Dr. Gautham's

Neuro Centre

(Established in 1988)

A Neuro-Behavioral Medicine Clinic

Dr. Gautham's Neuro Centre
4/68 P C Hostel Road
Chennai, Tamilnadu 600031

ph: +91 98410 10197
alt: +91 44 4285 9822








Aging With Grace

As we enter the new millennium we are also crossing a watershed in human history. For the first time the likelihood exists that a child born today will live to see his one-hundredth birthday. Genetics will play a large role in determining just who will enter that select group. The prevailing wisdom is that, if grandma lived to a ripe old age, so might you. But in point of fact, lifestyle and location may play an even greater role than genealogy in determining longevity.

Aging is a multi-factorial process. It is influenced and modified by various genetic, biochemical, regulation, and other systems working at once, together, and  in close contact, making a direct or indirect (e.g. through other pathways).  impact on the aging process.  



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Mitochondriae are the powerhouses of the human cell. During their functioning some molecules (oxidizing agents) take electrons from other molecules or atoms. The resulting substances with missing electrons are called free radicals. Most of these free radicals are oxygen molecules or atoms. Free radicals are highly reactive, and always ready to give away the odd electron, or to accept one. After they find a pair for the lonesome electron, they lose their activity, but the atom that has just lost an electron becomes a free radical in turn. While this is a necessary part of metabolic process, too many free radicals cause a dangerous chain reaction that destroys cellular compounds and can damage DNA, proteins and lipids (fats). This is known as Oxidative stress.

Oxidative stress is the main reason for accelerated senescence. Free radicals can result in tissue degeneration and cause early programmed cell death. They attack proteins that regulate the functioning of the cells and modify them, disturbing protein function and accelerating the aging process. When synthesized protein is modified incorrectly, its function alters. Such errors lower vitality of organism and accelerate aging.

Free radicals also inhibit enzyme production, leading to chaotic collagen cross-linking by attaching glucose to collagen molecules in the skin. Such extensive collagen cross-linking causes the skin to lose its elasticity and produces wrinkles.

Metabolism, environmental toxins and pollution are the main reasons why free radicals exist. Metabolism is a part of life, sun and toxins are hard to escape.

Aging is also related to stress through the body's stress response. Negative stress increases our body's production of free radicals. This is because the pituitary stimulates the adrenal glands, which in turn produce the stress hormones cortisol, epinephrine, and norepinephrine. These chemical reactions set off a chain reaction resulting in still more free radicals. Therefore a life filled with negative stress inducing life events (death of a loved one, loss of job, strained relationship with loved ones, loss of a loved object e.g. money" etc) could hasten the aging process.

The only way to counteract free radical damage is to neutralize them as they appear.

Antioxidants such as vitamins E, C, carotenes and flavonoids are an easy target for free radicals. They catch free radicals and bond with them, but don't become free radicals themselves. As soon as a free radical is bonded with an antioxidant molecule, it loses its activity and is no longer dangerous. Anti-oxidants, either dietary or as nutritional supplements, are said to have a role in slowing the aging process.

While the Mitochondrial metabolism stimulates oxidative damage, each cell also has repair systems defeating it (reparative systems, apoptosis, etc.). The first of these is the longevity gene. This gene is named gerontogene or aging gene. These genes are concerned with the repair machinery components of the cell. When gerontogenes are damaged, the organism ages much fast. Some people are blessed with good genes that allow them to look younger longer as long as they pursue a healthy lifestyle. Others are not so lucky and develop gray hair and skin wrinkling earlier in life.  The second is the existence of undifferentiated stem cells that act as a depot in the regeneration of damaged cells. The third are intracellular processes that regulate growth and repair through cell division. Last, but not the least, sex hormones play an important role in maintaining youthful skin conditions. Adequate hormones result in skin moisture with significant increases in the numbers of elastic collagen fibers.  Aging accelerates with decreased hormone production.

This aging and renovation process is, strictly regulated. Some chromosomes carry parts at their terminal portions called Telomeres. Telomeres are the  "molecular clock" of the cell. After each cell division (growth and repair)  telomeres get shorter. When the telomere shortens to the critical stage, the intensity of cell division significantly decreases, causing the cell to age.

