Anti-aging

Anti-aging addresses how to prevent, slow, or reverse the effects of aging and help people live longer, healthier, happier lives. It includes scientific research and applications in genetic engineering, tissue engineering, and other medical advances, e.g., finding treatments and cures for Alzheimer’s disease. It includes anti-aging psychology, e.g., coping skills for resiliently handling change, stress, and aging.

The anti-aging marketplace includes nutrition, physical fitness, skin care, hormone replacements, vitamins, supplements, and herbs. Alternative medicine and holistic approaches have often been an incubator for approaches initially shunned by traditional medicine. Life extension is arguably the most scientifically rigorous part of anti-aging, being a research program focused on slowing down, repairing or reversing the underlying processes of biological senescence in order to deliver improved health and quality of life. (Despite the name, increasing mean or maximum lifespan is not necessarily the main goal).

Leading sources of anti-aging information include the Life Extension Foundation (focusing on research and supplements), the American Academy of Anti-Aging Medicine (focusing on anti-aging physicians and cutting edge treatments), Andrew Weil (focusing on alternative medicine, holistic health, and herbal supplements), the Chopra Center for Wellbeing (focusing on mind-body medicine and integrating Eastern and Western medicine), and the Ageless Lifestyles Institute (focusing on anti-aging psychology). In India, some anti-aging activities are studied by Center for Longevity combining western medical appraoches with Siddha Vaidya nd Ayurveda.

History

Anti-aging pursuits date back at least to ancient Egypt. While the religion and pyramids focused on the afterlife, a lot of attention was given to herbs and remedies such as olive leaf to promote beauty and longevity. Over the centuries scientists and alchemists tried to find cures and potions. These included drinking, eating, or injecting substances such as gold, testicles, and transplanting monkey gonads. Many cultures such as India and China developed long traditions of herbs, foods, diets, and health practices to foster anti-aging.

There are many legends of magic places that give life, e.g., Ponce de León’s search for the “Fountain of Youth.” In 1933 British novelist James Hilton’s book Lost Horizon described Shangri-la – an ageless paradise somewhere in the Himalayan mountains near the Tibet-China border. Despite Shangri-la being a fictional place, expeditions have tried to find it.

Gerontologists have tended to paint a bleak picture of aging being all downhill with increasing loss of skills, functions, and quality of life. Women’s movements leaders, e.g., Betty Friedan’s book The Fountain of Youth and books like Gail Sheehy’s Passages helped paint a more positive, generative template for aging.

Around 2000 research started identifying strengths that go with aging. Daniel Mroczek, Ph.D., found that older people report being happier than younger people. At ages 18–27 only 28% reported being very happy. The percentage goes up with each age bracket with the bracket 68-77 at 38%. The rating dips a little at ages 78–89 to 34%. Other researcher found that seniors tend to be better story tellers and become more agreeable and conscientious with age. Laura Carstensen, Ph.D reports that as we age, we are tend to be more positive and in better control of our emotions.

Centenarians

One way to find what helps people live long healthy lives is to study those who have succeeded. Centenarians have written best selling books, excelled in sports, piloted airplanes, practiced medicine, danced, sculpted, taught in universities, graduated from universities, run for Congress, and even fathered children.

The current documented record holder for longevity was Jeanne Calment, a French woman who lived 122 years and died in 1997. There are reports of older people in some remote villages but there is no documentation to verify the claims (and they live in cultures that give great status to the oldest). Centenarians have become so common, the newest category is “Super Centenarians,” those 110+ years old.

The most definitive research on centenarians is Thomas Perls, MD and Margery’s Living to 100 study of New England centenarians. Interviews with centenarians include Lynn Adler’s Centenarians: The Bonus Years and photographer Liane Enkelis’ incredible photographs and stories in On Being 100. There are quite a few autobiographies and biographies including Jeanne Calment: From Van Gough’s Time to Ours.

Research suggests that centenarians have little in common physically. They are physically active people, most don’t smoke, and they typically maintained about the same body weight through their adult life.

The role of genetics in longevity is complex. A genetic vulnerability to a life threatening disease, e.g., malaria, reduces life expectancy. If a vaccine or cure is developed, the same genes no longer present a problem. With Alzheimer’s disease, for example, those with the certain apo-E gene patterns have a higher risk of developing Alzheimer’s. When scientists develop a cure, Alzheimer’s will no longer compromise the quality and length of life for those who are at risk.

There appear to be genes that foster living longer. Researchers have extended the life of fruit flies by 30% by giving them an extra copy of a gene. Other researchers extended the life of nematodes (microscopic worms) by 500% by removing a gene. It isn’t clear yet why the genetic engineering is extending the lives, but the results are promising.

Danish researchers compared identical and fraternal twins and extrapolated that only 30% of longevity is genetic. That means that 70% is lifestyle and the choices people make. George Valliant, Ph.D., and subsequent researchers have followed Harvard freshman in the classes from 1939–1949 periodically to the present. One especially notable finding was that men who had traits such as optimism and humor as freshmen were less likely to develop chronic illness or die by age 45. The difference was even more pronounced at age 60.

