Aging research provides various solutions for how we can stay fit despite our advanced years. Medication alone doesn’t help.
Physical decline begins by the age of 30 at the latest – it’s never too early to live a healthier life Photo: Meyer/Tendance Floue/Focus Agency
When does aging actually start? What if we get up from our chairs groaning? What if your hair keeps thinning? Or only when we retire? Geriatric medicine has a frightening answer to this. Physical decline begins at the age of 30 at the latest, when life has just really begun.
So it’s never too early to start thinking about long-term health. Because who doesn’t want to stay physically and mentally fit for as long as possible? The chances of this happening are better today than ever before. Researchers all over the world are working to better understand aging – and are making enormous progress.
Age-related diseases such as cardiovascular diseases, osteoporosis or cancer are easier to treat and are less likely to be a death sentence. Nevertheless, we age: the bones become brittle, the muscles atrophy, the heart becomes weak and the mind is confused. Could the next step be to prevent aging altogether?
Our knowledge about aging is growing
“We have learned a lot about aging processes in the last few decades. “We now know much better how which cells change over time and which factors can influence healthy aging,” says Markus Gosch, President of the German Society for Geriatrics and Chief Physician of the Clinic for Internal Medicine at the Nuremberg Clinic.
But that doesn’t mean that effective therapies will emerge in a short period of time. For example, it is still unclear why the regenerative ability of organs such as the kidney decreases over time. Are there perhaps switches or signaling pathways that can be used to switch off diseases before they arise?
In the search for answers, researchers face another problem. All of these processes can only be imitated in cell cultures or in animal models. Popular models are for example roundworms, who have twice as many genes as humans, or fish whose organs can permanently repair themselves.
“In basic research, we primarily focus on individual aspects of aging. This is how the big puzzle comes together piece by piece,” says Christoph Englert, Professor of Molecular Genetics at the Leibniz Institute for Aging Research. At the same time, transferring it to people is often difficult, especially because individual aspects reveal little about the big picture.
Different approaches, different hurdles
In any case, research is not lacking in possible points of attack. An example is senescent cells. They influence their environment by releasing inflammatory substances. There is a lot of research into their role, but their exact function is still unclear. Senescent cells increase with age because they cannot or can hardly be removed from the body.
Ultimately, they cause a kind of permanent inflammation and probably also promote age-related diseases such as osteoporosis, cancer or diabetes. “Removing the cells could be a possible approach,” says Englert. To do this, however, they would have to be destroyed – with drugs that have side effects similar to those of chemotherapy. The benefits are not yet fully understood. Nobody knows exactly how their removal affects surrounding cells and tissues.
Another source of hope in terms of rejuvenation comes from the Stem cell research. In the early 2000s, the Japanese Shinya Yamanaka succeeded in returning skin cells to an embryonic state.
This approach could be used to rejuvenate cells. The problem: Individual cells can be easily rejuvenated in the laboratory, but an entire organism is more difficult. In experiments with mice, the animals developed, among other things, malignant tumors. It almost seemed as if her body was resisting the rejuvenation treatment with all its might.
Repair, build, replace
Medicine has already made further progress in the individual areas of aging, for example when it comes to muscle loss. Muscle strength decreases significantly with age: people over 70 lose around three percent per year. Therefore, a long hospital stay combined with bed rest can be fatal for many old people. Patients who are already weakened can hardly get back on their feet.
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Researchers are therefore looking for drugs to combat muscle loss. One possible approach could be mRNA. To do this, muscle stem cells would be taken from patients, repaired with CRISPR/Cas9 genetic scissors and then reintroduced into the muscle.
In various laboratory studies, new muscle fibers were successfully formed. Clinical studies with patients are expected to follow soon. It is still unclear whether muscles not only grow but are also functionally resilient.
Even with the widespread disease Alzheimer’s, there are now legitimate hopes for medications that can at least slow down the progression of the disease. Two preparations have already been approved in the USA and Europe; their effect is still manageable and the side effects are high.
In the medium term, the researchers hope to inhibit the deposits of the two proteins amyloid-beta and tau. If these are present in an incorrect form, they can damage the brain. The preparations could therefore stop the disease at an early stage.
Medicine alone is not enough
Medicine is one step further when it comes to osteoporosis, the bone loss that occurs with age and significantly increases the risk of bone fractures. The disease is caused primarily by an imbalance in the cells that build and break down bone – osteoblasts and osteoclasts. Already after puberty, the number of bad osteoclasts, which break down bone, increases.
Common medications for osteoporosis inhibit its formation but do not contribute to bone formation. Doctors have found that light endurance sports and strength training help strengthen bones.
The example shows: Medicine alone does not save us. “It is estimated that our genes influence 10 to 25 percent of our aging process. Living conditions and the interaction between genes and lifestyle are at least as important,” explains Gosch, head physician at the Department of Internal Medicine.
Health in old age is stressful
The oldest German, 113-year-old Charlotte Kretschmann, always talks about her very active life in interviews. She goes for walks no matter what the weather and she still does sports to this day. She also had a happy and fulfilled life as a child. In addition to happiness and exercise, researchers have identified other factors for healthy aging.
According to Gosch, getting enough sleep and one helps balanced nutrition with lots of vegetables and fruit. Too much fast food, alcohol and nicotine are taboo. You should also challenge your brain regularly, stay curious, keep learning new things, maintain friendships and read books well into old age.
Here too, 113-year-old Charlotte Kretschmann is a role model: She is always inquisitive and interested in the world, and conversations with her grandchildren keep her mentally fit. And her mind, she says, is functioning at 150 percent.
