These predisease markers can then “be used and measured longitudinally to find interventions that are effective in altering the course toward later disease,” he said. “The well-accepted model of preventing atherosclerosis in heart disease by exercise and lowering cholesterol needs to be expanded to other disorders.”

We also would benefit from more cross-system studies, he said. “We need to maintain a life-course perspective and think about early life events and their effects on later life outcomes—not just in aging, but in midlife. [We should] be particularly interested in understanding gene-environment interactions now that we understand more about the fact that it is not nature or nurture, but nature interacting with nurture. And of course, [we must] include behavioral and social environment as important factors in causing changes in biology.”

He noted that “it is somewhat ironic that the National Institutes of Health primarily studies disease, not the factors of positive health and resilience.” This highlights the biggest and most fundamental challenge, Dr. McEwen said, which is to promote “the establishment of working groups that will give scientists time to get acquainted with each other, learn about each other’s disciplines, and plan interdisciplinary studies.”



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