Aging

By
Ahmed Zahran
MD, Internal Medicine
“We are all amateurs; we don’t live long
enough to become anything else.”

Charlie Chaplin
Stages of life
Aging is a syndrome of changes that are
deleterious, progressive, universal and
thus far irreversible

Some gerontologists prefer to use the

word senescence
 ?Who is old

• Limit is usually 65 years (retirement)

• Young old(65-74)
• Middle old(75-84)
• The oldest old (85 and above)
 Theory of Aging
Programmed aging
Aging due to something inside an
organism's control mechanisms that
forces elderliness & deterioration
Structural damage
Is not the result of any specific controlling
program, but is the effect of the sum effect
of many kinds of environmental assaults
Structural Damage Theories
• Structural damage theories of aging are
based on the view that the molecular
components of cells, over time, begin to
malfunction and break down:
:Wear and Tear Theory
• the theory postulates that the daily grind of life,
in particular abuse or overuse, degeneration of
cartilage and eventual grinding of bone on bone
is an example of the aging process on body
joints, as wear and tear exceed the body’s ability
to repair.
Waste Accumulation Theory:
• As we age, our cells accumulate waste products
as a consequence of normal metabolic
processes in the cells. It is believed that this
build-up of toxic “sludge” eventually
compromises normal cell functions.
:Faulty Reconstruction Theory
As we age, the repair process begins to
produce faulty reconstruction materials
that compromise the repair job and
weaken the cell
Molecular Cross-linkage Theory:
Disruption of cross linking between protein
molecules (collagen found in skin ,
ligaments) and glycation of lipids and
proteins lead to disrup function of these
molecules with acceleration of aging
:Mitochondrial Damage Theory
• Theory postulates that the oxidative
processes occurring deep within the
mitochondrial membranes eventually
damage the organelle, leading to a loss
of function. Once mitochondria are lost
to the cell, they cannot be replaced,
leading to a gradual loss of energy and
function in cells over time.
Free Radical Theory of Aging
Free radicals are atoms, molecules and molecular
fragments
They are powerful oxidizing agents, created by
the cell’s own metabolic reactions and also
present in the environmentnt
The free radicals most critical to the aging
process include:
superoxide ion, hydrogen radical, hydrogen
peroxide and hypochlorous acid.
In general, free radicals are extremely unstable,
short-lived and very reactive chemically,
inflicting substantial damage and changing the
chemical nature of structural molecules within
the cell.
Programmed aging
Programmed senescence
Aging results from gene interference
with the ability to the cell to reproduce
Hormonal
Biological clock alters hormone
secretion resulting in tissue changes
Immunological
T-Cell function decline increasing the
chance of developing infection and
cancer
Telomere shortening
Shortening of telomeres in somatic cells
lessens the ability of cells to divide
Telomeres consist of the six-base
repeating sequence TTAGGG at the
end of each chromosome
Manifestation of aging

Gray hair
Menopause
Gradual reduction in height and weightloss
Lower metabolic rate,
Lower reaction times,
Declines in certain memory functions,
Declinesin sexual activityand
Functional decline in audition, olfaction, and vision,
Declines in kidney, pulmonary, and immune functions,
Declines in exercise performance, and multiple endocrine
changes.
Effect of aging on organ and systems

Cardiovascular

Slow heart rate

Increase blood pressure
Diastolic dysfunction
Postural hypotension
Atherosclerosis
Arrhythmias
Respiratory
Chest wall stiffness
Decline of maximum breathing capacity
GIT
Shrinkage of the root pulp
Decline of taste and smell
Decrease lower esophageal sphincter tone
Decrease liver weight
Tendency to constipation
Renal
Decreased GFR
Bladder wall changes
UTI
Urinary incontinence
Prostate problems
Liability to dehydration and volume
depletion
Liability to electrolyte disturbances
Endocrine
Decrease G H levels
Thyroid abnormalities
Hypoclcemia and hyperparathyroidism
Impaired insulin response to glucose
Decreased testosteron
Menopause
Immune system
Decrease size of thymus gland
Decreased cellular and humoral
immunity
Increased susceptability to infections
Hematological
Less response to increased demands
Less response to erythropoetin
Muscloskeletal
Decrease bone mass and density
Tendons and ligaments become more lax
Cartilage become more calcified
Liability to osteoporosis and fractures
Neurological
Brain shrinkage
Decreased ability to distinguish colors
Hearing loss
Change of sleep patterns
Decreased cognitive function
Memory disturbances
Delerium and dementia
Prevention of aging
Caloric restriction and periodic fasting
Vegetables and fruits
Avoid smoking
Exercise programms
Social life
Antioxidants
Early diagnosis of diseases