Aging is inevitable, albeit its cadence is not. As the American writer Betty Friedan rightly said, “Aging is not lost youth, but a new stage of opportunity and strength.” While we all know that our bodies age, the whole internal experience smacks of ambiguity, also mystery — although new research explains the aging process better than ever before. It surmises that chronological age has little, or no real, bearing on biological age. Picture this — the number of candles that adorns your birthday cake only serves as a metaphor of time. It never speaks, reports, analyses, or lights, a glow about your health and well-being.
Age-related physical changes are obvious. They are as apparent as the ‘slowed’ reflexes of a great cricketer at the twilight of their career. The most visibly decipherable markers of aging are additional laugh lines, greying, or loss of hair, extra weight around the waist, among others. Add to this ‘hazy’ vision, ‘thinning’ skin, or brittle tissue, and you’ve the anatomy of aging sequentially told.
Your heart slows down too and it shows up as fatigue — this results in less blood being circulated, leading to reduced bustle of nutrients through your body. Besides, the nutrients, that ‘power’ the functional ‘engines’ of our metabolism, are also less available. Though this is normal, it shows how enormously interrelated, or interconnected, every part of us is. If one thing goes wrong somewhere, it will, as a spin-off, have a cascading, ‘rebound’ effect elsewhere.
These are, of course, clear changes — but, there are a host of alterations, such as the steady loss of bone tissue and reduced elasticity of blood vessels that go unobserved, for decades, before the signs of aging set in. ‘Seeing’ is, sometimes, not ‘believing’ in masquerade — we are all physiologically ‘engaged’ in the aging process, yet we think that it is not happening at all.
There is also a growing paradox, thanks to our augmented lifespan and life expectancy in the 21st century. The aging process is redefining new treatment modalities, especially in individuals surviving into ripe old age with chronic illnesses. This is a huge challenge, because coping with chronic conditions is not easy. It never ever was. Studies suggest that by the year 2050, about 2-3 million people are expected to have lived 100 years, or more. It is, therefore, imperative that the management and treatment of chronic illnesses would require optimisation of the aging process. This holds the key to amplifying our quality of life and daily functional capacity — two fundamental elements for the best possible maintenance of health and also the aging process.
It is established that a decline in physiological function begins after age 30, when our physical and emotional performance reaches the zenith. The rate, of course, varies depending on one’s lifestyle — the prospects of slow aging are better with people who are active than folks who lead sedentary and ‘flabby’ lives. Yet, the fact is nobody can ‘stall’ the tide of time. Not even ‘super-fit’ athletes. Research suggests that veteran athletes too experience a clear decline in their cognitive and physical function, thanks to the aging ‘construct.’
While most physiological functions remain satisfactory for healthy individuals surviving, or living, into old age, beyond the ‘nervous’ nineties, it is actually disease and disuse, not normal aging, that accounts for the larger part of functional slowdown in one’s mid-80s. Besides, one cannot discount the possibility of drug-interactions, or unpleasant effects of environmental pollution, donning the ‘killjoy’ role in healthy aging.
While the most fundamental process of aging is the destruction of cell membrane permeability, what also ‘triggers’ dysfunction is not only cellular communication glitch, but also consequential functional decline. The effects are collective — oxidative stress, metabolic syndromes, chronic inflammation, imbalanced reactions, chronic stress response, lipid surges, impaired detoxification, poor immune function, hormonal inequity, including physical and mental sluggishness. The presence, or progression, of one, or all, such processes in aging is not predestined. It is a vital, unalterable exemplar — a predictable ‘shortfall’ experienced by all of us.
There is a profound emphasis on new technologies, more so in the area of human genomics and stem cell research, today. The premise is to provide greater precision about genetic and cellular aging mechanisms and treatment. Studies suggest that optimal lifestyle behaviours could increase our average lifespan, or prolong life expectancy by ten years. A multicentre study, for example, among elderly adults across Europe showed that a modified Mediterranean diet was associated with longer survival rates — a 12 per cent reduction in mortality. On the other hand, studies estimate that 30-40 per cent of deaths, in the US alone, are the outcome of undesirable individual health [mis]demeanours.
Research has identified the effects of natural, or normal, aging that is ‘free’ of illness as distinctive from the development of age-related illnesses, such as heart disease, diabetes, arthritis, osteoporosis and cancer, not to speak of Alzheimer’s disease, a neurodegenerative disorder that leads to memory loss. Some studies, likewise, suggest that the effects of aging are extremely ‘plastic’ — it tends to vary from one individual to another. It is as characteristic as your fingerprint, or signature. In simple terms, it suggests that each individual’s ‘autograph’ of aging is a consequence of numerous interactions — right from one’s genetics and lifestyle to environmental challenges.
What, therefore, holds a dazzling, or exciting, prospect is the ‘seamless’ integration and evaluation of cumulative physiological and psychological, or emotional, challenges over our lifespan and medical science’s response to new challenges — while determining how ‘well’ a particular individual is aging and how to customise treatment programmes to reducing the effect of chronic illness. You’d call it ‘bespoke medicine’ — analysing ‘you’ as a distinct individual, tapping and mapping your unique, personalised responses in health and illness from the point-of-view of treatment. This also offers a supplementary advantage — preventing processes that may ‘activate’ chronic ailments in old age.
— First published in The Himalayan Times, Nepal
