A Vote for Aging-Related Research?

Although Alzheimer's disease and stem-cell research are receiving extraordinary media and political attention because of the upcoming election, the real politics of aging-related research lie largely outside the current presidential race.
 
Medical research is rarely a hot political topic, and work on aging-related diseases ranks still lower in the hierarchy of issues that keep campaign consultants awake at night. Yet during this election season, talk of stem-cell research as a potential cure for Alzheimer's disease (AD) made the front pages when it became the topic of an entire speech at a party convention and even warranted mention by the candidates themselves. But aside from that very specialized slice of aging-related research, the final tallies on 2 November probably won't affect progress in the field. Although President George W. Bush and Democratic contender John Kerry diverge strongly on their support for stem-cell work, they have not articulated any broader views on fighting aging's scourges from the lab bench. And when it comes to backing research with funding, the real clout lies outside the White House.
 
Research on AD, the most high-profile of aging-related diseases, took center stage following the June death of former U.S. President Ronald Reagan, who suffered from the illness for years. The Democrats subsequently gave a prime-time speaking slot at their Boston convention to his son Ron Reagan, who argued passionately for greater funding for stem-cell research to cure diseases such as the AD that afflicted his father.
 
Bush's Administration sees things differently. Although Republicans as a party have no set position on the issue, conservatives oppose such work as immoral--because the material is derived from embryos--and they remain adamant that stem-cell research should be strictly controlled, if not banned (see "Deja Vu"). So 3 years ago, Bush approved research using only a limited number of stem-cell lines. If the president wins the election, the Administration is unlikely to loosen the restrictions now in place. Kerry has harshly criticized the Bush Administration's policy on stem-cell research as "ideological shackles" on scientists. If Kerry triumphs, he promises to ease the rules--a move he says should provide "immense promise" for curing disease. This prediction remains controversial even among scientists, who voice concern that the stem-cell hype might falsely raise people's expectations for quick fixes for a host of conditions, including AD.
 
Aside from debating stem cells, however, neither campaign has put forward a clear agenda for aging-related research--a situation that comes as no surprise to scientists and lobbyists who follow the field. "Politicians don’t think long term, and this is a long-term issue," says Edward Schneider, a gerontologist at the University of Southern California in Los Angeles. Such research is time consuming and does not lead directly to cures, facts that make it a hard sell, adds Richard Miller, a gerontologist at the University of Michigan, Ann Arbor. And basic biology is not a topic that excites members of Congress or the powerful pharmaceutical companies.
 
But the real meat of aging-related politics lies not with the candidates or their advisers. It resides with the members of congress, who control the purse strings when it comes to federal funding. Most research on aging takes a back seat to diseases with strong and savvy lobbies that make use of celebrities and the tragedy of youthful illness to turn sympathy into money. Despite the rapid aging of the U.S. population, aging-related research has received only modest increases in the past decade, mostly as a result of the increase in the overall budget for the National Institutes of Health (NIH). Lobbyists and researchers say that this difficulty in winning the kinds of large funding boosts enjoyed by other fields such as AIDS research reflects the lack of a strong and powerful advocate on Capitol Hill. The late Senator Claude Pepper and retired House appropriations chair John Porter were tireless backers of research that benefited the elderly--but their successors have yet to appear.
 
The lack of political leadership doesn't mean aging-related research as a whole is being ignored. NIH spends $1 billion annually on its National Institute on Aging (NIA), with half funneled toward AD. But some researchers are concerned about the relative lack of funding for aging-related conditions that are less dramatic than AD. Debilitating problems that afflict millions of the elderly--such as urinary incontinence, degeneration of the retinas, and weakening of the lungs--remain "diseases in the shadows," says Daniel Perry, executive director of the Alliance for Aging Research, co-publisher of SAGE Crossroads. Such disorders receive less than $100 million in funding from NIA, or one-half of 1% of its annual budget. There is no hint that Bush or Kerry would deviate significantly in a future Administration.
 
Despite the fact that millions are afflicted with these conditions, the scientific community, Congress, and society as a whole resist focusing research dollars on them, scientists say. This lack of attention reflects a prejudice that treating the byproducts of aging is somehow unnatural, says Schneider: Illness is assumed to be part of life for the elderly, unlike that of the young (see "It's Not Age"). "This is an entirely false argument," he says. Providing a good quality of life in later years is sure to become a potent issue as baby boomers retire, Schneider adds--and he predicts there will be finger-pointing if the research has not been done. Advocates for many high-profile diseases such as cancer and AIDS use aggressive lobbying and well-known Hollywood celebrities to make their case, but such tactics are unexploited among those wanting more research into urinary incontinence.
 
Ultimately, researchers who study aging will need more than the brief and sudden exposure of this heated election campaign to further their cause. But that doesn’t mean politics don’t matter. "The obstacles to finding a cure for aging are 85% political and 15% scientific," says Miller, because lawmakers and the public don't have much interest in the basic mechanisms of aging. And with the rising tide of elderly--and elderly voters--the stem-cell debate might be just an early warning sign that politicians sooner or later must devote more time and energy to the science and politics of aging.
 
Andrew Lawler is the Boston correspondent for Science magazine and currently spends his time and money arresting the aging process of his 19th century house.