROW TRANSPLANT AND THEIR 4812 03:33:11,840 --> 03:33:13,080 CANCER DIAGNOSIS THEY DEVELOPED 4813 03:33:13,080 --> 03:33:17,040 A LOT OF CHRONIC CO MORBID 4814 03:33:17,040 --> 03:33:18,640 CONDITIONS AND THIS INCREASED AN 4815 03:33:18,640 --> 03:33:21,600 INTENSITY AND FREQUENCY IN CO 4816 03:33:21,600 --> 03:33:23,240 MORBID CONDITIONS THAT WAS NOT 4817 03:33:23,240 --> 03:33:24,680 LARGER THAN THE GENERAL 4818 03:33:24,680 --> 03:33:26,640 POPULATION SO, THEY'RE HAVING 4819 03:33:26,640 --> 03:33:30,120 DISEASES LIKE WE SEE IN THE 4820 03:33:30,120 --> 03:33:31,720 GENERAL POPULATION BUT THE 4821 03:33:31,720 --> 03:33:33,520 INTENSITY AND FREQUENCY OF THESE 4822 03:33:33,520 --> 03:33:36,440 DISEASES ARE HAPPENING FASTER. 4823 03:33:36,440 --> 03:33:38,680 NOT ONLY DID WE SEE AN INCREASE 4824 03:33:38,680 --> 03:33:49,200 IN PREMATURE MORBIDITY WHAT ARE 4825 03:34:16,520 --> 03:34:17,800 THE FUNDAMENTAL PROCESSES THAT 4826 03:34:17,800 --> 03:34:20,120 DRIVE AGING. 4827 03:34:20,120 --> 03:34:21,640 WE KNOW THAT THERE ARE CERTAIN 4828 03:34:21,640 --> 03:34:25,000 KEY PILLARS OR HALLMARKS AND 4829 03:34:25,000 --> 03:34:27,280 PROCESSES THAT THE MOLECULAR 4830 03:34:27,280 --> 03:34:29,680 CELLULAR LEVEL DRIVE THE WAY 4831 03:34:29,680 --> 03:34:33,840 THAT WE RATE OF OUR RATE OF OUR 4832 03:34:33,840 --> 03:34:44,360 BIOLOGICAL AGING HOW DOES AND 4833 03:34:47,360 --> 03:34:49,080 WHEN A PATIENT IS DIAGNOSED WITH 4834 03:34:49,080 --> 03:34:50,480 CANCER AND EXPOSED TO ALL 4835 03:34:50,480 --> 03:34:51,920 DIFFERENT TYPES OF CANCER 4836 03:34:51,920 --> 03:34:53,400 TREATMENTS THAT WE USE TO 4837 03:34:53,400 --> 03:34:58,280 ACHIEVE A CURE. 4838 03:34:58,280 --> 03:35:00,040 SO FOR THE LAST FEW YEARS, WE'VE 4839 03:35:00,040 --> 03:35:02,760 BEEN REALLY THINKING ABOUT WHAT 4840 03:35:02,760 --> 03:35:04,560 IS THE RELATIONSHIP BETWEEN 4841 03:35:04,560 --> 03:35:06,600 CANCER AND AGING AND IT'S JUST 4842 03:35:06,600 --> 03:35:08,880 THIS PAST YEAR, Dr. HARVEY 4843 03:35:08,880 --> 03:35:13,560 COHEN AND I HAD THE OPPORTUNITY 4844 03:35:13,560 --> 03:35:14,760 TO WRITE A PAPER TO DESCRIBE 4845 03:35:14,760 --> 03:35:16,440 THIS RELATIONSHIP AS A CYCLE. 4846 03:35:16,440 --> 03:35:17,800 SO I'M GOING TO SHARE WITH YOU 4847 03:35:17,800 --> 03:35:22,160 HOW I THINK ABOUT CANCER AND 4848 03:35:22,160 --> 03:35:22,760 AGING. 4849 03:35:22,760 --> 03:35:24,560 WE KNOW THAT AGING IS DRIVEN BY 4850 03:35:24,560 --> 03:35:28,600 THESE FUNDAMENTAL AGING 4851 03:35:28,600 --> 03:35:29,840 PROCESSES. 4852 03:35:29,840 --> 03:35:31,720 THEY LEAD TO AN INCREASE, A 4853 03:35:31,720 --> 03:35:36,680 DECLINE IN RESILIENCE, A 4854 03:35:36,680 --> 03:35:38,680 DECREASE IN IMPAIRED FUNCTION 4855 03:35:38,680 --> 03:35:40,680 AND CO MORBID CONTINUE INCLUDING 4856 03:35:40,680 --> 03:35:47,640 CANCER AND MORE FRAILTY AND IT 4857 03:35:47,640 --> 03:35:49,920 LEADS TO CANCER AND CANCER AND 4858 03:35:49,920 --> 03:35:52,480 AFTER A PERSON HAS CANCER, AND 4859 03:35:52,480 --> 03:35:54,720 THEN DEVELOPS CANCER TREATMENT, 4860 03:35:54,720 --> 03:35:57,560 BUT IT DOES IS THE CANCER AND 4861 03:35:57,560 --> 03:35:59,120 THE KANTER TREATMENT ACTS ON THE 4862 03:35:59,120 --> 03:36:02,560 FUNDAMENTAL AGING PROCESSES. 4863 03:36:02,560 --> 03:36:07,040 DRIVING EX ACCELERATED AGING 4864 03:36:07,040 --> 03:36:15,520 STATES AT THE WE SEE A DECREASE 4865 03:36:15,520 --> 03:36:17,920 IN RESILIENCE AND A INCREASE IN 4866 03:36:17,920 --> 03:36:19,000 COGNITIVE AND PHYSICAL 4867 03:36:19,000 --> 03:36:20,320 IMPAIRMENT AND MORE MULTI 4868 03:36:20,320 --> 03:36:21,840 MORBIDITY AND CHRONIC DISEASES 4869 03:36:21,840 --> 03:36:23,280 IN THEIR YEARS AFTER THEIR 4870 03:36:23,280 --> 03:36:25,960 CANCER DIAGNOSIS AND A 4871 03:36:25,960 --> 03:36:28,080 SIGNIFICANTLY HIGHER NUMBER OF 4872 03:36:28,080 --> 03:36:29,440 FRAILTY AS COMPARED TO THE 4873 03:36:29,440 --> 03:36:34,400 GENERAL POPULATION. 4874 03:36:34,400 --> 03:36:44,840 AND THE THE BETTER WE CAN 4875 03:36:45,680 --> 03:36:47,040 ACHIEVE TRUE PRECISION MEDICINE. 4876 03:36:47,040 --> 03:36:48,480 THERE ARE MULTIPLE WAYS WE CAN 4877 03:36:48,480 --> 03:36:50,800 LOOK AT THESE FUNDAMENTAL PROSES 4878 03:36:50,800 --> 03:36:52,840 FROM A CANCER AND AGING LENS AND 4879 03:36:52,840 --> 03:36:56,000 THERE'S A LOT OF WORK THAT IS ON 4880 03:36:56,000 --> 03:36:56,320 GOING. 4881 03:36:56,320 --> 03:36:58,360 ONE THAT IS PARTICULARLY 4882 03:36:58,360 --> 03:37:03,200 RELEVANT, TO BOTH, IS CELLULAR 4883 03:37:03,200 --> 03:37:05,080 SIN ESSENCE. 4884 03:37:05,080 --> 03:37:06,920 IT'S A CELLEL FATE. 4885 03:37:06,920 --> 03:37:10,800 CELLS UNDERGO THIS STATE OF 4886 03:37:10,800 --> 03:37:12,360 REVERSIBLE GROWTH ARREST IN THE 4887 03:37:12,360 --> 03:37:15,680 CONTEXT OF VARIOUS STIMULI, 4888 03:37:15,680 --> 03:37:16,720 VARIOUS DIFFERENT CUES. 4889 03:37:16,720 --> 03:37:21,080 SOME OF THESE CUES HAPPEN IN 4890 03:37:21,080 --> 03:37:31,600 DEVELOPMENTALLY AND AND OVER 400 4891 03:37:49,080 --> 03:37:51,080 DIFFERENT MOLECULES THAT CAN BE 4892 03:37:51,080 --> 03:37:52,160 SECRETED BY THESE CELLS, AND 4893 03:37:52,160 --> 03:37:56,400 WHAT WE KNOW IS THAT THESE 4894 03:37:56,400 --> 03:37:58,280 MOLECULES, THE SEN ESSENCE CELLS 4895 03:37:58,280 --> 03:38:02,640 ARE AN IMPORTANT PART OF NATURAL 4896 03:38:02,640 --> 03:38:13,040 PROCESSES OF WOUND REGENERATION. 4897 03:38:13,040 --> 03:38:16,560 TO CLAR SENESCENCE CELLS. 4898 03:38:16,560 --> 03:38:18,120 AS WE AGE AND ACCUMULATE MORE 4899 03:38:18,120 --> 03:38:20,120 AND MORE OF THESE SENESCENCE 4900 03:38:20,120 --> 03:38:24,040 CELLS AND WE HAVE HIGHER LEVELS 4901 03:38:24,040 --> 03:38:34,560 OF THESE MOL TOOLS WE LEAD TO AS 4902 03:38:40,760 --> 03:38:43,840 WE AGE THE NUMBER OF SENESCENCE 4903 03:38:43,840 --> 03:38:46,040 CELLS INCREASES THROUGHOUT 4904 03:38:46,040 --> 03:38:47,200 MULTIPLE TISSUES IN OUR BODY. 4905 03:38:47,200 --> 03:38:49,400 WE ALSO KNOW THERE'S A LOT OF 4906 03:38:49,400 --> 03:38:51,840 DIFFERENT AGE RELATED DISEASES 4907 03:38:51,840 --> 03:38:55,680 THAT HAVE BEEN SHOWN TO HAVE 4908 03:38:55,680 --> 03:38:57,280 SENESCENCE CELLS. 4909 03:38:57,280 --> 03:38:59,480 FOR EXAMPLE, ASTRO SITES IN 4910 03:38:59,480 --> 03:39:00,560 ALZHEIMER'S BRAIN HAVE LARGER 4911 03:39:00,560 --> 03:39:02,320 LEVELS OF SENESCENCE CELLS 4912 03:39:02,320 --> 03:39:03,840 COMPARED TO A NORMAL BRAIN SO 4913 03:39:03,840 --> 03:39:05,280 THERE'S AN OVERWHELMING AND 4914 03:39:05,280 --> 03:39:07,760 LARGE COMPELLING DATA TO SHOW 4915 03:39:07,760 --> 03:39:09,520 THAT SENESCENCE AND THE 4916 03:39:09,520 --> 03:39:12,160 SENESCENCE CELLS AND THE 4917 03:39:12,160 --> 03:39:14,360 ASSOCIATED PHENOTYPE PLAY A KEY 4918 03:39:14,360 --> 03:39:16,160 CONTRIBUTE OR IN THE DEVELOPMENT 4919 03:39:16,160 --> 03:39:22,360 OF AGING AND AGE RELATED 4920 03:39:22,360 --> 03:39:23,120 PATHOLOGIES. 4921 03:39:23,120 --> 03:39:24,480 MARCO DeMARIA AND JUDITH 4922 03:39:24,480 --> 03:39:26,480 SHOWED THAT THE CHEMOTHERAPY 4923 03:39:26,480 --> 03:39:29,240 THAT WE USE TO CURE PATIENTS 4924 03:39:29,240 --> 03:39:39,680 FROM THEIR CANCER, INDUCES 4925 03:39:40,720 --> 03:39:41,560 SENESCENCE CELLS WHERE THEY 4926 03:39:41,560 --> 03:39:44,160 LOOKED AT P16, WHICH IS A MARKER 4927 03:39:44,160 --> 03:39:46,560 OF CELLULAR SENESCENCE AND THEY 4928 03:39:46,560 --> 03:39:48,160 SHOWED THAT WHAT THEY SEE IS 4929 03:39:48,160 --> 03:39:50,840 THAT WHEN THE MICE WERE GIVEN 4930 03:39:50,840 --> 03:39:53,000 THE CHEMOTHERAPY THE CELL BURDEN 4931 03:39:53,000 --> 03:39:54,640 INCREASED AND IT DIDN'T REALLY 4932 03:39:54,640 --> 03:39:58,240 GO AWAY COMPLETELY OVER TIME. 4933 03:39:58,240 --> 03:40:00,920 WE KNOW THAT CHEMOTHERAPY AND 4934 03:40:00,920 --> 03:40:09,400 RADIATION AND OTHER KEY MODALITY 4935 03:40:09,400 --> 03:40:11,320 AND IT'S GOOD BECAUSE THAT HALTS 4936 03:40:11,320 --> 03:40:13,120 THE TUMOR GROWTH. 4937 03:40:13,120 --> 03:40:15,840 THEY ALSO INDUCE SENESCENCE 4938 03:40:15,840 --> 03:40:18,560 WHICH IS GOOD BECAUSE ON SOME 4939 03:40:18,560 --> 03:40:21,040 LEVEL, THE SENESCENCE AND THE 4940 03:40:21,040 --> 03:40:23,600 DOWNSTREAM SENESCENCE ASSOCIATED 4941 03:40:23,600 --> 03:40:25,880 PHENOTYPE DECREASES AND PREVENTS 4942 03:40:25,880 --> 03:40:28,000 TUMOR PROGRESSION AND HALTS 4943 03:40:28,000 --> 03:40:29,800 TUMOR GROWTH. 4944 03:40:29,800 --> 03:40:34,040 HOWEVER, OVER TIME, WHAT WE SEE 4945 03:40:34,040 --> 03:40:36,080 IS THAT THERE'S TILL LA THEY ARE 4946 03:40:36,080 --> 03:40:45,840 YUS EFFECTS OF THIS IN CANCER DF 4947 03:40:45,840 --> 03:40:56,240 THIS IN CANCER PATIENTS. 4948 03:40:59,840 --> 03:41:03,440 THIS IS NEGATIVE THAT SENESCENCE 4949 03:41:03,440 --> 03:41:05,920 CELLS, LEAD TO INCREASED ANGIO 4950 03:41:05,920 --> 03:41:07,360 GENESIS AND DRIVE TUMOR 4951 03:41:07,360 --> 03:41:11,280 RESISTANCE AND TUMOR METASTASIS 4952 03:41:11,280 --> 03:41:14,520 AND ALSO MARCO DeMARIA AND 4953 03:41:14,520 --> 03:41:15,240 JUDITH AND OTHERS HAVE SHOWN 4954 03:41:15,240 --> 03:41:17,720 THAT THEY ALSO DRIVE THE 4955 03:41:17,720 --> 03:41:19,040 ACCELERATED AGING STATE THAT WE 4956 03:41:19,040 --> 03:41:19,720 SEE. 4957 03:41:19,720 --> 03:41:21,600 THEY EFFECT CARDIOVASCULAR 4958 03:41:21,600 --> 03:41:23,040 DYSFUNCTION AND THEY SHORTEN 4959 03:41:23,040 --> 03:41:29,360 REJECTION FRACTION AND THEY LEAD 4960 03:41:29,360 --> 03:41:31,840 TO FATIGUE AS WELL AS COGNITIVE 4961 03:41:31,840 --> 03:41:33,040 IMPAIRMENT AND BONE HEALTH AND 4962 03:41:33,040 --> 03:41:35,000 SO, WE BELIEVE THAT THIS MAY BE 4963 03:41:35,000 --> 03:41:37,120 AN IMPORTANT PATHWAY AS WE THINK 4964 03:41:37,120 --> 03:41:41,000 ABOUT CANCER. 4965 03:41:41,000 --> 03:41:43,400 THERE'S BEEN A LOT OF PROPOSAL 4966 03:41:43,400 --> 03:41:45,280 OUT THERE THAT PERHAPS IN 4967 03:41:45,280 --> 03:41:47,520 ESSENCE MAY BE A WAY TO IMPROVE 4968 03:41:47,520 --> 03:41:52,120 THE WAY THAT WE CARE FOR CANCER 4969 03:41:52,120 --> 03:41:53,640 PATIENTS. 4970 03:41:53,640 --> 03:41:57,000 THERE'S A PARADIGM CALLED THE 4971 03:41:57,000 --> 03:41:57,800 ONE-TWO-PUNCH APPROACH. 4972 03:41:57,800 --> 03:41:59,760 WE GIVE OUR PATIENTS 4973 03:41:59,760 --> 03:42:01,760 CHEMOTHERAPY, RADIATION, WE GIVE 4974 03:42:01,760 --> 03:42:03,360 THEM THE TREATMENTS WE KNOW ARE 4975 03:42:03,360 --> 03:42:04,880 USED TO CURE CANCER IN THE 4976 03:42:04,880 --> 03:42:14,280 SECOND PUNCH, WE COULD GIVE THEM 4977 03:42:14,280 --> 03:42:20,240 A AGENT OF DIMINISH THE 4978 03:42:20,240 --> 03:42:23,160 DOWNSTREAM SENESCENCE ASSOCIATED 4979 03:42:23,160 --> 03:42:24,440 PHENOTYPE AND BY DOING THAT WE 4980 03:42:24,440 --> 03:42:26,760 MAY BE ABLE TO ACHIEVE GREATER 4981 03:42:26,760 --> 03:42:28,840 EFFICACY OF OUR CANCER TREATMENT 4982 03:42:28,840 --> 03:42:30,880 AND DECREASING SOME OF THE 4983 03:42:30,880 --> 03:42:32,440 ADVERSE EFFECTS THAT ARE RELATED 4984 03:42:32,440 --> 03:42:36,480 TO TUMOR GENESIS AND CANCER 4985 03:42:36,480 --> 03:42:39,560 PROGRESSION AND ALSO IMPROVE THE 4986 03:42:39,560 --> 03:42:41,000 DELIVERY OF THE TREATMENT BY 4987 03:42:41,000 --> 03:42:44,720 DECREASING THE ACCELERATED AGING 4988 03:42:44,720 --> 03:42:46,160 DECLINE AND DYSFUNCTION THAT IS 4989 03:42:46,160 --> 03:42:48,840 ON OUR CANCER SURVIVOR SO I WAS 4990 03:42:48,840 --> 03:42:51,240 HAPPY TO SEE THAT THE NCI HAD A 4991 03:42:51,240 --> 03:42:57,120 CALL OUT THAT JUST ENDED TO 4992 03:42:57,120 --> 03:42:59,760 INNOVATIVE COMPANIES AND TO 4993 03:42:59,760 --> 03:43:02,800 DEVELOP NOVEL AGES THIS 4994 03:43:02,800 --> 03:43:06,320 HYPOTHESIS AND SEE HOW WE CAN 4995 03:43:06,320 --> 03:43:08,800 IMPROVE ACCELERATED AGING AND 4996 03:43:08,800 --> 03:43:13,480 DECREASED CANCER AND LEVERAGING 4997 03:43:13,480 --> 03:43:17,440 OR CARN HE ISING AND CON SEX OF 4998 03:43:17,440 --> 03:43:18,160 CANCER. 4999 03:43:18,160 --> 03:43:19,960 ADDS I TOLD YOU BEFORE, AS WE 5000 03:43:19,960 --> 03:43:24,000 GET OLDER, THE HEALTHY FI TISSU, 5001 03:43:24,000 --> 03:43:27,640 WE HAVE MORE AND MORE AGING 5002 03:43:27,640 --> 03:43:30,240 TISSUE AND SENESCENCE CELLS AND 5003 03:43:30,240 --> 03:43:31,520 THERE'S A LOT OF WAYS OF PEOPLE 5004 03:43:31,520 --> 03:43:35,520 THINK ABOUT TARGETING AND AND 5005 03:43:35,520 --> 03:43:37,040 EXERCISE HAS BEEN SHOWN TO BE A 5006 03:43:37,040 --> 03:43:39,560 WAY TO REDUCE SENESCENCE CELL 5007 03:43:39,560 --> 03:43:42,760 BURDEN AND SO AS CALORIC 5008 03:43:42,760 --> 03:43:48,680 RESTRICTION, SIN A LET TICKS AND 5009 03:43:48,680 --> 03:43:51,200 AND THAT THEY TARGET THE 5010 03:43:51,200 --> 03:43:56,000 SENESCENCE CELLS THEMSELVES AND 5011 03:43:56,000 --> 03:43:59,040 DOWNSTREAM AND PATHWAY AND WORK 5012 03:43:59,040 --> 03:44:03,400 BY Dr. KIRKLAND AND ARE LOOK 5013 03:44:03,400 --> 03:44:05,320 TO GO SEE WELL AND HOW WE CAN 5014 03:44:05,320 --> 03:44:10,480 GET THEM TO INDUCE IT AND 5015 03:44:10,480 --> 03:44:15,440 THEY'VE EY IDENTIFIED KEY MOLECR 5016 03:44:15,440 --> 03:44:17,920 PATHWAYS THAT CAN BE USED AND 5017 03:44:17,920 --> 03:44:20,520 INDUCING IN THE SENESCENCE CELLS 5018 03:44:20,520 --> 03:44:26,640 AND THEY'VE DONE A LOT OF WORK 5019 03:44:26,640 --> 03:44:28,920 AND BOTH USING RE-PURPOSE AGENTS 5020 03:44:28,920 --> 03:44:30,120 AS WELL AS NEW AGENTS SO WE CAN 5021 03:44:30,120 --> 03:44:33,080 THINK ABOUT THESE AGENTS AS SORT 5022 03:44:33,080 --> 03:44:35,880 OF FIRST CLASS AGENTS AND THOSE 5023 03:44:35,880 --> 03:44:37,520 ARE THOSE WERE RECOVERED BY 5024 03:44:37,520 --> 03:44:39,360 IDENTIFYING THIS SENESCENCE 5025 03:44:39,360 --> 03:44:41,040 ASSOCIATED ANTI A POP AT THAT 5026 03:44:41,040 --> 03:44:43,000 TIME I CAN PATHWAYS AND LOOKING 5027 03:44:43,000 --> 03:44:44,440 FOR SOME OF THE KNOWN DRUGS OUT 5028 03:44:44,440 --> 03:44:48,560 THERE AND THE TARGET THESE 5029 03:44:48,560 --> 03:44:51,800 PATHWAYS. 5030 03:44:51,800 --> 03:44:55,440 LOOKING AT HIGH THOROUGH PUT FOR 5031 03:44:55,440 --> 03:44:57,520 SECOND GENERATION AND THERE'S 5032 03:44:57,520 --> 03:44:58,680 EVEN SOME REALLY EXCITING WORK 5033 03:44:58,680 --> 03:45:01,560 TO THINK ABOUT IMMUNO MODULATOR 5034 03:45:01,560 --> 03:45:04,000 AND CAR T CELLS AS A WAY TO 5035 03:45:04,000 --> 03:45:06,360 TARGET SENESCENCE CELLS AND 5036 03:45:06,360 --> 03:45:07,400 REDUCE SOME OF THE EFFECTS THAT 5037 03:45:07,400 --> 03:45:12,720 I JUST DISCUSSED. 5038 03:45:12,720 --> 03:45:14,960 THE WORKOUT THERE AND HAS BEEN 5039 03:45:14,960 --> 03:45:19,160 IN THE FIRST-GENERATION 5040 03:45:19,160 --> 03:45:22,680 PRIMARILY WITH THREE KEY DRUGS. 5041 03:45:22,680 --> 03:45:25,840 AND THE COMBINATION OF THE HAS 5042 03:45:25,840 --> 03:45:28,560 BEEN STUDIED IN MULTIPLE ANIMAL 5043 03:45:28,560 --> 03:45:32,560 MODELS AND THERE'S A LOT OF 5044 03:45:32,560 --> 03:45:34,560 COMPELLING AND THERE'S HUMAN 5045 03:45:34,560 --> 03:45:36,680 DATA IN EARLY PHASE STUDIES TO 5046 03:45:36,680 --> 03:45:41,960 SHE THIS COCKTAIL OF THESE TWO 5047 03:45:41,960 --> 03:45:43,720 AGENTS SKI CREASES IN ADD A POST 5048 03:45:43,720 --> 03:45:45,440 TISSUE IN THE BEGIN AND 5049 03:45:45,440 --> 03:45:48,480 DECREASES INFLAMMATION AND 5050 03:45:48,480 --> 03:45:50,800 THERE'S ALSO EARLY DATA IN I HAD 5051 03:45:50,800 --> 03:45:54,120 YO PATHIC PULMONARY FIE BROW 5052 03:45:54,120 --> 03:45:55,440 PATIENT THAT IMPROVES WALKING 5053 03:45:55,440 --> 03:45:57,000 SPEED AND PHYSICAL FUNCTION AND 5054 03:45:57,000 --> 03:45:58,920 THE SIXTH MINUTE WALK TEST AND 5055 03:45:58,920 --> 03:46:04,240 GATE SPEED, TIME CHAIR AND THE 5056 03:46:04,240 --> 03:46:14,800 SPP SCORE SO THIS REPRESENTS AND 5057 03:46:53,320 --> 03:46:54,280 WE WERE FLAG ANOTHER COMPOUND 5058 03:46:54,280 --> 03:46:56,760 AND IT'S A NATURAL FLAVONOIDS 5059 03:46:56,760 --> 03:47:01,160 FOUND THIS STRAWBERRIES AND 5060 03:47:01,160 --> 03:47:07,040 OTHER FRUITS AND SHOWING THIS 5061 03:47:07,040 --> 03:47:10,160 ASIAN CAN REDUCE CELLULAR 5062 03:47:10,160 --> 03:47:11,600 SENESCENCE CELL BURDEN IN MICE 5063 03:47:11,600 --> 03:47:15,840 AND THIS REDUCTION IN SENESCENCE 5064 03:47:15,840 --> 03:47:17,280 IS CONSISTENT AND PERSIST 5065 03:47:17,280 --> 03:47:18,800 APARTMENT OVER TIME AND IT'S 5066 03:47:18,800 --> 03:47:22,600 ASSOCIATED WITH A DECREASE AND 5067 03:47:22,600 --> 03:47:25,520 FRAILTY AND EVEN IN HUMANS 5068 03:47:25,520 --> 03:47:27,840 THERE'S SIGNALS IT CAN REDUCE 5069 03:47:27,840 --> 03:47:28,480 CELLULAR. 5070 03:47:28,480 --> 03:47:30,320 AND SO WE WANTED TO BEGIN 5071 03:47:30,320 --> 03:47:40,800 THINKING ABOUT THAT AND NED 5072 03:47:54,080 --> 03:47:55,080 SHARPLESS DID WORK LOOKING AT 5073 03:47:55,080 --> 03:47:57,720 BREAST CANCER PATIENTS AND THEY 5074 03:47:57,720 --> 03:48:00,320 SHOWED THAT P16 WHICH IS FOUND 5075 03:48:00,320 --> 03:48:03,160 IN CD3 POSITIVE T CELLS 5076 03:48:03,160 --> 03:48:04,720 INCREASES WITH AGE. 5077 03:48:04,720 --> 03:48:06,560 IT ALSO IN THE RED LINE HERE 5078 03:48:06,560 --> 03:48:08,480 THOSE ARE THE PEOPLE THAT GOT 5079 03:48:08,480 --> 03:48:19,040 CHEMOTHERAPY IN THE TOP FIGURE, 5080 03:48:23,440 --> 03:48:25,920 IT GOES UP AND IT REMAINS 5081 03:48:25,920 --> 03:48:27,080 ELEVATED OVER TIME AND IT 5082 03:48:27,080 --> 03:48:29,760 DOESN'T REALLY COME BACK DOWN AS 5083 03:48:29,760 --> 03:48:31,680 FAR AS THIS IS A 12-MONTH AND 5084 03:48:31,680 --> 03:48:33,560 WE'VE SHOWN THAT IN TWO TO THREE 5085 03:48:33,560 --> 03:48:35,920 YEARS LATER YOUR SENESCENCE CELL 5086 03:48:35,920 --> 03:48:39,200 BURDEN IS HIGH. 5087 03:48:39,200 --> 03:48:40,760 MORE RECENTLY IN OLDER WOMEN 5088 03:48:40,760 --> 03:48:42,840 WITH BREAST CANCER WE SHOWED THE 5089 03:48:42,840 --> 03:48:45,920 P16 WAS HIGHLY ASSOCIATED WITH 5090 03:48:45,920 --> 03:48:46,560 FRAILTY. 5091 03:48:46,560 --> 03:48:49,800 WE ALSO SHOW THAT SOME OF THE 5092 03:48:49,800 --> 03:48:51,200 SENESCENCE ASSOCIATED MARKERS 5093 03:48:51,200 --> 03:48:55,040 LIKE IL6 AND CRP WERE NOT ONLY 5094 03:48:55,040 --> 03:49:00,680 INDICATIVE BUT PREDICTIVE OF WHO 5095 03:49:00,680 --> 03:49:11,240 DEVELOPED FRAILTY AFTER WE HAVE 5096 03:49:16,320 --> 03:49:24,560 SEEN THAT COMPARED TO CONTROL, 5097 03:49:24,560 --> 03:49:25,840 SURVIVORS HAVE THEIR PHYSICAL 5098 03:49:25,840 --> 03:49:26,880 LOGIC RESERVE. 5099 03:49:26,880 --> 03:49:30,040 AS WE GET OLDER WE GO FROM 5100 03:49:30,040 --> 03:49:30,880 ROBUST TO FRAIL AND WE SEE WHEN 5101 03:49:30,880 --> 03:49:33,600 A WOMAN IS DIAGNOSED WITH BREAST 5102 03:49:33,600 --> 03:49:34,680 CANCER, FROM THE MOMENT THAT 5103 03:49:34,680 --> 03:49:36,720 SHE'S DIAGNOSED, THE MOMENT THAT 5104 03:49:36,720 --> 03:49:38,160 SHE GETS TREATMENT AND THE YEARS 5105 03:49:38,160 --> 03:49:40,400 THAT SHE HAS TO LIVE AFTER 5106 03:49:40,400 --> 03:49:42,640 TREATMENT, MANY OF THESE WOMEN 5107 03:49:42,640 --> 03:49:46,160 DEVELOP THIS TRAJECTORY WHERE 5108 03:49:46,160 --> 03:49:47,800 THEY BECOME AGING AT A FASTER 5109 03:49:47,800 --> 03:49:49,360 RATE THAN A HEALTHY CONTROL AND 5110 03:49:49,360 --> 03:49:52,360 WHAT OUR GOAL IS, IS TO IDENTIFY 5111 03:49:52,360 --> 03:49:54,360 WHO IS ON THAT TRAJECTORY AND 5112 03:49:54,360 --> 03:49:56,240 WHAT CAN WE DO ABOUT IT. 5113 03:49:56,240 --> 03:49:58,880 CAN WE INCREASE, CAN WE PREVENT 5114 03:49:58,880 --> 03:50:00,760 IT SO WE WERE REALLY INTERESTED 5115 03:50:00,760 --> 03:50:03,440 IN THE SURVIVORSHIP IN THE WOMEN 5116 03:50:03,440 --> 03:50:06,000 WHO WERE PRE FRAIL AND THOSE 5117 03:50:06,000 --> 03:50:07,080 WERE WERE FRAIL. 5118 03:50:07,080 --> 03:50:09,600 WE WANTED ASK THE QUESTION, CAN 5119 03:50:09,600 --> 03:50:15,600 WE BEGIN TESTING SEN A LIT TICKS 5120 03:50:15,600 --> 03:50:17,720 IN THIS POPULATION SO WE'RE 5121 03:50:17,720 --> 03:50:20,160 DOING A MULTI SENSOR STUDY AT 5122 03:50:20,160 --> 03:50:22,560 UNIVERSITY OF CONNECTICUT AND 5123 03:50:22,560 --> 03:50:25,400 HOW MUSS AT UNC AND JIM KIRKLAND 5124 03:50:25,400 --> 03:50:27,560 LOOKING AT POST MENOPAUSAL WOMEN 5125 03:50:27,560 --> 03:50:28,880 WITH EARLY STAGE BREAST CANCER 5126 03:50:28,880 --> 03:50:30,920 WHO HAVE RECEIVED CHEMOTHERAPY 5127 03:50:30,920 --> 03:50:33,040 AND ARE DEVELOPING PRE FRAILTY 5128 03:50:33,040 --> 03:50:35,640 STATUS AND WE'RE DOING IT TWO BY 5129 03:50:35,640 --> 03:50:38,040 TWO NOT FACTORIAL DESIGN TO LOOK 5130 03:50:38,040 --> 03:50:40,640 AT EXERCISE PLUS SEN A LET TICK 5131 03:50:40,640 --> 03:50:48,040 AND EXERCISE ALONE AND NO 5132 03:50:48,040 --> 03:50:52,600 EXERCISE -- IT'S A SIX MINUTE 5133 03:50:52,600 --> 03:50:57,840 WALK TEST AND A LOT OF 5134 03:50:57,840 --> 03:51:03,000 BIOLOGICAL COREL TIVES AND WOMEN 5135 03:51:03,000 --> 03:51:05,840 DIFFERENT THAN THE RO1 WHO HAVE 5136 03:51:05,840 --> 03:51:06,840 ACHIEVED FRAILTY AND THOSE WOMEN 5137 03:51:06,840 --> 03:51:08,360 WHO CENTERINGEL WITH EXERCISE 5138 03:51:08,360 --> 03:51:12,640 AND LOOKING AT PLACEBO ALONE BUT 5139 03:51:12,640 --> 03:51:15,080 USING THE SAME IDEA TO TRY TO 5140 03:51:15,080 --> 03:51:17,080 UNDERSTAND IF WE CAN IMPROVE 5141 03:51:17,080 --> 03:51:18,560 PHYSICAL FUNCTION. 5142 03:51:18,560 --> 03:51:19,720 THERE'S ALSO ANOTHER STUDY 5143 03:51:19,720 --> 03:51:21,360 THAT'S BEING DONE IN CHILDHOOD 5144 03:51:21,360 --> 03:51:24,040 CANCER SURVIVORS AND IT'S 5145 03:51:24,040 --> 03:51:26,440 LOOKING AT THE COR SETTEN VERSUS 5146 03:51:26,440 --> 03:51:30,080 PRO SETTEN IN FRAIL OPERATION OF 5147 03:51:30,080 --> 03:51:31,560 CHILDHOOD CANCER SURVIVOR AND 5148 03:51:31,560 --> 03:51:34,880 THIS IS A UO1 THAT'S DONE 5149 03:51:34,880 --> 03:51:36,800 THROUGH SAINT JUDE WITH JIM 5150 03:51:36,800 --> 03:51:38,560 KIRKLAND SO AS I FINISH HERE, I 5151 03:51:38,560 --> 03:51:46,320 WANT TO JUST SHOW YOU THAT WE 5152 03:51:46,320 --> 03:51:47,640 CAN LEARN FROM THE AGING 5153 03:51:47,640 --> 03:51:47,880 COMMUNITY. 5154 03:51:47,880 --> 03:51:49,280 WE CAN LEARN ABOUT STUDYING 5155 03:51:49,280 --> 03:51:50,600 DIFFERENT AGING OUTCOMES AND 5156 03:51:50,600 --> 03:51:52,840 FOCUS ON STUDYING, TRIALS WITH 5157 03:51:52,840 --> 03:51:54,000 BREAST CANCER BUT WE CAN DO THIS 5158 03:51:54,000 --> 03:51:56,320 IN OTHER CANCER SURVIVORSHIP AND 5159 03:51:56,320 --> 03:51:59,040 MOVE OTHER DISEASES AND I THINK 5160 03:51:59,040 --> 03:52:00,560 THERE'S REPORTED TO NOTE THAT AS 5161 03:52:00,560 --> 03:52:10,920 WE ARE STUDYING THIS, IN THE 5162 03:52:10,920 --> 03:52:12,480 CONTEXT OF CANCER AND THERE'S AN 5163 03:52:12,480 --> 03:52:14,480 OPPORTUNITY TO LEARN MORE AND TO 5164 03:52:14,480 --> 03:52:16,520 THINK ABOUT OTHER PROCESSES. 5165 03:52:16,520 --> 03:52:18,840 I WILL JUST SORT OF SAFE TOO 5166 03:52:18,840 --> 03:52:20,880 THAT I HAVE ONLY FOCUSED ON THE 5167 03:52:20,880 --> 03:52:22,280 LEFT SIDE OF THE CIRCLE. 5168 03:52:22,280 --> 03:52:23,960 THERE'S A RIGHT SIDE OF THE 5169 03:52:23,960 --> 03:52:26,960 CIRCLE WHERE AGING IS AN 5170 03:52:26,960 --> 03:52:28,520 MODULATES CANCER AND THERE'S A 5171 03:52:28,520 --> 03:52:34,720 LOT OF WORK LIKE DONE BY MARK LA 5172 03:52:34,720 --> 03:52:36,320 BARGE LOOKING AT STRUCTURAL AND 5173 03:52:36,320 --> 03:52:37,960 AGING RELATED CHANGES THAT LEAD 5174 03:52:37,960 --> 03:52:39,600 TO THE DEVELOPMENT OF CANCER AND 5175 03:52:39,600 --> 03:52:43,400 THERE'S A LOT THAT THE 5176 03:52:43,400 --> 03:52:44,920 GEROSCIENCE CAN BRING TO THE 5177 03:52:44,920 --> 03:52:46,000 UNDERSTANDING OF CANCER AND 5178 03:52:46,000 --> 03:52:47,440 CHEMO PREVENTION AS WE MOVE 5179 03:52:47,440 --> 03:52:49,440 FORWARD SO CANCER AND AGING IS 5180 03:52:49,440 --> 03:52:51,680 JUST ONE OF THE MANY THINGS THAT 5181 03:52:51,680 --> 03:52:53,480 WE CAN LEARN AS WE THINK ABOUT 5182 03:52:53,480 --> 03:52:55,400 ALL THESE DIFFERENT PARADIGMS 5183 03:52:55,400 --> 03:52:59,240 AND ULTIMATELY, THE MORE WE 5184 03:52:59,240 --> 03:52:59,880 UNDERSTAND THESE PROCESSES, THE 5185 03:52:59,880 --> 03:53:01,360 BETTER THAT WE'LL BE ABLE TO 5186 03:53:01,360 --> 03:53:07,920 TREAT NOT JUST CANCER BUT MANY 5187 03:53:07,920 --> 03:53:09,120 OF UNDERLYING FUNDAMENTAL 5188 03:53:09,120 --> 03:53:10,280 PROCESSES WE CAN POTENTIALLY 5189 03:53:10,280 --> 03:53:12,360 MAKE A DIFFERENCE IN MULTIPLE 5190 03:53:12,360 --> 03:53:14,080 AREAS AND LEAD TO AN IMPROVEMENT 5191 03:53:14,080 --> 03:53:15,880 AND SO, CANCER SURVIVORS ARE 5192 03:53:15,880 --> 03:53:18,960 LIVING LONGER AND THEY ARE -- 5193 03:53:18,960 --> 03:53:20,600 THERE'S A DYNAMIC INTER PLAY 5194 03:53:20,600 --> 03:53:22,400 BETWEEN CANCER AND AGING EX WE 5195 03:53:22,400 --> 03:53:25,000 NEED TO DEVELOP A COMPREHENSIVE 5196 03:53:25,000 --> 03:53:27,280 APPROACH TO UNDERSTANDING THE 5197 03:53:27,280 --> 03:53:28,560 FUNDAMENTAL PROCESSES AND THAT 5198 03:53:28,560 --> 03:53:32,240 WE CAN TRANSLATE THESE FINDINGS 5199 03:53:32,240 --> 03:53:34,520 ULTIMATELY INTO GEROSCIENCE OWE 5200 03:53:34,520 --> 03:53:36,120 INTERVENTIONS THAT CAN PREVENT 5201 03:53:36,120 --> 03:53:38,080 ACCELERATED AGING AND ALSO 5202 03:53:38,080 --> 03:53:39,960 PREVENT CANCER EMERGENCE AND 5203 03:53:39,960 --> 03:53:42,360 PROGRESSION AND THE MORE WE USE 5204 03:53:42,360 --> 03:53:44,600 CANCER AS A MODEL TO UNDERSTAND 5205 03:53:44,600 --> 03:53:46,280 THESE PROCESSES, I THINK THAT 5206 03:53:46,280 --> 03:53:48,200 WILL HELP US ALSO TO TRANSLATE 5207 03:53:48,200 --> 03:53:52,160 THIS AND MAKE POSITIVE IMPACT 5208 03:53:52,160 --> 03:53:52,640 ELSEWHERE. 5209 03:53:52,640 --> 03:53:53,960 THAT'S ALL I HAVE. 5210 03:53:53,960 --> 03:53:54,520 THANK YOU. 5211 03:53:54,520 --> 03:54:01,080 [APPLAUSE] 5212 03:54:01,080 --> 03:54:03,680 >>GOOD AFTERNOON, MY SLIDES ARE 5213 03:54:03,680 --> 03:54:04,440 UP NOW. 5214 03:54:04,440 --> 03:54:05,160 I APOLOGIZE. 5215 03:54:05,160 --> 03:54:06,320 AS MENTIONED IN THE 5216 03:54:06,320 --> 03:54:08,200 INTRODUCTION, I'M AN INFECTIOUS 5217 03:54:08,200 --> 03:54:09,520 DISEASE CLINICIAN AND 5218 03:54:09,520 --> 03:54:11,520 RESEARCHERS AND I HAD SPEND THE 5219 03:54:11,520 --> 03:54:12,960 MAJORITY OF CARING FOR PATIENTS 5220 03:54:12,960 --> 03:54:15,440 WITH HIV OR RESEARCHING PATIENTS 5221 03:54:15,440 --> 03:54:16,160 WITH HIV. 5222 03:54:16,160 --> 03:54:18,520 IN CONTRAST TO WHAT I SAW 5223 03:54:18,520 --> 03:54:19,320 PROBABLY 20 SOMETHING YEARS AGO 5224 03:54:19,320 --> 03:54:21,360 IN MEDICAL SCHOOL, THE MAJORITY 5225 03:54:21,360 --> 03:54:24,080 OF PEOPLE WITH HIV ARE NOW AGE 5226 03:54:24,080 --> 03:54:26,880 50 YEARS OR OLDER. 5227 03:54:26,880 --> 03:54:29,040 WE CONTINUE TO SEE, I SPEND MOST 5228 03:54:29,040 --> 03:54:30,960 OF MY TIME IN CLINICS TAKING 5229 03:54:30,960 --> 03:54:33,480 CARE OF CO MORBID TEASE, TALKING 5230 03:54:33,480 --> 03:54:38,760 ABOUT POLY PHARMACY, ADDRESSING 5231 03:54:38,760 --> 03:54:39,680 ADVANCE DIRECTIVES RATHER THAN 5232 03:54:39,680 --> 03:54:41,320 TALKING ABOUT OPPORTUNITY IS 5233 03:54:41,320 --> 03:54:43,120 TICK INFECTION OR TALKING THAT 5234 03:54:43,120 --> 03:54:47,480 MUCH ABOUT ANTI RETRO VIRAL 5235 03:54:47,480 --> 03:54:48,080 THERAPY. 5236 03:54:48,080 --> 03:54:49,160 IT'S THE RESULT OF THE 5237 03:54:49,160 --> 03:54:52,440 REMARKABLE SUCCESSES OF ANTI-THE 5238 03:54:52,440 --> 03:54:54,080 RETRO VIRAL THERAPY OVER THE 5239 03:54:54,080 --> 03:54:55,000 LAST 25-30 YEARS. 5240 03:54:55,000 --> 03:54:57,200 WE CONTINUE TO SEE NEW DIAGNOSIS 5241 03:54:57,200 --> 03:54:59,080 OF HIV IN OLDER ADULTS AND IN 5242 03:54:59,080 --> 03:55:01,160 FACT THE INCIDENTS OF HIV HAS 5243 03:55:01,160 --> 03:55:02,720 ACTUALLY REMAINED FAIRLY STABLE 5244 03:55:02,720 --> 03:55:04,720 AND IN POPULATIONS 55 OR OLDER 5245 03:55:04,720 --> 03:55:06,840 AND WE'VE HAD SOME SUCCESSES AND 5246 03:55:06,840 --> 03:55:08,160 DECREASING THE INCIDENTS OF NEW 5247 03:55:08,160 --> 03:55:12,320 HIV DIAGNOSIS IN YOUNGER 5248 03:55:12,320 --> 03:55:13,800 POPULATIONS. 5249 03:55:13,800 --> 03:55:14,680 THE PURSE PORTION OF PEOPLE WITH 5250 03:55:14,680 --> 03:55:16,320 HIV THAT ARE AGE 50 OR OLDER 5251 03:55:16,320 --> 03:55:17,840 LIVING IN THE U.S. IS EXPECTED 5252 03:55:17,840 --> 03:55:23,200 TO REACH ABOUT 75% BY THE YEAR 5253 03:55:23,200 --> 03:55:24,520 2030. 5254 03:55:24,520 --> 03:55:26,720 THE PREPORTION OF OLDER ADULTS 5255 03:55:26,720 --> 03:55:28,440 LIVING WITH HIV IN LOW AND 5256 03:55:28,440 --> 03:55:31,400 MIDDLE INCOME COUNTRIES HAS 5257 03:55:31,400 --> 03:55:32,160 CERTAINLY LAGGED HYPED AND IT'S 5258 03:55:32,160 --> 03:55:33,960 PROBLEM JUST A FRACTION OF THE 5259 03:55:33,960 --> 03:55:35,840 PERCENT OF THE -- A SMALL 5260 03:55:35,840 --> 03:55:37,000 PERCENT OF THE POPULATION IN 5261 03:55:37,000 --> 03:55:38,920 OTHER COUNTRY HOWEVER THIS MAKES 5262 03:55:38,920 --> 03:55:40,680 UP A DRASTIC NUMBER OF PATIENTS 5263 03:55:40,680 --> 03:55:42,760 JUST DUE TO THE SCHEER BURDEN OF 5264 03:55:42,760 --> 03:55:45,120 HIV AND MANY OF THESE COUNTRIES. 5265 03:55:45,120 --> 03:55:46,720 AND THIS HAS BEEN COMPLICATED BY 5266 03:55:46,720 --> 03:55:49,040 SLOWER ROLLOUT OF ANTI RETRO 5267 03:55:49,040 --> 03:55:50,960 VIRAL THERAPY AND AVAILABLE OF 5268 03:55:50,960 --> 03:55:53,360 ANTI RETRO VIABLE THERAPY BUT A 5269 03:55:53,360 --> 03:55:55,240 MAJOR HEALTH CRISIS IN THE 5270 03:55:55,240 --> 03:55:56,360 UPCOMING DECADES. 5271 03:55:56,360 --> 03:55:58,720 IT'S ALSO COMPLICATED BY A LACK 5272 03:55:58,720 --> 03:56:00,280 OF INFRASTRUCTURE FOR LONG-TERM 5273 03:56:00,280 --> 03:56:01,400 CO-MORBIDITY MANAGEMENT AND MANY 5274 03:56:01,400 --> 03:56:04,040 OF THESE COUNTRY. 5275 03:56:04,040 --> 03:56:06,080 THE LIFE EXPECTANCY OF PEOPLE 5276 03:56:06,080 --> 03:56:07,800 LIVING WITH HIV HAS IMPROVED 5277 03:56:07,800 --> 03:56:09,200 DRASTICALLY OVER THE LAST 40 5278 03:56:09,200 --> 03:56:11,240 YEARS NOW OF THE HIV EPIDEMIC 5279 03:56:11,240 --> 03:56:12,880 AND AS YOU CAN SEE BY THE TOP 5280 03:56:12,880 --> 03:56:15,120 TWO LINES, THE LIFE EXPECTANCY 5281 03:56:15,120 --> 03:56:17,680 OF SOMEONE WITH HIV ACTUALLY NOW 5282 03:56:17,680 --> 03:56:20,320 NEARS THAT OF A PERSON WITH OUT 5283 03:56:20,320 --> 03:56:20,840 HIV. 5284 03:56:20,840 --> 03:56:22,320 THERE'S STILL A GAP. 5285 03:56:22,320 --> 03:56:23,960 THIS GAP IS WHAT WE THINK MIGHT 5286 03:56:23,960 --> 03:56:26,080 BE CAUSED BY ACCELERATED AGING 5287 03:56:26,080 --> 03:56:28,240 THAT WE'VE SEEN IN PEOPLE WITH 5288 03:56:28,240 --> 03:56:28,720 HIV. 5289 03:56:28,720 --> 03:56:30,480 IF YOU LOOK AT THE TWO LINES AT 5290 03:56:30,480 --> 03:56:32,040 THE BOTTOM OF THIS FIGURE, IT 5291 03:56:32,040 --> 03:56:35,120 SHOWS THE EXPECTED TIME FOR A 5292 03:56:35,120 --> 03:56:36,800 21-YEAR-OLD TO DEVELOP AN 5293 03:56:36,800 --> 03:56:38,040 ADDITIONAL CO-MORBIDITY AND FOR 5294 03:56:38,040 --> 03:56:40,200 SOMEONE WITHOUT HIV, THAT MAY BE 5295 03:56:40,200 --> 03:56:41,720 ABOUT 30 YEARS AND IN CONTRAST, 5296 03:56:41,720 --> 03:56:44,280 WE EXPECT A 21-YEAR-OLD WITH HIV 5297 03:56:44,280 --> 03:56:47,080 WILL PROBABLY DEVELOP ANOTHER 5298 03:56:47,080 --> 03:56:49,520 CO-MORBIDITY WITHIN 10 YEARS. 