If you’re an adult in the U.S., you can expect to gain 10 to 25 pounds between your 20s and your 40s. Starting between ages 30 and 40, you may find losing weight and exercising more challenging. The exercise you do may not have the same effect as before. It’s not necessarily a sign that something is wrong. This weight gain in middle age—known as “middle-age spread”—is a natural consequence of aging.

“Your metabolism tends to slow down as you get older,” says NIH’s Dr. Rafael de Cabo, an expert on aging. “But your appetite and your food intake do not. So, you have a steady increase of body weight with age.”

Much of the weight gain comes in the form of fat tissue. The distribution of fat in your body also shifts. There’s less under your skin and more around your internal organs. Meanwhile, you start to lose lean muscle with age. Many people also become less active as they age, especially if they have a job that involves a lot of sitting. This can lead to further fat gain and muscle loss.

Those extra pounds have consequences beyond your clothes not fitting. The risk of many chronic diseases, such as diabetes, heart disease, and neurodegenerative diseases, goes up with age. Excess weight can further heighten these risks.

Fortunately, you can take steps to maintain a healthy weight as you age. Your diet can play a key role. Having a slower metabolism means you’ll need fewer calories. But you also want to make sure you still get all the nutrients your body needs. Get tips on healthy eating as you age.

De Cabo studies the effects of dietary changes on health and longevity. One example is intermittent fasting, in which meals are interspersed with long fasting periods. For example, you might limit eating to only eight hours per day. Studies suggest intermittent fasting may help some people to eat less and keep weight off. But De Cabo and others have been finding that it might also have benefits for your metabolism.

His work has shown that mice live longer and stay healthier when they go for long periods between meals. This was true even if they were eating the same amounts and types of foods as mice that ate whenever they wanted. Other studies have also suggested that periods of fasting may bring benefits beyond weight loss.

Physical activity is important for combating the changes that come with aging, too.

“The key is to maintain an active lifestyle,” de Cabo says. “Try to incorporate daily walks or daily visits to the gym. If you have an office job, get a standup desk, so you spend a few hours a day standing instead of sitting. Small doses of exercise throughout the day will help tremendously.”

Visit: https://newsinhealth.nih.gov/2024/10/stopping-middle-age-spread for more information.

The post Stopping Middle-Age Spread appeared first on Medika Life.

However, it was only recently that I began targeting something deeper.

Something upstream.

Something ancient.

Inflammation.

Not the helpful kind you get after a cut or cold. That kind heals.

I’m talking about chronic inflammation — the kind that lingers quietly, damaging your blood vessels, brain, joints, and organs like a slow, internal wildfire.

Over time, I’ve come to believe that chronic inflammation is the common thread behind most chronic diseases. The evidence keeps stacking up.

The Number That Predicts How Fast You’re Aging

Most doctors ignore it. I don’t.

medium.com

The Hidden Fire Behind Disease

Dementia? Check.

Type 2 diabetes? Check.

Heart attacks. Strokes. Obesity. Cancer?

Check, check, check.

We call these conditions separate diagnoses.

But I’ve come to see them as symptoms of a deeper cause: the body’s immune system stuck in the “on” position.

Scientists have even coined a term: inflammaging — the chronic, low-grade inflammation that accelerates aging and shortens lifespan.

That realization changed the way I live.

6 Ways I’m Extinguishing the Fire

I don’t believe in silver bullets. But I do believe in stacking small daily wins. Here’s how I’m pushing back against chronic inflammation:

1. Sleep Like It’s Medicine

Sleep isn’t optional. It’s therapeutic.
Insufficient sleep increases inflammatory markers, such as C-reactive protein. But quality sleep can lower them, especially when it becomes a consistent, protected ritual.

I now aim for 7.5–8 hours per night, without apology. I treat it like an appointment; I don’t cancel.

2. Move Daily, Not Occasionally

Exercise cools inflammation, especially the aerobic kind.
Walking. Cycling. Swimming. Even light strength training. They all lower pro-inflammatory cytokines and boost your cellular resilience.
And yes, I consider walking to be medicine.

3. Eat Food That Fights for You

I’ve shifted toward a Mediterranean-style diet, which includes olive oil, vegetables, nuts, berries, and fatty fish.
I’ve also added turmeric, green tea, and fiber-rich legumes.
These foods don’t just fuel me. They protect me from the inside out.

4. Avoid the Fire-Starters

Two habits pour gasoline on inflammation:

• Smoking
• Excess alcohol

I’ve never smoked. But I do drink on occasion — and now I limit that to one glass a week, if that. Most of the time, sparkling water does the trick just fine.

5. Stay Lean for the Right Reason

Weight isn’t just cosmetic — it’s biochemical.

Visceral fat (the kind that wraps around your organs) fuels inflammation and increases risk for cancer, dementia, and heart disease.

I stay lean, not for a mirror, but for my mitochondria.

6. Take Oral Health Seriously

Inflamed gums = inflamed body.

I didn’t always take flossing seriously. But the link between periodontal disease and heart disease — even cognitive decline — is real.

Now I treat my toothbrush like a prescription.

We Can’t Stop Time — But We Can Stop the Fire

Aging is inevitable.

But how do we age?

That’s far more flexible than most people realize.

If you want more energy, sharper cognition, and a lower risk of disease, start by cooling the flame of inflammation.

It’s not glamorous. But it works.

Final Thoughts

I used to think aging was just a number. Now I think it’s a pattern.

A pattern of how we sleep. How do we move? How do we eat?

And how we treat the quiet signals our body sends us — before they become sirens.

You don’t need a prescription to start.

You just need to start.

If you’re interested in aging better, you might also enjoy This One Lab Result Predicts How Long You’ll Live.

Ready to fight inflammation? Download my free ebook here.
📘 Debunked: 7 Health Myths That Quietly Hurt You
You’ll learn the truth about common habits that silently fuel inflammation, disease, and aging — and how to reverse them.

Author bio:
Michael Hunter, MD, is a cancer doctor, writer, and wellness advocate who believes the best medicine often starts outside the hospital walls.

The post How Chronic Inflammation Accelerates Aging — And 6 Ways to Slow It Down appeared first on Medika Life.

I cared whether I could still carry my groceries. Climb stairs. Finish a sentence without losing the thread

I cared how many good years I had left.

Not lifespan. Healthspan.

I wanted to know how long I could stay sharp, strong, and independent. Not just alive, but thriving. So I started asking a new question of my patients, my research, and myself:

What’s the one blood test that tells me how fast I’m aging?

Most people think it’s cholesterol. Or maybe blood sugar. But those are lagging indicators. They tell you what’s broken, not what’s brewing.

The test I care about most now?

Hs-CRP.

High-sensitivity C-reactive protein.

Hs-CRP levels predict more than inflammation — they can forecast your future health. The higher the number, the shorter the path to chronic disease.

It’s not flashy. It doesn’t trend on social media.

However, it may be the most important number you’re not tracking.

Why Inflammation Matters More Than You Think

Hs-CRP is a marker of inflammation.

And inflammation, more than almost anything else, is what turns time into damage.

Chronic inflammation accelerates heart disease. It promotes cancer. It fuels Alzheimer’s, frailty, and age-related decline.

You don’t need a PhD to understand this: aging well means inflaming less.

Hs-CRP doesn’t measure one disease. It measures your body’s silent alarm system.

And when it’s elevated, things are already smoldering.

