Skip to main content

Applying a Life Course Biological Age Framework to Improving the Care of Individuals With Adult Cancers: Review and Research Recommendations.

Publication ,  Journal Article
Mandelblatt, JS; Ahles, TA; Lippman, ME; Isaacs, C; Adams-Campbell, L; Saykin, AJ; Cohen, HJ; Carroll, J
Published in: JAMA Oncol
November 1, 2021

IMPORTANCE: The practice of oncology will increasingly involve the care of a growing population of individuals with midlife and late-life cancers. Managing cancer in these individuals is complex, based on differences in biological age at diagnosis. Biological age is a measure of accumulated life course damage to biological systems, loss of reserve, and vulnerability to functional deterioration and death. Biological age is important because it affects the ability to manage the rigors of cancer therapy, survivors' function, and cancer progression. However, biological age is not always clinically apparent. This review presents a conceptual framework of life course biological aging, summarizes candidate measures, and describes a research agenda to facilitate clinical translation to oncology practice. OBSERVATIONS: Midlife and late-life cancers are chronic diseases that may arise from cumulative patterns of biological aging occurring over the life course. Before diagnosis, each new patient was on a distinct course of biological aging related to past exposures, life experiences, genetics, and noncancer chronic disease. Cancer and its treatments may also be associated with biological aging. Several measures of biological age, including p16INK4a, epigenetic age, telomere length, and inflammatory and body composition markers, have been used in oncology research. One or more of these measures may be useful in cancer care, either alone or in combination with clinical history and geriatric assessments. However, further research will be needed before biological age assessment can be recommended in routine practice, including determination of situations in which knowledge about biological age would change treatment, ascertaining whether treatment effects on biological aging are short-lived or persistent, and testing interventions to modify biological age, decrease treatment toxic effects, and maintain functional abilities. CONCLUSIONS AND RELEVANCE: Understanding differences in biological aging could ultimately allow clinicians to better personalize treatment and supportive care, develop tailored survivorship care plans, and prescribe preventive or ameliorative therapies and behaviors informed by aging mechanisms.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

JAMA Oncol

DOI

EISSN

2374-2445

Publication Date

November 1, 2021

Volume

7

Issue

11

Start / End Page

1692 / 1699

Location

United States

Related Subject Headings

  • Survivors
  • Neoplasms
  • Life Change Events
  • Humans
  • Aging
  • Aged
  • Adult
  • Activities of Daily Living
  • 3211 Oncology and carcinogenesis
  • 1117 Public Health and Health Services
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Mandelblatt, J. S., Ahles, T. A., Lippman, M. E., Isaacs, C., Adams-Campbell, L., Saykin, A. J., … Carroll, J. (2021). Applying a Life Course Biological Age Framework to Improving the Care of Individuals With Adult Cancers: Review and Research Recommendations. JAMA Oncol, 7(11), 1692–1699. https://doi.org/10.1001/jamaoncol.2021.1160
Mandelblatt, Jeanne S., Tim A. Ahles, Marc E. Lippman, Claudine Isaacs, Lucile Adams-Campbell, Andrew J. Saykin, Harvey J. Cohen, and Judith Carroll. “Applying a Life Course Biological Age Framework to Improving the Care of Individuals With Adult Cancers: Review and Research Recommendations.JAMA Oncol 7, no. 11 (November 1, 2021): 1692–99. https://doi.org/10.1001/jamaoncol.2021.1160.
Mandelblatt JS, Ahles TA, Lippman ME, Isaacs C, Adams-Campbell L, Saykin AJ, et al. Applying a Life Course Biological Age Framework to Improving the Care of Individuals With Adult Cancers: Review and Research Recommendations. JAMA Oncol. 2021 Nov 1;7(11):1692–9.
Mandelblatt, Jeanne S., et al. “Applying a Life Course Biological Age Framework to Improving the Care of Individuals With Adult Cancers: Review and Research Recommendations.JAMA Oncol, vol. 7, no. 11, Nov. 2021, pp. 1692–99. Pubmed, doi:10.1001/jamaoncol.2021.1160.
Mandelblatt JS, Ahles TA, Lippman ME, Isaacs C, Adams-Campbell L, Saykin AJ, Cohen HJ, Carroll J. Applying a Life Course Biological Age Framework to Improving the Care of Individuals With Adult Cancers: Review and Research Recommendations. JAMA Oncol. 2021 Nov 1;7(11):1692–1699.

Published In

JAMA Oncol

DOI

EISSN

2374-2445

Publication Date

November 1, 2021

Volume

7

Issue

11

Start / End Page

1692 / 1699

Location

United States

Related Subject Headings

  • Survivors
  • Neoplasms
  • Life Change Events
  • Humans
  • Aging
  • Aged
  • Adult
  • Activities of Daily Living
  • 3211 Oncology and carcinogenesis
  • 1117 Public Health and Health Services