5299 03:56:49,520 --> 03:56:51,400 IN FACT WHEN WE LOOK AT COHORTS 5300 03:56:51,400 --> 03:56:52,840 THAT PEOPLE WITH AND WITHOUT HIV 5301 03:56:52,840 --> 03:56:55,480 THAT ARE MATCHED FOR DEMOGRAPHIC 5302 03:56:55,480 --> 03:56:57,000 DIFFERENCES, PEOPLE WITH HIV 5303 03:56:57,000 --> 03:56:58,680 EXPERIENCE A MUCH GREATER CO 5304 03:56:58,680 --> 03:57:00,320 MORBID BURDEN ACROSS THE 5305 03:57:00,320 --> 03:57:00,760 LIFESPAN. 5306 03:57:00,760 --> 03:57:02,000 FOR EXAMPLE, THE TWO BOXES I 5307 03:57:02,000 --> 03:57:04,480 HAVE OUTLINED IN RED, PEOPLE 5308 03:57:04,480 --> 03:57:07,800 WITH HIV ABOUT 80% OF PEOPLE IN 5309 03:57:07,800 --> 03:57:11,560 THEIR 50s OR 59 AGE RANGE HAVE 5310 03:57:11,560 --> 03:57:13,360 ONE CO-MORBIDITY IN CONTRAST TO 5311 03:57:13,360 --> 03:57:15,760 40% OF PEOPLE WITHOUT HIV. 5312 03:57:15,760 --> 03:57:17,520 IN FACT WE SEE INCREASED RISK OF 5313 03:57:17,520 --> 03:57:19,040 MANY DIFFERENT CO MORBID TEASE 5314 03:57:19,040 --> 03:57:22,240 SUCH AS CARDIOVASCULAR DIS TEASE 5315 03:57:22,240 --> 03:57:28,040 AND COGNITIVE IMPAIRMENT AND 5316 03:57:28,040 --> 03:57:38,200 DIABETES. 5317 03:57:41,240 --> 03:57:42,680 THERE'S INTRAVENOUS DRUG USERS 5318 03:57:42,680 --> 03:57:44,800 WITH AND WITHOUT HIV SO WE CAN A 5319 03:57:44,800 --> 03:57:48,400 IT TEMPT TO HAVE THIS SAME SCIO 5320 03:57:48,400 --> 03:57:49,840 DEMOGRAPHIC DIFFERENCES BETWEEN 5321 03:57:49,840 --> 03:57:50,840 THE TWO PARTICIPATIONS AND TEASE 5322 03:57:50,840 --> 03:58:02,920 OUT THE EFFEPAP POPULATIONS.CARS 5323 03:58:03,200 --> 03:58:05,640 50% HIGHER AMONG PEOPLE WITH HIV 5324 03:58:05,640 --> 03:58:07,440 AND CARDIOVASCULAR DISEASE 5325 03:58:07,440 --> 03:58:09,320 RELATED MORTALITY IS A LEADING 5326 03:58:09,320 --> 03:58:10,600 NON AIDS CAUSES OF DEATH. 5327 03:58:10,600 --> 03:58:12,160 AS YOU CAN SEE IN THE BOTTOM 5328 03:58:12,160 --> 03:58:14,240 FIGURE WITH OLDER DATA FROM THE 5329 03:58:14,240 --> 03:58:15,840 PARTNERS HEALTH COHORT IN BOSTON 5330 03:58:15,840 --> 03:58:18,440 THE RATE OF CARDIOVASCULAR 5331 03:58:18,440 --> 03:58:19,800 DISEASE ACCELERATES AMONG PEOPLE 5332 03:58:19,800 --> 03:58:22,040 WITH HIV STARTING AT ABOUT AGE 5333 03:58:22,040 --> 03:58:23,880 45 COMPARED TO CONTROL 5334 03:58:23,880 --> 03:58:24,320 POPULATIONS. 5335 03:58:24,320 --> 03:58:26,240 WITH OTHER CARDIOVASCULAR 5336 03:58:26,240 --> 03:58:27,760 DISEASES SUCH AS CONGESTION 5337 03:58:27,760 --> 03:58:29,680 HEART FAILURE OR SUDDEN CARDIAC 5338 03:58:29,680 --> 03:58:32,000 DEATH WE SEE VERY HIGH RATES IN 5339 03:58:32,000 --> 03:58:33,560 PEOPLE WITH HIV AS YOUNG AS 5340 03:58:33,560 --> 03:58:40,120 THEIR 30s AND 20s 24 THAT LEVEL 5341 03:58:40,120 --> 03:58:43,840 OUT WITH AGING. 5342 03:58:43,840 --> 03:58:45,720 THESE CARDIOVASCULAR EVENTS 5343 03:58:45,720 --> 03:58:48,360 OCCUR AFTER RISK FACTORS AND OUR 5344 03:58:48,360 --> 03:58:50,000 RISK SCORE CALCULATOR DON'T 5345 03:58:50,000 --> 03:58:52,400 ESTIMATE THIS RISK PARTICULARLY 5346 03:58:52,400 --> 03:58:52,720 WELL. 5347 03:58:52,720 --> 03:58:54,040 THIS LED TO THE DEVELOPMENT OF 5348 03:58:54,040 --> 03:58:56,120 WHAT IS NOW A LANDMARK TRIAL 5349 03:58:56,120 --> 03:58:58,320 CALLED REPRIEVE AND REPRIEVE 5350 03:58:58,320 --> 03:59:02,800 ENROLLED OVER 7,000 PARTICIPANTS 5351 03:59:02,800 --> 03:59:04,400 FROM AROU AROUND THE WORLD INCLG 5352 03:59:04,400 --> 03:59:06,440 LOW AND MIDDLE INEX COUNTRIES 5353 03:59:06,440 --> 03:59:10,040 AND RANDOMIZED PARTICIPANTS WITH 5354 03:59:10,040 --> 03:59:11,520 LOW RISK TO A STATEN THAT 5355 03:59:11,520 --> 03:59:13,120 DOESN'T HAVE DRUG INTERACTIONS 5356 03:59:13,120 --> 03:59:15,160 WITH OUR HIV MEDICATIONS OR A 5357 03:59:15,160 --> 03:59:16,360 PLACEBO AND JUST WITHIN THE LAST 5358 03:59:16,360 --> 03:59:18,600 COUPLE OF WEEKS WE HAD A PRESS 5359 03:59:18,600 --> 03:59:20,120 RELEASE AFTER SEVEN YEARS OF 5360 03:59:20,120 --> 03:59:21,680 FOLLOW-UP THAT THE DECREASE 5361 03:59:21,680 --> 03:59:27,160 DISEASE EVENTS BY 35% IN PEOPLE 5362 03:59:27,160 --> 03:59:29,760 WITH HIV HOPING TO DECREASE THIS 5363 03:59:29,760 --> 03:59:31,640 CO MORBID BURDEN WITH PEOPLE IN 5364 03:59:31,640 --> 03:59:32,080 HIV. 5365 03:59:32,080 --> 03:59:35,760 WE ALSO SEE INCREASED RISK OF 5366 03:59:35,760 --> 03:59:39,280 OSTEOPOROSIS, FALLS AND 5367 03:59:39,280 --> 03:59:40,120 ACCIDENTALLY FRACTURED IN A 5368 03:59:40,120 --> 03:59:42,040 OLDER ADULT POPULATION. 5369 03:59:42,040 --> 03:59:43,600 WITH PEOPLE WITH HIV TEND TO 5370 03:59:43,600 --> 03:59:45,640 EXPERIENCE ABOUT A TWO TO FOUR 5371 03:59:45,640 --> 03:59:48,200 PERCENT DECLINE IN THEIR BONE 5372 03:59:48,200 --> 03:59:49,120 MINERAL DENSITY IN THE FIRST 5373 03:59:49,120 --> 03:59:50,160 YEAR OF THERAPY. 5374 03:59:50,160 --> 03:59:53,400 THIS VARIES DEPENDING ON THE 5375 03:59:53,400 --> 03:59:54,440 THERAPY AND HOW TOXIC THE 5376 03:59:54,440 --> 03:59:55,400 TREATMENT MIGHT BE. 5377 03:59:55,400 --> 03:59:59,600 THERE'S PROBABLY SOME STABLATION 5378 03:59:59,600 --> 04:00:01,840 BUT AS YOU CAN SEE THERE'S A 5379 04:00:01,840 --> 04:00:04,080 DECLINE IN BONE MINERAL DENSITY 5380 04:00:04,080 --> 04:00:08,880 OVER TIME ANTI RETRO VIRAL 5381 04:00:08,880 --> 04:00:11,040 THERAPY AND THIS IS A THIGH RATE 5382 04:00:11,040 --> 04:00:12,960 OF FALLS IN PEOPLE WITH HIV AND 5383 04:00:12,960 --> 04:00:14,480 EVEN AT 50 WE SEE RATES OF FALLS 5384 04:00:14,480 --> 04:00:16,560 THAT ARE SIMILAR TO POPULATIONS 5385 04:00:16,560 --> 04:00:18,880 65 OR OLDER AND WITH UP TO 40% 5386 04:00:18,880 --> 04:00:20,800 OF PEOPLE EXPERIENCING ANY FALL 5387 04:00:20,800 --> 04:00:29,920 AND UP TO 25% AND WE CAN SEE 5388 04:00:29,920 --> 04:00:33,480 FROM SOME OLDER ANTI RETRO 5389 04:00:33,480 --> 04:00:34,680 MULTIPLE DIFFERENT 5390 04:00:34,680 --> 04:00:36,000 CO-MORBIDITIES AND NEURO 5391 04:00:36,000 --> 04:00:38,280 COGNITIVE HE H PAIRMENTMENT AND 5392 04:00:38,280 --> 04:00:42,440 WE SEE A HIGH RATE OF FRACTURES 5393 04:00:42,440 --> 04:00:44,080 AND WOMEN AND MEN INCREASES AS 5394 04:00:44,080 --> 04:00:45,520 SHOWN IN THE FIGURE BELOW 5395 04:00:45,520 --> 04:00:48,520 STARTING AT AGE 40 OR 50. 5396 04:00:48,520 --> 04:00:51,240 AND LASTLY I WANT TODAY 5397 04:00:51,240 --> 04:00:54,480 HIGHLIGHT THE CURES OF OTHER 5398 04:00:54,480 --> 04:01:02,760 GERIATRIC AND PEOPLE WITH HIV 5399 04:01:02,760 --> 04:01:04,880 AND COMPARED TO THOSE WITHOUT 5400 04:01:04,880 --> 04:01:15,440 HIV AND ACROSS THE AGE SPECTRUM 5401 04:01:21,400 --> 04:01:22,400 DEMOGRAPHIC CONTROL GROUP WITH A 5402 04:01:22,400 --> 04:01:25,000 DECLINE STARTING AT AGE 50 OR 60 5403 04:01:25,000 --> 04:01:26,800 IN THOSE WITH HIV AS INDICATED 5404 04:01:26,800 --> 04:01:31,000 IN THE RED LINE. 5405 04:01:31,000 --> 04:01:32,080 SO WE ARE OBSERVING WHAT WE 5406 04:01:32,080 --> 04:01:34,760 MIGHT CALL AN ACCELERATED OR AT 5407 04:01:34,760 --> 04:01:37,160 LEAST AN EX SEN YOUATED PROCESS 5408 04:01:37,160 --> 04:01:38,560 WITH PEOPLE IN HIV ON THE LEFT 5409 04:01:38,560 --> 04:01:41,640 SIDE OF THE SPEAKER YOU CAN SEE 5410 04:01:41,640 --> 04:01:44,200 A INCREASE IN THE AGING PROCESS 5411 04:01:44,200 --> 04:01:47,080 AND THE BIOLOGICAL AGE. 5412 04:01:47,080 --> 04:01:49,800 WITH ANTI RETRO VIRAL THERAPY 5413 04:01:49,800 --> 04:01:51,240 THAT MAY CONTINUE TO ACCELERATE 5414 04:01:51,240 --> 04:01:56,240 OVER TIME AND WE MAY BE ABLE TO 5415 04:01:56,240 --> 04:01:58,440 DECREASE THAT AND JUST HAVE AN 5416 04:01:58,440 --> 04:01:59,280 EX SEN TO YOUATED AGING PROCESS 5417 04:01:59,280 --> 04:02:03,240 OVER TIME. 5418 04:02:03,240 --> 04:02:04,760 DIFFERENT MECHANISMS CONTRIBUTE 5419 04:02:04,760 --> 04:02:08,600 TO THE AGE ACCELERATION IN HIV 5420 04:02:08,600 --> 04:02:09,320 OVERLAPPING WITH WHAT WE HEARD 5421 04:02:09,320 --> 04:02:12,200 IN THE CANCER POPULATION AND IF 5422 04:02:12,200 --> 04:02:14,640 MIGHT BE LOSS OF REGULATORY T 5423 04:02:14,640 --> 04:02:17,760 CELLS AND WE CONTINUE TO SEE 5424 04:02:17,760 --> 04:02:20,040 REPLICATION WHEN WE HAVE 5425 04:02:20,040 --> 04:02:23,080 PATIENTS ON RETRO VIRAL THERAPY 5426 04:02:23,080 --> 04:02:29,560 AND WE TOX SIT TEE FROM THERAPY 5427 04:02:29,560 --> 04:02:32,720 AND HEPATITIS C AND SYPHILIS AND 5428 04:02:32,720 --> 04:02:35,160 THERE'S A PURCHASED OF MICROBIAL 5429 04:02:35,160 --> 04:02:38,320 TRANCE LOCATION WITH DIFFERENT 5430 04:02:38,320 --> 04:02:41,280 ORGANISMS AND METABOLIC FACTORS 5431 04:02:41,280 --> 04:02:44,960 TO INFLAMMATION AND IMMUNE 5432 04:02:44,960 --> 04:02:46,720 DISREGULATION OF INCREASED 5433 04:02:46,720 --> 04:02:48,720 CO-MORBIDITIES EXPERIENCED IN 5434 04:02:48,720 --> 04:02:49,440 HIV. 5435 04:02:49,440 --> 04:02:51,840 TO FOLLOW-UP ON THIS MORNING'S 5436 04:02:51,840 --> 04:02:52,760 PRESENTATION, IT'S CRITICAL TO 5437 04:02:52,760 --> 04:02:54,920 NOTE THAT PEOPLE WITH HIV 5438 04:02:54,920 --> 04:02:57,880 PROBABLY 50 TO 60% AT MINIMUM, 5439 04:02:57,880 --> 04:02:59,800 PARTICULARLY OF OUR OLDER 5440 04:02:59,800 --> 04:03:01,080 POPULATION ARE INDIVIDUALS OF 5441 04:03:01,080 --> 04:03:03,520 ALCOHOL AND UNDER REPRESENTED 5442 04:03:03,520 --> 04:03:05,560 POPULATIONS, OR GENDER MINE TORR 5443 04:03:05,560 --> 04:03:06,520 TEE THAT MAY HAVE MANY DIFFERENT 5444 04:03:06,520 --> 04:03:08,680 TYPES OF STRUCTURAL INKILOMETRES 5445 04:03:08,680 --> 04:03:09,760 THAT THEY MACE IN THEIR 5446 04:03:09,760 --> 04:03:10,920 DAY-TO-DAY LIFE AND THESE 5447 04:03:10,920 --> 04:03:13,840 FACTORS MAY BE COMPLICATED BY 5448 04:03:13,840 --> 04:03:15,000 BIOBEHAVIORAL FACTORS SUCH AS A 5449 04:03:15,000 --> 04:03:17,040 HIGH RATE OF SUBSTANCE USE OR 5450 04:03:17,040 --> 04:03:19,120 DIET, LOW PHYSICAL ACTIVITY, AND 5451 04:03:19,120 --> 04:03:21,640 STIGMA BOTH RELATED TO AGING AND 5452 04:03:21,640 --> 04:03:22,280 HIV. 5453 04:03:22,280 --> 04:03:23,880 IN COMBINATION THESE FACTORS 5454 04:03:23,880 --> 04:03:27,680 CONTRIBUTE TO THAT ACCELERATED 5455 04:03:27,680 --> 04:03:30,800 AGE TAG WE SEE IN HIV WITH ANTI 5456 04:03:30,800 --> 04:03:34,560 RETRO VIRAL THERAPY. 5457 04:03:34,560 --> 04:03:36,440 IF WE GO BACK TO AGING IN THE 5458 04:03:36,440 --> 04:03:39,000 RIGHT UPPER CORNER, WE CAN SEE 5459 04:03:39,000 --> 04:03:41,440 THAT THE IMPACT OF HIV FAIRLY 5460 04:03:41,440 --> 04:03:43,480 BROADLY ACROSS NEARLY ALL OF THE 5461 04:03:43,480 --> 04:03:44,680 CRITICAL PATHWAYS THAT SEEM TO 5462 04:03:44,680 --> 04:03:46,440 DRIVE AGING OR BE CRITICAL 5463 04:03:46,440 --> 04:03:49,160 PATHWAYS AND AGING PROCESS. 5464 04:03:49,160 --> 04:03:50,240 SEVERAL HAVE SHOWN THAT PEOPLE 5465 04:03:50,240 --> 04:03:53,200 WITH HIV HAVE ACCELERATED 5466 04:03:53,200 --> 04:03:53,880 EPIGENETIC AGING SHOWN IN THE 5467 04:03:53,880 --> 04:03:57,600 RED LINE ON THIS FIGURE AND SOME 5468 04:03:57,600 --> 04:04:00,160 IS REVERSED OR DECREASED IN THE 5469 04:04:00,160 --> 04:04:02,360 ANTI RETRO VIRAL THERAPY BUT 5470 04:04:02,360 --> 04:04:04,880 THERE'S SOME ADVANCEMENT OF EP 5471 04:04:04,880 --> 04:04:10,600 DEN GEPIGENETIC AGE AND ALL KNOE 5472 04:04:10,600 --> 04:04:13,240 THIS REVERSES SOMEWHAT WITH 5473 04:04:13,240 --> 04:04:15,120 EFFECTIVE ANTI AND THERAPY WE 5474 04:04:15,120 --> 04:04:16,760 STILL SEE SOME DECLINE IN 5475 04:04:16,760 --> 04:04:18,640 CERTAIN POPULATIONS, WOMEN, FOR 5476 04:04:18,640 --> 04:04:20,760 EXAMPLE, SHOWN HERE. 5477 04:04:20,760 --> 04:04:24,000 AND THEN LASTLY MITOCHONDRIAL 5478 04:04:24,000 --> 04:04:24,800 DYSFUNCTION HAS BEEN RECOGNIZED 5479 04:04:24,800 --> 04:04:26,480 AS A CONSEQUENCE OF HIV AND OF 5480 04:04:26,480 --> 04:04:28,720 MANY OF OUR ANTI RETRO VIRAL 5481 04:04:28,720 --> 04:04:29,920 THERAPIES AND OUR NEW THERAPY 5482 04:04:29,920 --> 04:04:32,840 THAT WE THINK ARE MUCH MORE 5483 04:04:32,840 --> 04:04:33,320 SAFE. 5484 04:04:33,320 --> 04:04:35,280 STUDIES HAVE DEMONSTRATED I 5485 04:04:35,280 --> 04:04:38,160 OBJECT CREASED INFLAMMATION, 5486 04:04:38,160 --> 04:04:40,440 IMMUNE SENESCENCE DID METABOLIC 5487 04:04:40,440 --> 04:04:42,720 AND LOSS OF PRO TEE OWE AND 5488 04:04:42,720 --> 04:04:44,480 AGING AND COULD LEAD TO AN 5489 04:04:44,480 --> 04:04:46,000 ADVANCEMENT OR ACCELERATION IN 5490 04:04:46,000 --> 04:04:50,520 AGING AND PEOPLE WITH HIV. 5491 04:04:50,520 --> 04:04:55,200 I WANT TO COMMENT THE REMARKABLE 5492 04:04:55,200 --> 04:04:56,440 TIMELINE OF HIV RECOGNITION AND 5493 04:04:56,440 --> 04:04:57,880 TREATMENT OVER THE LAST 40 YEARS 5494 04:04:57,880 --> 04:04:59,640 REALLY COMPLICATES HOW WE PLAN 5495 04:04:59,640 --> 04:05:02,840 TO THINK ABOUT AGING AND PEOPLE 5496 04:05:02,840 --> 04:05:04,240 WITH HIV. 5497 04:05:04,240 --> 04:05:04,840 FOR PEOPLE I AM FACTED BACK IN 5498 04:05:04,840 --> 04:05:06,640 THE EARLY 780s, MANY OF THEM 5499 04:05:06,640 --> 04:05:09,120 HAD A PROFOUND PERIOD OF IMMUNE 5500 04:05:09,120 --> 04:05:10,760 SUPPRESSION AND REMARKABLE 5501 04:05:10,760 --> 04:05:12,880 WASTING THAT CONTINUES TO LONG 5502 04:05:12,880 --> 04:05:14,680 LASTING IMPACTS AND MUCH OF 5503 04:05:14,680 --> 04:05:17,720 WHICH IS NOT REVERSIBLE. 5504 04:05:17,720 --> 04:05:19,320 FOR EXAMPLE, WE HAVE PREVIOUSLY 5505 04:05:19,320 --> 04:05:21,000 SHOWN THAT HAVING ANY HISTORY OF 5506 04:05:21,000 --> 04:05:23,360 WASTING CAN HAVE AN GOING 5507 04:05:23,360 --> 04:05:24,680 IMPACTS OF PHYSICAL FUNCTION 5508 04:05:24,680 --> 04:05:26,360 MARKERS SUCH AS GRIP STRENGTH, 5509 04:05:26,360 --> 04:05:28,600 AND GATE SPEED OVER TIME AND 5510 04:05:28,600 --> 04:05:30,680 EASY WAS INTRODUCED IN THE LATE 5511 04:05:30,680 --> 04:05:32,440 80s AND REALLY PROMISED WAS 5512 04:05:32,440 --> 04:05:34,000 THE FIRST PROMISE WE HAD OF SOME 5513 04:05:34,000 --> 04:05:36,600 SORT OF ANTIRETROVIRAL THERAPY 5514 04:05:36,600 --> 04:05:37,920 THAT MAY SUPPRESS VIRUS 5515 04:05:37,920 --> 04:05:39,240 UNFORTUNATELY ALONE IT DIDN'T 5516 04:05:39,240 --> 04:05:41,880 WORK VERY WELL BUT IT DID CAUSE 5517 04:05:41,880 --> 04:05:48,360 MIGHT MIGHT OWE CON AGREAL WHICE 5518 04:05:48,360 --> 04:05:51,120 I AM REVERSIBLE AND WE SAW 5519 04:05:51,120 --> 04:05:52,720 HIGHLY ACTIVE THERAPY OR 5520 04:05:52,720 --> 04:05:54,880 COMBINATION THERAPY AND THIS IS 5521 04:05:54,880 --> 04:05:56,080 CERTAINLY TRANSFORMED OUR 5522 04:05:56,080 --> 04:05:58,000 TREATMENT AND OUR PROGNOSIS OF 5523 04:05:58,000 --> 04:06:08,840 HIV AND HOWEVER THESE TREATMENTI 5524 04:06:50,720 --> 04:06:51,800 WANTED TO MENTION THAT THERE'S 5525 04:06:51,800 --> 04:06:54,440 ALSO BEEN A GROWING INTEREST IN 5526 04:06:54,440 --> 04:06:55,040 USING THE GEROSCIENCE SCIENCE 5527 04:06:55,040 --> 04:06:56,080 APPROACH TO THE TREATMENT OF 5528 04:06:56,080 --> 04:07:01,600 AGING IN PEOPLE WITH HIV. 5529 04:07:01,600 --> 04:07:03,280 PEOPLE WITH HIV ARE CERTAINLY A 5530 04:07:03,280 --> 04:07:04,680 POPULATION THAT WE THINK MIGHT 5531 04:07:04,680 --> 04:07:05,960 BENEFIT MOST FROM SOME OF THESE 5532 04:07:05,960 --> 04:07:10,040 TREATMENTS ESPECIALLY AS WE SAW 5533 04:07:10,040 --> 04:07:12,400 HOW HIV CAN BE IMPACTED BY THE 5534 04:07:12,400 --> 04:07:14,240 PILLARS OF AGING AND THE CURVE 5535 04:07:14,240 --> 04:07:17,520 THAT WE THINK SOMEONE FOLLOWS 5536 04:07:17,520 --> 04:07:19,360 THIS NORMAL CURVE OF AGING WE 5537 04:07:19,360 --> 04:07:21,560 BELIEVE AGING WITH HIV MAY SHIFT 5538 04:07:21,560 --> 04:07:22,840 PEOPLE FURTHER AWAY FROM THAT 5539 04:07:22,840 --> 04:07:24,400 CURVE AND CERTAINLY JUST THE 5540 04:07:24,400 --> 04:07:26,680 INITIATION OF ANTI RETRO VIRAL 5541 04:07:26,680 --> 04:07:27,760 THERAPY COULD HELP MOVE THEM 5542 04:07:27,760 --> 04:07:29,320 CLOSER TO THE AGING CURVE BUT 5543 04:07:29,320 --> 04:07:32,120 THERE'S MANY OTHER MECHANISMS 5544 04:07:32,120 --> 04:07:33,720 THAT WILL KEEP PEOPLE AGING WITH 5545 04:07:33,720 --> 04:07:34,760 HIV FROM OFTEN TIMES HAVING THAT 5546 04:07:34,760 --> 04:07:41,080 NORMAL AGING PROCESS. 5547 04:07:41,080 --> 04:07:42,520 WE HAVE BEEN INTERESTED IN 5548 04:07:42,520 --> 04:07:43,440 LIFESTYLE MODIFICATION AND 5549 04:07:43,440 --> 04:07:45,000 EXERCISE CAN INCREASE OR IMPROVE 5550 04:07:45,000 --> 04:07:46,600 MANY OF THE AGING MECHANISMS 5551 04:07:46,600 --> 04:07:48,440 THAT WE SEE DIRECTLY IN SKELETAL 5552 04:07:48,440 --> 04:07:50,040 MUSCLE AND WE'VE SHOWN 5553 04:07:50,040 --> 04:07:53,360 IMPROVEMENTS IN PHYSICAL 5554 04:07:53,360 --> 04:08:03,640 FUNCTION AND AND ACCELERATED 5555 04:08:03,640 --> 04:08:05,200 WITH SOMEWHAT LIMITED SUCK IS 5556 04:08:05,200 --> 04:08:06,280 CEASE AND POPULATIONS WITH HIV 5557 04:08:06,280 --> 04:08:07,920 AND I THINK AS WE'VE SEEN 5558 04:08:07,920 --> 04:08:10,120 RESULTS FROM THE REPRIEVE TRIAL 5559 04:08:10,120 --> 04:08:11,160 ROLLOUT OVER THE NEXT SEVERAL 5560 04:08:11,160 --> 04:08:12,720 MONTHS TO YEARS, WE CAN 5561 04:08:12,720 --> 04:08:14,800 CERTAINLY LEARN A LOT ABOUT 5562 04:08:14,800 --> 04:08:15,680 POTENTIAL MECHANISMS THAT THEY 5563 04:08:15,680 --> 04:08:19,480 MAY HAVE ON THOSE AGING 5564 04:08:19,480 --> 04:08:20,680 PROCESSES AND SOME OF THE SIL 5565 04:08:20,680 --> 04:08:22,160 ARREST OF AGING AND I'M EXCITED 5566 04:08:22,160 --> 04:08:26,640 TO CONTRIBUTE TO A TEAM 5567 04:08:26,640 --> 04:08:29,680 INVESTIGATE A DRUGS THAT WE JUST 5568 04:08:29,680 --> 04:08:31,160 HEARD ABOUT AND ON PHYSICAL 5569 04:08:31,160 --> 04:08:33,520 FUNCTION AND PEOPLE WITH HIV AND 5570 04:08:33,520 --> 04:08:35,000 LED OR SUPPORTED BY THE NATIONAL 5571 04:08:35,000 --> 04:08:36,320 INSTITUTE ON AGING AND WITHIN 5572 04:08:36,320 --> 04:08:40,080 THE AIDS CLINICAL TRIALS GROUP. 5573 04:08:40,080 --> 04:08:41,960 SO MANY PEOPLE WITH HIV 5574 04:08:41,960 --> 04:08:43,960 EXPERIENCE AN EXCEL RACE OF THE 5575 04:08:43,960 --> 04:08:45,760 AGING POP AND COMPLICATED BY 5576 04:08:45,760 --> 04:08:48,440 YEARS OF IMMUNE SUPPRESSION AND 5577 04:08:48,440 --> 04:08:52,160 SOCIAL AND BEHAVIORAL STRESSORS 5578 04:08:52,160 --> 04:08:55,040 AND THERAPY RELATED TOX SIT TEE 5579 04:08:55,040 --> 04:08:57,840 AND PEOPLE WITH HIV MAY BENEFIT 5580 04:08:57,840 --> 04:08:58,480 FROM GEROSCIENCE APPROACHES TO 5581 04:08:58,480 --> 04:09:00,040 SLOW OR REVERSE THE AGING 5582 04:09:00,040 --> 04:09:00,440 PROCESS. 5583 04:09:00,440 --> 04:09:02,000 I WANTED TO ACKNOWLEDGING SOME 5584 04:09:02,000 --> 04:09:03,320 OF THE ORGANIZATIONS I WORKED 5585 04:09:03,320 --> 04:09:04,840 WITHIN AND MY FUNDING AGENCIES 5586 04:09:04,840 --> 04:09:05,920 THROUGH THE NATIONAL INSTITUTE 5587 04:09:05,920 --> 04:09:09,120 ON AGING AND TO ACKNOWLEDGE THE 5588 04:09:09,120 --> 04:09:19,600 PEOPLE WITH HIV WHO HAVE TIME. 5589 04:09:28,280 --> 04:09:38,640 THANK YOU FOR YOUR TIME. 5590 04:09:48,880 --> 04:09:50,200 >>GOOD AFTER, EVERYONE. 5591 04:09:50,200 --> 04:09:52,320 I'M FROM OHIO STATE AND I'M AN 5592 04:09:52,320 --> 04:09:54,160 AGING FOCUS AND I'M GOING TO 5593 04:09:54,160 --> 04:09:56,360 TALK ABOUT OUR WORK TO STUDY 5594 04:09:56,360 --> 04:09:58,400 LONG-TERM OUTCOMES AND HOW THAT 5595 04:09:58,400 --> 04:10:01,680 MAY SUGGEST THAT SURVIVORS OF 5596 04:10:01,680 --> 04:10:03,800 ILLNESS HAVE A PHENOTYPE OF 5597 04:10:03,800 --> 04:10:06,240 ACCELERATED AGING. 5598 04:10:06,240 --> 04:10:08,520 SO THIS IS A ICU ROOM AT THE 5599 04:10:08,520 --> 04:10:11,720 OHIO STATE MEDICAL CENTER AND IN 5600 04:10:11,720 --> 04:10:14,320 THIS ROOM, IN THE 85,000 ACROSS 5601 04:10:14,320 --> 04:10:16,120 IT IN THE UNITED STATES ARE 5602 04:10:16,120 --> 04:10:18,160 ADMITTED AND PEOPLE'S WHO LIFE 5603 04:10:18,160 --> 04:10:20,240 ANG IN THE BALANCE AND 6 MILLION 5604 04:10:20,240 --> 04:10:22,960 ARE ADMITTED TO AN ICU EVERY 5605 04:10:22,960 --> 04:10:24,560 YEAR THAT MEANS FOR EACH OF US, 5606 04:10:24,560 --> 04:10:26,480 ON AVERAGE, WE'LL BE ADMITTED TO 5607 04:10:26,480 --> 04:10:28,600 AN ICU ONCE IN YOU ARE LIVES. 5608 04:10:28,600 --> 04:10:32,600 THE GOOD NEWS IS THAT OVER THE 5609 04:10:32,600 --> 04:10:34,280 LAST 25 YEARS ADVANCED IN 5610 04:10:34,280 --> 04:10:35,360 CRITICAL CARE MEDICINE HAVE LED 5611 04:10:35,360 --> 04:10:37,040 TO IMPROVEMENTS IN SURVIVAL AND 5612 04:10:37,040 --> 04:10:39,680 IN FACT, SURVIVORSHIP IS ROUGHLY 5613 04:10:39,680 --> 04:10:44,480 DOUBLE WHAT IT WAS IN THE YEAR 5614 04:10:44,480 --> 04:10:44,800 2000. 5615 04:10:44,800 --> 04:10:45,880 TODAY IN THE UNITED STATES IT'S 5616 04:10:45,880 --> 04:10:49,760 ESTIMATED THAT THREE AND A HALF 5617 04:10:49,760 --> 04:10:51,440 MILLION AMERICANS WILL SURVIVE A 5618 04:10:51,440 --> 04:10:53,440 CRITICAL ILLNESS EACH YEAR AND 5619 04:10:53,440 --> 04:10:54,760 AS OPTIMISM FROM CRITICAL 5620 04:10:54,760 --> 04:11:00,120 ILLNESS IS TEMPERED BY GROWING 5621 04:11:00,120 --> 04:11:01,720 KNOWLEDGE THAT THEY WILL SUFFER 5622 04:11:01,720 --> 04:11:03,720 FROM SEVERITY FROM FATIGUE AND 5623 04:11:03,720 --> 04:11:05,160 MUSCLE WEAKNESS AND ALL THE WAY 5624 04:11:05,160 --> 04:11:07,200 UP TO SEVERE DISABILITIES IN THE 5625 04:11:07,200 --> 04:11:12,040 INABILITY TO CARE FOR THEMSELVES 5626 04:11:12,040 --> 04:11:13,640 AND SIMILAR PREPORTION ALSO HAVE 5627 04:11:13,640 --> 04:11:14,880 COGNITIVE IMPAIRMENT RANGING 5628 04:11:14,880 --> 04:11:17,080 FROM THINKING IN MEMORY OF THE 5629 04:11:17,080 --> 04:11:18,720 BRAIN FOG WE'RE HEARING ABOUT IN 5630 04:11:18,720 --> 04:11:21,080 COVID SURVIVORS UP TO 5631 04:11:21,080 --> 04:11:24,520 ALZHEIMER'S LIKE DEMENTIA. 5632 04:11:24,520 --> 04:11:27,000 EYE SMALL YOU ARE PREPORTION 5633 04:11:27,000 --> 04:11:30,240 SUFFERED IN NEW ANXIETY AND 5634 04:11:30,240 --> 04:11:31,880 STRESS DISORDER AND SO THE 5635 04:11:31,880 --> 04:11:34,440 QUESTION TODAY IS, DOES CRITICAL 5636 04:11:34,440 --> 04:11:36,560 ILLNESS LEAD TO ACCELERATED 5637 04:11:36,560 --> 04:11:37,240 AGING? 5638 04:11:37,240 --> 04:11:39,080 GOOD START FIRST WITH THE MOST 5639 04:11:39,080 --> 04:11:41,360 ROBUST BODY OF DATA THE CLINICAL 5640 04:11:41,360 --> 04:11:41,840 PERSPECTIVE. 5641 04:11:41,840 --> 04:11:44,560 I'LL SHARE WITH YOU DATA FROM 5642 04:11:44,560 --> 04:11:46,600 OUR GROUPS BRAIN ICU COHORT 5643 04:11:46,600 --> 04:11:49,160 STUDY PUBLISHED IN NEW ENGLAND 5644 04:11:49,160 --> 04:11:50,680 JOURNAL A DECADE AGO AND THE 5645 04:11:50,680 --> 04:11:51,960 BRAIN ICU STUDY WE WERE 5646 04:11:51,960 --> 04:11:53,280 INTERESTED IN THE EFFECTS OF 5647 04:11:53,280 --> 04:11:58,720 CRITICAL ILLNESS ON MEMORY, COG 5648 04:11:58,720 --> 04:12:02,160 ANYTHING SO WE ENROLLED 821 5649 04:12:02,160 --> 04:12:03,840 PATIENTS WITH CRITICAL ILLNESS 5650 04:12:03,840 --> 04:12:06,400 AND THEY WERE RECEIVING BASE 5651 04:12:06,400 --> 04:12:07,800 OPPRESSORS FOR SHOCK AND WE 5652 04:12:07,800 --> 04:12:10,240 EXCLUDED THOSE WITH A KNOWN 5653 04:12:10,240 --> 04:12:12,880 DIAGNOSIS OF DEMENTIA AND WENT 5654 04:12:12,880 --> 04:12:14,880 THROUGH A CENTER STEP PROCESS TO 5655 04:12:14,880 --> 04:12:18,440 QUANTIFY THE AMOUNT OF ANY 5656 04:12:18,440 --> 04:12:20,440 COGNITIVE IMPAIRMENT USING THE 5657 04:12:20,440 --> 04:12:22,120 IQ CODE AND THE RATING SCALES 5658 04:12:22,120 --> 04:12:24,120 AND IN FACT ONLY 6% OF PATIENTS 5659 04:12:24,120 --> 04:12:25,920 ENROLLED IN THIS POPULATION HAD 5660 04:12:25,920 --> 04:12:31,440 ANY EVIDENCE OF COGNITIVE 5661 04:12:31,440 --> 04:12:32,080 IMPAIRMENT. 5662 04:12:32,080 --> 04:12:35,280 THEN AMONG SURVIVORS AT THREE 5663 04:12:35,280 --> 04:12:36,800 AND 12 MONTHS, THEY USED TEST 5664 04:12:36,800 --> 04:12:39,400 CALLED THE REPEATED FOR THE 5665 04:12:39,400 --> 04:12:43,640 ASSETMENT OF NEUROPHYSIOLOGICAL 5666 04:12:43,640 --> 04:12:44,440 STATUS AND ABOUT WHAT I'M 5667 04:12:44,440 --> 04:12:48,440 SHOWING YOU HERE IS FOLLOW-UP 5668 04:12:48,440 --> 04:12:50,120 DATA SO IT'S THE GLOBAL AND THAT 5669 04:12:50,120 --> 04:12:53,200 HAS AN AGE ADJUSTED NEED OF 100 5670 04:12:53,200 --> 04:12:57,200 END INDICATED BY THE JELL-O AND 5671 04:12:57,200 --> 04:12:57,960 IT'S 15 POINTS ON EITHER SIDE 5672 04:12:57,960 --> 04:13:00,280 AND INDICATED BY THE GRAY BOX 5673 04:13:00,280 --> 04:13:05,120 AND WE'VE BROKEN THIS DOWN INTO 5674 04:13:05,120 --> 04:13:06,800 AGE GROUPS SO WE HAVE THE OVER 5675 04:13:06,800 --> 04:13:08,640 65 ON THE RIGHT AND 50 AND 60 IN 5676 04:13:08,640 --> 04:13:10,560 THE MIDDLE AND 30 AND 5677 04:13:10,560 --> 04:13:12,160 40-YEAR-OLDS ON THE LEFT SIDE 5678 04:13:12,160 --> 04:13:13,080 THERE. 5679 04:13:13,080 --> 04:13:17,160 THREE MONTH DATA ARE IN THE RED 5680 04:13:17,160 --> 04:13:18,840 BOXES AND 12 MONTH DATA IN THE 5681 04:13:18,840 --> 04:13:22,880 BLUE AND THE TOP OF THE BOX 5682 04:13:22,880 --> 04:13:33,440 REPRESENTS THE MOST HAVE SCORES 5683 04:13:36,360 --> 04:13:37,960 THAT ARE ONE STANDARD DEVIATION 5684 04:13:37,960 --> 04:13:39,880 BELOW WHAT WE COULD PECK. 5685 04:13:39,880 --> 04:13:41,680 KEEP IN MIND THOSE ARE PEOPLE 5686 04:13:41,680 --> 04:13:43,320 WITHOUT EXITING COGNITIVE 5687 04:13:43,320 --> 04:13:44,640 IMPAIRMENT AND WE HAVE 5688 04:13:44,640 --> 04:13:48,720 COMPARISON GROUPS FOR OTHER 5689 04:13:48,720 --> 04:13:52,120 FORMS OF BRAIN INJURIES. 5690 04:13:52,120 --> 04:13:53,320 AND YOU CAN SEE THAT ABOUT A 5691 04:13:53,320 --> 04:13:56,320 THIRD OF PATIENTS REGARDLESS OF 5692 04:13:56,320 --> 04:13:58,560 AGE, FALL BELOW THE CBI LEVEL 5693 04:13:58,560 --> 04:14:03,080 AND A QUARTER FALL BELOW THE 5694 04:14:03,080 --> 04:14:03,920 ALZHEIMER'S. 5695 04:14:03,920 --> 04:14:05,880 WE THOUGHT THOSE 30 AND 5696 04:14:05,880 --> 04:14:07,520 40-YEAR-OLD WE KNOW THEM WITH 5697 04:14:07,520 --> 04:14:08,160 CONTROLLED DIABETES AND THEY'RE 5698 04:14:08,160 --> 04:14:09,760 ON DIALYSIS AND THEY HAVE A LOT 5699 04:14:09,760 --> 04:14:11,240 OF CO-MORBIDITIES SO WE BROKE 5700 04:14:11,240 --> 04:14:13,720 THIS OUT FURTHER, ACCORDING TO 5701 04:14:13,720 --> 04:14:15,840 THE NUMBER OF CO-MORBIDITY AND 5702 04:14:15,840 --> 04:14:17,560 I'M SHOWING YOU IT'S BROKEN DOWN 5703 04:14:17,560 --> 04:14:21,160 WHETHER YOU HAVE NO CO-MORBIDITY 5704 04:14:21,160 --> 04:14:22,800 AND OR THREE CO-MORBIDITY AND 5705 04:14:22,800 --> 04:14:26,000 THE BOTTOM, RIGHT OF THIS SLIDE 5706 04:14:26,000 --> 04:14:27,000 WOULD NOT BE SURPRISING TO 5707 04:14:27,000 --> 04:14:28,040 ANYBODY. 5708 04:14:28,040 --> 04:14:29,720 OLDER ADULTS WITH LOTS OF 5709 04:14:29,720 --> 04:14:32,080 CO-MORBIDITY WHO GET ILL MAYBE 5710 04:14:32,080 --> 04:14:34,040 WE'RE UNMASKING A PREEXISTING 5711 04:14:34,040 --> 04:14:34,280 COGNITIVE. 5712 04:14:34,280 --> 04:14:36,320 I WANT TO DRAW WHY ATTENTION TO 5713 04:14:36,320 --> 04:14:39,040 THE UPPER LEFT. 5714 04:14:39,040 --> 04:14:42,840 THE 30 AND 40-YEAR-OLDS WITH NO 5715 04:14:42,840 --> 04:14:44,440 CO-MORBIDITY AND WEARING SHOWING 5716 04:14:44,440 --> 04:14:46,000 ONE STANDARD DEVIATION. 5717 04:14:46,000 --> 04:14:47,200 THIS SUGGESTS CLINICAL ILLNESS 5718 04:14:47,200 --> 04:14:51,800 IS LEADING TO THE NEWLY ACQUIRED 5719 04:14:51,800 --> 04:14:53,280 COGNITIVE APPROACH AND ON THAT 5720 04:14:53,280 --> 04:14:56,400 SAME COHORT WE ALSO LOOKED AT 5721 04:14:56,400 --> 04:14:57,400 FRAILTY AMONG OUR PATIENTS 18 5722 04:14:57,400 --> 04:14:59,520 AND UP USING THE CLINICAL 5723 04:14:59,520 --> 04:15:00,640 FRAILTY SKILL AND WE CHOSE THAT 5724 04:15:00,640 --> 04:15:02,480 BECAUSE OUR PATIENTS ARE 5725 04:15:02,480 --> 04:15:03,480 CRITICALLY ILL AND NONE OF THEM 5726 04:15:03,480 --> 04:15:05,440 ARE PLANNING TO GET PNEUMONIA 5727 04:15:05,440 --> 04:15:08,840 AND GET SEPTIC AND LAY ON A 5728 04:15:08,840 --> 04:15:09,960 VENTILATOR AND THEY CAN'T 5729 04:15:09,960 --> 04:15:11,720 PERFORM PHYSICAL PERFORMANCE 5730 04:15:11,720 --> 04:15:14,600 MEASURES NEEDED TO DO THE FAIL 5731 04:15:14,600 --> 04:15:16,680 AND WE USE THE CLINICAL TRAIL 5732 04:15:16,680 --> 04:15:17,880 TEE SCALE. 5733 04:15:17,880 --> 04:15:19,320 PUBLISHED THIS DATA IN CRITICAL 5734 04:15:19,320 --> 04:15:20,280 CARE MEDICINE AND WHAT I'M 5735 04:15:20,280 --> 04:15:23,400 SHOWING YOU HERE IS PREPORTION 5736 04:15:23,400 --> 04:15:24,960 OF PATIENTS GOING INTO THREE 5737 04:15:24,960 --> 04:15:26,360 DIFFERENT CATEGORIES AND 5738 04:15:26,360 --> 04:15:29,440 ACCORDING TO THE FRAILTY SCALES 5739 04:15:29,440 --> 04:15:31,080 FOR THEIR CRITICAL ILLNESS THE 5740 04:15:31,080 --> 04:15:41,680 BEST WE COULD OBTAIN -- THOSE AE 5741 04:15:44,760 --> 04:15:47,200 MOST ROBUST PATIENTS AND FOUR 5742 04:15:47,200 --> 04:15:52,160 VULNERABLE PATIENTS AND AND IN 5743 04:15:52,160 --> 04:15:55,960 THIS POPULATION A QUARTER OF 5744 04:15:55,960 --> 04:15:56,680 PATIENTS, FRAILTY AND THAT 5745 04:15:56,680 --> 04:15:59,360 NUMBER INCREASES AND ALMOST 5746 04:15:59,360 --> 04:16:03,800 DOUBLED AND 45% AT THREE MONTHS 5747 04:16:03,800 --> 04:16:05,800 AND STAYED HIGH AND 40% OF 5748 04:16:05,800 --> 04:16:06,600 SURVIVORS AT A YEAR. 5749 04:16:06,600 --> 04:16:08,640 IF YOU LOOK AT THE NUMBER OF 5750 04:16:08,640 --> 04:16:09,960 PATIENTS WITH FRAILTY AT THREE 5751 04:16:09,960 --> 04:16:12,040 AND 12 MONTHS, 60% WERE NOT 5752 04:16:12,040 --> 04:16:15,520 FRAIL BEFORE THEY WERE NO AND 5753 04:16:15,520 --> 04:16:17,480 WE'VE BROKEN OUT THESE RAW 5754 04:16:17,480 --> 04:16:21,920 SCORES HERE AGAIN BY AGE GROUPS 5755 04:16:21,920 --> 04:16:23,720 OVER 65 AND 30 AND 40-YEAR-OLDS 5756 04:16:23,720 --> 04:16:25,360 AT THREE AND 12 MONTHS AND WHAT 5757 04:16:25,360 --> 04:16:27,360 YOU CAN SEE IN THE UPPER LEFT 5758 04:16:27,360 --> 04:16:33,080 AND WE HAVE YOUNGER SURVIVORS 5759 04:16:33,080 --> 04:16:34,880 WHO SEALED FRAILTY SO 50 AND 5760 04:16:34,880 --> 04:16:37,160 60-YEAR-OLDS AND 30 AND 40 WITH 5761 04:16:37,160 --> 04:16:38,360 FRAILTY OF THEIR CRITICAL 5762 04:16:38,360 --> 04:16:41,440 ILLNESS AND SUGGESTING AGAIN 5763 04:16:41,440 --> 04:16:43,880 THAT IT LEADS TO AN ACCELERATED 5764 04:16:43,880 --> 04:16:46,440 AGING PHENOTYPE AND SOME NEW 5765 04:16:46,440 --> 04:16:48,440 DATA FROM A MORE RESENT COHORT 5766 04:16:48,440 --> 04:16:49,840 AND THE AWARD WHICH JUST 5767 04:16:49,840 --> 04:16:52,440 COMPLETED AS PART OF MY AWARD WE 5768 04:16:52,440 --> 04:16:55,800 LOOKED MORE AT PHYSICAL 5769 04:16:55,800 --> 04:16:56,080 FUNCTION. 5770 04:16:56,080 --> 04:16:56,640 APPROXIMATE APPROXIMATE IF 5771 04:16:56,640 --> 04:16:57,720 REPEAT THE SHORT PHYSICAL 5772 04:16:57,720 --> 04:16:59,240 PERFORMANCE BATTERY AND WE DON'T 5773 04:16:59,240 --> 04:17:01,160 HAVE BASELINE DATA ON THOSE 5774 04:17:01,160 --> 04:17:04,600 FOLKS BECAUSE THEY'RE CRITICALLY 5775 04:17:04,600 --> 04:17:05,360 ILL. 5776 04:17:05,360 --> 04:17:06,760 AS WE BREAK THESE OUT BY AGE, 5777 04:17:06,760 --> 04:17:08,520 YOU CAN SEE THESE NUMBERS ARE 5778 04:17:08,520 --> 04:17:11,760 LOW COMPARED TO POPULATION IF WE 5779 04:17:11,760 --> 04:17:13,040 TAKE YOUNGER FOLKS THERE'S A 5780 04:17:13,040 --> 04:17:15,080 COUPLE OF POPULATION COHORTS ONE 5781 04:17:15,080 --> 04:17:17,600 FROM NORWAY AND SINGAPORE AND 5782 04:17:17,600 --> 04:17:20,280 THE 40 AND 40-YEAR-OLD WERE 5783 04:17:20,280 --> 04:17:27,880 SCORING PERFECT AND IT'S PRETTY 5784 04:17:27,880 --> 04:17:30,840 SIGNIFICANT DIFFERENT SCORES. 