In healthy adults, hs-CRP should be below 1.0 mg/L.

Between 1 and 3 is a moderate risk. Anything above 3 is a warning sign.

Here’s the problem: Most people don’t know their number. And most doctors don’t order it unless you’ve already had a heart attack.

But if you care about your healthspan, you should.

Ask your doctor to add hs-CRP to your next blood panel. It could change how you age.

Why Most Doctors Don’t Order This Test

Medicine tends to focus on what’s urgent, not what’s important.

Hs-CRP doesn’t diagnose a specific disease. It doesn’t tell you what organ is failing. It just whispers: something’s wrong.

And in modern medicine, whispers get ignored.

In the U.S., insurance may not routinely cover it unless you’re already at high cardiovascular risk.

Clinical guidelines don’t push it for prevention.

And most physicians are too busy putting out fires to go looking for smoke.

But that’s exactly what this test reveals: slow, quiet inflammation that may not make headlines, but shortens your healthspan all the same.

Can You Order hs-CRP Without a Doctor? Yes — in most U.S. states, you can. Services like Ulta Lab Tests, Request A Test, or Walk-In Lab allow you to order an hs-CRP online for $30–$70. You choose a local draw site, such as Quest or Labcorp. No doctor visit required. Exceptions: New York, New Jersey, and Rhode Island restrict consumer lab orders.

What My Patients Taught Me

Some of my fittest-looking patients had elevated hs-CRP.

Not because they were overweight.

But because they were inflamed.

Sleep deprivation. Chronic stress. Processed foods. Environmental toxins. Dental infections. Even loneliness.

Inflammation has many faces.

And that’s what makes hs-CRP so powerful: it doesn’t just reflect one system. It integrates them all.

The gut. The immune system. The heart. Even the brain.

Want more patient insights? Read What Dying Patients Taught Me About Living.

The Science Behind CRP and Aging

The liver makes C-reactive protein in response to inflammation. But it’s not just a random flare-up detector — it’s a proxy for systemic stress.

Numerous studies have shown that oxidative stress is linked to accelerated telomere shortening and dysfunction. Oxidative stress caused by inflammation, cell factors, or environmental exposures contributes to degenerative diseases and cancer.

The lower your inflammation, the slower your biological clock.

What Happened When I Lowered Mine

The first time I measured my hs-CRP, it was 2.9.

I was sleeping 5 hours a night, skipping meals between consults, and not drinking enough water.

Nothing looked wrong on paper. But I felt off—mentally slower, physically stiff, emotionally flat.

Six months later, I made three changes:

• I walked every morning before checking my phone.
• I swapped protein bars for real food.
• I prioritized sleep as if it were a prescription.

My hs-CRP dropped to 0.7.

My brain felt clearer.

My joints were less inflamed.

Even my mood improved.

One number, many ripple effects.

Lowering Your hs-CRP (and Raising Your Healthspan)

No drug magically cures inflammation. But lifestyle can.

What works?

• Fiber (especially soluble fiber from legumes, chia seeds, oats, and vegetables
• Omega-3s (like those from fish or algae oil)
• Sleep (7–8 hours, not negotiable)
• Walking (daily, ideally in nature)
• Resistance training (2–3x/week)
• Social connection (yes, seriously)
• Oral hygiene (brush, floss, and keep your mouth free of inflammation — it’s your body’s open door to systemic disease)
• Screen-free wind-down time (to calm your nervous system)

You don’t need to be perfect. But you do need to be in rhythm.

I check my hs-CRP every 6 months now. Not because I’m afraid of dying.

But because I want to live well.

The Textbook Answer

For most healthy individuals, routine C-reactive protein (CRP) testing is not necessary.

However, there are some exceptions where it can be useful, especially high-sensitivity CRP (hs-CRP), which can assess chronic, low-grade inflammation, a known risk factor for heart disease and other conditions.

Here’s a breakdown of when it might be useful:

You might consider hs-CRP testing if you:

• Have a family history of heart disease or early cardiovascular events.
• Have metabolic syndrome or multiple cardiovascular risk factors (e.g., high blood pressure, diabetes, smoking, obesity).
• Have autoimmune symptoms (e.g., fatigue, joint pain, skin issues) and your doctor is evaluating for inflammatory conditions.
• You are already diagnosed with heart disease or chronic inflammatory conditions (like rheumatoid arthritis or lupus), and your provider uses CRP to monitor disease activity.

You probably don’t need CRP testing if:

• You’re young, healthy, and asymptomatic with no notable risk factors.
• You’re not going to change your treatment plan based on the result (i.e., no action would be taken).

Final Thoughts

You can’t choose your genes. But you can choose your daily fire level.

Inflammation is optional.

Hs-CRP is the one number I now track more than cholesterol, blood pressure, or glucose.

Because it reveals how much damage I’m silently absorbing.

And how much resilience I still have left.

If you want to extend your healthspan, start by asking for this one test.

Your primary healthcare provider can tell you if it is appropriate for you.

Curious how gut health and inflammation silently erode your health?
Read The Silent Killer in Your Gut — one of my most-read essays.

Scientific Sources

1. Ridker, P.M., Moorthy, M.V., Cook, N.R., Rifai, N., Lee, I.M., & Buring, J.E. (2024). Inflammation, Cholesterol, Lipoprotein(a), and 30-Year Cardiovascular Outcomes in Women. New England Journal of Medicine, 391(9), 2087–2097. https://doi.org/10.1056/NEJMoa2405182

2. Lassale, C., Batty, G.D., Steptoe, A., Cadar, D., Akbaraly, T.N., Kivimäki, M., & Zaninotto, P. (2019). Association of 10-Year C-Reactive Protein Trajectories With Markers of Healthy Aging: Findings From the English Longitudinal Study of Aging. The Journals of Gerontology: Series A, 74(2), 195–203. https://doi.org/10.1093/gerona/gly028

3. Yao, S.-M., Zheng, P.-P., Wan, Y.-H., Dong, W., Miao, G.-B., Wang, H., & Yang, J.-F. (2021). Adding high-sensitivity C-reactive protein to frailty assessment to predict mortality and cardiovascular events in elderly inpatients with cardiovascular disease. Experimental Gerontology, 146, 111235. https://doi.org/10.1016/j.exger.2021.111235

Want to Lower Inflammation and Extend Healthspan — Without Guesswork?

Want a clear plan to lower your inflammation and extend your healthspan?

I built a doctor-designed guide to lower your inflammation, heal your gut, and extend your healthspan:

Extending Life and Healthspan

Inside, you’ll find:

• The daily habits I use to reduce inflammation
• The #1 longevity lever I recommend to patients (that isn’t a pill)
• What I tell patients who want to age without decline

It’s simple. Practical. And rooted in the science, I trust.

Michael Hunter, MD, is a physician and writer focused on healthspan, helping people live longer, healthier lives — one lab result at a time.

The post The Number That Predicts How Fast You’re Aging appeared first on Medika Life.

No overuse in the gym.

No trauma.

Just age.

As I transition into my 60s, I occasionally notice small unpleasant elements.

You may relate: It seems that injuries happen more frequently.

I do not have my historical muscle strength.

A new study provides some insights, revealing what may be behind my physical decline.

The 40s

In my mid-40s, I noticed aging signs.

It wasn’t gradual; I suddenly realized I was in my 40s.

It seemed that I had rapidly aged.

As I transition into my 60s, I am noticing the same phenomenon.

Or was it just my imagination?

