Review article: Biomedical intelligence
Vol. 153 No. 6 (2023)
Translational longevity medicine: a Swiss perspective in an ageing country
- Marco M. Ruckstuhl
- Evelyne Bischof
- Dana Blatch
- Aliki Buhayer
- Jörg Goldhahn
- Edouard Battegay
- Andre Tichelli
- Collin Y. Ewald
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Cite this as:
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Swiss Med Wkly. 2023;153:40088
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Published
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30.06.2023
Summary
Breakthroughs in medical research in the last century have led to a significant extension of the human lifespan, resulting in a shift towards an elderly population worldwide. Due to the ongoing progress of global development towards elevated standards of living, this study specifically examines Switzerland as a representative nation to explore the socioeconomic and healthcare ramifications associated with an ageing population, thereby highlighting the tangible impact experienced in this context. Beyond the exhaustion of pension funds and medical budgets, by reviewing the literature and analysing publicly available data, we observe a “Swiss Japanification”. Old age is associated with late-life comorbidities and an increasing proportion of time spent in poor health. To address these problems, a paradigm shift in medical practice is needed to improve health rather than respond to existing diseases. Basic ageing research is gaining momentum to be translated into therapeutic interventions and provides machine learning tools driving longevity medicine. We propose that research focus on closing the translational gap between the molecular mechanisms of ageing and a more prevention-based medicine, which would help people age better and prevent late-life chronic diseases.
References
- Migration BSD und. Periodensterbetafeln für die Schweiz (1876-2150) nach Jahr, Geschlecht und Alter [Internet]. Bundesamt für Statistik; 2019 Apr. Available from: https://www.bfs.admin.ch/asset/de/px-x-0102020300_102
- Kohli R. Sterbetafeln für die Schweiz 2008/2013 [Internet]. Bundesamt für Statistik; 2017. Available from: https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&ved=2ahUKEwi8qb_ygPL2AhWM_6QKHbVxD54QFnoECAYQAQ&url=https%3A%2F%2Fwww.bfs.admin.ch%2Fbfsstatic%2Fdam%2Fassets%2F2103067%2Fmaster&usg=AOvVaw2eaEcfFAosBN8xQfnibWiJ
- STATPOP BE. Wachstum der ständigen Wohnbevölkerung nach Staatsangehörigkeit 1970-2020 [Internet]. Bundesamt für Statistik; 2021 Sep. Available from: https://www.bfs.admin.ch/bfs/de/home/statistiken/bevoelkerung/stand-entwicklung/alter-zivilstand-staatsangehoerigkeit.assetdetail.18264538.html
- BFS. Medianalter der ständigen Wohnbevölkerung nach Geschlecht und Staatsangehörigkeitskategorie, 1971-2020 [Internet]. Bundesamt für Statistik; 2021 Sep. Available from: https://www.bfs.admin.ch/bfs/de/home/statistiken/kataloge-datenbanken/tabellen.assetdetail.18344318.html
- BFS. Kohortensterbetafeln für die Schweiz, Geburtsjahrgänge 1876-2030, Technischer Bericht 2018 [Internet]. Bundesamt für Statistik; 2019 Apr. Available from: https://www.bfs.admin.ch/bfs/de/home/statistiken/bevoelkerung/geburten-todesfaelle/lebenserwartung.assetdetail.8126461.html
- Dong X, Milholland B, Vijg J. Evidence for a limit to human lifespan. Nature. 2016 Oct;538(7624):257–9. 10.1038/nature19793
- Olshansky SJ, Carnes BA. Inconvenient Truths About Human Longevity. Newman A, editor. The journals of gerontology Series A, Biological sciences and medical sciences. 2019 Nov 13;74(Supplement_1):S7–12. 10.1093/gerona/glz098
