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RESEARCH

Current Research on Aging

AGING AND DISEASE

It is possible, but rare, to age in relatively good health. For the majority of people, growing old is associated with an increased risk of developing a plethora of degenerative conditions and functional impairments Khaw  (1999). The burden of disease is probably the most distressing aspect of old age often leading to depression and other secondary psychiatric disabilities and no one likes it.  When rated against the standard benchmarks a biological gerontologist would use to measure successful aging (maintenance of normal function, avoidance of disease and social engagement), only about 18% of people can be described as undergoing “successful aging” Bowling and Dieppe (2005)., From self-report surveys, anywhere between half and a quarter of elderly people do not consider themselves to be aging well. They are not happy and are probably not healthy either.  Unless improved treatment systems are applied, we may end up with a world in which we spend more money than ever before to keep more people more miserable. On the other hand, we know that better secondary prevention will postpone the age of onset of morbidity and that a comprehensive treatment model, available in a fixed location, is the best treatment available when the individual has ownership of the treatment and it becomes part of the person’s daily routine.  Certainly just seeing the usual activities of life becoming chores, reveals the everyday challenges presented by advancing years.

In brief, the same aging mechanisms that contribute to age-related diseases also show themselves as features of aging which in the past were considered to be “natural changes” (e.g., the accumulation of senescent cells in the skin contributes to wrinkling, a “natural change” as well as to cardiovascular disease, an “age-related disease”).   We consider some aging process not diseases and not attempt a treatment while with others a treatment is critical. As we age, the cells become less able to ward off simple diseases, mutations, viral and bacterial invasions.  The chronic disease grows from these initial attacks.   Just as with our auto metaphor above, if we run the car too often with improper air in the tires, the tire will become flat while the properly filled tire will not have a flat until the rubber is more worn. The genotype was the same but the phenotype was very different. Taking care of the tires is the driver’s responsibility which includes going to the garage every few months to have them evaluate (diagnose) the tire.   If a year later, the tire ignorers finds themselves on a dark road with a flat, it is not the tire at that time which is at fault but also the lack of care of the tire a year ago. 

A COMPREHENSIVE TREATMENT APPROACH TO AGING

“As we've said before, there are many different things that can contribute to the total burden of aging damage in our bodies, including our genes, our lifestyles, and things in our environment. Genes, the conditions in the womb, nutrition, lack of exercise, pollution ... with all of the many factors that influence the onset of age-related disease, plus the side-effects of the very metabolic processes that give us life, you might think that completely preventing or curing those diseases would be a hopelessly complicated task. And indeed it would be, if your strategy were to try to hold back each and every one of those multiple causes of damage.”… (Rae, 2013)  Intervention protocols understand there are inherent links between all prevention levels and diseases in aging and treating one age related disease without treating the other may not be effective for either.  For instance, there would be no expectation to treat dementia without treating heart disease or vice versa.  For example in a recent John Hopkins study, the finding was that a midlife diagnosis of diabetes or prediabetes raises the risk of memory and thinking problems over the next 20 years.  Having diabetes in midlife was linked with a 19 percent greater decline in memory and thinking (cognitive) skills 20 years later, people with prediabetes, diabetes and poorly controlled diabetes had the higher risks of cognitive decline. The people with the worse cognitive decline were those with poorly controlled diabetes. In another study, blood pressure, diabetes, and smoking were found to be risk factors for Alzheimer’s disease and dementia. Obesity and sedentary behavior were also risk behaviors.

“The best evidence right now for the particular lifestyle factors that may reduce risk of Alzheimer’s and other chronic diseases is regular physical activity in combination with social and mental stimulation, and quitting smoking,” said Maria Carrillo, Alzheimer’s Association vice president of medical and scientific relations. “Other lifestyle activities that contribute to healthy-brain aging are eating a brain-healthy diet, being mentally active, and being socially engaged.”  These are the same treatments for heart disease but the focus here is on the most dangerous of the aging process, that of Alzheimer’s disease which is why we emphasize this disease in our aging program and will explore in more detail.  However we are aware that there are specific lifestyle factors that are integral to the aging process and thus each chronic disease.

AGING AND TECHNOLOGY

The commonality of individual behaviors that benefit so many diseases “suggests a new way to prevent and cure the diseases and disabilities of aging. Instead of fighting a hopeless battle to hold  back all of the multiple, relentless metabolic forces that damage the cellular and molecular machinery of our bodies, what if we could repair the damage itself — even after it had already happened, and no matter what had caused the damage in the first place? Remember: the diseases and disabilities of aging are nothing more or less than the dysfunction that happens in our tissues when they accumulate too much of this damage to carry on their normal, youthful function. If we could remove, repair, replace, and render harmless the cellular and molecular damage that renders our living systems dysfunctional, then we could actually restore aging organs and tissues to youthful health and functionality, making them better and healthier than they were when we started treatment. The power of such an approach is that it would not merely delay the inevitable appearance of age-related disease: if it were done with zeal, and applied to the full range of the damage of aging, it would maintain our health and hold off the diseases of aging indefinitely.” (Rae, 2013)

A recent review illustrated this approach when it reported the effectiveness of cognitive training on aging, using simple computer game programs designed to improve memory function.  The results were that the ability of neuronal plasticity allowed changes in brain structure, and a delayed progression of cognitive decline, particularly with MCI patients.  The authors hypothesized that a cognitive treatment program could delay the effect of Alzheimer’s disease for 5 years, and overall prevalence could decrease by 50% due to a treatment of the aging structure.  These statistical probabilities suggest that with intervention (cognitive training), in 2020, the number of people age 65 and older with Alzheimer’s disease in the severe stage would drop from 2.4 million to 1.1 million. In 2050, the number of people in the severe stage would decline from an expected 6.5 million to 1.2 million. (Buschert, A.L., Bokde, L. W. and Hampel, H.  Cognitive Intervention in Alzheimer’s disease.  Neurology, Vol 6, 508-517.). This is only one example.

Some interesting wok is being done with State–of-the-science Cognitive Health programs, provided by professionals, with only evidence-based technologies and newly-developed technologies such as trans-cranial direct-current stimulation (tDCS).  Although the devices are used for many “get smart” tasks supposedly by creating faster synapse speed, this zapping of the neurons is probably a fantasy that fits a young man’s guitar image.   However when you look at the results with the elderly, we find that proper stimulation along with cognitive computer training increases memory function.  That is a service required by the elderly; something that is Needed and if marketed correctly with a properly build devise would be very attractive to seniors

Are there other devices that are Needed.  Think of the apps on the iPhone and think how many are readily accessible to the elderly.    This is the generational gap I believe should be addressed by a Board to ensure that the product everyone loves is accessible and available to the groups most interested in purchasing.   For while it may be made by the young, it is probably to be used by the elderly.

The concept of disease being intertwined with aging calls for multiple technological devices to improve the quality of life.  It is the role of the tech creator to define that intersecting point of novelty and use.