Stanford researchers recently provided some answers.

Molecular and Microorganism Changes at 44 and 60

Was I wrong in my perception that I had experienced a moment of rapid aging?

A new Stanford University (USA) study tracked thousands of molecule types in adults aged 25 to 75.

The researchers analyzed blood (and other biological samples) from 108 subjects.

Here is the main takeaway message:

People tend to have two dramatic aging leaps — the first at around 44 and the second at approximately 60.

Aging appears to happen in bursts.

These changes appeared no matter what type of molecules the researchers analyzed.

Chasing Squirrels: Punctuated Equilibrium

My nurse sometimes protects me from getting distracted from the task at hand.

Chasing squirrels, Melissa likes to opine.

Well, I am about to chase a squirrel.

What comes to mind is punctuated equilibrium.

This evolutionary biology theory describes evolution as a series of short, rapid times of change interrupted by prolonged periods of stability.

My Harvard professor, the late Stephen Jay Gould, joined Niles Eldridge to develop this theory of how new species emerge and diversify.

They based their view on fossil record patterns developed by paleontologists.

Changes in the 40s

For those in their 40s, the Stanford researchers discovered significant changes in molecules related to:

• alcohol
• caffeine
• cardiovascular disease
• lipid metabolism
• muscle
• skin

Can’t resist sharing this:

“Aging is an extraordinary process whereby you become the person you always should have been.” — David Bowie.

Could Menopause Be Playing A Role?

My first thought?

The mid-40s aging acceleration among women might be secondary to perimenopausal (the transitional period before menopause) changes.

The researchers thought menopause might be playing a role until the scientists realized that men in their 40s had similar molecular alterations.

Changes in the 60s

For individuals in their 60s, molecular alterations appeared related to:

• caffeine metabolism
• carbohydrate metabolism
• cardiovascular disease
• kidney function
• immune regulation
• muscle
• skin

The Researchers Speculate

The scientists wonder if lifestyle influences the alterations in the 40s and 60s.

For example, folks might consume more alcohol in their 40s, a time of higher stress for many.

Anecdotally, I don’t find alcohol consumption to be higher among my patients in the 40 to 50 age group.

Summary

In conclusion, the rapid changes in our bodies during our 40s and 60s are associated with molecular alterations, affecting various aspects of our health and well-being.

Understanding these changes may help you focus on optimizing your lifestyle, including factors like sleep, diet, physical activity, and relationships.

Actionable Takeaways

The bursts of aging in the 40s and 60s remind this 61-year-old to stay focused on optimizing lifestyle.

I pay attention to:

• Sleep
• Diet
• Physical activity
• Relationships
• Minimizing alcohol
• Not smoking
• Sex

My perception of a sudden onset of age-related disorders (including more muscle achiness after working out) seems grounded in reality: We may experience a sudden onset of age-related changes in our bodies.

We don’t understand the full consequences of these molecular changes, but I now better understand my challenges in gaining lots of muscle.

Could it be that the origin of many diseases — that emerge later in life — is related to molecular changes in our 40s?

What has been your experience?

The post Your Body Ages in Leaps: Stanford’s Surprising Findings at Ages 44 and 60 appeared first on Medika Life.

The global population is ageing. This has long been a trend in Western nations. However, many developing countries are now witnessing a similar societal shift. This will profoundly affect our economic well-being (as I wrote about here) and security and cohesion (as I wrote about here) unless countries focus much more on the health of older people. Health systems must adapt to this new reality, or we will all face dire health and economic burdens in the future.

Adult vaccination is a key area where we are simply not keeping up with shifting dynamics. Pneumococcal disease is a prominent example. Pneumococcal disease is a name for any infection caused by bacteria called Streptococcus pneumoniae, or pneumococcus. Pneumococcal infections can range from ear and sinus infections to pneumonia, meningitis and bloodstream infections[1].

We have made great strides when it comes to pneumococcal disease prevention. However, there is a lot of work that needs to be done to improve protection through vaccination, most prominently among the adult population.

Paediatric pneumococcal vaccination had been introduced in 155 WHO Member States by the end of 2022. Though coverage rates vary considerably by region, the global third dose coverage was estimated at 60%[2]. This is contrasted sharply by the situation regarding adult vaccination. Despite WHO recommendations, only 31 countries currently include adults in the pneumococcal vaccination schedule. Coverage rates are often lacking in countries with a programme in place, and the implementation is suboptimal.

It has been estimated that between 2004 and 2040, the economic burden of pneumococcal pneumonia will increase by US $2.5 billion per year[3]. A global burden of disease study on lower respiratory tract infections (LRTIs) indicated that in 2016, a total of 2,377,697 deaths occurred from LRTIs in people of all ages. Of these, close to half, or 1,080,958 deaths, occurred in adults over 70 years of age[4]. Streptococcus pneumoniae was the leading cause of LRTI morbidity and mortality globally, causing more deaths than all other etiologies combined in 2016. As the population ages, the at-risk group is increasing. Despite nearly half of current deaths already being associated with older adults, adult pneumococcal vaccination remains a low priority for policy makers in most countries. This is a major mistake.

Health system recommendations are not the only issue. Perceptions and visibility of the pneumococcal vaccine also limit uptake where they are available. One assessment suggests that the two most cost-effective adult vaccines are flu and pneumococcal[5], but the pneumococcal vaccine uptake is much lower. A survey conducted by the International Longevity Centre (ILC)[6] found that in adults over 50 across a number of European countries, 94% had heard of the flu and COVID-19 vaccines. Still, only 42% had heard about the pneumococcal vaccine. This lack of knowledge translated directly into uptake rates. Flu vaccine uptake was 59%, 85% got the COVID-19 vaccine, while only 18% got the pneumococcal vaccine. “We know that knowledge is a key driver for vaccination…when people aren’t aware a vaccine exists, they won’t get it,” said Arunima Himawan, Senior Health Research Lead, ILC, UK.

Need for policy prioritisation and igniting longer-term thinking amongst decision-makers

Scientists working in the field of pneumococcal disease and immunisation feel that a key challenge is convincing policymakers to implement strategies within their five-year election cycles. This focus on reelection often favours spending on the immediate and the concrete rather than on prevention policies which will pay off over decades.

“Now, how can we make the same argument for adults? I think the argument is beginning to emerge in the concept of healthy ageing and living, and there are dividends in this. Healthier populations result in higher economic productivity and more societal cohesion. I think these are the things we need to be framing to policymakers,” said Dr Sipho Dlamini of the University of Cape Town, South Africa.

Policymakers make the same errors in value calculation over and over again. Officials calculate value in the short term without looking at the associated costs. The narrative must shift from thinking of pneumococcal vaccination as just preventing hospitalisations directly from the illness.

Many of the longer-term effects of pneumococcal infection are delayed and masked. Myocardial infarction risk is significantly elevated following a bout of pneumococcal infection[7]; however, due to the delay or a focus on the immediate issue of the myocardial infarction, the diagnosis of the infection may not occur. Without clear visibility of an issue, and a lack of data, there is no immediate political incentive to address it.

The relationship between viral and bacterial infections is another matter that must be highlighted. In many instances, a viral infection may be an instigator of a secondary infection from a bacterial pathogen.

