I would anticipate several questions: Wouldn't a Center within Child Health serve just as well? Clearly it would be a considerable improvement. However, such centers do not usually include intramural components. There are some real problems concerning the future development of intramural research on aging in Bethesda and Baltimore. These would be difficult to deal with from a conventional Center.

If the heart of the extramural problem is funding, the heart of the intramural problem is a mission. The tradition of the intramural program at the NIH is to emphasize quality and prestige science, somewhat independently of an Institute mission. The Gerontdogy Center was implemented as the first component of the intramural program, and the only one to be housed in its own building,This is.in contrast to the more balanced growth of Gerontology within the extramural program. The off campus and less attractive location in Baltimore and the necessity for a certain amount of rather dreary descriptive investigation has placed the Center in Baltimore in a defensive position, half funded and half occupied, but still envied and with some perplexing staffing problems. These could be better solved under an Institute.

Another question you might ask is: don't the existing catagorical disease institutes also study aging? The answer is: only to a limited extent. In spite of the importance of aging in cardiovascular disease, mental deterioration, cancer and infectious disease, these programs are also small and in aggregate do not

exceed in dollar amounts the Child Health program.

Another question is: what about people? Aren't social attitudes the

heart of the matter? Actually, about one-half of the Child Health program dollars in aging have been spent on good quality behavioral science. An Institute

3.

provides visability to other scientists, laymen, Congress and the Administration. An Institute has a statuatory council, which can provide guidance in programs and policy. This is particularly important in a field where medical advance may have profound social impact. An Instititue is something the elderly can identify with and from it can seek and receive support.

Service is sometimes a bad word at the NIH, but consider some of the accomplishments of Mental Health, the Heart Institute and the Cancer Institute in informing the public and improving the public health. Shouldn't an Institute of Aging play a similar role?

There is no effective voice which speaks for the health of the elderly. Certainly not the AoA and not Social and Rehabilitation Services. Why shouldn't there be a National Institute of Health initiated in the Senate in the year of the White House Conference on Aging?

4

Testimony on a Bill to Create a Commission on Aging Research

F. Marott Sinex, Ph.D.
June 1, 1971

In the fall of 1969 it seemed to a group of biologists,under the leadership of Bernie Strehler at the University of Southern California, that planning for the expanded Intramural Program of the Gerontology Center in Baltimore was bogged down in many problems not concerned with rational scientific planning of research on aging. Discussions of this problem led to the suggestion by Senator Harrison Williams that a Commission be created to study scientific priorities and make recommendations as to programs. The Commission was to consult with a board of scientific advisors and was to receive funds to implement its

program.

This bill was first introduced in 1969. No hearings were held until today, in spite of the efforts of the Gerontological Society and the American Association for Aging Research. I appreciate the opportunity to comment on this bill before this committee. This is actually a much more complex piece of legislation than the bill creating an Institute of Aging.

The Commission is not limited to the consideration of the research program

of the NIH. This is deliberate because we believe the National Laboratories at

Oak Ridge, Brookhaven, Argonne and Pine Bluff should share in the responsibility for mounting programs of aging research. So should the National Science Foundation. We believe that a stock taking on where we are in aging research and dis

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cussion about what types of programs should be particularly encouraged does have merit. The path may be more obscure than the path to the bomb or the moon but it is there. A Commission might help us traverse it sooner.

A behavioral component was later added to the Commission bill. I con sider this very important. Somewhere, whether at Child Health, Mental Health, or Neurological Disease and Blindness, there must be a program involving biochemists, neurologists, psychologists and psychiatrists, in the study of senile deterioration. The artificial separation of organic brain disease from behavioral disturbances is not the way.to clear our nursing homes of disturbed patients.

The method of funding research under the commission is not clear. The five year quinquennium provision does not provide much time to recruit personnel, and grow old animals. A good Commission may wish to make its own recommendations about implementation.

It is not necessarily intended that the implementation should be less costly than some existing programs. All kinds of models come to mind, ranging from the Atomic Energy Commission to the most innocous of Presidential Commissions. A Commission is not a substitute or a sop for an Institute. An Institute can not speak for utilization of appropriate federal facilities outside of the NIH. It may have difficulty in monitoring its own house. It can furnish a Commission with important data, and provide part of the conceptual frame work.

Ideally, the Commission and the Institute should be mutually supportive in concepts and funding, but independent in operation.

2.

Senator EAGLETON. Dr. Eisdorfer?

STATEMENT OF DR. CARL EISDORFER, PROFESSOR OF PSYCHIATRY AND DIRECTOR, CENTER FOR STUDY OF AGING AND HUMAN DEVELOPMENT, DUKE UNIVERSITY, DURHAM, N.C.

Dr. EISDORFER. Thank you.

Senator Eagleton, I am Carl Eisdorfer, director of the Center for the Study of Aging and Human Development at Duke University, Durham, N.C.

Currently, I hold office as president-elect of the Gerontological Society, a group of several thousand medical, biological, behavioral, and social scientists in the United States.

I am here to testify in support of S. 887 to provide for the establishment of a National Institute of Geronotology within the National Institutes of Health. I will try to summarize my reasons for supporting the creation and adequate funding of an Institute of Gerontology as briefly as possible since I feel that the current situation almost speaks for itself in compelling such an organization.

As a matter of fact, sir, a few years ago I might not have given my wholehearted support for such a bill, but the times have proved me wrong. Through no fault of those persons responsible for the aging program in the NIH, the structure of that organization has failed to be adequate to its mission.

I feel that there are several important reasons for the establishment of an Institute of Gerontology, all having to do with the most fundamental issue; namely, the need to advance health related research and training in the interest of understanding the medical, biological, and psychosocial processes of aging and the problems of the aged in the United States.

The first reason has to do with the orderly functioning of the National Institutes of Health in relation to the scientific and professional community who must deal with that agency. The second and perhaps most important issue has to do with the integrity of priorities and programs for much of the research and training concerning the health of the aged and the third has to do with policymaking concerning these matters.

In a report to Senator Williams' Special Committee on Aging several years ago, December 1967, I pointed out that research in aging from the Federal Government involved a wide number and variety of agencies each treating aging as a low priority item.

I suggested then that there was a need for bringing together and organizing in a central unit a focus for health related research and training programs in aging which would encompass the areas of biological, psychological, behavioral, and social factors as these relate to the current future well-being of older Americans.

To date, there is still no unit in the Federal Establishment which has a mandate for developing programs related to the health of older citizens that is not compromised by sharing its resources with a diversity of other programs and is headed by individuals who are competent and committed to the field.

I also pointed out that the priorities for research into aging seemed to be very poor and predicted that if funds became tighter, those pro