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A ging and the seniors K. Bernášková. Content What is aging?What is aging? LifespanLifespan Aging theoriesAging theories Syndromes of premature agingSyndromes.

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Presentation on theme: "A ging and the seniors K. Bernášková. Content What is aging?What is aging? LifespanLifespan Aging theoriesAging theories Syndromes of premature agingSyndromes."— Presentation transcript:

1 A ging and the seniors K. Bernášková

2 Content What is aging?What is aging? LifespanLifespan Aging theoriesAging theories Syndromes of premature agingSyndromes of premature aging Changes due to agingChanges due to aging How to prolong one’s life ?How to prolong one’s life ? A senior as a patientA senior as a patient

3 What is aging ? Complex biological process at the molecular, cellular and organ levels, which leads to progressive and inevitable (although gradual):  deterioration of all body functions  loss of ability to adapt to stress  increased risk of disease  structural changes Changes occur over time and are not caused by disease or injury, and can eventually lead to death

4 Lifespan Maximum lifespanMaximum lifespan Expected lifespan = life expectancyExpected lifespan = life expectancy AveragelifespanAverage lifespan

5 Maximum life span = maximum number of years a member of a group has been observed to survive flyfly tarantuletarantule horsehorse elephantelephant parrotparrot manman 3 20 40 78 80 122

6 Expected lifespan = life expectancy = the expected age at death a statistical measure of the average length of survival most often constructed as the life expectancy at birth for a given human population (according to statistical tablets) expected lifespan prolongs during years

7 Life expectancy men women 2001 (2008) 2001 (2008) men women 2001 (2008) 2001 (2008) Sveden 77,1 (78,7) 82,1 (84,2) Sveden 77,1 (78,7) 82,1 (84,2) Austria 76,1(78,9) 82,0 (83,6) Austria 76,1(78,9) 82,0 (83,6) France 75,2( 72.3) 82,8 (80.5) France 75,2( 72.3) 82,8 (80.5) Czech R. 72,2 ( 73.4) 78,4 ( 79.5) Czech R. 72,2 ( 73.4) 78,4 ( 79.5) 2065 (86,5) (91,0) Poland 69,8( 71.3) 78,1 ( 79.8) Poland 69,8( 71.3) 78,1 ( 79.8) Hungary 68,3( 69.2) 76,8 ( 77.4) Hungary 68,3( 69.2) 76,8 ( 77.4) is calculated separately for year, gender and geographic location

8 men women 2001 (2008) 2001 (2008) men women 2001 (2008) 2001 (2008) Sierra Leone 33 35Sierra Leone 33 35 Nigeria 37 (46,4) 41 (47,3)Nigeria 37 (46,4) 41 (47,3) Malawi37 (48,1) 38 (48,4)Malawi37 (48,1) 38 (48,4) Zambia38 (42,1) 39 (42,5)Zambia38 (42,1) 39 (42,5) Botswana39 (50,5) 39 (50,7)Botswana39 (50,5) 39 (50,7) Life expectancy

9 Causes of life expectancy differences between men and women GeneticGenetic –female genotype –male mortality during prenatal period HormonalHormonal –estrogens and lipid metabolism –androgens and immunity –androgens and behaviour Social roleSocial role

10 Averagelifespan Average lifespan = average number of years, which is a newborn supposed to live by maintaining of the contemporary mortality rate Is influenced by: –environment –diseases – (health care level) –life-style

11 The oldest human being Jeanne Louise Calment reached the longest confirmed lifespan in historyJeanne Louise Calment reached the longest confirmed lifespan in history 122 years and 164 days122 years and 164 days She died in 1997She died in 1997 Her recommendation: olive oil, chocolate, port, smokingHer recommendation: olive oil, chocolate, port, smoking

12 Aging in animals wild animals do not age (under normal conditions)wild animals do not age (under normal conditions) animals living with men may grow older (dogs, cats, horses)animals living with men may grow older (dogs, cats, horses) exception: salmon, whaleexception: salmon, whale

13 Cat given contact lenses | December 19, 2008 | staff reporter A 15-year-old cat's eyesight has been restored by contact lenses.

