We age the moment we are born. It is not that we begin to ‘grow old’ soon after we ‘come of age’ on planet earth. The fact is everyone ages slowly, or insidiously, or more quickly than the others, owing to illness — a poignant upshot. It begins at birth; it ends in death. This is called the aging process. It's a normal physiological or natural phenomenon. You just can’t avoid it, even if you want to. Yet, there are factors through which we can put more than a little ‘hold’ on the accelerated upshot of the aging process. This includes healthy living, eating balanced, nutritious diet, exercising and taking time off for leisure pursuits. Likewise, there are certain factors that can expedite the aging process — smoking, alcohol, stress, lack of exercise and recreation, not to speak of nutritional imbalance, aside from dietetic excesses. The sequence called chronic disease is yet another downside — it is not a normal pattern. It hastens the aging process.
“Aging,” as the American writer and activist Betty Friedan said, “is not lost youth, but a new stage of opportunity and strength.” It is also inevitable, albeit its cadence is not. While we all know that our bodies age, the whole internal experience still smacks of ambiguity, a mystery, no less — although researchers are learning more and more of the aging process than ever before. Studies also surmise that chronological age has little, or no real bearing on biological age. To cull a simile — the number of candles that adorns your birthday cake only serves as a metaphor of time. It never speaks, reports, lights, or ‘stills’ a glow about your health and well-being. No one exemplified the maxim better than the legendary Dev Anand — the ‘ageless’ Bollywood star.
Age-related physical changes are obvious. They are as apparent as the ‘slowed’ reflexes of a legendary batsman at the twilight of his career. Some of the visibly decipherable markers of aging are additional laugh lines, greying or loss of hair, extra weight around the waist, among others. Add to this failing vision, a ‘thinning’ skin, or brittle tissue, and you’ve the anatomy of aging sequentially told. Your heart slows down too and it shows up as fatigue — this results in less blood being circulated, leading in reduced flurry, including nutrients, through your body. Besides, the nutrients, that ‘power’ the functional ‘engines’ of your metabolism, are also less available. Though this is normal, it shows how enormously interrelated, or interconnected, every part of us is. If one thing goes wrong somewhere, it will, as a matter of course, have a cascading, ‘rebound’ effect elsewhere.
These are, of course, clear changes — but, there are a host of alterations, such as the steady loss of bone tissue and reduced elasticity of blood vessels that go unobserved, even for decades, before the signs of aging set in. ‘Seeing’ is, sometimes, not ‘believing’ in masquerade — we are all physiologically ‘engaged’ in the aging process, yet we think that it is not happening at all.
There is also a growing paradox. With a distinct increase likely in both lifespan and life expectancy in the 21st century, the aging process is defining new treatment modalities, especially in individuals surviving into ripe old age with chronic illnesses. This is a huge challenge — because, coping with chronic conditions is not going to be easy. It never ever was. Studies suggest that by the year 2050, about 2-3 million people are expected to have lived 100 years or more. It is, therefore, imperative that the management and control of chronic illnesses would require optimisation of the aging process. This holds the key to augment our quality of life and daily functional capacity — two fundamental elements for the best possible maintenance of health and also the aging process.
It is established that a decline in physiological function begins after age 30, when our physical and emotional performance reaches the zenith. The rate, of course, varies, depending on one’s lifestyle — the prospects of slow aging are better with people who are active than those who lead sedentary and ‘flabby’ lives. Yet, the fact is nobody can ‘stall’ the tide of time. Not even ‘super-fit’ athletes. Research evidences that veteran athletes too experience a clear decline in their cognitive and physical function, thanks to the aging ‘construct.’
While most physiological functions remain satisfactory for a healthy individual surviving or living into old age, beyond the ‘nervous’ nineties, it is actually disease and disuse, not normal aging, that accounts for the larger part of functional slowdown in people in their mid-80s. Besides, one cannot discount the possibility of drug-interactions, or unpleasant effects of environmental infections, donning the ‘killjoy’ role in healthy aging.
While the most fundamental process of aging is the destruction of cell membrane permeability, what also ‘triggers’ dysfunction is not only cellular communication chutzpah, but also consequential functional decline. The effects are collective — oxidative stress, metabolic syndromes, chronic inflammation, imbalanced reactions, chronic stress response, lipid surges, impaired detoxification, poor immune function, hormonal inequity, physical and mental sluggishness. The presence or progression of one or all such processes in aging is not predestined. It is an essential, unalterable exemplar — a predictable ‘shortfall’ experienced by all of us.
Today, there is a profound emphasis on new technologies, more so in the area of human genomics and stem cell research. The premise is to provide greater precision about genetic and cellular aging mechanisms and treatment. Studies, for instance, suggest that optimal lifestyle behaviours could increase our average lifespan, or prolong life expectancy by ten years. A multicentre study, for example, among elderly adults across Europe showed that a modified Mediterranean diet was associated with longer survival rates — up to 12 per cent reduction in mortality. On the other hand, studies estimate that 30-40 per cent of deaths, in the US alone, are the outcome of undesirable individual health [mis]demeanours.
Researchers have identified the effects of natural or normal aging that is ‘free’ of disease, or illness, as distinctive from the development of age-related illnesses, such as heart disease, diabetes, arthritis, osteoporosis and cancer, not to speak of Alzheimer's disease, a neurodegenerative disorder that leads to memory loss. Likewise, some studies suggest that the effects of aging are extremely ‘plastic’ — it tends to vary from one individual to another. It is as characteristic as your fingerprint or signature. In simple terms, it suggests that each individual's ‘autograph’ of aging is a consequence of numerous interactions — right from one’s genetics to environmental challenges.
What, therefore, holds a dazzling, or exciting, prospect is the ‘seamless’ integration and evaluation of cumulative physiological and psychological, or emotional, challenges over our lifespan and medical science’s response to new challenges — while determining how ‘well’ a particular individual is aging and how to customise treatment programmes to reduce the effect of chronic illness. You may call it ‘bespoke medicine’ — analysing ‘you’ as a distinct individual, tapping and mapping your unique, personalised responses in both health and illness from the point-of-view of treatment. This also proffers an additional advantage — preventing certain processes that may have the potential to ‘activate’ one or more chronic ailments in old age.
The inference is simple, also profound — it helps to be pragmatic. Because, being perceptive or knowing how and why our body changes with age, leading a healthy lifestyle and eating right, will assist us to age naturally and healthily — and, ‘slowdown’ cell, tissue and organ decline in its tracks. What’s more, it provides us with the wholesome ‘ammo’ to tweak or defer the development and progression of chronic disease, or illness, which is part of advancing age.