Aging does not proceed along the same pathways and timelines in all populations. Recent work shows that even diseases—including Alzheimer’s disease and others—can develop differently in some ethnic and minority groups. As a result, aging research offers new possibilities for careers at academic, government, and industrial organizations.
“The aging of the American population is wholly unprecedented,” says Daniel Perry, executive director of the Alliance for Aging Research. In When I’m 64 (2006) from the U.S. National Research Council, the authors write: “By 2030 there will be about 70 million people in the United States who are older than 64, nearly 22 percent of the population.” Even more significant from a health standpoint, Perry points out that the number of people 85 years of age or older will quadruple from 2000 to 2030. The authors of When I’m 64 add that the 2030 population will be more ethnically and racially diverse. Perry says, “This is an enormous social change, and it brings challenges and opportunities for people in medical research.”
Currently, the Caucasian population makes up about 84 percent of the elderly population in the United States, according to Perry. He adds, though, that this figure will drop to about 75 percent by 2030. The relative increase in the non-Caucasian population could trigger equal increases in some health problems—such as diabetes and high blood pressure—that afflict some minorities at high rates. “There’s a lot to learn about what is driving those disparities,” says Perry. “We want to improve the quality and length of life for people who are not currently enjoying the same opportunities for healthy aging.”
The most interesting research “attracts new investigators,” says J. Taylor Harden, assistant to the director for special populations at the National Institute on Aging of the U.S. National Institutes of Health. For example, she points out a recent study by Jonathan Skinner, John French Professor of Economics at the Dartmouth University School of Medicine. In Circulation in 2005, Skinner and his colleagues reported that risk-adjusted mortality from acute myocardial infarction is “significantly higher in [U.S.] hospitals that disproportionately serve blacks. A reduction in overall mortality at these hospitals could dramatically reduce black-white disparities in healthcare outcomes.”
As another example of intriguing research, Harden points out a 2005 study in the Archives of Neurology by Christopher Clark, associate professor of neurology at the University of Pennsylvania Health System, and his colleagues. In the abstract to this article, Clark and his colleagues wrote: “Latino individuals are the largest minority group and the fastest growing population group in the United States, yet there are few studies comparing the clinical features of Alzheimer disease (AD) in this population with those found in Anglo (white non-Latino) patients.” Clark and his colleagues found that “Latino patients had a mean age at symptom onset 6.8 years earlier … than Anglo patients.” In thinking about that research, Harden says, “We want to make sure that our diagnostic tools are appropriate and help people if this is an issue for this population. For example, families might think about getting older members examined and get support in place if needed.”
No one is surprised to hear that aging research related to ethnic or minority populations covers many aspects of basic and medical science. Consequently, a wide variety of backgrounds could lead to work in this field. For example, Perry says, “There is a great deal of interest in people who understand the basic mechanisms of cellular biology, genetics, and proteins.” He adds, “A person with strong credentials in immunology would also find much to do.”
Aging research will also impact the pharmaceutical industry. Perry says, “Because our society supports medical investigations with the hope of affecting people’s lives for the better, this field will increasingly be part of clinical trials and clinical medicine.”
The work on aging in ethnic and minority populations will also explore psychological and sociological aspects. “Feelings of worth and belonging,” says Perry, “are really determinant factors in aging. So there is a lot of interest in behavioral factors.” Keith Whitfield, associate professor of biobehavioral health at Pennsylvania State University, agrees. He says, “There’s a need for a solid understanding of the social and behavioral science of minority aging.”
Wrongly, older adults are often considered less competent than younger people. The authors of When I’m 64 write: “There is ample evidence to suggest that negative expectations and stereotypes about the competence of older adults pervade Western culture.” Nonetheless, such expectations are often false. The authors go on to write that “there is also evidence of older adults serving important roles in society.”
The impact of social factors could be especially relevant to neurological capabilities. For example, work by Whitfield and his colleagues suggests that social support might play a key role in preserving cognitive functioning among African-Americans. He says, “In the long run, this could be good for African-American families, because they often have strong kin networks. For example, the disproportionate rates of poverty among African-Americans lead to considerable custodial care by grandparents. It gives the grandparents activities and challenges, provides someone to take care of the children,” and seems to ultimately benefit the cognitive health of the grandparents.
The Big Boom
“Aging research, in general, is a very hot area,” says Perry, “given that we are now just five years from the date when the first baby boomer turns 65. We will soon go from about six thousand people turning 65 every day to close to ten thousand.” This enormous increase in the older portion of the population alone will drive more interest in research on aging and also require more services for those people. “There couldn’t be an area with more interest,” Perry continues, “and the current health disparities for ethnic and minority populations will only become more stark, unless we find ways to extend life for all races and backgrounds.”
In addition, the changes going on in the U.S. population create new opportunities. Whitfield says, “Even in tough financial times for many institutions of higher learning, there is a great interest in diversity and in aging.” In addition, he says that no one knows the details of how aging varies in different ethnic and minority groups. “It’s almost like we need to establish new starting points for much of our understanding of aging so we get it right.”
The future opportunities in aging for ethnic and minority populations will also go beyond basic and applied research. “There will also be considerable work in health delivery services,” says Perry. “We now have a shockingly small number of doctors, nurses, pharmacists, physical therapists, and so on who have extended education and credentials in geriatrics.” He adds, “The number of doctors with qualifications in geriatric medicine is only about 3 percent.” He thinks that will create a tremendous demand for such specialists in managed care organizations and hospitals.
“In 1999,” says Perry, “NIH identified health disparities as an area of special emphasis. It developed a minority aging review committee so that opportunities for jobs in this area will continue to grow.” Along with that NIH emphasis, research funds should be available. “Funding for medical- and health-related science continues to outstrip physical sciences, chemistry, and so on,” says Perry. Also, the aging population will probably enhance the pressure to fund research. “Every member of Congress has constituents who get sick or whose parents get sick,” says Perry.
Many biotechnology companies also work on aging. Elan is developing a vaccine for Alzheimer’s disease. Geron explores many therapies related to aging, including cell-based approaches to chronic diseases. Migenix also puts significant resources into treatments for degenerative diseases. “Even Genentech focuses a lot on aging,” says Perry.
To make the greatest strides on aging for ethnic and minority populations, scientists might need a new approach. “We need to stop thinking that we can take things that have been studied in other groups and simply apply that to minorities,” says Whitfield. “Results show that there are different patterns and causal pathways to similar outcomes.” Those results—seeing new mechanisms of aging in some populations—open new opportunities for everyone in this field.