Saturday, April 28, 2007

The Way We Age

Greetings,

A new interesting and detailed story on aging problem has being published by The New Yorker Magazine this month:

Annals of Medicine


The Way We Age Now


Medicine has increased the ranks of the elderly. Can it make old age any easier?

by Atul Gawande

April 30, 2007

Here are some excerpts, discussing our ideas and studies there:

Leonid Gavrilov, a researcher at the University of Chicago, argues that human beings fail the way all complex systems fail: randomly and gradually. As engineers have long recognized, many simple devices do not age. They function reliably until a critical component fails, and the whole thing dies instantly. A windup toy works smoothly until a gear rusts or a spring breaks, and then it doesn’t work at all. But complex systems -- power plants, say -- have to survive and function despite having thousands of critical components. Engineers therefore design these machines with multiple layers of redundancy: with backup systems, and backup systems for the backup systems. The backups may not be as efficient as the first-line components, but they allow the machine to keep going even as damage accumulates.

Gavrilov argues that, within the parameters established by our genes, that’s exactly how human beings appear to work. We have an extra kidney, an extra lung, an extra gonad, extra teeth. The DNA in our cells is frequently damaged under routine conditions, but our cells have a number of DNA repair systems. If a key gene is permanently damaged, there are usually extra copies of the gene nearby. And, if the entire cell dies, other cells can fill in.

Nonetheless, as the defects in a complex system increase, the time comes when just one more defect is enough to impair the whole, resulting in the condition known as frailty. It happens to power plants, cars, and large organizations. And it happens to us: eventually, one too many joints are damaged, one too many arteries calcify. There are no more backups. We wear down until we can’t wear down anymore.

It happens in a bewildering array of ways. Hair grows gray, for instance, simply because we run out of the pigment cells that give hair its color. The natural life cycle of the scalp’s pigment cells is just a few years. We rely on stem cells under the surface to migrate in and replace them. Gradually, however, the stem-cell reservoir is used up. By the age of fifty, as a result, half of the average person’s hairs have gone gray.

Inside skin cells, the mechanisms that clear out waste products slowly break down and the muck coalesces into a clot of gooey yellow-brown pigment known as lipofuscin. These are the age spots we see in skin. When lipofuscin accumulates in sweat glands, the sweat glands cannot function, which helps explain why we become so susceptible to heat stroke and heat exhaustion in old age.

The eyes go for different reasons. The lens is made of crystallin proteins that are tremendously durable, but they change chemically in ways that diminish their elasticity over time -- hence the farsightedness that most people develop beginning in their fourth decade. The process also gradually yellows the lens. Even without cataracts (the whitish clouding of the lens caused by excessive ultraviolet exposure, high cholesterol, diabetes, cigarette smoking, and other unhelpful conditions), the amount of light reaching the retina of a healthy sixty-year-old is one-third that of a twenty-year-old.

I spoke to Felix Silverstone, who for twenty-four years was the senior geriatrician at the Parker Jewish Institute, in New York, and has published more than a hundred studies on aging. There is, he said, “no single, common cellular mechanism to the aging process.” Our bodies accumulate lipofuscin and oxygen free-radical damage and random DNA mutations and numerous other microcellular problems. The process is gradual and unrelenting. “We just fall apart,” he said.

More here.

The New Yorker Magazine


When you read the entire article, which is eight pages long, you may find it depressing. But do not blame the author for this inconvenient truth about the aging process that makes human life so miserable. The take-home message to me is that we have to do something about aging, and to block this horrible process of body degradation!

To read comments on this story, and to post your own thoughts, click here.

Key words:
aging, age, elderly, mechanisms of aging, wearing-out, damage accumulation, New Yorker, Atul Gawande, Leonid Gavrilov, redundancy, reliability theory, systems failure, Felix Silverstone

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12 Comments:

Blogger Shek said...

good post. Thank you for the referral.

10:30 PM  
Blogger Nurse M said...

Interesting post! Thanks for the link :)

3:50 PM  
Blogger Avaron said...

A good read, and it makes a lot of sense. Thanks for the link.

8:28 PM  
Blogger Alexandre said...

Dr. Gravilov,

Is it fair to say that Aubrey de Grey's TEDtalk on aging as an engineering issue is compatible with some of your own research?

8:03 AM  
Blogger Dr. Leonid Gavrilov, Ph.D. said...

Yes, and this scientific compatibility is discussed in one of our publications:

Gavrilov LA, Gavrilova NS. Why We Fall Apart. Engineering's Reliability Theory Explains Human Aging. IEEE Spectrum, 2004, 41(9): 30-35.

9:06 AM  
Blogger AlvaroF said...

Dear Prof. Gavrilov: we feel honored that you dropped by and posted a note. Thanks for the very nice article, and your overall work!

How do you see the role of the brain, especially the frontal lobes & executive functions, in the "falling apart" framework? The New Yorker article implicitly points out the difficulties that aged individuals face to take good care of themselves.

9:15 PM  
Blogger Dr. Leonid Gavrilov, Ph.D. said...

Thank you for your kind comments and your interest!

Yes, the loss of brain cells with age may be very important component of the aging process, and we discuss this topic in our publication:

Gavrilov LA, Gavrilova NS. Reliability Theory of Aging and Longevity. In: Masoro E.J. & Austad S.N.. (eds.): Handbook of the Biology of Aging, Sixth Edition. Academic Press. San Diego, CA, USA, 2006, 3-42.

10:48 AM  
Blogger Eva the Deadbeat said...

Thanks for the heads up, great blog! Inspired by this article, I had a long talk with my 73 yr old mother about aging and her feet!

Luckily, she is insanely healthy and scoffs at anyone who cannot walk 6 miles in one day without complaining (like me). Wow! We should all be so lucky!

2:09 PM  
Anonymous Marc Joseph said...

Dr. Gavrilov, thank you for visiting my blog and suggesting that I visit yours. You have posted a lot of interesting info on both your blog and site.

Your aging overview:
http://longevity-science.org/Aging.html

and the IEEE article that further discusses the reliability theory and related concepts:
http://longevity-science.org/IEEE-Spectrum-2004.pdf

were especially interesting.

I agree with your perspective, in that I think the body is made up of redundant systems that can be maintained by potentially multiple different approaches.

Of these strategies, at least in the near- to medium-term, I think nutrition (diet, supplementation) and toxin avoidance are two of the most important.

I discuss these topics on my blog:
http://www.marcjosephnutrition.com/blog

and implement them in my counseling practice (Marc Joseph Nutrition):
http://www.marcjosephnutrition.com

Thanks again for the heads up on your blog and site. I wish you the best with your future research.

Sincerely,

Marc Joseph, M.Sc.

11:12 PM  
Anonymous Jerry Franks said...

It's always nice to know there are kindred souls out there. But I noticed no one addressed the problem presented in the article---how can we preserve and improve the geriatric help we will all need eventually?

7:59 PM  
Blogger Alexandre said...

Speaking of geriatrics, I wonder what you think of this discussion:
The New Age of Old Age.

12:44 PM  
Blogger Dr. Leonid Gavrilov, Ph.D. said...

One possible solution to these upcoming challenges is to speed-up dramatically the scientific innovations in both the geriatric care and aging prevention/reversal, see:

Engineering and Aging: The Best Is Yet to Be
IEEE Spectrum - September 2004, 41(9): 10,

8:54 AM  

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