5785 04:17:30,840 --> 04:17:32,280 OVER 65 WAS SIMILARLY AND THESE 5786 04:17:32,280 --> 04:17:33,720 ARE PATIENTS NOW THAT ARE 5787 04:17:33,720 --> 04:17:36,520 CONSIDERED AT HIGH-RISK, RIGHT. 5788 04:17:36,520 --> 04:17:37,800 THEY WOULD HAVE BEEN MET 5789 04:17:37,800 --> 04:17:39,560 INCLUSION CRITERIA FOR OUR 5790 04:17:39,560 --> 04:17:41,920 STUDIES TO REDUCE DISABILITY IN 5791 04:17:41,920 --> 04:17:45,480 OLDER ADULTS. 5792 04:17:45,480 --> 04:17:46,640 SO INVESTIGATE THAT SURVIVOR OF 5793 04:17:46,640 --> 04:17:48,240 CRITICAL ILLNESS HAS 5794 04:17:48,240 --> 04:17:54,680 SIGNIFICANTLY IMPAIRED PHYSICAL 5795 04:17:54,680 --> 04:17:56,120 FUNCTTHAT. 5796 04:17:56,120 --> 04:17:58,000 LET'S LOOK AT THE BIOLOGICAL 5797 04:17:58,000 --> 04:17:58,640 PERSPECTIVES. 5798 04:17:58,640 --> 04:18:00,600 THIS SERIES OF DATA IS MUCH LESS 5799 04:18:00,600 --> 04:18:02,920 WELL DEVELOPED THAN THE CLINICAL 5800 04:18:02,920 --> 04:18:04,320 COHORTS BUT THERE'S SEVERAL 5801 04:18:04,320 --> 04:18:06,520 LINES OF DATA THAT INDICATE THAT 5802 04:18:06,520 --> 04:18:08,160 PERHAPS CRITICAL ILLNESS IS 5803 04:18:08,160 --> 04:18:10,320 LEADING TO SOME OF THESE 5804 04:18:10,320 --> 04:18:11,560 BIOLOGICAL HALLMARKS OF AGING 5805 04:18:11,560 --> 04:18:12,920 WHICH WOULD GO ALONG WITH THE 5806 04:18:12,920 --> 04:18:16,840 CLINICAL DATA THAT I JUST SHOWED 5807 04:18:16,840 --> 04:18:18,320 YOU. 5808 04:18:18,320 --> 04:18:20,200 HE ENROLLED OVER 400 ADULT S 5809 04:18:20,200 --> 04:18:22,000 WITH PNEUMONIA AND BEEN IN THE 5810 04:18:22,000 --> 04:18:23,880 HOSPITAL WITH PNEUMONIA AND HE 5811 04:18:23,880 --> 04:18:25,640 DREW BLOOD AROUND THE TIME OF 5812 04:18:25,640 --> 04:18:27,120 HOSPITAL ADMISSION AND ABOUT A 5813 04:18:27,120 --> 04:18:29,040 WEEK LATER BEFORE THE PATIENTS 5814 04:18:29,040 --> 04:18:32,480 WENT HOME AND AT THREE, SIX AND 5815 04:18:32,480 --> 04:18:34,960 12 MONTHS LATER AND THE DOTTED 5816 04:18:34,960 --> 04:18:40,800 LINE REPRESENTS THE 95% FOR THE 5817 04:18:40,800 --> 04:18:43,000 NORMAL VALUE OF IL6 AND THE 5818 04:18:43,000 --> 04:18:43,760 CLINICAL LAB. 5819 04:18:43,760 --> 04:18:45,280 DURING THE ACUTE INFECTION, 5820 04:18:45,280 --> 04:18:46,960 WHICH IS NOT SURPRISING TO 5821 04:18:46,960 --> 04:18:48,600 ANYBODY, THOSE VALUES ARE 5822 04:18:48,600 --> 04:18:49,240 ELEVATED. 5823 04:18:49,240 --> 04:18:52,120 BUT AT THREE, SIX AND A YEAR 5824 04:18:52,120 --> 04:18:53,880 LATER, OVER HALF OF THOSE 5825 04:18:53,880 --> 04:18:55,400 PATIENTS, THEY HAVE ELEVATED 5826 04:18:55,400 --> 04:18:58,080 I'LL SIX SUGGESTING THAT 5827 04:18:58,080 --> 04:19:00,640 INFECTION IS LEADING TO A FORM 5828 04:19:00,640 --> 04:19:04,680 OF CHRONIC INFORMATION AND THEY 5829 04:19:04,680 --> 04:19:07,080 HAVE ACUTE INFECTION AS A 5830 04:19:07,080 --> 04:19:07,680 RESULT. 5831 04:19:07,680 --> 04:19:09,560 SECOND, SMALLER COHORT SCUDDY 5832 04:19:09,560 --> 04:19:11,480 OUT OF TORONTO AND LOOKED AT 5833 04:19:11,480 --> 04:19:15,560 SURVIVORS THE ACUTE RESPIRATORY 5834 04:19:15,560 --> 04:19:18,160 OR SEVERE MA KNOWNIA AND 5835 04:19:18,160 --> 04:19:20,160 VENTILATORS WAS THIS CALLING IT 5836 04:19:20,160 --> 04:19:21,680 ARDS AND WHAT THEY LOOKED AT IN 5837 04:19:21,680 --> 04:19:24,280 THIS COHORT OF 15 PATIENTS THE 5838 04:19:24,280 --> 04:19:25,840 AVERAGE AGE WAS IN THE LATE 5839 04:19:25,840 --> 04:19:27,240 40s AND EARLY 50s AND THEY 5840 04:19:27,240 --> 04:19:31,440 LOOKED AT MUSCLE BU BIOPSIES ANN 5841 04:19:31,440 --> 04:19:33,800 THE LEFT THERE IS A TWO-PAGES. 5842 04:19:33,800 --> 04:19:35,720 ONE ON THE TOP OF MUSCLE ATROPHY 5843 04:19:35,720 --> 04:19:37,920 AND ONE ON THE BOTTOM WITH 5844 04:19:37,920 --> 04:19:39,720 NORMAL MUSCLES AND WHAT THEY'RE 5845 04:19:39,720 --> 04:19:41,400 POINTING OUT TO YOU ARE 5846 04:19:41,400 --> 04:19:45,040 SATELLITE CELLS OR MUSCLE STEM 5847 04:19:45,040 --> 04:19:46,720 CELLS AND YOU CAN SEE IN THE TOP 5848 04:19:46,720 --> 04:19:57,280 THE MUSCLE AND AND THE VYING ANT 5849 04:19:58,000 --> 04:20:04,560 AND A CROP I CAN AND NORMAL AT 5850 04:20:04,560 --> 04:20:08,680 SEVEN DAYS AND SIX MONTHS AND 5851 04:20:08,680 --> 04:20:10,160 YOU CAN HE SEE AND AND THE 5852 04:20:10,160 --> 04:20:13,160 NUMBER OF SATELLITE CELLS IS 5853 04:20:13,160 --> 04:20:15,320 MARKETING REDUCED AND THESE ARE 5854 04:20:15,320 --> 04:20:18,320 YOUNGER FOLKS BUT SUGGESTING 5855 04:20:18,320 --> 04:20:26,360 THAT ARDS RELATES TO OTHER. 5856 04:20:26,360 --> 04:20:27,800 OUR GROUP PERFORMED EXERCISE 5857 04:20:27,800 --> 04:20:29,560 TESTING SURVIVORS AND CRITICAL 5858 04:20:29,560 --> 04:20:32,520 ILLNESS FROM OUR MOSAIC COHORT 5859 04:20:32,520 --> 04:20:33,960 AND WE HAD 14 PEOPLE COME BACK 5860 04:20:33,960 --> 04:20:39,480 TO OUR LAB AND GET ON THE FULL 5861 04:20:39,480 --> 04:20:41,000 CP I WANT TO SHOW YOU A COUPLE 5862 04:20:41,000 --> 04:20:43,520 OF THINGS RELATED TO 5863 04:20:43,520 --> 04:20:44,800 MITOCHONDRIAL AND ALMOST ALL OF 5864 04:20:44,800 --> 04:20:49,560 THESE PATIENTS HAD CARDIO 5865 04:20:49,560 --> 04:20:52,440 RESPIRATORY FITNESS BELOW 20 5866 04:20:52,440 --> 04:20:57,520 PLACING THEM PATIENTS WITH 5867 04:20:57,520 --> 04:21:01,800 SEVERE END-STAGE. 5868 04:21:01,800 --> 04:21:03,320 NONE HAD LUNG OR HEART DISEASE. 5869 04:21:03,320 --> 04:21:05,800 THEY HAD RESISTING CARDIO 5870 04:21:05,800 --> 04:21:07,000 PULMONARY DISEASE SO WHAT WE'RE 5871 04:21:07,000 --> 04:21:09,680 SHOWING YOU IS THE RELATIONSHIP 5872 04:21:09,680 --> 04:21:12,240 BETWEEN TWO MEASURES OF 5873 04:21:12,240 --> 04:21:15,200 EFFICIENCY AND DURING CONSIDER 5874 04:21:15,200 --> 04:21:19,480 THE WORK RATE AND ON THE RIGHT 5875 04:21:19,480 --> 04:21:26,040 SO WHAT YOU CAN SEE AND AND HAVE 5876 04:21:26,040 --> 04:21:31,600 THE WORST MITOCHONDRIA LOWY 5877 04:21:31,600 --> 04:21:32,680 EFFICIENCY DURING RECOVER THEY 5878 04:21:32,680 --> 04:21:34,120 HAVE THE LONGEST RECOVERY TIME 5879 04:21:34,120 --> 04:21:40,520 SO THIS IS SUGGESTING 5880 04:21:40,520 --> 04:21:44,200 MITOCHONDRIAL UNDERLIES SOME OF 5881 04:21:44,200 --> 04:21:50,600 THE AND IT'S THREE DIFFERENT 5882 04:21:50,600 --> 04:21:53,840 BIOMARKERS AND AS MUCH AND 5883 04:21:53,840 --> 04:21:55,840 CANCER AND HIV AND THE OTHER 5884 04:21:55,840 --> 04:21:57,360 THING TO CONSIDER IN TERMS OF 5885 04:21:57,360 --> 04:21:59,280 UNDERSTANDING WHETHER CRITICAL 5886 04:21:59,280 --> 04:22:01,640 ILLNESS LEADS TO ACCELERATED 5887 04:22:01,640 --> 04:22:05,960 AGING IS THE RELATIONSHIP AND 5888 04:22:05,960 --> 04:22:10,040 BIDIRECTIONAL RELATIONSHIP PREN 5889 04:22:10,040 --> 04:22:12,720 MENTAL ILLNESS AND RELATIONSHIP 5890 04:22:12,720 --> 04:22:16,040 AGING AND ARDS AND SEVERE 5891 04:22:16,040 --> 04:22:19,280 RESPIRATORY FAILURE AND 5892 04:22:19,280 --> 04:22:20,640 VENTILATOR AND THE SINGLE 5893 04:22:20,640 --> 04:22:21,960 BIGGEST RISK FACTORS. 5894 04:22:21,960 --> 04:22:25,400 BUT DEMENTIA CAN LEAD TO SEVERE 5895 04:22:25,400 --> 04:22:26,480 SEPSIS WHICH IS THE LEADING 5896 04:22:26,480 --> 04:22:28,800 CAUSE OF HOSPITAL ADMISSION IN 5897 04:22:28,800 --> 04:22:29,520 OLDER ADULTS. 5898 04:22:29,520 --> 04:22:32,080 THIS IS DATA FROM THE 5899 04:22:32,080 --> 04:22:34,280 CARDIOVASCULAR HEALTH STUDY OUT 5900 04:22:34,280 --> 04:22:37,080 OF PITTSBURG AND THEY LOOKED AT 5901 04:22:37,080 --> 04:22:40,160 THE RISK OF THE INFECTION AND 5902 04:22:40,160 --> 04:22:42,200 THE SEVERE H SEVERITY OF THAT 5903 04:22:42,200 --> 04:22:44,360 INFECTION SO SHOWN ARE THREE 5904 04:22:44,360 --> 04:22:46,360 DIFFERENT TRAJECTORIES OF 5905 04:22:46,360 --> 04:22:47,720 COGNITION, YELLOW SHOWING NO 5906 04:22:47,720 --> 04:22:49,240 DECLINE AND BLUE MINIMAL DECLINE 5907 04:22:49,240 --> 04:22:51,000 AND RED SHOWING SEVERE DECLINE 5908 04:22:51,000 --> 04:22:52,640 AND WHAT YOU CAN SEE IS THAT 5909 04:22:52,640 --> 04:22:54,800 THOSE WITH NO INFECTION, ON THE 5910 04:22:54,800 --> 04:22:56,680 LEFT, AS WE WORK LEFT AND RIGHT, 5911 04:22:56,680 --> 04:22:58,600 THE SEVERITY OF INFECTION GOES 5912 04:22:58,600 --> 04:23:01,720 UP SO NO INFECTION AND ANY 5913 04:23:01,720 --> 04:23:03,600 INFECTION AND SEPSIS SO THOSE 5914 04:23:03,600 --> 04:23:05,480 WITH NO DECLINE IN COGNITION 5915 04:23:05,480 --> 04:23:07,520 HAVE LOWER RATES OF NOT BEING 5916 04:23:07,520 --> 04:23:09,840 INFECTED AND LOWER RATES OF 5917 04:23:09,840 --> 04:23:12,080 HAVING SEVERE SUBSTANCE AND 5918 04:23:12,080 --> 04:23:14,400 MINIMAL DECLINE HAVE INCREASING 5919 04:23:14,400 --> 04:23:24,960 RATES OF SEVERE SUGGESTING THAT 5920 04:23:59,040 --> 04:24:01,120 THERE'S A CLINICAL PHENOTYPE OF 5921 04:24:01,120 --> 04:24:02,480 ACCELERATING AGING WITH HIGH 5922 04:24:02,480 --> 04:24:04,800 RATES OF COGNITIVE IMPAIRMENT 5923 04:24:04,800 --> 04:24:06,000 INCLUDING THOSE YOUNGER ADULTS 5924 04:24:06,000 --> 04:24:09,120 AND PHYSICAL IMPAIRMENTS AND 5925 04:24:09,120 --> 04:24:10,600 FRAILTY AND SOME EARLY DATA, 5926 04:24:10,600 --> 04:24:12,600 REALLY VERY EARLY DATA OF 5927 04:24:12,600 --> 04:24:13,960 DIFFERENT BIOLOGICAL PROCESSES 5928 04:24:13,960 --> 04:24:17,000 AND OF AGING AND PRESENT IN ICU 5929 04:24:17,000 --> 04:24:19,120 SURVIVORS AND IT'S AN AREA RIGHT 5930 04:24:19,120 --> 04:24:21,280 FOR FURTHER STUDY AND IN THE 5931 04:24:21,280 --> 04:24:23,400 MEANTIME, WE HAVE TO TEASE OUT 5932 04:24:23,400 --> 04:24:24,600 THIS BIDIRECTIONAL RELATIONSHIP 5933 04:24:24,600 --> 04:24:25,400 AND UNDERSTAND WAYS TO 5934 04:24:25,400 --> 04:24:26,960 UNDERSTAND HOW PEOPLE WERE DOING 5935 04:24:26,960 --> 04:24:28,760 MONTHS AND YEARS BEFORE THEIR 5936 04:24:28,760 --> 04:24:30,080 ILLNESS AND IF WE LOOKED AT 5937 04:24:30,080 --> 04:24:32,280 SOMEONE WHO WAS OR NOT AN 5938 04:24:32,280 --> 04:24:35,320 ALREADY ACCELERATED AGING 5939 04:24:35,320 --> 04:24:38,480 TRAJECTORY AND CATCH THEM AT ICU 5940 04:24:38,480 --> 04:24:41,080 ADMISSION WE MAY CONSUME THAT 5941 04:24:41,080 --> 04:24:45,000 THEY (INAUDIBLE). 5942 04:24:45,000 --> 04:24:47,480 SO THANK YOU AND IT'S TIME FOR 5943 04:24:47,480 --> 04:24:57,640 OUR PANEL. 5944 04:25:32,720 --> 04:25:33,800 >>GOOD AFTERNOON. 5945 04:25:33,800 --> 04:25:37,680 ANOTHER BUCK EYE PRESENTING THIS 5946 04:25:37,680 --> 04:25:38,600 AFTERNOON. 5947 04:25:38,600 --> 04:25:40,560 I WAS JUST MINDING MY OWN 5948 04:25:40,560 --> 04:25:43,920 BUSINESS AND RECEIVED AN E-MAIL 5949 04:25:43,920 --> 04:25:45,640 FROM NIH AND ASKING IF YOU WOULD 5950 04:25:45,640 --> 04:25:49,320 LIKE TO PARTICIPATE IN THE 5951 04:25:49,320 --> 04:25:50,720 GEROSCIENCE SUMMIT AND I WAS 5952 04:25:50,720 --> 04:25:53,880 HOPPERED TO ACCEPT THAT 5953 04:25:53,880 --> 04:25:56,440 INVITATION AND I'LL MAKE 5954 04:25:56,440 --> 04:25:57,720 COMMENTS ABOUT A PERSPECTIVE 5955 04:25:57,720 --> 04:25:59,360 FROM A FAMILY PHYSICIAN SERVING 5956 04:25:59,360 --> 04:26:03,440 IN MOSTLY AFRICAN AMERICAN 5957 04:26:03,440 --> 04:26:04,280 COMMUNITIES ON THE NEAR EASTSIDE 5958 04:26:04,280 --> 04:26:08,200 OF COLUMBUS AND PAST PRESIDENT 5959 04:26:08,200 --> 04:26:11,480 OF THE NATIONAL MEDICAL 5960 04:26:11,480 --> 04:26:15,480 ASSOCIATIONS AND SO LET'S GET 5961 04:26:15,480 --> 04:26:16,480 STARTED. 5962 04:26:16,480 --> 04:26:19,200 MY OBJECTIVES WILL BE TO SPEAK 5963 04:26:19,200 --> 04:26:24,360 TO THE CONCEPT OF A FIVE DAYS OF 5964 04:26:24,360 --> 04:26:26,080 ACCESS AND THE FULFILLMENT OF 5965 04:26:26,080 --> 04:26:28,320 THE PROMISE OF TRANSLATIONAL 5966 04:26:28,320 --> 04:26:31,400 RESEARCH FOR OLDER PERSONS AND 5967 04:26:31,400 --> 04:26:37,000 GOING TO SPEAK TO THE CONCEPT OF 5968 04:26:37,000 --> 04:26:39,840 WHOLE HEALTH AND WHOLE 5969 04:26:39,840 --> 04:26:50,560 HEALTH-WHO PERSON HEALTH SCA SCE 5970 04:26:51,400 --> 04:26:54,400 AND THE WHOLE HEART OF WHERE 5971 04:26:54,400 --> 04:26:55,000 WEATHERING. 5972 04:26:55,000 --> 04:26:58,960 ANYONE KNOW WHO THESE GENTLEMAN 5973 04:26:58,960 --> 04:27:06,960 ARE HERE? 5974 04:27:06,960 --> 04:27:08,520 AND THIS IS Dr. WILLIAM THOMAS 5975 04:27:08,520 --> 04:27:12,400 THEY PUBLISHED AN ARTICLE 5976 04:27:12,400 --> 04:27:13,960 CONCERNING THE FIVE As OF AK 5977 04:27:13,960 --> 04:27:22,680 IS CEASE AND T -- THISAS OVER 5L 5978 04:27:22,680 --> 04:27:25,800 BRIEFLY GO OVER THIS INFORMATION 5979 04:27:25,800 --> 04:27:27,800 WITH YOU. 5980 04:27:27,800 --> 04:27:31,760 I KNOW I DON'T HAVE A LOT OF 5981 04:27:31,760 --> 04:27:32,360 TIME. 5982 04:27:32,360 --> 04:27:38,360 WHEN WE THINK ABOUT GEROSCIENCE 5983 04:27:38,360 --> 04:27:41,320 AND GOING FROM BENCH AND BEDSIDE 5984 04:27:41,320 --> 04:27:45,760 AND A LOT OF DIFFERENT AND 5985 04:27:45,760 --> 04:27:48,440 METRICS AND AGING AND SPEAKING 5986 04:27:48,440 --> 04:27:51,760 TO THE MECHANISMS FOR AGING ON 5987 04:27:51,760 --> 04:27:58,000 THE NEAR EASTSIDE OF COLUMBUS, 5988 04:27:58,000 --> 04:28:00,520 I'M CONCERNED HOW THIS 5989 04:28:00,520 --> 04:28:01,680 INFORMATION AND I WANT TO HELP 5990 04:28:01,680 --> 04:28:03,800 THE PATIENTS I SEE ON A DAILY 5991 04:28:03,800 --> 04:28:05,320 BASIS. 5992 04:28:05,320 --> 04:28:07,320 SO, I WANTED TO BRING THIS 5993 04:28:07,320 --> 04:28:10,400 FORMAT AND THIS AND THIS 5994 04:28:10,400 --> 04:28:13,960 FRAMEWORK TO DISCUSSION AND 5995 04:28:13,960 --> 04:28:15,400 REGARDING THE FIVE As BECAUSE 5996 04:28:15,400 --> 04:28:18,840 THEY'RE GOING TO BE IMPORTANT 5997 04:28:18,840 --> 04:28:20,840 AND THESE NOVEL CONCEPTS AND 5998 04:28:20,840 --> 04:28:22,400 THIS GREAT RESEARCH THAT IS 5999 04:28:22,400 --> 04:28:25,840 GOING ON HERE AT THE NATIONAL 6000 04:28:25,840 --> 04:28:29,120 INSTITUTES OF AGING AND TO WHERE 6001 04:28:29,120 --> 04:28:34,520 THE PEOPLE ARE AT. 6002 04:28:34,520 --> 04:28:39,400 MY COLLEAGUES AT OHIO STATE TOOK 6003 04:28:39,400 --> 04:28:41,480 THESE FIVE As AND FRAMED THEM 6004 04:28:41,480 --> 04:28:44,040 FROM A STAND POINT OF TECH 6005 04:28:44,040 --> 04:28:49,480 EQUITY IN TERMS THEY'VE COINED 6006 04:28:49,480 --> 04:28:53,120 TO DEALING WITH OUR TELEHEALTH 6007 04:28:53,120 --> 04:28:58,640 AND BEING ABLE TO GIVE RANGE THE 6008 04:28:58,640 --> 04:29:04,400 BENCH TO THE BEDSIDE TO THE 6009 04:29:04,400 --> 04:29:05,600 COMMUNITY. 6010 04:29:05,600 --> 04:29:16,160 NOW THIS CONCEPT OF WHOLE I HAVE 6011 04:29:33,960 --> 04:29:35,240 JOKES AND I HAVE A SENSE OF 6012 04:29:35,240 --> 04:29:40,120 HUMOR SO DON'T THINK THAT IN THE 6013 04:29:40,120 --> 04:29:50,320 WRONG WAY. 6014 04:30:12,400 --> 04:30:19,400 LOOKING AT CLIENTS AND AND MOVE 6015 04:30:19,400 --> 04:30:21,880 FROM THAT PATIENTS IS NOT 6016 04:30:21,880 --> 04:30:23,080 COMPLIANT, THEY'RE JUST DON'T 6017 04:30:23,080 --> 04:30:27,440 WANT TO DO THAT IT'S REALLY NO 6018 04:30:27,440 --> 04:30:29,320 MATTER WHAT COULD BE OTHER 6019 04:30:29,320 --> 04:30:32,840 INVOLVED IN THAT SO-CALLED 6020 04:30:32,840 --> 04:30:33,120 CLIENTS. 6021 04:30:33,120 --> 04:30:38,760 I'M JUST GOING TO BRIEFLY GO 6022 04:30:38,760 --> 04:30:40,000 DOWN THE SPEAKING TO THE 6023 04:30:40,000 --> 04:30:46,080 PHYSICAL AND THE EMOTIONAL AND 6024 04:30:46,080 --> 04:30:50,120 THE RESOURCE AND SOCIAL 6025 04:30:50,120 --> 04:30:58,400 ECONOMICS AND I WANT TO BRING 6026 04:30:58,400 --> 04:31:02,640 AND SELF-EFFICACY ASPECT OF THIS 6027 04:31:02,640 --> 04:31:04,680 AND PARTNERSHIP AND WITH OUR 6028 04:31:04,680 --> 04:31:08,960 OLDER PATIENTS AND MANY PEOPLE 6029 04:31:08,960 --> 04:31:13,520 THAT ARE SPOKEN TO NUTRITION AND 6030 04:31:13,520 --> 04:31:21,560 SO THIS IS A SUMMARY TOOLS FOR 6031 04:31:21,560 --> 04:31:25,720 SOCIAL DETERMINANTS OF HEALTH 6032 04:31:25,720 --> 04:31:31,480 AND NOW Dr. PEREZ-STABLE AND 6033 04:31:31,480 --> 04:31:38,680 HIS TALK THERE WAS A PINNED -- 6034 04:31:38,680 --> 04:31:44,520 MEASURE HERE BEING USED FOR 6035 04:31:44,520 --> 04:31:45,000 EVALUATING CERTAINLY 6036 04:31:45,000 --> 04:31:46,040 DETERMINANTS OF HEALTH AND I 6037 04:31:46,040 --> 04:31:49,640 JUST WANT TO SHOW YOU SOME 6038 04:31:49,640 --> 04:31:58,320 RETABLE AND THE THING ABOUT AND 6039 04:31:58,320 --> 04:32:08,800 LEVELS FOR UNDERSTANDING AND 6040 04:32:25,160 --> 04:32:26,880 SOCIAL DETERMINANTS OF HEALTH 6041 04:32:26,880 --> 04:32:31,560 INCOMPETENT GRATING THAT WITHIN 6042 04:32:31,560 --> 04:32:37,760 OUR HEALTH RECORD AND AND THE 6043 04:32:37,760 --> 04:32:43,080 WEATHERING ALSO ANOTHER CONCEPT 6044 04:32:43,080 --> 04:32:48,280 DEVELOPED BY Dr. GERON NAMUS 6045 04:32:48,280 --> 04:32:51,800 WHEN INTRODUCED AND SHE ALSO 6046 04:32:51,800 --> 04:32:54,400 HAPPENS TO BE AT THE UNIVERSITY 6047 04:32:54,400 --> 04:33:03,200 OF MICHIGAN AND SHE'S OUR LAST 6048 04:33:03,200 --> 04:33:09,240 AND SO SPEAKING TO THE CONCEPT 6049 04:33:09,240 --> 04:33:11,160 OF LOWS AND YOU CAN SEE HERE, 6050 04:33:11,160 --> 04:33:18,120 THE PROBABILITY OF A LOW IN POV 6051 04:33:18,120 --> 04:33:23,680 FOR BEING PREDICTED BY A RACE OF 6052 04:33:23,680 --> 04:33:26,040 BLACK MEN AND WOMEN AND HIGHER 6053 04:33:26,040 --> 04:33:28,880 RATED HERE AND THEN SHE ALSO 6054 04:33:28,880 --> 04:33:36,600 TOOK INTO ACCOUNT THE POVERTY 6055 04:33:36,600 --> 04:33:41,360 INDEX RATE AND THE RATIO LESS 6056 04:33:41,360 --> 04:33:45,040 THAN 1.5 OR GREATER THAN 1.85 6057 04:33:45,040 --> 04:33:51,840 AND 1.85 IS THE POINT WHERE 6058 04:33:51,840 --> 04:33:53,840 PEOPLE QUALIFIED AND IN THE 6059 04:33:53,840 --> 04:33:59,640 PROGRAM AND EVEN, WITH 6060 04:33:59,640 --> 04:34:02,480 CONTROLLING FOR POVERTY, YOU 6061 04:34:02,480 --> 04:34:06,880 STILL HAVE THE DIFFERENCE HERE 6062 04:34:06,880 --> 04:34:13,520 IN THE LOW MEASURES BEING FIVE 6063 04:34:13,520 --> 04:34:15,760 OR HIGHER SO I THINK I'VE BEEN 6064 04:34:15,760 --> 04:34:18,440 ABLE TO KEEP WITHIN MY FIVE TO 6065 04:34:18,440 --> 04:34:20,800 SEVEN MINUTES AND THANK YOU FOR 6066 04:34:20,800 --> 04:34:22,280 ALLOWING ME TO PRESENT THIS 6067 04:34:22,280 --> 04:34:22,680 MORNING. 6068 04:34:22,680 --> 04:34:23,520 THANK YOU SO MUCH. 6069 04:35:18,760 --> 04:35:22,120 >>AND I THOUGHT I WOULD DO IS 6070 04:35:22,120 --> 04:35:24,640 USE A COUPLE OF POINTS THAT I 6071 04:35:24,640 --> 04:35:27,480 HAVE BEEN PONDERING ABOUT AS I 6072 04:35:27,480 --> 04:35:30,440 KEEP HEARING ABOUT THE REALLY 6073 04:35:30,440 --> 04:35:31,840 IMPORTANT SCIENTIFIC DISCOVERIES 6074 04:35:31,840 --> 04:35:33,040 THAT WERE BEING PRESENTED TODAY 6075 04:35:33,040 --> 04:35:34,800 AND SO FIRST YOU WILL START WITH 6076 04:35:34,800 --> 04:35:38,800 THE QUICKLY SUMMARIZING WHAT I 6077 04:35:38,800 --> 04:35:39,160 HEARD. 6078 04:35:39,160 --> 04:35:41,520 WE HEARD FROM THIS SESSION THAT 6079 04:35:41,520 --> 04:35:43,080 CENTENARIANS ARE AN IDEAL COHORT 6080 04:35:43,080 --> 04:35:45,560 AND SOMEONE LIVED THAT LONG 6081 04:35:45,560 --> 04:35:48,040 THERE ARE THINGS THAT WE CAN 6082 04:35:48,040 --> 04:35:49,200 LEARN FROM THE MICE. 6083 04:35:49,200 --> 04:35:51,120 I SEE IT DAY IN AND DAY OUT AND 6084 04:35:51,120 --> 04:35:54,160 I TALK ABOUT AGING BUT IT'S ALL 6085 04:35:54,160 --> 04:35:57,720 TEXTBOOK LEARN AND THEN I SEE MY 6086 04:35:57,720 --> 04:36:00,360 PATIENT WHO IS 102-YEARS-OLD 6087 04:36:00,360 --> 04:36:03,120 BROUGHT IN BY HIS SON WHO IS 68 6088 04:36:03,120 --> 04:36:06,320 AND THEY'RE BICKERING WAS THE 6089 04:36:06,320 --> 04:36:07,000 102-YEARS-OLD SEEN THESE YOUNG 6090 04:36:07,000 --> 04:36:07,760 PEOPLE THESE DAYS DON'T KNOW 6091 04:36:07,760 --> 04:36:11,440 WHAT THEY'RE TALKING ABOUT, 6092 04:36:11,440 --> 04:36:21,680 ABOUT HIS SON. 6093 04:36:34,360 --> 04:36:38,080 >>17,000 STEPS A DAY AND I 6094 04:36:38,080 --> 04:36:40,120 DON'T THINK ANY OF THEM HAVE A 6095 04:36:40,120 --> 04:36:42,000 FIT BIT BUT YET HERE THEY ARE 6096 04:36:42,000 --> 04:36:46,720 WITH SO MUCH TO TEACH US AND 6097 04:36:46,720 --> 04:36:52,280 THIS WAS ALSO A AH-HA MOMENT IT 6098 04:36:52,280 --> 04:36:54,240 WAS A STRESS STRESS AND WE PUT 6099 04:36:54,240 --> 04:36:58,240 IT ON THE TREADMILL WE FOUND 6100 04:36:58,240 --> 04:36:59,640 THAT OUR HEALTH-CARE SYSTEM IS 6101 04:36:59,640 --> 04:37:01,200 FAILING THE MOST AND AGAIN, 6102 04:37:01,200 --> 04:37:02,600 THERE'S SO MUCH TALK ABOUT THIS 6103 04:37:02,600 --> 04:37:04,160 IN TERMS OF HEALTH DIS PAR TIES 6104 04:37:04,160 --> 04:37:08,880 SO I WANTED TO PUT IT UP AND 6105 04:37:08,880 --> 04:37:16,800 HERE IS AND WE CAN MAKE US ALL 6106 04:37:16,800 --> 04:37:19,400 BETTER SO I PUT THAT POINT UP 6107 04:37:19,400 --> 04:37:22,840 AND WE LEARN THREE POINTS ABOUT 6108 04:37:22,840 --> 04:37:26,800 HAVE AND APPOINTMENTS THAT I 6109 04:37:26,800 --> 04:37:31,600 LEARNED AND IT CAN BE A LATINX 6110 04:37:31,600 --> 04:37:34,040 PERMENT AND AND DISPROPORTIONATE 6111 04:37:34,040 --> 04:37:36,840 AND HOW CANCER IS MOTIVATOR OF 6112 04:37:36,840 --> 04:37:38,960 AGE AND GIVEN THAT AGING IS SO 6113 04:37:38,960 --> 04:37:44,280 MULTI FACT OR AND IN TERMS OF 6114 04:37:44,280 --> 04:37:46,600 HOW THEY ACCELERATING THE AGING 6115 04:37:46,600 --> 04:37:47,920 PROCESS AND VICE VERSA AND ALSO 6116 04:37:47,920 --> 04:37:50,120 IT GIVES US A PLAN NEW IN SIGHT 6117 04:37:50,120 --> 04:37:54,960 AS WE LOOK AT HOW THESE FACTORS 6118 04:37:54,960 --> 04:37:58,560 INTER AGENT TO BETTER HOW I CAN 6119 04:37:58,560 --> 04:38:02,000 DO MY JOB BETTER THAN SERVING MY 6120 04:38:02,000 --> 04:38:02,280 PATIENTS. 6121 04:38:02,280 --> 04:38:04,440 I WAS REALLY FASCINATED BY THE 6122 04:38:04,440 --> 04:38:09,760 FAUTALK ABOUT THE POST I AM TENI 6123 04:38:09,760 --> 04:38:12,000 INTENSIVE CARE AND WE TALK ABOUT 6124 04:38:12,000 --> 04:38:12,880 SUBACUTE AND HOW IT IT'S 6125 04:38:12,880 --> 04:38:14,000 CONTROLLING AND IT'S AN 6126 04:38:14,000 --> 04:38:15,600 INDEPENDENT FACTOR THAT 6127 04:38:15,600 --> 04:38:16,320 INCREASES MORTALITY AND OF 6128 04:38:16,320 --> 04:38:20,520 COURSE MORBIDITY AND IT'S ALWAYS 6129 04:38:20,520 --> 04:38:23,200 THERE. 6130 04:38:23,200 --> 04:38:24,320 YOU THINK OF THE SORT STINT IN 6131 04:38:24,320 --> 04:38:25,440 THE ICU IT'S IN THE REALM OF 6132 04:38:25,440 --> 04:38:26,840 DAYS THAT'S GOING TO. 6133 04:38:26,840 --> 04:38:27,400 >>Shannon Zenk: PACT YOUR 6134 04:38:27,400 --> 04:38:32,760 IMPACT YOURCOGNITION AND THERE'H 6135 04:38:32,760 --> 04:38:34,200 POSSIBLE CAUTIOUS ABOUT SO WITH 6136 04:38:34,200 --> 04:38:35,920 THAT, WHAT I'M GOING TO DO, GIVE 6137 04:38:35,920 --> 04:38:42,640 US A LITTLE BIT OF LIGHT-HEARTED 6138 04:38:42,640 --> 04:38:44,680 MY TAKE ON ALL OF THIS I HAVE MY 6139 04:38:44,680 --> 04:38:46,200 PICTURE ON THE NIH AND PICTURE 6140 04:38:46,200 --> 04:38:47,600 OF HAVING AS AND BELOW WHAT I 6141 04:38:47,600 --> 04:38:54,560 DID I GIVE YOU THE MISSION OF TO 6142 04:38:54,560 --> 04:38:56,600 SEEK FUND MEMBER KNOWLEDGE ABOUT 6143 04:38:56,600 --> 04:38:57,520 BEHAVIOR AND APPLICATION OF 6144 04:38:57,520 --> 04:39:00,680 KNOWLEDGE TO ENHANCE AND LESSON 6145 04:39:00,680 --> 04:39:03,080 LIFE AND DISABILITY AND HERE 6146 04:39:03,080 --> 04:39:05,000 THIS IS HAVING AS, PROVIDED 6147 04:39:05,000 --> 04:39:06,760 HUMANITY AND UNFORGETTABLE 6148 04:39:06,760 --> 04:39:07,320 ESCAPE. 6149 04:39:07,320 --> 04:39:09,880 A UNIQUE WORLD FILLED WITH 6150 04:39:09,880 --> 04:39:11,520 ANTICIPATION AND ENTERTAINMENT 6151 04:39:11,520 --> 04:39:12,960 AND UNPARALLEL EXPERIENCES, 6152 04:39:12,960 --> 04:39:16,200 RIGHT. 6153 04:39:16,200 --> 04:39:21,960 SO THE MISSION THE HUMAN 6154 04:39:21,960 --> 04:39:24,560 CONDITION IT'S STILL SIGNIFICANT 6155 04:39:24,560 --> 04:39:27,080 REEL SO IS SIGNIFICANTLY 6156 04:39:27,080 --> 04:39:32,520 DIFFERENT AND AND ONE THING AND 6157 04:39:32,520 --> 04:39:34,400 IT SHOULD BE ABSOLUTELY OPPOSITE 6158 04:39:34,400 --> 04:39:39,560 TO DO IT DELIBERATE REAND WE 6159 04:39:39,560 --> 04:39:43,640 TALK ABOUT THE VEGAS RULE. 6160 04:39:43,640 --> 04:39:47,320 WHAT HAPPENS IN VEGAS STAYS IN 6161 04:39:47,320 --> 04:39:51,480 INVESTIGVEGAS, SCIENCE IS TAKINT 6162 04:39:51,480 --> 04:39:51,960 APPROACH. 6163 04:39:51,960 --> 04:39:53,120 SCIENCE STAYS WITHIN THE WALLS 6164 04:39:53,120 --> 04:40:03,640 OF THIS REALLY AMAZING, ICONIC 6165 04:40:05,280 --> 04:40:05,480 ABOUT THE. 6166 04:40:05,480 --> 04:40:06,840 I WOULD SHOW A PARTICULARTURE OF 6167 04:40:06,840 --> 04:40:08,280 THE NIH, RIGHT. 6168 04:40:08,280 --> 04:40:11,480 THE AUDIENCE HERE AND PRESENTERS 6169 04:40:11,480 --> 04:40:15,080 ARE BRILLIANT BUT A CONCERN I'VE 6170 04:40:15,080 --> 04:40:19,600 HAD IS ALL THE KNOWLEDGE STAYS 6171 04:40:19,600 --> 04:40:19,920 HERE. 6172 04:40:19,920 --> 04:40:21,520 NO ONE KNOWS ABOUT THE 17,000 6173 04:40:21,520 --> 04:40:22,120 STEPS. 6174 04:40:22,120 --> 04:40:24,960 MEANING, IF THE ONLY WAY YOU IS 6175 04:40:24,960 --> 04:40:27,880 DO THAT TO CRACK OPEN "THE NEW 6176 04:40:27,880 --> 04:40:31,400 ENGLAND JOURNAL" AND THAT LIVE 6177 04:40:31,400 --> 04:40:35,720 ALMOST IN-PERSON AVAILABLE BY 6178 04:40:35,720 --> 04:40:37,240 PROVIDED TWO SCIENTISTS WE NEED 6179 04:40:37,240 --> 04:40:39,640 TO GET IT OUT TO THE PUBLIC, SO 6180 04:40:39,640 --> 04:40:44,160 WITH THAT, MY CALL TO ACTION 6181 04:40:44,160 --> 04:40:46,120 TODAY IS I REALLY LOVE THIS 6182 04:40:46,120 --> 04:40:48,600 DIAGRAM OF DISSEMINATION AND 6183 04:40:48,600 --> 04:40:49,920 IMPLEMENTATION AND SO THIS IS MY 6184 04:40:49,920 --> 04:40:51,840 LAST SLIDE AND I'M GOING TO 6185 04:40:51,840 --> 04:40:53,160 LEAVE THIS LAST SLIDE WITH YOU 6186 04:40:53,160 --> 04:40:57,160 AND THEN INVITE MY PRESIDENT AND 6187 04:40:57,160 --> 04:40:58,680 CO PRESENTERS TO A PANEL OF 6188 04:40:58,680 --> 04:41:00,920 QUESTIONS BUT I FEEL LIKE WE 6189 04:41:00,920 --> 04:41:01,760 REALLY NEED TO THINK ABOUT 6190 04:41:01,760 --> 04:41:03,800 EVIDENCE ASSESSMENT AND HOW DO 6191 04:41:03,800 --> 04:41:06,200 WE GET THIS INFORMATION TO THE 6192 04:41:06,200 --> 04:41:08,120 PEOPLE, HOW MANY CENTENARIANS 6193 04:41:08,120 --> 04:41:10,520 KNOW THAT IT WASN'T THEIR 6194 04:41:10,520 --> 04:41:11,320 AMAZINGLY HEALTHY LIFESTYLE THAT 6195 04:41:11,320 --> 04:41:14,920 GOT THEM TO WHERE THEY ARE AND 6196 04:41:14,920 --> 04:41:15,640 THEIR OFF SPRINGS HEALTHY 6197 04:41:15,640 --> 04:41:17,280 LIFESTYLE IS NOT A FACTOR. 6198 04:41:17,280 --> 04:41:18,880 HOW MANY TIMES WHEN PEOPLE WANT 6199 04:41:18,880 --> 04:41:21,640 THEIR LOVED ONES AND THIS IS 6200 04:41:21,640 --> 04:41:25,920 GOING TO RESULT IN THE POST ICU 6201 04:41:25,920 --> 04:41:26,720 SYNDROME? 6202 04:41:26,720 --> 04:41:28,320 DO WE TELL PEOPLE FAMILY MEMBERS 6203 04:41:28,320 --> 04:41:30,080 HAVE PTSD AFTERWARDS. 6204 04:41:30,080 --> 04:41:33,520 WE KNOW ALL THAT BUT THAT 6205 04:41:33,520 --> 04:41:37,840 KNOWLEDGE STAYS WITHIN AND TO 6206 04:41:37,840 --> 04:41:39,240 THE AUDIENCE IDENTIFICATION AND 6207 04:41:39,240 --> 04:41:40,920 DO YOU DO WE DO THE 6208 04:41:40,920 --> 04:41:42,000 IMPLEMENTATION IN A WAY THAT YOU 6209 04:41:42,000 --> 04:41:47,000 ARE IDENTIFY WITH IT AND LISTED 6210 04:41:47,000 --> 04:41:54,040 ON GOING STAKEHOLDERS AND 6211 04:41:54,040 --> 04:41:56,040 INSEMINATION HAPPEN AND HOW DO 6212 04:41:56,040 --> 04:41:59,920 WE VALUE WAIT OUR DISSEMINATION 6213 04:41:59,920 --> 04:42:02,040 AND THIS SCIENCE GOES TO THE 6214 04:42:02,040 --> 04:42:03,720 MILLIONS WHO NEED TO PRACTICE 6215 04:42:03,720 --> 04:42:04,160 IT. 6216 04:42:04,160 --> 04:42:05,880 IF SCIENCE IS ONLY PRACTICED BY 6217 04:42:05,880 --> 04:42:07,640 THE SCIENTISTS, I THINK THAT 6218 04:42:07,640 --> 04:42:10,240 MAYBE I'M EXAGGERATING HERE BUT 6219 04:42:10,240 --> 04:42:11,920 IT'S A FAILED MISSION, RIGHT. 6220 04:42:11,920 --> 04:42:14,400 IF ONLY SCIENTISTS PRACTICE 6221 04:42:14,400 --> 04:42:15,720 SCIENCE, HOW DO WE GET THE 6222 04:42:15,720 --> 04:42:17,040 KNOWLEDGE TO THE CITIZENS OF THE 6223 04:42:17,040 --> 04:42:21,640 WORLD AND HOW DO WE HELP THEM 6224 04:42:21,640 --> 04:42:23,400 HELP US. 6225 04:42:23,400 --> 04:42:24,520 I'LL LEAVE YOU WITH THAT 6226 04:42:24,520 --> 04:42:26,960 QUESTION AND INVITE ALL MY CO 6227 04:42:26,960 --> 04:42:29,080 PRESENTERS BACK FOR QUESTIONS. 6228 04:42:29,080 --> 04:42:39,320 [APPLAUSE] 6229 04:43:51,600 --> 04:43:54,080 >>I DO NOT THINK AS OF RIGHT 6230 04:43:54,080 --> 04:43:55,400 NOW, THAT DURING CANCER 6231 04:43:55,400 --> 04:43:59,160 TREATMENT THAT THE USE OF 6232 04:43:59,160 --> 04:44:00,080 THERAPEUTIC IS RIGHT BECAUSE AS 6233 04:44:00,080 --> 04:44:04,800 YOU SAID, SENESCENCE IS A NATURE 6234 04:44:04,800 --> 04:44:06,480 TUMOR SUPPRESSISM MECHANISM 6235 04:44:06,480 --> 04:44:10,360 HOWEVER THERE'S A LOT OF DATA TO 6236 04:44:10,360 --> 04:44:19,240 SHOW THAT THE PATIENTS WHO ARE 6237 04:44:19,240 --> 04:44:20,640 GETTING BONE MARROW TRANSPLANT 6238 04:44:20,640 --> 04:44:24,400 THERE'S A ROLE FOR SENESCENCE 6239 04:44:24,400 --> 04:44:26,080 AND THERAPEUTICS BECAUSE AS I 6240 04:44:26,080 --> 04:44:30,440 SAID, WE BELIEVE THAT SENESCENCE 6241 04:44:30,440 --> 04:44:34,360 IS ALSO HAS A BAD ASPECT EVEN IN 6242 04:44:34,360 --> 04:44:36,280 CANCER PATIENTS BUT NOT DURING 6243 04:44:36,280 --> 04:44:40,080 CANCER, NOT DURING ACTIVE 6244 04:44:40,080 --> 04:44:47,880 TREATMENT. 6245 04:44:47,880 --> 04:44:55,480 >>I REALLY JO REALLY ENJOYED YK 6246 04:44:55,480 --> 04:44:57,000 AND ONE THING THAT I HAVE ALSO 6247 04:44:57,000 --> 04:44:58,760 NOTICED IN MY OWN STUDIES, I 6248 04:44:58,760 --> 04:45:07,000 HAVE NOTICED THAT A LOT OF AGE 6249 04:45:07,000 --> 04:45:08,440 RELATED AND SENESCENCE AND I WAS 6250 04:45:08,440 --> 04:45:11,560 WONDERING HAVE YOU LOOKED AT 6251 04:45:11,560 --> 04:45:22,080 THAT AND THERE'S POTENTIAL IF. 6252 04:45:27,680 --> 04:45:29,200 >>THAT IT IS SOMETHING WE ARE 6253 04:45:29,200 --> 04:45:30,560 DOING THESE TRIALS AS ONE OF THE 6254 04:45:30,560 --> 04:45:33,920 THINGS THAT I'M REALLY LEARNING 6255 04:45:33,920 --> 04:45:36,440 IS ON SOME ASPECT THESE DRUGS 6256 04:45:36,440 --> 04:45:37,560 ARE STILL NEW. 6257 04:45:37,560 --> 04:45:39,720 WE DON'T KNOW ABOUT THEM AND SO 6258 04:45:39,720 --> 04:45:44,320 I THINK THAT WE HAVE TO ALSO USE 6259 04:45:44,320 --> 04:45:45,520 THE TRIALS TO LEARN MORE ABOUT 6260 04:45:45,520 --> 04:45:46,480 THE BIOLOGY. 6261 04:45:46,480 --> 04:45:47,640 THERE'S A LOT WE DON'T KNOW 6262 04:45:47,640 --> 04:45:49,080 ABOUT SENESCENCE, ESPECIALLY IN 6263 04:45:49,080 --> 04:45:50,720 THE COP TEXT OF CANCER. 6264 04:45:50,720 --> 04:45:52,320 AND SO I THINK THAT THE TRIALS 6265 04:45:52,320 --> 04:45:57,560 ARE GOING TO SERVE AS A PLATFORM 6266 04:45:57,560 --> 04:45:59,880 TO GO BACK TO THE LAB TO DO 6267 04:45:59,880 --> 04:46:01,320 DISCOVERY AND DO DEEPER DIVE 6268 04:46:01,320 --> 04:46:02,400 UNDERSTANDING IN THIS CONTEXT 6269 04:46:02,400 --> 04:46:03,720 BUT IT'S A REALLY GOOD QUESTION. 6270 04:46:03,720 --> 04:46:05,280 >>IT WOULD BE GREAT TO CONNECT. 6271 04:46:05,280 --> 04:46:06,000 >>ABSOLUTELY. 