14 Aging in animals wild animals do not age (under normal conditions)wild animals do not age (under normal conditions) animals living with men may grow older (dogs, cats, horses)animals living with men may grow older (dogs, cats, horses) exception: salmon, whaleexception: salmon, whale

15 Theories of aging Earlier:  punishment for “godlessness ”  loss of humidity of the tissues  loss of body warmth

16 Recent biological theories of aging Many types of theories: Social (why)Social (why) Evolutionary (why)Evolutionary (why) Physiological (how)Physiological (how)  Systemic level  Cellular level  Molecular level

17 Biological Ageing Theories Evolutionary Physiological Social Programmed Stochastic Intrinsic timing Chance events

18 Evolutionary theories 1)„Disposable Body Theory“ Once an organism has produced viable offspring its body is no longer needed, it then ages and dies. 2) „Antagonistic Pleiotropy Theory“ Certain genes maybe useful in early life but detrimental in later life 3) „Accumulation of Late Acting Error Theory“ Late acting genes have not been removed because Late acting genes have not been removed because they act after reproduction they act after reproduction

19 All physiological theories must meet basic requirements: The process of „ageing“ should be The process of „ageing“ should be - ubiquitous (in all cells) - harmful - progressive - endogenous

20 Physiological theories of ageing Physiological theories of ageing 1) Systemic level - neuroendocrine theory - immunologic theory - endocrine theory 2) Cellular level - free radicals - cross-link theory - “wear and tear” 3) (Mitochondrias) - free radicals

21 Physiological theories of aging 4) Molecular level - programmed theory (telomeres) - special genes - theory of accumulaton of failures in DNA transcription and theory of somatic mutations - FREE RADICALS

22 Which theory is the right ONE ? no one and all of themno one and all of them there are about 200 teories about aging mechanismsthere are about 200 teories about aging mechanisms

23 Properties of ageing cells:  slower division  change in cellular metabolism (decreased basal metabolic rate and slowing of all chemical reactions)  change in cellular function (production of non- physiological proteins, cytokines, growth factors, etc.)  inability of apoptosis  decreased sensitivity of all receptors  reduced ability to withstand oxygen free radicals  DNA instability, which may result in cancerous growth

24 Syndromes of premature aging Diseases characterized by symptoms of premature aging = progerias Diseases characterized by symptoms of premature aging = progerias Are progerias disease conditions or a premature aging? Are progerias disease conditions or a premature aging? Segmental progerias Segmental progerias

25 Syndromes of premature ageing 1 Hutchinson-Gilford‘s syndrome:Hutchinson-Gilford‘s syndrome: - exceedingly rare disorder - exceedingly rare disorder - (shortened telomeres) ? - mutations in the lamin A gene - (shortened telomeres) ? - mutations in the lamin A gene - first signs during 1st year of life - first signs during 1st year of life –growth deceleration, baldness, no subcutaneous fat, wrinkles, salient nose, receding chin, stiff muscles and articles –death from coronary artery disease is frequent and may occur before 10 years of age

26 Differences between Hutchinson- Gilford syndrome and real ageing: Men don’t develop prostate problems. Men don’t develop prostate problems. No increased risk of cancer or cataracts. No increased risk of cancer or cataracts. Despite the rapid development of atherosclerosis the high blood pressure is very rare. Despite the rapid development of atherosclerosis the high blood pressure is very rare. Diabetes is very rare. Diabetes is very rare. They don’t get Alzheimer’s disease or suffer mental degeneration. They don’t get Alzheimer’s disease or suffer mental degeneration.

27 Syndromes of premature ageing 2 Werner‘s syndromeWerner‘s syndrome –helicase failure –changes start in adults (around the 30th year) –progressive wrinkles, „bird“ face, greying of hair, osteoporosis, muscle atrophy –tendency to diabetes, hypertension, cataract, increased incidence to cancer –death on average in 47 years from ICHS

28 Werner‘s syndrome (AK, 58)

29 Differences between Werner‘s syndrome and real ageing: No increased tendency to neurodegenerationNo increased tendency to neurodegeneration In men no prostate problemsIn men no prostate problems No changes in immune systemNo changes in immune system

30 Syndromes of premature ageing 3 Cockayne’s syndromeCockayne’s syndrome –failure to repair DNA transcription –first signs during 1st to 2nd year –cachectic dwarfism (1 m), early postnatal contractures of the spine (kyphosis, scoliosis) and joints, fotosensitivity, mental retardation, progressive degeneration of CNS and retina –death at age around 7 years

