Wrinkles are a natural part of ageing, especially for the face, neck, hands and forearms. But some people are more prone to wrinkles based on sun exposure and other factors.
Although genetics mainly determine skin structure and texture, sun exposure is a major cause of wrinkles, especially for fair-skinned people. Pollutants and smoking also contribute to wrinkling.
While some people welcome their wrinkles as a sign of character, if your wrinkles bother you there are things you can do to minimise developing them.
Protect your skin from the sun: Protect your skin – and prevent future wrinkles – by limiting the time you spend in the sun and always wearing protective clothing, such as wide-brimmed hats, long-sleeved shirts and sunglasses.
Also, use sunscreen when outdoors, even during cloudy days. The American Academy of Dermatology recommends using a broad-spectrum sunscreen with an SPF of 30 or more.
Apply sunscreen generously, and reapply every two hours – or more often if you’re swimming or perspiring.
Use products with built-in sunscreen: When selecting skin care products, choose those with a built-in broad-spectrum sunscreen – meaning it blocks both UVA and UVB rays.
Use moisturisers: Dry skin shrivels plump skin cells, which can lead to premature fine lines and wrinkles.
Though moisturisers can’t prevent wrinkles, they may temporarily mask tiny lines and creases.
Don’t smoke: Even if you’ve smoked for years or smoked heavily, you can still improve your skin tone and texture, and prevent future wrinkles by quitting smoking.
Eat a healthy diet: There is some evidence that certain vitamins in your diet help protect your skin.
More study is needed on the role of nutrition, but it’s good to eat plenty of fruits and vegetables.
Alternative medicine: Many over-the-counter wrinkle creams and lotions promise to reduce wrinkles and prevent or reverse damage caused by the sun.
But these products are not likely to make a noticeable difference in your skin.
The US Food and Drug Administration (FDA) classifies these creams and lotions as cosmetics, which are defined as having no medical value. So, it regulates them less strictly than it does drugs.
This means that products don’t need to undergo rigorous testing for safety and effectiveness before approval to go on the market.
Because the FDA doesn’t evaluate cosmetic products for effectiveness, there’s no guarantee that any over-the-counter product will reduce your wrinkles.
If you’re looking for a face-lift in a bottle, you probably won’t find it in over-the-counter wrinkle creams. The benefits of these products are usually only modest at best.
The effectiveness of anti-wrinkle creams depends in part on the active ingredient or ingredients.
Here are some common ingredients that may result in some improvement in the appearance of wrinkles.
• Retinol – Retinol is a vitamin A compound, the first antioxidant to be widely used in nonprescription wrinkle creams.
Antioxidants are substances that neutralise free radicals – unstable oxygen molecules that break down skin cells and cause wrinkles.
• Vitamin C – Another potent antioxidant, vitamin C may help protect skin from sun damage.
Before and between uses, wrinkle creams containing vitamin C must be stored in a way that protects them from air and sunlight.
• Hydroxy acids – Alpha hydroxy acids, beta hydroxy acids (salicylic acid) and poly hydroxy acids are exfoliants – substances that remove the upper layer of old dead skin and stimulate the growth of smooth, evenly pigmented new skin.
• Coenzyme Q10 – This ingredient may help reduce fine wrinkles around the eyes and protect the skin from sun damage.
• Peptides – This ingredient has been used in products for wound healing, stretch marks, and now wrinkles.
• Tea extracts – Green, black and oolong tea contain compounds with antioxidant and anti-inflammatory properties. Green tea extracts are the ones most commonly found in wrinkle creams.
• Grape seed extract – In addition to its antioxidant and anti-inflammatory properties, grape seed extract promotes wound healing.
• Niacinamide – A potent antioxidant, this substance is related to vitamin B3 (niacin).
It helps reduce water loss in the skin and may improve skin elasticity. – Mayo Clinic News Network/Tribune News Service
Tom and Rosemary Ryan’s story parallels the story of Down syndrome these past 59 years.
Not only has the couple lived the joy, challenge and learning curve that accompanies raising a child with special needs, they’ve dedicated their lives to pioneering change in governmental support, educational opportunities and societal views.
“A lot has changed over the years,” Rosemary said. “We’ve come a long, long way.”
Like many parents of special needs children, love thrust them into the world of advocacy. When there was no preschool for their son, Rosemary started one.
