Portrait and video Eline Slagboom: "The delta region is a place where currently everything comes together"

For over 20 years, Prof. dr. Eline Slagboom has been studying multiple generations of families. She collects data on why some people age in good health and others decline early. With this knowledge, you can more accurately determine someone's biological age and provide the most appropriate individual treatment or lifestyle advice. The goal: to grow old vitally. "Although the population is aging, and will become increasingly prominent, a lot of people pretend it doesn't exist."

Eline Slagboom is professor of molecular epidemiology at LUMC and one of the Scientific Leader of the scientific program METABODELTA: Metabolomics for clinical advances in the Medical Delta. Recently, she was also appointed as a Medical Delta Professor with a dual appointment at Delft University of Technology. "This appointment feels like a pat on my back," Slagboom says. "I have been working with Rotterdam and Delft for a long time and it is very nice that this is now becoming more visible and taking on a pink Medical Delta color. Science is collaboration and this is a great way to promote that. Hopefully it will inspire and lead to more cross-pollination and more opportunities for young people to get involved in research about aging."

Can you briefly share what your expertise is?

"I am a biologist and professor of molecular epidemiology. My expertise is biological thinking, especially in the field of human biology of aging. Rising age is the biggest risk factor for almost all population diseases. I look for answers to questions such as: can you use biomarkers to identify people who are rapidly deteriorating with aging and are biologically vulnerable, and what do you do with that information in the population and clinic? Can you slowdown that process, what is the physiological and mental capacity of the elderly that you can still stimulate with interventions? And the mechanistic question: why does one person benefit much more from treatment than another? The elderly still have much to gain on their own level. Nutrition and exercise contribute to healthy aging and you can measure and biologically interpret that effect all over again."

Attention from creative and smart youngsters on issues of the aging population is badly needed

Is there enough attention for the elderly?

"Too little with young people. Huge numbers of older people are arriving. By 2040, as many as 25% of the Dutch population will be 65 or older. These will all be coming to the clinic as well. Young doctors are needed for that. They must realize that treating the elderly and elderly patients is a separate story. There must be creative and new ways to keep the elderly vital in society and clinic. The elderly are not willing or able to undergo every treatment. At LUMC, we are working on how to encourage young doctors and researchers to think more about that. 

Aging is not a fancy subject. Unless you explain that the whole life cycle is part of it and you can make measurements over several generations. Then it's already getting closer for young researchers and doctors. Although aging is there, and will become increasingly prominent, a lot of people pretend it doesn't exist. You can especially encourage young people to realize how aging is going to affect their profession. Engineers also need to start thinking about solutions for the wave of older people. Attention from creative and smart youngsters on issues of the aging population is badly needed."

What is your ambition as a researcher?

"My work spreads across three legs: mechanistic research, biomarkers and interventions. I will have achieved the ultimate if I establish something in each of these that I am really proud of. I have long been on the hunt for the "longevity genes" in people from the families in the Leiden Longevity Study. Generation after generation, family members age exceptionally well in good health. Of the 20,000 genes in the genome, after 20 years of research we have reduced that to just 300 genes. A huge step that I am very proud of. At the same time, it is a cliffhanger, exactly which genes are they and how do they work? Stopping research now is not an option.

Steps have also been made in the field of biomarkers. You can now measure from molecular profiles in the blood how healthy or unhealthy you age and learn something about your biological age. This method is already being looked at in clinical trials. We've really stumbled on particular biomarkers, which we're now looking at to see how useful that is.

It turns out that when you're 65 or 70 you can still improve a lot about your own health. That's a lot about exercise, nutrition, your biorhythm and sleep, stress and your social network. Biomarkers allow you to measure how you are improving. Apparently there is always a hidden capacity to make yourself healthier. When you can demonstrate progress, it's motivating. We have done nice interventions and are seeing the results."

What do you hope to have accomplished for patients and healthcare professionals in 5 years?

"I hope to understand the mechanisms of healthy aging and that that gives insight into what people in old age can do themselves to stay as healthy as possible. When you're about 60 years old you think, 'I want to enjoy my retirement later too.' It would be good if we could make better use of that "moment of realization. That people learn how healthy or unhealthy they are, that they are properly helped with what they can still do themselves and that treatment is tailored to their profile. Personalized advice with what works for them. That also requires behavioral scientists. I may be able to prove what works for whom, but the trick is to get someone to do that as well.

Around 60-65 is really the momentum. I feel that myself. You start thinking about what you can get out of life for the next thirty years. Forty percent of 65-year-olds already have two illnesses or more. Just when you want to start enjoying your freedom more."

How does Medical Delta add value to your work?

"In the area of biomarkers and interventions, I collaborate a lot within Medical Delta. For biomarkers, I do research in large population or patient populations. I often work together with Arfan Ikram, Joyce van Meurs and Mohsen Ghanbari of Erasmus MC, fine partners with a lot of knowledge about epidemiology. For the computational interpretation of all that data, I again work a lot with TU Delft. For example, with Medical Delta professor Marcel Reinders. Innovative measurements for this research are done by Thomas Hankemeier of Leiden University, also a Medical Delta professor. He has the most extraordinary metabolomics lab in the Netherlands in his Netherlands Metabolomics Centre in Leiden. In the Public Private Project VOILA of which I am principal investigator, we complete the circle: special measurements in Leiden, cohort studies in Rotterdam and Leiden and innovative computational measurement methods in Delft. I work with scientists internationally and throughout the Netherlands, but the delta region is for me a place where currently everything comes together."

What is your advice for a successful collaboration?

"Two things. First, you drive your own ideas. That means you first think carefully about what you want. You put that on paper, backed up with good literature. That way people see that you know what you are talking about and trust that you are a good scientist. The second thing is to immerse yourself in the other party and understand what drives them. Why are they in this? What is most important to them? There has to be added value for both. If that's not balanced, you won't last long. So come prepared, with respect for the other person. That sounds simple, but putting that into practice takes some getting used to. Working together is like a marriage. You always have to put energy into it and keep an eye on how well you work together. Don't step on other people's toes, don't forget other people's interests and make sure they don't forget your interests either."

What other scientists have inspired you and why?

"Someone who has been very influential for me is Prof. Dr. Dorret Boomsma of VU Amsterdam. She researches twins. In conversations with her, I found out how you can also do very good DNA research in humans, previously I was mainly studying rats. I approached her in 1991. It was about research into telomeres, which are DNA structures at the ends of chromosomes. They shorten, and if that happens very quickly it is a biomarker for diseases of old age. I asked her if we could see if that shortening is hereditary. The telomeres article in twins ended up being my most cited article. That was because of her. She motivated me to write it up and scrape away until it was really good. Because of her, I also sent it to a good journal and it was read by a lot of people. She sparked in me the scientist. At that time I was still doing a lot of jazz singing and was hesitating between those two careers. She was the deciding factor that made me stay in science."

This article is part of a series in which we highlight the eight new Medical Delta professors. Click here for the other portraits published so far.