Ask the Expert: Thomas M. Gill, MD, on his experience as a clinician-researcher, disability care, and his 2022 Irving S. Wright Award

A practicing geriatrician and clinical epidemiologist, Dr. Gill is a leading international authority on the epidemiology and prevention of disability among older persons. His nomination for the Wright Award lauded his groundbreaking research on the mechanisms underlying and interventions targeting functional decline and disability among community-living older persons. He collaborates with investigators throughout the country, is a leader of multisite clinical trials, and is a devoted mentor. He has published more than 350 original reports and has been continuously funded by the National Institutes of Health (NIH) and multiple foundations since 1997. Upon receiving the 2022 Irving S. Wright Award, AFAR connected with Dr. Gill to learn more about what inspired his renowned career and how he imagines the future of geroscience and geriatrics.

What inspired you to pursue a career in aging research?

As a geriatrician, I was most interested in investigating issues that could improve the health, well-being and functional outcomes of older persons. I am also committed to training the next generation of clinician investigators across disciplines to focus their research on aging. As one example, I am one of the multiple principal investigators for the Clinician-Scientists Transdisciplinary Aging Research (Clin-STAR) Coordinating Center, which provides a multi-faceted national platform to promote and enrich the career development, training, and transdisciplinary research of clinician investigators across the US, particularly early-stage investigators, who are committed to careers in aging research.

As a clinician-researcher, you bring insights from bench to bedside. As an educator, you also influence generations of future leaders. What continually inspires or challenges you about the intersection of biology, care, and public health in aging?

Due to new discoveries that have elucidated the molecular and physiologic processes underlying biological aging, the opportunities to pursue translational geroscience research have never been greater. The primary premise of this burgeoning field is that aging is the major risk factor for most chronic diseases. Rather than playing “whack-a-mole” by focusing on the treatment or prevention of individual age-related diseases, the geroscience hypothesis purports that significant gains in healthspan, as opposed to lifespan, can only be achieved by intervening upon the fundamental mechanisms of aging. To translate geroscience discoveries into new therapeutic agents that can be rigorously tested in clinical trials, a much larger pool of clinician investigators steeped in geriatric principles and knowledge are needed. Geriatric medicine should embrace the challenge of attracting and training the next generation of translational geroscientists.

The work you have done at the Center for Disability and Disabling Disorders has enhanced the scientific knowledge base of the disablement process and evaluated possible interventions through studies and clinical trials. What is something you wish was better understood by society about aging and disability?

When older persons are asked “What’s your number one priority?”, they almost always respond that it’s to maintain their independence. They want to stay in their own homes and not have to rely on others. Their goal is not necessarily to live longer, but to live longer better. So, investigators should focus on developing and testing treatments and other strategies that will increase healthspan, not lifespan.

This award is named in honor of Irving S. Wright, AFAR’s founder. How far has this field come since Dr. Wright founded AFAR in 1981, and where do you think it’s going?

The pace of new discoveries on the processes underlying biological aging is accelerating rapidly. The promise of new therapeutic agents informed by these geroscience discoveries, especially those targeting frailty, multimorbidity, and other age-related conditions, provides an exciting set of opportunities to improve the health, well-being and functional outcomes of older persons.

Dr. Gill will present his lecture, “Late-Life Disability: A Clinician’s Perspective Backed by Epidemiologic Data," at the Gerontological Society of America (GSA) 2022 Annual Scientific Meeting. Learn more and RSVP here.