Successful Aging: A Life Journey
There's a lot of buzz in the media related to an aging population, along with a plethora of purported anti-aging products that contribute to a very profitable multi-billion dollar industry. The baby boomers, once again, are not happy with the status quo and are looking to do something about it. They are in the company of Ponce de Leon and others who have searched for the ultimate "fountain of youth" throughout the history of civilization.
According to Dr. Al Sears, one of the first board-certified anti-aging physicians, "Aging is the process by which you gradually weaken and lose function. Anti-aging seeks to understand this process and intervene to preserve youthful characteristics." Life extension refers to those interventions that attempt to slow down the aging process in order to extend the maximum life span of an individual, or the average life expectancy of a broader population.
Over the past 150 years, we have just about doubled the average American life expectancy, from 40 years of age in 1870 to just over 80 years in 2013. But life expectancy is just a statistic that applies to a general population based on sex, race and other demographics. Some people still die very young, or live much longer than the average.
Despite significant advances in medicine and finding the cures for many diseases, Americans are really not living much longer than some of the ancient Greeks. Plato lived to a ripe old age of 81 and Socrates lived 70 years. Even today, it is extremely rare for any human being to live beyond about 110 years of age. But that, and many other aspects of aging, may change within our lifetime!
While the thought of living indefinitely may not appeal to everyone, successful aging—that is, living vitally without disease such that we are able to use our bodies and our minds to their full potential throughout our entire lives—seems to be a common human desire.
Why Do We Age?
In Age Right, Dr. Karlis Ullis notes that many living creatures do not age as humans do. Many insects, fish and other invertebrates maintain the same biological age throughout their life span. So what's different about human cells? There are dozens of theories on aging, spanning centuries of study, which Dr. Ullis summarizes as falling basically into one of two camps:
- Chance, whereby the fallout of living a life in the form of toxins, free radicals, glucose metabolism, and other processes take their toll on our body (what we might call the "wear & tear" effect)
- Grand design, whereby human cells are pre-programmed, as a species, to die off at a certain point.
The fact that very few people live past about 110 seems to support the camp of grand design; but current research seems to indicate that there's more to it, and that the two camps may not be mutually exclusive. Dr. Ullis believes that there is probably some truth to both, based on his extensive research involving young, Olympic-caliber elite athletes. He discovered that there is a fine line between peak training and overtraining and, once that line is crossed, the body goes into a state very similar to rapid aging.
That threshold is the critical point between cellular anabolism (the replenishing activity or cell renewal) and catabolism (the breaking down activity or cell death). Biomarkers, available from lab or self-tests, can indicate where a person lies on that continuum. These biomarkers are what Dr. Ullis used first to study peak performance in athletes, and later on to study aging.
In 1987, two researchers Dirk Pearson and Sandy Shaw published a book called Life Extension. Within the book, they described the nutrient deficiencies involved in the symptoms and representation of what we commonly describe as aging. Their book sparked a revolution in the study of age-related imbalances.
In 1990, Nature magazine published an article describing groundbreaking research on a part of DNA at the end of each chromosome called a telomere. What they found is that the telomere gets shorter with each cell division, inherently limiting the number of times that a cell can divide before dying off, and that different types of cells have different telomere lengths. Researchers are now exploring interventions that curtail or stop the telomere from getting shorter, and ways to add length back on to the telomere.
Another hot area of research involves stem cells and regenerative medicine. Dr. David Williams reports that most of the problems typically associated with aging "are directly linked to the degeneration of the nervous system (neurodegeneration)." Dr. Williams suggests that, if we can slow neurodegeneration, we can mitigate those problems.
The promise of these and other discoveries over the past few decades has spawned several new professional medical groups related to the study and practice of age-related medicine, including:
- the American Academy for Anti-Aging Medicine (A4M)
- the Age Management Medicine Group (AMMG)
- the American College for the Advancement of Medicine (ACAM)
- the International College of Integrative Medicine (ICIM).
Although it is not their only focus, the practitioners in these groups recognize that adequate and balanced levels of hormones are a foundation for successful aging.
What Happens As We Age?
