Through a series of broadly based but well-integrated initiatives that address the need to advance our understanding of the complexity of biological systems; to explore new organizational models for team science; and to conduct even more efficiently the complex clinical studies needed to make rapid medical progress, the ultimate goal of the NIH Roadmap for Medical Research is to accelerate medical discovery and improve people's health. A number of the NIH Roadmap initiatives are particularly relevant to aging research. For example, the “Molecular Libraries and Imaging” component of the Roadmap will offer biomedical researchers access to small molecules that can be used as chemical probes—providing new ways to explore the functions of genes, cells, and biochemical pathways in healthy aging and disease. Small molecule development, by providing chemical compounds to validate new drug targets, is crucial to the development of drugs for a variety of age-related diseases, degenerative conditions, and disabilities. The refinement of molecular imaging techniques, particularly those for imaging brain function, can similarly be accelerated by enhancing the development and availability of small molecule libraries, and could, in turn, greatly enhance our ability to diagnose and monitor neurological conditions such as Alzheimer's disease.
Another major theme of the NIH Roadmap is “Re-engineering the Clinical Research Enterprise.” Clinical trials are necessary to the development of new treatments for age-related conditions, but many aspects of patients' subjective experiences—such as symptom severity and frequency, emotional and social well-being, and perceived level of health and functional ability—are not adequately captured by conventional clinical and functional measures of disease status, even though they are important targets for treatment interventions. Correctly measuring patient-reported outcomes can be particularly challenging with regard to the ways in which chronic diseases and their treatments affect the elderly. One Roadmap initiative has established a network of investigators to improve the measurement of patient-reported outcomes from a diverse population of individuals, having a variety of chronic diseases. Ongoing projects of particular relevance to the aged population are addressing pain, fatigue, arthritis, psychiatric symptoms, including depression, and social functioning.