- Barbi E, Lagona F, Marsili M, Vaupel JW, Wachter KW. The plateau of human mortality: demography of longevity pioneers. Science. 2018 Jun;360(6396):1459–61. 10.1126/science.aat3119
- Network GB of DC. Global Burden of Disease Study 2017 (GBD 2017) Results [Internet]. Institute for Health Metrics and Evaluation (IHME); 2018. Available from: http://ghdx.healthdata.org/gbd-results-tool
- Xu J, Murphy SL, Kochanek KD, Arias E. Mortality in the United States, 2015 [Internet]. NCHS Data Brief. 2016 Dec;(267):1–8. Available from: https://pubmed.ncbi.nlm.nih.gov/27930283/
- Rosenquist K, Fox C. Chapter 36 Mortality Trends in Type 2 Diabetes. In: Diabetes in America. 3rd edition. 2018. Available from: https://www.ncbi.nlm.nih.gov/books/NBK568010
- Case A, Deaton A. Mortality and morbidity in the 21st century. Brookings Pap Econ Act. 2017;2017(1):397–476. 10.1353/eca.2017.0005
- Group WB. Databank World Development Indicators [Internet]. 2022 [cited 2022 Feb 27]. Available from: https://databank.worldbank.org/reports.aspx?source=2&series=SP.DYN.LE00.MA.IN&country=
- Janssen F, van Poppel F. The Adoption of Smoking and Its Effect on the Mortality Gender Gap in Netherlands: A Historical Perspective. BioMed Res Int. 2015;2015:370274. 10.1155/2015/370274
- OECD. Health at a Glance 2021. Heal Glance; 2021.
- Migration BSD und. Lebendgeburten nach Monat und Geburtenhäufigkeit seit 1803 [Internet]. Bundesamt für Statistik; 2021. Available from: https://www.pxweb.bfs.admin.ch/pxweb/de/px-x-0102020204_111/px-x-0102020204_111/px-x-0102020204_111.px
- Craig J. Replacement level fertility and future population growth. Popul Trends. 1994;(78):20–2.
- Wyler J. Die Geburtenhäufigkeit der Schweiz während des Weltkrieges [Internet]. 1921. Available from: https://www.sgvs.ch › sjesBackIssues › 1921_PDF
- Wanner P. Harmonisation de la statistique ESPOP 1981-2010 avec la statistique STATPOP. Universite de Geneva; 2012.
- Bauer AB. AHV-Statistik: Die Geschichte der AHV [Internet]. Hintergrunddokument Die Geschichte der AHV. 2018 [cited 2022 Mar 20]. Available from: https://www.bsv.admin.ch/bsv/de/home/sozialversicherungen/ahv/statistik.html
- Sozialversicherungen B für. Anzahl AHV-Renten, Rentensumme und Mittelwert im Dezember nach Rententyp, Wohnsitzstaat (Kategorie), Staatsangehörigkeit (Kategorie) und Geschlecht [Internet]. 2020. Available from: https://www.pxweb.bfs.admin.ch/pxweb/de/px-x-1305000000_101/px-x-1305000000_101/px-x-1305000000_101.px
- Feldstein M, Liebman J. Social Security. 10.3386/w8451
- Schaltegger C, Leisibach P. Eidgenössische Volksinitiative «Für eine sichere und nachhaltige Altersvorsorge» (Renteninitiative) Eine ökonomische Beurteilung der wichtigsten Argumente [Internet]. Universitaet Luzern; 2020 May p. 1–60. Available from: https://renten-sichern.ch/uploads/renteninitiative/Gutachten_Renteninitiative.pdf
- Wasserfallen C. Renteninitiative [Internet]. 2022 [cited 2022 Mar 20]. Available from: https://renten-sichern.ch/article/4566/gesucht-200-milliarden-franken
- Vorsorge SB. Überblick über den Stand der Vorsorgeeinrichtungen (VE): Bilanzsumme, aktive Versicherte, Bezüger und Leistungen [Internet]. Bundesamt für Statistik; 2022. Available from: https://www.pxweb.bfs.admin.ch/pxweb/de/px-x-1303030000_101/px-x-1303030000_101/px-x-1303030000_101.px
- OECD. Old-age dependency ratio [Internet]. 2022 [cited 2022 Jun 6]. Available from: https://data.oecd.org/pop/old-age-dependency-ratio.htm
- Bank TW. Age dependency ratio, old (% of working-age population) [Internet]. 2022 [cited 2022 Jun 6]. Available from: https://data.worldbank.org/indicator/SP.POP.DPND.OL
- Summers L. Accepting the Reality of Secular Stagnation. Finance Dev. 2020;57(1).
