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Extending Life, Enhancing Life: A National Research Agenda on Aging
have seen substantial growth from their meager beginnings over four decades ago.
Notwithstanding this progress, the medical and scientific community 's knowledge, research, and clinical capacity lag far behind the human need, and society currently is paying a heavy price for decades of neglect of aging and the special needs of older persons. The burgeoning elderly population will increasingly burden the nation's fiscally troubled health care system. Despite our recognition that investments in research ultimately yield substantial financial, clinical, and social benefits, the nation's commitment to aging research is minuscule in comparison to the costs of health care for older persons. Even in the case of Alzheimer's disease—one of the best-supported areas of age-related research—expenditures for scientific investigation equal less than one-half of one percent (0.1 percent) of the costs of care for the victims of this disease (Report of the Advisory Panel on Alzheimer 's Disease 1988-1989, U.S. Department of Health and Human Services, DHHS Pub. No. (ADM)89-1644).
Given the heavy toll and long duration of chronic illness and disability, the small national commitment to aging research is a particularly risky and potentially wasteful strategy, especially in light of the enormous promise of properly supported research, not only to improve the status of older adults, but also to reduce substantially the costs of their care. Effective strategies against many disorders common in old age, such as dementia, urinary incontinence, osteoporosis, and falls, could yield huge financial savings and, at the same time, enhance well-being. Likewise, research is needed on intervention strategies to ameliorate the deleterious conditions of economic and social dependency, the growing caregiving burden, and inadequate coping capacities. Such research could reduce negative health effects and their attendant costs while improving the aging experience for millions of Americans.
A factor limiting the development of gerontologic and geriatric research is the critical shortage of workers in this area. Current funding mechanisms often do not provide adequate research or training support for young investigators interested in studying aspects of aging. The United States must develop effective mechanisms to attract established scientists from other fields into aging or age-related research, and it must construct attractive career ladders for young investigators from a variety of fields who enter the study of aging as a career.
A growing sense of urgency mandates that the time is right to narrow the gap between the needs of an aging society and the scientific knowledge base. Building on the existing academic sub-