However, the source of the aging and renovation signals are of material nature (biomolecules). These biomolecules change during the life cycle and these changes may be related to factors such as

1.    Sun exposure

2.    Diet &  malnutrition

3.    Smoking

4.    Air pollution

5.    Infection

6.    Food Allergy

7.    Contact allergy

8.    Contact irritants and toxins

The two worst environmental aging factors are smoking and sunlight. The third large factor is nutrition. . Repeated exposure to UV radiation from the sun causes premature skin aging. This photo aging is characterized by wrinkles, mottled pigmentation, dry and rough skin, and loss of skin tone. Photo aging is becoming more important as people live longer with increased sun exposure associated with leisure time, outdoor recreational sports,  sun bathing and holes in the ozone layer. . Bad food choices over a lifetime can accelerate skin aging and add a variety of disease conditions that spoil skin appearance  

The skin is also a portal of entry for substances capable of causing injury. Of particular importance is the hazard from occupational exposure to pesticides (e.g., chlordane), cutting oils used by machinists, polychlorinated biphenyls (PCBs) from the soil, topical drugs, and poor quality cosmetics.

The other major factor is nutrition, A generation that has devoted itself to eating right and keeping fit has a far better chance of becoming centenarians than those who by circumstance or decision eat poorly and get little or no exercise. Thus, longevity may well be determined as much by our own desires as by our genealogy.  Middle-age men, who are not overweight, do not smoke cigarettes, and who have low blood pressure and low sugar levels have the best chance of aging well.  

When talking about "successful aging", attention inevitably turns to the physical aspects of growing older, and how changes in diet or physical activity may prevent age-related disease. However, researchers have known for decades that psychological and social well-being are inextricably linked to health and, as such, tied to quality of life. Three factors that have proven to be strongly related to well being in the aged are socioeconomic class, the extent of social networks, and the sense of control retained over life.  

Socioeconomic status is a variable that has been extensively studied and has been shown to have a pointed association with mortality rates. For persons above retirement age, increases in mortality rates have been shown for those who have the lowest levels of education, as well as those who are living at or near the poverty level. It remains unclear how education may impact mortality, and it may be that the association emerges due to a close relationship between level of education and overall socioeconomic position. The pathways between poverty and mortality have been more often discussed, with researchers suggesting that financially restricted individuals suffer from, among other things, poorer nutrition and lesser access to quality health care.  

Better living conditions with low exposure to the sun, adequate nutrition, timely and appropriate health care, affordability of nutritional supplements that battle the aging process, and less exposure to surface toxins can account for longevity and slowed aging in the affluent.  

Americans, who make it to old age, do so better than elderly people anywhere. One probable explanation for older Americans' longevity is the quality and availability of their health care. When people turn sixty-five, America becomes a country with universal health care. Americans on Medicare get virtually any care they need - new knees, coronary bypass surgery, transplants, whatever-without long waits. Other countries hold down costs by limiting the availability of expensive services and requiring patients to queue up, sometimes for many months.  

The strength and extent of social networks has also been associated with aging. Research has shown that individuals having little contact with family or friends have shown slower rates of recovery from illness and higher levels of stress. Studies have even suggested that extensive social networks offer protection against aging.  

A factor that has been repeatedly implicated in the social psychology of aging is a sense of control over life.  It is interesting to note that this is typically a measure of "perceived", rather than objective, control. In other words, it is more important that individuals believe that they exercise a sufficient amount of influence on the events that occur in their life, rather than actually doing so.

People age differently and experience aging differently based on heredity, lifestyle, and attitudes getting older usually signifies age-related discomforts such as

o   Retirement. Retirement is not the same for everyone. In general, those who foresee retiring to meaningful activities age better than those who can only see retiring from a job with no outside interests.

o   Changes in vision, hearing, and other senses. All of our senses tend to change with age. Our eyes have more difficulty focusing on near objects and adjusting to changes in light intensity. Our lenses gradually become clouded. We may have difficulty hearing tones that have a high pitch. Such changes may be especially fearsome for those who have cared for the elderly who experienced sensory loss.

o   Health. As we grow older, we become more likely to develop chronic health problems. Adjusting often depends on our prior health and how well the conditions can be controlled. Someone who has been healthy most of his life may struggle with the fear of health problems related to aging.

o   Mobility. Those who have been active may fear decline in strength, endurance, and mobility that may limit daily activities.

o   Memory. Aging is often associated with memory problems and this may causes a major concern to a person who is aging.

o   Death of spouse, other family, and friends. One of the most difficult changes is loss of significant people in one's life.

o   Income. Incomes usually decline at retirement. Since older people don"t know long they"ll live or what their expenses will be, they may be reluctant to spend money and/or worry about their financial security.  

The changes that many older adults experience can affect how they see their lives. Many may feel that they may lose their independence, and look upon aging as a loss of self-esteem, with a lack of confidence in their ability to live a meaningful life and continue to make valuable contributions to the community.

Fear of aging also results from a fear of isolation. With age, sociologic changes occur between aging individuals and family and friends due to the loss of peers and contemporaries -- a spouse, siblings, other relatives, old friends and neighbors. This can lead to isolation unless a concerted effort is made to stay socially active. Aging is also feared due to the physical infirmities of old age. Another fear is the fear of losing sexuality.