In humans, cell death or turnover is constantly occurring throughout the body; it is a natural part of life. However, just as different parts of the body peak at different stages of development, different types of cells die off or renew at different rates. For example, research now suggests that:
- Epidermal skin cells are replaced about every 2 weeks.
- Red blood cells renew about every 4 months.
- Most bone cells are about 10 years old.
- Some muscle cells last about 15 years. One exception is the heart muscle, in which the cells die off and are replaced by scar tissue.
- Most of the nervous system cells do not renew (with the exception of the hippocampus); they are as old as you are, according to Dr. Williams.
- Interestingly, Dr. Ullis notes that only sperm cells (representing life) and cancer cells (representing death) do not die off naturally.
Given the many cells in the body that are in a constant state of renewal, one might think that people should stay "young" forever—or at least the body parts that are rapidly regenerating. But obviously that's not the case. In Your 6-Week Anti-Aging Plan, Dr. Sears notes that "newly minted cells from an 80-year old are readily recognizable as cells from an aging body. These brand-new cells look and act older than cells from a younger person."
Most people go through a "decade of vulnerability" roughly between the ages of 40 and 50. Dr. Ullis notes that, by the age of 50, the cascade of age-related demise typically includes the following:
- Decreased cognitive abilities, with brain size diminished by about 6%
- Increased fat accumulating around the mid-section, with a sagging abdomen due to muscle loss
- Decreased muscle, limiting overall strength and ability to grip
- Wrinkles in skin, thin skin, sagging skin and sun-damaged skin
- Gray hair, thinning hair, and bald spots in men
- Increased farsightedness due to the loss of elasticity in the eye lens
- Poorer color perception and night vision due to the yellowing of the lens and loss of rods
- Decreased sensitivity to hearing higher tones, accelerated by listening to loud music or noise in the work environment
- Decreased sensitivity to smells and taste, accelerated by zinc deficiency, pollution and smoking
- Decreased bone density leading to brittle bones, especially in women
- Decreased kidney function due to diminishing kidney size (with the peak in kidney function occurring around age 30)
- Decreased bladder elasticity, resulting in less capacity and more frequent urination
- Decreased lung elasticity, resulting in a loss of about 20% capacity by age 50 (more for smokers)
- Diminished libido and sexual function.
While these declines can be radically affected by genetics and lifestyle choices, they represent the normal signs of aging that occur across the majority of the population, with women typically aging more quickly than men.
Recognizing that many of these conditions can also represent a hormone imbalance, restoring hormones to optimum balance has been a cornerstone of anti-aging for centuries. From the ancient Chinese, whose emperors mandated the collection of urine from young people and consumed the dried urine for the hormones it contained, to consuming the hormone producing glands of animals, to the modern day extraction and synthesis of the actual hormones, all have been used as methods to control and diminish the negative effects of aging.
Can We Influence Aging?
When it comes to geriatrics, most physicians tend to treat symptoms rather than search out the root cause(s) of those symptoms. But Dr. Ullis, Dr. Sears, Dr. Williams, and other researchers are identifying ways to do both—treat symptoms and address root causes—no matter how old a person is.
Dr. Ullis recognizes five dimensions of aging in his regimen, with the most influential being the neuroendocrine dimension (i.e., how well the hormones and nervous system work together). His other dimensions relate to energy metabolism (how well we gain and use energy), biomechanics (how well we move our body), and a social dimension that embodies our perception of ourselves as well as our relationships with each other, our community, the world and the environment.
Dr. Ullis' fifth dimension is genetics, which he did not include in his anti-aging regimen because, at that time, most people believed it was not something that could be manipulated. However, since then, the burgeoning field of epigenetics has demonstrated that DNA can be modified by external sources such as diet, toxins and the environment. These external sources can affect how cells behave by turning specific genes in the DNA sequence "on" or "off," without altering the DNA itself.
Dr. Sears suggests that the "wear & tear" theories of aging, such as those pointing to free radical damage and glucose metabolism, "appear to be simply features of the aging process but not the true cause." He notes that our bodies are "assaulted by free radicals from the day we are born" but that we become increasingly less effective at correcting the damage as we age. To help combat these effects, Dr. Sears recommends a 6-week plan of action designed to specifically target telomeres and mitochondria, the energy source in each cell.