- Rachel Ł, Summers L. On Secular Stagnation in the Industrialized World. 10.3386/w26198
- Klose J. Secular Stagnation in Non-EMU European Countries : Equilibrium Real Rate Approach. J Econ Integr. 2017;32(2):400–32. 10.11130/jei.2017.32.2.400
- Murakami Y, Bohn J. The Japanification of the world [Internet]. 2020 [cited 2022 Apr 3]. Available from: https://www.swissre.com/institute/conferences/the-ageing-effect/the-japanification-of-the-world.html
- Brunner AD, Kamin S; System B of G of the FR. Brunner AD, Kamin S. Determinants of the 1991-93 Japanese Recession: Evidence from a Structural Model of the Japanese Economy. Int Finance Discuss Pap. 1994;1994(479):1–56. 10.17016/IFDP.1994.479
- Goodhart C, Pradhan M. The Great Demographic Reversal: Ageing Societies, Waning Inequality, and an Inflation Revival. Palgrave Macmillan; 2020. 280 pp. 10.1007/978-3-030-42657-6
- Case A, Deaton A. Mortality and morbidity in the 21st century. Brookings Pap Econ Act. 2017;2017(1):397–476. 10.1353/eca.2017.0005
- Partridge L, Fuentealba M, Kennedy BK. The quest to slow ageing through drug discovery. Nat Rev Drug Discov. 2020 Aug;19(8):513–32. 10.1038/s41573-020-0067-7
- Polliack ML, Barak Y, Achiron A. Late-onset multiple sclerosis. J Am Geriatr Soc. 2001 Feb;49(2):168–71. 10.1046/j.1532-5415.2001.49038.x
- Vaughn CB, Jakimovski D, Kavak KS, Ramanathan M, Benedict RH, Zivadinov R, et al. Epidemiology and treatment of multiple sclerosis in elderly populations. Nat Rev Neurol. 2019 Jun;15(6):329–42. 10.1038/s41582-019-0183-3
- Fratiglioni L, De Ronchi D, Agüero-Torres H. Worldwide prevalence and incidence of dementia. Drugs Aging. 1999 Nov;15(5):365–75. 10.2165/00002512-199915050-00004
- Schweiz GP. Alzheimer Schweiz Demenzkostenstudie 2019 [Internet]. 2019 [cited 2022 Jun 14]. Available from: https://www.alzheimer-schweiz.ch/de/ueber-demenz/beitrag/alzheimer-schweiz-demenzkostenstudie-2019-gesellschaftliche-perspektive
- Wieser S. Die Kosten der nichtübertragbaren Krankheiten in der Schweiz : Schlussbericht [Internet]. 2014 [cited 2022 Jun 14]. Available from: https://digitalcollection.zhaw.ch/handle/11475/14988
- Schneider H, Venetz W. Cost of Obesity in Switzerland in 2012 [Internet]. Bundesamt für Gesundheit, Contract-Number 13.005335; 2012 [cited 2022 Jun 14]. Available from: https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&ved=2ahUKEwjA9rv31tD7AhWTgv0HHVVsA7wQFnoECA8QAQ&url=https%3A%2F%2Fwww.bag.admin.ch%2Fdam%2Fbag%2Ffr%2Fdokumente%2Fnpp%2Fforschungsberichte%2Fforschungsberichte-e-und-b%2Fcost-of-obesity.pdf.download.pdf%2Fcost-of-obesity.pdf&usg=AOvVaw0qr2JEtm2J7f4oM8cjH_l4
- Toyoda K, Yoshimura S, Nakai M, Koga M, Sasahara Y, Sonoda K, et al.; Japan Stroke Data Bank Investigators. Twenty-Year Change in Severity and Outcome of Ischemic and Hemorrhagic Strokes. JAMA Neurol. 2022 Jan;79(1):61–9. 10.1001/jamaneurol.2021.4346
- Antonia K, Glen P K, Andreas D F. P KG, D FA. The Impact of Heat Waves on Mortality among the Elderly: A Mini Systematic Review. J Geriatr Med Gerontol. 2018;4(3). 10.23937/2469-5858/1510053
- Kenny GP, Sigal RJ, McGinn R. Body temperature regulation in diabetes. Temperature. 2016 Jan;3(1):119–45. 10.1080/23328940.2015.1131506
