Preventive Medicine and Healthy Longevity: Basis for Sustainable Anti-Aging Strategies

Abstract

In the last century, both human life expectancy and maximum life span potential increased [1]. The analysis of North European mortality curves suggests that a relevant role for this phenomenon was played by the reduction of lifetime pathogen burden [2]. Whatever was the real cause, at the end of 1900, the improved hygienic conditions, the proper diet, the better health condition, and the decreased infant mortality elevated life expectation up to 80 years, with a consequent raise in elderly population of industrialized countries. In the society, the public perception of advanced aging involves the inability to survive alone due to chronic diseases and the combined loss of mobility, sensory functions, and cognition [3]. Age-related diseases, such as cardiovascular diseases, osteoporosis, cancer and neurodegenerative disorders, represent the major cause of morbidity and mortality in Western countries, with an exponential growth of health costs linked to increased size of elderly. For example, Alzheimer’s disease (AD) is the fifth leading cause of death in Americans aged 65 and older and deaths attributable to AD have been rising dramatically in the last decade (47 % increase between 2000 and 2006) [4]. With the increasingly aging population of the United States, the number of AD patients is predicted to reach 14 million in 2050, with an expected incidence of AD nearly to a million people per year and similar considerations apply worldwide [5]. Similar trends follow main age-related chronic diseases. This will pose an immense economic and personal burden on the actual and future generations, creating a critical emergency for effective therapeutic and preventive interventions. However, there is a judge difference among people that ages: There are people at the age of 60 years old that have extensive cognitive difficulties and chronic diseases and other that at 90 years old are still in good mental and physical condition. Avoiding age-related disease until late in life is key to “successful” aging. It is possible to transform in reality the constant dream of humankind: to stop, postpone, and/or reverse the aging process? During the last years, an increasing number of scientific meetings, articles, and books have been devoted to antiaging strategies and therapies. This topic is very popular among the general public, whose imagery has been fascinated by all possible tools and tricks to retard aging, thus approaching immortality, but it is also full of misleading, simplistic, or wrong ideas. In almost all instances, claims of drugs, health supplements, and other types of intervention are not based on any evidence supported by sound scientific knowledge. Of course, other approaches, including intervention in telomere shortening, cell cycle control, interfering with the oncogene/anti-oncogene homeostatic balance, etc. are being studied as possible “antiaging” manipulations. Although solid data suggesting increased survival time in vitro or life span expansion in experimental animals in vivo has been reported in some of these instances, these interventions are still far from being applicable in the complex human situation, and must therefore await further scrutiny, particularly with regard to still unknown side effects [6]. Thus, in the present chapter, antiaging strategies aimed not to rejuvenate, but to slow aging and to delay or avoid the onset of age-related diseases are discussed, allowing to substantially slow down the aging process, extending people’s productive, youthful lives. In particular, it will briefly focus on the most promising approaches proposed to obtain a healthy longevity: nutritional strategies, physical activity, and hormone therapy. Furthermore in this context, some specific skin antiaging aspects will be also discussed. Skin aging, in fact, is particularly important because of its social impact, but also represents an ideal model organ for investigating the aging process.