6272 04:46:06,000 --> 04:46:13,040 I WOULD BE HAPPY TO. 6273 04:46:13,040 --> 04:46:15,920 >>CAN YOU COMMENT OR SHARE YOUR 6274 04:46:15,920 --> 04:46:17,240 INSIGHTS ON THE CONTRIBUTION OF 6275 04:46:17,240 --> 04:46:18,840 THE PERCENTAGE OF GENETIC 6276 04:46:18,840 --> 04:46:22,080 FACTORS VERSUS SOCIAL STRUCTURAL 6277 04:46:22,080 --> 04:46:29,040 IN THE CENTENARIAN POPULATION? 6278 04:46:29,040 --> 04:46:31,520 >>SO FROM THE GENETIC STUDIES 6279 04:46:31,520 --> 04:46:36,440 THAT WE DO HAVE IT SEEMS THAT 6280 04:46:36,440 --> 04:46:40,240 SPAN IN GENERAL IS 15 TO 35% 6281 04:46:40,240 --> 04:46:41,440 INHERITABLE HOWEVER WHEN IT 6282 04:46:41,440 --> 04:46:47,320 COMES TO CENTENARIANS, THE 6283 04:46:47,320 --> 04:46:48,840 INHERITABILITY IS MUCH GREATER 6284 04:46:48,840 --> 04:46:53,160 THAN THE LIFESPAN IN GENERAL 6285 04:46:53,160 --> 04:46:55,800 POPULATIONS AND BECAUSE THE 6286 04:46:55,800 --> 04:46:59,240 POPE' TYPE IS EXTREME, THE MORE 6287 04:46:59,240 --> 04:47:01,920 CONTRIBUTION GENETICS PLAYS AND 6288 04:47:01,920 --> 04:47:04,880 FROM MOST OF THE WORK WE'VE 6289 04:47:04,880 --> 04:47:06,360 DONE, WE HAVE NOT SEEN 6290 04:47:06,360 --> 04:47:10,200 CONTRIBUTION FROM LIFESTYLE AS 6291 04:47:10,200 --> 04:47:17,040 I'SHOWN, HABITS ARE SIMILAR 6292 04:47:17,040 --> 04:47:21,240 BETWEEN CENTENARIANS AND GENERAL 6293 04:47:21,240 --> 04:47:27,120 POPULATION. 6294 04:47:27,120 --> 04:47:31,120 SO GENETICS PLAY A BIGGER ROLE 6295 04:47:31,120 --> 04:47:31,720 THAN LIFESTYLE. 6296 04:47:31,720 --> 04:47:33,840 >>I HAVE A QUESTION. 6297 04:47:33,840 --> 04:47:35,320 THANK YOU TO ALL THE SPEAKER FOR 6298 04:47:35,320 --> 04:47:37,560 THE FANTASTIC PRESENTATIONS. 6299 04:47:37,560 --> 04:47:40,760 THERE ARE CERTAIN ORGANISMS THAT 6300 04:47:40,760 --> 04:47:45,360 LIVE LONG COMPARED TO HUMANS FOR 6301 04:47:45,360 --> 04:47:48,720 INSTANCE, MORE CLOSER MOPPING 6302 04:47:48,720 --> 04:47:49,960 THE WORK GREEN SHARKS THEY CAN 6303 04:47:49,960 --> 04:47:53,360 LIVE UP TO 400 YEARS, GIANT 6304 04:47:53,360 --> 04:47:55,160 TORTOISES LIVE UP TO 150 SO MOST 6305 04:47:55,160 --> 04:47:58,360 OF THE STUDIES THAT ARE ON THE 6306 04:47:58,360 --> 04:48:04,360 BENCH SIDE FOCUSES ON SEA 6307 04:48:04,360 --> 04:48:06,680 ELEGANCE AND MAYBE EVEN PRIMATES 6308 04:48:06,680 --> 04:48:08,840 AND WE'RE TRYING TO TRANSLATE 6309 04:48:08,840 --> 04:48:10,280 THAT TO BEDSIDE TO SEE HOW WE 6310 04:48:10,280 --> 04:48:14,160 CAN EXTEND HUMAN LIFESPAN 6311 04:48:14,160 --> 04:48:18,000 WITHOUT THE ISSUES OF 6312 04:48:18,000 --> 04:48:19,800 CO-MORBIDITIES BUT HAS THERE 6313 04:48:19,800 --> 04:48:21,880 BEEN RESEARCH THAT'S TRIED TO 6314 04:48:21,880 --> 04:48:24,320 DERIVE IS SOME LESSONS FROM 6315 04:48:24,320 --> 04:48:25,960 THESE ORGANISMS THAT LIVE LONG 6316 04:48:25,960 --> 04:48:30,200 AND HAVE SOME EXCEPTIONAL 6317 04:48:30,200 --> 04:48:33,080 MECHANISMS TO PREVENT DISEASES 6318 04:48:33,080 --> 04:48:35,200 LIKE ELEPHANTS ARE RESISTANT TO 6319 04:48:35,200 --> 04:48:36,800 DANCED AND MOLE RATS ARE 6320 04:48:36,800 --> 04:48:44,960 RESISTARESISTANT TO CANCER SO HE 6321 04:48:44,960 --> 04:48:48,960 THERE BEEN ANY LESSONS DERIVED 6322 04:48:48,960 --> 04:48:51,480 FROM BENCH TO BEDSIDE FROM 6323 04:48:51,480 --> 04:48:52,320 NATURE TO BEDSIDE. 6324 04:48:52,320 --> 04:48:57,240 HAS THERE BEEN SU SUBSTANTIAL 6325 04:48:57,240 --> 04:49:02,000 TRANSLATION WITH REGARD TO THEE 6326 04:49:02,000 --> 04:49:02,440 ORGANISMS, THANK YOU. 6327 04:49:02,440 --> 04:49:03,200 >>THAT'S A GREAT QUESTION. 6328 04:49:03,200 --> 04:49:05,520 I WANT TO MAKE ONE COMMENT HERE. 6329 04:49:05,520 --> 04:49:08,160 I REALLY LIKE THE PHASE 6330 04:49:08,160 --> 04:49:08,720 RIDICULOUSLY LONG. 6331 04:49:08,720 --> 04:49:12,640 I WOULD SAY THAT LIFESPAN IS 6332 04:49:12,640 --> 04:49:14,200 IMPORTANT BUT IT'S ALSO HAS TO 6333 04:49:14,200 --> 04:49:17,640 BE LONGEVITY HEALTH SPAN SO 6334 04:49:17,640 --> 04:49:19,440 SOMETIMES WHEN I THINK QUALITY 6335 04:49:19,440 --> 04:49:30,000 OF LIFE HAS A HUGE IMPACT ON AND 6336 04:49:32,360 --> 04:49:37,440 ONE OF THE SPEAKERS THIS MORNING 6337 04:49:37,440 --> 04:49:40,080 WAS JIM REESE'S WHERE IT'S NOT 6338 04:49:40,080 --> 04:49:42,600 ONLY DO WE INCREASE LIFESPAN AND 6339 04:49:42,600 --> 04:49:52,960 WE INCREASE FUNCTIONAL STATUS. 6340 04:49:52,960 --> 04:49:54,720 WHAT CAN WE LEARN FROM A TURTLE 6341 04:49:54,720 --> 04:49:55,200 PERHAPS. 6342 04:49:55,200 --> 04:49:59,440 I'LL OPEN IT UP TO THE PANEL 6343 04:49:59,440 --> 04:49:59,640 HERE. 6344 04:49:59,640 --> 04:50:01,120 >>I'LL BE QUICK. 6345 04:50:01,120 --> 04:50:02,760 ONE I THINK THERE'S A FUTURE 6346 04:50:02,760 --> 04:50:04,600 SESSION THAT IS ACTUALLY FOCUSED 6347 04:50:04,600 --> 04:50:06,960 A BIT ON DIVERSE SPECIES SO THEY 6348 04:50:06,960 --> 04:50:08,240 WOULD HAVE A LOT MORE TO SAY. 6349 04:50:08,240 --> 04:50:10,960 ONE THING I CAN SAY, SOME OF 6350 04:50:10,960 --> 04:50:14,680 WHAT WE THINK ABOUT HUMAN 6351 04:50:14,680 --> 04:50:16,240 UNIQUENESS, OUR BIG BRAINS, 6352 04:50:16,240 --> 04:50:17,520 COOPERATION, ET CETERA, THESE 6353 04:50:17,520 --> 04:50:19,320 BUNDLES OF TRADES YOU DO SEE IN 6354 04:50:19,320 --> 04:50:21,880 MANY LONG LIVED SPECIES AND SO 6355 04:50:21,880 --> 04:50:24,200 SOME OF THE LESSONS ARE THAT 6356 04:50:24,200 --> 04:50:27,160 WE'RE NOT UNIQUE IN HOW WE 6357 04:50:27,160 --> 04:50:28,280 ATTAINED OUR LONG LIFESPAN SO 6358 04:50:28,280 --> 04:50:31,120 IT'S BEEN REALLY CONSTRUCTIVE 6359 04:50:31,120 --> 04:50:33,000 BUT I AGREE ABOUT THE NAKED MOLE 6360 04:50:33,000 --> 04:50:37,160 A LRATS AND CRITTERS THERE ARE E 6361 04:50:37,160 --> 04:50:40,880 WORKING ON IT BUT NONE OF US. 6362 04:50:40,880 --> 04:50:44,320 >>THANK YOU. 6363 04:50:44,320 --> 04:50:49,880 >>HI, I HAVE A QUESTION. 6364 04:50:49,880 --> 04:50:52,720 I WAS VERY STRUCK BY THE LACK OF 6365 04:50:52,720 --> 04:50:53,920 CARDIOVASCULAR DISEASE IN THE 6366 04:50:53,920 --> 04:50:54,840 POPULATION YOU DESCRIBED. 6367 04:50:54,840 --> 04:50:57,600 I WONDER HOW GENERALIZABLE IT IS 6368 04:50:57,600 --> 04:51:00,080 ACROSS INDIGENOUS POPULATIONS? 6369 04:51:00,080 --> 04:51:02,920 >>IT'S FUNNY, WHEN THE MEDIA 6370 04:51:02,920 --> 04:51:10,920 FIRST REPORTED ON SOME OF THESE 6371 04:51:10,920 --> 04:51:20,920 FINDINGS, AND AND YEAH, THE 6372 04:51:20,920 --> 04:51:23,680 LOWEST LEVELS OF HEART DISEASE 6373 04:51:23,680 --> 04:51:25,520 ANYWHERE AND WE HAD LEFT BECAUSE 6374 04:51:25,520 --> 04:51:29,520 I KNOW AND AND AND DISEASE AND 6375 04:51:29,520 --> 04:51:32,920 SO I DO THINK THAT OUR STUDY, 6376 04:51:32,920 --> 04:51:37,000 WHICH IS ONE OF THE FIRST TO USE 6377 04:51:37,000 --> 04:51:38,040 TECHNOLOGY BUT IT WOULD BE 6378 04:51:38,040 --> 04:51:39,840 SUPPLIES EVEN IN THE U.S. IF WE 6379 04:51:39,840 --> 04:51:47,240 DID STUDIES IN THE IN TRADES 6380 04:51:47,240 --> 04:51:49,840 THAT WOULD SHOW SIMILAR LEVELS 6381 04:51:49,840 --> 04:51:54,240 OF LOW HEART DISEASE AS WELL AND 6382 04:51:54,240 --> 04:52:04,760 WHAT WE KNOW YOU'VE GROUPS HAVE 6383 04:52:05,560 --> 04:52:07,480 LEVELS OF LOW HEART DISEASE. 6384 04:52:07,480 --> 04:52:09,160 >>THIS IS A PROVOCATIVE 6385 04:52:09,160 --> 04:52:10,640 QUESTION. 6386 04:52:10,640 --> 04:52:12,720 LISTENING TO SESSION, I HAVE THE 6387 04:52:12,720 --> 04:52:17,920 'EM EXPRESS I AM IF I WAS AN ALN 6388 04:52:17,920 --> 04:52:19,200 COMING TO MY TODAY THERE'S MORE 6389 04:52:19,200 --> 04:52:21,640 THAN MEDICINE CREATING 6390 04:52:21,640 --> 04:52:23,120 GEROSCIENCE BECAUSE ALL THIS 6391 04:52:23,120 --> 04:52:25,240 MORBID TEES AND SYNDROMES ARE 6392 04:52:25,240 --> 04:52:27,080 HAPPENING AS A RESULT, 6393 04:52:27,080 --> 04:52:28,680 QUOTE-UNQUOTE, OF THE SUCCESS OF 6394 04:52:28,680 --> 04:52:30,560 MODERN MEDICINE TREATING 6395 04:52:30,560 --> 04:52:31,400 DISEASES. 6396 04:52:31,400 --> 04:52:36,640 AND YET WE ARE HERE DISCUSSING 6397 04:52:36,640 --> 04:52:39,680 CURING NOW THIS DISEASES SO DO 6398 04:52:39,680 --> 04:52:42,080 WE NEED RADICAL DIFFERENT 6399 04:52:42,080 --> 04:52:43,840 APPROACH OR ARE WE ON THE RIGHT 6400 04:52:43,840 --> 04:52:45,400 TRACK ASK THIS IS JUST A PRODUCT 6401 04:52:45,400 --> 04:52:53,240 OF OUR SUCCESS TO SOME EXTENT? 6402 04:52:53,240 --> 04:52:55,720 BECAUSE WE HAVE ICU AND CANCER 6403 04:52:55,720 --> 04:52:57,280 TREATMENT AND HIV AND I DON'T 6404 04:52:57,280 --> 04:52:59,480 KNOW, JUST A GENERAL FEELING. 6405 04:52:59,480 --> 04:53:04,960 >>I THINK THAT'S A VERY, VERY 6406 04:53:04,960 --> 04:53:05,720 PERCEPTIVE COMMENT. 6407 04:53:05,720 --> 04:53:07,760 ONE OF MY MENTORS USED TO DO A 6408 04:53:07,760 --> 04:53:10,760 TALK AND THE TITLE OF THE TALK 6409 04:53:10,760 --> 04:53:12,440 WAS SEATBELTSES ARE CARCINOGENIC 6410 04:53:12,440 --> 04:53:14,800 SO IF YOU PUT YOUR SEATBELT AND 6411 04:53:14,800 --> 04:53:16,760 DON'T DIE IN A CAR ACCIDENT AND 6412 04:53:16,760 --> 04:53:18,600 YOU LIVE LONG YOU AGE AND AGING 6413 04:53:18,600 --> 04:53:21,000 IS THE BIGGEST RISK FACT OR FOR 6414 04:53:21,000 --> 04:53:21,680 CANCER, RIGHT. 6415 04:53:21,680 --> 04:53:24,440 BY SOLVING ONE PROBLEM WE ALWAYS 6416 04:53:24,440 --> 04:53:26,240 GET A HIGHER LEVEL OF PROBLEMS 6417 04:53:26,240 --> 04:53:28,240 AND SO I HAVE LOOKED AT MY LIFE 6418 04:53:28,240 --> 04:53:31,960 AS EVERY TIME I GET A WHITE BELT 6419 04:53:31,960 --> 04:53:34,640 AND YELLOW BELT AND NOW I'M LIKE 6420 04:53:34,640 --> 04:53:36,080 THE LOWEST IN THE CLASS SO I 6421 04:53:36,080 --> 04:53:38,120 HAVE TO ADVANCE AND SO THAT'S 6422 04:53:38,120 --> 04:53:39,920 HOW LIFE IS SO I DON'T THINK, I 6423 04:53:39,920 --> 04:53:41,680 MEAN THE WORK OF SCIENCE WILL 6424 04:53:41,680 --> 04:53:43,720 NEVER STOP AND OUR PATIENTS ARE 6425 04:53:43,720 --> 04:53:45,200 VERY SMART AND THEY WILL ALWAYS 6426 04:53:45,200 --> 04:53:48,480 KEEP US ON OUR TOES, THOUGH 6427 04:53:48,480 --> 04:53:49,400 MATTER HOW SMART THEY ARE THEY 6428 04:53:49,400 --> 04:53:50,840 ARE THINKING OF THE NEXT FIVE 6429 04:53:50,840 --> 04:53:51,920 THINGS THAT THEY CAN BRING TO US 6430 04:53:51,920 --> 04:53:54,600 AND WHEN I GO BACK TO CLINIC ON 6431 04:53:54,600 --> 04:53:55,760 MONDAY, THAT WILL BE A 6432 04:53:55,760 --> 04:53:56,120 CHALLENGE. 6433 04:53:56,120 --> 04:53:57,040 NA MUCH I KNOW. 6434 04:53:57,040 --> 04:54:01,160 THAT'S MY TWO CENTS. 6435 04:54:01,160 --> 04:54:03,280 >>I WOULD LIKE TO WEIGH IN ON 6436 04:54:03,280 --> 04:54:03,640 THAT. 6437 04:54:03,640 --> 04:54:07,920 SO I'M A FAMILY PHYSICIAN AND WE 6438 04:54:07,920 --> 04:54:09,520 KNOW OUR HEALTH-CARE SYSTEM IS 6439 04:54:09,520 --> 04:54:10,880 BROKEN. 6440 04:54:10,880 --> 04:54:16,120 AND SO, WE NEED TO AND 6441 04:54:16,120 --> 04:54:17,040 FOUNDATIONAL APPROACH WHERE 6442 04:54:17,040 --> 04:54:21,400 PRIMARY CARE IS THE FOUNDATION 6443 04:54:21,400 --> 04:54:24,760 AND COMMUNITIES SUCH AS THE ONE 6444 04:54:24,760 --> 04:54:28,120 THAT I SERVED HAS THE ABILITY TO 6445 04:54:28,120 --> 04:54:34,680 BE STUDIED AND REACHING THE AGE 6446 04:54:34,680 --> 04:54:37,680 AND SO I THINK FROM A STANDPOINT 6447 04:54:37,680 --> 04:54:42,080 AS WE APPROACH AND GEROSCIENCE, 6448 04:54:42,080 --> 04:54:47,080 DO KNOW THAT AS I STATED AND 6449 04:54:47,080 --> 04:54:50,920 WITH THE PANDEMIC IT WAS STRESS 6450 04:54:50,920 --> 04:54:59,200 AND AND IT WAS A FAILED STRESS 6451 04:54:59,200 --> 04:55:07,560 EXISFOR THEFIRST COMMUNITIES TOE 6452 04:55:07,560 --> 04:55:12,960 DISCOVERY IS FUNDED AND BY THE 6453 04:55:12,960 --> 04:55:18,800 NATIONAL INSTITUTE AND THEY ARE 6454 04:55:18,800 --> 04:55:21,480 A HIGHER PERCENTAGE OF PRIMARY 6455 04:55:21,480 --> 04:55:27,200 CARE POSITIONS HAVE BETTER AND 6456 04:55:27,200 --> 04:55:28,640 SO THAT'S MY TAKE AN YOUR 6457 04:55:28,640 --> 04:55:29,800 QUESTION AND THAT WAS A VERY 6458 04:55:29,800 --> 04:55:30,200 GOOD QUESTION. 6459 04:55:30,200 --> 04:55:31,600 >>CAN I ADD TO THAT. 6460 04:55:31,600 --> 04:55:33,280 IT'S A REALLY IMPORTANT POINT. 6461 04:55:33,280 --> 04:55:36,880 I DO THINK THAT I TALKED A LOT 6462 04:55:36,880 --> 04:55:38,680 ABOUT FOR CANCER THE CANCER 6463 04:55:38,680 --> 04:55:41,560 TREATMENT ACCELERATES AGING BUT 6464 04:55:41,560 --> 04:55:43,280 I WANT TO JUST GO BACK TO THAT 6465 04:55:43,280 --> 04:55:45,000 FIGURE AND SAY WELL, YOU KNOW, 6466 04:55:45,000 --> 04:55:47,720 AGING LEADS TO CANCER AND SO I 6467 04:55:47,720 --> 04:55:48,800 ALWAYS THINK ABOUT WHEN I SEE 6468 04:55:48,800 --> 04:55:52,160 THE PATIENT IN CLINIC, AND I 6469 04:55:52,160 --> 04:55:54,120 GIVE HER CHEMOTHERAPY AND 6470 04:55:54,120 --> 04:55:55,320 RADIATION AND SURGERY AND SHE 6471 04:55:55,320 --> 04:55:57,400 HAS A DECLINE IN HER PHYSICAL 6472 04:55:57,400 --> 04:55:58,680 AND COGNITIVE FUNCTION RELATIVE 6473 04:55:58,680 --> 04:56:02,600 TO HER PEERS, I DON'T REALLY 6474 04:56:02,600 --> 04:56:04,160 KNOW IF IT WAS JUST THE DECLINE 6475 04:56:04,160 --> 04:56:05,920 OCCURRED BECAUSE OF THE 6476 04:56:05,920 --> 04:56:07,320 TREATMENTS TA I HAVE GIVEN HER. 6477 04:56:07,320 --> 04:56:09,360 THERE'S THE POSSIBILITY THAT THE 6478 04:56:09,360 --> 04:56:11,160 FACT SHE DEVELOPED CANCER WAS 6479 04:56:11,160 --> 04:56:13,480 THAT SHE WAS ALREADY ON AN 6480 04:56:13,480 --> 04:56:15,840 ACCELERATED AGING TRAJECTORY SO 6481 04:56:15,840 --> 04:56:18,680 I THINK THAT THE WHOLE PREMISE 6482 04:56:18,680 --> 04:56:23,240 FOR ME AS AN ONCOLOGIST OR THE 6483 04:56:23,240 --> 04:56:24,120 PROMISE I GUESS OF GEROSCIENCE 6484 04:56:24,120 --> 04:56:26,360 IS THAT IT'S NOT JUST ABOUT 6485 04:56:26,360 --> 04:56:27,760 IMPROVING LIFE AFTER CANCER AND 6486 04:56:27,760 --> 04:56:29,960 THE CONTEXT OF THE DAMAGE THAT I 6487 04:56:29,960 --> 04:56:32,520 HAVE DONE AS AN ONCOLOGIST BUT 6488 04:56:32,520 --> 04:56:34,640 REALLY AS AN ONCOLOGIST WE 6489 04:56:34,640 --> 04:56:36,160 BELIEVE THAT YOU CAN ONLY CURE 6490 04:56:36,160 --> 04:56:37,640 CANCER BY PREVENT PARTICULAR IN 6491 04:56:37,640 --> 04:56:42,080 THE FIRST PLACE AND SO I THINK 6492 04:56:42,080 --> 04:56:44,000 IF GEROSCIENCE CAN HELP US LEAD 6493 04:56:44,000 --> 04:56:46,040 TO PREVENTION LIKE IN THE FAMILY 6494 04:56:46,040 --> 04:56:48,080 MEDICINE PRACTICE, IN THE FIRST 6495 04:56:48,080 --> 04:56:50,120 PLACE, THEN I THINK THAT'S 6496 04:56:50,120 --> 04:56:52,040 REALLY WHERE THE WIND WOULD BE 6497 04:56:52,040 --> 04:56:54,120 AND IT'S WAY BIGGER THAN 6498 04:56:54,120 --> 04:56:55,680 PREVENTING THE ACCELERATING 6499 04:56:55,680 --> 04:56:57,120 AGING IN THE CON TECH OF THE 6500 04:56:57,120 --> 04:57:00,920 TREATMENTS THAT WE GIVE OUR 6501 04:57:00,920 --> 04:57:03,160 PATIENT. 6502 04:57:03,160 --> 04:57:04,240 >>QUEER ALMOST AT THE END OF 6503 04:57:04,240 --> 04:57:08,080 THE SESSION, I WANT TO GIVE NATE 6504 04:57:08,080 --> 04:57:11,560 AND CHRISTINE A MOMENT TO SHARE 6505 04:57:11,560 --> 04:57:12,480 IT IT WILL BEFORE WE CLOSE THIS 6506 04:57:12,480 --> 04:57:14,160 SESSION SO MAYBE NATE YOU CAN GO 6507 04:57:14,160 --> 04:57:16,080 FIRST AND CHRISTINE YOU CAN TAKE 6508 04:57:16,080 --> 04:57:17,120 US HOME. 6509 04:57:17,120 --> 04:57:20,800 >>WE WERE TALKI TALKING ABOUT S 6510 04:57:20,800 --> 04:57:21,280 EARLIER. 6511 04:57:21,280 --> 04:57:22,840 THERE'S TWO HOSPITALS, WE HAVE 6512 04:57:22,840 --> 04:57:25,480 ONE ACADEMIC MEDICAL CENTER WITH 6513 04:57:25,480 --> 04:57:26,760 CANCER HOSPITAL AND HEART 6514 04:57:26,760 --> 04:57:28,440 HOSPITAL AND BRAIN AND SPINE 6515 04:57:28,440 --> 04:57:30,760 HOSPITAL AND THEN THERE'S SIX 6516 04:57:30,760 --> 04:57:33,280 MILES AWAY, NEAR WHERE YOUR 6517 04:57:33,280 --> 04:57:35,920 PRACTICE IS A COMMUNITY ACADEMIC 6518 04:57:35,920 --> 04:57:37,160 PARTNERSHIP HOSPITAL AND I WORK 6519 04:57:37,160 --> 04:57:40,040 IN BOTH AND IT'S REALLY 6520 04:57:40,040 --> 04:57:42,640 INTERESTING AND THE DIFFERENCE 6521 04:57:42,640 --> 04:57:45,200 IF CRON LOGIC AGE, THE ACADEMIC 6522 04:57:45,200 --> 04:57:48,120 CENTER YOU ARE SEES AND THE 75 6523 04:57:48,120 --> 04:57:50,440 AND 80-YEAR-OLDS WITH CANCER AND 6524 04:57:50,440 --> 04:57:51,520 COMPLICATIONS FROM CHEMO AND 6525 04:57:51,520 --> 04:57:53,920 WHAT HAVE YOU, UT GO TO THE 6526 04:57:53,920 --> 04:57:56,760 COMMUNITY ACADEMIC CENTER AND IT 6527 04:57:56,760 --> 04:57:59,840 IS EARLY 60s WITH SEVERE COPD, 6528 04:57:59,840 --> 04:58:03,360 UNCONTROLLED HEART FAILURE AND 6529 04:58:03,360 --> 04:58:05,120 THE DIFFERENCE IN SIX MILES IN 6530 04:58:05,120 --> 04:58:07,280 THE POPULATION THAT YOU TREAT 6531 04:58:07,280 --> 04:58:08,600 AND THE 20 YEARS DIFFERENCE 6532 04:58:08,600 --> 04:58:13,400 BETWEEN THE PATIENTS THAT GET 6533 04:58:13,400 --> 04:58:16,720 AND AND IT'S A PRIMARY CARE 6534 04:58:16,720 --> 04:58:21,000 PERSPECTIVE AND THAT KIND OF IN 6535 04:58:21,000 --> 04:58:23,360 DRAMATIC AND MEDICINE THAT WE 6536 04:58:23,360 --> 04:58:23,920 SEE. 6537 04:58:23,920 --> 04:58:25,120 SO IT'S VERY INTERESTING TO 6538 04:58:25,120 --> 04:58:28,040 THINK ABOUT THAT IN A LARGER 6539 04:58:28,040 --> 04:58:29,840 CONTEXT AND IT'S ONE OF OUR 6540 04:58:29,840 --> 04:58:31,080 TRAINING CLINICALLY. 6541 04:58:31,080 --> 04:58:42,480 >>Carolyn: .AND SO WE SEE THISF 6542 04:58:43,560 --> 04:58:45,680 PATIENTS THAT HAVE EXCELLENT 6543 04:58:45,680 --> 04:58:47,200 INSURANCE AND ALL OF THEIR 6544 04:58:47,200 --> 04:58:48,360 BENEFITS COVERED AND WE HAVE A 6545 04:58:48,360 --> 04:58:51,240 MIX OF PATIENTS THAT WOULD BE 6546 04:58:51,240 --> 04:58:52,240 DRASTICALLY UNINSURED AND HAVE 6547 04:58:52,240 --> 04:58:54,520 THE BENEFIT OF HAVING DECREASED 6548 04:58:54,520 --> 04:58:57,440 COST MEDICATION THIS IS MY STATE 6549 04:58:57,440 --> 04:58:58,640 AND CERTAINLY VERY STATE BUT 6550 04:58:58,640 --> 04:59:01,240 SOME OF THAT ASPECT OF THE TWO 6551 04:59:01,240 --> 04:59:02,600 DIFFERENT AGES OR AGES THAT YOU 6552 04:59:02,600 --> 04:59:04,160 SEE AT DIFFERENT POPULATIONS WE 6553 04:59:04,160 --> 04:59:07,800 SEE ALL THOSE AGES WITHIN ONE 6554 04:59:07,800 --> 04:59:09,000 CLINIC WITH DIFFERENT SOCIAL 6555 04:59:09,000 --> 04:59:10,320 STRESSORS THAT THE SAME ACCESS 6556 04:59:10,320 --> 04:59:14,240 TO MEDICATION WHICH CHANGES OUR 6557 04:59:14,240 --> 04:59:15,920 PERSPECTIVES A BIT AND I WANT 6558 04:59:15,920 --> 04:59:17,560 ODD COME IN OBVIOUSLY HIV IS 6559 04:59:17,560 --> 04:59:19,640 DIFFERENT THAN CANCER OR ICU 6560 04:59:19,640 --> 04:59:21,760 STAYS WHERE AGE IS GOING TO 6561 04:59:21,760 --> 04:59:31,320 PREDICT THE CURE OWE OCCURRENCEE 6562 04:59:31,320 --> 04:59:33,840 LEARNED O MUCH FROM THE HIV 6563 04:59:33,840 --> 04:59:36,640 EPIDEMIC CAN AGING IMPACTING HOW 6564 04:59:36,640 --> 04:59:37,840 WE INTERPRET LONG COVID AND THE 6565 04:59:37,840 --> 04:59:39,320 IMPACT OF OTHER CHRONIC 6566 04:59:39,320 --> 04:59:42,760 INFECTIONS OR DISEASE AND SO I 6567 04:59:42,760 --> 04:59:50,760 THINK THAT THE ENDEMIC NOW AND 6568 04:59:50,760 --> 04:59:53,320 AND WE CAN'T REVERSE AND PEOPLE 6569 04:59:53,320 --> 04:59:56,480 WITH HIV POPULATION AND AMAZING 6570 04:59:56,480 --> 05:00:00,600 IN TERMS OF PROVIDING OVER THE 6571 05:00:00,600 --> 05:00:01,000 LAST 40 YEARS. 6572 05:00:01,000 --> 05:00:02,400 >>THANK YOU SO MUCH. 6573 05:00:02,400 --> 05:00:03,400 REALLY WELL SAID AND THANK YOU 6574 05:00:03,400 --> 05:00:05,040 ALL FOR BEING SO PATIENT. 6575 05:00:05,040 --> 05:00:12,000 I KNOW THAT WE WERE OVER BUT 6576 05:00:12,000 --> 05:00:14,160 WE'LL HAVE YOUR BREAK FOR THE 6577 05:00:14,160 --> 05:00:14,680 NEXT 15 MINUTES. 6578 05:00:14,680 --> 05:00:17,880 WE'LL SEE YOU BACK AGAIN IN 15 6579 05:00:17,880 --> 05:00:19,520 MINUTE. 6580 05:00:19,520 --> 05:00:23,720 [APPLAUSE] 6581 05:00:23,720 --> 05:00:26,040 IT'S MY PLEASURE AND HONOR, MY 6582 05:00:26,040 --> 05:00:31,280 NAME IS ALLEY SANDRO 6583 05:00:31,280 --> 05:00:32,720 BARTOLOMUCCI AND IT'S MY GREAT 6584 05:00:32,720 --> 05:00:34,160 HONOR TO INTRODUCE AND CHAIR 6585 05:00:34,160 --> 05:00:34,760 THIS SESSION. 6586 05:00:34,760 --> 05:00:38,200 THEY ASKED ME TO DO A VERY SHORT 6587 05:00:38,200 --> 05:00:39,000 INTRODUCTION WILL I'LL KEEP 6588 05:00:39,000 --> 05:00:42,040 EXTREMELY SHORT DUE TO THE TIME 6589 05:00:42,040 --> 05:00:43,680 AND JUST TO INTRODUCE WHAT WE'LL 6590 05:00:43,680 --> 05:00:45,960 LISTEN TO IN THIS SESSION, AS WE 6591 05:00:45,960 --> 05:00:47,800 AGE AND WE ALL KNOW AND WE'VE 6592 05:00:47,800 --> 05:00:50,200 BEEN LISTENING IN THE MORNING 6593 05:00:50,200 --> 05:00:54,720 AND THIS EARLY AFTERNOON, 6594 05:00:54,720 --> 05:01:00,000 THERE'S GERIATRIC AND 6595 05:01:00,000 --> 05:01:01,440 MULTIMORBITITIES THAT CAN 6596 05:01:01,440 --> 05:01:03,040 ACCUMULATE AND DEVELOP IN PEOPLE 6597 05:01:03,040 --> 05:01:07,840 AND IN THIS SESSION, WE WILL 6598 05:01:07,840 --> 05:01:09,400 KEEP AND SPEAK NOT ME BECAUSE 6599 05:01:09,400 --> 05:01:10,800 I'M NOT PRESENTING MY OWN DATA 6600 05:01:10,800 --> 05:01:14,480 BUT THE SPEAKER WILL KEEP THE 6601 05:01:14,480 --> 05:01:15,320 GEROSCIENCE PERSPECTIVE AND THE 6602 05:01:15,320 --> 05:01:17,800 MEASURES OF BIOLOGICAL AGING AS 6603 05:01:17,800 --> 05:01:20,040 A BACKGROUND REALLY AND IT WILL 6604 05:01:20,040 --> 05:01:23,720 REALLY FOCUS ON HUMAN STUDIES, 6605 05:01:23,720 --> 05:01:30,400 TRANSLATIONAL STUDIES IN ANIMAL 6606 05:01:30,400 --> 05:01:32,640 MODELS LIKE PRIMATES, DOGS AND 6607 05:01:32,640 --> 05:01:35,080 ALSO RODENTS AND OTHER SPECIES. 6608 05:01:35,080 --> 05:01:36,920 I WOULD SAY THAT THINKING ABOUT 6609 05:01:36,920 --> 05:01:38,560 THIS SESSION, MY FEELINGS IS 6610 05:01:38,560 --> 05:01:40,880 THAT IT HAS THREE MAIN GOALS. 6611 05:01:40,880 --> 05:01:43,320 THE FIRST IS TO REALLY INTRODUCE 6612 05:01:43,320 --> 05:01:44,960 AND SUGGEST EXPERIMENTAL 6613 05:01:44,960 --> 05:01:52,000 APPROACHES TO THE FIELD. 6614 05:01:52,000 --> 05:01:53,120 EXTENDS TO MULTIMORBITITIES 6615 05:01:53,120 --> 05:01:57,600 WHICH ARE REALLY CRUCIAL IN THE 6616 05:01:57,600 --> 05:01:58,000 GERIATRIC SYNDROMES. 6617 05:01:58,000 --> 05:02:00,640 IT WILL ALSO PROVIDE TOOLBOX 6618 05:02:00,640 --> 05:02:03,320 USING ANIMAL MODELS WHICH OFFER, 6619 05:02:03,320 --> 05:02:05,240 IN MY OPINION, I WORK WITH MICE, 6620 05:02:05,240 --> 05:02:09,800 WORKING WITH ANIMAL MODELS OF 6621 05:02:09,800 --> 05:02:13,200 UNPRECEDENTED TO PROVIDE 6622 05:02:13,200 --> 05:02:15,560 CONTROLLED EX PER MEMBER DESIGN 6623 05:02:15,560 --> 05:02:18,720 AND APART VARIABLE LIKE SOCIAL 6624 05:02:18,720 --> 05:02:20,760 DETERMINANTS WHICH ARE VERY 6625 05:02:20,760 --> 05:02:23,160 DIFFICULT TO BEST IN RANDOMIZED 6626 05:02:23,160 --> 05:02:33,680 TRIALS IN HUMAN APPS, THE FIRST 6627 05:02:45,520 --> 05:02:49,160 SPEAKER DOES NOT NEED A 6628 05:02:49,160 --> 05:02:51,960 INTRODUCTION AND HE WILL SET THE 6629 05:02:51,960 --> 05:02:54,520 AIMING ON MULTIMORBITITIES AND 6630 05:02:54,520 --> 05:02:55,600 GERIATRIC SYNDROMES ON HUMANS 6631 05:02:55,600 --> 05:02:59,680 AND WE'LL SWITCH TO ANIMAL 6632 05:02:59,680 --> 05:03:05,720 MODEL. 6633 05:03:05,720 --> 05:03:14,560 ELLEN QUILLEN AND NATASHA OLBY 6634 05:03:14,560 --> 05:03:19,000 PROFESSOR OF NEUROLOGY AND WILL 6635 05:03:19,000 --> 05:03:22,080 PRESENT THE SAME CONCEPT BUT 6636 05:03:22,080 --> 05:03:26,800 SPEAKING OF CON PAN YUN DOGS AND 6637 05:03:26,800 --> 05:03:31,720 WE WILL END WITH CAROLINE ZEISS 6638 05:03:31,720 --> 05:03:34,200 WHO WILL PROVIDE AN OVERVIEW OF 6639 05:03:34,200 --> 05:03:35,280 MULTIMORBITITIES IN OUR PEE 6640 05:03:35,280 --> 05:03:37,280 SEIZE AND WE WILL END THE DAY 6641 05:03:37,280 --> 05:03:41,920 WITH A PANEL DISCUSSION PRODUCED 6642 05:03:41,920 --> 05:03:45,760 AND LED BY NOAH SCHNEIDER-MAKLER 6643 05:03:45,760 --> 05:03:48,000 AT THE CENTER OF EVOLUTION AND 6644 05:03:48,000 --> 05:03:49,480 MEDICINE AT ARIZONA STATE 6645 05:03:49,480 --> 05:03:52,280 UNIVERSITY AND WITH THIS, 6646 05:03:52,280 --> 05:03:56,800 WITHOUT FURTHER ADIEU, PLA PLEA. 6647 05:03:56,800 --> 05:03:59,800 >>THANK YOU, VERY MUCH. 6648 05:03:59,800 --> 05:04:02,080 IT'S MY PLEASURE TO BE TALKING 6649 05:04:02,080 --> 05:04:06,760 IN FRONT OF THIS AUDIENCE AND 6650 05:04:06,760 --> 05:04:08,720 CONTINUING THE VERY IMPORTANT 6651 05:04:08,720 --> 05:04:10,240 DISCUSSION THAT WE HAD THIS 6652 05:04:10,240 --> 05:04:11,400 MORNING. 6653 05:04:11,400 --> 05:04:13,720 I THINK THAT THE PEOPLE THAT 6654 05:04:13,720 --> 05:04:18,560 HAVE STARTED AGING ALMOSTEN 6655 05:04:18,560 --> 05:04:22,280 COUNTER AND REGULATE AGING AT 6656 05:04:22,280 --> 05:04:27,440 THE LIFE AND IN FACT, THAT A LOT 6657 05:04:27,440 --> 05:04:36,280 OF ALLOW US TO MAINT TO MAINTAIM 6658 05:04:36,280 --> 05:04:40,720 AND AT THE LEVEL AND MORE 6659 05:04:40,720 --> 05:04:43,200 IMPORTANT FOR ME IS THE FACT 6660 05:04:43,200 --> 05:04:47,920 THAT THE PRINCIPLE OF 6661 05:04:47,920 --> 05:04:48,440 GEROSCIENCE HAS INCREDIBLY 6662 05:04:48,440 --> 05:04:51,560 POWERFUL POSSIBLE APPLICATION TO 6663 05:04:51,560 --> 05:04:54,040 INCLUDE THE HEALTH OF THE 6664 05:04:54,040 --> 05:04:56,040 POPULATION AND THE REASON WHY I 6665 05:04:56,040 --> 05:04:58,480 THINK THIS IS TRUE, I HOPE WE'LL 6666 05:04:58,480 --> 05:05:08,960 BE CLEAR IN MY PRESENTATION. 6667 05:05:23,240 --> 05:05:24,600 AND IN EACH YEAR WE SELECTED 6668 05:05:24,600 --> 05:05:28,720 THOSE WITH THE LONGEST LIFE 6669 05:05:28,720 --> 05:05:30,720 EXPECTANCY AND FROM 1914 AND ON 6670 05:05:30,720 --> 05:05:33,240 THEY INCREASED IN LIFE 6671 05:05:33,240 --> 05:05:39,560 EXPECTANCY TO FOLLOW ALMOST A 6672 05:05:39,560 --> 05:05:41,280 PERFECT LINEAR POPULATION AND IT 6673 05:05:41,280 --> 05:05:44,320 SHOWS ME AT THAT TIME AROUND 6674 05:05:44,320 --> 05:05:46,280 2,000 IT WAS A NUMBER OF 6675 05:05:46,280 --> 05:05:49,880 MEETINGS THAT STARTED AND WHAT 6676 05:05:49,880 --> 05:05:51,920 WAS HAPPENING IN THE FUTURE AND 6677 05:05:51,920 --> 05:05:54,600 THEY CAME UP WITH SOME 6678 05:05:54,600 --> 05:05:58,840 PREDICTIONS THAT ILLUSTRATES BY 6679 05:05:58,840 --> 05:05:59,400 THIS DASHED LINE. 6680 05:05:59,400 --> 05:06:01,400 OF COURSE THEY WERE ALL WRONG 6681 05:06:01,400 --> 05:06:04,040 BECAUSE THE AGING OF THE 6682 05:06:04,040 --> 05:06:06,760 POPULATION, START INCREASING 6683 05:06:06,760 --> 05:06:16,960 OVER TIME. 6684 05:06:28,400 --> 05:06:30,000 NOT ONLY THE GOOD LIFE IS 6685 05:06:30,000 --> 05:06:33,840 BECOMING LONGER, BUT THE LIFE 6686 05:06:33,840 --> 05:06:37,400 THAT IS CHARACTERIZED BY ILLNESS 6687 05:06:37,400 --> 05:06:39,080 AND DISABILITY IS ALSO 6688 05:06:39,080 --> 05:06:42,880 INCREASING AND WHAT THIS MEANS 6689 05:06:42,880 --> 05:06:45,120 LOOKING AT THESE PROJECTIONS 6690 05:06:45,120 --> 05:06:50,960 FROM THE UNITED NATION AND 6691 05:06:50,960 --> 05:06:52,280 SHOWING THAT MORE YOU SPEND IN 6692 05:06:52,280 --> 05:06:58,320 HEALTH CARE, THE MORE THE 6693 05:06:58,320 --> 05:07:00,440 DIFFERENT NATIONED SPEND IN 6694 05:07:00,440 --> 05:07:01,840 HEALTHCARE THE LONGER YOU HAVE 6695 05:07:01,840 --> 05:07:03,560 THIS DISABILITY SO THERE'S 6696 05:07:03,560 --> 05:07:05,080 SOMETHING WRONG THE MORE WE 6697 05:07:05,080 --> 05:07:13,240 SPEND, THE MORE THERE IS IN OUR 6698 05:07:13,240 --> 05:07:17,400 LIVES AND THAT SHOULD MAKE US 6699 05:07:17,400 --> 05:07:18,800 PAUSE AND UNDERSTAND WHY AND 6700 05:07:18,800 --> 05:07:23,800 UNDERSTAND WHAT WE CAN DO TO 6701 05:07:23,800 --> 05:07:24,960 THESE TRENDS. 6702 05:07:24,960 --> 05:07:26,360 ANOTHER WAY OF LOOKING AT THAT 6703 05:07:26,360 --> 05:07:31,520 IS LOOKING THE MULTIMORBITITIES. 6704 05:07:31,520 --> 05:07:36,240 IN THIS PAPER WE HAVE RECEN RESU 6705 05:07:36,240 --> 05:07:38,480 CAN LOOK AT THE CHANGE IN 6706 05:07:38,480 --> 05:07:39,640 MULTIMORBITITIES WITH AGING. 6707 05:07:39,640 --> 05:07:42,240 WE'VE SEEN THIS MORNING THAT KEY 6708 05:07:42,240 --> 05:07:45,880 MULTIMORBITITIES INCREASES WITH 6709 05:07:45,880 --> 05:07:46,560 AGING. 6710 05:07:46,560 --> 05:07:50,160 IF YOU SELECT THE 6711 05:07:50,160 --> 05:07:51,400 MULTIMORBITITIES AND IN HIGH 6712 05:07:51,400 --> 05:07:56,040 INCOME COUNTRY AND IN LOW INCOME 6713 05:07:56,040 --> 05:07:58,560 COUNTRY YOU HAVE A LOT OF 6714 05:07:58,560 --> 05:08:00,000 MULTIMORBITITIES IN HIGH INCOME 6715 05:08:00,000 --> 05:08:01,800 COUNTRIES THAN IN LOW INCOME 6716 05:08:01,800 --> 05:08:03,000 COUNTRY. 6717 05:08:03,000 --> 05:08:04,680 WHAT'S GOING ON HERE? 6718 05:08:04,680 --> 05:08:06,560 YOU KNOW, WHY IS THAT AND WHAT'S 6719 05:08:06,560 --> 05:08:10,320 THE PROBLEM THAT WE ARE 6720 05:08:10,320 --> 05:08:13,440 ENCOUNTERING? 6721 05:08:13,440 --> 05:08:14,880 SO WHAT IS REALLY HAPPENING WILL 6722 05:08:14,880 --> 05:08:17,480 BE CLEAR BY LOOK AT THE 6723 05:08:17,480 --> 05:08:18,560 MORTALITY DATA. 6724 05:08:18,560 --> 05:08:21,440 OVER THE LAST FEW DECADES, AND 6725 05:08:21,440 --> 05:08:23,360 HERE ON ONLY SURE WITH NEW DATA 6726 05:08:23,360 --> 05:08:26,480 FROM THE YEAR 2000 TO 2019 6727 05:08:26,480 --> 05:08:28,920 THERE'S BEEN A DRAMATIC DECLINE 6728 05:08:28,920 --> 05:08:31,720 IN THE MORBIDITY OF MORTALITY OF 6729 05:08:31,720 --> 05:08:34,000 HEART DISEASE AND THERE'S BEEN 6730 05:08:34,000 --> 05:08:38,040 ALSO A DISTR DECLINE IN CANCER 6731 05:08:38,040 --> 05:08:43,360 ACCELERATING DUE TO THE NEW 6732 05:08:43,360 --> 05:08:45,200 AVAILABLE. 6733 05:08:45,200 --> 05:08:51,120 IT ISN'T CLEAR DECLINE IN THE 6734 05:08:51,120 --> 05:08:53,520 AND HOWEVER, THE DIFFICULTY 6735 05:08:53,520 --> 05:09:00,000 DISEASE THAT EFFECT THE 6736 05:09:00,000 --> 05:09:07,480 INDIVIDUALS THAT ARE EITHER 6737 05:09:07,480 --> 05:09:11,200 STABLE AND AND THE CAUSE THAT AS 6738 05:09:11,200 --> 05:09:16,120 MULTIPLE CAUSE OF DEATH AND MORE 6739 05:09:16,120 --> 05:09:17,520 AND MORE INDIVIDUALS ACROSS THE 6740 05:09:17,520 --> 05:09:20,120 TIME TEND TO HAVE MULTI CAUSES 6741 05:09:20,120 --> 05:09:21,840 OF DEATH IN THEIR DEATH 6742 05:09:21,840 --> 05:09:23,880 CERTIFICATE SO MORE PEOPLE 6743 05:09:23,880 --> 05:09:27,280 SURVIVE DEVELOP MULTIPLE DISEASE 6744 05:09:27,280 --> 05:09:31,120 AND WHEN THEY THINK THEY HAVE 6745 05:09:31,120 --> 05:09:34,120 MULTIPLE AND COMPARE THAT AND IN 6746 05:09:34,120 --> 05:09:36,520 THE DEATH CERTIFICATE AND IN 6747 05:09:36,520 --> 05:09:39,960 THOSE WHO DIE ABOVE THE AGE OF 6748 05:09:39,960 --> 05:09:45,400 90, WE REALLY DON'T KNOW 90% OF 6749 05:09:45,400 --> 05:09:47,400 THE TIME WHAT THESE PEOPLE HAVE 6750 05:09:47,400 --> 05:09:48,080 BEEN DYING FOR. 6751 05:09:48,080 --> 05:09:50,000 UP WITH OF THE ISSUES THAT WE 6752 05:09:50,000 --> 05:09:55,120 ALWAYS TALK ABOUT, IN THE 6753 05:09:55,120 --> 05:09:55,720 FIRSTEN COUNT I REMEMBER WITH 6754 05:09:55,720 --> 05:09:56,920 EPIDEMIOLOGY THE IDEA OF WHAT 6755 05:09:56,920 --> 05:10:04,120 HAPPENED IF WE ELIMINATE CARDIAC 6756 05:10:04,120 --> 05:10:06,160 RESISTANCE AND WE ARE REALIZING 6757 05:10:06,160 --> 05:10:07,240 THAT WAS THE WRONG QUESTION 6758 05:10:07,240 --> 05:10:09,240 BECAUSE DISEASE OCCURS BECAUSE 6759 05:10:09,240 --> 05:10:10,680 PAGE CONSTITUTES THE GREATEST 6760 05:10:10,680 --> 05:10:12,200 POSITION TO DISEASE. 