- Meehl G, Stocker T. Global Climate Projections. In: Climate Change 2007 [Internet]. 2007. Available from: https://www.ipcc.ch/site/assets/uploads/2018/02/ar4-wg1-chapter10-1.pdf
- Kohler A. So stark trifft der Klimawandel die Schweiz [Internet]. 2019 [cited 2022 Jun 14]. Available from: https://www.swissinfo.ch/ger/schweiz-klimawandel-temperaturen-hitze/45090938
- Statistik B für. Weekly number of deaths, 2020-2022 [Internet]. 2022 [cited 2022 Jun 14]. Available from: https://www.bfs.admin.ch/bfs/de/home/statistiken/kataloge-datenbanken/tabellen.assetdetail.22264685.html
- Kohli R. Auswirkungen der Covid-19-Pandemie auf die Sterblichkeit in der Schweiz [Internet]. 2021 [cited 2022 Jun 14]. Available from: https://www.bfs.admin.ch/bfs/de/home/statistiken/bevoelkerung/geburten-todesfaelle/lebenserwartung.assetdetail.19305028.html
- Gagnon A, Miller MS, Hallman SA, Bourbeau R, Herring DA, Earn DJ, et al. Age-specific mortality during the 1918 influenza pandemic: unravelling the mystery of high young adult mortality. PLoS One. 2013 Aug;8(8):e69586. 10.1371/journal.pone.0069586
- Simonsen L, Clarke MJ, Schonberger LB, Arden NH, Cox NJ, Fukuda K. Pandemic versus epidemic influenza mortality: a pattern of changing age distribution. J Infect Dis. 1998 Jul;178(1):53–60. 10.1086/515616
- Kennedy BK, Berger SL, Brunet A, Campisi J, Cuervo AM, Epel ES, et al. Geroscience: linking aging to chronic disease. Cell. 2014 Nov;159(4):709–13. 10.1016/j.cell.2014.10.039
- López-Otín C, Blasco MA, Partridge L, Serrano M, Kroemer G. The hallmarks of aging. Cell. 2013 Jun;153(6):1194–217. 10.1016/j.cell.2013.05.039
- Remund A, Cullati S, Sieber S, Burton-Jeangros C, Oris M, Egger M, et al.; Swiss National Cohort. Longer and healthier lives for all? Successes and failures of a universal consumer-driven healthcare system, Switzerland, 1990-2014. Int J Public Health. 2019 Nov;64(8):1173–81. 10.1007/s00038-019-01290-5
- Statistik B für. Lebenserwartung in guter Gesundheit nach Staatsangehörigkeit und Geschlecht [Internet]. 2019 [cited 2022 Jun 14]. Available from: https://www.bfs.admin.ch/bfs/de/home/statistiken/bevoelkerung/migration-integration/integrationindikatoren/indikatoren/lebenserwartung-gute-gesundheit.assetdetail.9186024.html
- Partridge L, Deelen J, Slagboom PE. Facing up to the global challenges of ageing. Nature. 2018 Sep;561(7721):45–56. 10.1038/s41586-018-0457-8
- Gnädinger M, Herzig L, Ceschi A, Conen D, Staehelin A, Zoller M, et al. Chronic conditions and multimorbidity in a primary care population: a study in the Swiss Sentinel Surveillance Network (Sentinella). Int J Public Health. 2018 Dec;63(9):1017–26. 10.1007/s00038-018-1114-6
- Olshansky SJ, Carnes BA, Cassel C. In search of Methuselah: estimating the upper limits to human longevity. Science. 1990 Nov;250(4981):634–40. 10.1126/science.2237414
- Scott AJ, Ellison M, Sinclair DA. The economic value of targeting aging. Nat Aging. 2021 Jul;1(7):616–23. 10.1038/s43587-021-00080-0
- Statzer C, Reichert P, Dual J, Ewald CY. Longevity interventions temporally scale healthspan in Caenorhabditis elegans. Biorxiv. 2021;2021.05.31.446397.
