Slow ageing

Slow ageing is a scientifically-backed and distinct approach to successful aging, advocating a personal and wholly encompassing positive choice to the process of ageing.[1][2] Established as part of the broader Slow Movement in the 1980s,[1][2] as opposed to the interventionist-based and commercially backed medical anti-aging system, it involves personal ownership and non-medical intervention options in gaining potential natural life extension.[1][2]

Ageing

Main article: Ageing
A human face showing signs of ageing

Ageing (British English) or aging (American English) is the accumulation of changes in a person over time.[3] Ageing in humans refers to a multidimensional process of physical, psychological, and social change. Some dimensions of ageing grow and expand over time, while others decline. Reaction time, for example, may slow with age, while knowledge of world events and wisdom may expand. Research shows that even late in life, potential exists for physical, mental, and social growth and development.[4] Ageing is an important part of all human societies reflecting the biological changes that occur, but also reflecting cultural and societal conventions. Roughly 100,000 people worldwide die each day of age-related causes.[5]

Age is measured chronologically, and a person's birthday is often an important event. However the term "ageing" is somewhat ambiguous. Distinctions may be made between "universal ageing" (age changes that all people share) and "probabilistic ageing" (age changes that may happen to some, but not all people as they grow older including diseases such as type two diabetes). Chronological ageing may also be distinguished from "social ageing" (cultural age-expectations of how people should act as they grow older) and "biological ageing" (an organism's physical state as it ages).[6] There is also a distinction between "proximal ageing" (age-based effects that come about because of factors in the recent past) and "distal ageing" (age-based differences that can be traced back to a cause early in person's life, such as childhood poliomyelitis).[7]

The first formal studies of ageing appear to be those of Muhammad ibn Yusuf al-Harawi (1582) in his book Ainul Hayat, published by Ibn Sina Academy of Medieval Medicine and Sciences.[8] This book is based only on ageing and its related issues. The original manuscript of Ainul Hayat was scribed in 1532 by the author Muhammad ibn Yusuf al-Harawi. Four copies of the manuscript survive and were reprinted in an edited and translated version by Hakim Syed Zillur Rahman (2007). The book discusses behavioural and lifestyle factors putatively influencing ageing including diet, environment and housing conditions.

Theories of ageing

Biological theories

At present, the biological basis of ageing is unknown. Most scientists agree that substantial variability exists in the rates of ageing across different species, and that this to a large extent is genetically based. Even in the relatively simple and short-lived organisms, the mechanism of ageing remain to be elucidated. Less is known about mammalian ageing, in part due to the much longer lives in even small mammals such as the mouse (around 3 years). Many have argued that life-span, like other phenotypes, is selected. Biological theories of ageing include:

Genetic theories

Many theories suggest that ageing results from the accumulation of damage to DNA in the cell, or organ. Since DNA is the formative basis of cell structure and function, damage to the DNA molecule, or genes, can lead to its loss of integrity and early cell death.Examples include: Accumulative-Waste Theory; Wear-and-Tear Theory; Somatic Mutation Theory; Error Accumulation Theory. Some have argued that ageing is programmed: that an internal clock detects a time to end investing in the organism, leading to death. But this idea is in contradiction with the evolutionary based theory of ageing.[16][17] Other genetic theories include: Cross-Linkage Theory;[17][18] Free-Radical Theory;[17][19] Reliability theory of ageing and longevity; Mitohormesis;[20] Misrepair-Accumulation Theory.[21]

Non-biological theories

An elderly Iraqi man.

Many of the latest systems, procedures and theories on care for the elderly, as well as the scientific basis principles of slow ageing,[1][2] are based on both the scientific data as well as the positive engagement process of the various Non-biological theories of ageing:[7][22][23]

Disengagement Theory
This is the idea that separation of older people from active roles in society is normal and appropriate, and benefits both society and older individuals. Disengagement theory, first proposed by Cumming and Henry, has received considerable attention in gerontology, but has been much criticised.[7]
Activity theory
In contrast to disengagement theory, this theory implies that the more active elderly people are, the more likely they are to be satisfied with life. The view that elderly adults should maintain well-being by keeping active has had a considerable history, and since 1972, this has come to be known as activity theory.[23] However, this theory may be just as inappropriate as disengagement for some people as the current paradigm on the psychology of ageing is that both disengagement theory and activity theory may be optimal for certain people in old age, depending on both circumstances and personality traits of the individual concerned.[7]
Selectivity Theory
This theory mediates between Activity and Disengagement Theory, which suggests that it may benefit older people to become more active in some aspects of their lives, more disengaged in others.[23]
Continuity Theory
The view that in ageing people are inclined to maintain, as much as they can, the same habits, personalities, and styles of life that they have developed in earlier years. Continuity theory is Atchley's theory that individuals, in later life, make adaptations to enable them to gain a sense of continuity between the past and the present, and the theory implies that this sense of continuity helps to contribute to well-being in later life.[22] Disengagement theory, activity theory and continuity theory are social theories about ageing, though all may be products of their era rather than a valid, universal theory.

