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Senator HARKIN. Thank you very much for your testimony. ARC has always played a very important role in the deliberations of this subcommittee. And I appreciate your input. These are all programs of importance to us, to this Senator, particularly. Operating under the constraints that we have, I can assure you we will do the best we can.

Mr. MOORE. I am sure you will and we appreciate that very much.

Senator HARKIN. And who is that guy sitting behind you?
Mr. MOORE. Paul Marchand, the director of our operation.

Senator HARKIN. I know. I want to welcome you here. Welcome, Paul.

Thank you very much.

Mr. MOORE. Thank you very much. STATEMENT OF DANIEL PERRY, EXECUTIVE DIRECTOR, ALLIANCE

FOR AGING RESEARCH Senator HARKIN. Next is Daniel Perry, executive director for the Alliance for Aging Research.

Welcome to the subcommittee. Your statement will be made a part of the record.

Mr. PERRY. Thank you, Mr. Chairman.

Good morning. It is a pleasure to address this subcommittee on behalf of the Alliance for Aging Research.

This subcommittee and its members and its staff can be very pleased with the progress made in aging research. Last year largely due to your leadership, Mr. Chairman, and a truly bipartisan support shown by this committee, research at the National Institutes of Health and especially at the National Institute on Aging, is now halfway, more than halfway, to our goal of $1 billion a year for research in the chronic diseases of aging. This is the goal that was recommended by your legislation, Mr. Chairman, the Independence for Older Americans Act and by the Pepper Commission and has been endorsed by over 80 national health and aging organizations.

Tremendous scientific progress in aging was also made last year. A few examples, the early results of research to combat frailty in nursing home populations, including research at the University of Iowa, prove that a program of just moderate weight training can dramatically restore muscle and bone strength and reduce the danger of falls.

A study released earlier this year points to a 57-percent reduction in urinary incontinence, one of the primary conditions leading to nursing home admissions.

And also progress in genetic research is narrowing the search for the cause and the treatment of Alzheimer's disease.

While progress is indeed being made, the need to increase research substantially in aging becomes more pressing every day. Of the more than 2 million Americans that turned 65 years this last year, almost one-half are expected to enter a nursing home at least once before they die. This year approximately $250 billion will be spent in this country on health care for older Americans. Yet, less than two-tenths of 1 percent of that amount will be invested in the research that could cure, prevent, or at least postpone the chronic conditions of aging that lead to long-term care and unnecessarily cut life short.

Of the National Institutes of Health's total budget, more than $8 billion this year, only about 7 percent will be devoted to programs of aging research. Considering that older Americans are the largest health care users, that is simply an inadequate investment.

It is a priority for the Alliance for Aging Research, as I know it is for you, Mr. Chairman, to reach that goal of $1 billion a year for research in aging. That amount would apply to aging research across many Institutes of the NIH and the National Institute of Mental Health. It would allow for a $600 million budget this year at the National Institute on Aging, an amount that according to our best professional judgment would be a prudent investment.

One of the top priorities for this year should be to achieve full funding for the Claude D. Pepper Independence Centers. The NIA currently has enough funds to establish four centers this fiscal year. Funding for six more centers would meet the requirements established last year by your legislation, the Independence for Older Americans Act. Full funding of the centers would truly provide a living legacy to Senator Pepper's lifelong commitment to aging.

There is a great deal of good news and potential from aging research today, Mr. Chairman. A great deal of that exciting work is taking place as a direct result of the commitment and leadership of this subcommittee. The challenge of achieving independence for older Americans through research in aging remains a top priority for the Nation. We simply cannot afford to do less.

PREPARED STATEMENT

I thank you for this opportunity to testify and to include for the record further details of funding recommendations for the National Institute on Aging and other institutes.

The alliance looks forward to working with you and your staff to achieve these important goals.

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STATEMENT OF DANIEL PERRY

Mr. Chairman and members of this Subcommittee, it is indeed a pleasure to

present testimony on the fiscal year 1992 budget on behalf of the Alliance for Aging

Research. This Subcommittee can be very pleased with the progress made in aging

research last year. Largely due to your leadership and the truly bi-partisan concern

shown by this Committee, aging research at the National Institutes of Health is now

more than half-way to the goal of $1 billion. This goal was recommended by your

legislation, the Independence for Older Americans Act, and by the Pepper Commission

and has been endorsed by over 80 national health and aging organizations.