6761 05:10:12,200 --> 05:10:17,600 AND IN FACT, IN ORDER TO KIND OF 6762 05:10:17,600 --> 05:10:22,280 DEMONSTRATE THIS IDEA AND YOU 6763 05:10:22,280 --> 05:10:24,880 CAN SEE CLEARLY HERE THAT IF YOU 6764 05:10:24,880 --> 05:10:27,240 HAVE INFORM DISEASE, THIS IS A 6765 05:10:27,240 --> 05:10:30,280 FORMER MODEL ASSUME AIMING 70 6766 05:10:30,280 --> 05:10:31,520 AND CLEAR FOLLOW-UP AND IF YOU 6767 05:10:31,520 --> 05:10:34,600 HAVE ZERO DISEASE, YOUR 6768 05:10:34,600 --> 05:10:36,720 PROBABILITY TO DEVELOP ONE 6769 05:10:36,720 --> 05:10:39,520 DISEASE IS 50%. 6770 05:10:39,520 --> 05:10:42,520 IF YOU HAVE ONE DISEASE YOUR 6771 05:10:42,520 --> 05:10:43,800 PROBABILITY IS 20% AND IF YOU 6772 05:10:43,800 --> 05:10:46,320 HAVE TWO DISEASE YOU ARE 6773 05:10:46,320 --> 05:10:47,600 PROBABILITY IS 23%. 6774 05:10:47,600 --> 05:10:57,200 AND SO ON AND IF OF FOUR DISEASE 6775 05:10:57,200 --> 05:11:00,120 IS 51% WILL DEVELOP ANOTHER 6776 05:11:00,120 --> 05:11:02,240 DISEASE, THIS MEANS THAT DISEASE 6777 05:11:02,240 --> 05:11:06,600 DEVELOPS IF CLUSTERS AND THAT IS 6778 05:11:06,600 --> 05:11:12,920 REALLY THE UNDERSTANDING OF THE 6779 05:11:12,920 --> 05:11:14,560 PAOPAO TEN SHALL AND IT'S 6780 05:11:14,560 --> 05:11:15,480 SUMMARIZED IN THIS SLIDE. 6781 05:11:15,480 --> 05:11:23,120 YOU HAVE A NUMBER OF DISEASE 6782 05:11:23,120 --> 05:11:24,560 THAT ARE OCCURRING OVER TIME AND 6783 05:11:24,560 --> 05:11:25,960 IT WILL EMERGE AND AFTER THE 6784 05:11:25,960 --> 05:11:27,840 DEVELOP OF THE FIRST DISEASE, 6785 05:11:27,840 --> 05:11:30,480 YOU WILL HAVE MANY MORE DISEASE 6786 05:11:30,480 --> 05:11:36,480 THAT DEVELOP IN CLUSTERS IN 6787 05:11:36,480 --> 05:11:37,480 ACCUMULATE IN FACT THE PEOPLE 6788 05:11:37,480 --> 05:11:39,160 THAT HAVE LONGER DISEASES FEEL 6789 05:11:39,160 --> 05:11:41,240 LIKE EXTRACTING IT WILL HAVE A 6790 05:11:41,240 --> 05:11:44,000 DELAY IN THE BEGINNING OF THE 6791 05:11:44,000 --> 05:11:47,640 FIRST DISEASE BUT THEN THERE 6792 05:11:47,640 --> 05:11:51,000 WILL EXPERIENCE MULTIMORBITITIES 6793 05:11:51,000 --> 05:11:52,920 LATER ON AND THOSE WHO HAVE 6794 05:11:52,920 --> 05:11:54,480 SHORT DISEASE LIFE EXPECTANCY 6795 05:11:54,480 --> 05:11:56,480 WILL HAVE THE SAME PROBLEM, YOU 6796 05:11:56,480 --> 05:11:58,000 KNOW, WHERE THEY WILL DEVELOP A 6797 05:11:58,000 --> 05:12:00,600 FIRST DISEASE EARLY AND THEN THE 6798 05:12:00,600 --> 05:12:02,240 CUMULATIVE EFFECT OF THIS 6799 05:12:02,240 --> 05:12:06,040 CLUSTER WILL EFFECT THE 6800 05:12:06,040 --> 05:12:16,280 INDIVIDUALS. 6801 05:12:16,880 --> 05:12:20,320 YOU CAN IMPROVE OUR ABILITY TO 6802 05:12:20,320 --> 05:12:23,080 TREAT DISEASE BUT ONLY THINK WE 6803 05:12:23,080 --> 05:12:26,160 CAN ACCOMPLISH IS INCLUDE THE 6804 05:12:26,160 --> 05:12:29,960 HEALTH DURING THE PERIOD OF TIME 6805 05:12:29,960 --> 05:12:30,560 AFTER THESE. 6806 05:12:30,560 --> 05:12:33,240 WE ARE DOING VERY, VERY LITTLE 6807 05:12:33,240 --> 05:12:37,880 TO IMPROVE HEALTH IN THE 6808 05:12:37,880 --> 05:12:40,240 PROGRESSION OF PATHOLOGY IN 6809 05:12:40,240 --> 05:12:45,280 VICTIM DURING THE PRIOR TO THE 6810 05:12:45,280 --> 05:12:47,040 CLINICAL EMERGENCE OF DISEASE. 6811 05:12:47,040 --> 05:12:48,440 THAT IS IMPORTANT, BECAUSE 6812 05:12:48,440 --> 05:12:51,720 UNLESS WE DO SOMETHING BEFORE, 6813 05:12:51,720 --> 05:12:54,120 IMPROVING OUR HEALTHCARE WOULD 6814 05:12:54,120 --> 05:12:55,000 ONLY EXPAND MULTIMORBITITIES AND 6815 05:12:55,000 --> 05:12:57,040 AT IS SOME POINT, WE WILL NOT BE 6816 05:12:57,040 --> 05:13:03,720 ABLE TO ADDRESS THAT THE PROBLEM 6817 05:13:03,720 --> 05:13:06,160 IS IN MY MIND, AN ITALIAN 6818 05:13:06,160 --> 05:13:08,040 EXPRESSION, THAT WE SEE THE EGG 6819 05:13:08,040 --> 05:13:10,240 IS KIND OF FALLING DOWN AND WE 6820 05:13:10,240 --> 05:13:16,400 KNOW THAT AT SOME POINT, IT WILL 6821 05:13:16,400 --> 05:13:18,200 SLASH WE WANT TO DO IN FACT IS 6822 05:13:18,200 --> 05:13:25,640 TO KIND OF GET THE EGG, WHILE 6823 05:13:25,640 --> 05:13:26,800 IT'S STILL IN THE CHICKEN AND 6824 05:13:26,800 --> 05:13:28,720 THAT'S THE STRATEGY TO WORK. 6825 05:13:28,720 --> 05:13:29,800 HOW THIS MAY WORK? 6826 05:13:29,800 --> 05:13:34,960 I'LL GO BACK TO THE MODEL I 6827 05:13:34,960 --> 05:13:45,240 SHOWED YOU BEFORE. 6828 05:13:56,200 --> 05:13:58,160 SO, THE ISSUE IS THAT IF YOU 6829 05:13:58,160 --> 05:13:59,720 LOOK UNDER THE IN THE 6830 05:13:59,720 --> 05:14:03,040 ACCUMULATION OF PATHOLOGY, THE 6831 05:14:03,040 --> 05:14:06,520 PEOPLE WILL LIVER EXPECTANCY 6832 05:14:06,520 --> 05:14:07,800 HAVE DIFFERENT RATE AVENUE 6833 05:14:07,800 --> 05:14:11,360 ACCUMULATION OF PATHOLOGY BEFORE 6834 05:14:11,360 --> 05:14:21,880 THEY BECOME EVIDENCE AND I THINK 6835 05:14:58,720 --> 05:15:00,720 IT IS CORRECT FOR MANY 6836 05:15:00,720 --> 05:15:03,400 PROSPECTIVE AND IT'S EFFECTED 6837 05:15:03,400 --> 05:15:06,200 VEMMENT ON MANY DISEASE AND WHEN 6838 05:15:06,200 --> 05:15:09,640 THIS DISEASE OCCUR, WE ARE 6839 05:15:09,640 --> 05:15:13,400 DEVELOPED AND POWERFUL AND DRUGS 6840 05:15:13,400 --> 05:15:16,600 AND INTERVENTIONS THAT PROLONG 6841 05:15:16,600 --> 05:15:18,720 THE LIFE AND TO SOME EXTENT, 6842 05:15:18,720 --> 05:15:21,800 REDUCE THE SYMPTOMS OF THESE 6843 05:15:21,800 --> 05:15:22,240 INDIVIDUALS. 6844 05:15:22,240 --> 05:15:25,680 BUT ONE POTENTIAL ALTERNATIVE 6845 05:15:25,680 --> 05:15:28,040 APPROACH WILL BE TO REDUCE THE 6846 05:15:28,040 --> 05:15:30,120 PACE OF AGING BY REDUCING THE 6847 05:15:30,120 --> 05:15:33,640 PACE OF AGING, WE CAN DELAY THE 6848 05:15:33,640 --> 05:15:38,120 BEGINNING OF DISEASE AND ALSO 6849 05:15:38,120 --> 05:15:41,360 DELAY THE BEGINNING OF MULTI 6850 05:15:41,360 --> 05:15:41,960 MORBIDITY. 6851 05:15:41,960 --> 05:15:44,160 IS THAT DOABLE? 6852 05:15:44,160 --> 05:15:47,160 THE POWER OF THIS IDEA IS THAT 6853 05:15:47,160 --> 05:15:49,280 IT'S IMMEDIATELY EVIDENCE IT'S 6854 05:15:49,280 --> 05:15:59,640 CLINICAL CONNECTIONS. 6855 05:16:09,200 --> 05:16:14,120 AIMING IS LIKELY IS A PROCESS 6856 05:16:14,120 --> 05:16:15,640 AND WE HAVE THOSE THAT DEAL WITH 6857 05:16:15,640 --> 05:16:18,160 THAT CULMINATION OF DAMAGE 6858 05:16:18,160 --> 05:16:19,560 BECOMES LESS EFFECTIVE. 6859 05:16:19,560 --> 05:16:21,360 AND WHEN THIS AND ASSUMING THAT 6860 05:16:21,360 --> 05:16:23,520 THIS IS A COMPLETE LIST WHICH I 6861 05:16:23,520 --> 05:16:29,600 DON'T THINK IT IS, WHAT THEY DO 6862 05:16:29,600 --> 05:16:32,600 IS THEY CREATE IN THE PHENOTYPE 6863 05:16:32,600 --> 05:16:38,200 AND THE WAY AND NIA IS STUDIED 6864 05:16:38,200 --> 05:16:40,360 AND THE PHENOTYPE IS CHANGING 6865 05:16:40,360 --> 05:16:42,960 BODY COMPOSITION, IMBALANCE IN 6866 05:16:42,960 --> 05:16:47,280 ENERGY PRODUCTION AND DEMAND AND 6867 05:16:47,280 --> 05:16:50,400 HOMEOSTATIC AND A AND THEN, 6868 05:16:50,400 --> 05:16:53,280 THESE CHANGES IN THE PHENOTYPE, 6869 05:16:53,280 --> 05:16:55,920 DETERMINING WHAT WE CALL THE 6870 05:16:55,920 --> 05:17:01,960 AGING SYNDROME OF THE GERIATRIC 6871 05:17:01,960 --> 05:17:03,400 SYNDROME. 6872 05:17:03,400 --> 05:17:06,200 WHEN YOU THINK ABOUT 6873 05:17:06,200 --> 05:17:07,720 INCONTINENCE YOU THINK ABOUT 6874 05:17:07,720 --> 05:17:09,440 CHANGING BODY COMPOSITION 6875 05:17:09,440 --> 05:17:14,800 BECAUSE THE MUSCLE THAT IS 6876 05:17:14,800 --> 05:17:16,160 AROUND THE SYSTEM AND AT THE 6877 05:17:16,160 --> 05:17:21,000 SAME TIME, IT'S LOSS PLASTIC 6878 05:17:21,000 --> 05:17:23,560 TYPE OF THIS SYSTEM AND WHEN YOU 6879 05:17:23,560 --> 05:17:25,360 HAVE TWO TYPES EFFECTED BY AGING 6880 05:17:25,360 --> 05:17:29,360 YOU GET THE GENETIC SYNDROME. 6881 05:17:29,360 --> 05:17:32,880 I WANT TO START GIVE YOU A HINT 6882 05:17:32,880 --> 05:17:34,200 OF WHAT WE ALREADY KNOW BECAUSE 6883 05:17:34,200 --> 05:17:36,400 I DON'T THINK THERE'S A FAMILIAR 6884 05:17:36,400 --> 05:17:37,240 SEE, IS THINK WE'RE ALREADY 6885 05:17:37,240 --> 05:17:39,080 EVIDENT AND SOME OF THESE 6886 05:17:39,080 --> 05:17:41,960 MECHANISMS ARE REALLY IMPORTANT 6887 05:17:41,960 --> 05:17:44,320 AND MY SHORT, YOU KNOW, 6888 05:17:44,320 --> 05:17:46,360 DIVERSION IS TO TALK ABOUT 6889 05:17:46,360 --> 05:17:47,040 MITOCHONDRIA. 6890 05:17:47,040 --> 05:17:50,000 WHY I THINK THAT MITOCHONDRIA, I 6891 05:17:50,000 --> 05:17:58,160 AM A HIGH DEGREE CON MYCO CON DS 6892 05:17:58,160 --> 05:18:00,760 CENTRAL TO ENERGY AND THE 6893 05:18:00,760 --> 05:18:03,400 DIFFERENT BIOLOGICAL MECHANISM 6894 05:18:03,400 --> 05:18:06,200 THAT PREVENT OR REPAIR DAMAGE, 6895 05:18:06,200 --> 05:18:08,160 ALL NEED MASSIVE AMOUNTS OF 6896 05:18:08,160 --> 05:18:09,360 ENERGY TO WORK. 6897 05:18:09,360 --> 05:18:10,760 IF YOU DON'T PROVIDE ENERGY TO 6898 05:18:10,760 --> 05:18:14,720 THIS MECHANISM, YOU WILL NOT BE 6899 05:18:14,720 --> 05:18:19,040 ABLE TO SEE THE SAME FINANCING 6900 05:18:19,040 --> 05:18:20,680 AND THE EVIDENCE IS CLEAR. 6901 05:18:20,680 --> 05:18:23,240 FOR EXAMPLE, THESE ARE DATA 6902 05:18:23,240 --> 05:18:25,400 FUNDED ON THE STUDY OF AGING IN 6903 05:18:25,400 --> 05:18:28,280 WHICH WE USE, WE MEASURE 6904 05:18:28,280 --> 05:18:29,880 MITOCHONDRIA FUNCTION IN A 6905 05:18:29,880 --> 05:18:33,640 MAGNET BY HAVING SOMEONE 6906 05:18:33,640 --> 05:18:38,200 EXERCISING IN THE MAGNET AND WE 6907 05:18:38,200 --> 05:18:44,240 MEASURE HOW FAST IT CAN BE 6908 05:18:44,240 --> 05:18:47,920 RECHARGED AND IT WILL GIVE YOU 6909 05:18:47,920 --> 05:18:51,080 AN IDEA AND THIS IS ASSOCIATED 6910 05:18:51,080 --> 05:18:52,720 WITH SOMETHING THAT IS IMPORTANT 6911 05:18:52,720 --> 05:18:55,280 WITH AGING IS WHAT WE SPEED IN 6912 05:18:55,280 --> 05:18:57,560 DIFFERENT TASK AND WHEN YOU DO A 6913 05:18:57,560 --> 05:19:02,400 MEDIATION IN OUR, YOU FIND IT'S 6914 05:19:02,400 --> 05:19:04,960 THROUGH MUSCLE STRENGTH SO IT'S 6915 05:19:04,960 --> 05:19:08,920 IMPORTANT FOR THE PHYSICAL 6916 05:19:08,920 --> 05:19:09,560 STRENGTH. 6917 05:19:09,560 --> 05:19:11,880 NEXT STEP, WE DEMONSTRATED 6918 05:19:11,880 --> 05:19:13,680 RECENTLY THAT MITOCHONDRIA 6919 05:19:13,680 --> 05:19:21,400 FUNCTION MEASURED IN MUSCLE ARE 6920 05:19:21,400 --> 05:19:26,280 PREDICTIVE OF THE AMYLOID IN THE 6921 05:19:26,280 --> 05:19:31,160 RAIN ARE AND AND I ALSO AND IT'S 6922 05:19:31,160 --> 05:19:33,880 VERY IMPORTANT ON THE MARKER OF 6923 05:19:33,880 --> 05:19:38,880 DISEASE AND SUCH AS THE GLIO 6924 05:19:38,880 --> 05:19:42,760 AGING PROCESS. 6925 05:19:42,760 --> 05:19:45,200 MITOCHONDRIA COURT LATE 6926 05:19:45,200 --> 05:19:46,520 PREDICTORS OF COGNITIVE FUNCTION 6927 05:19:46,520 --> 05:19:48,960 WHICH IS REALLY THE THEORY OF 6928 05:19:48,960 --> 05:19:51,080 AGING IF WE ACT ON THIS 6929 05:19:51,080 --> 05:19:52,640 RESILIENCE MECHANISMS, WE CAN 6930 05:19:52,640 --> 05:19:57,000 DELAY AND PREVENT MANY OF 6931 05:19:57,000 --> 05:20:03,040 DISEASE THAT CAN BE CLINICALLY 6932 05:20:03,040 --> 05:20:03,920 PHYSICAL FUNCTIONS DELINE WITH 6933 05:20:03,920 --> 05:20:04,880 AGING. 6934 05:20:04,880 --> 05:20:07,320 WITH THAT, I'M FINISHED AND 6935 05:20:07,320 --> 05:20:14,040 MANY, MANY PEOPLE THAT NOT 6936 05:20:14,040 --> 05:20:18,560 HELPED ME AND NOT JUST FUEL 6937 05:20:18,560 --> 05:20:20,880 EXAMPLES. 6938 05:20:20,880 --> 05:20:31,080 [APPLAUSE] 6939 05:20:45,840 --> 05:20:47,160 >>THANK YOU ALL FOR BEING HERE 6940 05:20:47,160 --> 05:20:48,560 AND THANK YOU FOR IN INVITING ME 6941 05:20:48,560 --> 05:20:48,920 TODAY. 6942 05:20:48,920 --> 05:20:51,320 I'M REALLY EXCITED TO BE HERE TO 6943 05:20:51,320 --> 05:20:53,440 TALK A LITTLE BIT ABOUT 6944 05:20:53,440 --> 05:20:55,080 MULTIMORBITITIES AND GERIATRIC 6945 05:20:55,080 --> 05:21:01,320 SYNDROME IN NON HUMAN PRIMATES. 6946 05:21:01,320 --> 05:21:03,480 SOL THANKFULLY, BECAUSE I'M 6947 05:21:03,480 --> 05:21:04,840 AFTER, I DON'T NEED TO EXPLAIN 6948 05:21:04,840 --> 05:21:06,680 WHY RESILIENCE IS IMPORTANT BUT 6949 05:21:06,680 --> 05:21:08,840 I WILL JUST BRIEFLY POINT OUT 6950 05:21:08,840 --> 05:21:10,480 THAT WHEN WE THINK ABOUT 6951 05:21:10,480 --> 05:21:12,080 RESILIENCE AND OUR ABILITY TO 6952 05:21:12,080 --> 05:21:15,040 RESIST OR RECOVER FROM AN ACUTE 6953 05:21:15,040 --> 05:21:17,400 STRESSOR, WE TEND TO THINK ABOUT 6954 05:21:17,400 --> 05:21:20,200 SORT OF A VERY SHORT TIMEFRAME 6955 05:21:20,200 --> 05:21:21,880 AND THIS IS PARTICULARLY TRUE 6956 05:21:21,880 --> 05:21:23,440 WHEN WE THINK ABOUT A LOT OF THE 6957 05:21:23,440 --> 05:21:25,920 MOST COMMON ACUTE STRESSORS 6958 05:21:25,920 --> 05:21:28,840 THINGS LIKE RADIATION EXPOSURE, 6959 05:21:28,840 --> 05:21:31,320 VACCINATIONS, SHORT PERIODS OF 6960 05:21:31,320 --> 05:21:34,520 BED REST SURGERY, ET CETERA, AND 6961 05:21:34,520 --> 05:21:37,160 THIS NOT RESPONSE OF SORT OF 6962 05:21:37,160 --> 05:21:41,520 THIS SHORT WEEKS OR MAYBE EVEN 6963 05:21:41,520 --> 05:21:52,000 MONTHS AND SUBPOENA WHETHER 6964 05:21:52,000 --> 05:21:54,360 WE'RE ABLE TO BOUNCE BACK OR OUR 6965 05:21:54,360 --> 05:21:57,480 NORMAL FUNCTION OR STAY IN THIS 6966 05:21:57,480 --> 05:22:00,320 FRAILTY AREA AND DEVELOP 6967 05:22:00,320 --> 05:22:01,640 MULTIMORBITITIES AND WHAT IS 6968 05:22:01,640 --> 05:22:03,200 INTERESTING ABOUT OUR A LOT TO 6969 05:22:03,200 --> 05:22:07,360 LOOK AT A LOT OF THIS THESE CAN 6970 05:22:07,360 --> 05:22:09,840 BE MODELED IN NON HUMAN PRIMATES 6971 05:22:09,840 --> 05:22:11,480 SO I'M GOING TO TALK ABOUT 6972 05:22:11,480 --> 05:22:13,480 RADIATION EXPOSURE AND I DO WANT 6973 05:22:13,480 --> 05:22:15,120 TO EMPHASIZE WHAT I'M SPEAKING 6974 05:22:15,120 --> 05:22:16,600 OF IS MUCH BROADER THAN THAT AND 6975 05:22:16,600 --> 05:22:18,720 THIS IS REALLY ABOUT RESPONSE TO 6976 05:22:18,720 --> 05:22:21,840 A STRESSOR AND NOT ONLY HOW THAT 6977 05:22:21,840 --> 05:22:25,280 MIGHT BE HETERO GENIUS IN THE 6978 05:22:25,280 --> 05:22:26,760 SHORT TERM, WHERE SOME ANIMALS 6979 05:22:26,760 --> 05:22:28,680 AND SOME INDIVIDUALS MAY DIE 6980 05:22:28,680 --> 05:22:31,080 SOON AFTER THAT ACUTE STRESS AND 6981 05:22:31,080 --> 05:22:33,480 SOME BOUNCE BACK BUT OVER A MUCH 6982 05:22:33,480 --> 05:22:35,400 LONGER TIME PERIOD, WHEN WE 6983 05:22:35,400 --> 05:22:37,840 THINK ABOUT YEARS LATER, THERE 6984 05:22:37,840 --> 05:22:40,440 IS A LOT OF VARIATIONS AND THAT 6985 05:22:40,440 --> 05:22:42,640 IS GOING TO BE INFLUENCED BY THE 6986 05:22:42,640 --> 05:22:49,240 MAGNITUDE OF THE STRESSOR BUT 6987 05:22:49,240 --> 05:22:59,760 ALSO, AND MULTI MORBIDITY INDEX 6988 05:23:07,080 --> 05:23:08,720 AND I WANT TO START BY 6989 05:23:08,720 --> 05:23:10,240 EMPHASIZING A LOT OF CHRONIC 6990 05:23:10,240 --> 05:23:11,640 CONDITIONS THAT WE THINK ABOUT 6991 05:23:11,640 --> 05:23:14,680 IN TERMS OF MULTIMORBITITIES ARE 6992 05:23:14,680 --> 05:23:16,960 WELL ESTABLISHED IN NON HUMAN 6993 05:23:16,960 --> 05:23:18,120 APP PRIMATE MODELS. 6994 05:23:18,120 --> 05:23:19,680 I'VE SELECTED FIVE OF THE MOST 6995 05:23:19,680 --> 05:23:21,880 COMMON NON HUMAN PRIMATE MODELS 6996 05:23:21,880 --> 05:23:23,680 HERE BUT THERE ARE MANY OTHERS. 6997 05:23:23,680 --> 05:23:25,480 IF YOU ARE INTERESTED IN THESE 6998 05:23:25,480 --> 05:23:26,800 QUESTIONS, THIS LINK AT THE 6999 05:23:26,800 --> 05:23:29,960 BOTTOM, IS A VERY HELPFUL 7000 05:23:29,960 --> 05:23:31,440 RESOURCE AND WHAT DISEASES ARE 7001 05:23:31,440 --> 05:23:36,360 BEST MODELED IN DIFFERENT NON 7002 05:23:36,360 --> 05:23:38,240 HUMAN PRIMATES. 7003 05:23:38,240 --> 05:23:40,040 THERE'S A LOT OF OVERLAP. 7004 05:23:40,040 --> 05:23:43,560 WE'RE INTERESTED ABOUT IN TERMS 7005 05:23:43,560 --> 05:23:45,320 OF UNDERSTANDING AIMING RELATED 7006 05:23:45,320 --> 05:23:46,840 DISEASE THINGS LIKE 7007 05:23:46,840 --> 05:23:48,720 CARDIOVASCULAR DISEASE, OBESE 7008 05:23:48,720 --> 05:23:50,280 TEES, ALZHEIMER'S, DIABETES, ALL 7009 05:23:50,280 --> 05:23:53,480 SORTS OF IMPAIRMENTS AND THINGS 7010 05:23:53,480 --> 05:23:54,400 LIKE CANCER, ARE ALL REALLY 7011 05:23:54,400 --> 05:23:56,920 NICELY STUDIED AND NON HUMAN 7012 05:23:56,920 --> 05:23:58,440 PRIMATES AND IT HAS A LOT TO DO 7013 05:23:58,440 --> 05:24:00,480 WITH THE FACT THAT THEY HAVE 7014 05:24:00,480 --> 05:24:04,200 LONG LIFE SPANS AND THAT GIVES 7015 05:24:04,200 --> 05:24:06,880 US THE ABILITY TO WATCH THEM 7016 05:24:06,880 --> 05:24:07,960 NATURALLY DEVELOPMENT SO IN A 7017 05:24:07,960 --> 05:24:18,520 LOT OF OTHER MODEL ORGANISMS AND 7018 05:24:18,520 --> 05:24:20,160 DISEASE AND OF COURSE NON HUMAN 7019 05:24:20,160 --> 05:24:21,800 PRIMATES ARE MUCH MORE SIMILAR 7020 05:24:21,800 --> 05:24:24,880 TO US, THAT IS GOING TO BE MAKE 7021 05:24:24,880 --> 05:24:30,720 IT ALL THE MORE READILY AND AND 7022 05:24:30,720 --> 05:24:32,520 I'M GOING TO PICK ONE STRESSOR 7023 05:24:32,520 --> 05:24:36,640 TO THINK ABOUT TODAY AND I'M 7024 05:24:36,640 --> 05:24:38,800 GOING TO DO RADIATION. 7025 05:24:38,800 --> 05:24:40,520 THAT'S WHAT I'VE BEEN STUDYING. 7026 05:24:40,520 --> 05:24:41,920 YOU GUYS ARE PROBABLY WELL AWARE 7027 05:24:41,920 --> 05:24:43,360 OF THE FACT THAT THERE ARE 7028 05:24:43,360 --> 05:24:44,520 LONG-TERM DIET STUDIES AND 7029 05:24:44,520 --> 05:24:48,200 THINGS LIKE THAT THAT ALSO 7030 05:24:48,200 --> 05:24:52,360 MODERATE AGING IN NON HUMAN 7031 05:24:52,360 --> 05:24:53,200 PRIMATES. 7032 05:24:53,200 --> 05:24:55,960 SO OUR PROGRAM IS CALLED RARRE 7033 05:24:55,960 --> 05:24:57,400 BECAUSE WE'RE WORKING WITH A 7034 05:24:57,400 --> 05:24:59,160 VERY RARE RESEARCH AND THIS IS 7035 05:24:59,160 --> 05:25:01,760 SOMETHING CALLED THE WAKE FOREST 7036 05:25:01,760 --> 05:25:04,960 RADIATION LATEST EFFECTS COHORT 7037 05:25:04,960 --> 05:25:08,480 RUN FOR 15 YEARS BY Dr. MARK 7038 05:25:08,480 --> 05:25:10,800 KLEIN WHO STARTED TAKING IN 7039 05:25:10,800 --> 05:25:21,320 ANIMALS WITH NIAID FUNDING AND 7040 05:25:54,440 --> 05:25:56,320 IT'S AN AGING COHORT NOW SO, 7041 05:25:56,320 --> 05:25:58,720 JUST TO SORT OF HIGHLIGHT FOR 7042 05:25:58,720 --> 05:26:00,680 YOU THE EFFECT OF THE RADIATION 7043 05:26:00,680 --> 05:26:02,000 EXPOSURE ON THE RIGHT YOU WILL 7044 05:26:02,000 --> 05:26:04,280 SEE, IN THE GOLD, THE RADIATED 7045 05:26:04,280 --> 05:26:07,000 ANIMALS AND IN THE GRAY THE 7046 05:26:07,000 --> 05:26:08,360 CONTROL NON ANIMALS AND THIS IS 7047 05:26:08,360 --> 05:26:10,200 LOOKING AT AGE OF ONSET SO YOU 7048 05:26:10,200 --> 05:26:12,920 WILL NOTICE THAT THE GOLD IS 7049 05:26:12,920 --> 05:26:14,040 SHIFTED TO THE LEFT AND WE HAVE 7050 05:26:14,040 --> 05:26:17,760 AN EASTERLY YEAR AGE OF ONSET OF 7051 05:26:17,760 --> 05:26:19,600 THE VARIETY OF DISEASES WE'RE 7052 05:26:19,600 --> 05:26:22,240 INTERESTED IN THINKING ABOUT 7053 05:26:22,240 --> 05:26:23,200 GERIATRIC SYNDROME. 7054 05:26:23,200 --> 05:26:25,920 HOWEVER, I ALSO WANT TO 7055 05:26:25,920 --> 05:26:28,160 EMPHASIZE WITH A FEW LIMITED 7056 05:26:28,160 --> 05:26:29,920 PERCEPTIONS THINGS LIKE 7057 05:26:29,920 --> 05:26:34,080 TESTICULAR ASTRO FEE AND BRAIN 7058 05:26:34,080 --> 05:26:40,440 LESIONS. 7059 05:26:40,440 --> 05:26:41,840 WE ARE SEEING DISEASE THAT'S 7060 05:26:41,840 --> 05:26:46,320 OCCUR NATURALLY JUST EARLIER. 7061 05:26:46,320 --> 05:26:56,760 AMONG THOSE, THESE ARE SAME 7062 05:26:57,120 --> 05:26:59,000 ANIMALS AT AGE FIVE AND AGE 7063 05:26:59,000 --> 05:26:59,800 EIGHT. 7064 05:26:59,800 --> 05:27:02,800 EVEN THOUGH AN 8-YEAR-OLD ANIMAL 7065 05:27:02,800 --> 05:27:04,840 IS EARLY MID LIFE, WE'RE STILL 7066 05:27:04,840 --> 05:27:07,560 SEEING 10% TO 20% PRESENCE OF 7067 05:27:07,560 --> 05:27:12,680 SOME OF THESE SKIN DISEASES AND 7068 05:27:12,680 --> 05:27:13,920 AT A RACKS HEART DISEASE SO 7069 05:27:13,920 --> 05:27:15,120 WE'RE SEEING HIGH LEVELS OF 7070 05:27:15,120 --> 05:27:17,200 DISEASE IN THESE ANIMALS AND IT 7071 05:27:17,200 --> 05:27:18,320 LET'S US UNDERSTAND MULTI 7072 05:27:18,320 --> 05:27:23,000 MORBIDITY IN A MUCH MORE RICHER 7073 05:27:23,000 --> 05:27:31,600 WAY THAN NON RADIATED ANIMALS. 7074 05:27:31,600 --> 05:27:35,000 WE CAN SEE IN THE TEMPORAL AND 7075 05:27:35,000 --> 05:27:40,040 IN THE ADDITION CEASES AND WE 7076 05:27:40,040 --> 05:27:50,520 CAN YEARS AND SO, YOU WILL 7077 05:27:54,440 --> 05:27:55,720 NOTICE THAT NOT AGE IS REALLY 7078 05:27:55,720 --> 05:27:58,160 THE STRONGEST PREDICT OR OF AGE 7079 05:27:58,160 --> 05:28:00,600 OF ONSET AND WE'RE SEEING AS 7080 05:28:00,600 --> 05:28:02,960 SORT OF RELATIVELY RAPID 7081 05:28:02,960 --> 05:28:04,720 ACCUMULATIONS OF VARIOUS 7082 05:28:04,720 --> 05:28:06,840 DISEASES STARTING AROUND AGE 7083 05:28:06,840 --> 05:28:13,040 SEVEN TO 10 AND 10 IS ABOUT 35 7084 05:28:13,040 --> 05:28:17,040 TO 40% OF MEDIUM LIFESPAN SO 7085 05:28:17,040 --> 05:28:18,840 WE'RE TALKING ABOUT A RELATIVELY 7086 05:28:18,840 --> 05:28:21,480 YOUNG AGE THEY'RE GETTING A LOT 7087 05:28:21,480 --> 05:28:21,720 OF THESE. 7088 05:28:21,720 --> 05:28:25,280 YOU WILL NOTICE SOME IN ARE VERY 7089 05:28:25,280 --> 05:28:26,160 COMMON. 7090 05:28:26,160 --> 05:28:29,760 THINGS LIKE PERRY OWE DON 7091 05:28:29,760 --> 05:28:32,560 ADVERTISE AND SKIN DISEASE, 7092 05:28:32,560 --> 05:28:36,200 HEART DISEASE, ARTHRITIS, AND 7093 05:28:36,200 --> 05:28:40,600 SOME ARE UNCOMMON. 7094 05:28:40,600 --> 05:28:41,840 SO THIS IS OVER ALL INCIDENTS. 7095 05:28:41,840 --> 05:28:45,640 IF WE THINK ABOUT, NORMALIZING, 7096 05:28:45,640 --> 05:28:47,600 THE OCCURRENCE OF THIS DISEASE, 7097 05:28:47,600 --> 05:28:50,240 TO THEIR OVER ALL INCIDENTS WE 7098 05:28:50,240 --> 05:28:52,000 CAN SEE WHEN THEIR EMERGING AND 7099 05:28:52,000 --> 05:28:55,800 IN WHAT COMBINATIONS THEY'RE 7100 05:28:55,800 --> 05:28:56,160 EMERGING. 7101 05:28:56,160 --> 05:28:57,720 WHAT WE CAN DO WHEN WE LOOK AT 7102 05:28:57,720 --> 05:29:05,160 EVERY ANIMAL AND EVERY ORGAN 7103 05:29:05,160 --> 05:29:15,720 SYSTEM, IT'S A POSITIVE CONTROL, 7104 05:30:09,960 --> 05:30:12,000 IF IT'S NOT A COMBINATION YOU 7105 05:30:12,000 --> 05:30:15,160 ARE SEEING YOU ARE NOT CAPTURING 7106 05:30:15,160 --> 05:30:19,400 NIPPING THAT RESEMBLES 7107 05:30:19,400 --> 05:30:20,120 OSTEOPOROSIS OWE. 7108 05:30:20,120 --> 05:30:23,480 WE ARE SEEING A BEING OVER 7109 05:30:23,480 --> 05:30:24,720 WEIGHT AND DIABETES BUT WE CAN 7110 05:30:24,720 --> 05:30:26,520 START TO SEE THINGS LIKE A 7111 05:30:26,520 --> 05:30:27,840 RELATIONSHIP BETWEEN DIABETES 7112 05:30:27,840 --> 05:30:32,680 AND LUNG FIBRO SIS AND BETWEEN 7113 05:30:32,680 --> 05:30:33,880 LUNG FIBRO SIS AND SKIN 7114 05:30:33,880 --> 05:30:35,320 DISORDERS AND SO WE CAN START TO 7115 05:30:35,320 --> 05:30:37,560 SORT OF PICK APART BECAUSE THESE 7116 05:30:37,560 --> 05:30:39,920 ARE RELATIVELY COMMON DISEASES 7117 05:30:39,920 --> 05:30:42,160 IN THIS COHORT AND WE CAN START 7118 05:30:42,160 --> 05:30:44,400 TO SEE WHAT DISEASES ARE 7119 05:30:44,400 --> 05:30:46,320 OCCURRING TOGETHER MORE THAN WE 7120 05:30:46,320 --> 05:30:56,800 WOULD EXPECT PURELY BY CHANCE. 7121 05:31:02,320 --> 05:31:04,680 OUT OF 17 DISEASES WE COLLECTS 7122 05:31:04,680 --> 05:31:06,400 DATA ON, HOW MANY OF THEM DOES 7123 05:31:06,400 --> 05:31:08,080 AN ANIMAL HAVE? 7124 05:31:08,080 --> 05:31:11,560 AS YOU CAN TELL, PRETTY CLEARLY 7125 05:31:11,560 --> 05:31:12,640 HERE, THEY ARE HEALTHY, MOST OF 7126 05:31:12,640 --> 05:31:15,600 THEM HAVE ZERO AND A FEW HAVE 7127 05:31:15,600 --> 05:31:16,520 ONE. 7128 05:31:16,520 --> 05:31:19,760 WHEN WE GET TO 12 AND 13 INJURY 7129 05:31:19,760 --> 05:31:22,200 OLD ANIMALS WE'RE SEEING 7130 05:31:22,200 --> 05:31:23,720 HETEROGENEITY IN THE AMOUNT OF 7131 05:31:23,720 --> 05:31:24,600 MULTIMORBITITIES AND IT'S 7132 05:31:24,600 --> 05:31:27,600 SOMETHING THAT COMES BACK OVER 7133 05:31:27,600 --> 05:31:31,560 AND OVER IN OUR CONVERSATION 7134 05:31:31,560 --> 05:31:39,280 TODAY THAT IT'S A TEE FEWER AND 7135 05:31:39,280 --> 05:31:41,080 NOT A BUG AND UNDERSTANDING THE 7136 05:31:41,080 --> 05:31:47,520 CORRECTIONION OF DISEASE SO YOU 7137 05:31:47,520 --> 05:31:49,040 MIGHT WANT TO KNOW DOES 7138 05:31:49,040 --> 05:31:49,720 MULTIMORBITITIES PRO DICTIONARY 7139 05:31:49,720 --> 05:31:51,560 MORTALITY SO THESE ARE IS 7140 05:31:51,560 --> 05:31:52,440 SURVIVAL CURVES BY I AM DEX EACH 7141 05:31:52,440 --> 05:31:55,080 SO AT AGE FIVE, MOST VICTIMS ARE 7142 05:31:55,080 --> 05:31:56,760 GOING TO LIVE ANOTHER THREE OR 7143 05:31:56,760 --> 05:31:59,040 FOUR YEARS AT LEAST REGARDLESS 7144 05:31:59,040 --> 05:32:04,200 OF HOW MANY MULTIPLE MORBIDITIES 7145 05:32:04,200 --> 05:32:05,560 THEY HAVE. 7146 05:32:05,560 --> 05:32:08,400 FOUR THE BLUE AND THE PURPLE 7147 05:32:08,400 --> 05:32:09,880 HERE, THEY'RE SURVIVING A LOT 7148 05:32:09,880 --> 05:32:10,600 LESSON AVERAGE. 7149 05:32:10,600 --> 05:32:13,600 THOSE ANIMALS THAT EARLY IN LIFE 7150 05:32:13,600 --> 05:32:14,680 HAVE HIGH MULTIMORBITITIES ARE 7151 05:32:14,680 --> 05:32:18,960 LESS LIKELY TO SURVIVE OVER THE 7152 05:32:18,960 --> 05:32:22,840 NEXT GIVEN SEVERAL YEARS AND BY 7153 05:32:22,840 --> 05:32:24,920 AGE 10, WE STILL SEE A LOT OF 7154 05:32:24,920 --> 05:32:25,200 DIFFERENCE. 7155 05:32:25,200 --> 05:32:27,680 THERE'S A LOT OF HETERO BEGIN A 7156 05:32:27,680 --> 05:32:32,600 HETEROGENEITYBETWEEN ZERO AND OK 7157 05:32:32,600 --> 05:32:34,080 SEVEN BUT WHAT IS INTERESTING TO 7158 05:32:34,080 --> 05:32:37,800 ME IS YOU SEE THERE'S A LOT MORE 7159 05:32:37,800 --> 05:32:41,880 OVER LAP MANY OF IT'S NOT A 7160 05:32:41,880 --> 05:32:43,200 COUNCILOR CURT DIFFERENCE. 7161 05:32:43,200 --> 05:32:47,640 OVER ALL IT PREDICTS THROUGH 75% 7162 05:32:47,640 --> 05:32:51,800 OF LIFESPAN AND HAVING A HIGHER 7163 05:32:51,800 --> 05:32:53,600 COUNT INDICATES A SHORTER 7164 05:32:53,600 --> 05:32:59,160 REMAINING LIFESPAN. 7165 05:32:59,160 --> 05:33:04,040 THIS IS OUR HAZARD RATIO SO FOR 7166 05:33:04,040 --> 05:33:05,960 EVERY ADDITIONAL CO MORBID 7167 05:33:05,960 --> 05:33:06,920 CONDITION WHEN YOU ARE YOUNGER 7168 05:33:06,920 --> 05:33:10,240 AND YOU ARE AT AGE FIVE, YOU CAN 7169 05:33:10,240 --> 05:33:13,040 SEE THAT EVERY INDIVIDUAL, EVERY 7170 05:33:13,040 --> 05:33:15,000 ADDITIONAL DISEASE MORE THAN 7171 05:33:15,000 --> 05:33:16,240 DOUBLES YOUR RISK OF DISEASE, OF 7172 05:33:16,240 --> 05:33:20,800 DYING OVER THE NEXT YEAR. 7173 05:33:20,800 --> 05:33:23,000 SO IT HAS A LARGE EFFECT. 7174 05:33:23,000 --> 05:33:25,280 WHAT IS INTERESTING IS IT 7175 05:33:25,280 --> 05:33:27,280 CHANGES OVER THE LIFESPAN AND WE 7176 05:33:27,280 --> 05:33:29,520 MIGHT ASSUME THAT AS WE GET 7177 05:33:29,520 --> 05:33:31,680 OLDER, MULTIPLE MORBIDITY MIGHT 7178 05:33:31,680 --> 05:33:33,960 IN FACT BE WORSE FOR YOU. 7179 05:33:33,960 --> 05:33:40,520 WE'RE SEEING THE OPPOSITE. 7180 05:33:40,520 --> 05:33:42,400 AS THE ANIMALS GET OLDER WE'RE 7181 05:33:42,400 --> 05:33:48,920 SEEING A REDUCT RETHAT OLDER ANS 7182 05:33:48,920 --> 05:33:54,000 MAY BE ABLE TO TOLERATE, BUFFER 7183 05:33:54,000 --> 05:33:54,720 THOSE UNTIL THE POLL CHRONIC 7184 05:33:54,720 --> 05:33:57,080 CONDITIONS AND THIS IS OUR NEXT 7185 05:33:57,080 --> 05:34:00,960 OBSERVATION THAT AS IN HUMANS, 7186 05:34:00,960 --> 05:34:02,600 MULTIMORBITITIES IS CORRELATED 7187 05:34:02,600 --> 05:34:04,480 WITH LIFESPAN. 7188 05:34:04,480 --> 05:34:07,240 THIS SEEMS OBVIOUS BECAUSE THE 7189 05:34:07,240 --> 05:34:11,400 LONGER YOU LIFT CHANCE YOU HAVE 7190 05:34:11,400 --> 05:34:12,600 TO DEVELOP THESE BUT THIS 7191 05:34:12,600 --> 05:34:14,360 SUGGESTS WHEN WE COMBINE IT WITH 7192 05:34:14,360 --> 05:34:17,960 OUR SURVIVAL ANALYSIS, WITH THE 7193 05:34:17,960 --> 05:34:19,720 OLDER ANIMALS THAT LIVED TO 7194 05:34:19,720 --> 05:34:25,680 DEVELOP 10 DOUGH MORBID 7195 05:34:25,680 --> 05:34:28,680 CONDITIONS, THEY'RE ABLE TO BEAT 7196 05:34:28,680 --> 05:34:30,680 THAT AND WITHIN ON TO BE ABLE TO 7197 05:34:30,680 --> 05:34:31,760 MAINTAIN THAT AND INCREASE THE 7198 05:34:31,760 --> 05:34:42,320 NUMBER OF CO MORBID CONDITIONS. 7199 05:35:15,680 --> 05:35:16,440 UNTIL THEY VOLKSWAGEN THESE 7200 05:35:16,440 --> 05:35:19,040 DISEASES AND THEY'RE ABLE TO 7201 05:35:19,040 --> 05:35:19,960 SURVIVE WITH THEM. 7202 05:35:19,960 --> 05:35:24,320 SO MULTIMORBITITIES CAN BE SEEN 7203 05:35:24,320 --> 05:35:28,360 AS AN ADVANCED BIOLOGICAL AGE OR 7204 05:35:28,360 --> 05:35:30,880 FRAILTY YOUNG THE AND WHEN WE 7205 05:35:30,880 --> 05:35:32,200 THINK OF THE CONTEXT OF THE 7206 05:35:32,200 --> 05:35:34,680 OLDER ANIMALS WE MAYBE NEED TO 7207 05:35:34,680 --> 05:35:37,440 SEE A GREATER MULTIMORBITITIES 7208 05:35:37,440 --> 05:35:39,800 AS A MEASURE OF RESILIENCE AND 7209 05:35:39,800 --> 05:35:43,400 NOT THE RESULTS OF POOR 7210 05:35:43,400 --> 05:35:44,520 RESILIENCE SO GIVEN THE 7211 05:35:44,520 --> 05:35:47,320 OVERLAPPING BUT DISTINCT TIVE 7212 05:35:47,320 --> 05:35:49,000 PATTERNS, HOW CAN WE REALLY 7213 05:35:49,000 --> 05:35:59,560 UNDERSTAND WHAT MULTI MORBIDITY 7214 05:36:10,680 --> 05:36:13,120 THAT BY LOOKING FOR ONE OR THE 7215 05:36:13,120 --> 05:36:17,280 OTHER AND MAYBE MISSING THE 7216 05:36:17,280 --> 05:36:17,520 POINTS. 7217 05:36:17,520 --> 05:36:19,320 WE CAN THINK ABOUT TISSUE 7218 05:36:19,320 --> 05:36:20,960 SPECIFIC AND AGING AND THAT 7219 05:36:20,960 --> 05:36:26,240 MIGHT LEAD TO DISEASE AND WE 7220 05:36:26,240 --> 05:36:28,480 SHOULD BE THINKING ABOUT THESE 7221 05:36:28,480 --> 05:36:30,480 BROADER GEROSCIENCE AND WHERE WE 7222 05:36:30,480 --> 05:36:34,640 DO HAVE SORT OF UNDERLYING 7223 05:36:34,640 --> 05:36:35,960 UNIVERSAL PATTERNS THAT SHIFT 7224 05:36:35,960 --> 05:36:39,600 WITH AGE AND CAN LEAD TO 7225 05:36:39,600 --> 05:36:42,920 WIDESPREAD MULTI MORBIDITY AND A 7226 05:36:42,920 --> 05:36:44,080 SINGLE INTERVENTION MAY IMPACT 7227 05:36:44,080 --> 05:36:54,640 ALL DISEASES SO I THINK THAT TO 7228 05:37:06,440 --> 05:37:08,000 DO COLLECTIONS WHICH ARE MUCH 7229 05:37:08,000 --> 05:37:10,680 MORE FEASIBLE IN A LARGE BODY 7230 05:37:10,680 --> 05:37:12,400 MODEL AND IN PARTICULAR, I THINK 7231 05:37:12,400 --> 05:37:14,200 WE NEED TO TAKE EXCELLENT 7232 05:37:14,200 --> 05:37:22,920 ADVANTAGE OF THE MANY AVAILABLE 7233 05:37:22,920 --> 05:37:24,240 BUYER REPOSITORIES SO THANK YOU 7234 05:37:24,240 --> 05:37:25,720 TO EVERYONE WHO HAS WORKED ON 7235 05:37:25,720 --> 05:37:27,720 OUR RARE PROJECT SO FAR AND AS 7236 05:37:27,720 --> 05:37:31,600 WELL AS THE NIANAID FOR FUNDING. 