Antimicrobial resistance (AMR) brings enormous costs — even in 2013, the US Centers for Disease Control and Prevention estimated that antimicrobial resistance added $20 billion to direct healthcare costs in the United States alone and a further $35 billion in loss of productivity annually. Vaccines reduce antibiotic use and this slows AMR, especially in life-threatening illnesses such as pneumonia where clinicians are reluctant to postpone treatment until lab results on bacterial susceptibility are available.

If a policymaker wishes to implement longer-term strategies, they must be reelected. It is vital, therefore, to have evidence-based information available to them. To justify the immediate expense of vaccination campaigns, they also need immediate rewards that alert the electorate or their superiors to their far-sighted decision-making. This might come from social media posts or press events with heads of NGOs and professional societies or through recognition in international comparisons.

Productivity as an incentive for vaccination

Productivity may be a critical narrative focus for adult immunisation. Politicians, in the face of an ageing society, are more interested in getting older people to stay in work.Employers may fund vaccination too to keep an older workforce engaged and productive.

Population demographics across the globe are aligning to effectively make it a necessity for adults to work into older ages. The world’s median age has been projected to increase from 31 to 36 by 2050. Europe is projected to have the oldest median age, at 47 years[8]. A considerable, and ever-increasing proportion of the population will fall into the over-65 category. Keeping these individuals healthy and productive will be essential to the economy.

Businesses must also be persuaded of the merits of adult vaccination, as they both directly benefit from them, and can also be one of the most powerful advocates for changes in government policy. “The reason that Rotary was so successful in their polio campaign was that they had so many business leaders there who could influence governments and had access,” said Michael Moore, former member of the ACT Legislative Assembly of Australia and Former District Governor, Rotary.

Younger workers also benefit, as they will not be taking time off work to care for their older family members.

Delivering the data to policymakers

A very small proportion of health budgets is earmarked for preventative health, and less specifically for immunisation and even less for adult immunisation. According to ILC UK, if preventative health spending increases by just 0.1% of GDP, it could unlock a 9% increase in annual spending by people aged 60 plus and an additional 10 hours of volunteering[9].

Data may not be enough; we need charismatic individuals. Australia is a clear example of the benefits of having a champion to rally around. Professor Ian Fraser, one of the inventors of the HPV vaccine, had a significant impact on the uptake of the vaccine by the government and was named Australian of the Year. Having a well-known, trusted advocate can be invaluable in providing policymakers with support.

Clear messaging, confidence, and convenience

Often unclear messaging permeates where vaccines are available, and this can have an impact on coverage rates. South Africa has provided a case study on how to address this. A group from a number of medical disciplines met with the aim of producing a simple-to-use guide. “The idea is that you produce a one-stop document. So any clinician anywhere, whether it be a GP or other specialist can say, I’ve got a haematology patient, how should I give vaccination? And the document is there.” said Dr Sipho Dlamini. This massively simplified the process and allowed for standardisation, overall improving access. It also meant that cardiologist, rheumatologists, diabetologists and others could be reassured that their own colleagues had endorsed the guidelines.

Confidence and awareness play important roles in the acceptance of vaccination. However, convenience is a factor that is often overlooked. “Older adults may need to rely on their children and their schedules to be able to take them to get the vaccines. That can make a very big difference,” said Lois Privor Dumm, Johns Hopkins Bloomberg School of Public Health.

A documented success story is the availability of vaccines through pharmacies. Pharmacists are a well-trusted source, but they’re also convenient, and many people are used to going to their pharmacy much more regularly than a general practitioner.

If we are to convince both policymakers and the public that adult vaccination for illnesses such as pneumococcal disease is a necessity, the narrative must shift. The health of older adults has an impact on the entire community. Vaccination has a significant positive economic impact on the productivity of older adults, the people who are taking care of older adults and the people who rely on older adults for childcare. Much like childhood vaccination, life course immunisation is an investment opportunity that will pay dividends for years to come and improve the health of the population.

[1]https://www.cdc.gov/pneumococcal/index.html#:~:text=Pneumococcal%20%5Bnoo%2Dmuh%2DKOK,to%20help%20prevent%20pneumococcal%20disease.

[2] WHO Immunization Coverage https://www.who.int/news-room/fact-sheets/detail/immunization-coverage

[3] Wroe PC, Finkelstein JA, Ray GT, et al. Aging population and future burden of pneumococcal pneumonia in the United States. J Infect Dis. 2012;205(10):1589–1592. doi: 10.1093/infdis/jis240

[4] Anderson R, Feldman C. The Global Burden of Community-Acquired Pneumonia in Adults, Encompassing Invasive Pneumococcal Disease and the Prevalence of Its Associated Cardiovascular Events, with a Focus on Pneumolysin and Macrolide Antibiotics in Pathogenesis and Therapy. Int J Mol Sci. 2023 Jul 3;24(13):11038. doi: 10.3390/ijms241311038. PMID: 37446214; PMCID: PMC10341596.

[5] Leidner AJ, Murthy N, Chesson HW, Biggerstaff M, Stoecker C, Harris AM, Acosta A, Dooling K, Bridges CB. Cost-effectiveness of adult vaccinations: A systematic review. Vaccine. 2019 Jan 7;37(2):226–234. doi: 10.1016/j.vaccine.2018.11.056. Epub 2018 Dec 4. PMID: 30527660; PMCID: PMC6545890.

[6] https://ilcuk.org.uk/european-pneumococcal-vaccination-a-progress-report/

[7] Ohland, J., Warren-Gash, C., Blackburn, R., Mølbak, K., Valentiner-Branth, P., Nielsen, J., & Emborg, D. (2020). Acute myocardial infarctions and stroke triggered by laboratory-confirmed respiratory infections in Denmark, 2010 to 2016. Eurosurveillance, 25(17). https://doi.org/10.2807/1560-7917.ES.2020.25.17.1900199

[8] https://www.imf.org/en/Publications/fandd/issues/2020/03/infographic-global-population-trends-picture

[9] https://ilcuk.org.uk/major-conditions-strategy-time-to-act-on-prevention/

The post An Ageing Population Underlines Need for New Strategies to Improve Uptake of Adult Pneumococcal Immunisation appeared first on Medika Life.

Researchers published a study that shows people with severe mental illness are almost twice as likely to have more than one physical illness. This shows how important it is to look at how mental and physical health are connected. The study looked at data from 194,123 psychiatric patients around the world and compared them to 7,660,590 people in control groups. But this study, while highly relevant to the topic, didn’t address the consequences of cultural notions of “old” even though we know this has gained increased fluidity in recent years.

On a personal level, people from different cultures have different ideas about how to deal with getting older. However, people from Mainland China, India, Malaysia, Russia, and New Zealand thought that society was neutral or slightly positive about getting older. All cultures agree that getting older means losing your physical attractiveness, finding it harder to do everyday things, and learning new things. In Eastern societies, people were a little kinder to older people.

It is expected that there will be 94.7 million older people in the United States alone by 2060. This is almost three times as many as there were in 2000. Which of them will be viewed as “old,” and how will the concept of “old” have changed by then? Is a psychology professor correct when he said, “the pandemic helped reinforce images of older people as sick, frail, and isolated — as people who aren’t like the rest of us” or is he failing to see that we have stoked some areas of business against older adults and rooted them out of the workplace because they were too old for the techno climate? Of course, salaries always play a role, and it’s not necessarily technology but age and health insurance premiums that are the driving forces here.

But finance may play an emerging role in how we view older adults (stop saying “old people”) because we note that the age at which Social Security will be re-aligned is aiming at 70 years. Money is always an issue in most things, and here it can have a dramatic impact on both the self-esteem and the financial situation of older adults.

