Bringing longevity into the public eye is not an easy thing. There exist many misconceptions about aging, like that aging is way too complex to do something about it, or that aging can at best be slowed down.
Therefore, when bringing up the notion of addressing aging, the following things also often need to be discussed.
1. The notion that aging can be partially reversed. Many people (including MDs and scientists) think that aging at best can be slowed down. Recent studies, however, show that aging can be partially reversed, making old animals younger again. Addressing aging is not just about slowing down aging, but about actually reversing it.
2. Give people a framework. Aging is complex, but it helps if people can boil it down to a few simple rules, like the hallmarks of aging (see for example this seminal paper explaining some hallmarks of aging).
3. Tackling aging scares many people. It conjures up things like overpopulation, the emergence of a biological aristocracy that has the means to rejuvenate itself, and so on. However, it's important to realize that addressing aging is the best way to address dozens of aging-related diseases at the same time, like heart disease, Alzheimer’s disease, osteoporosis, and so on. Tackling aging is not about immortality (or amortality), but about healthy aging, living longer in the best possible health, tackling dozens of aging-related diseases simultaneously by addressing their root cause, and more.
During my talks, I often ask the audience the following question: "How much longer do you think life expectancy would be if we could cure all heart disease, the most important cause of death in most countries?" The answer: only about 2.8 years longer. This because if people don’t die anymore of heart disease, they will die a few years later of another aging-related disease. Therefore, it’s paramount to tackle aging itself.
4. Address the “I don’t want to become 150 years old if I have to sit in a wheelchair for 70 years” misconception many people have. When people are asked whether they want to live to 150 years, most people will say "no" because they think that they will suffer from frailty and debilitating diseases for many decades. However, if you ask the question: "Do you want to become 150 years old and still look like a thirty-something?", many more people would want to become that “old”. Recent research shows that it possible, at least in lab animals, to partially reverse aging.
Addressing aging is the best and most powerful way to substantially reduce the risk of dozens of aging-related diseases, and to substantially improve the health of people. By addressing aging, many diseases are tackled at the root cause, instead of just reducing their symptoms (a bit), or just tweaking at some downstream mechanisms of a disease. Addressing aging has the potential to truly impact and change medicine forever.
Many genes involved in the aging process have been discovered. These genes can in part predict our life span and our risk of aging-related diseases.
A well-known gene is the APOE gene. This gene is the most important predictor of the risk of contracting Alzheimer’s disease.
The APOE gene comes in 3 variants: APOEe2, APOEe3 and APOEe4. You always carry 2 variants. The e4 variant confers an increased risk of Alzheimer’s disease. People who carry one e4 variant (for example APOEe4/APOEe3), have twice the risk of developing Alzheimer’s disease. People who carry both e4 variants (APOEe4/APOEe4) have a nine times increased risk of Alzheimer’s disease.
Of course, nine times a small risk still equals a small risk, especially when you are still young (‘young’ referring to 50 to 70 years). However, research shows that e4 carriers have life expectancies that are 6 years shorter on average.
Interestingly, it seems that people who carry the e4 variant(s) have strong immune systems. They can ward off infections better. This would have been a big advantage in prehistoric times, when infectious diseases were rampant.
However, in this day and age, with improved hygiene and increased survival rates into older age, the tables are somewhat turned, and the e4 variant seems to be a disadvantage because the strong immune response can accelerate the aging process and increase your risk of Alzheimer’s disease.
The APOE gene is also involved in cholesterol and fat metabolism, and e4 carriers tend to accumulate more fat and cholesterol in their blood, raising the risk of cardiovascular disease, another aging-related disease.
About 65% of people of European ethnicity carry the e3 variant, and 25% the e4 variant.
Author: Kris Verburgh, MD
The older we get, the more our brains are susceptible to brain shrinkage. This shrinkage is accompanied by a steady cognitive decline, meaning difficulty to concentrate, forgetfulness or difficulty in retrieving words.
However, research has shown that this brain shrinkage can be substantially reduced by taking B vitamins.
Researchers from the University of Oxford gave old people vitamin B6, B9 (folic acid) and B12 during 2 years.
They found that the brains of people taking B vitamins shrunk seven times less compared to the placebo group.
The researchers concluded that B vitamins ‘may substantially slow down, or even potentially arrest the disease process in those with early stage cognitive decline' and that 'this is the first treatment that has been shown to potentially arrest Alzheimer's related brain shrinkage'.