7237 05:37:31,600 --> 05:37:32,000 THANK YOU. 7238 05:37:32,000 --> 05:37:42,200 [APPLAUSE] 7239 05:37:54,760 --> 05:37:57,760 GOOD AFTERNOON, EVERYBODY, I'M 7240 05:37:57,760 --> 05:38:03,720 NATASHA OLBY AND I'M A VET AND A 7241 05:38:03,720 --> 05:38:04,640 NEUROLOGIST AND I AM VERY 7242 05:38:04,640 --> 05:38:06,680 INTERESTED IN UNDERSTANDING THE 7243 05:38:06,680 --> 05:38:10,800 AGING OF THE NERVOUS SYSTEM OF 7244 05:38:10,800 --> 05:38:12,360 COMPANION OR PET DOGS. 7245 05:38:12,360 --> 05:38:16,400 TODAY I'M GOING TO TALK ABOUT 7246 05:38:16,400 --> 05:38:19,160 PET DOGS AND IN PARTICULAR ABOUT 7247 05:38:19,160 --> 05:38:21,760 OUR IDEAS ON HOW WE CAN DEFINE A 7248 05:38:21,760 --> 05:38:24,200 GERIATRIC SYNDROME OF USED TO 7249 05:38:24,200 --> 05:38:29,240 VETS AND HOPEFULLY TO 7250 05:38:29,240 --> 05:38:29,680 GEROSCIENCE AS WELL. 7251 05:38:29,680 --> 05:38:32,400 I WANT TO START OUT FIRST OF ALL 7252 05:38:32,400 --> 05:38:34,320 BY JUST MAKING THE POINT THAT 7253 05:38:34,320 --> 05:38:36,320 DOGS ARE VERY, VERY IMPORTANT IN 7254 05:38:36,320 --> 05:38:38,360 OUR SOCIETY. 7255 05:38:38,360 --> 05:38:40,600 NOW HOW MANY PEOPLE HERE OWN 7256 05:38:40,600 --> 05:38:41,040 DOGS? 7257 05:38:41,040 --> 05:38:42,560 QUITE A FEW OF YOU. 7258 05:38:42,560 --> 05:38:44,480 OKAY, YES. 7259 05:38:44,480 --> 05:38:46,960 SO IN 2017 THEY DID A NICE 7260 05:38:46,960 --> 05:38:54,000 SURVEY AND CONCLUDE THERE WERE 7261 05:38:54,000 --> 05:38:55,480 78.6 MILLION PET DOGS IN 38% OF 7262 05:38:55,480 --> 05:38:57,920 OUTS HOLDS AND 500,000 SERVICE 7263 05:38:57,920 --> 05:38:59,600 DOGS IN THE U.S. AND POST COVID 7264 05:38:59,600 --> 05:39:00,920 WE KNOW EVERYBODY GOT DOGS SO 7265 05:39:00,920 --> 05:39:04,600 THE NUMBER IS CLOSER TO 90 AT 7266 05:39:04,600 --> 05:39:06,880 THIS POINT SO VERY, VERY 7267 05:39:06,880 --> 05:39:08,760 IMPORTANT IN OUR SOCIETY. 7268 05:39:08,760 --> 05:39:11,040 AS A VET, I HOPE THEY'RE ALL 7269 05:39:11,040 --> 05:39:20,480 GOING TO COME TO SEE US. 7270 05:39:20,480 --> 05:39:22,640 KAMALA HARRIS WE COLLECT USEFUL 7271 05:39:22,640 --> 05:39:23,840 DATA FOR OUR TRAMS RATIONALLY 7272 05:39:23,840 --> 05:39:26,080 SEARCH AND OUR VET RESEARCH THAT 7273 05:39:26,080 --> 05:39:26,880 ARE COMING INTO VETS. 7274 05:39:26,880 --> 05:39:28,480 THERE ARE PEOPLE LIKE ME IN 7275 05:39:28,480 --> 05:39:30,000 EVERY ACADEMIC INSTITUTION WHO 7276 05:39:30,000 --> 05:39:31,320 ARE DOING THEIR RESEARCH 7277 05:39:31,320 --> 05:39:35,840 PROJECTS AND COLLECTING DATA AND 7278 05:39:35,840 --> 05:39:37,640 COLLABORATING AND SHARING WE IN 7279 05:39:37,640 --> 05:39:38,880 ADDITION WE HAD GREAT 7280 05:39:38,880 --> 05:39:42,560 OPPORTUNITIES FOR LARGE DATASETS 7281 05:39:42,560 --> 05:39:46,480 NOW AND SO THEY HAVE NUMBER OF 7282 05:39:46,480 --> 05:39:47,800 ANIMALS AND WE START LOOKING AT 7283 05:39:47,800 --> 05:39:49,520 RESEARCH PROJECT DATABASES AND I 7284 05:39:49,520 --> 05:39:52,720 AM TENSIONAL PROSPECTIVE WELL 7285 05:39:52,720 --> 05:39:54,520 DESIGNED STUDIES USING A CITIZEN 7286 05:39:54,520 --> 05:39:55,760 SCIENCE APPROACH SO GOING OUT TO 7287 05:39:55,760 --> 05:39:57,400 THE CITIZENRY AND GETTING THEM 7288 05:39:57,400 --> 05:40:00,320 TO SUBMIT SAMPLES AND FILL OUT 7289 05:40:00,320 --> 05:40:01,720 ANOTHER OF QUESTIONNAIRES SO WE 7290 05:40:01,720 --> 05:40:03,680 HAVE A LIFETIME IN GOLDEN 7291 05:40:03,680 --> 05:40:07,000 RETRIEVERS TRETRIEVERS BEEN GOIE 7292 05:40:07,000 --> 05:40:08,520 LOOKING AT CANCER AND AGING AND 7293 05:40:08,520 --> 05:40:10,800 WE HAVE THE MONSTER DOG AGING 7294 05:40:10,800 --> 05:40:12,560 PROJECT THAT IS A REALLY 7295 05:40:12,560 --> 05:40:19,720 GENERATED A LOT OF DATA ON 7296 05:40:19,720 --> 05:40:21,600 AIMING AND PRIMARY VET CARE HAS 7297 05:40:21,600 --> 05:40:22,880 BEEN CORPORATE TIESED AND THERE 7298 05:40:22,880 --> 05:40:24,680 ARE VERY LARGE CORPORATE 7299 05:40:24,680 --> 05:40:27,840 PRACTICES ACROSS THE UNITED 7300 05:40:27,840 --> 05:40:31,680 STATES AND THEY ALL'S THE SAME 7301 05:40:31,680 --> 05:40:35,360 ELECTRONIC DATABASE AND THEY 7302 05:40:35,360 --> 05:40:38,840 HAVE LARGE STUDIES LOOKING AT 7303 05:40:38,840 --> 05:40:39,520 AGING, FOR EXAMPLE. 7304 05:40:39,520 --> 05:40:40,360 WE HAVE INSURANCE RECORDS. 7305 05:40:40,360 --> 05:40:42,120 THESE ARE MUCH MORE COMMONLY 7306 05:40:42,120 --> 05:40:44,400 USED IN EUROPE WHEN COMPARED TO 7307 05:40:44,400 --> 05:40:46,400 HERE BECAUSE IN EUROPE, MOST 7308 05:40:46,400 --> 05:40:48,120 PETS ARE INSURED AND WELL 7309 05:40:48,120 --> 05:40:49,280 CERTAIN COUNTRY AND AMERICA 7310 05:40:49,280 --> 05:40:51,080 THAT'S LESS COMMON AND AGAIN, 7311 05:40:51,080 --> 05:40:55,480 THEY HAVE VERY DETAILED DATAB 7312 05:40:55,480 --> 05:41:05,680 DATABASES. 7313 05:41:18,560 --> 05:41:19,240 THE INTENTION POINT IS WHETHER 7314 05:41:19,240 --> 05:41:20,800 OR NOT DOGS ARE RELEVANT TO 7315 05:41:20,800 --> 05:41:21,200 HUMAN NATURE. 7316 05:41:21,200 --> 05:41:22,360 I WOULD SAY YES. 7317 05:41:22,360 --> 05:41:24,000 THEY LIVE IN OUR ENVIRONMENT AND 7318 05:41:24,000 --> 05:41:25,920 WE'VE HEARD A LOT ABOUT HOW OUR 7319 05:41:25,920 --> 05:41:27,600 ENVIRONMENT PLAYS A ROLE SO THEY 7320 05:41:27,600 --> 05:41:34,240 SHARE THE AIR WE BREATH, THEY 7321 05:41:34,240 --> 05:41:37,200 SHARE ALL THE CHEMICALS, THEY 7322 05:41:37,200 --> 05:41:38,080 SHARE OUR FOOD. 7323 05:41:38,080 --> 05:41:40,080 MY DAUGHTER IS SHARING HER DOG'S 7324 05:41:40,080 --> 05:41:41,680 FOOD BUT USUALLY IT'S THE OTHER 7325 05:41:41,680 --> 05:41:42,320 WAY AROUND. 7326 05:41:42,320 --> 05:41:43,960 AND I THINK A COUPLE OF THINGS 7327 05:41:43,960 --> 05:41:52,480 WE DON'T TALK ABOUT SO MUCH, 7328 05:41:52,480 --> 05:41:53,720 THEY SHARE THE EXERCISE PATTERNS 7329 05:41:53,720 --> 05:41:57,920 AND THE SLEEP PATTERNS OF THE 7330 05:41:57,920 --> 05:42:01,800 HOUSEHOLD AND YOU MIGHT SAY 7331 05:42:01,800 --> 05:42:03,000 THEY'RE NOT EFFECTED BY THOSE 7332 05:42:03,000 --> 05:42:05,040 BUT I LOVE THE PAPER THAT SHOWS 7333 05:42:05,040 --> 05:42:08,120 THAT DOGS WITH HIGHER ANXIETY GO 7334 05:42:08,120 --> 05:42:09,800 GRAY SOONER. 7335 05:42:09,800 --> 05:42:11,480 THEY HAVE PREMATURE GRAYING. 7336 05:42:11,480 --> 05:42:13,240 IF YOU ARE STRESSED AS A DOG YOU 7337 05:42:13,240 --> 05:42:15,680 GO GRAY SOONER AND THEY ARE 7338 05:42:15,680 --> 05:42:17,240 STRESSORS AND THERE'S BEAUTIFUL 7339 05:42:17,240 --> 05:42:23,120 DATA AVAILABLE ON HOW SOMEONE'S 7340 05:42:23,120 --> 05:42:25,080 OWNERSHIP STYLE CAN EFFECT THEIR 7341 05:42:25,080 --> 05:42:25,960 ANXIETY LEVELS AND FOR EXAMPLE 7342 05:42:25,960 --> 05:42:30,520 AND FINALLY HAS BEEN MENTIONED A 7343 05:42:30,520 --> 05:42:32,560 LOT IN THIS PARTICULAR DAY OF 7344 05:42:32,560 --> 05:42:34,400 TALKS, UNFORTUNATELY WE SEE 7345 05:42:34,400 --> 05:42:35,400 SOCIOECONOMIC CONSEQUENCES WHEN 7346 05:42:35,400 --> 05:42:45,760 IT COMES TO LIFESPAN. 7347 05:42:49,800 --> 05:42:55,520 WE CAN LOOK AT OBSERVATIONAL AND 7348 05:42:55,520 --> 05:42:56,520 INTERSECTIONAL STUDIES SO THAT 7349 05:42:56,520 --> 05:42:58,360 IS A VERY HELPFUL THINGS BUT I 7350 05:42:58,360 --> 05:43:02,560 ALSO WANTED TO POINT SOMETHING 7351 05:43:02,560 --> 05:43:12,400 OUT HERE, AND THEY GO THROUGH 7352 05:43:12,400 --> 05:43:13,640 THE LIFE STAGES AND I WANT TO 7353 05:43:13,640 --> 05:43:16,000 POINT OUT VERY IMPORTANT THING, 7354 05:43:16,000 --> 05:43:17,440 THEY ACCELERATE THROUGH MUCH 7355 05:43:17,440 --> 05:43:19,440 QUICKER SO THEY LEAVE HOME MUCH 7356 05:43:19,440 --> 05:43:21,480 SOONER FOR OUR PARENTS OUT THERE 7357 05:43:21,480 --> 05:43:23,120 SO DOGS GO THERE THAT QUICKLY 7358 05:43:23,120 --> 05:43:33,440 BUT THEY EVEN OUT. 7359 05:43:36,160 --> 05:43:39,200 A DOG WITH BE A SMALL AND A 7360 05:43:39,200 --> 05:43:39,520 GREAT DANE. 7361 05:43:39,520 --> 05:43:41,400 I DO SURGEON BOTH AND IT'S GREAT 7362 05:43:41,400 --> 05:43:45,240 FUN. 7363 05:43:45,240 --> 05:43:50,960 THEY ARE COMPLETELY DIFF COMPLE. 7364 05:43:50,960 --> 05:43:52,280 THERE'S A OBVIOUS DIFFERENCE IN 7365 05:43:52,280 --> 05:43:54,920 SIZE IS THE LITTLE TINY DOGS 7366 05:43:54,920 --> 05:43:59,920 LIVE MUCH IMPORTANT ABOUT THE 7367 05:43:59,920 --> 05:44:02,960 GIANT DEGREED BOGS AND TOY AND 7368 05:44:02,960 --> 05:44:05,160 WHAT THAT DRAMATIC PHENOTYPIC 7369 05:44:05,160 --> 05:44:06,400 DIFFERENCE IN LIFESPAN ALLOWS US 7370 05:44:06,400 --> 05:44:08,840 TO DO WITH THE ASK QUESTIONS 7371 05:44:08,840 --> 05:44:10,360 ABOUT DIFFERENT ORGAN SYSTEMS 7372 05:44:10,360 --> 05:44:13,200 AND WHETHER THEY AGE RELATED TO 7373 05:44:13,200 --> 05:44:23,720 THE STAGE OF LIFE, OR THEY'RE 7374 05:44:26,880 --> 05:44:29,960 HERE AND THEY ASK YOU QUESTIONS 7375 05:44:29,960 --> 05:44:33,600 OF THIS COGNITION DECLINE AND 7376 05:44:33,600 --> 05:44:34,920 THEY WERE JUST RELATED TO THE 7377 05:44:34,920 --> 05:44:36,640 AMOUNT OF TIME THAT YOU ARE ON 7378 05:44:36,640 --> 05:44:38,960 EARTH OR A COMPRESSION THEORY 7379 05:44:38,960 --> 05:44:40,720 DOES IF ACCELERATE THROUGH WITH 7380 05:44:40,720 --> 05:44:41,880 YOUR LIFE STAGE AND THEY 7381 05:44:41,880 --> 05:44:44,120 COLLECTED A TON MUCH DATA FROM 7382 05:44:44,120 --> 05:44:46,080 OWNERS DOING COGNITIVE TESTS AT 7383 05:44:46,080 --> 05:44:47,680 HOME AND SUBMITTING THAT DATA 7384 05:44:47,680 --> 05:44:50,000 AND SHOWED VERY CLEARLY THAT IT 7385 05:44:50,000 --> 05:45:00,400 WAS RELATED TO THEY ARE 7386 05:45:14,000 --> 05:45:15,480 COGNITIVELY NOT FINE SO WHAT I 7387 05:45:15,480 --> 05:45:17,800 SEE COMPARES WITH THAT. 7388 05:45:17,800 --> 05:45:20,000 ALSO THEIR GENETIC MAKE UP LENDS 7389 05:45:20,000 --> 05:45:20,880 ITSELF TO DISCOVERY. 7390 05:45:20,880 --> 05:45:24,000 SO BREEDING FOR PHYSICAL AND 7391 05:45:24,000 --> 05:45:25,560 BEHAVIORAL TRAITS MEANS WE GET 7392 05:45:25,560 --> 05:45:28,840 LONG RUNS OF HOME SEW SIGH GOSSE 7393 05:45:28,840 --> 05:45:30,640 TEE AND WE HAVE DISEASES WITH A 7394 05:45:30,640 --> 05:45:34,640 SINGLE EFFECTED DOG AT THIS 7395 05:45:34,640 --> 05:45:44,720 POINT. 7396 05:45:50,360 --> 05:45:52,120 SO HAVING SAID ALL OF THAT, I 7397 05:45:52,120 --> 05:45:57,280 WANT TO GET ON TALK A LITTLE BIT 7398 05:45:57,280 --> 05:45:58,840 ABOUT OLD DOGS AND I HOPE THIS 7399 05:45:58,840 --> 05:46:00,720 WILL SHOW YOU MY VIDEO. 7400 05:46:00,720 --> 05:46:03,040 SO HERE IS AN OLD DOG TAKING 7401 05:46:03,040 --> 05:46:04,640 PART IN OUR TRIAL AND SHE'S 7402 05:46:04,640 --> 05:46:06,120 DOING A TEST OF ATTENTION. 7403 05:46:06,120 --> 05:46:08,000 SHE KNOWS THIS HANDLER WELL BUT 7404 05:46:08,000 --> 05:46:09,280 SHE CAN NO LONGER UNDERSTAND 7405 05:46:09,280 --> 05:46:13,120 WHAT HE WANTS HER TO DO. 7406 05:46:13,120 --> 05:46:16,920 SHE'S GATHERED SOME LUMPS AND 7407 05:46:16,920 --> 05:46:19,960 BUMPS AND SEE A VERY POOR BODY 7408 05:46:19,960 --> 05:46:20,360 CONDITION. 7409 05:46:20,360 --> 05:46:24,280 SO THAT IS AN OLD DOG AND EVERY 7410 05:46:24,280 --> 05:46:27,120 VET SEES LOTS OF OLD DOGS BUT WE 7411 05:46:27,120 --> 05:46:30,000 TEND TO SEE THEM AS A LIST 7412 05:46:30,000 --> 05:46:31,840 DIAGNOSIS AND RATHER THAN SEE 7413 05:46:31,840 --> 05:46:35,640 THEM HOLISTICALLY AND WHAT WE 7414 05:46:35,640 --> 05:46:38,360 WOULD REALLY LIKE TO DO IS TRY 7415 05:46:38,360 --> 05:46:40,600 TO CAPTURE ALL OF THE DIFFERENT 7416 05:46:40,600 --> 05:46:41,480 THINGS THAT ARE HAPPENING AND 7417 05:46:41,480 --> 05:46:45,920 PULL THEM TOGETHER AND DEFINE 7418 05:46:45,920 --> 05:46:50,120 THE GERIATRIC SYNDROME SO I WANT 7419 05:46:50,120 --> 05:46:52,520 TO TALK ABOUT THIS PAPER BY 7420 05:46:52,520 --> 05:46:54,560 MCKENZIE SO THIS IDEA WAS 7421 05:46:54,560 --> 05:47:00,200 BROUGHT BY FRANCIS AND THEY 7422 05:47:00,200 --> 05:47:01,560 COLLABORATED WITH US AND IT CALL 7423 05:47:01,560 --> 05:47:04,640 CAME TO ME AND THEY PROSE POD A 7424 05:47:04,640 --> 05:47:05,680 FRAMEWORK TO ESTABLISH A 7425 05:47:05,680 --> 05:47:08,240 CLINICAL DIAGNOSIS OF A 7426 05:47:08,240 --> 05:47:10,320 GERIATRIC SYNDROME AND IT WOULD 7427 05:47:10,320 --> 05:47:12,920 ALLOW VETS TO CAPTURE CHANGES 7428 05:47:12,920 --> 05:47:14,960 WHEN THEY WERE PRE CLIP CAL. 7429 05:47:14,960 --> 05:47:16,640 THAT IS THE HOPE AND AIM WE CAN 7430 05:47:16,640 --> 05:47:19,160 CAPTURE AND INTERVENE AND SEE 7431 05:47:19,160 --> 05:47:22,080 AGE AS A RISK FACTOR FOR THE 7432 05:47:22,080 --> 05:47:22,760 VARIOUS DIFFERENT THINGS GOING 7433 05:47:22,760 --> 05:47:24,480 ON AND INTERVENE AND ALSO IT 7434 05:47:24,480 --> 05:47:26,360 WOULD REALLY FACILITATE RESEARCH 7435 05:47:26,360 --> 05:47:27,880 INTO PRACTICE AND IMPACTING 7436 05:47:27,880 --> 05:47:30,360 HEALTH SPAN AND A LOUSE YOU TO 7437 05:47:30,360 --> 05:47:33,200 TRY TO UNDERSTAND WHAT MOLECULAR 7438 05:47:33,200 --> 05:47:34,400 MECHANISMS ARE LEADING TO 7439 05:47:34,400 --> 05:47:44,720 CLINICAL DISEASE. 7440 05:47:52,600 --> 05:47:54,480 AND ONE ISN'T REALLY WELL 7441 05:47:54,480 --> 05:47:58,000 DEFINED YET IN PHENOTYPE AND 7442 05:47:58,000 --> 05:47:59,440 LOOKING AT THE CLINICAL KILLS 7443 05:47:59,440 --> 05:48:02,960 CEASES AND QUALITY OF LIFE AND 7444 05:48:02,960 --> 05:48:04,520 CAREGIVER BURDEN. 7445 05:48:04,520 --> 05:48:06,920 I FEEL THIS IS CENTRAL TO VET 7446 05:48:06,920 --> 05:48:08,960 MEDICINE BECAUSE THE MOST COMMON 7447 05:48:08,960 --> 05:48:14,240 END POINT THAT WEN COUNTER FOR 7448 05:48:14,240 --> 05:48:18,480 ENDERLY DOGS IS HUMAN EUTHANASIA 7449 05:48:18,480 --> 05:48:20,480 AND IT HAPPENS WHEN A OWNER OR 7450 05:48:20,480 --> 05:48:22,280 VET, A SUPPORT SYSTEM AROUND 7451 05:48:22,280 --> 05:48:25,800 THEM DECIDE THE QUALITY OF LIFE 7452 05:48:25,800 --> 05:48:27,480 IS UNACCEPTABLE AND THERE'S NO 7453 05:48:27,480 --> 05:48:30,720 CHANCE OF ALTERING THAT IN A 7454 05:48:30,720 --> 05:48:31,440 POSITIVE DIRECTION. 7455 05:48:31,440 --> 05:48:35,600 IT'S A IMPORTANT END POINT FOR 7456 05:48:35,600 --> 05:48:45,680 US. 7457 05:48:50,880 --> 05:48:54,480 WE SEE LUMPS AND BUMPS AND LOTS 7458 05:48:54,480 --> 05:48:59,520 OF LIE POMA THAT PROBLEM IF THEY 7459 05:48:59,520 --> 05:49:01,320 GET BIG AND WE SEE LOSS OF 7460 05:49:01,320 --> 05:49:03,440 VISION AND HEARING AND THE 7461 05:49:03,440 --> 05:49:04,840 SCLEROSIS AND CAT A RACK 7462 05:49:04,840 --> 05:49:08,240 FORMATION AND WE SEE CHANGES IN 7463 05:49:08,240 --> 05:49:09,880 BODY CONDITION AND WE KNOW 7464 05:49:09,880 --> 05:49:11,560 OBESITY AND MIDDLE AGE FOR DOGS 7465 05:49:11,560 --> 05:49:16,640 IS NEGATIVE LEOSATED WITH 7466 05:49:16,640 --> 05:49:17,000 LIFESPAN. 7467 05:49:17,000 --> 05:49:21,960 WE KNOW FROM THE WORK WE'VE DONE 7468 05:49:21,960 --> 05:49:23,760 THAT SARK OWE PENA IS ASSOCIATED 7469 05:49:23,760 --> 05:49:27,440 WITH SIX MONTH MORTALITY AND 7470 05:49:27,440 --> 05:49:33,320 KEITH, OH TEETH. 7471 05:49:33,320 --> 05:49:34,560 DOGS DON'T BRUSH THEIR TEETH AND 7472 05:49:34,560 --> 05:49:35,680 PARTICULARLY THE SMALL BREEDS 7473 05:49:35,680 --> 05:49:37,520 HAVE JUST THE MOST TERRIBLE 7474 05:49:37,520 --> 05:49:38,800 MOUTHS AND WHEN YOU DON'T WANT 7475 05:49:38,800 --> 05:49:41,120 TO GET BIT BY AN OLD DOG, THAT'S 7476 05:49:41,120 --> 05:49:45,000 MU AADVICE TO YOU. 7477 05:49:45,000 --> 05:49:47,280 WE LOOKED AT THE ORAL MICROBIOME 7478 05:49:47,280 --> 05:49:50,600 IN DOGS AND WITH AGE THEY GET 7479 05:49:50,600 --> 05:49:56,000 THIS PER PONDERANCE PRODUCING 7480 05:49:56,000 --> 05:49:58,320 BACTERIA AND ALSO ONE STUDY, ONE 7481 05:49:58,320 --> 05:50:02,400 OF THE LARGER STUDIES THAT'S 7482 05:50:02,400 --> 05:50:06,280 BEEN DONE ON LIFESPAN, IT WAS 7483 05:50:06,280 --> 05:50:08,520 ASSOCIATED WITH A LONGER 7484 05:50:08,520 --> 05:50:10,320 LIFESPAN SO THOSE DENTAL CHANGES 7485 05:50:10,320 --> 05:50:14,560 ARE IMPORTANT. 7486 05:50:14,560 --> 05:50:15,760 AND WE HAVE FINANCINGAL CHANGES. 7487 05:50:15,760 --> 05:50:25,440 IN PEOPLFUNCTIONAL CHANGES.IT'SO 7488 05:50:25,440 --> 05:50:27,760 WHAT WE WANT THEM TO DO AND WE 7489 05:50:27,760 --> 05:50:28,960 DON'T HAVE THE HAND GRIP. 7490 05:50:28,960 --> 05:50:33,600 WE CAN DO JAW GRIP BUT I IF THEY 7491 05:50:33,600 --> 05:50:34,200 DON'T UNDERSTAND THERE'S 7492 05:50:34,200 --> 05:50:34,560 PROBLEMS. 7493 05:50:34,560 --> 05:50:38,640 WE HAVE A FEW VERY SIMPLE 7494 05:50:38,640 --> 05:50:46,120 MEASURES AND THOSE DOGS KNOW THE 7495 05:50:46,120 --> 05:50:49,560 HANDLERS VERY WELL AND THEY ARE 7496 05:50:49,560 --> 05:50:50,520 JUST PET DOGS. 7497 05:50:50,520 --> 05:50:52,200 THEY HAVE A SOTE DISTANCE TO 7498 05:50:52,200 --> 05:50:54,600 MOVE OVER AND THEY'RE RELEASED 7499 05:50:54,600 --> 05:50:55,960 AND CALLED FOR A TREAT. 7500 05:50:55,960 --> 05:50:58,080 ONE DOG MAKES IT REALLY FAST AND 7501 05:50:58,080 --> 05:51:08,640 THE OTHER DO MAKES IT BUT LOWER. 7502 05:51:12,520 --> 05:51:14,520 WE THINK THIS IS A ROBUST AND 7503 05:51:14,520 --> 05:51:16,560 USEFUL TEST THAT WE HAVE 7504 05:51:16,560 --> 05:51:19,760 DEVELOPED. 7505 05:51:19,760 --> 05:51:20,800 AND WE HAVE CHANGES AND THEY 7506 05:51:20,800 --> 05:51:24,000 REALLY MOVE INTO THAT SPHERE OF 7507 05:51:24,000 --> 05:51:24,800 OWNERS DECIDE TAG THEY'VE 7508 05:51:24,800 --> 05:51:28,200 REACHED THE POINT, OKAY. 7509 05:51:28,200 --> 05:51:32,560 THE POINT OF EUTHANASIA SO WE'VE 7510 05:51:32,560 --> 05:51:37,840 SHOWN AS DOGS LOSE THEIR 7511 05:51:37,840 --> 05:51:41,680 HEARINGS, THEY SCORE THEM LOWER. 7512 05:51:41,680 --> 05:51:43,080 CHANGES IN-HOUSE TRAINING AND 7513 05:51:43,080 --> 05:51:45,320 SLEEP PATTERNS AND THOSE ARE 7514 05:51:45,320 --> 05:51:46,440 TERRIBLE FOR THE DOGS AND WORSE 7515 05:51:46,440 --> 05:51:48,880 FOR THE OWNERS SO THOSE CAN 7516 05:51:48,880 --> 05:51:53,040 TRIGGER A TIME WHERE IT'S 7517 05:51:53,040 --> 05:51:59,400 EUTHANASIA TIME. 7518 05:51:59,400 --> 05:52:01,800 MANY DOGS GET MORE ANXIOUS AS 7519 05:52:01,800 --> 05:52:02,120 THEY AGE. 7520 05:52:02,120 --> 05:52:04,000 THESE THINGS COME SOLIDLY INTO 7521 05:52:04,000 --> 05:52:05,520 THE FUNCTIONAL HALLMARKS OF 7522 05:52:05,520 --> 05:52:09,360 CHANGES IN COGNITION AND 7523 05:52:09,360 --> 05:52:14,480 MOBILITY. 7524 05:52:14,480 --> 05:52:16,280 WE'RE LOOKING AT CLINICAL 7525 05:52:16,280 --> 05:52:16,640 DISEASE. 7526 05:52:16,640 --> 05:52:19,120 I HAVE A SUMMARY SLIDE FROM THE 7527 05:52:19,120 --> 05:52:21,920 DOG AGING PROJECT. 7528 05:52:21,920 --> 05:52:24,200 IN THIS PROJECT THEY LOOKED AT 7529 05:52:24,200 --> 05:52:28,800 THE DIFFERENT DISEASE PROCESSES 7530 05:52:28,800 --> 05:52:30,160 THAT HAPPENED WITH AGE. 7531 05:52:30,160 --> 05:52:33,400 AND THEN THE ACTUAL SYSTEMS. 7532 05:52:33,400 --> 05:52:34,840 THEY COMPARED AND CONTRASTED 7533 05:52:34,840 --> 05:52:37,960 THEM TO HUMANS. 7534 05:52:37,960 --> 05:52:40,560 YOU HAVE HUMANS AT THE TOP AND 7535 05:52:40,560 --> 05:52:49,640 DOGS AT THE BOTTOM. 7536 05:52:49,640 --> 05:52:51,160 IN MANY WAYS THEY'RE SIMILAR BUT 7537 05:52:51,160 --> 05:52:53,040 THERE'S ONE DRAMATIC DIFFERENCE, 7538 05:52:53,040 --> 05:52:54,960 DRAMATIC DIFFERENCE, AND THAT 7539 05:52:54,960 --> 05:52:57,720 DIFFERENCE IS VASCULAR DISEASE. 7540 05:52:57,720 --> 05:53:05,520 ZOO THERE IT IS IN HUMANS AND 7541 05:53:05,520 --> 05:53:06,600 THERE IT IS IN DOGS. 7542 05:53:06,600 --> 05:53:11,600 WE SEE DON'T HAVE DOGS DIE OF 7543 05:53:11,600 --> 05:53:12,880 VASCULAR DISEASE. 7544 05:53:12,880 --> 05:53:15,240 WHAT DO WE KNOW ABOUT DISEASE 7545 05:53:15,240 --> 05:53:17,240 CLUSTERS IN DOGS AND I THOUGHT 7546 05:53:17,240 --> 05:53:20,960 THESE WOULD SUMMARIZE TWO POINTS 7547 05:53:20,960 --> 05:53:23,480 AND IF YOU LOOK AT DISEASE 7548 05:53:23,480 --> 05:53:26,920 CLUSTERS, YOU CAN ACTUALLY GROUP 7549 05:53:26,920 --> 05:53:29,520 DOGS BY LIFE STAGE. 7550 05:53:29,520 --> 05:53:31,680 WE CAN DEFINE DEFINITE DISEASE 7551 05:53:31,680 --> 05:53:32,600 CLUSTERS FOR THE DIFFERENT 7552 05:53:32,600 --> 05:53:36,200 STAGES OF LIFE. 7553 05:53:36,200 --> 05:53:37,080 ANOTHER ONE AND THIS IS 7554 05:53:37,080 --> 05:53:38,520 INTERESTING TO ME IN THIS PAPER 7555 05:53:38,520 --> 05:53:40,840 THEY DIVIDED DOGS INTO SMALL, 7556 05:53:40,840 --> 05:53:43,600 MEDIUM AND LARGE BREED DOGS AND 7557 05:53:43,600 --> 05:53:45,520 THEY HAVE DIFFERENT LIFE SPANS 7558 05:53:45,520 --> 05:53:47,440 AND YET WHEN YOU LOOK AT THEIR 7559 05:53:47,440 --> 05:53:49,800 ACCRUAL OF MORBIDITIES AND THE 7560 05:53:49,800 --> 05:53:51,960 NUMBER OF MORBIDITIES THEY HAVE 7561 05:53:51,960 --> 05:53:55,800 IT AGES, IT HAPPENS AT THE SAME 7562 05:53:55,800 --> 05:53:56,400 RATE. 7563 05:53:56,400 --> 05:53:57,960 SO THAT IS INTERESTING TO THINK 7564 05:53:57,960 --> 05:53:58,880 ABOUT, ISN'T IT. 7565 05:53:58,880 --> 05:54:01,240 IT'S REALLY INTERESTING TO THINK 7566 05:54:01,240 --> 05:54:02,920 ABOUT AND IT GIVES ME A HEADACHE 7567 05:54:02,920 --> 05:54:03,760 TO THINK ABOUT IT. 7568 05:54:03,760 --> 05:54:05,800 WE HAVE METABOLIC CHANGES AND 7569 05:54:05,800 --> 05:54:08,600 WE'RE WAY BEHIND THE HUMAN 7570 05:54:08,600 --> 05:54:10,200 MEDICINE ON THAN THIS AND 7571 05:54:10,200 --> 05:54:14,120 SURVISUFFICE IT TO SAY WE SEE CS 7572 05:54:14,120 --> 05:54:16,200 IN FAT DISTRIBUTION AND 7573 05:54:16,200 --> 05:54:17,680 REDISTRIBUTES FROM UNDER THE 7574 05:54:17,680 --> 05:54:20,360 SKIN AND WE SEE INSULIN 7575 05:54:20,360 --> 05:54:22,280 RESISTANCE ASSOCIATED WITH THAT 7576 05:54:22,280 --> 05:54:25,800 AND WE SEE DIFFERENT LIPID 7577 05:54:25,800 --> 05:54:32,760 PROFILES WITH AGE AND WE KNOW IT 7578 05:54:32,760 --> 05:54:34,720 WILL PREDICT MORTALITY AND SOME 7579 05:54:34,720 --> 05:54:37,240 OF THE BEST STUDY WAS THIS STUDY 7580 05:54:37,240 --> 05:54:40,560 AND IT STARTED IN 1987 AND IT 7581 05:54:40,560 --> 05:54:44,560 WAS A DIETARY RESTRICTION AND 7582 05:54:44,560 --> 05:54:46,200 THE OLDEST DOG LIVED TO BE 15 7583 05:54:46,200 --> 05:54:48,120 AND A HALF AND THEY DID IT IN 7584 05:54:48,120 --> 05:54:50,680 LABRADOR RETRIEVERS, A BREED 7585 05:54:50,680 --> 05:54:53,840 THAT LOVES TO EAT AND THEY TOOK 7586 05:54:53,840 --> 05:54:56,640 DOG PAIRS AND THEY GAVE ONE THE 7587 05:54:56,640 --> 05:55:01,120 START FREE CHOICE FOOD AND THE 7588 05:55:01,120 --> 05:55:03,080 OTHER 75% CALORIE RESTRICTION, I 7589 05:55:03,080 --> 05:55:05,280 GUESS 25% CALORIE RESTRICTION 7590 05:55:05,280 --> 05:55:06,920 AND 75% OF WHAT THEY WANTED AND 7591 05:55:06,920 --> 05:55:08,320 AFTER A COUPLE YEARS THEY HAD TO 7592 05:55:08,320 --> 05:55:09,880 CHANGE THAT BECAUSE THE FREE 7593 05:55:09,880 --> 05:55:11,800 CHOICE LABS WERE GETTING SO 7594 05:55:11,800 --> 05:55:15,520 OBESE SO THE FREE CHOICE BECAME 7595 05:55:15,520 --> 05:55:16,360 SENSIBLE CHOICE BUT WHAT THEY 7596 05:55:16,360 --> 05:55:17,920 SHOWED VERY, VERY DEFINITELY 7597 05:55:17,920 --> 05:55:19,800 WITH 245 WAS A CHANGE IN 7598 05:55:19,800 --> 05:55:21,800 LIFESPAN, AND A STRONG 7599 05:55:21,800 --> 05:55:23,000 EVERYTHING ON HEALTH SPAN 7600 05:55:23,000 --> 05:55:25,640 INCLUDING AN EFFECT ON OSTEO 7601 05:55:25,640 --> 05:55:27,000 ARTHRITIS WHICH IS A REALLY 7602 05:55:27,000 --> 05:55:29,040 IMPORTANT MORBIDITY IN LABS AND 7603 05:55:29,040 --> 05:55:31,320 THEN ALL OF THESE METABOLIC 7604 05:55:31,320 --> 05:55:32,880 EFFECTS THEY DEFINE THEM 7605 05:55:32,880 --> 05:55:34,280 EXTREMELY WELL IN THIS 7606 05:55:34,280 --> 05:55:37,560 PARTICULAR STUDY. 7607 05:55:37,560 --> 05:55:38,960 DO WE HAVE ANYTHING WE USE IN 7608 05:55:38,960 --> 05:55:40,720 THE CLINIC YET? 7609 05:55:40,720 --> 05:55:41,680 NO WE DON'T. 7610 05:55:41,680 --> 05:55:43,000 AND FRAILTY, I MADE THE COMMENT 7611 05:55:43,000 --> 05:55:46,440 THAT WE DON'T HAVE A FRAILTY 7612 05:55:46,440 --> 05:55:46,840 PHENOTYPE. 7613 05:55:46,840 --> 05:55:49,640 WE CAN ASK DO DOGS GET FRAIL AND 7614 05:55:49,640 --> 05:55:53,960 HERE IS A LITTLE FRAIL DOG. 7615 05:55:53,960 --> 05:55:54,720 SHE'S 15. 7616 05:55:54,720 --> 05:55:58,400 SHE'S HAVING TROUBLE GETTING 7617 05:55:58,400 --> 05:55:59,000 AROUND. 7618 05:55:59,000 --> 05:56:03,360 SHE HAS REPEATED INFECTIONS AND 7619 05:56:03,360 --> 05:56:04,840 SHE'S LOST A LOT OF MUSCLE AND 7620 05:56:04,840 --> 05:56:07,240 SHE'S BECOME VERY, VERY WEAK AND 7621 05:56:07,240 --> 05:56:08,080 FRAIL. 7622 05:56:08,080 --> 05:56:10,200 WHAT YOU FIND IN VET MEDICINE 7623 05:56:10,200 --> 05:56:12,880 AND THEY'LL A OH MY DOG DIED OF 7624 05:56:12,880 --> 05:56:15,400 OLD AGE SO WE BELIEVE THEY'LL 7625 05:56:15,400 --> 05:56:18,880 THE FRAIL NI KNOWN FEN OWE TYPE. 7626 05:56:18,880 --> 05:56:21,520 THERE'S ONE PUBLISHED INDEX AND 7627 05:56:21,520 --> 05:56:22,800 THEY'RE BOTH DIFFICULT TO APPLY 7628 05:56:22,800 --> 05:56:26,040 SO WE DEVELOPED A VERY SIMPLE 7629 05:56:26,040 --> 05:56:30,680 FRAILTY PHONFRAIL PHENOTYPE BECE 7630 05:56:30,680 --> 05:56:35,200 OBSEOWNER DECIDEWHEN THEY'LL EUR 7631 05:56:35,200 --> 05:56:37,800 DOGS SO WE ADDED IN MUSCLE 7632 05:56:37,800 --> 05:56:41,400 CONDITIONS SCORING AND BODY 7633 05:56:41,400 --> 05:56:44,440 CONDITION SCORE AND OF YOU APPLY 7634 05:56:44,440 --> 05:56:46,840 THAT AND LOOK AT SIX MONTH 7635 05:56:46,840 --> 05:56:50,200 MORTALITY THE FRAILTY SCORES 7636 05:56:50,200 --> 05:56:54,760 DIVIDE OUT AND IF YOU DO FINE 7637 05:56:54,760 --> 05:56:56,200 THEM AS FRAIL, THIS IS NOT 7638 05:56:56,200 --> 05:56:58,360 FRAIL, FROM HAVING THREE OR 7639 05:56:58,360 --> 05:56:59,320 MOREEL SPHERES THAT ARE FRAIL 7640 05:56:59,320 --> 05:57:03,480 AGAIN THEY SEPARATE THAT 7641 05:57:03,480 --> 05:57:04,360 EXTREMELY WELL. 7642 05:57:04,360 --> 05:57:06,240 WE HAVE QUALITY OF LIFE AND 7643 05:57:06,240 --> 05:57:07,120 OWNER CAREGIVER BURDEN AND IF 7644 05:57:07,120 --> 05:57:10,800 YOU WANT TO ANIMATE ANY GROUP OF 7645 05:57:10,800 --> 05:57:12,240 VETS, JUST ASK THEM HOW THEY 7646 05:57:12,240 --> 05:57:15,560 TALK TO OWNERS ABOUT END-OF-LIFE 7647 05:57:15,560 --> 05:57:17,120 AND THEY ALL SPEND A LOT OF TIME 7648 05:57:17,120 --> 05:57:19,960 DOING IT, RESOLVING PROBLEMS 7649 05:57:19,960 --> 05:57:21,800 WITHIN A FAMILY ET CETERA, ET 7650 05:57:21,800 --> 05:57:22,360 CETERA. 7651 05:57:22,360 --> 05:57:25,520 THERE ARE MANY DIFFERENT TOOLS 7652 05:57:25,520 --> 05:57:26,960 AVAILABLE IN VET MEDICINE AND 7653 05:57:26,960 --> 05:57:28,520 MANY ARE SPECIFIC TO CERTAIN 7654 05:57:28,520 --> 05:57:30,160 DISEASES BUT THERE ARE SOME 7655 05:57:30,160 --> 05:57:31,840 GENERAL TOOLS AND HERE IS ONE 7656 05:57:31,840 --> 05:57:34,920 THAT WE LOVE CALLED QOLQ AND YOU 7657 05:57:34,920 --> 05:57:37,880 CAN SEE AGAIN IF YOU LOOK AT 7658 05:57:37,880 --> 05:57:40,280 SURVIVAL, AND THE SCORES HOW 7659 05:57:40,280 --> 05:57:45,480 WELL IT SEPARATES OUT SURVIVAL. 7660 05:57:45,480 --> 05:57:49,080 THAT BEING SAID, KNOWLEDGE GAPS, 7661 05:57:49,080 --> 05:57:50,760 WELL, AS YOU CAN SEE WE LACK A 7662 05:57:50,760 --> 05:57:53,120 LOT OF PREDICTIVE DATA ON 7663 05:57:53,120 --> 05:57:54,560 MORBIDITY AND MORTALITY AND MANY 7664 05:57:54,560 --> 05:57:56,480 OF THOSE AREAS I TALKED ABOUT 7665 05:57:56,480 --> 05:57:59,440 AND WE LACK PREDICTIVE 7666 05:57:59,440 --> 05:58:01,760 BIOMARKERS AND WE SEE LACK EASY 7667 05:58:01,760 --> 05:58:03,800 TO DEPLOY, RELAY ABLE SAFE, 7668 05:58:03,800 --> 05:58:05,760 FUNCTIONAL TOOLS ALTHOUGH WE'RE 7669 05:58:05,760 --> 05:58:07,200 GROWING THOSE RAPIDLY. 7670 05:58:07,200 --> 05:58:09,600 WE DEFINITELY NEED TO MOVE OUR 7671 05:58:09,600 --> 05:58:10,760 RESEARCH TO LOOK AT LINKS 7672 05:58:10,760 --> 05:58:12,440 BETWEEN MOLECULAR AGING AND 7673 05:58:12,440 --> 05:58:13,800 CLINICAL DISEASE AND THAT'S 7674 05:58:13,800 --> 05:58:18,360 REALLY STARTED AND SOME OF THE 7675 05:58:18,360 --> 05:58:22,800 CHALLENGES THAT WE HAVE DIDN'T 7676 05:58:22,800 --> 05:58:24,360 EPIDEMIOLOGY MENTION THE ISSUE 7677 05:58:24,360 --> 05:58:28,080 OF GONADECTOMY. 7678 05:58:28,080 --> 05:58:29,680 SO MOST EVER OUR PATIENTS ARE 7679 05:58:29,680 --> 05:58:31,680 NOT SEXUALLY INTACT. 7680 05:58:31,680 --> 05:58:33,360 IT HE IS LIFESPAN AND HEALTH 7681 05:58:33,360 --> 05:58:37,880 SPAN SO THERE'S ONE WAY YOU CAN 7682 05:58:37,880 --> 05:58:40,000 DO IT WE HAVE THE ISSUE OF 7683 05:58:40,000 --> 05:58:40,200 BREED. 7684 05:58:40,200 --> 05:58:41,200 IT'S ALWAYS BROUGHT UP TO ME 7685 05:58:41,200 --> 05:58:43,400 WHEN I TALK TO BASIC SCIENCE 7686 05:58:43,400 --> 05:58:44,240 RESEARCHERS OF HOW ARE YOU GOING 7687 05:58:44,240 --> 05:58:46,640 TO DEAL WITH THE FACT THERE ARE 7688 05:58:46,640 --> 05:58:47,440 DIFFERENT BREEDS AND MY ANSWER 7689 05:58:47,440 --> 05:58:49,520 IS, WELL WE CAN ACTUALLY USE IT 7690 05:58:49,520 --> 05:58:50,440 TO GREATER ARE EFFECT. 7691 05:58:50,440 --> 05:58:52,360 WE CAN ASK AND ANSWER VERY 7692 05:58:52,360 --> 05:58:54,680 DIFFERENT QUESTIONS, WE CAN 7693 05:58:54,680 --> 05:58:56,600 COMPARE AND CONTRAST. 7694 05:58:56,600 --> 05:58:59,080 WE JUST NEED TO CONTROL FOR IT. 7695 05:58:59,080 --> 05:59:01,920 WE HAVE THE EUTHANASIA END POINT 7696 05:59:01,920 --> 05:59:08,000 AND THE RELATIVE ASK AND I'M 7697 05:59:08,000 --> 05:59:11,400 GOING TO MOVE ON AND MANY 689 7698 05:59:11,400 --> 05:59:12,880 DOGS THAT TAKE PART IN OUR 7699 05:59:12,880 --> 05:59:16,280 STUDIES AND WE HAVE THE CLINICAL 7700 05:59:16,280 --> 05:59:19,280 TRIAL GOING RIGHT NOW AND THEN 7701 05:59:19,280 --> 05:59:23,080 MY MANY POSTDOCS AND 7702 05:59:23,080 --> 05:59:26,880 COLLABORATORS AND HAVE HELPED 7703 05:59:26,880 --> 05:59:28,680 WITH THIS AS WELL AS THIS. 7704 05:59:28,680 --> 05:59:29,720 THANK YOU, VERY MUCH. 7705 05:59:29,720 --> 05:59:40,040 [Please stand by] 7706 06:00:08,240 --> 06:00:10,160 >>I SEE THEM HERE BUT IT 7707 06:00:10,160 --> 06:00:13,920 DOESN'T HELP YOU BUT THEY'RE 7708 06:00:13,920 --> 06:00:17,560 HERE. 7709 06:00:17,560 --> 06:00:19,520 THANK YOU FOR WAITING UNTIL 7710 06:00:19,520 --> 06:00:20,040 4:00. 7711 06:00:20,040 --> 06:00:20,880 I'LL BE BRIEF. 7712 06:00:20,880 --> 06:00:25,400 I'M CAROLINE ZEISS AND I'M A 7713 06:00:25,400 --> 06:00:26,560 PRIME AT COMMISSION SO I SEE 7714 06:00:26,560 --> 06:00:27,760 PATIENTS THROUGHOUT THEIR 7715 06:00:27,760 --> 06:00:29,720 LIFESPAN AND THEY END UP ON THE 7716 06:00:29,720 --> 06:00:34,480 TABLE WHERE WE DO A NECROPSY ON 7717 06:00:34,480 --> 06:00:35,240 THEM. 7718 06:00:35,240 --> 06:00:37,280 WHAT EYE LIKE TO TALK ABOUT ARE 7719 06:00:37,280 --> 06:00:40,880 UNIFYING FACTORS REGARDLESS 7720 06:00:40,880 --> 06:00:43,920 SPECIES WE'RE USING TO STUDY 7721 06:00:43,920 --> 06:00:44,200 GEROSCIENCE. 7722 06:00:44,200 --> 06:00:45,880 ANIMAL MODEL PROVIDE A RICH 7723 06:00:45,880 --> 06:00:48,920 SOURCE OF MECHANISTIC IN SIGHT. 7724 06:00:48,920 --> 06:00:50,560 HOW DO WE HARNESS THAT AND 7725 06:00:50,560 --> 06:00:53,000 DEVELOP PREDICTIVE MODELS THAT 7726 06:00:53,000 --> 06:00:56,000 HELP HUMAN PATIENTS IN 7727 06:00:56,000 --> 06:00:56,400 GEROSCIENCE FIELD. 7728 06:00:56,400 --> 06:00:57,680 I THINK WE'RE ALL FAMILIAR WITH 7729 06:00:57,680 --> 06:00:59,560 THE TERM THE TRANSLATIONAL GAP 7730 06:00:59,560 --> 06:01:02,760 AND THAT REFERS TO THE FACT THAT 7731 06:01:02,760 --> 06:01:03,960 INTERVENTIONS THAT APPEAR 7732 06:01:03,960 --> 06:01:07,480 PROMISING IN THE PRECLINICAL 7733 06:01:07,480 --> 06:01:09,880 SPACE OFTEN FAIL WHEN WE APPLY 7734 06:01:09,880 --> 06:01:11,560 THEM TO HUMAN PATIENTS AND THE 7735 06:01:11,560 --> 06:01:13,360 PLACE WHERE THAT FAILURE CURSE 7736 06:01:13,360 --> 06:01:15,280 IS IN EFFICACY AND IT'S 7737 06:01:15,280 --> 06:01:18,440 DETERMINED TRANSLATIONAL GAP OR 7738 06:01:18,440 --> 06:01:19,040 VALUED DEATH. 