Is there an antiaging medicine?

¿Puede hablar el senescente? Por un envejecimiento tolerable

El acelerado envejecimiento poblacional ha sido preocupación creciente del mundo contemporáneo, dadas las dificultades económicas y sociales para asegurar la satisfacción de necesidades básicas y de cuidado de los senescentes. Las propuestas de envejecimiento exitoso, saludable, activo, de capacidades intrínsecas, son todas estrategias elitistas disponibles para personas que han llevado una vida próspera y de bienestar inalcanzable para la mayoría en el contexto mundial de desigualdad en aumento. Se presenta una propuesta que reconoce el deterioro etario de los rasgos antropológicos trascendentales de todo ser humano: relacionalidad, trascendencia inmanente y trascendencia de sí, que requieren la atención y el reconocimiento individual por profesionales sociales que reconozcan las necesidades de cada persona y proporcione los cuidados institucionales pertinentes en cada caso, a objeto de brindar un envejecimiento tolerable, alcanzable para todos sin caer en las desigualdades de propuestas elitistas indisponibles para la mayoría.

Carnosine research in relation to aging brain and neurodegeneration: A blessing for geriatrics and their neuronal disorders

Carnosine, an endogenous dipeptide (β-Ala-l-His), is enriched in prefrontal cortex and olfactory bulb of the brain, blood and also in muscle. It has mainly antioxidant and antiglycating properties which makes this molecule unique. Its content reduces during aging and aging-induced neurodegenerative diseases. Aging is a progressive biological process that leads to develop the risk factors of diseases and death. During aging the morphological, biochemical, cellular and molecular changes occur in brain and blood including other tissues. The objective of this review is to combine the updated information from the existing literature about the aging-induced neurodegeneration and carnosine research to meet the lacuna of mechanism of carnosine. The grey matter and white matter loses its normal ratio in aging, and hence the brain volume and weight. Different aging related neurodegenerative disorders arise due to loss of neurons, and synapses as a result of proteinopathies in some cases. Carnosine, being an endogenous biomolecule and having antioxidant, antiglycating properties has shown its potency to counteract erroneous protein biosynthesis, stress, activated microglial and astrocyte activity, and different neurodegenerative disorders. It (carnosine) can also inhibit the metal ion-induced degeneration by acting as a metal chelator. In this review the trends in carnosine research in relation to aging brain and neurodegeneration have been discussed with a view to its (carnosine) eligibility (including its mechanism of action) to be used as a promising neurotherapeutic for the betterment of elderly populations of our society at the national and international levels in near future.

State of the art in anti-aging trends

This chapter is an effort to provide a cursory overview of current paradigms in the realm of anti-aging medicine. This subject will be evaluated according to current philosophic, clinical and scientific perspectives which are predominant in the field at this time.

[Is there any scientific evidence supporting antiaging medicine?]

The objective of antiaging medicine is to interfere in the normal human biological aging process. Is there any scientific basis to justify classifying antiaging medicine as a medical specialty and not a branch of basic biological science? This review evaluated 110 papers, nine of which (8.2% of the total) reported studies involving human subjects. Only one of these studies was randomized and double-blinded (Jadad 2). In accordance with their classification of recommendations and level of evidence, these studies were considered CII. Three of the nine articles were published in journals with an impact factor over 1.110. Therefore, there does not appear to be any solid scientific and/or clinical evidence that would justify the application of antiaging medicine in current medical practice.

Mechanical approach to aging and wrinkling of human facial skin based on the multistage buckling theory

A wrinkle formation mechanism with cutaneous aging is addressed through a mechanical calculation of linear buckling. Skin is divided into five mechanically distinct layers in this study. In general, the outer layer is stiffer than the inner layer, so buckling occurs in the outer layer against the uniform compression caused by muscle contraction. This buckling damages the skin and affects the formation of permanent wrinkles. We propose a multistage buckling theory for evaluation of the wrinkle property, namely, the specific wrinkle size and critical strain in three stages. The specific wrinkle size is derived as the wavelength of the minimum-buckling mode for infinite-length skin. A sensitivity analysis is carried out to investigate the effect of age-related changes of the mechanical parameters on the wrinkle property. We employ some aging hypotheses and prepare two sets of mechanical parameters, one for young and one for aged skin. The numerical results show that the buckling mode switch from Stage I to Stage II is the main reason why pronounced wrinkles suddenly appear in aged skin.