How does fear of aging develop? At some point in past, there was likely an event linking old age and emotional trauma. Whilst the original catalyst may have been a real-life incident like a grandmother who suffered through her old age, the fear can also be triggered by myriad, benign events like movies, TV, or perhaps seeing someone else experience trauma.

But so long as the negative association is powerful enough, the unconscious mind attaches a powerful emotion to any thought about aging. The most important changes people reported negative emotions about were in their physical appearance: hair color, amount of body fat, and vision.

Fear of aging, low self esteem, body image disturbance due to the external signs of aging are all factors that lead to cosmetic surgery. Research shows that majority of people who undergo age-masking cosmetic surgery are in the age group 45 to 54 years. . According to a survey by the American Society for Aesthetic Plastic Surgery, Americans spent $7.7 billion on 7 million cosmetic procedures, In 2002. This was more than triple the number in 1997. Women accounted for 88 percent of these. Men more commonly resorted to Rogaine and Viagra (2002 U.S. sales: $1 billion).

The discovery at, say, 51 that age is catching up with them or that life has disappointed, inspires some people to act as though they're 21. It's not simply that the mass media celebrate youth, beauty and vigor -- the ideal age seems to be about 26 -- and thereby taunt anyone younger or older. These are powerful forces, which are sometimes nudged along by something else -- a little old-fashioned "need to feel young".

Depression is a common mental health problem among older adults. This is due somewhat to the occurrence of aging related symptoms such as memory disturbances, decrease in the acuity of the senses, disability, physical illness, bereavement, loss of independence and security, etc.

So how does one prepare to age gracefully? It isn't stressful situations that age you or make you sick. It's how you react to them.

People who grow old gracefully are the ones who maintain a positive self-image. By contrast, an individuals who brood about the aging process and its effects on their bodies find aging difficult and their self-esteem suffers. The key element to successful aging, is how much emphasis people give to the aging process when they think about themselves. Those who handle aging successfully don't change their identity drastically as they get older. They do alter their behavior in response to physical changes brought on by aging, but basically, they don't start to think of themselves as 'old,' even if others do. On the contrary, they take aging in their stride, and prepare for it. Here is what they do:

Sufficient financial resources are the first condition. Retirement may bring financial hardship, and a corresponding change in lifestyle, so it is wise to plan ahead for your non-employment years. The key word in this condition is "sufficient", and research has shown that having more than enough money does not necessarily mean more happiness.  

Perceived good health is another condition for happiness in seniors. While age does bring with it a greater chance of illness, and diminished physical condition, it need not mean a bed-ridden existence. Proper nutrition and regular exercise go a long way in fighting age-related illness. However, it is the perception of one's health that matters more than the absolute condition. With the maintenance of a positive attitude, a person with minor, or even major ailments can still live a vibrant and active life.  

Having goals, in the form of a project or passion, is another condition for happiness in your retirement years. This may be something as simple as playing a musical instrument, or as involved as running a business. The main idea is to have an interest that fills you with a sense of purpose.  

Perhaps the most important determinant of happiness in old age is the maintenance of good relationships. For many seniors, this primarily refers to a relationship with a spouse. However, positive relations with family and friends also go a long way in increasing life- enjoyment, and have even been cited as a protective factor against dementia.  

New friends may never replace the lost closeness shared with someone who knew you before your hair turned grey, or before your first child was born. But the support network that comes with sharing life with peers can counter loneliness and goes a long way toward dispelling feelings of isolation. The more people you interact with daily, the more chance there is to form new bonds. The more people there will be to bond, with in years to come.

Here are some tips for growing young:

Eat fresh. Greens and fruits provide vitamins, minerals and antioxidants to boost your body's immune system.

Commit to exercise daily. Go for the great outdoors or grow your own garden for healthy, organic vegetables and fruits. You get exercise, fresh air and sunshine.

Reduce stress to lessen the strain on your nervous system. Meditate or pray for inner peace and serenity. The healing power of meditation and prayer is both psychological and physiological.

Adopt a pet. You'll be saving a life. Pet therapy produces good emotions which increase the endorphins in the body. Your immune system gets a boost.

Think positive. If you go around with a frown, it may become a permanent feature on your face. Be thankful for what you have and don't envy what you don't. Forgive and forget. This reduces stress. Practice positive anger management.

If all this is too cumbersome to follow, just remember that clean living and peace of mind helps you to age gracefully into the twilight years. You'll have less healthcare costs and thus less stress on money matters. Those whose self-esteem remains high do not give age related changes a great deal of thought even when they have significant health problems as well as normal age-related changes. They keep themselves involved and busy, focusing on the present and future, thereby keeping themselves mentally (and physically) young.