7739 06:01:19,040 --> 06:01:22,800 AND SO IF YOU LOOK AT HOW THESE 7740 06:01:22,800 --> 06:01:23,760 ARE DEVELOPED A LOT OF WORK IS 7741 06:01:23,760 --> 06:01:25,840 DONE IN THE PRECLINICAL SPACE 7742 06:01:25,840 --> 06:01:27,600 AND A LOT OF IT IS DISCOVERY 7743 06:01:27,600 --> 06:01:29,840 WORK THAT'S DONE IN ACADEMIA AND 7744 06:01:29,840 --> 06:01:32,000 CARRIED FORWARD USUALLY BY A 7745 06:01:32,000 --> 06:01:36,040 DRUG COMPANY AND GETS THROUGH 7746 06:01:36,040 --> 06:01:46,520 PHASE 1 OR TWO -- AND TISSUE 7747 06:02:10,840 --> 06:02:15,720 AGING AND H CELLULAR AGING WE 7748 06:02:15,720 --> 06:02:19,440 HOPE TO USE THOSE AS ENDPOINTS 7749 06:02:19,440 --> 06:02:24,960 AND ASSOCIATE THEM WITH 7750 06:02:24,960 --> 06:02:25,840 FUNCTIONAL OUTCOME MEASURES. 7751 06:02:25,840 --> 06:02:27,160 I DON'T THINK WE'RE THERE YET 7752 06:02:27,160 --> 06:02:28,520 WITH PEOPLE AND WE'RE NOT THERE 7753 06:02:28,520 --> 06:02:35,560 YET WITH ANIMALS. 7754 06:02:35,560 --> 06:02:36,960 ONE REASON IS THE FUNCTIONAL 7755 06:02:36,960 --> 06:02:38,760 OUTCOMES WE PICK IN ANIMALS ARE 7756 06:02:38,760 --> 06:02:40,040 SELF-SELECTED AND THEY TEND TO 7757 06:02:40,040 --> 06:02:42,520 BE THINGS THAT ARE SIMILAR TO 7758 06:02:42,520 --> 06:02:43,920 THE FIELD OF INTEREST THAT IS 7759 06:02:43,920 --> 06:02:45,720 INTERESTING TO US AND THEY MAY 7760 06:02:45,720 --> 06:02:48,840 NOT RELATE DIRECTLY TO SOMETHING 7761 06:02:48,840 --> 06:02:53,120 IMPORTANT TO THE PATIENT. 7762 06:02:53,120 --> 06:02:55,120 I THINK ONE BIG GAP WE NEED TO 7763 06:02:55,120 --> 06:02:57,200 CLOSE AS WE DEVELOP MARKERS OF 7764 06:02:57,200 --> 06:02:59,240 BIOLOGICAL AGING HOW DO WE 7765 06:02:59,240 --> 06:03:01,160 ASSOCIATE THOSE WITH FUNCTIONAL, 7766 06:03:01,160 --> 06:03:03,240 CLINICAL MARKERS IN ANIMALS AND 7767 06:03:03,240 --> 06:03:05,280 THAT TRANSLATE ACCURATELY TO 7768 06:03:05,280 --> 06:03:09,680 THOSE SAME OUTCOMES IN PEOPLE. 7769 06:03:09,680 --> 06:03:13,040 SO ON THE LEFT, I'VE GIVEN A 7770 06:03:13,040 --> 06:03:22,480 ROUGH OVERVIEW OF AND YOU KNOW, 7771 06:03:22,480 --> 06:03:24,360 THIS IS VARIES OBVIOUSLY BY WHAT 7772 06:03:24,360 --> 06:03:26,640 YOU READ AND THE PURPOSE OF THIS 7773 06:03:26,640 --> 06:03:28,320 REALLY IS TO FORM A FRAMEWORK 7774 06:03:28,320 --> 06:03:29,960 FOR COMPARISON WITH THE OTHER 7775 06:03:29,960 --> 06:03:36,360 SPECIES I'M GOING TO TALK ABOUT 7776 06:03:36,360 --> 06:03:43,160 SO THERE ARE DIFFERENCES IN THE 7777 06:03:43,160 --> 06:03:44,000 NATURE OF THOSE MULTI 7778 06:03:44,000 --> 06:03:46,840 MORBIDITIES THAT ARE VERY 7779 06:03:46,840 --> 06:03:47,160 IMPORTANT. 7780 06:03:47,160 --> 06:03:50,160 SO WE CAN COMPARE THE MACAQUE 7781 06:03:50,160 --> 06:03:51,440 WITH HUMANS, THE MACAQUE IN 7782 06:03:51,440 --> 06:03:52,040 ORANGE. 7783 06:03:52,040 --> 06:03:53,560 THERE ARE SOME SIMILARITIES IN 7784 06:03:53,560 --> 06:03:54,080 DIFFERENCES. 7785 06:03:54,080 --> 06:03:59,040 THE BIGGEST DIFFERENCE IS THAT 7786 06:03:59,040 --> 06:04:03,320 IN NON HUMAN PRIMATES, VASCULAR 7787 06:04:03,320 --> 06:04:04,120 DISEASE INCIDENTS AND YOU WILL 7788 06:04:04,120 --> 06:04:06,240 SEE IT IN ANIMALS OF DIABETICS 7789 06:04:06,240 --> 06:04:09,240 AND SOME ANIMALS YOU CAN 7790 06:04:09,240 --> 06:04:11,560 OCCASIONALLY STROKE AND YOU 7791 06:04:11,560 --> 06:04:12,920 DON'T SEE THE HEART DISEASE AND 7792 06:04:12,920 --> 06:04:15,920 YOU DON'T SEE A HIGH PREVALENCE 7793 06:04:15,920 --> 06:04:16,360 OF HYPERTENSION. 7794 06:04:16,360 --> 06:04:19,480 MANY OF THESE ANIMALS DEVELOPED 7795 06:04:19,480 --> 06:04:20,480 DIABETES AND THIS IS COMMON AND 7796 06:04:20,480 --> 06:04:21,680 PARTICULARLY COMMON IN ANIMALS 7797 06:04:21,680 --> 06:04:23,560 THAT ARE HOUSED IN URBAN 7798 06:04:23,560 --> 06:04:25,840 SETTINGS WHERE THE CAGE LIMIT IS 7799 06:04:25,840 --> 06:04:28,640 VERY SMALL AND IT CAN SIT IN A 7800 06:04:28,640 --> 06:04:29,880 CAGE THEIR WHOLE LINE FOR 30 7801 06:04:29,880 --> 06:04:32,040 YEARS AND THEY BECOME OBESE AND 7802 06:04:32,040 --> 06:04:33,880 DEVELOP DIABETES AND SECOND TO 7803 06:04:33,880 --> 06:04:37,680 THAT THEY GET SECONDARY 7804 06:04:37,680 --> 06:04:38,640 INFECTIONS AND STREP ARTHRITIS 7805 06:04:38,640 --> 06:04:39,960 AND THEY DON'T TEND TO GET THE 7806 06:04:39,960 --> 06:04:42,440 VERY COMMON SEQUELAE THAT WE GET 7807 06:04:42,440 --> 06:04:44,880 WITH DIABETES, THEY DON'T GET 7808 06:04:44,880 --> 06:04:51,960 RENAL DISEASE, NATUROPATH I CANC 7809 06:04:51,960 --> 06:04:53,480 DISEASE AND IT'S A ORGAN 7810 06:04:53,480 --> 06:04:55,040 SPECIFIC AND SYSTEM SPECIFIC 7811 06:04:55,040 --> 06:04:59,320 DIFFERENCE IN BIOLOGICAL AGING 7812 06:04:59,320 --> 06:05:09,840 THAT IS ONE DUE TO ONE FORM OF 7813 06:05:16,880 --> 06:05:18,560 CANCER AND IT'S A CANCER THAT 7814 06:05:18,560 --> 06:05:24,080 CAUSES TYPICALLY AN CONSTRICTION 7815 06:05:24,080 --> 06:05:25,680 AND IT IS CAUSED BY COMBINATION 7816 06:05:25,680 --> 06:05:29,640 OF TWO THINGS, ONE IS, 7817 06:05:29,640 --> 06:05:32,360 ABNORMALITY AND MISMATCH REPAIR 7818 06:05:32,360 --> 06:05:35,000 JEANS AND THE OTHER IS A 7819 06:05:35,000 --> 06:05:36,720 TENDENCY FOR MACAQUES TO DEVELOP 7820 06:05:36,720 --> 06:05:39,840 THE SYNDROME CALLED CHRONIC 7821 06:05:39,840 --> 06:05:41,480 DIARRHEA OF RECESS MACAQUES AND 7822 06:05:41,480 --> 06:05:46,440 WE DO KN DON'T KNOW WHAT CAUSES. 7823 06:05:46,440 --> 06:05:49,120 IT RESPONDS TO STEROIDS AND IT 7824 06:05:49,120 --> 06:05:51,080 CREATES, SETS THEM UP FOR IN 7825 06:05:51,080 --> 06:05:53,960 FLAM TORI AND IT'S FOR THEIR 7826 06:05:53,960 --> 06:05:54,600 ENTIRE LIVES. 7827 06:05:54,600 --> 06:05:56,000 THEY TEND TO GET ARTHRITIS RUN 7828 06:05:56,000 --> 06:05:57,600 ABOUT MID AGE AND BY THE TIME 7829 06:05:57,600 --> 06:06:00,440 THEY DIE AROUND LATE 20s AND 7830 06:06:00,440 --> 06:06:02,360 30s, THAT IS RAMPANT AMONGST 7831 06:06:02,360 --> 06:06:05,600 ALL OF THEM AND IT'S IMPORTANT 7832 06:06:05,600 --> 06:06:07,440 CONTRIBUTE OR TO FRAILTY AND IN 7833 06:06:07,440 --> 06:06:09,360 TERMS OF COGNITIVE DECLINE, THEY 7834 06:06:09,360 --> 06:06:12,040 DO DECLINE WITH AGE AND THIS 7835 06:06:12,040 --> 06:06:13,520 WOULD BE WITHIN THE PARAMETERS 7836 06:06:13,520 --> 06:06:15,600 OF NORMAL DECLINE OF AGING, THEY 7837 06:06:15,600 --> 06:06:19,800 DO NOT BECOME DEMENTED. 7838 06:06:19,800 --> 06:06:22,160 SO HERE IS SOME OF THE PATHOLOGY 7839 06:06:22,160 --> 06:06:24,280 THAT YOU WOULD SEE. 7840 06:06:24,280 --> 06:06:27,320 CARDIAC DISEASE IS NOT HE IS 7841 06:06:27,320 --> 06:06:28,200 KEEP I CAN AND ANIMALS MAY 7842 06:06:28,200 --> 06:06:30,200 DEVELOP ARRHYTHMIA AND THEY 7843 06:06:30,200 --> 06:06:31,640 COULD DEVELOP HEART FAILURE AND 7844 06:06:31,640 --> 06:06:37,960 WHAT YOU SEE IS THIS KIND OF 7845 06:06:37,960 --> 06:06:42,680 FIBROSIS AND THIS IS AN EXAMPLE 7846 06:06:42,680 --> 06:06:45,280 FROM A 30-YEAR-OLD ANIMAL WITH 7847 06:06:45,280 --> 06:06:46,000 SEVERE DIABETES AND YOU COMPARE 7848 06:06:46,000 --> 06:06:48,920 THAT TO A VERY OLD HUMAN AND 7849 06:06:48,920 --> 06:06:50,600 IT'S NOT NEARLY AS BAD. 7850 06:06:50,600 --> 06:07:00,720 AND AT THE BOTTOM, WE HAVE THE 7851 06:07:00,720 --> 06:07:03,360 CARCINOMA THAT IS A COMMON CAUSE 7852 06:07:03,360 --> 06:07:06,040 FOR EUTHANASIA AND WHEN WE LOOK 7853 06:07:06,040 --> 06:07:08,320 AT REPRODUCTIVE CAPACITY, FEMALE 7854 06:07:08,320 --> 06:07:10,600 MACAQUES WILL CONTINUE TO CYCLE 7855 06:07:10,600 --> 06:07:11,880 WELL INTO THEIR LATE 20s EVEN 7856 06:07:11,880 --> 06:07:15,080 THOUGH THEY HAVE A VERY AND 7857 06:07:15,080 --> 06:07:18,280 OFTEN THEY DEVELOP ENDOMETRIOSES 7858 06:07:18,280 --> 06:07:21,040 AND AT THE TOP RIGHT WE HAVE 7859 06:07:21,040 --> 06:07:23,160 DISSEMINATED AND ENDOMETRIOSES 7860 06:07:23,160 --> 06:07:24,840 AND YOU CAN IMAGINE THE 7861 06:07:24,840 --> 06:07:26,360 COMPLICATIONS OF THAT AND AT THE 7862 06:07:26,360 --> 06:07:29,360 BOTTOM RIGHT, WE HAVE 7863 06:07:29,360 --> 06:07:31,480 DISSEMINATED ENDOMETRIOSES THAT 7864 06:07:31,480 --> 06:07:35,200 CONVERTED TO STROMAL SARCOMA AND 7865 06:07:35,200 --> 06:07:41,400 IT'S ENCASED IN THE TUMOR SO 7866 06:07:41,400 --> 06:07:42,960 BETWEEN THE TWO THEY'RE COMMON 7867 06:07:42,960 --> 06:07:46,800 CAUSES OF EUTHANASIA IN FEMALE 7868 06:07:46,800 --> 06:07:47,320 MACAQUES. 7869 06:07:47,320 --> 06:07:48,200 THIS IS VERY DIFFERENT TO WHAT 7870 06:07:48,200 --> 06:07:56,720 WE SEE IN PEOPLE. 7871 06:07:56,720 --> 06:07:59,000 ON THE RIGHT AND IT'S HUGE AND 7872 06:07:59,000 --> 06:08:01,160 LARGE RESTRICTIONS AND WE SEE 7873 06:08:01,160 --> 06:08:03,400 SOME PHYSICAL PARAMETERS THAT 7874 06:08:03,400 --> 06:08:06,040 ARE RELATIVELY EASY TO COLLECT 7875 06:08:06,040 --> 06:08:08,040 AND A LOT OF METABOLIC 7876 06:08:08,040 --> 06:08:11,000 PARAMETERS, DIABETES IS SO 7877 06:08:11,000 --> 06:08:12,640 COMMON, SOME MOTOR COORDINATION 7878 06:08:12,640 --> 06:08:14,280 AND IMMUNE MARKERS AND CAUSE OF 7879 06:08:14,280 --> 06:08:20,720 DEATH AND ORGAN PATHOLOGY. 7880 06:08:20,720 --> 06:08:24,080 THIS IS AN ENTITY COMPARED ABLE 7881 06:08:24,080 --> 06:08:26,800 TO PEOPLE AND IT'S COMPARABLE AT 7882 06:08:26,800 --> 06:08:28,520 THE CLINICAL LEVEL, BIOMARKER 7883 06:08:28,520 --> 06:08:30,400 LEVEL AND ? NICE TICK LEVEL EX 7884 06:08:30,400 --> 06:08:32,760 IN TERMS OF AN IDEAL MODEL FOR 7885 06:08:32,760 --> 06:08:34,080 HUMAN DISEASE THIS IS AN EXAMPLE 7886 06:08:34,080 --> 06:08:36,360 OF A VERY GOOD MODEL FOR HUMAN 7887 06:08:36,360 --> 06:08:39,320 CONDITION SO ANIMALS CAN BE 7888 06:08:39,320 --> 06:08:40,760 HYPER IN MID LIFE AND THEY 7889 06:08:40,760 --> 06:08:45,240 DEVELOPED DIABETES BECAUSE OF 7890 06:08:45,240 --> 06:08:47,160 AND THEY BECOME OBESE AND THEY 7891 06:08:47,160 --> 06:08:49,320 GET ABDOMINAL OBESITY AND AS 7892 06:08:49,320 --> 06:08:52,840 TIME PASSES THEY'RE RETAIN THIS 7893 06:08:52,840 --> 06:08:54,880 BIG BELLY AND EVENTUALLY THEY'RE 7894 06:08:54,880 --> 06:08:57,120 EUTHANIZED BECAUSE OF DECLINING 7895 06:08:57,120 --> 06:08:57,800 BODY CONDITIONS. 7896 06:08:57,800 --> 06:08:59,840 WE'VE SHOWN THAT BOTHEN DOUGH 7897 06:08:59,840 --> 06:09:07,520 ENEMY TRIOSIS DEKEYS LIFESPAN AB 7898 06:09:07,520 --> 06:09:08,960 VALUES ARE SIMILAR TO WHAT YOU 7899 06:09:08,960 --> 06:09:12,160 SEE IN PEOPLE AND THERE'S 7900 06:09:12,160 --> 06:09:15,800 INSULIN RESISTANCE AND THERE'S 7901 06:09:15,800 --> 06:09:17,840 FRANCO HYPO GLYCEMIA AND THEN 7902 06:09:17,840 --> 06:09:20,840 ALL KINDS OF LIPID ABNORMALITIES 7903 06:09:20,840 --> 06:09:21,240 TOO. 7904 06:09:21,240 --> 06:09:25,520 AND IN TERMS OF MESA NICK TICK 7905 06:09:25,520 --> 06:09:26,600 STUDIES THERE'S MANY IN 7906 06:09:26,600 --> 06:09:28,000 MACAQUES. 7907 06:09:28,000 --> 06:09:30,480 HERE IS ONE COMPARING 7908 06:09:30,480 --> 06:09:32,440 SPONTANEOUS DIABETES WITH 7909 06:09:32,440 --> 06:09:34,040 DIET-INDUCED DIABETES AND THE 7910 06:09:34,040 --> 06:09:36,000 TAKE HOME POINT THAT SPONTANEOUS 7911 06:09:36,000 --> 06:09:37,720 DIABETES AND INFLAMMATORY 7912 06:09:37,720 --> 06:09:40,920 BIOMARKERS ARE MUCH MORE 7913 06:09:40,920 --> 06:09:41,400 PREVALENT. 7914 06:09:41,400 --> 06:09:48,160 THE DOGS, SO Dr. OLBY DID A 7915 06:09:48,160 --> 06:09:50,360 GREAT JOB OF DESCRIBING THE DOG. 7916 06:09:50,360 --> 06:09:51,600 THERE ARE SOME DIFFERENCES IN 7917 06:09:51,600 --> 06:09:55,680 TERMS OF THESE METABOLIC 7918 06:09:55,680 --> 06:09:59,600 DISEASES. 7919 06:09:59,600 --> 06:10:03,800 IN DOGS YOU SEE IT WITH 7920 06:10:03,800 --> 06:10:04,360 HYPOTHYROIDISM. 7921 06:10:04,360 --> 06:10:06,040 DIABETES IS TYPE 2, DIABETES, 7922 06:10:06,040 --> 06:10:07,360 IT'S LESS COMMON IN DOGS AND YOU 7923 06:10:07,360 --> 06:10:09,600 MAY SEE IN ASSOCIATION OF 7924 06:10:09,600 --> 06:10:11,000 CURBINGS DISEASE WHICH IS 7925 06:10:11,000 --> 06:10:12,600 RELATIVELY MUCH MORE COMMON AND 7926 06:10:12,600 --> 06:10:16,960 IT IS IN PEOPLE AND COGNITIVE 7927 06:10:16,960 --> 06:10:19,800 DISORDER, THIS IS A REAL BIG 7928 06:10:19,800 --> 06:10:24,200 DIFFERENCE BETWEEN OTHER AGING 7929 06:10:24,200 --> 06:10:26,000 MAMMALS AND HUMANS AND DOGS, 7930 06:10:26,000 --> 06:10:27,760 DOGS DEVELOP THE MOST SEVERE 7931 06:10:27,760 --> 06:10:31,240 COGNITIVE DECLINE SO Dr. OLBY 7932 06:10:31,240 --> 06:10:32,800 SHOWED THE OLD LABRADOR THAT 7933 06:10:32,800 --> 06:10:34,480 KIND OF ABSENCE COGNITIVE 7934 06:10:34,480 --> 06:10:36,040 ABSENCE THAT YOU WOULD SEE IN A 7935 06:10:36,040 --> 06:10:37,280 DOG LIKE THAT AND YOU WOULD JUST 7936 06:10:37,280 --> 06:10:40,120 NOT SEE IN A MACAQUE AND DON'T 7937 06:10:40,120 --> 06:10:41,960 PROGRESS TO THAT DEGREE OF 7938 06:10:41,960 --> 06:10:43,840 COGNITIVE IMPAIRMENT. 7939 06:10:43,840 --> 06:10:46,560 AND IN TERMS OF CARDIAC DISEASE, 7940 06:10:46,560 --> 06:10:48,920 YOU DON'T SEE VASCULAR INITIATED 7941 06:10:48,920 --> 06:10:50,920 CARDIAC DISEASE BUT INSUFFICIENT 7942 06:10:50,920 --> 06:10:52,480 SEE THAT'S THE MOST COMMON THING 7943 06:10:52,480 --> 06:10:56,680 IN ALL DOGS AND OVER ALL, DOGS 7944 06:10:56,680 --> 06:10:58,960 HAVE A MUCH BROADER SPECTRUM OF 7945 06:10:58,960 --> 06:11:00,760 DESCRIBED DISEASES AND THAT'S A 7946 06:11:00,760 --> 06:11:01,640 FUNCTION OF THE FACT THAT THERE 7947 06:11:01,640 --> 06:11:03,920 ARE MILLIONS OF DOG AND A WHOLE 7948 06:11:03,920 --> 06:11:05,240 DISCIPLINE OF VET MEDICINE THAT 7949 06:11:05,240 --> 06:11:07,920 DESCRIBES ALL THESE DISEASES AND 7950 06:11:07,920 --> 06:11:09,520 I THINK THAT THERE MAY BE 7951 06:11:09,520 --> 06:11:14,320 SOMETHING BIOLOGICAL AS WELL IN 7952 06:11:14,320 --> 06:11:14,880 THAT. 7953 06:11:14,880 --> 06:11:16,320 MY OBSERVATIONS ARE THE SPECTRUM 7954 06:11:16,320 --> 06:11:18,920 OF RESENT MACAQUES DIE OF IS 7955 06:11:18,920 --> 06:11:20,640 THERE'S MUCH NARROW SPECTRUM OF 7956 06:11:20,640 --> 06:11:22,160 WHAT THEY DIE OF COMPARED TO 7957 06:11:22,160 --> 06:11:25,000 DOGS AND I THINK THAT MAY HAVE A 7958 06:11:25,000 --> 06:11:28,760 LOT TO DO WITH THE -- THIS IS 7959 06:11:28,760 --> 06:11:31,920 ALREADY BEEN SHOWN. 7960 06:11:31,920 --> 06:11:35,640 TO UNDERSCORE Dr. OLBY'S 7961 06:11:35,640 --> 06:11:38,120 COMMENT THEY SHARE OUR 7962 06:11:38,120 --> 06:11:39,520 ENVIRONMENT AND MACAQUES DON'T 7963 06:11:39,520 --> 06:11:40,120 SHARE OUR ENVIRONMENT. 7964 06:11:40,120 --> 06:11:41,440 THEY HAVE A CONTROLLED 7965 06:11:41,440 --> 06:11:43,360 ENVIRONMENT. 7966 06:11:43,360 --> 06:11:45,480 DOGS ARE EXPOSED TO THE SAME 7967 06:11:45,480 --> 06:11:47,400 DIET, STRESSES AND HAVE A 7968 06:11:47,400 --> 06:11:48,120 SHORTER LIFESPAN SO EVERYTHING 7969 06:11:48,120 --> 06:11:51,360 IS COMPRESSED AND ALL OF THOSE 7970 06:11:51,360 --> 06:11:53,400 STIMULI ARE COMPRESSED INTO A 7971 06:11:53,400 --> 06:11:55,440 SHORTER LIFESPAN WHICH IS 7972 06:11:55,440 --> 06:12:00,600 CONVENIENT FOR US TO STUDY. 7973 06:12:00,600 --> 06:12:01,840 THEIR BACKGROUND IS DESCRIBED 7974 06:12:01,840 --> 06:12:05,920 AND THE DIFFEREN DIFFERENCES INS 7975 06:12:05,920 --> 06:12:07,400 REAL STRENGTH. 7976 06:12:07,400 --> 06:12:11,400 WE HAVE THE APPEARANCE OF BREED 7977 06:12:11,400 --> 06:12:12,120 ASSOCIATED CONDITIONS. 7978 06:12:12,120 --> 06:12:13,480 ALSO DOGS ARE A LOT EASIER TO 7979 06:12:13,480 --> 06:12:14,320 WORK WITH. 7980 06:12:14,320 --> 06:12:16,320 YOU CAN TELL I HAVE A BUY AS 7981 06:12:16,320 --> 06:12:19,480 WORKING WITH DOGS. 7982 06:12:19,480 --> 06:12:20,920 WE ALL LOVE DOGS BUT THERE ARE 7983 06:12:20,920 --> 06:12:22,920 MANY PRACTICAL ADVANTAGES TO 7984 06:12:22,920 --> 06:12:24,560 WORKING WITH DOGS EVEN THOUGH 7985 06:12:24,560 --> 06:12:26,920 THEY ARE EVOLUTIONARILY DISTANT 7986 06:12:26,920 --> 06:12:29,200 FROM US COMPARED TO MACAQUES AND 7987 06:12:29,200 --> 06:12:31,360 THERE ARE MANY PRACTICAL 7988 06:12:31,360 --> 06:12:32,560 ADVANTAGES TO WORKING WITH THEM. 7989 06:12:32,560 --> 06:12:36,760 YOU CAN'T REALLY DO HOW LONG IT 7990 06:12:36,760 --> 06:12:39,840 TAKES TO CROSS A ROAD IN A 7991 06:12:39,840 --> 06:12:42,280 HUMAN, THAT'S A MEASURE OF 7992 06:12:42,280 --> 06:12:43,240 FUNCTIONAL ABILITY AND YOU CAN 7993 06:12:43,240 --> 06:12:45,360 DO THE SAME THING IF A DOG AND 7994 06:12:45,360 --> 06:12:47,040 IT'S VERY DIFFICULT TO DO THAT 7995 06:12:47,040 --> 06:12:50,280 IN A MACAQUE. 7996 06:12:50,280 --> 06:12:54,920 AND THE MOUSE, SO, AS YOU KNOW, 7997 06:12:54,920 --> 06:12:56,840 THEY'RE HOMOZYGOUS AND THAT 7998 06:12:56,840 --> 06:12:58,120 MEANS THAT THE SPECTRUM OF 7999 06:12:58,120 --> 06:13:00,000 CONDITIONS THAT THEY DEVELOP 8000 06:13:00,000 --> 06:13:03,760 WITH AGING VARIES GREATLY BY 8001 06:13:03,760 --> 06:13:05,320 INBRED STRAIN. 8002 06:13:05,320 --> 06:13:06,800 SOME STRAINS THAT COLLABORATIVE 8003 06:13:06,800 --> 06:13:08,800 ACROSS MICE THAT ATTEMPT TO 8004 06:13:08,800 --> 06:13:13,440 OVERCOME THAT AND HERE I'VE 8005 06:13:13,440 --> 06:13:15,120 SELECTED C57 BECAUSE THEY HAVE A 8006 06:13:15,120 --> 06:13:17,920 BACKGROUND FOR MOST EXPERIMENTS 8007 06:13:17,920 --> 06:13:19,440 THAT ARE DONE. 8008 06:13:19,440 --> 06:13:20,960 TYPICALLY WHAT YOU SEE IS THEY 8009 06:13:20,960 --> 06:13:23,240 DIE OF CANCER AND IT'S RELATED 8010 06:13:23,240 --> 06:13:25,720 TO THEIR UNDERLINE GENETICS AND 8011 06:13:25,720 --> 06:13:27,600 THEY MAY HAVE OBESITY AND THAT'S 8012 06:13:27,600 --> 06:13:30,800 VERY COMMON AND THEY DON DEVELOP 8013 06:13:30,800 --> 06:13:32,120 DIABETES IN ASSOCIATION WITH 8014 06:13:32,120 --> 06:13:34,880 THAT AND THEY DON'T GET VASCULAR 8015 06:13:34,880 --> 06:13:42,960 DISEASE THEY GET CHRONIC 8016 06:13:42,960 --> 06:13:44,560 NEPHROPATHY AND THIS WAS MORE 8017 06:13:44,560 --> 06:13:46,640 COMMON AND WE DECREASED THE 8018 06:13:46,640 --> 06:13:48,200 PROTEIN IN THEIR DIETS AND THEY 8019 06:13:48,200 --> 06:13:51,560 GET A RANGE OF HISS TA LOGIC 8020 06:13:51,560 --> 06:13:54,640 LESIONS THAT CONTRIBUTE TO A 8021 06:13:54,640 --> 06:13:55,800 MORBIDITY SCORE BUT CLINICALLY 8022 06:13:55,800 --> 06:13:57,600 WE DON'T REALLY KNOW WHAT THEY 8023 06:13:57,600 --> 06:13:58,880 CONTRIBUTE TO THE CLINICAL 8024 06:13:58,880 --> 06:14:02,280 STATUS OF THE ANIMAL. 8025 06:14:02,280 --> 06:14:03,880 SO HERE IS A TYPICAL OLD MOUSE 8026 06:14:03,880 --> 06:14:07,360 ON THE TOP LEFT AND IT'S LOSING 8027 06:14:07,360 --> 06:14:17,880 ITS FUR AND IT HAS AN ULCER AND 8028 06:14:20,520 --> 06:14:21,840 YOU GET INFLAMMATION. 8029 06:14:21,840 --> 06:14:23,240 IN THE TOP RIGHT YOU WILL SEE 8030 06:14:23,240 --> 06:14:29,920 THE STRAIN ASSOCIATED DISEASE 8031 06:14:29,920 --> 06:14:32,040 AND AT THE BOTTOM YOU WILL SEE 8032 06:14:32,040 --> 06:14:33,360 THE FIE PRO SIS THAT ACCOMPANIES 8033 06:14:33,360 --> 06:14:42,200 MANY ELDERLY MICE AS WELL AS THE 8034 06:14:42,200 --> 06:14:42,800 NEPHOPTHY. 8035 06:14:42,800 --> 06:14:47,600 THESE ARE COMMON ACROSS SPECIES. 8036 06:14:47,600 --> 06:14:50,160 MANY OF THEM CAN BE MEASURED IN 8037 06:14:50,160 --> 06:14:51,560 ADVANCED WEIGHS AND 8038 06:14:51,560 --> 06:14:54,520 SOPHISTICATED WAYS BECAUSE THEY 8039 06:14:54,520 --> 06:14:56,640 HAVE DEVELOPED, CAT SCANS, MICRO 8040 06:14:56,640 --> 06:14:59,120 CT, IF APPROXIMATE YOU CAPTURE 8041 06:14:59,120 --> 06:15:02,480 THESE PATHOLOGY PRE MORTEM AND 8042 06:15:02,480 --> 06:15:05,040 IT SHOULD BE NOTED THAT MANY 8043 06:15:05,040 --> 06:15:08,720 MEASURES OF -- MANY OF THESE 8044 06:15:08,720 --> 06:15:11,280 MEASURES THAT FOLKS HAVE 8045 06:15:11,280 --> 06:15:12,440 ATTEMPTED TO AGO AGREE GATE INTO 8046 06:15:12,440 --> 06:15:14,360 HEALTH SPAN MAY NOT CORRELATE 8047 06:15:14,360 --> 06:15:16,120 ACROSS STRINGS AND LIFESPAN AND 8048 06:15:16,120 --> 06:15:18,400 SO WE CAN COLLECT A LOT OF DATA 8049 06:15:18,400 --> 06:15:19,800 BUT THE PROBLEM ALWAYS REMAINS 8050 06:15:19,800 --> 06:15:23,320 HOW DO WE RELATE IT TO A SET OF 8051 06:15:23,320 --> 06:15:24,760 FUNCTIONAL OUTCOMES AND 8052 06:15:24,760 --> 06:15:29,440 TRANSLATABLE TO PEOPLE. 8053 06:15:29,440 --> 06:15:31,200 AND NO AGING TALK WILL BE 8054 06:15:31,200 --> 06:15:33,960 COMPLETE WITHOUT A REFERENCE TO 8055 06:15:33,960 --> 06:15:34,640 THE MOLE RAT. 8056 06:15:34,640 --> 06:15:37,680 THIS IS A VERY UNUSUAL SPECIES. 8057 06:15:37,680 --> 06:15:41,200 IT'S A ROTE APAR RODENT WITH A F 8058 06:15:41,200 --> 06:15:43,160 30 YEARS SO THIS IS EQUIVALENT 8059 06:15:43,160 --> 06:15:44,720 TO A MACAQUE. 8060 06:15:44,720 --> 06:15:46,680 THEY'RE SOCIAL. 8061 06:15:46,680 --> 06:15:48,320 SUBTERRANEAN AND STRIKINGLY 8062 06:15:48,320 --> 06:15:49,960 THEIR AGE SPECIFIC HAS MORTALITY 8063 06:15:49,960 --> 06:15:52,880 DOES NOT INCREASE WITH 8064 06:15:52,880 --> 06:15:53,760 INCREASING AGE. 8065 06:15:53,760 --> 06:15:55,480 THE PHYSIOLOGICAL DECLINE YOU 8066 06:15:55,480 --> 06:15:57,880 SEE WITH AGING DOESN'T OCCUR AND 8067 06:15:57,880 --> 06:15:59,360 THEY'RE PRE PRODUCTIVELY 8068 06:15:59,360 --> 06:16:00,760 FUNCTIONAL UNTIL THE END OF 8069 06:16:00,760 --> 06:16:01,600 THEIR LIVES. 8070 06:16:01,600 --> 06:16:03,040 AND THE QUESTION THEN IS WELL 8071 06:16:03,040 --> 06:16:06,280 WHY DO THEY DIE? 8072 06:16:06,280 --> 06:16:09,480 AND IF WE LOOK AT NECROPSY 8073 06:16:09,480 --> 06:16:10,920 FINDINGS, THIS IS ONE EXAMPLE. 8074 06:16:10,920 --> 06:16:13,280 WE SEE THAT IN THESE ANIMALS, 8075 06:16:13,280 --> 06:16:16,320 ONE OF THE MOST PREVALENT WAS 8076 06:16:16,320 --> 06:16:17,160 THE DEATH OF FIGHTS THAT OCCUR 8077 06:16:17,160 --> 06:16:19,480 WHEN A QUEEN DIES AND THE SOCIAL 8078 06:16:19,480 --> 06:16:20,840 UNREST THAT FOLLOWS THAT DEATH. 8079 06:16:20,840 --> 06:16:23,160 THE EVOLUTION OF A NEW QUEEN. 8080 06:16:23,160 --> 06:16:31,800 WE SEE CHRONIC NEPROTHAPY AND I 8081 06:16:31,800 --> 06:16:33,160 THINK THAT'S PROBABLY RELATED TO 8082 06:16:33,160 --> 06:16:35,520 THE AMOUNT OF PROTEIN IN THE 8083 06:16:35,520 --> 06:16:38,160 DIET, JUST LIKE OTHER RODENTS 8084 06:16:38,160 --> 06:16:41,800 AND WE HAVE OTHER FINDINGS THAT 8085 06:16:41,800 --> 06:16:43,200 LOOK RODENTISH IN THEIR 8086 06:16:43,200 --> 06:16:45,480 DISTRIBUTION BUT DON'T EFFECT 8087 06:16:45,480 --> 06:16:47,120 CLINICAL STATUS OF THE ANIMAL 8088 06:16:47,120 --> 06:16:47,920 VERY MUCH. 8089 06:16:47,920 --> 06:16:49,840 AND NEVERTHELESS, THEY DO 8090 06:16:49,840 --> 06:16:51,880 EXHIBIT AGE ASSOCIATED 8091 06:16:51,880 --> 06:16:53,200 EPIGENETIC CHANGE AND THE RATE 8092 06:16:53,200 --> 06:16:55,120 IS SLOWER THAN MICE BUT FASTER 8093 06:16:55,120 --> 06:16:57,760 THAN HUMANS. 8094 06:16:57,760 --> 06:16:59,200 AND I'VE BEEN TRUE TO THE 8095 06:16:59,200 --> 06:17:01,000 PICTURE AT THE BOTTOM THAT'S A 8096 06:17:01,000 --> 06:17:02,680 NORMAL LUNG AND IT LOOKS UNDER 8097 06:17:02,680 --> 06:17:05,280 DEVELOPED BECAUSE THEY RETAIN 8098 06:17:05,280 --> 06:17:07,920 THESE FEATURES OF LUNG MOR 8099 06:17:07,920 --> 06:17:10,280 FOLLOW GEE BECAUSE THEY MOSTLY 8100 06:17:10,280 --> 06:17:12,760 LIVE UNDERGROUND AND THEY CAN 8101 06:17:12,760 --> 06:17:14,880 TOLERATE CARBON DIOXIDE AND 8102 06:17:14,880 --> 06:17:16,400 HYPOXIA SO EVOLUTIONARILY THEY 8103 06:17:16,400 --> 06:17:19,040 HAVE A LOT OF ADAPTATIONS THAT 8104 06:17:19,040 --> 06:17:23,440 ARE THOUGHT TO UNDERPIN THEIR 8105 06:17:23,440 --> 06:17:25,600 LONGEVITY. 8106 06:17:25,600 --> 06:17:28,600 ANIMALS DO NOT MODEL VASCULAR 8107 06:17:28,600 --> 06:17:29,320 DISEASE WELL. 8108 06:17:29,320 --> 06:17:32,000 I'VE PUT THE RAT THERE AS ONE 8109 06:17:32,000 --> 06:17:33,160 EXCEPTION, JUST TO REMIND MYSELF 8110 06:17:33,160 --> 06:17:36,560 TO TELL YOU THERE ARE SOME RATS 8111 06:17:36,560 --> 06:17:38,200 THAT HAVE HYPERTENSION AND 8112 06:17:38,200 --> 06:17:42,240 OBESITY AS A SPONTANEOUS DISEASE 8113 06:17:42,240 --> 06:17:44,160 BUT THEY'RE THE EXCEPTIONS AND 8114 06:17:44,160 --> 06:17:47,120 VASCULAR DISEASE IS AT THE ROOTS 8115 06:17:47,120 --> 06:17:50,440 OF OUR ILLS AS HUMAN BEINGS. 8116 06:17:50,440 --> 06:17:51,960 SO, I THINK THIS IS SOMETHING TO 8117 06:17:51,960 --> 06:17:54,840 BEAR IN MIND AS WE DEVELOP 8118 06:17:54,840 --> 06:17:55,960 BIOLOGICAL CLOCKS AND WE A IT 8119 06:17:55,960 --> 06:17:59,040 TEMPT TO TRANSLATE FINDINGS FROM 8120 06:17:59,040 --> 06:18:00,920 ANIMALS TO BE HUMANS WITHOUT THE 8121 06:18:00,920 --> 06:18:03,360 COMPONENT OF VASCULAR DISEASE 8122 06:18:03,360 --> 06:18:05,040 AND IT'S SOMETHING THAT WE 8123 06:18:05,040 --> 06:18:07,200 REALLY HAVE TO BEAR IN MIND WHEN 8124 06:18:07,200 --> 06:18:08,000 TRYING TO INTERPRET WHAT WE SEE 8125 06:18:08,000 --> 06:18:10,040 IN ANIMALS AND RELATE THOSE TO 8126 06:18:10,040 --> 06:18:14,080 HUMAN BIOLOGICAL AGING. 8127 06:18:14,080 --> 06:18:15,760 IN TERMS OF DEMENTIA THE IMAGE 8128 06:18:15,760 --> 06:18:19,920 ON THE RIGHT IS FAMILIAR TO ALL 8129 06:18:19,920 --> 06:18:25,760 OF YOU ABOUT 40% ARE MODIFIABLE 8130 06:18:25,760 --> 06:18:28,040 AND IN ANIMALS, THERE ARE MANY, 8131 06:18:28,040 --> 06:18:30,320 MANY MODELS OF ALZHEIMER'S, THE 8132 06:18:30,320 --> 06:18:31,560 TAKE HOME POINT FOR AWFUL THEM 8133 06:18:31,560 --> 06:18:34,160 IS PRETTY MUCH EVERYBODY GETS 8134 06:18:34,160 --> 06:18:36,800 COMPLEX AS THEY AGE EXCEPT 8135 06:18:36,800 --> 06:18:37,960 RODENTS. 8136 06:18:37,960 --> 06:18:38,560 RODENTS DON'T GET THEM BUT THE 8137 06:18:38,560 --> 06:18:40,200 OTHER LARGER ANIMALS DON'T GET 8138 06:18:40,200 --> 06:18:40,760 THEM. 8139 06:18:40,760 --> 06:18:42,960 AND THEY CAN BE QUITE PERVASIVE 8140 06:18:42,960 --> 06:18:45,480 AND THEY SPEND TO BE DIFFUSE IN 8141 06:18:45,480 --> 06:18:46,880 THE NEUROPATHOLOGICAL PHENOTYPE 8142 06:18:46,880 --> 06:18:51,560 AND BECAUSE OF THAT THEY DON'T 8143 06:18:51,560 --> 06:18:55,080 INVETO TRACKING USING PIB AND 8144 06:18:55,080 --> 06:18:56,680 IT'S NOT USED IN DOGS OR MONKEYS 8145 06:18:56,680 --> 06:18:59,080 AND THE OTHER BIG DIFFERENCE IS 8146 06:18:59,080 --> 06:19:01,480 YOU GET HYPER PHOSPHORYLATION 8147 06:19:01,480 --> 06:19:03,720 AND ACCUMULATION OF WHAT COULD 8148 06:19:03,720 --> 06:19:08,120 CALL TANGLES AND YOU DON'T GET 8149 06:19:08,120 --> 06:19:11,960 TANGLES AND IT'S RARE AND YOU 8150 06:19:11,960 --> 06:19:17,400 SEE PHOSPHORYLATION AND 8151 06:19:17,400 --> 06:19:19,280 HIPPOCAMPUS AND EVEN IN THE 8152 06:19:19,280 --> 06:19:20,440 SHEEP YOU SEE THIS SO IT IS NOT 8153 06:19:20,440 --> 06:19:23,120 AN OUTLIER TO SEE THIS IN NOM 8154 06:19:23,120 --> 06:19:23,840 HUMAN PRIMATES. 8155 06:19:23,840 --> 06:19:25,520 THEY DON'T DEVELOP THAT TO ANY 8156 06:19:25,520 --> 06:19:28,080 GREATER DEGREE AND MANY OF THESE 8157 06:19:28,080 --> 06:19:30,920 OTHER SPECIES. 8158 06:19:30,920 --> 06:19:32,320 INTERESTING TO NOTE THAT IN 8159 06:19:32,320 --> 06:19:35,200 DOGS, REDUCED HEARING IS 8160 06:19:35,200 --> 06:19:45,600 ASSOCIATED WI INCREASE CREASED T 8161 06:19:45,600 --> 06:19:47,760 SEE THE MULTI MORBID NEURO 8162 06:19:47,760 --> 06:19:49,440 PATHOLOGY OF THESE MIXED 8163 06:19:49,440 --> 06:19:50,800 PATHOLOGIES THAT ARE SO COMMON 8164 06:19:50,800 --> 06:19:51,720 IN OLD ARE PEOPLE. 8165 06:19:51,720 --> 06:19:53,640 THEY DO NOT SEE THAT IN ANIMALS 8166 06:19:53,640 --> 06:19:58,760 AND WE DON'T SEE A SPONTANEOUS 8167 06:19:58,760 --> 06:20:01,680 CONDITION. 8168 06:20:01,680 --> 06:20:03,200 THAT BRINGS ME TO THIS SLIDE THE 8169 06:20:03,200 --> 06:20:04,640 MOST IMPORTANT SLIDE IN THE TALK 8170 06:20:04,640 --> 06:20:06,280 WHICH IS THE NOTION OF ORGAN 8171 06:20:06,280 --> 06:20:08,720 SPECIFIC BIOLOGICAL AGE AND CRON 8172 06:20:08,720 --> 06:20:10,880 LOGIC AGE AND IF THERE'S SPECIES 8173 06:20:10,880 --> 06:20:13,600 DIFFERENCES IN THIS. 8174 06:20:13,600 --> 06:20:17,640 THIS BOX AT TOP DESCRIBES A TALK 8175 06:20:17,640 --> 06:20:20,400 WHICH DEFINES ORGAN SPECIFIC 8176 06:20:20,400 --> 06:20:22,120 BIOLOGIC CLOCKS AND SHOWS THAT 8177 06:20:22,120 --> 06:20:26,080 THESE CLOCKS VERY WITH 8178 06:20:26,080 --> 06:20:36,640 INDIVIDUALS AND THE BRAIN LOOKS 8179 06:21:25,640 --> 06:21:27,640 GOOD AND IF WE LOOK AT 8180 06:21:27,640 --> 06:21:28,480 BIOLOGICAL CLOCKS AND WE'RE 8181 06:21:28,480 --> 06:21:30,280 LOOKING AT THE BRAIN, WE MAY NOT 8182 06:21:30,280 --> 06:21:32,040 BE ABLE TO APPLY DIRECTLY WHAT 8183 06:21:32,040 --> 06:21:35,440 WE SEE IN PRIMATES TO HUMANS. 8184 06:21:35,440 --> 06:21:37,120 PRIMATES MAY REFLECT THE HUMAN 8185 06:21:37,120 --> 06:21:39,160 IN MID AGE RATHER THAN THE HUMAN 8186 06:21:39,160 --> 06:21:44,120 IN OLD AGE. 8187 06:21:44,120 --> 06:21:47,200 SO LAST SLIDE, HOW BEST CAN WE 8188 06:21:47,200 --> 06:21:48,480 TRANSLATE INTERVENTIONS TO THE 8189 06:21:48,480 --> 06:21:50,720 CLINIC USING ANIMALS AND I THINK 8190 06:21:50,720 --> 06:21:52,480 THESE SPECIES ON THE LEFT ARE 8191 06:21:52,480 --> 06:21:53,800 INCREDIBLY IMPORTANT AND 8192 06:21:53,800 --> 06:21:55,800 IDENTIFYING BASIC MECHANISMS AND 8193 06:21:55,800 --> 06:21:57,480 THEY ALLOW US TO DO REDUCTION OF 8194 06:21:57,480 --> 06:21:59,840 SCIENCE AND IT MEANS THAT WE 8195 06:21:59,840 --> 06:22:01,720 REMOVE ALL VARIABLES EXCEPT THE 8196 06:22:01,720 --> 06:22:03,200 ONES THAT WE'RE INTERESTED AND 8197 06:22:03,200 --> 06:22:05,200 WE CAN ISOLATE A MECHANISM AND 8198 06:22:05,200 --> 06:22:06,960 THE DOWNFALL IS IT CREATES A 8199 06:22:06,960 --> 06:22:09,440 SENSITIVE SYSTEM AND WHERE WE 8200 06:22:09,440 --> 06:22:11,200 CAN REACH STATISTICAL 8201 06:22:11,200 --> 06:22:13,880 SIGNIFICANCE RELATIVELY EASILY 8202 06:22:13,880 --> 06:22:16,880 AND AND IN HAVING THAT KIND OF 8203 06:22:16,880 --> 06:22:21,280 HIGH INTRINSIC VALIDITY WE USE 8204 06:22:21,280 --> 06:22:22,400 VALIDITY IN OTHER WORDS WHEN WE 8205 06:22:22,400 --> 06:22:23,720 TROY TO EXTRAPOLATE THAT TO MUCH 8206 06:22:23,720 --> 06:22:30,240 MORE HETERO GENIOUS IT FALLS 8207 06:22:30,240 --> 06:22:33,360 APART SO THE LARGER MODELING A 8208 06:22:33,360 --> 06:22:34,640 GOOD SEG WAY BETWEEN THESE 8209 06:22:34,640 --> 06:22:36,000 MODELS AND HUMANS BECAUSE 8210 06:22:36,000 --> 06:22:38,480 THEY'RE MORE HETERO GENIUS AND 8211 06:22:38,480 --> 06:22:40,200 THAT IMPLIES WE GO TO NEED 8212 06:22:40,200 --> 06:22:44,560 LARGER SAMPLE SIZES AND IT 8213 06:22:44,560 --> 06:22:46,440 ALLOWS US TO COMPARE CONDITIONS 8214 06:22:46,440 --> 06:22:47,880 THAT HAVE MORE IMMEDIATE A 8215 06:22:47,880 --> 06:22:50,360 PARENT SIMILARITIES TO HUMAN 8216 06:22:50,360 --> 06:22:51,560 CONDITIONS AND I HAVE INDICATED 8217 06:22:51,560 --> 06:22:53,120 THOSE THAT I THINK ARE THE MOST 8218 06:22:53,120 --> 06:22:55,280 SIMILAR AND THE MOST USEFUL IN 8219 06:22:55,280 --> 06:22:58,320 RED AND IN DOING SO, WE NEED TO 8220 06:22:58,320 --> 06:23:00,560 BEAR IN MIND SOME THINGS AND THE 8221 06:23:00,560 --> 06:23:02,960 FIRST IS TO DEFINE A MECHANISM 8222 06:23:02,960 --> 06:23:06,960 OF THE DISEASE BEARING IN MIND 8223 06:23:06,960 --> 06:23:10,640 THE DEVELOPMENT OF SOME OF THOSE 8224 06:23:10,640 --> 06:23:13,400 DISEASES SPECIFICITY OF 8225 06:23:13,400 --> 06:23:17,440 MECHANISM AND VALIDATED 8226 06:23:17,440 --> 06:23:23,120 BIOMARKERS AND THAT AND FIFTH 8227 06:23:23,120 --> 06:23:24,000 WINK FIFTH THOUGH BIOMARKERS 8228 06:23:24,000 --> 06:23:26,280 NEEDS TON RELEVANT TO THE HUMAN 8229 06:23:26,280 --> 06:23:26,880 DISEASE CONDITIONS. 