Maximum human mortality

Like any species, human survival is governed by the Force of mortality, a mathematical expression for the chance of dying each year. Every year, an average human adult ages, this unavoidable force increases by around 9%. The result is that every eight years an individuals chance of not making your next birthday roughly doubles.[24]

By the late 1990s, scientists theorized that the maximum life-span duration for a human being was around 120 years. But statistical and scientific research lead by Professor John Wilmouth from the University of California in 2000 stated that better sanitation, improved public health and safer water supplies during the late 1800s in Western Europe had resulted there in fewer childhood diseases, which had combined to help extend human life.[25] The result is that as these factors have improved, the force-of-mortality has been decreasing.[24]

From data, those born between the mid-1750s and the mid-1860s had an upper age limit of around 101. But this rose quickly over the next 40 years, with the upper age limit reaching 109 for those born in the mid 1880s.[25] From the early 1970s, breakthroughs in medical practices such as understanding, treating and then preventing heart disease and stroke created an additional latter-life extension.[25] Hence presently in the mid-2010s, life expectancy in developed countries is rising at about three months a year. The UK Office of National Statistics - assuming improvements in health continue - on their "high" projection suggests that girls born now could on average live to 105, and boys to 103.[24]

Wilmouth concluded that the study had shown that maximum life span in human beings was advancing:[25]

Maximum life span in human beings is not a biological constant. Whether or not this can go on indefinitely is difficult to say. There is no hint yet that the upward trend is slowing down. Human progress is real, somehow. We are changing the limits of human life span over time.

In 2003 a team at the University of California found they could double the lifespan of the nematode worm Caenorhabditis elegans, if they caused a mutation that inhibited insulin signalling and removed the reproductive system. The resulting life extension if applied to human beings would be the equivalent of 500 years life span.[26]

Calorie restriction

It has been known since the 1930s that restricting calories while maintaining adequate amounts of other nutrients can extend lifespan in laboratory animals. Since then, a number of studies have shown that reducing consumed calories by as much as 30%, to just above malnutrition levels, could add an extra 25 years to the average human life expectancy. However, as the resultant calorie intake is so low, the diet would need individual tailoring, probably made from milk protein and corn oil, and involving numerous vitamin and mineral supplements.[27]

These studies are based around the gene pha-4, originally identified as critical in ageing in nematode worms.[28] A later study at Stanford University School of Medicine was able to rejuvenate the skin of two-year-old mice to resemble that of newborns by blocking the activity of the gene NF-kappa-B.[29]

Principles of Slow Ageing

Whilst ageing itself is seen most often by those in Western culture as a slowing and process of loss, the seven principles of slow ageing are based around the basics of personal ownership and engagement with the process:[1]

  1. Awareness and engagement in the aging process
  2. Strategic planning and targeting of appropriate goals
  3. Accent the positive, eliminate the negative
  4. Making choices that are sustainable
  5. Don’t be Exclusive. Complex problems require complex solutions
  6. Support is out there, so get help
  7. Be selective, do what’s right for you

Resultantly, slow ageing is a positive process, built on the back of wisdom and skill acquired over many years, and more akin with the view of age and ageing taken by Eastern cultures.[1]

However, slow ageing is not an alternative medicine approach, as it encompasses practical and research-based ways to prevent disease and avoid death.[1] Whilst slow ageing does not exclude medical intervention and procedures, or shun technologies, it is an encompassing personal ownership and practically-based engagement process, which acknowledges the role that many different and diverse resources can provide in reaching individual goals, as well as accepting their acknowledged limitations.[1][2]

Resultantly, slow ageing is based secondly around a planning process, in which no option is initially excluded, but within which personal choices from the diverse options are made based on facts relating to your personal goals.[1] The result is that slow ageing is an eyes wide open approach,[30] directing the individual to making conscious mental smart choices and decisions now about their lives and their future.[1][2]

At the core of principles within slow ageing, is ownership of all aspects of health and anti-ageing. Any effective anti-ageing process must taken ownership of both disease prevention and control.[1] But as opposed to the interventionist principles espoused by anti-ageing practises with the singular physical goal of life extension, slow ageing has complementary goals of disease prevention and maintaining structure, function and quality of life.[1][2]

In summary, slow ageing seeks to empower the individual within the ageing process, putting each pro-actively in control of managing their own lives and future.[1][2]