Melatonin reduces oxidative stress in erythrocytes and plasma of senescence-accelerated mice

It has been suggested that oxidative stress is a feature of aging. The goal of the present study was to assess the oxidant effects related to aging and the protective role of exogenous melatonin in senescence-accelerated mice (SAMP8). Two groups of SAMP8 mice (males and females) were compared with their respective control groups of SAMR1 mice (senescence-resistant inbred strain) to determine their oxidative status without melatonin treatment. Four other groups of the same characteristics were treated with melatonin (10 mg/kg/day) in their drinking water. The melatonin concentration in the feeding bottles was titrated according to water consumption and body weight (i.e. 0.06 mg/mL for 30 g of body weight and 5 mL/day of water consumption). The treatment began when animals were 1-month old and continued for 9 months. When mice were 10-month old, they were anesthetized and blood was obtained. Plasma and erythrocytes were processed to examine oxidative stress markers: reduced glutathione (GSH), oxidized glutathione (GSSG), superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPX), glutathione reductase (GR), glutathione S-transferase (GST), thiobarbituric acid reactive substances (TBARS), and hemolysis. The results showed greater oxidative stress in SAMP8 than in SAMR1, largely because of a decrease in GSH levels and to an increase in GSSG and TBARS with the subsequent induction of the antioxidant enzymes GPX and GR. Melatonin, as an antioxidant molecule, improved the glutathione-related parameters, prevented the induction of GPX in senescent groups, and promoted a decrease in SOD and TBARS in almost all the groups.

Orthopaedic care of the aging athlete

Increasing numbers of middle-aged and older adults participate in sports, and athletes wish to remain active as they age. Understanding the anatomic, physiologic, and psychosocial differences between older and younger athletes can help aging athletes maintain function. Athletic capacity may be sustained well into advanced age, and many of the physiologic consequences of aging may be mitigated or reversed by regular exercise. Most injuries in older athletes are chronic and overuse injuries that result in diminished flexibility and endurance. In addition, many aging athletes have medical and musculoskeletal problems that mandate tailoring athletic activity to the patient's general health and functional requirements.

Drug therapy in the elderly

Drug dosage in the elderly requires an understanding of the age-dependent changes in drug disposition and sensitivity. The most important pharmacokinetic alteration is a decline in renal function, the elderly should therefore be treated as renally insufficient patients. Metabolic clearance is primarily reduced with drugs that display high hepatic extraction, whereas the metabolism of drugs with low hepatic extraction usually is not diminished. The reduction of metabolic clearance is especially pronounced in malnourished or frail patients. The water content of the aging body decreases, the fat content rises. Hence the distribution volume of hydrophilic drugs may be reduced in the elderly, resulting in increased plasma concentrations. In contrast, the distribution volume of liphophilic drugs is increased, their plasma concentrations may decrease. Intestinal absorption of most drugs is not altered in the elderly. Aside of these pharmacokinetic changes, one of the characteristics of old age is a progressive decline in counterregulatory (homeostatic) mechanisms. Therefore, drug effects are attenuated less, the responses are usually stronger than in younger subjects, the rate and intensity of adverse effects are higher. Examples of drug actions augmented is this manner are postural hypotension with agents that lower blood pressure, dehydration and electrolyte disturbances in response to diuretics, bleeding complications with oral anticoagulants, hypoglycemia with antidiabetics, and gastrointestinal irritation with non-steroidal anti-inflammatory drugs. The brain is an especially sensitive drug target in old age. Psychotropic drugs, anticonvulsants, and centrally acting antihypertensives may impede intellectual function and motor coordination. Hence drugs should be used restrictively in geriatric patients.

Anti-aging medicine--the good, the bad, and the ugly

Complementary and alternative medicine has flourished since the beginning of time because of a human need to postpone the aging process and to reverse disease. Complementary and alternative medicine sells, because in some cases it works as well or better than mainstream medicine. In addition, many practitioners of complementary medicine understand Hippocrates' aphorism: "It is more important to know the person that has the disease than the disease the person has." It is important to recognize that spending time with the patient is often as therapeutic as drugs. CAM offers patients the time, touch, attention, and level of personal interaction that are increasingly uncommon in contemporary medical care. There is a major need for large and appropriately designed studies to test the effectiveness of complementary techniques. As in other areas of health care, studies in the elderly are consistently lacking. With the growing interest in CAM, it is important for medical providers to keep an open mind--to both the potential benefits and potential harms of alternative treatments. When treatments are shown to be dangerous or ineffective, we must educate the public and work to remove these therapies from the market place. When treatments are proven effective, Western and Eastern medical providers must work together with patients to provide the most appropriate and comprehensive health care.

Antiaging methods and medicines for the memory

The interaction of bedside and basic science has led to the identification ofa short list of pathological proteins as causal in Alzheimer's disease. AI3P has received the most attention, and work with animal models has reinforced the evidence that overproduction of ABP causes cognitive impairments. Animal models are now being used to discover and develop unique therapeutics directed at reversing the deleterious effects of ABP. These models strongly suggest that established Alzheimer's disease might be reversible, not just preventable. Animal models are also demonstrating that other peptides and proteins can enhance or impair cognitive function. These peptides and proteins add further to the list of possible therapeutic candidates. Approaches such as these, and not the commercial antiaging remedies that have no scientific basis, will eventually provide medicine for memory enhancement.