Did you know that the Social Security disability system (which views 55 as “advanced age”) has a quiet little secret? They don’t believe anyone over 55 can find a job if they’ve lost theirs, and any health impairment may be acceptable for benefits. I know this from personal experience as a prior medical consultant for them. It seems Social Security has bought into this type of discrimination, too.

Not that I’m advocating for people to work longer, but if they are healthy and fit, why should they be sent to Coventry at 65? Even France is looking at pushing their retirement age up from 62 to 65, and people there are up in arms. They get three weeks of vacation anyway, far better than the American worker. Yes, there are exceptions to this vacation policy in the US. Some companies provide three weeks of paid vacation after ten years of working with them and after eleven years an employee is considered “fully vested,” meaning they are eligible for retirement benefits if a pension system exists at that corporation.

The age myths are corroding the potential in cultures that need both the experience, the wisdom, and the talents of their older citizens. Different older people have different levels of physical and mental ability. Some 80-year-olds are as strong and smart as 20-year-olds, while others may need a lot of help with basic tasks like eating and dressing. Policy should be made to improve the functional ability of all older people, whether they are strong and independent or need a lot of help. A very small number of older people need help from others. Older people make important contributions to their families and communities.

Age does not mean someone is less capable. This is even more important as the population ages. Older adults deserve respect, consideration, and understanding, just like everyone else. As the population ages and grows, so should we. We should welcome the older generation, build on their strengths, and keep making our world more understanding and welcoming.

And remember that you can teach an old dog new tricks. The assumption that today’s technocentric society means we must exclude those who never grew up with computers is hogwash. People can learn at any age, and I always look back at “The Nun’s Study” for wisdom on this.

The post “Old” Is Both a State of Mind and a Matter of Mental and Physical Health appeared first on Medika Life.

Three Ways to Adapt

We might get very lucky: artificial intelligence might take over a higher proportion of all work as the labour force shrinks and as lots of old people need more and more services. We might, but that is not what has happened in any previous technological revolution, as I explain below. AI may, though, solve the only problem that policymakers do worry much about: health could become more affordable.

There are only a few large areas of the world where the number of births is still well above two per couple. The young from those areas may need to move to places where many couples are having one child or none. Indeed, there may be a global competition for increasingly rare youth resources. It will require a radical shift in thinking about culture.

Neither of these mitigation approaches will be smooth or easy, so we need now to be focussed on making every child we have as healthy and productive as she can be. We also need to think about how to keep the disenchanted elderly at work: they are mostly able to work for longer but prefer racking up debts for the next generation while they enjoy an unsustainably long retirement.

The ageing world will soon come to dominate discussions about who pays what for health and much else. Those who think about it now will be best able to respond to the panic when it comes.

How we got here

Over the past fifty years, we have worried too much about overpopulation and not enough about shifting dynamics.

Fear of the consequences of overpopulation dates back at least to the Reverend Thomas Malthus, who started to publish his theories in 1798. Malthus argued that, however much technological progress might improve supply, exponential population growth would eventually exhaust the world’s resources. Scholars still argue about where he was right and where he was wrong, but he certainly did not foresee our current reality of few children.

The big error in Malthus’s thinking was that population growth would be exponential until crises caused it to plunge. Malthus was thinking mostly about famine;  Neo-Malthusians later pointed to an ecological collapse.  In the second part of the last century, the rise in the world’s population looked terrifying. The Earth’s population was estimated at three billion in 1960; by 1975, it was four billion; by 1987, it was five billion.  Today, it is eight billion, and the UN estimates that it will peak in 2086 at about 10.4 billion (another reputable forecast has a lower and earlier peak). That bolus of people in the second part of the twentieth century is the reason we now have such a rapid shift in the average age on the planet. When I first started working in the field in the late 1980s, some still thought Malthus might have had a point and that the spurt might be a long-term trajectory.

The shortcomings in Malthus’s reasoning were obvious, albeit in hindsight. Europe’s population growth was long over, and its pattern would be replicated in most of the world. The most charismatic of those who explained the process was Hans Rosling, a professor of international health at the Karolinska Institute in Sweden. Rosling’s key theory was mainstream, but he explained it much better than most demographers. (I can’t begin to do justice to his genius as a communicator – have a look). “Only by raising the living standards of the poorest can we check population growth,” he said. Specifically, child survival was key to lowering the number of children that each couple decided to have. As parents see their children surviving and as women gain access to economic opportunities, population growth screeches to a halt. Rosling’s powers of persuasion about the ties between survival and a lower birth rate were a large part of what got Bill and Melinda Gates to focus so relentlessly on child health.

For the great self-regulating mechanism to work, couples, especially women, need to have the ability to make their own choices about how many children to have and when –  a choice about fertility is also a fundamental human right for women. That means access to a range of family planning methods. A coalition of the fanatical, the misguided, and the evil have worked tirelessly since the 1950s to stop women from being able to make choices about their fertility.

The extraordinary sight of Vatican officials plotting with fundamentalist Islamists, African dictators and deluded radical feminists was, for me, the most abiding memory of the 1994 Cairo International Conference on Population and Development. (The Vatican thought its sincerely held beliefs should be imposed by law. The radical Islamists thought something similar. The dictators convinced themselves that large, poor, unhealthy populations would be a route to power. I never understood what possessed the radical feminists into believing that unplanned pregnancies would advance the rights of women)

Had the advocates of universal access to voluntary family planning won the day, hundreds of millions of women would have led better, happier lives and more children would have reached their potential in a manner that was often impossible in families too big for parents to support. Then and since, international efforts have had only limited success in meeting the gaps in family planning services

Had they done better, the global population would peak at a lower level, the demographic cliff edge would be less shear, and the climate crisis would be less severe. A decade ago, we worked with the Hewlett Foundation to promote policies based on voluntary family planning as one of the most cost-effective ways to mitigate climate change. I don’t think I have ever been so vilified or ostracised (and I was the head of communications for an AIDS charity in 1983!) No one was suggesting that women be forced to have fewer children, but that is how the debate was often heard.

The Cairo conference, those Hewlett-funded researchers and others working for women’s reproductive human rights have lived in the shadow of China’s coercive family planning policies and the short-lived attempts of Mrs Indira Gandhi and her son to bring those policies to India in the late 1970s.

I escorted a group of Western journalists to China in the mid-1990s as part of a Rockefeller Foundation-funded project on reporting population issues. The reporters asked about punishments, fines and forced abortions for women who had more than one child. Our hosts at the State Family Planning Commission told us, “You have misunderstood. The state is happy to provide all health, education and food to the first child; families are simply asked to contribute to the costs of further children.” The officials were lying.

The draconian one-child policy brought China’s population growth down very fast, but it entailed massive social pressure and frequent abusive treatment of couples who tried to have second or, heaven forbid, third children. Fines, exile to rural areas and even forced abortions were common as overzealous local officials tried to meet national targets. It has also left China with a plummeting number of people entering the workforce in the years ahead.

We find ourselves in a world of extremes: some women are still forced to have more children than they want, while it is only in the past few years that most Chinese women have had the freedom to have larger families. Booming economies have led to falls as fast as China’s in countries with no hint of coercion. The net effect will be a fundamentally unbalanced world.

