Overview

Dr David Melzer is Professor of Epidemiology and Public Health at the Medical School, University of Exeter, UK. His research interests are in the causes and consequences of chronic diseases of later life.

Research

David Melzer has led a series of high profile studies of the iron overload disease Haemochromatosis (see e.g,  Pilling et al BMJ 2019, and Atkins et al, JAMA 2020), showing major excess morbidity with the HFE C282Y genotype, especially at ages 65 and older. He is currently working on a project on brain iron and its links to dementia and mobility problems, funded by the US National Institute on Aging. He is a co-investigator on the GEMINI study of multimorbidity. He is also contributing to clinical epidemiology studies of blood pressure trajectories in later life, and pharmacogenetic studies of responses to blood pressure related medications. 

In NIHR funded work, the group has shown that blood pressure in older people declines for over a decade before death. This work suggests that it may not be valid to apply treatment approaches proven in younger or fitter groups to people aged seventy and over. 

The group has published a series of genome wide association studies in UK Biobank, supported by the Medical Research Council. The group increased the number of proven genetic variants associated with human longevity. This work is clarifying the role of several fundamental pathways in ageing, including senescence pathways. It is also underlining the importance of cardiovascular risk factors as major preventable threats in human ageing. 

The group also examined the claimed obesity risk paradox in older people i.e. that being overweight or obese at older ages has little impact on survival. In a series of large-scale studies, the group showed that the paradox is not true. The paradox is generated by a number of biases, mainly due to loss of weight commonly seen with the development of serious disease. For older people who were free of major diseases at baseline, increased adiposity was a substantial risk factor, significantly shortening life. 

Other genomics outputs have included a series of transcriptome wide analyses (with Professor Harries, UEMS), showing that advancing age is associated with changes in splicing ratios and the expression of several components of the splicing machinery.

Qualifications

• 1981 MB BCh Medicine and Surgery, University of Witwatersrand, South Africa
• 1987 MSc Community Medicine, London School of Hygiene and Tropical Medicine
• 1998 - 2021 Fellow of the Faculty of Public Health Medicine
• 2006 PhD Public Health, Cambridge University

Career

Prof Melzer trained in medicine in South Africa (graduating 1981), studied public health at the London School of Hygiene (1987) and completed his PhD at the University of Cambridge (2006). He received a Harkness Fellowship in 1998, spent at the Guralnik laboratory at the US National Institute on Aging. He moved to the University of Exeter in 2005. He was a visiting Professor at the University of Connecticut’s Center on Aging from 2015 to 2021. 

Prof. Melzer has received research support from UKRI (Medical Research Council), National Institute for Health Research, the US National Institutes of Health/National Institute on Aging, the Wellcome Trust, British Heart Foundation, Age UK, and other funders.

Research group links

• Institute of Biomedical and Clinical Science

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Research

Research interests

Notable research outputs have included

• Quantifying the previously disputed excess liver disease, diabetes and arthritis experienced by people in the general population found to have two copies of the iron overload Haemochromatosis genetic variants (e.g. Pilling et al BMJ 2019, and Atkins et al, JAMA 2020), plus showing novel associations with dementia and frailty
• First evidence of declines in blood pressure during the last 15 years of life (Jama Internal Medicine, 2017)
• Identifying genetic variants associated with parental longevity (Aging NY 2016 & 2017) and highlighting the importance of human genetic variants linked to both cancer and diseases of ageing (Nature Reviews Genetics 2020)
• Series of papers debunking the claimed ‘obesity risk paradox’ in older people
• First evidence in a human population of splice ratio and splicing machinery changes with advancing age (Aging cell, 2011)
• The first studies linking environmental endocrine disrupting chemical BPA to adult disease in the general population (JAMA, 2008) with first longitudinal study (Circulation, 2012)

Notable policy contributions:

• Work on Bisphenol A and human health has been cited in policy documents in many countries
• Age UK sponsored report on health care quality Health Care Quality for an Active Later Life
• Regulation of genetic tests and pharmacogenetics (attracting a US Food and Drug administration Director’s award 2006)

Research projects

• Iron overload and ageing
• Genetics of multimorbidity
• Outcomes in hypertension in older people, including pharmacogenetic studies of anti-hypertensive medications

Fellowships in the Melzer group

• NIHR. Clincial Advanced Fellowship Dr Jane Masoli. 2022-2029 (Blood Pressure in later life)
• NIHR Senior Fellowship Dr Janice Atkins (Haemochromatosis) 
• Alzheimer’s Society Fellowship, Joao Delgado
   

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External Engagement and Impact

Awards and Honours

Fellowship of the Gerontological Society of America, May 2017

Director’s Collaboration Award from the US Food and Drug Administration (for work on clinical evaluation of genetic testing), July 2006

UK National Public Health Career Scientist Award, 2001

Harkness Fellowship, 1998/9, Commonwealth Fund of New York: Guest Researcher, US National Institute on Aging, August 1998 to July 1999

Committee/panel activities

Member, International Scientific Advisory Board, MRC Unit for Lifelong Health and Ageing (2018 - )

Member of Executive, NIHR National School of Public Health Research, England 2012 to 2017

External positions

(Visiting) Professor, University of Connecticut Center on Aging: 2016 - 

Invited lectures

1. British Society for Research into Ageing: plenary talk “Transcriptomics and ageing: from humans to lab models and back again” August 2017
2. Invited Biology of Aging seminar: “Why is aging so variable”. Yale University, 27 March 2017
3. Epidemiology of aging interest group, Gerontological Society of America: Invited speaker in debate: Will big data improve outcomes for older people debate:, November 2015
4. Bradford Hill Lecture, Cambridge Institute of Public Health, 10th October 2014

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Teaching

• Supervision of students from the BSc Medical Sciences programme undertaking either Year 3 Research Project or Year 3 Professional Training Year with the group
• Research in Action (RiA) Special Study Unit (SSU) teaching for UEMS Year 4 BMBS medical students and Research (R) Special Study Unit (SSU) teaching for UEMS Year 3 BMBS medical students

Postgraduate Teaching

• PhD supervisor

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Office Hours:

Research Office Hours: Tuesday mornings and Thursdays. 

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