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      A research agenda for aging in China in the 21st century

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          Highlights

          • The elderly population in China is growing exponentially and this growth will last for decades.

          • The aging problem in China is expected to lead to a significant socioeconomic burden which will require a combined effort among gerontologists, healthcare professionals, policymakers, and social forces.

          • A research agenda on the collection of public health data, diet and food safety, physical exercise, pharmacological interventions in age associated diseases, the elderly and geriatric care, and policy dialogues are potential ways to relieve the aging problem.

          • Increased political and financial commitments from the Chinese government are critical for achieving a research agenda on aging in China for the 21st century.

          Abstract

          China is encountering formidable healthcare challenges brought about by the problem of aging. By 2050, there will be 400 million Chinese citizens aged 65+, 150 million of whom will be 80+. The undesirable consequences of the one-child policy, rural-to-urban migration, and expansion of the population of ‘empty nest’ elders are eroding the traditional family care of the elders, further exacerbating the burden borne by the current public healthcare system. The challenges of geriatric care demand prompt attention by proposing strategies for improvement in several key areas. Major diseases of the elderly that need more attention include chronic non-communicable diseases and mental health disorders. We suggest the establishment of a home care-dominated geriatric care system, and a proactive role for researchers on aging in reforming geriatric care through policy dialogs. We propose ideas for preparation of the impending aging burden and the creation of a nurturing environment conducive to healthy aging in China.

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          Most cited references44

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          Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013.

          In 2010, overweight and obesity were estimated to cause 3·4 million deaths, 3·9% of years of life lost, and 3·8% of disability-adjusted life-years (DALYs) worldwide. The rise in obesity has led to widespread calls for regular monitoring of changes in overweight and obesity prevalence in all populations. Comparable, up-to-date information about levels and trends is essential to quantify population health effects and to prompt decision makers to prioritise action. We estimate the global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013. We systematically identified surveys, reports, and published studies (n=1769) that included data for height and weight, both through physical measurements and self-reports. We used mixed effects linear regression to correct for bias in self-reports. We obtained data for prevalence of obesity and overweight by age, sex, country, and year (n=19,244) with a spatiotemporal Gaussian process regression model to estimate prevalence with 95% uncertainty intervals (UIs). Worldwide, the proportion of adults with a body-mass index (BMI) of 25 kg/m(2) or greater increased between 1980 and 2013 from 28·8% (95% UI 28·4-29·3) to 36·9% (36·3-37·4) in men, and from 29·8% (29·3-30·2) to 38·0% (37·5-38·5) in women. Prevalence has increased substantially in children and adolescents in developed countries; 23·8% (22·9-24·7) of boys and 22·6% (21·7-23·6) of girls were overweight or obese in 2013. The prevalence of overweight and obesity has also increased in children and adolescents in developing countries, from 8·1% (7·7-8·6) to 12·9% (12·3-13·5) in 2013 for boys and from 8·4% (8·1-8·8) to 13·4% (13·0-13·9) in girls. In adults, estimated prevalence of obesity exceeded 50% in men in Tonga and in women in Kuwait, Kiribati, Federated States of Micronesia, Libya, Qatar, Tonga, and Samoa. Since 2006, the increase in adult obesity in developed countries has slowed down. Because of the established health risks and substantial increases in prevalence, obesity has become a major global health challenge. Not only is obesity increasing, but no national success stories have been reported in the past 33 years. Urgent global action and leadership is needed to help countries to more effectively intervene. Bill & Melinda Gates Foundation. Copyright © 2014 Elsevier Ltd. All rights reserved.
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            Small molecule activators of SIRT1 as therapeutics for the treatment of type 2 diabetes.