When the concept of housing adults with Down syndrome in group homes instead of institutions was proposed, they jumped on board, landing smack in the centre of a national debate and garnering the attention of ABC-TV’s Nightline with Ted Koppel.
And, now, as their oldest son endures perhaps the cruelest of characteristics often associated with his condition – accelerated ageing – the Ryans are again at the forefront of the discussion.
Kevin Ryan is 59 but a checkup last spring revealed “he’s more like going on 70”, Rosemary said. “He’s gonna pass us up.”
Raising a child with Down syndrome is “perpetual parenthood”, Rosemary said, “if you are committed to wanting the best for them.”
Now in their 80s, the Ryans, who live in a retirement community, are simultaneously discussing end-of-life care for themselves and for their son.
Into the light
When Kevin Ryan was born in 1959, Tom and Rosemary felt the way many parents of newborns with special needs felt back then – alone.
The support and advice that today are showered upon parents of babies born with Down syndrome was nonexistent then, Rosemary said.
Three paediatricians examined Kevin and agreed he had the condition characterised by an extra chromosome.
“They called it ‘Mongolism’ back then,” she said.
The “new” thinking at the time was that the couple should take their newborn home, she said.
And that’s where the advice ended. Rosemary could find only one very dated guidebook at the library that she said was so negative, “I couldn’t get past page three.”
So she relied on her instincts and on training she’d received en route to becoming a paediatric nurse to get through the early years, she said.
“And we just kind of forged ahead,” she said.
The Ryans went on to have three more children, with their second son quickly passing his older brother developmentally. Rosemary gave up her nursing career to stay home and care for the children.
Testing had revealed that Kevin was on the border of EMH (educable mentally handicapped) and TMH (trainable mentally handicapped), she said.
Those terms have fallen from the lexicon, along with “Mongolism”, but what Kevin’s score meant, Rosemary said, was that he’d struggle in an academic programme, but likely excel in a training setting. They chose the latter.
“Back in 1962,” she said, “public schools had EMH but no TMH.”
Rosemary and another mother then decided to start a school in a nearby church. They set up an advisory board with a host of professionals and townspeople, and hired two teachers.
Kevin attended for a year and a half, until Tom, who had given up teaching high school to work at State Farm Insurance, was transferred to the south suburbs.
Tom has seen society’s changing attitude towards Down syndrome in caring for Kevin over the past 59 years.
Changing laws and attitudes
While Rosemary had been organising a school, other parents were doing the same elsewhere.
In 1965, Kevin began at privately run Happy Day School.
Ten years later, Public Law 94-142 mandated that public school be available to all kids ages three to 21 (later extended to age 22), and Kevin transferred to Speed Development Centre. Speed, Tom said, “was the creme de la creme” and Kevin continued there until he turned 21 and returned to Happy Day for adult workshop.
The end of public school life often is a time of great concern and confusion for parents of children with special needs, Tom said, particularly if they haven’t planned ahead.
“Some people choose to have their adult kids just stay home,” Tom said, but that can lead to problems if the parents’ health begins to fail.
Kevin continued attending workshop at Happy Day and living with his parents until 1995.
Down syndrome is the most commonly occurring genetic condition, said Linda Smarto, director of programmes and advocacy at the National Association for Down Syndrome (NADS). Approximately 6,000 babies with the condition are born each year in the United States, Smarto said.
That translates to one of every 730 live births, a number that seems to be on the rise, she said.
“When my daughter was born 24 years ago, the number was one in 1,200,” she said.
“Eighty-five percent of (these) children are born to mums 35 years old and younger,” she said. “So it’s a great myth that (Down syndrome) only occurs to parents who are older.”
While individuals with the condition develop more slowly at the beginning of life, the end of life seems to rush at them. Not everyone with Down syndrome is afflicted with premature ageing, Smarto said, but there does seem to be a precursor to that and Alzheimer’s disease.
“Down syndrome, (researchers) say, will find the cause for Alzheimer’s because (scientists are) really pushing to find some sort of a cure and learn why this is happening,” Smarto said.
The phenomenon can be heartbreaking for loved ones already wrestling with end-of-life care decisions. What to do with ageing children who have Down syndrome is a huge concern, Smarto said, especially if the individual has medical issues.