8230 06:23:26,880 --> 06:23:30,480 AND WITH THAT, I WILL STOP. 8231 06:23:30,480 --> 06:23:30,920 THANK YOU. 8232 06:23:30,920 --> 06:23:41,160 [APPLAUSE] 8233 06:23:47,800 --> 06:23:58,280 >>CAN ALL THE SPEAKERS COME UP. 8234 06:24:10,160 --> 06:24:11,720 THAT WAS A WONDERFUL WAY TO END 8235 06:24:11,720 --> 06:24:17,040 THE DAY AND IT FIGHT NICELY AND 8236 06:24:17,040 --> 06:24:18,400 WITH SOME OF THE TALKS THAT WEPT 8237 06:24:18,400 --> 06:24:19,200 ON BEFORE. 8238 06:24:19,200 --> 06:24:22,840 SORRY I HAVE TO HOLD THIS DOWN. 8239 06:24:22,840 --> 06:24:24,920 AND I THINK IT IS A REALLY NICE 8240 06:24:24,920 --> 06:24:26,560 EXTENSION OF ANOTHER WORKSHOP 8241 06:24:26,560 --> 06:24:28,800 ACTUALLY THAT DIVISION OF AGING 8242 06:24:28,800 --> 06:24:31,520 BIOLOGY ORGANIZED TWO WEEKS AGO 8243 06:24:31,520 --> 06:24:33,280 AND ON STRESS IN MID LIFE WHERE 8244 06:24:33,280 --> 06:24:34,800 THEY COMBINED WORK RESEARCHERS 8245 06:24:34,800 --> 06:24:36,600 WHO WERE STUDYING HUMANS WITH 8246 06:24:36,600 --> 06:24:39,040 THOSE STUDYING MODEL ORGANISMS 8247 06:24:39,040 --> 06:24:41,160 AND NON MODEL ORGANISMS SOME 8248 06:24:41,160 --> 06:24:42,440 WHICH WERE TOUCHED ON HERE AND 8249 06:24:42,440 --> 06:24:43,520 BRINGING EVERYONE INTO THE ROOM 8250 06:24:43,520 --> 06:24:45,800 TOGETHER TO SORT OF TALK HOW WE 8251 06:24:45,800 --> 06:24:47,480 CAN LEVERAGE THE TWO DIFFERENT 8252 06:24:47,480 --> 06:24:48,880 SYSTEMS AND DIFFERENT 8253 06:24:48,880 --> 06:24:50,640 POPULATIONS THAT WE'RE STUDYING 8254 06:24:50,640 --> 06:24:52,000 TO DRAW REALLY INTERESTING 8255 06:24:52,000 --> 06:24:53,840 INSIGHTS INTO THE BIOLOGY OF 8256 06:24:53,840 --> 06:24:54,320 AGING. 8257 06:24:54,320 --> 06:24:58,880 HERE PARTICULARLY WE'RING ABOUT 8258 06:24:58,880 --> 06:25:00,240 MULTIMORBITITIES AND I THINK 8259 06:25:00,240 --> 06:25:02,040 WHAT WAS REALLY HIGHLIGHTED WAS 8260 06:25:02,040 --> 06:25:03,440 YOU NEED TO FIND WITH THE RIGHT 8261 06:25:03,440 --> 06:25:05,680 TOOL FOR THE RIGHT JOB HERE. 8262 06:25:05,680 --> 06:25:07,040 AND THAT WAS PARTICULARLY THE 8263 06:25:07,040 --> 06:25:10,120 CASE WITH THE LAST SPEAKER, 8264 06:25:10,120 --> 06:25:12,440 SAYING YOU KNOW, CERTAIN ANIMAL 8265 06:25:12,440 --> 06:25:14,400 SYSTEMS, CERTAIN ANIMAL MODELS 8266 06:25:14,400 --> 06:25:16,160 ARE BETTER FITS FOR CERTAIN 8267 06:25:16,160 --> 06:25:18,040 ASPECTS OF AGING AND CERTAIN 8268 06:25:18,040 --> 06:25:21,720 DISEASES OF AGING AND OTHERS ARE 8269 06:25:21,720 --> 06:25:22,440 NOT. 8270 06:25:22,440 --> 06:25:25,000 SO THAT'S JUST SORT OF A GENERAL 8271 06:25:25,000 --> 06:25:26,080 COMMENT TO BRING THESE THINGS 8272 06:25:26,080 --> 06:25:27,880 TOGETHER BUT I HAVE A FEW 8273 06:25:27,880 --> 06:25:29,600 QUESTION AND I'LL OPEN ONE HERE 8274 06:25:29,600 --> 06:25:31,560 AND HOPEFULLY WE CAN OPEN UP TO 8275 06:25:31,560 --> 06:25:33,560 THE ROOM. 8276 06:25:33,560 --> 06:25:34,640 SOMETHING THAT WAS A THREAT THIS 8277 06:25:34,640 --> 06:25:36,400 LAST SESSION AS WE GET OLDER, WE 8278 06:25:36,400 --> 06:25:38,440 GET MORE DISEASES, RIGHT. 8279 06:25:38,440 --> 06:25:40,200 AND IT'S JUST NATURAL, THE 8280 06:25:40,200 --> 06:25:42,000 LONGER YOU ARE AROUND THE HIGHER 8281 06:25:42,000 --> 06:25:43,400 YOU ARE, LIKE THE MORE LIKELY 8282 06:25:43,400 --> 06:25:47,040 YOU ARE TO BE DIAGNOSED WITH THE 8283 06:25:47,040 --> 06:25:47,800 DISEASE. 8284 06:25:47,800 --> 06:25:52,400 AND I THOUGHT ABOUT THIS IN THE 8285 06:25:52,400 --> 06:25:58,600 CONTEXT OF DIAGNOSIS DIG 8286 06:25:58,600 --> 06:26:00,880 DISEASES IN RESEARCH ON HUMAN 8287 06:26:00,880 --> 06:26:01,800 POPULATIONS AND THIS FITS WITH 8288 06:26:01,800 --> 06:26:04,640 THE EARLIER TALKS ON DISPARITIES 8289 06:26:04,640 --> 06:26:06,880 IN HEALTH AND AGING. 8290 06:26:06,880 --> 06:26:09,000 BECAUSE HEALTHCARE'S REALLY 8291 06:26:09,000 --> 06:26:10,200 NECESSARY FOR ACCESS TO 8292 06:26:10,200 --> 06:26:11,520 HEALTHCARE IS NECESSARY FOR YOU 8293 06:26:11,520 --> 06:26:14,520 TO STAY HEALTHY BUT IT'S ALSO 8294 06:26:14,520 --> 06:26:16,520 CRITICAL FOR DIAGNOSING 8295 06:26:16,520 --> 06:26:17,840 DISEASES, RIGHT. 8296 06:26:17,840 --> 06:26:19,480 IF YOU DON'T GO TO SEE A 8297 06:26:19,480 --> 06:26:20,320 HEALTHCARE PROFESSIONAL YOU WILL 8298 06:26:20,320 --> 06:26:21,880 NOT BE DIAGNOSED WITH DISEASE 8299 06:26:21,880 --> 06:26:23,920 AND SOME OF THE ANIMAL MODELS 8300 06:26:23,920 --> 06:26:30,880 STUDIED HERE, ARE UNDER INTENSE 8301 06:26:30,880 --> 06:26:33,440 VETERINARY WATCH AND CARE AND WE 8302 06:26:33,440 --> 06:26:35,560 DO NECROPSY AFTER THEY DIE TO 8303 06:26:35,560 --> 06:26:36,720 KNOW WHAT THEY HAD. 8304 06:26:36,720 --> 06:26:39,520 AUTOPSIES ARE NOT ALWAYS 8305 06:26:39,520 --> 06:26:41,200 PERFORMED FOR DISEASES THAT HAVE 8306 06:26:41,200 --> 06:26:44,640 OCCURRED IN HUMA HUMANS AND THEY 8307 06:26:44,640 --> 06:26:46,360 CANNOT SEE DOCTORS AND MAY NOT 8308 06:26:46,360 --> 06:26:48,600 BE DIAGNOSED WITH DISEASES. 8309 06:26:48,600 --> 06:26:50,640 THIS ALSO EXTENDS TO DOGS. 8310 06:26:50,640 --> 06:26:52,360 THERE'S A RESENT STUDY OUST OF 8311 06:26:52,360 --> 06:26:54,480 THE DOG AGING PROJECT MY LAB WAS 8312 06:26:54,480 --> 06:26:57,960 A PART OF SHOWING THAT THERE ARE 8313 06:26:57,960 --> 06:26:59,560 SOCIOECONOMIC GRADIENTS IN 8314 06:26:59,560 --> 06:27:01,480 HEALTH AND DISEASE AND THE 8315 06:27:01,480 --> 06:27:04,400 DISEASE DIAGNOSIS WAS COUNT ERIN 8316 06:27:04,400 --> 06:27:12,760 TO YOU ACTIVIER ITIN INTUITY. 8317 06:27:12,760 --> 06:27:16,520 THOSE FROM LOWER SES HOUSEHOLDS 8318 06:27:16,520 --> 06:27:18,480 AND IT'S LIKELY DO YOU TO JUST 8319 06:27:18,480 --> 06:27:19,680 HOW FREQUENTLY THESE OWNERS ARE 8320 06:27:19,680 --> 06:27:20,920 TAKING THEIR DOGS TO THE VET, 8321 06:27:20,920 --> 06:27:21,320 RIGHT. 8322 06:27:21,320 --> 06:27:23,160 I SORT OF WANT TO OPEN IT UP TO 8323 06:27:23,160 --> 06:27:24,920 HOW CAN WE THINK ABOUT MEASURING 8324 06:27:24,920 --> 06:27:27,640 THESE DISEASES AND HOW TO 8325 06:27:27,640 --> 06:27:28,720 IMPACTS ARE QUANTIFICATION OF 8326 06:27:28,720 --> 06:27:33,560 MULTI MORBIDITY WITH AGING? 8327 06:27:33,560 --> 06:27:38,640 >>I CAN START WITH THAT. 8328 06:27:38,640 --> 06:27:45,640 WELL, I THINK THAT 8329 06:27:45,640 --> 06:27:46,320 VETERINARIANS, WHATEVER PEE 8330 06:27:46,320 --> 06:27:48,040 SEIZE IS THEIR SPECIALTY I THINK 8331 06:27:48,040 --> 06:27:52,040 OVER TIME WE RECOGNIZE, WE LEARN 8332 06:27:52,040 --> 06:27:53,160 TO RECOGNIZE CLINICAL SIGNS AND 8333 06:27:53,160 --> 06:27:55,720 WE HAVE A GOOD IDEA OF WHAT THE 8334 06:27:55,720 --> 06:27:56,520 ANIMAL HAS. 8335 06:27:56,520 --> 06:27:59,120 THERE AREN'T TOO MANY SURPRISES 8336 06:27:59,120 --> 06:28:00,280 IN NECROPSY. 8337 06:28:00,280 --> 06:28:02,280 THE KEY REALLY IS WHAT DISEASES 8338 06:28:02,280 --> 06:28:04,480 DO WE INCLUDE IN A 8339 06:28:04,480 --> 06:28:05,520 MULTIMORBITITIES INDEX. 8340 06:28:05,520 --> 06:28:06,920 THINGS ARE NOT RELEVANT IN THE 8341 06:28:06,920 --> 06:28:08,480 SENSE OF THEY DON'T CAUSE GREAT 8342 06:28:08,480 --> 06:28:10,600 SUFFERING AND THEY DON'T 8343 06:28:10,600 --> 06:28:11,920 CONTRIBUTE TO FRAILTY AND THEY 8344 06:28:11,920 --> 06:28:13,400 DON'T SHORTEN THE ANIMAL'S LIFE 8345 06:28:13,400 --> 06:28:15,040 AND THEY DO END UP WITH A 8346 06:28:15,040 --> 06:28:15,960 MEDICAL RECORDS. 8347 06:28:15,960 --> 06:28:18,320 DO THEY ARE PART OF A FRAILTY 8348 06:28:18,320 --> 06:28:22,160 INDEX OR MULTIMORBITITIES INDEX? 8349 06:28:22,160 --> 06:28:23,480 THINGS LIKE RENAL DISEASE. 8350 06:28:23,480 --> 06:28:26,560 HOW DO WE DEFINE RENAL DISEASE? 8351 06:28:26,560 --> 06:28:29,480 IS IT AS A TEAM OF SOME DURATION 8352 06:28:29,480 --> 06:28:31,520 OR IS IT SOMETHING THAT WE FIND 8353 06:28:31,520 --> 06:28:33,520 IN DECK ROP SEE AND IF IT'S JUST 8354 06:28:33,520 --> 06:28:35,480 SOMETHING YOU FIND IN NECROPSY, 8355 06:28:35,480 --> 06:28:36,960 IT'S EFFECTING THE WHOLE SYSTEM 8356 06:28:36,960 --> 06:28:38,560 FOR SURE BUT CLINICALLY, IT'S 8357 06:28:38,560 --> 06:28:41,320 NOT GOTTEN TO THE POINT WHERE IT 8358 06:28:41,320 --> 06:28:42,840 IS EFFECTING THE CLINICAL STATUS 8359 06:28:42,840 --> 06:28:46,360 OF THE ANIMAL SO I THINK IF WE 8360 06:28:46,360 --> 06:28:48,040 DO NEED TO COMMUNICATE ACROSS 8361 06:28:48,040 --> 06:28:49,720 SPECIES WITH PEOPLE WHO WORK 8362 06:28:49,720 --> 06:28:55,280 WITH DIFFERENT SPECIES AND 8363 06:28:55,280 --> 06:28:58,560 HUMANS AND DOGS TO COME UP WITH 8364 06:28:58,560 --> 06:29:09,080 A SET OF DISEASES AND I THINK 8365 06:29:19,240 --> 06:29:21,000 ONE OF THE THINGS THAT WE'RE 8366 06:29:21,000 --> 06:29:24,840 CERTAINLY FINDING IN THE 8367 06:29:24,840 --> 06:29:35,360 MACAQUES IS YOU RAISE THE POINT 8368 06:29:44,360 --> 06:29:46,760 IF WE'RE LOOKING TO DEVELOP A 8369 06:29:46,760 --> 06:29:48,160 FRAILTY INDEX WHAT IS RELEVANT 8370 06:29:48,160 --> 06:29:51,640 TO THE END-OF-LIFE AND I THINK 8371 06:29:51,640 --> 06:29:53,040 THERE'S ALSO AN INTERESTING 8372 06:29:53,040 --> 06:29:54,240 THING THAT WE CAN BRING BY 8373 06:29:54,240 --> 06:29:56,480 LOOKING AT MODEL ORGANISMS IS TO 8374 06:29:56,480 --> 06:30:00,200 CAPTURE THAT PRECLINICAL PHASE. 8375 06:30:00,200 --> 06:30:02,680 AND IN FACT THAT MAY BE 8376 06:30:02,680 --> 06:30:09,240 IMPORTANT AS WELL BECAUSE IT'S 8377 06:30:09,240 --> 06:30:10,680 SOMETHING WE CAN'T DO IN HUMANS. 8378 06:30:10,680 --> 06:30:13,360 WE GET AROUND THIS ISSUE OF SORT 8379 06:30:13,360 --> 06:30:15,960 OF SOCIOECONOMIC COMPONENT BY 8380 06:30:15,960 --> 06:30:18,360 MONITORING THESE ANIMALS BUT WE 8381 06:30:18,360 --> 06:30:21,000 MAYBE MISS OUT ON THE 8382 06:30:21,000 --> 06:30:23,480 OPPORTUNITY TO IDENTIFY EARLY 8383 06:30:23,480 --> 06:30:26,120 BIOMARKERS SO IT'S SOMETHING 8384 06:30:26,120 --> 06:30:27,920 THAT IS ABOUT WHAT THE QUESTION 8385 06:30:27,920 --> 06:30:28,600 YOU ARE ASKING IS. 8386 06:30:28,600 --> 06:30:32,440 IS IT DO WE WANT A CLINICALLY 8387 06:30:32,440 --> 06:30:34,160 TRANSLATABLE INDEX OR ARE WE 8388 06:30:34,160 --> 06:30:35,800 TRYING TO DEVELOP SOMETHING THAT 8389 06:30:35,800 --> 06:30:38,840 MAYBE LET'S US STRATIFY WITH A 8390 06:30:38,840 --> 06:30:40,280 HIGHER RESOLUTION THAN WE WILL 8391 06:30:40,280 --> 06:30:44,320 EVER BE ABLE TO IN HUMANS AND 8392 06:30:44,320 --> 06:30:46,320 USE THAT AS A MECHANISM TO GET 8393 06:30:46,320 --> 06:30:48,240 AT THE UNDERLYING FACTORS 8394 06:30:48,240 --> 06:30:51,960 CONTRIBUTING TO MULTIPLE 8395 06:30:51,960 --> 06:30:52,360 MORBIDITY. 8396 06:30:52,360 --> 06:30:54,920 >>I WANT TO MAKE TWO COMMENTS. 8397 06:30:54,920 --> 06:30:56,800 ONE IS, REALLY IT DEPENDS ON 8398 06:30:56,800 --> 06:30:59,160 WHAT YOU WANT TO DO. 8399 06:30:59,160 --> 06:31:01,080 BECAUSE IF WE ARE TRYING TO 8400 06:31:01,080 --> 06:31:02,640 UNDERSTAND WHAT IS THE 8401 06:31:02,640 --> 06:31:04,440 MECHANISMS OF AGING AND HOW THE 8402 06:31:04,440 --> 06:31:06,640 MECHANISMS OF AGING EFFECT 8403 06:31:06,640 --> 06:31:07,960 HEALTH, ACROSS DIFFERENT 8404 06:31:07,960 --> 06:31:11,080 SPECIES, IT'S LIKELY THAT IT 8405 06:31:11,080 --> 06:31:12,400 WILL EFFECT IT IN A DIFFERENT 8406 06:31:12,400 --> 06:31:17,080 WAY SO WE CAN'T REALLY REDUCE 8407 06:31:17,080 --> 06:31:27,600 THE TYPE OF DISEASE WE ARE ONLY 8408 06:31:31,960 --> 06:31:33,040 MEASURING SOME THAT ARE 8409 06:31:33,040 --> 06:31:35,840 IMPORTANT BY HUMANS AND MAY NOT 8410 06:31:35,840 --> 06:31:36,840 BE CAPTURING THOSE THAT ARE 8411 06:31:36,840 --> 06:31:39,760 EFFECTED BY AGING IN THESE 8412 06:31:39,760 --> 06:31:41,280 SPECIFIC SPECIES. 8413 06:31:41,280 --> 06:31:43,400 IF WE'RE TRYING TO HAVE A 8414 06:31:43,400 --> 06:31:46,720 CLINICAL PAT A LEGAL COMPARISM 8415 06:31:46,720 --> 06:31:57,200 BETWEEN ANIMAL AND IT WAS A 8416 06:32:10,960 --> 06:32:14,480 DESIGN IN MIND FOR THE 8417 06:32:14,480 --> 06:32:17,680 PHENOTYPES THAT ARE COMPARABLE 8418 06:32:17,680 --> 06:32:20,280 BETWEEN HUMAN AND ANIMAL AND 8419 06:32:20,280 --> 06:32:23,920 MICE IN THIS CASE AND DISCARDING 8420 06:32:23,920 --> 06:32:27,240 FOR EXAMPLE THAT IN THE MICE, 8421 06:32:27,240 --> 06:32:29,160 HIGH GLUCOSE IS NOT A PREDICT OR 8422 06:32:29,160 --> 06:32:31,800 OF MORTALITY AND IT IS AND A 8423 06:32:31,800 --> 06:32:33,600 VERY STRONG, PROBABLY ONE OF THE 8424 06:32:33,600 --> 06:32:35,000 PREDICTORS OF MORTALITY IN 8425 06:32:35,000 --> 06:32:36,560 HUMANS SO I THINK THAT WE NEED 8426 06:32:36,560 --> 06:32:39,840 TO BE CAREFUL WHAT IS THE INTENT 8427 06:32:39,840 --> 06:32:42,160 OR WHAT WE WANT TO DO TO DECIDE 8428 06:32:42,160 --> 06:32:44,080 YOU KNOW, WHETHER WE CAN HAVE 8429 06:32:44,080 --> 06:32:51,680 THE COMMON INTEXT AND HOW WE 8430 06:32:51,680 --> 06:32:54,640 CREATE IT. 8431 06:32:54,640 --> 06:32:59,000 >>FROM PERSPECTIVE AS A VET, I 8432 06:32:59,000 --> 06:33:00,560 HAVE TWO COMMENTS, ONE IS THE 8433 06:33:00,560 --> 06:33:02,240 VET LEGISLATURE THAT'S COMING 8434 06:33:02,240 --> 06:33:05,120 OUT OF THE CORPORATIZED 8435 06:33:05,120 --> 06:33:06,240 PRACTICES, IS SIMPLY LISTING 8436 06:33:06,240 --> 06:33:08,640 NUMBERS OF MEDICAL DIAGNOSIS 8437 06:33:08,640 --> 06:33:10,680 THAT THEY COULD BE A SKIN WART 8438 06:33:10,680 --> 06:33:12,600 THAT HAS NO MEDICAL SIGNIFICANCE 8439 06:33:12,600 --> 06:33:13,200 WHATSOEVER. 8440 06:33:13,200 --> 06:33:15,080 SO WE HAVE TO BE A LITTLE 8441 06:33:15,080 --> 06:33:15,920 CAUTIOUS ABOUT THOSE NUMBERS 8442 06:33:15,920 --> 06:33:17,480 BECAUSE THAT IS TRULY WHAT THEY 8443 06:33:17,480 --> 06:33:19,960 ARE CAPTURING. 8444 06:33:19,960 --> 06:33:22,200 BUT, WHAT WE ARE REALLY 8445 06:33:22,200 --> 06:33:23,520 INTENTIONALLY TRYING TO DO IN 8446 06:33:23,520 --> 06:33:26,360 OUR DOG WORK, IS UNDERSTAND THE 8447 06:33:26,360 --> 06:33:28,840 AGING PROCESS IN THE DOG TO TRY 8448 06:33:28,840 --> 06:33:32,960 TO ADVANCE THEIR HEALTH AND WE 8449 06:33:32,960 --> 06:33:33,920 ANTICIPATE THERE'S OVERLAP IN 8450 06:33:33,920 --> 06:33:35,440 CERTAIN PARTS OF THAT WHICH CAN 8451 06:33:35,440 --> 06:33:43,560 THEN BE TAKEN TO HUMANS AND SO 8452 06:33:43,560 --> 06:33:45,200 WE'RE SITTING AND UNDERSTANDING 8453 06:33:45,200 --> 06:33:47,960 THE AGING OF EACH ORGAN IN MUCH 8454 06:33:47,960 --> 06:33:49,760 MORE DETAIL SO WE CAN TRANSLATE 8455 06:33:49,760 --> 06:33:51,520 THEM BUT SOME OF IT WON'T BE 8456 06:33:51,520 --> 06:33:53,080 TRANSLATABLE BUT IT WILL HELP 8457 06:33:53,080 --> 06:33:56,880 DOG OWNERS AND DOGS. 8458 06:33:56,880 --> 06:33:59,320 >>A SHORT COMMENT ON WORKING 8459 06:33:59,320 --> 06:34:00,080 WITH MICE. 8460 06:34:00,080 --> 06:34:01,760 ONE OF THE REASONS WHY YOU DON'T 8461 06:34:01,760 --> 06:34:03,680 SEE A LOT OF DOSE DISEASES 8462 06:34:03,680 --> 06:34:08,080 APPEARING IN MICE IS THAT MOST 8463 06:34:08,080 --> 06:34:10,960 OF THE MOUSE WORK IS SCIENTIFIC 8464 06:34:10,960 --> 06:34:15,800 WORK IS REALLY DOMINATED BY THE 8465 06:34:15,800 --> 06:34:20,000 GENETIC APPROACH AND FOCUS ON A 8466 06:34:20,000 --> 06:34:27,040 SINGLE DISEASE IN A SINGLE MOUSE 8467 06:34:27,040 --> 06:34:37,560 AND PEOPLE ARE NOT LOOKING AT 8468 06:35:03,080 --> 06:35:05,080 THE DISEASES AND WORKING IN 8469 06:35:05,080 --> 06:35:07,720 AGING AND THAT FORCES YOU TO 8470 06:35:07,720 --> 06:35:10,320 OPEN YOUR TO MOVE TO MORBIDITY 8471 06:35:10,320 --> 06:35:14,160 AND LOOKING AT THE FACTOR FOR 8472 06:35:14,160 --> 06:35:16,560 THAT AND MAJOR FACTOR IN THAT 8473 06:35:16,560 --> 06:35:17,440 CONTEXT SO, THAT'S ONE OF THE 8474 06:35:17,440 --> 06:35:19,160 RELATION WHY YOU DON'T SEE THAT 8475 06:35:19,160 --> 06:35:21,080 POTENTIAL BUT WE SEE A POTENTIAL 8476 06:35:21,080 --> 06:35:23,400 VERY STRONGLY AND VERY SEVERE 8477 06:35:23,400 --> 06:35:25,000 ACTUALLY AND MONTHS MODELS. 8478 06:35:25,000 --> 06:35:35,560 SOCIAL STRESS SO ANYWAY, IF YOU 8479 06:35:41,320 --> 06:35:43,520 SEE YOU CAN DEVELOP AND VOTE. 8480 06:35:43,520 --> 06:35:53,960 >>WE HAVE A FEW QUESTIONS. 8481 06:37:42,680 --> 06:37:45,920 >>WHERE THEY'VE EXPLICITLY FED 8482 06:37:45,920 --> 06:37:48,080 MODELED AFTER HUMAN DIETS. 8483 06:37:48,080 --> 06:37:49,400 THE MEDITERRANEAN AND WESTERN 8484 06:37:49,400 --> 06:37:52,320 DIET IN A CONTROLLED SETTING TO 8485 06:37:52,320 --> 06:37:53,880 MACAQUES OVER A THREE-YEAR 8486 06:37:53,880 --> 06:37:56,440 PERIOD AND SAW MANY 8487 06:37:56,440 --> 06:37:58,520 PHYSIOLOGICAL AND BEHAVIORAL 8488 06:37:58,520 --> 06:37:59,680 EFFECTS OF THESE MANY OF WHICH 8489 06:37:59,680 --> 06:38:01,760 ARE RELATED TO THE AGING PROCESS 8490 06:38:01,760 --> 06:38:04,880 INCLUDING INCREASED 8491 06:38:04,880 --> 06:38:06,200 INFLAMMATION, PERIPHERAL 8492 06:38:06,200 --> 06:38:07,880 INFLAMMATION AFTER BEING ON THIS 8493 06:38:07,880 --> 06:38:10,640 WESTERN DIET RELATIVE TO THE 8494 06:38:10,640 --> 06:38:12,040 MEDITERRANEAN DIET FOR 15 MONTHS 8495 06:38:12,040 --> 06:38:15,640 AT THAT POINT AND IMPACTS ON THE 8496 06:38:15,640 --> 06:38:16,440 STRESS RESPONSE PATHWAY. 8497 06:38:16,440 --> 06:38:20,640 I CAN POINT YOU TO MORE OF THAT 8498 06:38:20,640 --> 06:38:25,160 LITERATURE. 8499 06:38:25,160 --> 06:38:26,680 >>WE'LL SAVE TIME FOR OTHER 8500 06:38:26,680 --> 06:38:26,920 QUESTIONS. 8501 06:38:26,920 --> 06:38:28,960 I DON'T KNOW WHO CAME FIRST BUT 8502 06:38:28,960 --> 06:38:29,360 OKAY, PLEASE. 8503 06:38:29,360 --> 06:38:33,480 >>I JUST WOULD LIKE TO OPEN YOU 8504 06:38:33,480 --> 06:38:34,720 ALL UP TO ANOTHER OPPORTUNITY 8505 06:38:34,720 --> 06:38:37,960 THAT IS KIND OF TIES IN WITH OUR 8506 06:38:37,960 --> 06:38:38,960 THEME OF THE GEROSCIENCE, RIGHT. 8507 06:38:38,960 --> 06:38:40,320 EARLIER IN THE DAY, WE HEARD 8508 06:38:40,320 --> 06:38:42,840 ABOUT THE SOCIAL DISPARITIES AND 8509 06:38:42,840 --> 06:38:44,400 WE'RE NOW HEARING ABOUT ANIMALS 8510 06:38:44,400 --> 06:38:46,320 AND FOR THE DOGS AND PROBABLY 8511 06:38:46,320 --> 06:38:48,800 CATS AND BIRDS AND WHATEVER 8512 06:38:48,800 --> 06:38:50,000 COMPANION ANIMALS THEY'RE LIVING 8513 06:38:50,000 --> 06:38:53,080 WITH THE HUMANS, RIGHT AND ALL 8514 06:38:53,080 --> 06:38:54,320 SOCIOECONOMIC CLASSES AND WE'RE 8515 06:38:54,320 --> 06:38:56,360 TRYING TO RECRUIT PEOPLE FROM 8516 06:38:56,360 --> 06:38:58,000 ALL DIFFERENT BACKGROUNDS AND WE 8517 06:38:58,000 --> 06:38:59,880 KNOW SOCIAL ISOLATIONS AND 8518 06:38:59,880 --> 06:39:04,320 LONELINESS IS A CONTRIBUTE OR TO 8519 06:39:04,320 --> 06:39:10,240 POOR OUTCOMES IN OLDER ADULTS, 8520 06:39:10,240 --> 06:39:11,800 HOW OFTEN THEY'RE WALKING AND 8521 06:39:11,800 --> 06:39:13,040 EXERCISING MAY BE RELATED IF 8522 06:39:13,040 --> 06:39:14,520 THEY HAVE AN ANIMAL THAT THEY 8523 06:39:14,520 --> 06:39:16,360 WALK AND SO, I THINK YOU KNOW, 8524 06:39:16,360 --> 06:39:20,120 EARLIER TODAY, WE'RE HEARING 8525 06:39:20,120 --> 06:39:20,920 ABOUT DIFFERENT DISCIPLINES 8526 06:39:20,920 --> 06:39:22,440 TRYING TO INTERACT WITH EACH 8527 06:39:22,440 --> 06:39:23,840 OTHER WHILE HERE WE'RE TALKING 8528 06:39:23,840 --> 06:39:25,400 ABOUT THIS ANIMAL GETS THIS AND 8529 06:39:25,400 --> 06:39:27,520 THAT HUMAN GETS THAT BUT MAYBE, 8530 06:39:27,520 --> 06:39:29,480 THERE'S REALLY THIS OPPORTUNITY 8531 06:39:29,480 --> 06:39:33,480 TO WORK TOGETHER TO UNDERSTAND 8532 06:39:33,480 --> 06:39:35,200 BOTH THE INTERACTIONS OF THE 8533 06:39:35,200 --> 06:39:37,320 HUMAN AND THE ANIMALS ON 8534 06:39:37,320 --> 06:39:38,760 OUTCOMES FOR THEM BOTH, IT'S 8535 06:39:38,760 --> 06:39:40,200 KIND OF A DYAD BUT IT'S A 8536 06:39:40,200 --> 06:39:42,280 DIFFERENT KIND OF DYAD. 8537 06:39:42,280 --> 06:39:44,400 AS WELL AS A WAY TO KIND OF 8538 06:39:44,400 --> 06:39:46,160 ENCOURAGE PEOPLE FROM MANY 8539 06:39:46,160 --> 06:39:47,160 DIFFERENT BACKGROUNDS THAT 8540 06:39:47,160 --> 06:39:48,800 THERE'S A LOT OF NUDGE 8541 06:39:48,800 --> 06:39:50,320 INTERVENTIONS AND THERE'S A LOT 8542 06:39:50,320 --> 06:39:52,320 OF WAYS THEY COULD BE IN 8543 06:39:52,320 --> 06:39:54,000 OBSERVATIONAL STUDIES AND SO I 8544 06:39:54,000 --> 06:39:56,760 JUST WANTED THROW OUT THAT MAYBE 8545 06:39:56,760 --> 06:40:01,480 INSTEAD OF HAVING THESE SEPARATE 8546 06:40:01,480 --> 06:40:02,880 DISCIPLINES OF VET AND HUMAN 8547 06:40:02,880 --> 06:40:06,960 MEDICINE WE COULD ACTUALLY WORK 8548 06:40:06,960 --> 06:40:17,160 TOGETHER. 8549 06:40:21,520 --> 06:40:23,280 WE KNOW EXERCISE IS GOOD AND 8550 06:40:23,280 --> 06:40:24,400 DIET EFFECTS OUR HEALTH AND I 8551 06:40:24,400 --> 06:40:26,200 MEAN I THINK VERY OFTEN DO WE DO 8552 06:40:26,200 --> 06:40:28,040 ANIMAL STUDIES TO CONFIRM TO SAY 8553 06:40:28,040 --> 06:40:29,640 LOOK WE HAVE AN ANIMAL MODEL FOR 8554 06:40:29,640 --> 06:40:31,120 THIS THING WE ALREADY KNOW 8555 06:40:31,120 --> 06:40:32,080 OCCURS IN PEOPLE AND HOW MUCH OF 8556 06:40:32,080 --> 06:40:34,440 THAT ARE WE REALLY DOING IN 8557 06:40:34,440 --> 06:40:35,920 ANIMALS THAT IS YOU NEW AND 8558 06:40:35,920 --> 06:40:38,120 ABOUT WHAT CAN WE REALLY LEARN 8559 06:40:38,120 --> 06:40:38,960 FROM ANIMALS THAT BREAKS 8560 06:40:38,960 --> 06:40:42,480 BOUNDARIES THAT WE CANNOT BREAK 8561 06:40:42,480 --> 06:40:42,720 IN PEOPLE. 8562 06:40:42,720 --> 06:40:44,520 >>I WANT TO MAKE A COMMENT. 8563 06:40:44,520 --> 06:40:48,840 I THINK THAT IT'S TRANSLATION 8564 06:40:48,840 --> 06:40:52,160 AND WE USE ANIMAL MODEL BECAUSE 8565 06:40:52,160 --> 06:40:53,600 ONE SIDE WE WANT TO LEARN 8566 06:40:53,600 --> 06:40:55,200 SOMETHING WE SEE WHETHER IT'S 8567 06:40:55,200 --> 06:40:57,320 APPLIED TO HUMANS AND THEN WE 8568 06:40:57,320 --> 06:40:58,600 MAY DISCOVER IN HUMANS WE WANT 8569 06:40:58,600 --> 06:41:01,080 TO SEE IN A MODEL WHERE WE MAY 8570 06:41:01,080 --> 06:41:05,520 DO INTERVENTIONS AND WHETHER 8571 06:41:05,520 --> 06:41:08,640 WHAT WE ARE DISCOVER IN HUMANS 8572 06:41:08,640 --> 06:41:19,120 AND IT'S FUNDAMENTAL AND WE 8573 06:41:24,080 --> 06:41:24,920 WON'T KNEE WHETHER WE'RE DOING 8574 06:41:24,920 --> 06:41:26,360 REAL TRANSITION OWN. 8575 06:41:26,360 --> 06:41:27,760 >>ONE VALUE OF THE ANIMAL MODEL 8576 06:41:27,760 --> 06:41:32,880 IS THAT YOU CAN DO RANDOMIZED 8577 06:41:32,880 --> 06:41:34,640 TRIAL OF THE IT WOULD BRING YOU 8578 06:41:34,640 --> 06:41:36,040 CLOSER TO THE CAUSATION THAT FOR 8579 06:41:36,040 --> 06:41:38,680 A LOT OF THESE HUMAN STUDIES, OF 8580 06:41:38,680 --> 06:41:39,800 PARTICULARLY ON SOCIAL 8581 06:41:39,800 --> 06:41:41,440 DETERMINANTS, SIMPLY CANNOT BE 8582 06:41:41,440 --> 06:41:45,680 PERFORMED FOR ETHICAL REASONS OR 8583 06:41:45,680 --> 06:41:55,920 OTHER REASONS. 8584 06:42:05,640 --> 06:42:08,000 ONE IS FUNDAMENTAL AND I WANTED 8585 06:42:08,000 --> 06:42:11,120 TO KNOW ALSO ABOUT DIET BUT HOW 8586 06:42:11,120 --> 06:42:12,880 MUCH OF THESE DISEASE 8587 06:42:12,880 --> 06:42:14,600 PROGRESSION OF FUNCTION OF HUMAN 8588 06:42:14,600 --> 06:42:16,400 DOG CO EVOLUTION AND WHETHER WE 8589 06:42:16,400 --> 06:42:19,480 KNOW ANYTHING ABOUT DISEASE THIS 8590 06:42:19,480 --> 06:42:20,760 IS OTHER AND MY OTHER QUESTION 8591 06:42:20,760 --> 06:42:22,280 AND MAYBE IT WAS -- 8592 06:42:22,280 --> 06:42:23,320 >>SORRY, CAN YOU SPEAK? 8593 06:42:23,320 --> 06:42:24,520 >>MY APOLOGIES. 8594 06:42:24,520 --> 06:42:27,400 >>FROM HERE WE CAN'T HEAR YOU. 8595 06:42:27,400 --> 06:42:32,440 >>SO, I WANTED TO UNDERSTAND 8596 06:42:32,440 --> 06:42:34,200 DISEASE HE'DOLOGY AND I WAS 8597 06:42:34,200 --> 06:42:35,640 WONDERING WHETHER OTHER CANINE 8598 06:42:35,640 --> 06:42:37,640 HAVE THE SAME TYPE OF DISEASES 8599 06:42:37,640 --> 06:42:39,160 THAT WE'RE SEEING IN DOGS AND 8600 06:42:39,160 --> 06:42:40,480 HOW MUCH OF THAT IS A FUNCTION 8601 06:42:40,480 --> 06:42:43,320 OF DOG HUMAN CO EVOLUTION, 8602 06:42:43,320 --> 06:42:46,440 QUESTION ONE AND TWO, I MAY HAVE 8603 06:42:46,440 --> 06:42:47,640 MISUNDERSTOOD BUT IT SOUNDED 8604 06:42:47,640 --> 06:42:50,920 LIKE I WAS HEARING THAT THESE 8605 06:42:50,920 --> 06:42:53,160 INCIDENTAL FINDINGS WERE 8606 06:42:53,160 --> 06:42:54,600 INCIDENTAL AND THEY WERE NOT THE 8607 06:42:54,600 --> 06:42:55,920 SYMPTOMATIC TYPES OF THINGS THAT 8608 06:42:55,920 --> 06:42:59,200 BROUGHT THE ANIMAL TO THE 8609 06:42:59,200 --> 06:43:02,840 NECROPSY AND WOULDN'T IT BE 8610 06:43:02,840 --> 06:43:05,760 INFORMATIVE TO UNDERSTAND THOSE 8611 06:43:05,760 --> 06:43:06,480 INCIDENTAL FINDINGS GIVEN THAT 8612 06:43:06,480 --> 06:43:09,560 THAT COULD BE A CONTRIBUTING 8613 06:43:09,560 --> 06:43:11,840 FACTOR TO THE OTHER DISEASES AND 8614 06:43:11,840 --> 06:43:13,600 IT SEEMS TO ME THAT THAT WOULD 8615 06:43:13,600 --> 06:43:18,160 BE PRESUMING AN UNDERSTANDING OF 8616 06:43:18,160 --> 06:43:19,880 THESE ORGAN INTER RELATIONSHIPS 8617 06:43:19,880 --> 06:43:23,280 THAT WE DON'T HAVE YET. 8618 06:43:23,280 --> 06:43:26,720 AND SO, YES -- SO ADDRESS, 8619 06:43:26,720 --> 06:43:27,440 PLEASE. 8620 06:43:27,440 --> 06:43:30,240 SOLVE IT. 8621 06:43:30,240 --> 06:43:30,880 [LAUGHTER] 8622 06:43:30,880 --> 06:43:33,000 >>I CAN COMMENT ON THE SECOND 8623 06:43:33,000 --> 06:43:33,440 QUESTION. 8624 06:43:33,440 --> 06:43:34,840 I HAVE LEAVE THE CO EVOLUTION 8625 06:43:34,840 --> 06:43:35,880 QUESTION TO OTHERS. 8626 06:43:35,880 --> 06:43:39,200 ALTHOUGH THERE'S A FANTASTIC 8627 06:43:39,200 --> 06:43:41,880 BOOK ON DOG HUMAN CO EVOLUTION 8628 06:43:41,880 --> 06:43:43,200 THAT I DON'T KNOW ANSWERS TO 8629 06:43:43,200 --> 06:43:46,480 THAT QUESTION BUT IT'S 8630 06:43:46,480 --> 06:43:48,240 FASCINATING. 8631 06:43:48,240 --> 06:43:49,080 TERMS OF THE INCIDENTAL 8632 06:43:49,080 --> 06:43:49,920 FINDINGS, THIS IS SOMETHING 8633 06:43:49,920 --> 06:43:51,440 WE'VE BEEN WRESTLING WITH SO 8634 06:43:51,440 --> 06:43:53,000 IT'S FRONT OF MY MIND. 8635 06:43:53,000 --> 06:43:56,480 SO WE DO HAVE A NUMBER OF 8636 06:43:56,480 --> 06:43:58,640 DISEASES THAT ARE MUCH MORE 8637 06:43:58,640 --> 06:43:59,640 COMMONLY, I MEAN, I DON'T KNOW 8638 06:43:59,640 --> 06:44:02,120 THAT YOU CAN SAY YOU DIAGNOSE A 8639 06:44:02,120 --> 06:44:03,480 DISEASE AT NECROPSY BECAUSE YOU 8640 06:44:03,480 --> 06:44:05,120 KNOW, WHAT WAS THE MANIFESTATION 8641 06:44:05,120 --> 06:44:06,680 IN THE ANIMAL. 8642 06:44:06,680 --> 06:44:08,360 BUT TUMORS, FOR EXAMPLE, ARE 8643 06:44:08,360 --> 06:44:10,840 VERY COMMON TO FIND AT NECROPSY 8644 06:44:10,840 --> 06:44:13,240 AND IN FACT ABOUT HALF ARE THERE 8645 06:44:13,240 --> 06:44:16,440 AT THAT POINT AND SO I THINK, I 8646 06:44:16,440 --> 06:44:18,000 MEAN I THINK IT'S AN INTERESTING 8647 06:44:18,000 --> 06:44:19,640 QUESTION AND IT SUGGESTS THAT 8648 06:44:19,640 --> 06:44:21,800 THERE WAS SOME DISRUPTION OF THE 8649 06:44:21,800 --> 06:44:24,440 UNDERLYING PHYSIOLOGY AND I 8650 06:44:24,440 --> 06:44:25,880 THINK THAT THAT HAS BEEN VERY 8651 06:44:25,880 --> 06:44:27,280 INTERESTING FOR US TO TRY TO 8652 06:44:27,280 --> 06:44:29,200 FIGURE OUT HOW TO DEAL WITH IT 8653 06:44:29,200 --> 06:44:30,200 PARTICULARLY BECAUSE YOU DON'T 8654 06:44:30,200 --> 06:44:32,200 KNOW WHEN THEY EMERGED AND WE'VE 8655 06:44:32,200 --> 06:44:34,320 BEEN FOCUSED ON THESE 8656 06:44:34,320 --> 06:44:36,040 LONGITUDINAL QUESTIONS BUT AS A 8657 06:44:36,040 --> 06:44:38,640 OVER ALL SORT OF IN THIS CONTEXT 8658 06:44:38,640 --> 06:44:39,280 OF THE GEROSCIENCE HYPOTHESIS I 8659 06:44:39,280 --> 06:44:40,520 THINK YOU ARE RIGHT AND I THINK 8660 06:44:40,520 --> 06:44:43,880 YOU NEED TO, IF WHAT WE'RE 8661 06:44:43,880 --> 06:44:45,080 EXPECTING THERE'S SOME 8662 06:44:45,080 --> 06:44:47,280 UNDERLYING DISREGULATION, THEN 8663 06:44:47,280 --> 06:44:49,880 YES, WE DO NEED TO TAKE THOSE 8664 06:44:49,880 --> 06:44:50,760 INCIDENTAL FINDINGS INTO 8665 06:44:50,760 --> 06:44:52,640 CONSIDERATION AND HOW WE WEIGHT 8666 06:44:52,640 --> 06:44:55,000 THEM, HOW WE THINK ABOUT THEM IN 8667 06:44:55,000 --> 06:44:57,000 TERMS OF THEIR EMERGENCE IS THE 8668 06:44:57,000 --> 06:44:58,240 IMPLICATION PART IS THE TRICKY 8669 06:44:58,240 --> 06:45:00,120 PART BUT I THINK THAT YOU KNOW, 8670 06:45:00,120 --> 06:45:01,680 IN TERMS, YES, I WOULD 8671 06:45:01,680 --> 06:45:02,640 ABSOLUTELY AGREE WE SHOULD BE 8672 06:45:02,640 --> 06:45:04,400 THINKING ABOUT THEM. 8673 06:45:04,400 --> 06:45:10,400 >>OKAY, I CAN TACKLE THE DINGO 8674 06:45:10,400 --> 06:45:11,680 ABOUT WOLVES WHICH I KNOW 8675 06:45:11,680 --> 06:45:12,640 NOTHING. 8676 06:45:12,640 --> 06:45:14,280 SPEAKING AS A VETERINARIAN, MOST 8677 06:45:14,280 --> 06:45:18,600 OF THE DISEASE WE SEE IN DOGS IS 8678 06:45:18,600 --> 06:45:19,960 GENETIC IN ORIGIN. 8679 06:45:19,960 --> 06:45:22,640 IT'S GENERATED BY VERY SPECIFIC 8680 06:45:22,640 --> 06:45:24,840 BREEDING FOR VERY SPECIFIC 8681 06:45:24,840 --> 06:45:25,880 TRAITS. 8682 06:45:25,880 --> 06:45:27,880 AND SO WOLVES ARE DIFFERENT TO 8683 06:45:27,880 --> 06:45:28,080 THAT. 8684 06:45:28,080 --> 06:45:30,280 SO THE MAJOR THREE DISEASES THAT 8685 06:45:30,280 --> 06:45:33,600 WE SEE KILL OFF OUR DOGS AND OUR 8686 06:45:33,600 --> 06:45:34,600 LONGITUDINAL STUDY FOR EXAMPLE, 8687 06:45:34,600 --> 06:45:37,480 NUMBER ONE, MASSIVE CANCER. 8688 06:45:37,480 --> 06:45:40,200 THEY GET A CAR SIN OWN A OR 8689 06:45:40,200 --> 06:45:42,120 SARCOMA AROUND 10 AND 11 YEARS 8690 06:45:42,120 --> 06:45:43,400 OF AGE AND THEY'RE OUT OF THE 8691 06:45:43,400 --> 06:45:45,520 STUDY AND IF THEY GET BEYOND 8692 06:45:45,520 --> 06:45:47,920 THAT, IT'S RENAL DISEASE EX 8693 06:45:47,920 --> 06:45:49,160 DEMENTIA AND WE HAVE MOBILITY 8694 06:45:49,160 --> 06:45:50,800 ISSUES AND SOME DOGS GET 8695 06:45:50,800 --> 06:45:52,920 EUTHANIZED FOR THAT BUT MOVE THE 8696 06:45:52,920 --> 06:45:54,920 PORT ART IT'S OTHER THINGS AND I 8697 06:45:54,920 --> 06:45:57,200 REALLY COULD NOT TELL YOU WHAT 8698 06:45:57,200 --> 06:45:59,800 HAPPENS TO THESE OTHER WILD 8699 06:45:59,800 --> 06:46:00,760 DOGS, I'M AFRAID. 8700 06:46:00,760 --> 06:46:02,160 BUT I KNOW THAT THEY DON'T GET 8701 06:46:02,160 --> 06:46:06,400 THAT GENETIC DISEASE IN THE SAME 8702 06:46:06,400 --> 06:46:07,240 WAY. 8703 06:46:07,240 --> 06:46:12,040 >>I THINK IF WE CONSIDER ANY 8704 06:46:12,040 --> 06:46:13,280 LESION THAT ACCUMULATES WITH AGE 8705 06:46:13,280 --> 06:46:15,640 AS BEING A REFLECTION WITH 8706 06:46:15,640 --> 06:46:19,280 DISRUPTED HOMEY' STAY IS BUT AS 8707 06:46:19,280 --> 06:46:21,640 WE MOVE FORWARD WITH COLLECTING 8708 06:46:21,640 --> 06:46:22,480 EPIGENETIC DATA IN DIFFERENT 8709 06:46:22,480 --> 06:46:25,760 ORGAN SYSTEMS I ALSO THINK IT'S 8710 06:46:25,760 --> 06:46:26,480 IMPORTANT TO RECOGNIZE THAT 8711 06:46:26,480 --> 06:46:28,760 SPECIES DIFFERENCES IN DISEASE 8712 06:46:28,760 --> 06:46:29,680 MANIFESTATION BETWEEN THOSE 8713 06:46:29,680 --> 06:46:39,920 ORGAN SYSTEMS.