Current Anti-aging

American life expectancy has increased from 47 in 1900 to 77 in 2007. It is important to remember that this number is an overall average, which includes every person born, no matter how short their life might be. In 1900, average life expectancy appeared disproportionately short because of very high infant mortality, numerous serious childhood diseases, and also because of the high numbers of women who died in childbirth or shortly thereafter. Reducing infant mortality, reducing the incidence of childhood diseases and reducing the number of women who die bearing children have been three of the most significant factors in changing the overall life expectancy. General factors include:

Preventing (for example vaccinations) and curing (for example antibiotics) diseases
Medical and pharmaceutical treatment advances
Increased affluence, affording better living conditions
Better education, (in 1900 most adult Americans didn’t have an eighth-grade education, now more than 80% of American 25+ years old are high school graduates and 27% have at least a bachelor’s degree)
Improved overall sanitation and hygiene
Safer, healthier working conditions

A comprehensive list of treatments or therapies used in anti-aging medicine includes:

Hormonal (including bio-identical hormones), such as DHEA, growth hormone, androgens, testosterone, oestrogens
Antioxidants, such as vitamins, resveratrol, glutathione, co-enzyme Q10 etc
Antiglycators, such as carnosine, aminoguanidine, tenisletam, and cross link-breakers such as Alagebrium (ALT 711)
Methylators, such as TMG, SAMe
Nootropics, such as ginkgo biloba, memantine, bacopa, centrophenoxine, piracetam
Anti-agers, such as Deprenyl, melatonin, and caloric restriction mimetics, such as Metformin
Lifestyle, including hormesis/stress, brain exercises, physical exercise, calorie restriction, and general health education
Technology such as nanotechnology, and genetic technology
Treatment for specific age-related diseases such as Alzheimer’s disease, Parkinson’s, osteoporosis
Cosmetics against ageing of the skin, such as Botox, Isolagen, collagen, face lifts
Less well-accepted such as chelation, human stem cells, cell therapy, immune therapies
Complementary treatments such as plants and nutrients which protect against specific illnesses (cassia, rutin etc)
Treatment of conditions (diabetes, hypothyroidism, menopause, andropause) at a pre-clinical level.

Nutrition has been an extremely controversial area in anti-aging medicine with gurus offering a huge variety of diets to help people stay healthy and live longer. The diets are often contradictory. One of the better validated studies is Dr. Dean Ornish Program for Reducing Heart Disease. Note, however, that the program also places a strong emphasis on exercise, relaxation skills, managing stress, emotional intimacy, and lifestyles. Thus it is not clear to what extent the nutritional program is achieving the results and how big a role the lifestyles components play. One of the few areas of consensus among nutritionists is the importance of keeping stable blood sugar levels, achieved in part by managing the glycemic indices of food choices.

Some fitness and longevity advocates love grueling sports and activities such as running marathons. This runs the risk of injuries and wear and tear on body parts such as knee joints. Some fitness experts focus on being healthy and fit enough and emphasize a balanced approach. This includes cardiovascular fitness, strength, flexibility, balance, and posture – whether achieved through exercise or sports.

Researchers continue to search for causes and cures for diseases. Tissue engineering is developing ways to grow new tissue, e.g., for burned skin, damaged heart muscle. Tissue engineering includes using stem cells to grow new tissue, organ transplants, and artificial tissue or organs. Nanotechnology, genetic research, and pharmaceutical research are all contributing as well.

Anti-aging medicine has tended to focus on age conscious consumer’s desires to look good, feel good, and live as long as possible. Anti-aging medicine has tended to focus on hormone therapies, supplements, skin care treatments (e.g., skin resurfacing, Botox treatments, Argireline based products), and plastic surgery.

Millions of women have used Premarin (synthetic estrogens and made from mare’s urine) to reduce the impact of menopause. In 1991 the Women’s Health Initiative, studied 161,808 postmenopausal women with randomized trials of hormone supplements vs. placebo. It discontinued the study in 2002 because it concluded that on the whole the supplements were doing more harm than good (primarily due to an increased risk of breast cancer). Suzane Sommers has been championing the use of bioidentical hormone replacement for women as more efficacious. She has received a lot of opposition from doctors.

Millions of men are taking testosterone supplements (usually creams or patches) and tens of thousands of Americans are taking Human Growth Hormone (HGH) injections at a cost of $10–12,000 a year. The Internet has more than a hundred website promoting less expensive secretagogues that claim to prompt the body to naturally produce HGH. There is little independent research on HGH secretagogues.

The U.S. now has more than 5,000 health spas generating $5 billion dollars in revenue. Most are day spas that offer relaxation and beauty treatments. Many are including medical treatments as well.

Associations

The American Academy of Anti-Aging Medicine is an international professional organization with 18,500 members (primarily anti-aging physicians). It sponsors a journal, publications, and conferences including an annual conference in Las Vegas. The organization’s founder, Ronald Klatz, MD, DO claims he coined the term anti-aging.^{[citation needed]}

The Life Extension Foundation, is an organization conducting and funding anti-aging research. It has focused on vitamins and supplements and much of its income is derived from selling vitamins and supplements. It takes a strong advocacy posture and is often critical of the practices of mainstream medicine and pharmaceutical companies.^{[citation needed]}

Doctors

Deepak Chopra, MD., Indian physician involved in mind-body medicine.

Andrew Weil, MD, American proponent of integrative medicine.

Roy L. Walford, MD, American researcher in the field of life extension.

Marios Kyriazis MD, British Anti-aging physician and Gerontologist.