But, she added, it’s the same concern for anyone with a disability. And it’s the same for elderly adults who don’t have a living child to help care for them, she said.
If a sibling or other family member isn’t available to assist, an individual may be placed in a state-run home.
“Our goal is to have our individuals either live independently or with a family member,” she said.
Smarto said much of the evolution of Down syndrome inclusion is owed to parents like the Ryans, mums and dads who’ve helped usher in change by volunteering, serving on boards and doing the work. Many of the improvements in the special needs community, she said, is credited to parental advocacy.
In 1992, at the urging of NADS, the Adult Down Syndrome Clinic opened and the Ryans were introduced to Dr Brian Chicoine, and what Rosemary calls “a world of support”.
Rosemary calls Chicoine’s book, The Guide to Good Health for Teens & Adults With Down Syndrome, the “Dr Spock for parents of kids with Downs.”
Kevin continues to see Chicoine, these days for premature ageing symptoms. His hearing is declining, he’s having trouble with his teeth, he walks with a cane, Rosemary said.
In 2012, fearing their son might encounter early ageing issues down the line, the Ryans moved Kevin out of the group home.
“We got to thinking, if he was left in a group home environment and his physical or mental health declined, their only option is to put him in a (Medicaid) nursing home,” Rosemary said. “We didn’t want that.”
Good Shepherd Manor, Tom said, is the closest thing to a forever home. It serves 125 adults, many of them aged.
“They’re committed to lifetime care, no matter what happens,” Rosemary said. “If he gets dementia, if hospice is needed, they’ll take care of it.”
Now, Rosemary said, Kevin’s lifestyle mimics that of his parents. “We have every level of care we’re ever gonna need here, and so does he there,” she said.
The Ryans’ other children are scattered from Maine to Hawaii, with Kevin’s closest sibling living 1,000 miles away, so, Rosemary said, “If Kevin outlives us, we’d like him to stay at Good Shepherd because that’s what he’s familiar with.”
Raising Kevin has always been about choosing the best path for him, Rosemary said.
Special needs can mean special, or additional, considerations, she said, but the condition can also bring a special kind of joy.
Their son has had many positive life experiences, including participating in Special Olympics, attending Prairie State College, serving as a church usher and holding several jobs in the community.
“He’s truly been a joy,” Rosemary said. “But it is hard watching him age. You almost forget you’re a senior citizen because you’re taking care of a senior citizen.”
Kevin, she said, “is still funny. He’s still a character. He still steals the limelight at family get-togethers.”
And, Tom said, a quiet day is when Kevin calls only two or three times on his cell phone.
“In a way,” Tom said, “he is sort of the person who ties our family together.”
Although Dr John Langdon Down first identified the condition marked by an extra chromosome in 1866, it wasn’t until the 1970s that “Mongolism” was renamed Down syndrome.
“Some people,” Rosemary said, “like to call it ‘up syndrome,’ because the people who have it are more up than down.” – Chicago Tribune/Tribune News Service
Jerry Jackson, a retired accountant, described the accumulation of losses that accompany old age in concrete, mathematical terms.
When he and his wife moved to Rydal Park, a Jenkintown, Pennsylvania, retirement community, they joined an informal breakfast group of about 10. “They were a great bunch of people,” said Jackson, who is now 90.
Seven years later, “I’m still in the same chair as when everybody was here, but there are only two of us left, and we eat at different times.” Among the empty chairs is the one his wife of almost 70 years occupied. She died in May.
Coping with the deaths of friends and family members and the inescapable knowledge that time is limited for remaining peers is among the great emotional challenges of ageing.
“It sucks, period,” said Dorree Lynn, a 77-year-old psychologist in Charleston, South Carolina, who recently lost two close colleagues. “It starts in your 60s and gets worse.” Not everyone can overcome it, but those who are resilient enough to navigate this dance with mortality well can find wisdom and everyday joy made sweeter by the depletion of time.
Jerry Jackson having breakfast alone at Rydal Park retirement community, in Jenkintown, Pennsylvania. Jackson said that he was part of a group of about 10 friends who ate together when he first moved there. All but two are dead now.
Thelma Reese, 85
A retired professor of English and education, she co-authored The New Senior Woman and The New Senior Man and is working on another book about seniors.
She’s a believer in “doing things that take you out of yourself enough to widen your horizon a little” to improve mental health and prevent focus on the physical problems of old age.