Tremendous scientific progress in aging has also been made in the last year. The

early results of research to combat frailty in nursing home patients, including research

at the University of Iowa, prove that a program of moderate weight-training care can

dramatically restore muscle and bone strength. A study released earlier this year by the

Alliance for Aging Research and the National Institute on Aging points to a 57 percent

reduction in urinary incontinence, one of the three primary conditions leading to

nursing home admissions. Progress in genetic research is narrowing the search for the

cause and treatment of Alzheimer's disease.

The Alliance is also very pleased that the Food and Drug Administration is

considering approval of tacrine, the first drug for the treatment of Alzheimer's disease.

Our organization, Mr. Chairman, shares your concern that the FDA's procedures should

not hinder the availability of this drug to the four million Americans who need help

now.

While progress is indeed being made, the need to increase research substantially

in aging becomes more pressing each and every day. Of the 2.2 million people who

turned age 65 last year, almost half are expected to enter a nursing home at least once

before they die. Just this month, a report by the Social Security Commission predicts

that the Medicare hospital trust fund will be bankrupt in just 15 years. Medicare costs

could more than triple and the share of total health care dollars consumed by older

Americans could exceed $1 trillion as the baby boom generation ages.

As a nation we can do better. This year, approximately $250 billion will be

spent on health care for older Americans. Yet, less than two-tenths of one percent of

this amount will be invested in research to cure, prevent or postpone the chronic

conditions of aging that can lead to long-term care or unnecessarily cut life short. Of

the National Institutes of Health total budget of more than $8 billion this year, only

$548 million

or about 7 percent

will be devoted to programs of aging research.

Considering that older Americans are the largest health care users, that is simply an

inadequate investment.

It is a priority for the Alliance for Aging Research

as I know it is for you Mr.

Chairman

to reach the goal of $1 billion for research in aging. That amount would

apply to aging research across many of the National Institutes of Health. It would

allow for a $600 million budget this year at the National Institutes on Aging, an

amount that according to our best professional judgement would be a prudent

investment.

Mr. Chairman, we know that the terms of the budget agreement limit what this

Committee will be able to commit to aging research as well as to other valuable and

needed programs. But we must continue to push toward that goal. Aging research is

more than half way there. Now it's time to finish the job.

Pepper Centers One of the top priorities for this year should be to achieve full

funding for the Claude D. Pepper Independence Centers. The NIA currently has enough

funds to establish four centers this fiscal year. Funding for six more centers would meet

the requirements established last year by your legislation. The response from the public

and the research community to the Pepper Centers has been overwhelming. I

understand more than 25 universities and research centers have submitted applications

and more are still coming in. Full funding of the centers would truly providing a living

legacy to Senator Pepper's lifelong commitment to aging.

Basic Biology. Generating knowledge of the basic biological processes is key to

fostering research which will lead to preventive interventions to keep older people

independent. Basic research in the molecular biology of cell aging, the genetic basis of

aging and longevity and the decline of the immune system associated with aging should

be made priority areas for basic research.

Alzheimer's Disease. Research into the causes of Alzheimer's disease to

ultimately find a cure or prevention to this terrible illness should remain a top priority

of aging research. Successful containment of health care costs depends upon progress

in curing, preventing or postponing Alzheimer's disease. Without a breakthrough in

research, the number of individuals and families devastated by Alzheimer's disease in

the next 50 years could more than triple. The costs will be unmanageable. Even

modest interventions will help. A recent study by Battelle Medical Technologies

estimates that even just a 10 to 15 percent reduction in severe cases of Alzheimer's

disease could save as much as $76 billion in today's dollars over the next 25 years.

Collaborative Efforts. Due to the limited funds the Committee has to work with

this year, one area which should be vigorously pursued is collaborative research efforts

between the NIA and other institutes. The Alliance continues to be concerned about

the low level of funding given to aging research programs at several institutes. For

example, the National Cancer Institute, according to figures supplied by that institute,

only devotes $15 million to research programs on aging and its relevance to cancer.

This is despite the fact that more than half of all cancers are diagnosed in people over

age 65. Encouraging the NIA to offer matching grants to other institutes and have

other institutes, like the cancer institute, program more funds to aging would be a cost

effective way to leverage greater support for needed research in aging.

Frailty, Falls and Fractures. Frailty and related falls and fractures is a major

cause of long-term care needs, afflicting over 3.25 million older Americans, with annual

costs exceeding $80 billion annually. This accounts for over half the total costs of

disability among older people. By the year 2030, this burden could grow to over $170

billion in current dollars unless better means are found to reduce or prevent frailty.

Research to improve strength, mobility, balance and endurance should be increased.

Health and Behavior. Research is showing that behavior can have a positive

impact on health at any age. Unfortunately, the large majority of research on behavior

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