Clinical Interventions in Aging: a forum for practitioners of evidence-based ?anti-aging medicine?

Abstract

In 1990, data from an article published in the New England Journal of Medicine suggested that the age-related decline in human growth hormone (hGH) production contributes, at least in part, to senescence (Rudman et al 1990). Youthful changes in body composition associated with hGH administration to elderly men gave rise to the idea that replacement of vital substances such as hormones, cofactors, neurotransmitters, antioxidants, and other intrinsic factors that decline during aging might oppose or even reverse senescence. Adoption of this concept by healthcare providers during the 1990s resulted in the coining of the now popular term, “anti-aging medicine”. At first, the practice of replacement therapy to maintain health and vitality during aging seemed reasonable and scientifically valid. However, overinterpretation and sensational reporting of research data by the media misled many lay persons into believing that the means to reverse aging had been discovered. Public enthusiasm for access to the “fountain of youth” presented a great opportunity for entrepreneurs and charlatans to sell “anti-aging” products without providing evidence of their safety and efficacy. Eventually, commercial interests that exploited the public desire for enduring youth had tainted anti-aging medicine and raised concern among many healthcare professionals that the field was illegitimate. Commercialism also significantly reduced the availability of private and public research funds that could have helped expand upon the legitimate, original findings. This created significant obstacles to generating a database of information on safe, effective, and practical methods for increasing longevity with good quality of life during aging. The use of anti-aging products by those concerned with protecting their professional and ethical reputations became something of a liability (Wick 2002). Nonetheless, public interest in anti-aging therapies, especially those involving hormone and other vital substance replacement, continues and in many cases is growing. As a result, many physicians and healthcare providers have been forced to treat their patients without the benefit of reliable information that could be provided by professionally organized educational programs, seminars, and evidence-based, peer-reviewed reports from their colleagues in research and practice. A forum has been organized in recognition of the need for a reliable source of scientifically valid information on interventions in aging. Its purpose is to serve the needs and interests of medical practitioners whose practices include some aspect of longevity medicine. The forum includes a new international organization called the Society for Applied Research in Aging (SARA) and its official, peer-reviewed journal, Clinical Interventions in Aging (CIA). As a first step, SARA will sponsor, jointly with the University of South Florida College of Medicine, an organizational and charter member meeting and symposium in Tampa, FL, USA on October 28–30, 2005. All speakers will be experts in their field and have peer-reviewed publications demonstrating their competence. Participation is open to all physicians and healthcare providers, and SARA will take applications for charter membership at the meeting. The Society will offer a unique opportunity for members to contribute to the development of longevity medicine while at the same time provide the means to gain recognition of their skills and elevate their professional status among peers and patients alike. Achievement of these goals will be facilitated by participation in Society activities including the Institutional Review Board-approved clinical trials of hormone replacement therapies, protocols, and treatment paradigms for a variety of clinical situations; e-consult services/chat rooms for questions and debate of controversial issues; and training sessions/focus groups for intensive analysis of specific subjects. University-based, continuing medical educational credits (CME) will be provided for participation at many Society functions. As the result of participation, members will gain basic information on how the use of exercise, diet, nutrition and natural products, hormone and antioxidant replacement therapies, chelation and acupuncture, meditation, and other approaches may help promote and extend healthy life. They will also come to understand the risks and benefits of interventions in aging as well as some of the legal and ethical questions relevant to the healthcare practitioner. Through such professional development, the practitioner will more easily discriminate between legitimate and unfounded claims about healthy aging and longevity. Most importantly, members will receive subscriptions to CIA and will also be provided with instruction and assistance on gathering outcomes of their work, analyzing data, and creating publishable articles. Clinical Interventions in Aging will provide anti-aging practitioners the opportunity to gather information and communicate new perspectives, questions, and issues of importance to their peers through its pages. A major objective of SARA is to collect and report outcomes from studies of aging and its treatments; therefore, submissions of manuscripts for publication in CIA will be solicited as a major part of the Society's efforts. The journal is devoted to reporting the outcomes of current research and therapies that increase our knowledge of how the aging process can be better managed. Its highly respected editorial board will ensure publication of only the highest quality, peer-reviewed reports. In recognition of the value of clinical data and the relevance of such information to the needs of longevity medicine practitioners, the journal's format will include observations, case reports, new techniques, subjective conclusions and opinions, letters, and relevant articles. These submissions will be held to the same high standards for publication as are basic and clinical research papers. Accordingly, they should complement practical information on current treatments as reported by other practitioners. The journal will also periodically publish an educational section on current topics in longevity and integrative medicine for which CME credits as well as those for related healthcare professionals (CPE) will be offered. As Founding Editor of Clinical Interventions in Aging, I am proud to be part of these worthy efforts. I thank Dove Medical Press for giving me the opportunity to be integral to the initiatives that will make the practice of longevity medicine more interactive among its practitioners, and through their complementary efforts, bring the practice of “anti-aging medicine” to unprecedented levels of excellence.