It’s tough to lose old friends, either from death or growing apart. “You feel like you’re losing part of your history when they go.” New friends can listen to your stories, but you haven’t “lived and breathed it together”.
She is “extremely” conscious of her mortality and has been reading about psychologist Erik Erikson’s stages of development. His last stage (65 and up) is the age of integrity or despair. That resonates with Reese. Once you have a “sense of an ending”, she said, “it can either make you despair or make you think: ‘I’ve got to do something. I’ve got to get it done somehow’.”
Interviewing other seniors who are leading active lives helps her open up. “I’m interested in these people because they’re doing things I’m not. I admire them. I find it encouraging that they’re in the world.”
There’s no doubt that many elders let their social world contract. “They sort of shrink into a box,” said Reese, who lives in the Bella Vista neighbourhood of Philadelphia.
Pain and joy
Scientific evidence that isolation and loneliness are harmful, both physically and emotionally, is mounting. “Being by yourself with the shades drawn and not interacting with other people can be deadly,” said Stephen Scheinthal, a geriatric psychiatrist who is chair of psychiatry at the Rowan University School of Osteopathic Medicine.
And yet research also shows that, as a group, older people in decent health score higher on measures of happiness than young and middle-aged adults. (Scores sometimes dip a bit as infirmities increase.) This is true even though deaths are not the only losses the aged face. Many have also lost their independence and professional prestige. Friends and family members have moved away or cut ties.
What allows some people to thrive emotionally at a time when losses are piling up? How do they find the courage to care when they have so much experience with heartbreak?
The answer, according to experts and older people themselves, is not as simple as “you have to keep making new friends”, although that is a common part of the equation. It also helps to embrace the idea that life can have meaning and purpose at any age, to treasure the people who are left, to cultivate gratitude and seek personal growth. A sense of humour is invaluable. Curiosity helps, too.
Marc Agronin, a Miami geriatric psychiatrist and author of The End Of Old Age, said that more of his clients in their 80s and 90s still have friends from childhood around now than in the past because people are living longer. But, he said, the concept of loss has also changed with modern life. Families are smaller and more scattered. Friends may also have moved. Travel becomes more difficult with age. Older people often feel less connected whether their friends are alive or not.
This can all sound pretty depressing to younger people, but Agronin said many of us make a crucial error when we imagine how it will feel to be older. We forget, he said, that “we will be different people”.
Young Bin Lee, 81
Raised in both North and South Korea, Lee came to the US for advanced medical training in 1964. He had planned to go back to Korea, but his wife, also a doctor, got cancer, and they stayed. She died in 2000. Two good friends died this year.
He works four half-days a week as a neuropsychiatrist and is active in his church and Korean organisations. He loves opera. He has had heart surgery and a kidney transplant. His kidney came from his second wife, Eulie, whom he married 10 years ago.
Young Bin Lee, a neuro-psychiatrist, listening to his wife Euli play the piano in their home. He stays young by maintaining a younger mindset and keeping busy. “I focus on now … I will do my best until I die,” he says.
Asked about grief, Lee, a resident of Medford, quoted a character from the opera Nabucco, who said, “Lord, give us the courage to endure suffering.” Notice, Lee said, the character did not say, “Lord, do not give us any suffering.”
Keeping busy and maintaining a younger mindset help him live with loss. “I like to think I’m still in my 50s and 60s. At that age, you work hard. You take care of your children and you think about your grandchildren and try to study and learn more. That kind of lifestyle, I like that.”
He keeps his eye on today. “I don’t think about how long I’m going to live. I focus on now. I have no fear of dying, actually, but I will do my best until I die.”
Along with loss and decline, Agronin said, old age can mean “a simultaneous process of growth and development”. Ideally, perspectives broaden and people become more resistant to adversity.
Caroline Wroblewski, 75
She retired at 70 as director of a counselling and treatment programme for women in Washing-ton, DC. Never married, she has lost a sister and moved to be near her brother. Close friends have moved to Texas and Massachusetts. She counts leaving her beloved condo near Washington as a loss. She volunteers with hospice patients.
Wroblewski is clear-eyed about her mortality now that she is well past the halfway point in her life. “I am healthy, but I know I’ve lived longer than I’m going to live.”
