Anti-Aging Medicine: How we Can Extend Lifespan and Live Longer and Healthier Lives
Theodore C. Goldsmith
Some material in this book previously appeared in Introduction to Biological Aging Theory Theodore C. Goldsmith 2019
1. Introduction
Would you like to live a longer, healthier, and happier life?
For centuries it was widely thought that aging was an unavoidable and untreatable aspect of life. We can find treatments for highly age-related diseases such as cancer and heart disease but aging and death of old age was inevitable, a law of nature. Many people still think of human aging as the sort of inescapable gradual deterioration we see in automobiles, bridges, and other inanimate objects.
However, today there is extensive evidence and new theoretical support for the idea that aging is itself a treatable condition and can be generally delayed by anti-aging agents as well as lifestyle choices such as diet and exercise. Substantially funded research is now underway to find and develop those agents and protocols.
The reader may be surprised to read that going into the 21 st Century there was no wide scientific agreement regarding even the general nature of aging despite decades of spectacular progress in medicine. After all, highly age-related diseases were the major cause of death and health care expense in developed countries. Surely by the year 2000 we would have definitively determined how and why we age!
Today there is still major scientific disagreement regarding even the fundamental nature of aging and the reasons for this will be discussed in detail. Dramatic and some rather recent advances in genetics science have significantly altered modern evolution theories and dependent aging theories.
Anti-aging medicine has multiple interpretations. Cosmetic medicine can include delaying the visual appearance of aging. Healthy aging (sometimes described as better aging or aging gracefully ) refers to extending the active and productive portion of a lifetime without necessarily increasing total lifetime. Most would like to reduce the length of the nursing-home stage in favor of a longer productive and more enjoyable life. Finally, lifespan extension refers to generally delaying aging, increasing both the healthy and total lifetime and therefore essentially includes healthy aging. Aging is itself a treatable condition. Aging is like a disease as opposed to an unalterable aspect of life.
This book describes the history and main controversies regarding the nature of and especially the treatability of aging and concentrates on current theories, medical research developments, and developments in the practice of anti-aging medicine.
For most of human history, aging was much less important to human health and well-being because most people died at relatively young ages from infant mortality, injuries, and infectious diseases. Today dramatic improvements in medicine, health care, and general safety have resulted in a situation where most people in developed countries die of aging or diseases mainly caused by aging.
Theories of biological aging (senescence) are important to medical research on aging and age-related diseases and conditions because aging and associated symptoms are difficult subjects for research and theories can help guide research directions. Of course, an incorrect theory might hinder research!
Among gerontologists there is now general agreement that aging is a trait or inherited organism design characteristic that has been determined by the evolution process. Therefore, evolution theory and specifically the relationship between the evolution process and the aging trait is critical to medical research on aging and related symptoms. Modern evolutionary aging theories are based on slightly different minor modifications to Darwins survival-of-the-fittest concept. Unresolved scientific arguments regarding the mechanics of evolution and the evolutionary nature of aging have existed at some level since Darwins theory was introduced (1859) and continue today.
A key aspect of evolution theory is that it applies to all living organisms and was derived from Darwins comparative observations of many different animal and plant species. All species are substantially related to each other. Humans are mammals and are even more closely related to other mammals. Therefore, evolutionary aging theories need to provide multi-species explanations for observations about aging. Some earlier theories only attempted to explain human aging.
As will be described, all digital information systems share common characteristics, features, and constraints. These common aspects have implications for the nature of biological inheritance and consequently the nature of the evolution process and for the evolutionary nature of aging.
Medicine and healthcare are similar but not identical in developed countries. This book is mainly concerned with the medicine, research, and health care situation with respect to aging in the United States.
Today there are two main evolutionary theories of biological aging called programmed aging (or adaptive aging) and non-programmed (or non-adaptive) aging. The huge practical consequence is that non-programmed theories strongly lead to the conclusion that aging is itself an untreatable condition. In contrast, programmed theories strongly suggest that aging is itself a treatable condition and that lifespan extension in addition to healthier aging is possible.
Another major practical consequence is that the two theories suggest radically different concepts regarding the nature of massively age-related diseases like cancer and heart disease and lead to somewhat different paths for researchers looking for ways to prevent or treat these diseases.
As this book will summarize, current science greatly favors programmed aging and thereby lifespan extension but many non-science factors favor non-programmed aging and oppose lifespan extension. This conflict is the primary reason there is still no wide scientific agreement on even the general nature of aging.
I am not a medical doctor and have not recently been employed in the health industry and so I have an outsiders perspective. Nothing in this book should be considered medical advice and everyone should consult a doctor prior to making changes in their medications, diet, or exercise regimen.
2. Nature of Aging and Lifespan
Age-related diseases or conditions drastically increase in incidence and severity with age. Age-related diseases such as cancer, heart disease, stroke, arthritis, and Alzheimers disease are each common but not universal in older people while rare or even essentially non-existent in young people. Age-related conditions are more universal and include loss of strength and muscle mass, reduction of sensory capabilities such as vision, hearing, smell, taste, and balance, appearance changes such as changes in skin and hair, and reduced immune response. Death of old age could be considered a universal fate of those that escape specific age-related diseases.
We can use the term lifetime to refer to the time a particular individual lives. Lifetimes of billions of humans have been recorded (it is carved into their tombstones). Lifespan is the length of a typical lifetime in the absence of any external limitations such as predators, food supply, infectious diseases, harsh environmental conditions, or habitat such as might exist under zoo conditions . Lifespan is internally limited in most complex species.