Dr. Williams also targets mitochondria as the source of neurodegeneration and poor glucose control, which he believes are the primary causes of age-related decline. When mitochondria become damaged or compromised at any age, a wide variety of symptoms and health problems can result, many of which resemble the age-related conditions previously identified.
With all of the recent high-tech discoveries, it is interesting that the anti-aging programs of Drs. Ullis, Sears and Williams (as well as many others) share three basic principles:
- Exercise: Across the board, anti-aging specialists promote the immediate benefits of exercise. Regular physical exercise will:
- Retain and regain muscle mass
- Improve the supply of oxygen to mitochondria
- Reduce stress (lower cortisol)
- Improve balance and coordination, reducing the likelihood of falls
- Build stronger bones (if weight-bearing exercise)
- Boost human growth hormone (HGH) levels, naturally
- Improve the quality of sleep
- Help control blood sugar.
Dr. Sears suggests that long endurance exercise, such as marathon running, is not the best way to prevent or reverse the effects of aging. It causes muscle fatigue, with additional "wear and tear" on your body, and does not build muscle. He recommends short bursts of intense exercise for the best results, but it is important to check with your doctor before starting any new exercise program to avoid injury. It also helps to work with a personal trainer when getting started to ensure proper form for maximum benefit.
- Testosterone deficiency
- Progesterone deficiency
- Estrogen hormones deficiency or excess
- Thyroid hormones deficiency
- DHEA deficiciency
- Cortisol excess
- Insulin excess.
Working with a healthcare practitioner to correct hormone imbalances is a crucial step toward successful aging.
Antioxidants are crucial in fighting against the damage caused by the oxidative stress of free radicals. Dr. Sears notes that "oxidative damage correlates with the negative effects of aging in each organ system. For instance, it's not the amount of cholesterol you have that correlates to cardiovascular disease but the oxidation of LDL cholesterol."
According to Dr. Ullis, supplements that specifically protect the mitochondria include:
- Acetyl-L-Carnitine (ALC)
- Alpha Lipoic Acid
- Pyrroloquinoline Quinone (PQQ)
- Coenzyme Q10 (CoQ10)
Most of the recommended vitamins, minerals and antioxidants can be found bundled in a single supplement at your local pharmacy. Again, work with your healthcare practitioner to determine which supplements are best for you, and in which doses.
What is Successful Aging?
Successful aging goes beyond the ramifications of physical health, incorporating cognitive function, social support, and satisfying life experiences. Some, like Dr. Ullis, define it more as an integrated "wellness," representing a contented balance among the physical, emotional, spiritual, social and cultural aspects of an individual's life.
It is important to note that the "success" in aging is very subjective and will vary from one person to another. Our goal in this newsletter is to plant a seed for you to start on a path toward successful aging and wellness, whatever that means to you. While your physical health is just one aspect, it is one that significantly affects most other aspects of wellness.
To start, you may want to have a baseline physical to assess your current condition, including evaluating hormone levels. You might also make important lifestyle changes to better meet your body's basic needs for healthy food and nutrients, clean air and adequate hydration. You might strive to keep your body running smoothly by increasing your physical activity, so you can engage more in social activities and play. And, with the help of healthcare practitioners attuned to healthy aging, you may choose to replenish those hormones that decline with age, as well as take steps to moderate the ones that tend toward excess.
Your body will reward you for each of the steps you take on your journey toward successful aging.
- "Aging: What to expect as you get older" published by the Mayo Clinic as of August 2, 2012.
- "Age Right: Turn Back the Clock with a Proven, Personalized Antiaging Program" by Karlis Ullis, MD, with Greg Ptacek; Fireside, New York NY; 2004.
- "Telomeres shorten during ageing of human fibroblasts" C. B. Harley, A.B. Futcher and C.W. Greider; Nature; May 31, 1990.
- "The Link Between Aging and the Nervous System" David Williams, MD; Alternatives For the Health Conscious Individual, Volume 15, No. 2; February 2012.
- "Your 6-Week Anti-Aging Plan by Al Sears, MD; self-published; 2012.
- "Epigenetics: Definition & Examples" by Rachael Rettner, June 24, 2013.