Geroscience posits that molecular drivers underlie the aging process. Gerotherapeutics entail strategies to counter molecular drivers of aging to reduce the chronic diseases and geriatric syndromes they trigger. Although the concept of gerotherapeutics for prevention has generated much excitement, the implications of prescribing potentially harmful medications to older adults who are “healthy” have been associated with many delays. Concerns regarding safety and valid endpoints have contributed to holdups. In contrast, it has been relatively easier to implement trials of medications with gerotherapeutic properties as novel approaches to remedy disease. In these applications, the risks of the medications are easier to justify when therapeutic benefits are perceived as outweighing the harms of the disease. Likewise, metrics of effective disease treatments are often seen as more reliable and quantifiable than metrics of health prolongation. Overall, clarifying geroscience mechanisms in disease therapeutic applications provides key opportunities to advance translational geroscience, especially as preventive geroscience trials are often encumbered. In this review, gerotherapeutic benefits of canakinumab, cholchicine, and zoledronic acid as parts of disease management are considered. Longevity Clinics and other opportunities to advance translational geroscience as parts of contemporary care are also discussed.

中文翻译：

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将转化老年科学引入临床的实用方法：基于衰老相关临床研究增量进展的范式


Geroscience 假设分子驱动因素是衰老过程的基础。老年疗法需要对抗衰老的分子驱动因素的策略，以减少它们引发的慢性疾病和老年综合征。尽管用于预防老年疗法的概念引起了极大的兴奋，但为“健康”的老年人开具可能有害的药物的影响与许多延误有关。对安全性和有效终点的担忧导致了延误。相比之下，将具有老年治疗特性的药物作为治疗疾病的新方法进行试验相对容易。在这些应用中，当治疗益处被认为大于疾病的危害时，药物的风险就更容易证明。同样，有效疾病治疗的指标通常被认为比健康延长的指标更可靠和可量化。总体而言，阐明疾病治疗应用中的老年科学机制为推进转化老年科学提供了关键机会，尤其是在预防性老年科学试验经常受到阻碍的情况下。在本综述中，考虑了卡纳单抗、胆碱和唑来膦酸作为疾病管理的一部分的老年治疗益处。还讨论了长寿诊所和其他将转化老年科学作为当代护理一部分的机会。