31 Cockayne’s syndrome (boy, 4 years) - No increased tendency to cancer development

32 Syndromes of premature ageing 4 Dyskeratosis congenitaDyskeratosis congenita rare hereditary diseaserare hereditary disease –telomerase failure (failure of tissues with rapidly dividing cells) –first signs around the 10th year of life –characterized by cutaneous pigmentation, dysgenesis of nails, changes of mucous membranes (GIT), osteoporosis, progressive bone marrow failure syndrome (thrombocytopenia, anemia ) –high susceptibility to develope malignancies (skin and blood) –death around the 16th year of life

33 Syndromes of premature ageing 5 Down‘s syndrome (trisomy of the 21th chromosome – excess of hydroxyl radicals)Down‘s syndrome (trisomy of the 21th chromosome – excess of hydroxyl radicals) Diabetes mellitus (pentosidin linkages, cross link theory)Diabetes mellitus (pentosidin linkages, cross link theory)

34 Changes due to healthy ageing

35 Age groups in men (according to WHO) Age groups in men (according to WHO) Youth: 15-24 yearsYouth: 15-24 years Young adult: untill 30Young adult: untill 30 Mature adult: 31 - 45Mature adult: 31 - 45 Middle age:46 - 60Middle age:46 - 60 Older age: 61 - 75Older age: 61 - 75 Old age : 76 - 90Old age : 76 - 90 Very old age: more than 90Very old age: more than 90

36 Healthy ageing  starts in the 3 decade of life  does not restrict everyday life  does not lead to immediate changes in physical state  increases the risk of occurence of disease (including polymorbidity) and death The result of healthy aging is homeostenosis and increased fragility

37 Homeostenosis –means decreased homeostatic (functional) reserves of many organs –leads to easier activation of stress reaction –leads to earlier development of signs and symptoms of diseases

38 Properties of ageing cells:  slower division  change in cellular metabolism (decreased basal metabolic rate and slowing of all chemical reactions)  change in cellular function (production of non- physiological proteins, cytokines, growth factors, etc.)  inability of apoptosis  decreased sensitivity of all receptors  reduced ability to withstand oxygen free radicals  DNA instability, which may result in cancerous growth

39 Changes due to ageing 1 Generally  hydration of all tissues  hydration of all tissues  protein body mass (bones, muscles..)  protein body mass (bones, muscles..)  percentage of body fat  percentage of body fat  basal metabolism  basal metabolism  elasticity of all tissues (elastin fibers)  elasticity of all tissues (elastin fibers)  sensitivity of receptors  sensitivity of receptors Endocrine system changed (mainly decreased) rate of endocrine secretion: estrogenes, melatonin, testosterone, STH, thyroid hormones, renin and aldosterone changed (mainly decreased) rate of endocrine secretion: estrogenes, melatonin, testosterone, STH, thyroid hormones, renin and aldosterone  basal secretion of ADH and ANP  basal secretion of ADH and ANP glucose tolerance failure glucose tolerance failure  secretion of active vitamin D  secretion of active vitamin D

40 Changes due to ageing 2 Nervous system  brain weight,  brain weight, brain perfusion and ability to autoregulate it   psychosomatic activity downgrade of righting reflexes, prolonged nerve conduction fragmentation of sleep Locomotor apparatus   muscle and bone mass changes in articular cartilages Immune system involution of thymus   function of T lymphocytes   production of antibodies after exogenous activation   secretion of autoantibodies  increased secretion of cytokins (x IL2)

41 Changes due to ageing 3 Respiratory system  rigidity (of chest and lungs),  rigidity (of chest and lungs),  vital capacity and forsed expiratory volume,  elasticity  vital capacity and forsed expiratory volume,  elasticity changed ventilation/perfusion ratio changed ventilation/perfusion ratio  activity of the ciliary epithelium  activity of the ciliary epithelium  irritability of the respiratory tract, but decreased efficiency of caugh  irritability of the respiratory tract, but decreased efficiency of caugh Cardiovascu lar system  elasticity and compliance of arterial walls (x atherosclerosis)  elasticity and compliance of arterial walls (x atherosclerosis)  sensitivity of baroreceptors  automatism of SA node  sensitivity of baroreceptors  automatism of SA node  heart compliance  heart compliance  sensitivity to β adrenergic stimulation  sensitivity to β adrenergic stimulation x T3  cardiac output  cardiac output

