What is Science Doing? What is Science Doing? Studying populations - - PDF document

AGING: KEEPING YOUR MORTALITY AT BAY

Richard E Ya Deau M.D. FACS, FACHE (HON)

Studying populations without either cancer or

• diabetes. But:

These genetic predeterminants also produce profound dwarfism! Ecuadoreans with “Laron Syndrome” will inform us about both the genetics of these problems and the need for caution to avoid unintended consequences.

What is Science Doing?

Valter Longo, University of Southern California Online journal “Science Translational Medicine” February 17,2011

The search for proteins that improve memory led to one “IGF-II” which improves “declarative memory.” When blocked, memory was destroyed.

What is Science Doing?

Cristina Alberini Mount Sinai School of Medicine Nature, January 2011

An Immune Aid for Aging or “Increasing health span versus lifespan”

What is Science Doing?

Edward Goetzi University of California, San Francisco. Clinical Immunology, January 2011 Edward Goetzi University of California, San Francisco. Clinical Immunology, January 2011

Lenalidomide:

• Increases T cells and their ability to migrate.

(IL-2 and IFN-gamma a cytokine)

• The levels of the active cytokines in treated

adults equals those of young adults Lenalidomide:

• Increases T cells and their ability to migrate.

(IL-2 and IFN-gamma a cytokine)

• The levels of the active cytokines in treated

adults equals those of young adults

Predictive Testing ”

The West Family: Totally Sequenced

Evan Ashley, Stanford University PLOS Genetics September 16 2011 www.technologyreview.com/biomedicine/38612/

Father: Blood clots, emboli, genetic defect “Factor V Leiden.” Daughter Anne: Same defect, refused birth- control hormones for acne. Mother Judy: Risk-marker for carotid stenosis. The cost of sequencing is now on par with diagnostic tests that analyze just a few genes. For those suspected of having inherited disorders, it now makes economic sense to sequence the entire genome rather than just suspect genes. "Even if these highly predictive and actionable [variations] are considered rare" collectively, "everyone is at risk and should be just as willing to spend on this as on fire insurance and other unlikely contingencies." George Church, geneticist at Harvard

Genetics alone cannot project how long you will live.

The key is “Epigenetics”: the science of what you do with your life and how it effects the genetic expression

• f the genes you were born with.

Diet and Exercise

• Together they attenuate the loss of lean

body mass and bone mineral density.

• Ameliorates frailty more then either

modality alone.

• A program of weight loss and exercise

provide the greatest improvement in physical function.

Dennis T. Villareal M.D. Washington University of Medicine, St. Louis NEJM 2011:364:1218-29

Foods linked to Longevity

• High Fiber Diets:

Whole Grains and Beans Nuts and fruits Vegetables

• High Fiber equals: 30 grams male, 20 female
• Reduces cardiovascular disease, infections &

respiratory disease.

• 22% decrease in death rate over 9 years

388,000 people in the NIH-AARP diet and health study Archives of Internal Medicine, June 14 2011

Mediterranean Diet

• High in mono-saturated fats, whole grains, fruit,

vegetables and fish (low on animal fat)

• 50 studies with 500,000 patients
• Reduced waist circumference, blood pressure,

blood sugar, triglycerides and increased HDL

• The Nurses Health Study, Harvard Medical

School supports these findings in US Populations

Elizabeth Jackson M.D. University of Michigan, at Ann Arbor March 7, online Journal of the American College of Cardiology

Whole Diet Changes & Alzheimer’s

Jennifer L. Bayer-Carter, Ms Veterans Affairs Puget Sound Health Care Archives of Neurology, on line June 2011

Healthy People: Diet low in saturated fat and simple carbohydrates decreases Alzheimer’s biomarkers in cerebral spinal fluid. Requires wholesale diet changes. Works either on risk factors (weight, B/P, lipids)

• r on Alzheimer’s gene expression.

