Senator EAGLETON. I agree with that, too. Dr. SINEX. May I give my testimony for Senator Williams now, very briefly? Senator EAGLETON. I thought you had. Dr. SINEX. I have not gotten into my commission testimony. Senator EAGLETON. Let us put that in the record since he is not here to defend himself. You are for his bill, I take it? Dr. SINEX. Yes. Senator EAGLETON. And you find no inconsistency or irreconcilable barriers between my bill and his bill? Or do you? Dr. SINEX. I see more barriers than most people who will testify. Dr. SINEX. For instance, it has been suggested that the advisory council of an institute could serve the purpose of the Commission. The initial concept of this Commission was that it would monitor aging research in the total Federal Establishment, that it would consider what is being done at the National Laboratories, such as Brookhaven, Argonne, Pine Bluff, and Mental Health, and that it not be limited to the NIH. An advisory council within an institute can only address itself to the problems of that institute. Senator EAGLETON. Is there any way you could conceive we could make this sort of a mixed advisory commission? That is, it would serve as the typical advisory commission within the NIH, as other advisory groups are already structured therein, but also it would have ancillary authority to go beyond the narrow confines of an institute? Could it wear two hats? Dr. SINEX. Yes, sir; but I think it should be able to go beyond the confines of the institute. I am concerned about the future of the national laboratory program. I point out that the national laboratories, because of the nature of aging research, its involvement with DNA, chromosomal breaks, and certain other things that happen in aging animals, that there are unique skills at our national laboratories. These skills should be used. I think that as we go into research on environment as to what is the effect of heavy metals, what are environmental effects on the living organism, that aging research should be built into that, and I think a commission not tied into the promotion of a single National Institute should have a look. Senator EAGLETON. Very good, Doctor. Thank you. (The prepared statement of Dr. Sinex with an attachment follows:) Testimony on a Bill to Create an Institute of Gerontology at the National Institutes of Health F. Marott Sinex, Ph. D. 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, four years on the gerontology study section of the Extramural Program of the National Institutes of Health, which reviews training grants and program projects, and two years on the Intramural Council 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. An Institute of Gerontology is needed for a number of reasons; some scientific, some administrative, and some related to the delivery of health care. This need is pressing. The cost of not aggresively pursuing aging research is great. Nearly one-half of the elderly in our nursing homes are mentally incompetent to care for themselves. The incidence of cardiovascular and infectious disease, and cancer, increases exponentially with age. The death rate doubles every eight and one-half years. Aging is the most common cause of disease. It decreases our productivity and prevents the healthy enjoyment of our retirement years. If our aged were healthier, they would be less of a burden on the federal budget. · Aging is not a great scientific mystery. We do know many of the factors which must be involved in aging. While we lack some basic information there is also a need to evaluate and apply what we have already learned. This has proved administratively difficult. Research on aging is one of the five program areas of the Institute of Child Health. The Institute of Child Health has other very important responsibilities. It must handle research in pediatrics, obstetrics, family planning and mental retardation. The inclusion of aging in its mission has the unfortunate effect of pitting old against young for dollars and for the attention and expertise of the staff. Rather forcibly, this has come to a head, when the Institute of Child Health was asked to reduce its request for 1972 funds for its aging program, from 8 to 6.7 million dollars, in order to meet priorities in child health and family planning. This means no competitive renewals, and no new innovative grants for the promising and expanding field of aging, which is just now feeling the stimulating impact of the graduates of its training programs. I estimate that with currently approved and unfunded grants, together with the new applications, we could justifiably fund twelve to thirteen million in programs in 72, and sustain a growth of from two to three million dollars a year over the next five years. 2. 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. |