1. Diseases of Aging Lecture 8 PS Timiras

2. Recent approaches challenge the inevitability of functionpathology by grouping the aging processes into three categories: 1.Aging with disease and disability 2.Usual aging, with absence of overt pathology but presence of some declines in function 3.Successful or healthy aging, with no pathology and little or no functional loss

3. Such a grouping of aging processes: 1.De-emphasizes the view that aging is exclusively characterized by declines in functional competence & health 2.Refocuses on the substantial heterogeneity among old persons 3.Underscores the existence of positive trajectories (i.e., without disability, disease, major physiological decline) 4.Highlights the possible avoidance of many, if not all, the diseases and disabilities usually associated with old age

4. Figure 2.3: Common causes of death by age in the United States (also look 3.7) Pathology: abnormal function leading to disease * COPD: Chronic Obstructive Pulmonary Disease ** Disease of Kidney

8. Disease may be viewed as a process that is : Selective (i.e., varies with the species, tissue, organ, cell and molecule) Intrinsic and extrinsic (I.e., may depend on environmental and genetic factors) Discontinuous (may progress, regress, or be arrested) Occasionally deleterious (damage is often variable, reversible) Often treatable (with known etiopathology, cure may be available)

9. Causes of Death According to Age All Races, Both Sexes Ages: 65-84Ages: 85+2003 1. Heart disease (28.2%)1. Heart Disease (36.2%) 2. Cancer (27.7%)2. Cancer (11.6%) 3. COPD ‡ (7.1%)3. Stroke (9.4%) 4. Stroke (6.6%)4. Alzheimer’s Disease (5.5%) 5. Diabetes Mellitus (3.6%)5. Pneumonia/Influenza (4.6%) 6. Pneumonia/Influenza (2.4%)6. COPD ‡ (4.4%) 7. Alzheimer’s Disease (2.2%)7. Diabetes Mellitus (2.2%) 8. Nephritis (1.9%)8. Nephritis (2%)9. Accidents (1.9%) 10.Septicemia (1.5%)10.Septicemia (1.4%) - All others (17%) - All others (20.9%)

10. Causes of Death According to Age and Time Period All Races, Both Sexes (1996 vs 2003) Ages: 85+ 20031996 1. Heart Disease (36.2%)1. Heart Disease (41.2%) 2. Cancer (11.6%)2. Cancer (11.7%) 3. Stroke (9.4%)3. Stroke (10.5%) 4. Alzheimer’s Disease (5.5%)4. Pneumonia/Influenza (6.6%) 5. Pneumonia/Influenza (4.6%)5. COPD ‡ (3.5%) 6. COPD ‡ (4.4%)6. Diabetes Mellitus (1.9%) 7. Diabetes Mellitus (2.2%)7. Alzheimer’s Disease (1.9%) 8. Nephritis (2%)8. Accidents (1.8%) 9. Accidents (1.9%)9. Atherosclerosis (1.6%) 10.Septicemia (1.4%)10.Nephritis (1.4%) - All others (20.9%)- All others (17.9%) ‡ COPD = Chronic Obstructive Pulmonary Disease

14. Diseases as a tool for the study of aging Syndromes in humans: having multiple characteristics of premature (early onset) of aging, or accelerated (rapid progression) of aging Are called: progeria-like progeroid segmental syndrome. Progeria-like: Hutchinson-Gilford syndrome, becomes apparent at early age and Werner’s syndrome becomes apparent at later ages

15. Slow growth, all body characteristics of old age. Advanced cardiovascular disease (generally the cause of death)

16. Note: Skin changes, some cardiovascular problems, metabolic disturbances, NO Alzheimer’s Disease, dementia, and hypertension Responsible for WS is the WRN gene located on chromosome 8.

17. Down Syndrome: Trisomy at chromosome 21. There are somatic malformations, and severe mental disability, early symptoms of Alzheimer’s Disease