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As expressed in a recent published report entitled “Past, Present, and Future of Healthy Life Expectancy,” it has become apparent the current “disease model” paradigm in healthcare may have to be abandoned and replaced by a “delayed aging” approach because of the large number of chronic comorbidities inflicting older people.

Caring for millions of senior Americans with chronic brain, eye and heart disease would be so overwhelming as to drain insurance pools as well as incapacitate society.  Given that most chronic disease among senior adults is caused by aging, any technology that slows aging would delay the onset of physically or mentally debilitating diseases.

While aging is the most important risk factor for major chronic diseases, little or nothing is done about the cause while treatment of symptoms prevails.

A breaking point

A breaking point has been reached.  In Great Britain healthcare budgets are so overtaxed that they have resorted to withholding water from institutionalized patients in a covert effort to induce death by dehydration.  Healthcare is no longer affordable in America.  The per capita cost of Medicare now exceeds $10,000 a year.

There is sufficient evidence that human aging can be delayed with improvements in health and functional independence at older ages.  Already a simulation model of delayed aging indicates there is a potential to increase both the length of life and the number of years spent disability free.

A recent report published in the journal Demography examined how biological age relative to calendar (chronological) age changed between 1988 to 2010.  In recent times measures of biological age are lower, especially older male adults.

Using blood markers of biological age (hemoglobin, cholesterol, creatinine, albumin, C-reactive protein, blood pressure) it has now been determined that a significant portion of older Americans delayed biological aging during the period 1988-2010.

Change in biological age by age groups in USA 1988-2010.
Biological age decline is underway.

According to another report, old age does not begin till age 74 with middle age lasting nine years longer than current estimates.

The disease paradigm is slowly being supplanted by the delayed aging paradigm.

The wrong markers

The problem with the above markers of aging is that they were initially used to detect disease not assess the prospect of living longer.  Blood markers like leptin, AMPK, and TNF, markers of food satiety, calorie burning and inflammation respectively, are better associated with slowing the rate of aging.

The advantage of delayed aging is that all fatal and disabling disease is reduced simultaneously.  This would result in more older adults remaining employed and maintaining their independence with delayed admission to a long-term care institution (nursing home).

Offsetting costs and savings

A delayed aging paradigm would predictably result in disability-free older adults living for many decades to come.  There would be offsetting costs – dramatically reduced Medicare bills but greater Social Security payments.  The average monthly Social Security benefit is ~$1342/month while Medicare bills now approach $800-900/ month per enrollee.  While Social Security costs are capped at their predetermined rate Medicare bills can run up to hundreds of thousands of dollars for an individual.

And of course, if older adults remain in the workforce another 5-10 years, that could also reduce retirement fund drain.

Ten percent (10%) of Medicare enrollees represent nearly 50% of the costs of delivering care.  A targeted “delayed aging” approach among these individuals would likely yield even greater results and economy.

While Medicare and Social Security are considered “transfer of wealth” programs or “welfare,” they are in reality trust funds the public “invested in” that were guaranteed they would pay for retirement or medical bills in the future.

In 2016 Social Security and Medicare accounted for 42% of federal expenditures.  These trust funds have been incorporated into the general fund and are partly paid for my current revenues (FICA payroll deductions from younger workers to retirees) as the trust funds are not fully funded.

Out-of-pocket costs

Medicare enrollees with no supplemental insurance pay ~$5374 per year in out-of-pocket expenses (2016 projected figures).   Medicare enrollees with supplemental insurance pay ~$2587 per year in out-of-pocket costs.  In either case, that could mean many seniors have enough money to purchase an economical intervention that would slow aging and save them hard dollars.

Physician reluctance

Anticipate a strong reluctance from practicing physicians to put any delayed aging technologies into practice.  It is unlikely that politicians would legislate a new paradigm to force doctors to comply.  There is too much political lobbying by the AMA for that to happen.  Meaning any such a departure from the current model where each and every disease of aging is detected and treated to a scenario where the onset of eye, heart and brain disease is significantly delayed will have to be a course chosen by senior adults themselves without guidance from their reluctant physicians.  Of course, that is if financial rewards to healthcare practitioners are not forthcoming for doing so.

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Any such a departure from the current model where each and every disease of aging is detected and treated to a scenario where the onset of eye, heart and brain disease is significantly delayed will have to be a course chosen by senior adults themselves without guidance from their reluctant physicians.

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Pharmacologists are working feverishly to develop age delaying drugs but these are likely to be beyond affordability.  Pharma companies are going to demand a trade off – higher prices for anti-aging drugs in exchange for fewer drugs needed to quell the symptoms of each and every age-related disease.

Delayed aging may be difficult to sell to the public too

Because there has not been an accompanying increase in healthspan to go along with the rise in life expectancy in developed countries, the public foresees old age as being diapered, confined to a wheelchair, drooling from the mouth, feeble and mentally impaired.  That is nothing to look forward to.

Delayed aging scenario already charted

According to one report under a delayed aging scenario, there would be a greater proportion of the aged population that is disability free, and would be projected to increase annually for the next 50 years.

The disease model of health care is also likely to produce health improvements, but with diminishing returns because a large number of people will suffer comorbidities and not be mentally or physically independent (drive a car, balance a checkbook, be mobile – walking).

Under the delayed aging scenario, these comorbidities are estimated to be 20% lower, which is significant.  The goal is to prolong the number of years of independent living at the end of life.

However, biogerontologists write: “a means to slow the rate of aging may not be applied on a wide scale, may be prohibitively expensive and may only be utilized by a small fraction of the population and increase the number of years of Medicare and Social Security payouts.”  But economical anti-aging strategies do exist and are underutilized.