- Venz R, Pekec T, Katic I, Ciosk R, Ewald CY. End-of-life targeted degradation of DAF-2 insulin/IGF-1 receptor promotes longevity free from growth-related pathologies. eLife. 2021 Sep;10:e71335. 10.7554/eLife.71335
- Lu Y, Brommer B, Tian X, Krishnan A, Meer M, Wang C, et al. Reprogramming to recover youthful epigenetic information and restore vision. Nature. 2020 Dec;588(7836):124–9. 10.1038/s41586-020-2975-4
- Ocampo A, Reddy P, Martinez-Redondo P, Platero-Luengo A, Hatanaka F, Hishida T, et al. In Vivo Amelioration of Age-Associated Hallmarks by Partial Reprogramming. Cell. 2016 Dec;167(7):1719–1733.e12. 10.1016/j.cell.2016.11.052
- Ailshire JA, Beltrán-Sánchez H, Crimmins EM. Becoming centenarians: disease and functioning trajectories of older US Adults as they survive to 100. J Gerontol A Biol Sci Med Sci. 2015 Feb;70(2):193–201. 10.1093/gerona/glu124
- Ismail K, Nussbaum L, Sebastiani P, Andersen S, Perls T, Barzilai N, et al. Compression of Morbidity Is Observed Across Cohorts with Exceptional Longevity. J Am Geriatr Soc. 2016 Aug;64(8):1583–91. 10.1111/jgs.14222
- Andersen SL, Sebastiani P, Dworkis DA, Feldman L, Perls TT. Health span approximates life span among many supercentenarians: compression of morbidity at the approximate limit of life span. J Gerontol A Biol Sci Med Sci. 2012 Apr;67(4):395–405. 10.1093/gerona/glr223
- Evans CJ, Ho Y, Daveson BA, Hall S, Higginson IJ, Gao W, et al. Place and cause of death in centenarians: a population-based observational study in England, 2001 to 2010. Prigerson HG, editor. PLoS medicine. 2014 Jun;11(6):e1001653.
- Evert J, Lawler E, Bogan H, Perls T. Morbidity profiles of centenarians: survivors, delayers, and escapers. The Journals of Gerontology: Series A. 2003 Mar;58(3):232–7. 10.1093/gerona/58.3.M232
- Kheirbek RE, Fokar A, Shara N, Bell-Wilson LK, Moore HJ, Olsen E, et al. Characteristics and Incidence of Chronic Illness in Community-Dwelling Predominantly Male U.S. Veteran Centenarians. J Am Geriatr Soc. 2017 Sep;65(9):2100–6. 10.1111/jgs.14900
- Demidenko O, Barardo D, Budovskii V, Finnemore R, Palmer FR 3rd, Kennedy BK, et al. Rejuvant®, a potential life-extending compound formulation with alpha-ketoglutarate and vitamins, conferred an average 8 year reduction in biological aging, after an average of 7 months of use, in the TruAge DNA methylation test. Aging (Albany NY). 2021 Nov;13(22):24485–99. 10.18632/aging.203736
- Kaeberlein M. Translational geroscience: A new paradigm for 21st century medicine. Transl Med Aging. 2017 Oct;1:1–4. 10.1016/j.tma.2017.09.004
- Fitzgerald KN, Hodges R, Hanes D, Stack E, Cheishvili D, Szyf M, et al. Potential reversal of epigenetic age using a diet and lifestyle intervention: a pilot randomized clinical trial. Aging (Albany NY). 2021 Apr;13(7):9419–32. 10.18632/aging.202913
- Fahy GM, Brooke RT, Watson JP, Good Z, Vasanawala SS, Maecker H, et al. Reversal of epigenetic aging and immunosenescent trends in humans. Aging Cell. 2019 Dec;18(6):e13028. 10.1111/acel.13028
