Recent events remind us that what constitutes “normal” aging is beginning to change as people live longer and healthier lives.
For example, 36-year-old Floyd Mayweather Jr. recently outclassed a 23-year-old opponent in a championship boxing match. The recent first-time crossing of the channel from Cuba to Florida by 64-year-old Diana Nyad was another triumph of persistence in the face of mature chronological age.
The Oakland A’s ace pitcher Bartolo Colon, who should be in his declining years at age 40, is having one of his best seasons.
How is it that athletes who previously might be viewed as “old” are now performing at an elite level? Nutrition and better training may play a role. For those of us who are not elite athletes, however, it is worth thinking about other scientific insights into the aging process that are emerging.
What we consider to be “normal” aging may in fact be a process characterized by inflammation that damages cells and tissues over many decades. The normal immune response is critical to fighting off infections, but healthy cells may be the innocent bystanders that incur some damage as white blood cells release cellular messengers and antibodies.
For example, we now appreciate that even chronic gum inflammation may increase the risk of heart disease. Consequently, taking care of our teeth and gums may confer a broader degree of health benefit than merely allowing us to chew and smile. No one knows precisely why this correlation may exist, but we do know of diseases in which “molecular mimicry” fools the body into attacking its own tissues.
A classic example is rheumatic fever, in which an infection with a particular strain of Streptococcus bacteria causes the immune system to attack the heart’s muscle and valves, potentially causing heart failure or irregular heart rhythms. Chronic bronchitis in smokers results in inflammatory changes that ultimately may damage the delicate bronchioles of the lungs. Years ago, rheumatologists observed a lower rate of dementia in rheumatoid arthritis patients treated with high doses of aspirin-like agents, prompting consideration of a broader role for so-called “nonsteroidal anti-inflammatory drugs” in the treatment or prevention of memory loss.
The popularity of vitamin C and E is also driven in part by a belief that these compounds may decrease inflammation by destroying harmful free-radical compounds that mediate inflammation. The goal of such treatments would be to preserve cellular health as we age.
In a similar manner, a type of arthritis called ankylosing spondylitis, or AS, may be mediated by molecular similarities between a normal tissue molecule called HLA-B27 and some unknown bacterial antigen. The result is an inflammatory attack that may damage the spine, heart and eye tissues of patients with AS.
Rheumatologists have yet to elucidate the specific mechanisms by which genes, antigenic exposures and other factors give rise to the clinical entity of AS. Researchers have postulated connections between antecedent infections and many forms of arthritis, including rheumatoid disease, without achieving success in proving these theories. The one exception may be Lyme disease, which seems clearly related to infection with specific tick-borne bacteria called Borrelia burgdorferi.
The Canadian Medical Association Journal just published an article by Tasnime Akbaraly, and co-authors, describing 3,044 middle-aged adults as they aged.
Elevations of Interleukin-6, a pro-inflammatory cellular messenger, correlated with a higher rate of heart disease and other illnesses.
Even if we cannot see a “fountain of youth” on the horizon, future research into the aging process may yield results related to minimizing inflammatory damage to tissues. Exercise and diet will also remain cornerstones of healthy lifestyles. There is reason for optimism, as we contemplate a healthier future for tomorrow’s senior citizens.
Scott T. Anderson, M.D., Ph.D. (firstname.lastname@example.org) is clinical professor of medicine, UC Davis. This column is informational, and does not constitute medical advice.