Whole Diet Changes & Alzheimer’s

Jennifer L. Bayer-Carter, Ms Veterans Affairs Puget Sound Health Care Archives of Neurology, on line June 2011

People with aMCI: (Amnestic Mild Cognitive Impairment) Improved visual-recall memory tests. Did not change cerebral spinal fluid markers. The differences suggest that dietary changes are not as effective in the late stages of aMCI.

Alzheimer’s disease

• Early diagnosis is

cost effective and limits disability

• 8,000 veterans,

<70 screened

Riley McCarten MD, Minneapolis VA Med Center Department of Veterans Affairs International Conference on Alzheimer’s Disease

Exercise

“Exercise training increases the size of the hippocampus and improves memory” Kirk Erickson et al., Salk Institute, San Diego Proceedings of the National Academy of Sciences , February 2011

Modest aerobic exercise reverses normal brain shrinkage and neuro-cognitive decline. In controls, a 1-2% per year shrinkage in the hippocampal volume, but for those with exercise a gain of 2%. (Hippocampal volume relates to memory)

Health Behaviors Study: 10 year study of 20,000 people, age 45-79

Results: all + factors with all – factors:  74 year olds = the life expectancy of a 60 y.o. Measures:  Non-smoker  Moderate alcohol use (1-7 glass/wine/week)  5 or more servings fruit & vegetables/day  Exercise

Professor K. T. Khaw, University of Cambridge Published on line “Public Library of Sciencemedicine”, January 14, 2008

#1. Weight #2. Diet #3. Exercise #4. Never Stop Learning Bottom line

Learning causes structural changes in brain cells. The brain area enhanced is specific to the task. Tasks become “hard wired” in the brain, tasks being recalled even after some time. Structural change is necessary to learn different tasks; math or language modify different unique areas of the brain.

Never Stop Learning

“Structural Plasticity…motor learning in the adult brain” Mark H. Tusunski M.D. PhD. University of California, San Diego Proceedings of the National Academy of Sciences, January 21, 2011

Self identified Liberals tend to have a larger anterior cingulate cortex. This results in a greater ability to cope with conflicting information. Self identified Conservatives have a larger

• amygdala. This results in a greater ability to

recognize threat. “It is very unlikely that political orientation is directly encoded into these brain regions.”

Never Stop Learning

“Political Orientations Are Correlated with Brain Structure in Young Adults” Ryota Kanai et al, University College of London Current Biology, April 7 2011, on-line addition

• The fastest growing segment of our population

is the very old. Expect 6 million centenarians by 2050.

• All economic premises of aging are null.
• The meaning of age has become elusive.
• Age-appropriate behavior has little meaning
• Death has disappeared in a sea of people

exercising, dieting and getting plastic surgery.

• The fastest growing segment of our population

is the very old. Expect 6 million centenarians by 2050.

• All economic premises of aging are null.
• The meaning of age has become elusive.
• Age-appropriate behavior has little meaning
• Death has disappeared in a sea of people

exercising, dieting and getting plastic surgery.

The consequences of Aging

A shark that stops moving dies. (Woody Allen) All options remain open from youth to old age. The multi-tiered society was destroyed by the danger of being marginalized by age in the very youth culture we created. Age disappears in direct proportion to the vitality of your ideas.

The consequences of Aging

Retirement isn’t an appealing proposition unless life after work is busier and better than before. Genes don’t make us ageless, socialization does, and authority cedes dominance to a digital culture. All of this is inherent in extending the health-span, not the life-span of those who are aging.

The consequences of Aging

Live Long, Stay Healthy www.guardian.co.uk, The Observer, Sunday May 1 2011

The Dalai Lama

When asked what surprised him most about humanity he answered “Man. Because he sacrifices his health in order to make money. Then he sacrifices his money to recuperate his

• health. And then he is so anxious about the

future that he does not enjoy the present; the result being that he does not live in the present

• r the future; he lives as he is never going to

die and then dies having never really lived.”

Transferring the responsibility for successful aging to each and every member of society may be the best cost-saving strategy health care will uncover.

Eat Chocolate