- Justice JN, Nambiar AM, Tchkonia T, LeBrasseur NK, Pascual R, Hashmi SK, et al. Senolytics in idiopathic pulmonary fibrosis: results from a first-in-human, open-label, pilot study. EBioMedicine. 2019 Feb;40:554–63. 10.1016/j.ebiom.2018.12.052
- Hickson LJ, Langhi Prata LG, Bobart SA, Evans TK, Giorgadze N, Hashmi SK, et al. Senolytics decrease senescent cells in humans: preliminary report from a clinical trial of Dasatinib plus Quercetin in individuals with diabetic kidney disease. EBioMedicine. 2019 Sep;47:446–56. 10.1016/j.ebiom.2019.08.069
- Mannick JB, Morris M, Hockey HP, Roma G, Beibel M, Kulmatycki K, et al. TORC1 inhibition enhances immune function and reduces infections in the elderly. Sci Transl Med. 2018 Jul;10(449):eaaq1564. 10.1126/scitranslmed.aaq1564
- Chung CL, Lawrence I, Hoffman M, Elgindi D, Nadhan K, Potnis M, et al. Topical rapamycin reduces markers of senescence and aging in human skin: an exploratory, prospective, randomized trial. Geroscience. 2019 Dec;41(6):861–9. 10.1007/s11357-019-00113-y
- Andreux PA, Blanco-Bose W, Ryu D, Burdet F, Ibberson M, Aebischer P, et al. The mitophagy activator urolithin A is safe and induces a molecular signature of improved mitochondrial and cellular health in humans. Nat Metab. 2019 Jun;1(6):595–603. 10.1038/s42255-019-0073-4
- Nielsen JL, Bakula D, Scheibye-Knudsen M. Clinical Trials Targeting Aging. Front Aging. 2022 Feb;3:820215. 10.3389/fragi.2022.820215
- Liu S, D’Amico D, Shankland E, Bhayana S, Garcia JM, Aebischer P, et al. Effect of Urolithin A Supplementation on Muscle Endurance and Mitochondrial Health in Older Adults: A Randomized Clinical Trial. JAMA Netw Open. 2022 Jan;5(1):e2144279. 10.1001/jamanetworkopen.2021.44279
- Bulterijs S, Hull RS, Björk VC, Roy AG. It is time to classify biological aging as a disease. Front Genet. 2015 Jun;6:205. 10.3389/fgene.2015.00205
- Zhavoronkov A, Bhullar B. Classifying aging as a disease in the context of ICD-11. Front Genet. 2015 Nov;6:326. 10.3389/fgene.2015.00326
- Flatt T. A new definition of aging? Front Genet. 2012 Aug;3:148. 10.3389/fgene.2012.00148
- Banerjee D, Mukhopadhyay S, Rabheru K, Ivbijaro G, de Mendonca Lima CA. Not a disease: a global call for action urging revision of the ICD-11 classification of old age. Lancet Healthy Longev. 2021 Oct;2(10):e610–2. 10.1016/S2666-7568(21)00201-4
- Bischof E, Maier AB, Lee KF, Zhavoronkov A, Sinclair D. Advanced pathological ageing should be represented in the ICD. Lancet Healthy Longev. 2022 Jan;3(1):e12. 10.1016/S2666-7568(21)00303-2
- Creevy KE, Akey JM, Kaeberlein M, Promislow DE, Consortium TD, Barnett BG, et al.; Dog Aging Project Consortium. An open science study of ageing in companion dogs. Nature. 2022 Feb;602(7895):51–7. 10.1038/s41586-021-04282-9
- Maresova P, Javanmardi E, Barakovic S, Barakovic Husic J, Tomsone S, Krejcar O, et al. Consequences of chronic diseases and other limitations associated with old age - a scoping review. BMC Public Health. 2019 Nov;19(1):1431. 10.1186/s12889-019-7762-5