Successful ageing

The concept of successful ageing can be traced back to the 1950s, and was popularised in the 1980s. Previous research into ageing exaggerated the extent to which health disabilities, such as diabetes or osteoporosis, could be attributed exclusively to age, and research in gerontology exaggerated the homogeneity of samples of elderly people.[31][32]

Research on successful ageing, acknowledges the fact that there is a growing number of older adults functioning at a high level and contributing to the society. Scientists working in this area seek to define what differentiates successful from usual ageing in order to design effective strategies and medical interventions to protect health and well-being from ageing.[33][34][35][36][37][38][39]

According to most research at present, successful ageing consists of three components:[38]

  1. Low probability of disease or disability
  2. High cognitive and physical function capacity
  3. Active engagement with life

Successful ageing is an interdisciplinary concept, spanning both psychology and sociology, where it is seen as the transaction between society and individuals across the life span with specific focus on the later years of life.[40] The terms "healthy ageing"[31] and "optimal ageing" have been proposed as alternatives to successful ageing, partly because the term "successful ageing" has been criticised for making healthy ageing sound too competitive.[41]

Therapies

Whilst scientific theories have always tended to concentrate on the physical changes that individuals can make to their lifestyle in an attempt to avoid age related diseases and prolong life expectancy, focused on taking regular exercise and eating a balanced, healthy diet, rich in vitamins and minerals.[42] However, slow ageing approaches go beyond this simplistic and solely physical-based approach, for a multi-disciplined holistic and more resultantly more complex but individually-centric life style.[1][2]

Mental approach

Key in the slow ageing principles and the primary approach above all others, are the realisations and choices that the individual makes in their approach to their own ageing process, at all levels.

Research suggests a decrease in mortality among those who put others before themselves. Current theory is that giving back can provide a sense of purpose and self-worth and result in the "helper's high" - a "physical sensation" resulting from the endorphin release after an act of kindness or generosity. Some argue that these feelings can reduce stress, promote wellbeing and strengthen the immune system.[42]

Mental choices and exercises

Mental approaches and exercises towards slow ageing are based around a core of relaxation and meditation and sleep.[2]

The connection between ageing, brain health - especially memory - and sleep are presently unknown, but studies have shown links between each individual competent. It is currently thought that as part of the ageing process, accrued damage within the ageing brain reduces the quality of deep sleep, which has been shown to hamper the ability to store memories.[43]

In 1979, Harvard University psychology professor Ellen Langer carried out an experiment on a group of 70 and 80 year old men, to find if changing thought patterns could slow ageing. Asking them to take part in a "week of reminiscence", the men were split into two groups: the control group would be reminiscing about life in the 50s; the experimental group were placed in a virtual time warp, surrounded by props, they were asked to act as if it was actually 1959. Asked to carry their own suitcases to their bedrooms, by the end of the week both groups were undertaking all chores and domestic duties, walking faster and feeling more confident. Langer took physiological measurements both before and afterwards, finding that in both groups that the men's gait, dexterity, arthritis, speed of movement, cognitive abilities and their memory was all measurably improved, blood pressure dropped and, even more surprisingly, their eyesight and hearing got better. Both groups showed improvements, but the experimental group improved the most.[44]

Brain fitness promoted by the virtues of Brain training have been shown over time to either slow the effects of ageing, or at least slow the timeline affects associated with ageing and promote overall health and hence longevity.[45] Transcendental Meditation (TM technique) may have beneficial age-related effects.[46][47][48][49][50]

Diet

Diet is key to slow ageing. Scientific backed-principles encompassing nutrients and micronutrients, slow food based seasonal principles, hydration and minimising the intake of known toxic and waste products to slow ageing.[1][2]

Although many dietary supplements on the market are advertised as having anti-ageing effects, there is a general lack of evidence as for their impact on ageing, with some researchers even point to several possible health risks and most government authorities not categorising them as drugs.[51]

Numerous studies into the affects of Fish oils show that the fatty acids contained within it, when taken on a regular basis, can promote numerous health effects, especially in retaining mental fitness, promoting a healthy heart and combating sarcopenia.[52] During healthy ageing, muscle size is reduced by 0.5-2% per year, known as sarcopenia. This effects over half of people over 80, resulting in frailty and immobility. Research has shown that men and women differ in their ability to synthesise new protein and also in their response to exercise, with older women have similar levels of protein synthesis to younger women, whereas older men have lower levels compared to younger men but adapt to exercise to increase their protein synthesis.[52] The result is a clear depreciative difference in older women, leading to higher levels of sarcopenia. In a study undertaken by the University of Aberdeen, women over 65 who received omega-3 fatty acids gained almost twice as much muscle strength following exercise, than those taking the marker of olive oil.[52] However, studies of data associated with the application of fish oils in the prevention and combating of dementia, show that it has little effect.[53]

