Aging and Anti-Aging

As the New Year arrived, many people made New Year’s resolutions. Some, I’m sure, resolved not to age, or at least to age as slowly and healthily as possible. I wondered if I should make such a resolution. 

That particular question just came up as I communicated with an old high school classmate for the first time in 50 years. We were casual friends back then. For our 50th year reunion, he posted a picture and profile on our website. He looked good and healthy, but it was his blurb that really got my attention: 

“. . . About 13 years ago, I changed my practice focus onto ‘anti-aging’. Ever since, I have been trying to hold back the hands of time. Hopefully with some success. Memory, energy and libido are all excellent. I hit my golf drives 15 yards longer.”

 Given that he lives in Florida, the land of the legendary “Fountain of Youth,” had he discovered a modern fountain of youth? 

I suppose that the connection of anti-aging and high school reunions made perfect psychological sense. What high schoolers don’t want to look terrific at their 50th year reunion? 

My classmate was not only a geriatric physician, but “board certified in anti-aging.” And, yes, there is an American Academy of Anti-Aging Medicine. I asked for some literature. He recommended the book Fantastic Voyage by Grossman and Kurzwell, as well as some by the actress Suzanne Summers, including her Ageless: The Naked Truth About Bioidentical Hormones

For his Longevity Clinic, there were recommendations for several “syndromes”. For “Adult Related Memory Decline Syndrome”, his clinic recommended “Balance with Bioidentical Hormones.” There those hormones were again! Dietary changes recommended were low saturated fat, more cruciferous vegetables, and soy products. Nutritional supplements recommended were Simplicity, Intellect, EPA/GLA, and coenzyme Q10. For chronic fatigue syndrome, inflammation, and insulin resistance, there were some similar as well as different recommendations. Now, even as a psychiatrist, I pride myself on keeping up with general medicine, but I never heard of some of these products. A “brave new world,” indeed!

 I did, however, know of coenzyme Q10, and thought of starting that, but we asked another geriatric physician friend, who said he tried it for months and it didn’t seem to help. Was that not long enough? Who knows?

 Then, serendipitously, we heard from another friend, not a physician, who was selling anti-aging products. Information came with some sample drinks. I tried them, didn’t like their taste, and didn’t feel anything, even though they are supposed to be as stimulating as one-to-two cups of caffeinated coffee. And, in addition, this friend looked older than his age in pictures.

 With some reservations about this whole field, I decided to do a little research on my own. I found out that the medication metformin may improve “healthspan” and lifespan in mice, perhaps the equivalent of a few years in humans. Now, I do know some about the diabetes drug metformin, for its additional use in combating the weight gain and metabolic syndrome that is a typical side effect of our atypical antipsychotic medications. Since my classmate had highlighted insulin resistance, even though not mentioning metformin, I was intrigued. Metformin for anti-aging is supposed to have effects similar to caloric restriction. However, research in humans has not started and is much more complicated. Well, at least this information made me feel better that I kept many patients on their helpful antipsychotics when I added the metformin. Of course, metformin, like all medications, has side effects of its own, as I assume any of the anti-aging products would.

 Another promising substance seemed to be the anti-oxidant resveratrol. Pistachios, peanuts, red wine, and dark chocolate are supposed to be rich in it. It may also work thorough a caloric mimic-effect. My primary care doctor would be pleased if I lost some weight through dietary caloric restriction, so why not at least eat more food load with resveratrol, especially since I liked them all except dark chocolate?

 I didn’t explore the costs of particular programs. But anti-aging products are a lucrative global industry, estimated at well over tens of billions of dollars in annual revenue, and growing.

 Besides my nagging doubts about the actual effectiveness of our current anti-aging products, as well as the significant costs, there is another concern. In the U.S. and other countries like Japan and China, we have a population that is indeed aging relative to the youth, as we live longer and birth rates decrease. If we age even further, are the social and health care costs too high? I suppose that if we age more healthily, perhaps the answer is no. However, if we liver ever longer, with longer chronic illnesses and social needs, are we selfishly taking away too much from the next generation? 

What do you think? Have you tried any of the anti-aging strategies? And, if so, what results do you think you got?

 (For an interesting Wall Street Journal video on “5 Things the Anti-Aging Industry Won’t Tell You,” see here.)

H. Steve Moffic, M.D., 67, retired from clinical practice at 66. He was fondly deemed a “psychiatric gadfly” by the Chair of the Department of Psychiatry where he first trained. His book The Ethical Way: Challenges and Solutions for Managed Behavioral Healthcare, published in 1997, was the first extended discussion of the ethics of managed mental health care.

 

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