            Calorie restriction extends lifespan and produces a metabolic profile desirable for treating diseases of ageing such as type 2 diabetes. SIRT1, an NAD+-dependent deacetylase, is a principal modulator of pathways downstream of calorie restriction that produce beneficial effects on glucose homeostasis and insulin sensitivity. Resveratrol, a polyphenolic SIRT1 activator, mimics the anti-ageing effects of calorie restriction in lower organisms and in mice fed a high-fat diet ameliorates insulin resistance, increases mitochondrial content, and prolongs survival. Here we describe the identification and characterization of small molecule activators of SIRT1 that are structurally unrelated to, and 1,000-fold more potent than, resveratrol. These compounds bind to the SIRT1 enzyme-peptide substrate complex at an allosteric site amino-terminal to the catalytic domain and lower the Michaelis constant for acetylated substrates. In diet-induced obese and genetically obese mice, these compounds improve insulin sensitivity, lower plasma glucose, and increase mitochondrial capacity. In Zucker fa/fa rats, hyperinsulinaemic-euglycaemic clamp studies demonstrate that SIRT1 activators improve whole-body glucose homeostasis and insulin sensitivity in adipose tissue, skeletal muscle and liver. Thus, SIRT1 activation is a promising new therapeutic approach for treating diseases of ageing such as type 2 diabetes.
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              Is Open Access

              Interventions to Slow Aging in Humans: Are We Ready?

              The workshop entitled ‘Interventions to Slow Aging in Humans: Are We Ready?’ was held in Erice, Italy, on October 8–13, 2013, to bring together leading experts in the biology and genetics of aging and obtain a consensus related to the discovery and development of safe interventions to slow aging and increase healthy lifespan in humans. There was consensus that there is sufficient evidence that aging interventions will delay and prevent disease onset for many chronic conditions of adult and old age. Essential pathways have been identified, and behavioral, dietary, and pharmacologic approaches have emerged. Although many gene targets and drugs were discussed and there was not complete consensus about all interventions, the participants selected a subset of the most promising strategies that could be tested in humans for their effects on healthspan. These were: (i) dietary interventions mimicking chronic dietary restriction (periodic fasting mimicking diets, protein restriction, etc.); (ii) drugs that inhibit the growth hormone/IGF-I axis; (iii) drugs that inhibit the mTOR–S6K pathway; or (iv) drugs that activate AMPK or specific sirtuins. These choices were based in part on consistent evidence for the pro-longevity effects and ability of these interventions to prevent or delay multiple age-related diseases and improve healthspan in simple model organisms and rodents and their potential to be safe and effective in extending human healthspan. The authors of this manuscript were speakers and discussants invited to the workshop. The following summary highlights the major points addressed and the conclusions of the meeting.
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                Author and article information

                Contributors
                Journal
                Ageing Res Rev
                Ageing Res. Rev
                Ageing Research Reviews
                Elsevier B.V. Published by Elsevier B.V.
                1568-1637
                1872-9649
                22 August 2015
                November 2015
                22 August 2015
                : 24
                : 197-205
                Affiliations
                [a ]School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
                [b ]Laboratory of Molecular Gerontology, National Institute on Ageing, National Institutes of Health, Baltimore, MD 21224, USA
                [c ]Department of Public Health Medicine, School of Public Health, Bielefeld University, Bielefeld 33615, Germany
                [d ]Center on Aging Psychology, Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China
                [e ]Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
                [f ]Sun Yat-sen Center for Migrant Health Policy, Guangzhou 510080, China
                [g ]School of Public Health, Fudan University, Shanghai 200032, China
                [h ]Institute of Nutrition and Food Safety, and Department of Toxicology and Nutrition, School of Public Health, Zhejiang University, Hangzhou 310058, China
                [i ]Diabetes & Nutritional Sciences Division, School of Medicine, King’s College London, London WC2R 2LS, UK
                [j ]Peking Union School of Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100006, China
                [k ]Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
                Author notes
                [* ]Corresponding author at: Peking Union School of Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100006, China and Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA. yuanliu@ 123456hsph.harvard.edu yliu@ 123456pumc.edu.cn
                [** ]Corresponding author. Fax: +86 85226035123. b021770@ 123456mailserv.cuhk.edu.hk tzibunng@ 123456cuhk.edu.hk
                Article
                S1568-1637(15)30016-7
                10.1016/j.arr.2015.08.003
                5179143
                26304837
                f2efd525-142c-4413-89e3-18db3d3c0415
                Copyright © 2015 Elsevier B.V. Published by Elsevier B.V. All rights reserved.

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

                History
                : 3 June 2015
                : 3 August 2015
                : 17 August 2015
                Categories
                Article

                aging,public health,chronic non-communicable diseases,mental health,geriatric care,policy,physical exercise,pharmacological interventions

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