Our quest to keep people healthy and vital for life
We are living longer than ever before, but what’s our quality of life like during those extra years? The average 65-year-old has two chronic illnesses, and we generally spend our last years of life in poor health. That’s a terrible burden for patients, for their loved ones and carers, and for society. The Janssen Prevention Center is tackling this problem by driving research to prevent age-related, non-communicable diseases, with a current focus on Alzheimer’s disease. Frank de Wolf leads the 120 people who are working at the Janssen Prevention Center to realize this vision.
From HIV to Alzheimer’s
Frank was appointed Global Head of the Janssen Prevention Center in March 2017, after two years of leading research into prevention biomarkers at the center. He is also a professor at the School of Public Health of Imperial College London, United Kingdom.
Frank joined Janssen after a successful career in HIV/AIDS research. As director of the Dutch HIV Monitoring Foundation, which monitors the health status of HIV-infected patients and the efficacy of interventions, Frank gained expertise in studying large cohorts to predict the onset and progression of AIDS. He is now applying this knowledge at the Janssen Prevention Center to explore the prediction and prevention of age-related illnesses, such as Alzheimer’s disease.
Fewer years of illness
According to James Fries, an eminent researcher from Stanford University, we are at high risk of developing lifestyle-related illnesses before we turn 801. Beyond 80 years of age, the risk declines: from then on, people often die from old age rather than a particular disease. The body simply gives out.
Per Fries, it should be possible to shorten the period of illness—he called this “compression of morbidity”—if we can delay the development of chronic diseases. Based on this hypothesis, Frank and his team at the Janssen Prevention Center are investigating how to keep people healthy and vital for life.
"Instead of treating sick people, we want to help people stay healthy."
Frank de Wolf,
Global Head, Janssen Prevention Center
In the current healthcare system, people are treated when they get sick. But that’s really too late. At the Janssen Prevention Center, the focus is on preventing illness. The researchers study healthy people to find the factors predicting age-related diseases, such as Alzheimer’s. Identifying these early warning signs could enable the development of interventions to prevent progression to symptomatic disease and lasting damage.
The Prevention Markers team at the Janssen Prevention Center works to identify biomarkers that can measure a person’s health status and risks for age-related diseases. “We follow initially healthy people in various cohort studies and study biological parameters, taking lifestyle into account. Using mathematical models, we investigate disease risks, but also the effect of preventive interventions,” Frank explains.
Biological age is an important concept in this research. Biological age is not dependent on years of life, but on overall health status. A person’s health status depends on various factors, including the presence of disease and lifestyle factors. Biological age can be measured by looking at biological parameters such as heart function and kidney function.
“We are exploring which factors affect biological age and how to influence them to lower biological age,” says Frank. “We play with time, as it were.”
Prevention calls for a new mind-set, Frank emphasizes. “People tend to wait until someone is sick before they take action, whereas we want to keep healthy people healthy, if necessary using interventions. But that effect is harder to measure.” Social acceptance will play an important role in prevention, according to Frank. And prevention raises ethical questions: will people want to know that they have an increased risk of Alzheimer’s disease, for example?
There are also technical challenges: “Our biomarker research is progressing well, but we need to develop very reliable tests so that people can test themselves. People want more control over their own health. Just look at all the health apps.” According to Frank, there’s a long way to go, but the goal is clear: staying healthy for longer.
“Treating healthy people is contentious, but I believe it will happen. It has worked for infectious diseases. Many people get themselves vaccinated,” Frank says. “Preventive measures have also dramatically reduced the incidence of cardiovascular diseases.”
Future of healthcare
Frank believes prevention may also be the route to sustainable healthcare.
“At the moment, people are typically ill for a long period in old age and most healthcare costs are made in the last three years of life,” Frank says. “That burdens healthcare systems, but also the patient and society. If we can shorten the period of age-related illness, it will be a great step forward.”
1. [N Engl J Med. 1980 Jul 17;303(3):130-5; N Engl J Med. 1998 Apr 9;338(15):1035-41]