only acceptable solution while waiting for eligibility for old-age

payments.

The National Council of Senior Citizens therefore urges that the employment preference provision of S.1163 be broadened to include the low-income elderly aged 55 or over.

Senator EAGLETON. Thank you very much, Mr. Cruikshank. I will let the staff work this out, but you have also, as you well know, testified with respect to S. 1163, which will be the subject of tomorrow's hearings; and in order to expedite your presentation we thought we would have you come 1 day only, so perhaps we will separate out the testimony on the first two bills from the third bill, S. 1163.

In your testimony, Mr. Cruikshank, you endorsed both S. 887 and S. 1925 as being valuable proposals to investment in research on the question of aging. Do you have any suggestions as to how these two bills could be integrated? That is, the National Institute of Gerontology concept, which is the theme of S. 887, and the other bill, the Aging Research Commission bill, S. 1925. How could they be successfully dovetailed?

Mr. CRUIKSHANK. Certainly, Mr. Chairman, they are not inconsistent in their objectives and their proposals. It is only the machinery that is proposed that seems to be somewhat different.

Your advisory council setup under the bill would be the one that I think that would be preferable, but it actually does not need to supplant the advisory structure that is proposed in S. 1925. I think some minor modifications in each of these programs could bring them together. I think it is very important in the final outcome to have this input from the people affected and the people who bring together the knowledge in the various disciplines.

I noted that it was not only the biological disciplines and the scientific, and the hard sciences, as they are sometimes called, but also the sociological; and including even the economic. I think these are all bound together. And I think it is very important that whatever the outcome of the merging of the two, that that concept be maintained. Senator EAGLETON. The facts will speak for themselves, but it is my recollection that there are 10 or more existing institutes of health, and that each of these institutes now in existence has some kind of advisory body connected with it, on which either doctors and/or scientists and other people serve, advising that particular institute of health. If that be the case, and I am inclined to think that it is, if we had an Institute of Gerontology, it would be anticipated there would be some kind of an advisory structure to have an input into that Institute; and hence if we were to pursue that line of approach, the two bills then would dovetail; is that correct?

Mr. CRUIKSHANK. Yes. I do not think there would be any trouble in bringing them together, particularly since there is no conflict in the purpose. Probably it would be easier to make it conform to the existing patterns of these other institutes.

However, I would certainly want to include these social science impacts because in the problem of aging, it is probably distinctly different from the others in some respects; that the research needs to be conducted with the interplay of these various causes that bring about the process of aging. It is not just a biological process, certainly, and it is important, for example, to have, as your advisory council does, an economist here. That probably is not so important in, let's say, cancer. Certainly there are economic impacts; but the economic situation is not a contributory factor to cancer, I would think-I am not a specialist in this; but it would seem obvious to a layman or to a scien

tist, I would suspect, that it is not nearly so important as the economic process on the condition of aging and to the process of aging.

We have seen where lifting people's economic status has brought them out of what appeared to be the decay of senility. We could cite scores of cases from our senior AIDES programs.

For example, when a woman who had been an important part of an office, playing an important role, retired on an inadequate income and could not afford to buy the dresses that enabled her to continue in her social life-she could not go to her bridge club, could not go to church-with just the little $40 a week we could pay her as a senior AIDE, it made the marginal difference and she just blossomed out. And I would say the aging process there was almost reversed simply because of a change in her economic status.

Now again, this is not the whole thing. If she had been suffering from some biological disease, the kind of thing Dr. Sinex can tell us about in more detail, then improving her economic status would not have cured her if there was a functional disorder. But the fact is, these all interplay and all intermingle; and it would be very important to have the kind of an advisory group that you envisage in your bill, I think.

Senator EAGLETON. I think you made a very pertinent point. When we think of research done at NIH, at these Institutes that are already in existence, we normally think of biomedical research that is carried on in a laboratory with test tubes and guinea pigs and the like.

When we are talking about gerontology, we go beyond laboratory research-which is important. But we get into areas of behavioral research and psychological problems; and then also the social problems to which you have alluded, be they economic, environmental or what have you.

So it is a more broadly gauged concept than is reflected in some of the existing Institutes that zero in rather narrowly on biomedical research as pertaining to a particular identifiable disease.

Having said that, I might say that I suspect that that will be used as one of the more persuasive arguments against creating a National Institute of Gerontology. That is because it is more sweeping in its scope, getting into matters of sociology, psychology, economics, and other related fields, that it may be argued by some that it does not fit into the category of an institute of health.

Mr. CRUIKSHANK. Well, I am not a scientist, but I would suggest that that argument could be turned just the other way around because in all the sciences relating to human beings, where there is medicine, the ones I talk to tell me that it is more and more important to consider the whole man and that you cannot separate these factors and you cannot categorize them.

Senator EAGLETON. I agree with that. I am just being the devil's advocate in stating that perhaps that will be raised. And I agree, it can and should be rebutted.