If each couple has, on average, 2.1 children, the population will remain stable. Globally, couples had 2.3 children on average in 2022. Both India (2.0) and China (1.2) are below the replacement level, as is most of Europe and all of North America. The native-born population is falling precipitously in countries and regions including the Canary Islands (0.98), Hong Kong (0.8), Italy (1.3), Japan (1.3), the Republic of Korea (0.9), Singapore (1.0) and Ukraine (1.3). Countries such as Hungary and Russia have introduced policies of social pressure and incentives to boost the birth rate, with limited success, as both are still well below the replacement level. Countries with high immigration do better in the short term, but the immigrants seem soon to conform to the fertility patterns of the native-born.

Nineteen of the 20 countries with the highest birth rates are in Africa (the exception is Afghanistan). Several countries in West Africa face very fast-growing populations: couples in Niger, for example, still have 6.7 children per couple. Even well-organised and relatively prosperous Senegal still has a total fertility rate of 4.3. Most of the countries with high population growth, though, are very troubled: the Central African Republic, Chad and Somalia, for example.

By 2100, one estimate suggests that China’s population will have fallen from 1.4 billion to 732 million; South Korea’s population will have halved. Nigeria will have risen from 206 million people to 791 million. Nigeria, already densely populated, cannot support 800 million people; China probably cannot function with 700 million; South Korea, almost certainly, cannot support itself with 24 million. By then, over a quarter of the world’s population will be aged over 65.

This older world will need help. The two most likely external sources are artificial intelligence taking the place of many human workers and immigrants taking the place of ageing ones. Help from within will involve making the most of all of the human resources in mature economies.

Can AI save Europe, China and Korea?

“You should worry more about the clerical, white-collar jobs than the physical [jobs]. A large number of them will get replaced. So the question is: ‘What jobs do you create to replace those?’” said IBM’s chairman and chief executive Arvind Krishna at the World Economic Forum in 2023. Respectfully, I don’t think he needs to worry

The Industrial Revolution, which began in England at the end of the eighteenth century, brought a massive shift from an economy centred on production in family units to a system based on salaries and factories. Blacksmiths and seamstresses did badly, but most became mechanics or machine operatives; some earned less, but many earned more. Many had to move to new regions. The Industrial Revolution happened alongside a steady rise in population, but there appears to have been little long-term mass unemployment.

Imagine the reaction if you had told someone in the 1950s that there would soon be very few ledger clerks, shorthand typists or local bank managers, but there would be lots of personal trainers, baristas and app developers.

The history of technological breakthroughs is that new jobs and needs replace those that are lost. Out-of-work lawyers will find jobs we haven’t imagined yet. So we can’t rely on AI to make up for Korea’s 50 per cent drop in population.

There is likely to be one particularly important reshuffling of work. “When you get to medical school, all the complex math concepts, physics, and organic chemistry goes out the window. If there was one way to explain medical school, it was rote memorization.” wrote Kevin Jubbal, MD in 2016. These recall and matching skills are exactly the ones that AI will make redundant. AI has already been shown to be better than British GPs at diagnosing and treating bacterial infections and better than Indian health professionals at spotting early-stage leprosy. AI is better than pubic health doctors at predicting which populations are at high risk of heart disease and better than many oncologists at predicting which cancer patients will have a recurrence. A wholly autonomous surgery robot outperformed American human surgeons in suturing as early as 2016.

Soon, AI will be better at almost everything doctors do other than talking to patients, and most doctors are not nearly as good at that as nurses. The average American physician earned about $350,000 per year in 2022. Hospital and clinic services account for about 60% of US healthcare spending (while prescription medicines account for about 11%). We will still need hospitals, but they will be much cheaper to staff and run.

Technologies and medicines should become more expensive as the research required becomes more intensive, but AI may come to the rescue there too, with more efficient identification of targets and treatments and with more intelligent patient selection. Healthcare is likely to get much more affordable in the AI era

What About the Workers?

The shortage of workers will be exacerbated because each of us expects to work less and less.

Most of us are working many fewer hours than we used to and for a smaller proportion of our lives. In 1870, the average German worked 3,285 hours per year (yes, that’s about 63 hours a week for every week of the year); in 2017, she worked 1,354 hours. Americans had less of a decline – from 3,096 to 1,757 hours.  We also have much longer retirements: in 1870, there was no paid retirement for most (the first state payments for older people were introduced in Germany in 1889). By 1950, Americans received social security at age 65; by 2020, it was by 66. Average American life expectancy in 1950 was just over 68; by 2020, it was over 79 years.

The trend has accelerated since COVID. Many late fifty-somethings seem to have tried retirement and liked it; others are less able to work because of long waiting lists for hospital treatment or because they are worried about lack of care should they contract COVID. In the United Kingdom in 2022, there were almost 400,000 more economically inactive adults aged 50 to 64 years than in the pre-pandemic period (out of a total population in that age group of about 11 million). 

The closest historical parallel to fewer workers and shorter working lives may be the black death in Europe and West Asia in the fourteenth century. Between 30 and 50 per cent of the population died in wave after wave of the bubonic plague – over about the same period that Korea’s population will halve. The remaining workers soon realised the power that they had. It was the beginning of the end of feudal servitude in many places. Despite the best efforts of governments, answering to their rich patrons, wages rose and working conditions improved dramatically. The precedent is bad news for some major retailers and a delivery company that we won’t name because I don’t want my packages to start disappearing..

In the fifteenth century, education became more common and access to healthcare did seem to increase in most places, although it’s far from clear that was a good thing – bleeding and cupping probably did little for productivity. Today, we have the means to make much better use of the people we have, whatever jobs they end up doing.

Health is heavily determined early in life. Over the past twenty years, we have made remarkable progress in preventing diseases of childhood that can impair for life the children who survive them. Some of that progress is now being lost to Luddite anti-vaxxers whose malign influence is reaching from North America and Europe to Africa and Asia, and because of irrational constraints on access to care – infant deaths actually rose in the United States in 2022. Every human life has inherent value, but every child now has unprecedented economic value. We should be spending much more on their health. As societies, we must also find effective ways to stigmatise and marginalise the, often well-educated and persuasive, fantasists who look back with nostalgia to stone-age societies where people in their thirties were considered unusual survivors.

Older people have to work longer. This is not simple: witness the riots in Paris occasioned by the suggestion that the retirement age should rise very gradually. Older people are much more likely to vote than younger ones, so politicians listen to them. And, except for the political élite, most of the old seem not to want to work into their seventies.

The British Office of National Statistics looked at why those over 50 did not come back to work after COVID. Many of those findings can guide broader policies on keeping the mature productive.

Around one in five of the non-returners said they were waiting for medical treatment; this rose to 35% for those who left their previous job for a health-related condition. The UK health system is particularly dysfunctional but this statistic hints at a much more important economic issue: there is a longevity dividend if we keep older people healthy. As the International Longevity Centre UK has shown in an impressive and fascinating series of reports, “We know that countries that invest more in health see more people working, spending and volunteering and that investment in prevention drives a return. Spending just 0.1 percentage points more on preventative health can unlock an additional 9% in spending by older consumers and an average of 10 additional hours of volunteering across the G20.” (Here is a link to the India report. Those for other countries are on the same website. Here’s a link to something I wrote on the subject in 2022)

Healthy older people do not just work, they spend. Across the G20, which contains many emerging economies with young populations, 56% of total spending in 2015 came from families over 50.