Whilst alcohol may be seen by some as a toxin, and excessive intake has been known for some time to be highly detrimental to human life expectancy, studies are also now showing that a moderate intake of alcohol can significantly increase human life expectancy. Researchers have shown that low intakes of alcohol can double the life expectancy of nematodes in research studies.[54]

Physicality and exercise

An older adult doing a simple at home strength exercise

Physicality goes beyond exercise, but the benefits of physical exercise are well researched and known. These benefits also extend beyond the physical, with studies showing that a healthy heart is closely linked to healthy functioning mental capability.[55]

Physical exercise maintains physical fitness and can contribute positively to maintaining a healthy weight, building and maintaining healthy bone density, muscle strength, joint mobility, promoting physiological well-being, reducing surgical risks, and strengthening the immune system. Developing research has demonstrated that many of the benefits of exercise are mediated through the role of skeletal muscle as an endocrine organ.[56] Exercise reduces levels of cortisol,[57] which causes many health problems, both physical and mental.[58] Both aerobic and anaerobic exercise work to increase the mechanical efficiency of the heart by increasing cardiac volume (aerobic exercise), or myocardial thickness (strength training). Such changes are generally beneficial and healthy if they occur in response to exercise.

According to the World Health Organization, lack of physical activity contributes to approximately 17% of heart disease and diabetes, 12% of falls in the elderly, and 10% of breast cancer and colon cancer.[59]

Not everyone benefits equally from exercise. There is tremendous variation in individual response to training; where most people will see a moderate increase in endurance from aerobic exercise, some individuals will as much as double their oxygen uptake, while others can never augment endurance.[60][61] However, muscle hypertrophy from resistance training is primarily determined by diet and testosterone.[62] This genetic variation in improvement from training is one of the key physiological differences between elite athletes and the larger population.[63][64] Studies have shown that exercising in middle age leads to better physical ability later in life.[65]

Personal hygiene

Motivations for personal hygiene go beyond the reduction of personal illness, optimal health and sense of well being, social acceptance and prevention of spread of illness to others. Practices that are generally considered universal proper hygiene include: bathing regularly; washing hands regularly and especially before handling food;[66] washing scalp hair; keeping hair short or removing hair; wearing underwear; wearing clean clothing; brushing one's teeth; cutting finger nails. Personal grooming extends personal hygiene as it pertains to the maintenance of a good personal and public appearance, which need not necessarily be hygienic, such as the use of deodorants or perfume, shaving and combing. Other personal hygienic practices would include: covering one's mouth when coughing; disposal of soiled tissues appropriately; making sure toilets are clean; and making sure food handling areas are clean.[1][2]

Sleep and rest

The multiple hypotheses proposed to explain the function of sleep reflect the incomplete understanding of the subject. One theorem is that a considerable amount of sleep-related behavior, such as when and how long a person needs to sleep, is regulated by genetics.[67] ABCC9 is one gene found which influences the duration of human sleep.[68] However, it is likely that sleep evolved to fulfil some primeval function and took on multiple functions over time, but some of the key proposed functions of sleep are:

The result of too-little sleep is termed sleep debt, which has been shown to cause mental, emotional and physical fatigue, resulting in diminished abilities to perform high-level cognitive functions.[79]

Environment

Slow ageing principles extend to creating both a non-toxic environment that slows physical and mental ageing, as well as creating a harmonious and easily flowing life style.[1][2]

Studies of epigenetics have shown that even with identical twins, minor changes and even singular factors in upbringing or attitude could potentially alter the genetic path.[80] Research data suggests that mildly optimistic people live longer than pessimistic people,[81] with doctors proposing that the human brain could change certain chemicals and alter stress levels, resultantly having an effect on health and longevity.[82]

Social integration

Social integration strategies, such as seeking and giving social support through volunteering, working in a group, learning a new skill, or mentoring younger individuals, have been found to promote successful ageing.[83][84][85]

Criticism

The opposing view is that interventionist based medical therapies may be in part wholly excluded, and hence life span decreased, when known diseases and issues with readily identifiable procedures are rejected. Part of the opposition to slow ageing is due to the invested commercial scale of life extension science putative anti-ageing products and services, such as: nutrition; skin care; hormone replacement; supplements and herbs. A lucrative global industry, the US market alone for life extension science generates about $50 billion of revenue each year.[86] Some medical experts state that the use of such products has not been proven to affect the ageing process, and many claims of anti-ageing medicine advocates have been roundly criticized by medical experts, including the American Medical Association.[86][87][88]

See also

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