B vitamins play an important role in metabolism. These vitamins are the oil that greases the wheels of our metabolism. The brain is metabolically very active and therefore needs a lot of B vitamins.
One can simply buy B vitamins in the supermarket or pharmacist and preferably a supplement that contains as much different B vitamins as possible (like vitamin B1, B2, B3, B5, B6, B9 and B12).
Author: Kris Verburgh, MD
- Preventing Alzheimer’s disease-related gray matter atrophy by B vitamin treatment. Proceedings of the National Academy of Sciences, 2013
- Vitamin B12 status and rate of brain volume loss in community-dwelling elderly. Neurology, 2008.
Progeria is often called a disease of accelerated aging. Patients mostly die of a heart attack at age 13, looking frail and old with bald heads, a wrinkled skin, a beaked nose, tin lips and tired looking eyes. It’s a very rare disease, afflicting about 1 in 8 million people. The official medical name is Hutchinson-Gilford syndrome.
However, some scientists believe that progeria isn’t in fact a disease of accelerated aging. They consider progeria a disease that resembles aging, but that isn’t really like the aging process itself.
After all, progeria doesn’t exhibit all the symptoms of the classic aging process. Patients with progeria don’t seem to have an increased risk of other typical age-related diseases, like dementia, cancer, cataract, diabetes, a declining immune system, increased cholesterol and triglycerides (fats), deteriorating eyesight or hearing loss.
Why then does progeria looks so similar to the aging process itself? This is probably because the final result of progeria is in some way the same as the aging process: massive loss of cells. As well as in progeria as in aging, cells everywhere in the body die and the final result of this massive cell die off is that the body looks old and frail.
In progeria, cells massively die because of extensive DNA damage. A malfunctioning protein in the nucleus of the cell makes the nucleus (that stores the DNA) unstable. This contorted and twisted nucleus damages the DNA inside it and causes the cell to die.
In aging, cells everywhere in the body also die, but this because of other ways of damage than only DNA damage. As we age, cells get damaged by protein agglomeration, advanced glycation end products, continuous growth signals, clogged up lysosomes and malfunctioning mitochondria, inevitably resulting in cells succumbing everywhere in our body, making our tissues and organs frail and weak.
So it’s possible that progeria isn’t really an aging disease, but a syndrome that only bears resemblance with the aging process. The same goes for other seemingly ‘accelerated aging diseases’, like Werners syndrome or Cockayne syndrome, which also mainly involve DNA damage.
While many people look at progeria and other progeria-like diseases as evidence that aging mainly involves DNA damage, those diseases in fact show that the aging process involves much more than only DNA damage.
Author: Kris Verburgh, MD
Picture: The Cell Nucleus and Aging: Tantalizing Clues and Hopeful Promises. PLoS Biology Vol. 3/11/2005. Creative Commons Attribution 2.5 Generic license.
We are often being told - especially by sellers of food supplements and skin cremes- that antioxidants slow down the aging process. Antioxidants would delay aging by mopping up reactive free radicals that otherwise damage our DNA. These dreadful free radicals are produced as a side effect by our metabolism.
But mounting evidence shows that antioxidants don’t slow down aging. And the free radicals aren’t always the bad guys. Free radicals can even function as a benign warning sign, revving up the cell’s defense mechanisms, like detoxification enzymes and repair proteins, protecting our cells against age-related damage.
Studies have shown that genetically modified worms that produce more free radicals, live 32% longer. Giving worms a weed-controlling herbicide that creates a surge in free radical production makes these worms even live 58% longer.
While free radicals aren’t always bad, antioxidants can be damaging. A large meta-analysis of 230 000 patients has shown that people who take antioxidants have an increased rate of death.
In conclusion, taking antioxidants isn’t always a good thing. Of course, when you are deficient of certain antioxidants, you do have to take them to replenish the ranks. But taking extra antioxidants to slow down the aging process doesn’t seem to work unfortunately. Meanwhile, aging seems much more complex than just free radicals damaging our cellular machinery.
Author: Kris Verburgh, MD
A Mitochondrial Superoxide Signal Triggers Increased Longevity in Caenorhabditis elegans. Wen Yang, Siegfried Hekimi. PLoS Biology, 2013.
Is the oxidative stress theory of ageing dead? Pérez VI et al. Biochim Biophys Acta, 2009. Mortality in randomized trials of antioxidant supplements for primary and secondary prevention: systematic review and meta-analysis. Bjelakovic, G. et al. JAMA, 2007. Picture: cc Wikicommons