For all the British over 50s, those who had left work and those who had stayed, flexible working and reasonable adaptation were key to staying employed. Those in their seventies probably do not want to work 40 hours a week; they might well want to work for 15, though. Does the job description for a 20-year-old shelf stacker have to be the same as that for a 75-year-old? Probably not, although age may not be the only reason to customise job requirements: in a time where people are scarce and AI is pervasive, maybe every job requirement should be tailored to the health, interests, capabilities and aspirations of every individual.

Among those currently in work, active employer support seemed an important factor in their decision to stay. Again, AI means that this will not require tripling the HR department.

We should note a few paradoxes in the British data that don’t seem wholly idiosyncratic. Those aged 50 to 59 were more than twice as likely to report mental health problems and disability issues as those aged 60 to 69. Part of that is because some of those in their sixties were going to retire anyway, but part is probably culture.  As someone who grew up in the 1960s and 70s, I know the downsides of a “just get on with it” attitude to pain and distress, but maybe we’ve gone too far in the opposite direction.

Big institutional employers seem to do a much better job of supporting older workers than hospitality or personal services firms. This is counter-intuitive. It should be much easier to have flexible, adapted work patterns in a hair salon than in a local authority. Maybe smaller employers are too worried about inadvertently breaking rules on age discrimination or creating grounds for action by an employee who feels disadvantaged. If so, this should be relatively easy to fix.

The Populist Nightmare

We can keep people employed more flexibly and longer but most societies will need workers and some Africans, especially West Africans, are not going to be able to survive in their home countries. Africans will need to migrate, and the rest of the world will thank them.

My undergraduate degree comes from an Alabama university that was, at the time, the late Governor George Wallace’s pet project (Governor Wallace is the one who barred the entrance to a university to stop the first Black student from coming in and set police dogs on civil rights marchers). Our required reading didn’t quite parallel Harvard’s. In political science, we were assigned Jean Raspail’s racist dystopia, The Camp of Saints. In it, Indians set sail for Europe and seized it – at the time, the scare was about birth rates in India. Africans from the north invade apartheid South Africa, and the Chinese invade Russia. Although it was first published in 1973, the book has had a surprisingly long-lived popularity, with Steve Bannon and Viktor Orbán among its fans. It is the inspiration for many populist memes about the demise of Western civilisation.

Among the book’s many flaws is the idea that Europe has always been stable, white and homogenous. Roman emperors were often North Africans or Middle Easterners. This is, in fact, the longest period in recorded European history in which Western Europe has been at peace. The last mass movement of millions of Europeans happened in living memory when ethnic Germans fled large sections of Eastern Europe after the Second World War. North America is even more turbulent, and the conflict over its transition from Native American (actually, mostly invaders from Siberia) to European and African was still going on at the end of the nineteenth century. For most of history, wars were the main business of states; invasions and enslavement were the main way of sorting out population imbalances.

Raspail is dead, so I’ll risk saying it: there aren’t really many, if any, French people. In Roman times, France was inhabited largely by Celtic tribes who were displaced and assimilated by invaders from the East. The Bretons are Cornish people, displaced by the Saxon invasions of the British Isles. The “Normans” who conquered England were actually Vikings who had come to France only decades before – the same Vikings went on to conquer swathes of Europe: the Kingdom of Sicily was largely run by blond, blue-eyed courtiers.

Even Raspail’s adherents aren’t actually “European”: Orbán’s ancestors arrived in Hungary from central Asia about 1500 years ago. I’ll spare you the rest of the history lesson; the point is that people have always moved to find land, jobs or simply new vistas.

People are moving, and more will move. We may be competing for them to come. The likelihood is AI will not create pools of the unemployed; in most of the world, the population will shrink and age very fast; and we will mostly decline to do what our ancestors did and work until two or three years before we die. Only Africa will have the people we need to staff our security forces, our care homes, our leisure industries and everything else that machines cannot do. Now, we have to figure out how to make this reality as welcome as it should be.

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They drew blood at the many clinical trial sites, psychological testing was administered and the families, dutifully and in hope, brought their affected loved ones week after week. The trial would go on with hundreds of supposedly healthy, but impaired, older adults agreeing to all of it. And yet there was one piece missing in the trials and no one noticed it. What was it?

We stood at a major medical center in the New England states and talked about the patients, the test results, and the findings. Among those peering at the data were several interns writing dissertations on the disease, each one looking for a scrap on which to pin their epic piece of professional accomplishment.

I had recently returned from a trip to the Mid-West as part of my travels to various centers and I had one question that bothered me. As a psychologist, they trained me to look at people, but not confine my questions to one person, but to look at the group. After visiting at least ten centers, something became apparent to me and I had to voice my concern.

“Where’s the data on the caregivers,” I asked the group. They looked at me as though I must be falling into Alzheimer’s grip, too. Data on caregivers? No one was collecting that.

We know people don’t live in vacuums, and yet here was a multi-million dollar grant, written over weeks, that concentrated solely on testing the patient in every regard but one, the social side. Sure, they had a scale for that. How did they prepare themselves for the day? Were they able to dress, close their buttons, and comb their hair? Could they recognize themselves in the mirror? How did they interact with others?

I remembered my interaction with a couple where the wife began crying. Her husband, a former editor of a well-known journal, was frequently in the basement, fashioning bayonets from kitchen knives. The reason? He said he’d have to defend them once “they” came. Who “they” were was never mentioned, but they were out there and they’d be coming.

She had to put a bracelet with his name and phone number on it around his wrist when he went out on his bicycle now because he often got lost. Driving was out of the question after several car accidents. But the bike didn’t prove a suitable solution, either. Now, he had to wait and prepare at home and couldn’t leave her alone because they were coming.

As I sat and listened to her and many other spouses over the months of my travels, I became convinced that the protocol had a flaw; nothing about the caregivers. We didn’t ask them if they were depressed or anxious, or how they got through this incredible journey into darkness. Most of the time, they sat quietly next to the patient. This was less to help our research than to encourage the patient to take part.

I recall the husband who tried to eat paperclips because he couldn’t decide what was food and what wasn’t. Often, he’d leave the couple’s seventeenth-floor apartment, and, once out the door, he didn’t know which apartment was theirs. He’d opened the only door he found and was then locked into the stairwell.

Another patient, a woman in her 70s, once she took her eyeglasses off, couldn’t figure out how to put them back on. She also had difficulty at dinnertime, trying to eat the flatware instead of the food.

Imagine the frustration, alarm, and depression any of this can cause someone when it happens daily. How can anyone tolerate it without some help for their mental health?

We have diagnosed slightly fewer than seven million people in the United States with Alzheimer’s. If each of them has one caregiver, the number of people who require help with this disorder will be doubled. And, if things progress, thanks to medical advances, the number may quadruple in the next decade or two. But who is looking at the disease’s effects on caregivers, who, like the primary patient, are suffering from, if not with, Alzheimer’s?

I saw the mental torment of the man who had to drive his wife for almost two hours from their home to the testing center. “She kept changing the radio dials all the way,” he said, almost sobbing. “I couldn’t get her to stop.”

Then there was the extremely patient aide who had to keep coaxing an elderly woman with a promise of ice cream and lunch at a local deli. “All she wants to do is go for ice cream,” she said. The patient was delightful and used humor to answer every question. It turned out to be a common defense against memory loss and the pain it caused so many people.

One man, who had been married for almost fifty years, was on the verge of tears as he told me how his wife screamed when he tried to get into bed with her. “She keeps saying she has a husband, and he’ll come and find him there.”