- Jindai K, Nielson CM, Vorderstrasse BA, Quiñones AR. Multimorbidity and Functional Limitations Among Adults 65 or Older, NHANES 2005-2012. Prev Chronic Dis. 2016 Nov;13:E151. 10.5888/pcd13.160174
- Salive ME. Multimorbidity in older adults. Epidemiol Rev. 2013;35(1):75–83. 10.1093/epirev/mxs009
- Harrison C, Fortin M, van den Akker M, Mair F, Calderon-Larranaga A, Boland F, et al. Comorbidity versus multimorbidity: why it matters. J Multimorb Comorb. 2021 Mar;11:2633556521993993. 10.1177/2633556521993993
- Pitkala KH, Strandberg TE. Clinical trials in older people. Age Ageing. 2022 May;51(5):afab282. 10.1093/ageing/afab282
- Smith SM, Soubhi H, Fortin M, Hudon C, O’Dowd T. Managing patients with multimorbidity: systematic review of interventions in primary care and community settings. Bmj Br Medical J. 2012;345(sep03 1):e5205. 10.1136/bmj.e5205
- Guthrie B, Payne K, Alderson P, McMurdo MET, Mercer SW. Adapting clinical guidelines to take account of multimorbidity. Bmj Br Medical J. 2012;345(oct04 1):e6341. 10.1136/bmj.e6341
- Organization WH. Medication Safety in Polypharmacy: Technical Report [Internet]. 2016 [cited 2022 Oct 14]. Available from: https://apps.who.int/iris/handle/10665/325454
- Markun S, Holzer BM, Rodak R, Kaplan V, Wagner CC, Battegay E, et al. Therapeutic conflicts in emergency department patients with multimorbidity: a cross-sectional study. PLoS One. 2014 Oct;9(10):e110309. 10.1371/journal.pone.0110309
- Tran PB, Kazibwe J, Nikolaidis GF, Linnosmaa I, Rijken M, van Olmen J. Costs of multimorbidity: a systematic review and meta-analyses. BMC Med. 2022 Jul;20(1):234. 10.1186/s12916-022-02427-9
- McPhail SM. Multimorbidity in chronic disease: impact on health care resources and costs. Risk Manag Healthc Policy. 2016 Jul;9:143–56. 10.2147/RMHP.S97248
- Beverly EA, Wray LA, Chiu CJ, LaCoe CL. Older Adults’ Perceived Challenges With Health Care Providers Treating Their Type 2 Diabetes and Comorbid Conditions. Clin Diabetes. 2014 Jan;32(1):12–7. 10.2337/diaclin.32.1.12
- Moffat K, Mercer SW. Challenges of managing people with multimorbidity in today’s healthcare systems. BMC Fam Pract. 2015 Oct;16(1):129. 10.1186/s12875-015-0344-4
- Zhavoronkov A, Bischof E, Lee KF. Artificial intelligence in longevity medicine. Nat Aging. 2021 Jan;1(1):5–7. 10.1038/s43587-020-00020-4
- Bischof E, Scheibye-Knudsen M, Siow R, Moskalev A. Longevity medicine: upskilling the physicians of tomorrow. Lancet Healthy Longev. 2021 Apr;2(4):e187–8. 10.1016/S2666-7568(21)00024-6
- The importance of aging in cancer research. Nat Aging. 2022 May;2(5):365–6. 10.1038/s43587-022-00231-x
- Management of Elderly and Old Cancer Patients – Geriatric Oncology. Heal Times Oncol Hematology. 2021;(10).
- Hurria A, Mohile S, Gajra A, Klepin H, Muss H, Chapman A, et al. Validation of a Prediction Tool for Chemotherapy Toxicity in Older Adults With Cancer. J Clin Oncol. 2016 Jul;34(20):2366–71. 10.1200/JCO.2015.65.4327
- Ihaka R, Gentleman RR. A Language for Data Analysis and Graphics. J Comput Graph Stat. 2012;5(3):299–314.