While the number of proposed anti-aging interventions is small they are promising.  There is conclusive evidence calorie-restriction can prolong human lifespan and healthspan but food deprivation is unlikely to be practiced.  This leads to a growing interest in compounds that may molecularly mimic the benefits of reduced calorie intake without having to resort to food restriction.

Biggest challenge

The emergence of long-living populations is certainly going to present challenges.

One of the biggest challenges nowadays is to increase the human lifespan with parallel increases in healthspan.

Or as some researchers have said, “age is just a number.”  There are animals, namely the naked (hairless) mole rat that not only lives ten times longer than other rodents but shows no cosmetic or functional signs of aging (wrinkles, arthritis, etc.) as it gets older.  Biologists say the naked mole rat is “forever young,” which gives hope to those who use the mirror as a gauge of their age, that they don’t have look old or lose their mental and physical faculties as they add years to their lives.

One such strategy

What would happen today if a person opted to adhere to a lifespan/healthspan doubling limited calorie diet plus a molecular mimic of calorie restriction?  Unfortunately that can’t be conclusively determined in humans because a study lasting many decades would be required.  So animal studies must suffice.

So aged (21-month old) laboratory rats were placed on an ad libitum diet, a calorie-restricted diet, a quercetin-fortified diet and a quercetin+ calorie restricted diet.  The combination of food restriction + quercetin more demonstrably slowed the decline in internally produced enzymatic antioxidants (glutathione, catalase, superoxide dismutase) and reduced the accumulation of cellular debris (lipofuscin) and decline in blood vessel-dilating nitric oxide gas.

Researchers writing in Central Nervous System Neurological Disorders & Drug Targets journal concluded: “Combined caloric restriction and quercetin (but not either treatment alone) in late life is an effective anti-aging therapy to counteract the age related accumulation of oxidative macromolecular damage.”  There is emphasis on “late in life” because this suggests it is never too late to put anti-aging technologies into practice.

Another strategy

As described in a recent issue of Biochemical Pharmacology, an overlooked anti-aging strategy is to increase the endogenous release of hydrogen sulfide gas, which sends signals throughout the human body.  While modern medicine ponders how to develop hydrogen sulfide releasing drugs, a simpler and more economical approach is at hand.  Hydrogen sulfide release is a feature of calorie restricted diets but can also be mimicked by garlic (allicin) consumption.  (Be aware, all garlic pills don’t deliver allicin, garlic’s chief ingredient, and garlic cloves must be crushed and not heated to deliver allicin.)

The most compelling evidence

The most compelling evidence a mimic of calorie restriction can activate the same genes activated by a limited calorie diet was published in 2008.  While life-long calorie restriction significantly alters 831 genes, a nutraceutical matrix composed of resveratrol, quercetin and IP6 from rice bran favorably altered 1711 genes and switched 82% of those 831 longevity genes in the same direction (on or off) as calorie restriction.  This study has gone overlooked and largely unapplied.

Does memory have to fail with advancing age?

Does memory have to fail with advancing age?  Biologists writing in a recent issue of Scientific Reports have tabulated 14 factors that slow episodic memory (recollection of personal living experiences) with advancing age.  The following chart reveals that GREEN factors — wine, omega-6 oils/linoleic acid, hormone therapy, physical and mental (computer use) activity, blood pressure (MAP- mean arterial pressure and a high score on a mental test (MMSE) — predict maintenance of memory while cholesterol, sodium levels and processed food predict memory decline.

The unexpected factor was omega-6 oils (GLA oils from borage, evening primrose, black currant seed oil) intake was the strongest dietary factor in retention of memory.  Other studies confirm omega-3 oil is important for mental function with advancing age.

GREEN = memory retention; ORANGE = memory loss

Mis-folded proteins and aging

Living cells are protein-making machines.  A recent analysis shows a simple cell holds 42 million protein molecules.  The dynamic protein-making aspect of genes is what is called epigenetics.  When genes generate proteins that is called gene “expression” and when they don’t that is called gene “silencing.”  These proteins must be processed as they emanate from the cell nucleus through a maze-like intracellular body called the endoplasmic reticulum.

Improper folding of proteins, which is associated with a myriad number of age-related diseases (eye, brain and metabolic disorders like diabetes), causes proteins to aggregate within cells.  This intracellular protein aggregation plays an important role in aging and “opens a novel approach to increase longevity and the quality of life” with advancing age.  Natural molecules like resveratrol (wine, grapes), quercetin (apples, onions) and vitamin D improve protein folding and passage within living cells.  No synthetic drugs need to be developed to do this.

A ketogenic diet is an anti-aging diet

It is increasingly becoming clear to the American population that it was deceived when the cholesterol phobia era of medicine was oversold.  This intentional misdirection is nothing that public health authorities, pharmaceutical or physician groups will apologize for as the public was gamed for more disease to treat.

As more evidence mounts for the health benefits posed by a high-fat (ketogenic) diet, which has been shown to extend the lives of lifespan and healthspan of laboratory animals and improve their memory, the misdirection has been revealed. The widely disseminated food pyramid that restricted essential fats and oils has been abolished.  Low carbohydrate (bread, rice, pasta, cereal) diets are thought to not only promote health but also longevity.

It has now been shown that lifespan extension achieved by calorie restriction and be duplicated in part by ketosis.  Ketosis is a shift from burning sugar calories to burning fat calories.  High levels of ketone bodies in a blood sample indicate carbohydrate intake is low.  A recent study shows that ketone bodies mimic the life extending properties of calorie restriction.  ©2018 Bill Sardi, ResveratrolNews.com