Another man said that his wife was sure that someone was trying to break into their million-dollar home, so they had security systems put in at least three times. She never felt safe, whatever system was installed. And she kept firing the staff because she was sure they were stealing. In fact, she couldn’t remember where she’d put her jewelry and accused them of stealing it.

I turned to the group that day and asked what was the reason no measures were being taken for caregivers. As I recall, I said, “It’s a great resource for a dissertation any of you want to write.” I think that caught more attention than the computer screen.

Of course, that was two decades ago and we’re still trying to figure out how to help the other Alzheimer’s patients, the caregivers. How has the spread of this scary disease through social contact hurt their physical and mental health?

We have two groups that need to be assessed and treated, but we often fail to notice the second one.

The post The Forgotten Ones in the Tragedy of Alzheimer’s Disease appeared first on Medika Life.

Let’s cut to the chase and look at the six lifestyle interventions the study indicates slow aging:

• Diet
• Sleep
• Physical activity
• Relaxation
• Probiotics
• Phytonutrients

“How many loved your moments of glad grace,
And loved your beauty with love false or true;
But one man loved the pilgrim soul in you,
And loved the sorrows of your changing face.”
― William Butler Yeats, The Collected Poems of W.B. Yeats

Biological aging (senescence)

Biological aging, or senescence, is a complex process involving genetic, environmental, and lifestyle factors. Here are some of the major factors that contribute to biological aging:

1. Genetic factors: Aging has a hereditary component, meaning that certain genes can predispose individuals to age faster or slower than others.
2. Oxidative stress occurs when there is an imbalance between the production of free radicals and the body’s ability to neutralize them. Free radicals can damage cells, tissues, and DNA, leading to aging and age-related diseases.
3. Telomere shortening: Telomeres are protective caps at the end of chromosomes that shorten each time a cell divides. Over time, telomeres become too short to function properly, leading to cell damage and aging.
4. Epigenetic changes: Epigenetic modifications, such as DNA methylation and histone modification, can affect gene expression and contribute to aging.
5. Inflammation: Chronic inflammation can damage cells and tissues, leading to aging and age-related diseases.
6. Environmental and lifestyle factors: These include exposure to pollutants, UV radiation, and other stressors, as well as lifestyle factors such as diet, exercise, and stress management.

It’s important to note that biological aging is a complex process that involves many different factors, and scientists are still working to understand all the mechanisms involved.

Reversing biological aging

Do we have some evidence that we can reverse aging? For example, the first human study reported in 2019 showed biological age reversal of up to three years.

This small clinical trial from California (USA) suggested reversing our body’s epigenetic clock (the timekeeper for our biological age) is possible.

Nine healthy volunteers consumed a cocktail of three common drugs, including growth hormone and two diabetes medicines, for one year. On average, they shed 2.5 years off their biological ages, measured by analyzing genomic markers. The subjects also had signs of immune system improvements.

While the results were impressive (and surprised the researchers), the study was small and did not include a control arm. Here is Steve Horvath, the University of California, Los Angeles geneticist who performed the epigenetic analysis:

“I’d expected to see slowing down of the clock but not a reversal. That felt kind of futuristic.” The scientists published their findings in Aging Cell.

A separate study of obese African Americans with vitamin D deficiency discovered this finding:

The African American study subjects — deficient in vitamin D — reversed their biological age by 1.85 years in 16 weeks with a vitamin D supplement program.

For this clinical trial, researchers enrolled 70 overweight or obese African Americans with serum vitamin D levels of less than 50.

They randomized the participants into four dose groups, including 600 IU, 2,000 IU, and 4,000 IU of daily vitamin D3 supplements or placebo, followed by 16-week interventions.

The results suggested that vitamin D supplements may slow epigenetic aging. The study is not definitive, as it was small, short, and not randomized.

“The wisest are the most annoyed at the loss of time.”
― Dante Alighieri

Reversing biological aging — new evidence

In an eight-week clinical trial, multi-institutional researchers examined how diet and lifestyle intervention might reverse biological age. Here are the results:

The intervention, which included sleep, diet, exercise, relaxation guidance, supplemental probiotics, and phytonutrients, was associated with a 3.23-year decrease in biological age.

Each study participant followed this regimen:

1. A healthy diet with dense, colorful cruciferous vegetables; low glycemic fruits; and some animal protein (for example, eggs or liver). In addition, subjects consumed foods with polyphenol compounds, such as tumeric, curcumin, green tea, and mushrooms.
2. Hydration
3. Exercise for a minimum of 30 minutes daily, five days weekly, at a perceived exertion of 60 to 80 percent of one’s maximum.
4. Meditate regularly.
5. Sleep for at least seven hours per night.
6. Two supplements: extra polyphenols (a greens powder) and a simple probiotic.

The researchers designed each component, brick by brick, on what influences DUA methylation and epigenetics favorably. As one researcher put it, they aimed to “sweet talk gene expression and turn off bad genes, like genes associated with cancer or even inflammation, and turn on good ones.”

Lead author Kara Fitzgerald adds, “the best time to start implementing diet and lifestyle changes to impact your biological age is in your 30s as changes in the aging journey really kick in during our 40s.”

My take

Biological age reflects the rate at which you are aging physically. On the other hand, your chronological age is simply the number of birthdays that you have celebrated.

While we are stuck with our chronological age, a growing body of evidence indicates that you have more flexibility with your biological age. That is good news for those who aim to optimize our lifestyles, however imperfect we are.

Aging remains a central risk factor for both acute and chronic diseases. The recent study reminds me that we are moving closer to understanding how to wind back our biological clocks.

The post Stop Getting Older! Six Steps to Slow Aging appeared first on Medika Life.

In his groundbreaking On the Origin of Species, English naturalist Charles Darwin expressed the idea of natural selection. In this 1859 book, he reports the results of his research in the Pacific Islands and South America.

Natural selection is selfish; it favors traits that promote reproductive success. Selection pressure can take out deleterious genetic mutations that occur during early life and through our reproductive years.

Are you a giraffe with an especially long neck, a structure that allows you to feast on leaves others cannot access? With more food, you are more likely to survive to reproduce and pass your propensity to have a long neck on to your offspring. Your friends with shorter necks are less likely to survive to pass on their genes to future generations.

An adaptation is a physical or behavioral characteristic that helps an organism to survive in its environment.

In summary, we pass genetic mutations beneficial to our survival through reproduction. This process results in a new generation of organisms more likely to survive and reproduce.

On the other hand, once fertility stops, natural selection becomes less interested in what happens to our bodies — we become more likely to suffer from harmful mutations. For most animals, death often follows soon after fertility ceases.

The importance of elders

New research challenges the prevailing view that the natural selection force in humans must drop to zero once we complete reproduction. The secret sauce? Modern medicine? Nope. It’s grandparents.

Enter the Grandmother Hypothesis: Through their efforts, maternal grandmothers can increase their fitness by improving their grandchildren’s survival. Their daughters can have more children, and grandma’s genes are passed on to future generations.

Here’s what the researchers’ model yields:

“Elders are valuable, but only up to a point. “And not all grandmothers are worth their weight. By about their mid-seventies, hunter-gatherers and farmers end up soaking up more resources than they provide. Plus, by their mid-seventies, most of their grandkids won’t be dependents anymore, and so the circle of close kin who stand to benefit from their help is small.”

I appreciate my elders more than ever. Let’s celebrate older folks. Thank you for joining me today.

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