France has launched an institute to study the issues raised by its ageing population. Jane Marshall meets the eminence grise who will lead the effort.
He may not look like a pensioner, but endocrinologist Etienne-Emile Baulieu is perfectly qualified to take the lead in France's research effort into ageing. An energetic septuagenarian, he is the brains behind, and the first head of, the Institute of Longevity, which starts work in the new year.
Baulieu heads a laboratory at the National Health and Medical Research Institute (Inserm), is a professor at the Collège de France and is a rare foreign associate of the US National Academy of Sciences. He made his name in 1965 with his discovery of DHEA, a hormone that improves skin and bone condition and restores libido. In 1980, more controversially, Baulieu synthesised mifepristone - the active ingredient of the "morning-after" pill, RU486 - for which he was awarded the Lasker prize in 1989.
Baulieu, who was recently elected vice-president of the French Academy of Sciences, says he is "not a scientist, but a physician doing science". He is a doctor by training who "moved over to science" via his work with hormones. Early in his career, in the 1960s, he went to the United States. At Colombia University, he teamed up with Gregory Pincus, a pioneer of the contraceptive pill - after whom his laboratory building in south Paris is named.
Returning to France, he undertook the work that led to mifepristone. Baulieu says that as well as inducing abortion, RU486 can be used for other purposes, such as easing the delivery of babies and treating fibroids, "but because of the controversy of abortion, its capability has never really been fully investigated". Research soon to be published will demonstrate its efficacy in treating psychotic major depression.
Now Baulieu's research is focused on neurosteroids, which may restore memory to old people.
It was about two years ago that Baulieu was first asked "to do something on ageing" by Claude Allègre, who was then minister of education and research. Baulieu was interested in the subject because he had found that the body's production of DHEA diminished with age, and, while teaching at the Coll ge de France, he had conducted research into whether DHEA could reduce symptoms of ageing if replenished.
"I widened the research, and All gre approached me. I asked if there was money available, and he said 'yes' so I devised a very wide-ranging programme."
This was submitted to the Living Sciences Coordination Committee in July 2000. At the end of October, research minister Roger-Gerard Schwartzenberg opened the Institute of Longevity with an initial budget of €3.2 million (about £2 million).
Baulieu will coordinate this "institute without walls" from his lab. The institute will consist of a network of national research bodies such as Inserm and the National Centre for Scientific Research (CNRS), universities and associations concerned with diseases associated with the elderly such as France Alzheimer and France Parkinson.
Baulieu says: "We must promote the wellbeing of the elderly so they can live longer in better health. It is about reconciling length of life and quality of life."
Like other western nations, the French are getting older. The proportion of over-60s in the population is expected to rise from a fifth today to a quarter within ten years and to a third by 2050. France has about 9,000 centenarians, compared with about 100 a century ago, 200 in 1950 and 6,840 in 1998.
"The base that interests me is that 50 per cent of girls born in 2000 will reach the age of 100," Baulieu says. "Currently, in Britain as in France, more than 50 per cent of women reach 85 years." Men trail by about five years, "though it is less of a gap now".
As Baulieu's plans for the institute cover a wide range of issues, they will involve specialists from many fields, including the human and social sciences as well as biological and medical experts. Its first projects will concentrate on four areas:
- Genome and post-genome research, which will include giving fresh impetus to the Trois Cites study. For this, nearly 10,000 over-65s living in Bordeaux, Dijon and Montpellier are regularly tested to measure their cognitive capacities and vascular systems. It is building up a bank of biological material such as serum, plasma and DNA
- Raising animals that are suitable for the study of ageing. The two principal projects are to create a national index of ageing patterns in animals that will be available on a website and to develop breeding centres linked to specific laboratories
- Age-linked degeneration of sense organs, such as failing eyesight and deafness, and troubles with balance or walking
- Use of information technologies, with the development of innovations such as "intelligent apartments" and sensors in clothing that can monitor the health of old people living alone or alert others if they fall.
Baulieu also foresees studies investigating such areas as the application of genetics to problems of ageing; cancers; the nervous, immune and cardiovascular systems; ageing of cells; the prostate gland; skin; nutrition; prevention of dementia; and, in the social field, familial relations as people live longer and families consist increasingly of four generations or more.
Another line of research Baulieu wants to investigate is the effects of medicines on the elderly. "Thirty per cent of the drugs business goes to the over-70s, but only 3 per cent of the drugs have been studied on these old people. So there is a need to see if they are useful rather than harmful, and to do tests over a long time period."