Mr. CRUIKSHANK. I have had quite a bit to do in my former work with the labor movement before I retired from there-we spent an awful lot of money building senior centers, and I have always been suspicious that a lot of it was wasted because it was not well planned. We would like to know more about what contributes best to the full life

of people in retirement homes, the structure of the homes, their placement in relationship with the rest of the community.

There are a lot of arguments about this. There are some that are claiming today that a home all for seniors, where they are all put off by themselves, is the most ideal, and this is what they want. Others say the creation of something more like a family environment is more what is needed and more what contributes to the full life.

I do not think there is really any simple answer, and I do not think anybody really knows the proportion and the best designs of retirement homes in this country. I do not think they have answered the question yet. And there is a lot of research needed here to enable all kinds of private investment in retirement homes, and unions and churches and all, to do the very best possible planning.

Senator EAGLETON. Thank you, Mr. Cruikshank.

Madam, did you have something you wished to add?
Miss MCCAMMAN. No, thank you.

Senator EAGLETON. Thank you for being with us, in any event.
Thank you, Mr. Cruikshank.

Let me say, before calling our next witness, that the administration does intend, as we understand it, to make a presentation in connection with these bills, and we will schedule, in the next 2 to 3 weeks, I would hope, another day of hearings so as to hear from the administration as to how they view S. 887 and S. 1925.

Our next witness is Dr. F. Marott Sinex, chairman, Department of Biochemistry, Boston University School of Medicine.

Dr. Sinex?

STATEMENT OF DR. F. MAROTT SINEX, CHAIRMAN, DEPARTMENT OF BIOCHEMISTRY, BOSTON UNIVERSITY SCHOOL OF MEDICINE, BOSTON, MASS.

Dr. SINEX. Senator Eagleton, I am F. Marott Sinex, professor and chairman of the Biochemistry Department of Boston University School of Medicine. I wish to support your bill to create an Institute of Aging at the National Institutes of Health.

My experience includes the presidency of the Gerontological Society in 1970, 4 years on the gerontology study section of the extramural program of the National Institutes of Health, which reviews training grants and program projects, and 1 year on the intramural Council of Advisers of the National Institute of Child Health and Human Development. I was formerly executive officer of the Biochemistry Department of the Medical Division at Brookhaven National Laboratory. The cost of not aggressively pursuing aging research is great. Nearly one-half of the elderly in our nursing homes are mentally incompetent to care for themselves. We ought to be able to solve or at least partially solve this problem through research. The incidence of cardiovascular and infectious disease, and cancer, increases exponentially with age. The death rate doubles every 812 years. Aging is the most common cause of disease. But more than that, it is aging which decreases our productivity and prevents the healthy enjoyment of our later years. If our aged were healthier, they would be less of a burden on the Federal budget.

Aging is not a great scientific mystery. The fact that people think that it is a cultural thing. It is a matter of cultural attitude, not a reasoned matter. It is true that we do not know all we should know about aging. While we lack some basic information, there is also a need to evaluate what we know and to apply what we have already learned. I will be glad to go into the technical details concerning DNA, genes and chromosomes, and what actually causes aging, if you wish, in the discussion.

There have been administrative problems in getting aging research in this country underway. As you know, it is one of the five program areas of the Institute of Child Health. The Institute of Child Health has other very important responsibilities like child health. Populations research, aging, and child health compete for funds and for the attention and expertise of the senior staff.

This came to a head in the President's budget when, whomp, out came about $1.3 million for research on aging. This means no competitive renewals, no new innovative grants. It means that progress and expansion of this field of research is dead. Those who are unlucky enough to have their grants come up for renewal in the year of the White House Conference on Aging have had it.

Now in actual fact, I think the budget for this year could easily go at about $12 million to $13 million. The backlog of approved research grants in 1971 with a budget of $8 million was $3 million. About onehalf of these had excellent priority scores. The funded slots at the intramural center for aging research in Baltimore have dropped from 130 in 1968 to 114, although unpaid guest scientists have been added which increases the body count. The building was designed for 450. I believe the field could sustain a growth rate of from $2 million to $3 million a year, at least for the next 5 years.

When we discuss these things, I think certain questions come up. One of the first questions is: Why not create a center out of the program within the existing structure? Would that not do just as well?

Well, if it got more money it would clearly be an improvement over what we have. It might even be a short term, interim step toward the creation of an institute.

However, there are a number of things that centers do not do. For one thing, they do not ordinarily include intramural components. And there are some real problems associated with the development of research programs on aging in Bethesda and Baltimore, and these would not be easy to deal with from a conventional center.

The heart of the problem within the extramural program is funding. The heart of the problem within the intramural program is one of dedication to mission.

The tradition of the intramural program at the NIH is to emphasize quality and prestige science, which is good. On the other hand, this is sometimes at the cost of denying the importance of mission within the Institutes of Health. In the case of aging research, a commitment to the mission of research on aging is an important commitment.

There are things that make the situation difficult. The gerontology center in Baltimore was the first component of the intramural program of Child Health, and it is the only one to be housed in its own research building. This is in contrast to the growth of aging as a program area within extramural at Child Health which, if you accept