42 Changes due to ageing 4 Skin  amount of subcutaneous fat  amount of subcutaneous fat atrophy of sweat glands (  dryness and fragility of skin) atrophy of sweat glands (  dryness and fragility of skin)  synthesis of vitamin D precursors  synthesis of vitamin D precursors Sight Presbyopia (less effective accomodation) Presbyopia (less effective accomodation)  transparency of the lens  transparency of the lens  pupillary diameter (decreased visul acuity in darkness)  pupillary diameter (decreased visul acuity in darkness) Hearing presbyacusia presbyacusia increased sensitivity to loud sounds increased sensitivity to loud sounds Smell and taste  sensitivity  sensitivity

43 Photoageing A 58 year old American Indian female who spent practically all of her time outdoors A 72 year old Tibetian monk who spent practically all of his time indoors away from the sun. A 72 year old Tibetian monk who spent practically all of his time indoors away from the sun.

44 Changes due to ageing 4 Skin  amount of subcutaneous fat  amount of subcutaneous fat atrophy of sweat glands (  dryness and fragility of skin) atrophy of sweat glands (  dryness and fragility of skin)  synthesis of vitamin D precursors  synthesis of vitamin D precursors Sight Presbyopia (less effective accomodation) Presbyopia (less effective accomodation)  pupillary diameter (decreased visual acuity in darkness)  pupillary diameter (decreased visual acuity in darkness)  transparency of the lens  transparency of the lens Hearing presbyacusia presbyacusia increased sensitivity to loud sounds increased sensitivity to loud sounds Smell and taste  sensitivity  sensitivity

45 What influences the quality and length of life? Congenital dispositionsCongenital dispositions Nutrition and lifestyleNutrition and lifestyle Living environment (pollutions, irradiation)Living environment (pollutions, irradiation) Social aspects (culture, marriage, income)Social aspects (culture, marriage, income) Medical care, hygieneMedical care, hygiene AntioxidantsAntioxidants Restriction of risk factors (sunbathing, stres etc)Restriction of risk factors (sunbathing, stres etc)

46 How to prolong one’s life ? Special longevity elixirsSpecial longevity elixirs PlantsPlants –mandragora, ginseng Animal products:Animal products: –yolk,... bathing in milk or virgin blood Water, electricity, magnetismWater, electricity, magnetism In the end of the 19th century more „scientific“ methods:In the end of the 19th century more „scientific“ methods: –injections of gonadal extract –“transplantation” of monkey glands –vasectomy, sterilisation

47 How to prolong one’s life ? In the 20th century: Yogurth (Mečnikov) Yogurth (Mečnikov) Healthy life style : Healthy life style : sport and physical exercise sport and physical exercise memory training (sudoku!) memory training (sudoku!) Eustres Eustres

48 How to prolong one’s life ? In the 20th and 21 centuries: „Youth hormones“ „Youth hormones“ - DHEA - melatonin - STH Dietary caloric restriction Dietary caloric restriction Red wine (resweratrol) Red wine (resweratrol) Drugs ? (Metformin, mTor downregulators,…) Drugs ? (Metformin, mTor downregulators,…)

49 The seniors

50 In the senior organism: Each organ or system ages on its own (undependently on other organs) –Older people differ much more one from another than young people –There exist vulnerable organs or systems which respond to different changes first brainbrain lower urinary tractlower urinary tract cardiovascular systemcardiovascular system motor systemmotor system

51 Older patient has atypical findings (first affected the most vulnerable organs) has atypical findings (first affected the most vulnerable organs) findings appear at earlier stages of the disease the disease some pathological findings are normal increased tendency to polymorbidity has increased tendency to polymorbidity

52 Main problems of older patients (five I) 1. Instability 2. Immobility 3. Intelectual impairment 4. Iatrogenic impairment 5. Inkontinency

53 Literature: http://elegans.uky.edu/300/index.htmlhttp://elegans.uky.edu/300/index.html http://www.merck.com/mrkshared/mm_ger iatrics/contents.jsphttp://www.merck.com/mrkshared/mm_ger iatrics/contents.jsp


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