Hormonal fountains of youth

Any hope of a fountain of youth to stop people from getting older is a long way off, with science just beginning to understand the complex genetic, physical, and hormonal causes of aging. Clearly, modem research has demonstrated that the concept of a hormonal fountain of youth is predominantly mythology. The best evidence supporting use of hormonal replacement is vitamin D and estrogen replacement to prevent hip fractures. Other than that, treatment should be limited to hormone replacement in persons who have endocrine disease.

When drug therapy gets old: pharmacokinetics and pharmacodynamics in the elderly

The age-related changes in the functions and composition of the human body require adjustments of drug selection and dosage for old individuals. Drug excretion via the kidneys declines with age, the elderly should therefore be treated as renally insufficient patients. The metabolic clearance is primarily reduced with drugs that display high hepatic extraction ('blood flow-limited metabolism'), whereas the metabolism of drugs with low hepatic extraction ('capacity-limited metabolism') usually is not diminished. Reduction of metabolic drug elimination is more pronounced in malnourished or frail subjects. The water content of the aging body decreases, the fat content rises, hence the distribution volume of hydrophilic compounds is reduced in the elderly, whereas that of lipophilic drugs is increased. Intestinal absorption of most drugs is not altered in the elderly. Aside of these pharmacokinetic changes, one of the characteristics of old age is a progressive decline in counterregulatory (homeostatic) mechanisms. Therefore drug effects are mitigated less, the reactions are usually stronger than in younger subjects, the rate and intensity of adverse effects are higher. Examples of drug effects augmented is this manner are postural hypotension with agents that lower blood pressure, dehydration, hypovolemia, and electrolyte disturbances in response to diuretics, bleeding complications with oral anticoagulants, hypoglycemia with antidiabetics, and gastrointestinal irritation with non-steroidal anti-inflammatory drugs. The brain is an especially sensitive drug target in old age. Psychotropic drugs but also anticonvulsants and centrally acting antihypertensives may impede intellectual functions and motor coordination. The antimuscarinic effects of some antidepressants and neuroleptic drugs may be responsible for agitation, confusion, and delirium in elderly. Hence drugs should be used very restrictively in geriatric patients. If drug therapy is absolutely necessary, the dosage should be titrated to a clearly defined clinical or biochemical therapeutic goal starting from a low initial dose.

Effect of delta-sleep inducing peptide-containing preparation Deltaran on biomarkers of aging, life span and spontaneous tumor incidence in female SHR mice

From the age of 3 months until their natural deaths, female Swiss-derived SHR mice were subcutaneously injected 5 consecutive days every month with 0.1 ml of normal saline (control) or with 2.5 microg/mouse (approximately 100 microg/kg) of delta-sleep inducing peptide (DSIP, Trp-Ala-Gly-Gly-Asp-Ala-Ser-Gly-Glu) as the preparation Deltaran solved in 0.1 ml of saline. There were 54 mice in each group. The results of this study show that the treatment with Deltaran did not influence food consumption, but decreased the body weight of mice; it slowed down the age-related switching-off of estrous function; it decreased by 22.6% the frequency of chromosome aberrations in bone marrow cells; it did not influence mean life span; and it increased by 17.1% life span of the last 10% of the survivors and by 24.1% maximum life span in comparison with the control group. We also found that treatment with Deltaran significantly decreased total spontaneous tumor incidence (by 2.6-fold), mainly mammary carcinomas and leukemias in mice as compared with the control group. This is the first report on geroprotector and anticarcinogenic effect of DSIP-containing preparation Deltaran.

The war on "anti-aging medicine"

Leading members of the gerontological community have recently launched a war on anti-aging medicine, seeking to discredit what they judge to be fraudulent and harmful products and therapies, and to distinguish their research from what they regard as the pseudoscience of the anti-aging movement. This article interprets the contemporary war on anti-aging medicine as largely an attempt by established gerontological researchers to preserve their hard-won scientific and political legitimacy, as well as to maintain and enhance funding for research on the basic biological mechanisms of aging. First, it recounts the difficult struggle of U.S. biogerontologists to join the scientific mainstream in terms of legitimization and public funding. Second, it examines how elements of a contemporary anti-aging movement seem to threaten the hard-won public legitimacy of established gerontological researchers and practitioners. Third, it looks at the "boundary work" responses of the gerontological community to the anti-aging movement. Finally, it assesses the consequences of the war on anti-aging medicine to date.