Caroline Wroblewski in her apartment at Normandy Farms Estates retirement community, looking at momentos from her past. She volunteers to work with hospice patients and with some residents who are having memory problems.
Her deepest friendships are those established long ago, but she is forming strong relationships at (retirement community) Norman-dy Farms, too. One, Pat, is in her late 80s. They do jigsaw puzzles and water aerobics together.
“I am coming to love Pat. She’s one of my trusted friends here. … Granted, she is at the end of her life, but she’s very alive in the moment.”
One of her hospice patients was 89 and able to communicate only with her eyes. The day before she died, Wroblewski told her: “I just want you to know it’s been a joy working with you, being with you. I believe you’re already in the hands of God.” Wroblewski felt lucky to have had time with her. “I learned the most from her. She was just a gracious receiver. She had no complaints. She enjoyed the moment.”
Wroblewski treasures hearing the stories of older residents. “They’re my mentors right now. They’re in places where I have yet to go, and they’re helping me choose how I want to go there.”
Therapists recommend volunteering as a way to do something valuable and meet like-minded people. Learn a new skill. Get involved in politics. Join a book club. Friendships will follow.
At Rydal Park, Jerry Jackson organised a show of his wife’s photos from their travels as a tribute. He does not expect to ever “get over” her death but said, “You have to go on.” He’s still making new friends and is well aware that they need to make the most of their time.
“They’re friends today and tomorrow, and that’s fine,” he said.
A new group is starting to form. “Maybe that’s the beginning of the next (breakfast) table,” Jackson said. “I hope so.” – Tribune News Service/The Philadelphia Inquirer/Stacey Burling
Occupational therapy is not a career that one often hears about. However, the more this writer learns about the client-centred profession, the more impressed I become.
Occupational therapists are professionals who work with individuals of all ages and abilities, to address the difficulties – psychological and physical – that hinder them from living their fullest lives.
“Occupations” refer to the daily activities that people do as individuals, in families and within communities to bring purpose to their lives. In a nutshell, the primary goal of occupational therapy is to help people to participate in the meaningful occupations of everyday life, easily.
In May, occupational therapist and dean of the Perdana University School of Occupational Therapy (PUScOT), Professor Nathan Vytialingam, 65, was conferred the World Federation of Occupational Therapists Honorary Fellowship at the 17th Congress 2018 in Cape Town, South Africa.
The accomplished Malaysian proudly made history as the first person from the Asean region to receive this award. Since 1954, there have only been 41 such Honorary Fellowships conferred.
According to the World Federation of Occupational Therapists (WFOT), this is the highest functioning award for outstanding contributions and distinguished service to the profession. And with 44 years of experience and unrivalled achievement, it’s no surprise that Prof Nathan was honoured.
“I felt very emotional to have received a standing ovation from my colleagues. There are only 16 of us Fellowship holders in the world right now so it’s a real honour. I had a great mentor in the late Professor Dr Quazi M. Iqbal from Universiti Kebangsaan Malaysia who told me that, to excel, I should remain focused and stay the course,” says Prof Nathan.
An Ipoh boy, he was educated at St George’s Institution in Taiping, Perak.
“I always knew that I wanted to pursue a career in the field of health, but I didn’t want to become a doctor.
“I discussed my career path with the only speech pathologist in the country, who told me to go across the hall to the Occupational Therapy department. The rest is history. What appealed to me was the chance to work with children and adults with disabilities. It’s my calling!”
Professor Nathan Vytialingam (sixth from left), with Chief Operating Officer, Sarawak Convention Bureau, Amelia Roziman (fifth from left), president of the World Federation of Occupational Therapists, Marilyn Pattison (eighth from left), and the organising committee of the Asean Conference on Healthy Ageing 2017 in Sarawak. Photo: Handout
The professor graduated from the London School of Occupational Therapy in 1976 and was then awarded a Kellogg Fellowship to pursue his post graduate studies in Western Australia.
“There were days when we had to spend classes in a wheelchair or with our dominant hand in a sling! We did our chores and school work like that, which was illuminating, to say the least! We got a sense of what it meant to be disabled, which made us more empathetic.”
After graduation, Prof Nathan worked in Friern hospital in London and Singapore General Hospital before returning to Kuala Lumpur (University Hospital and General Hospital).
After practising for a number of years, the halls of academia beckoned and the good professor answered their call. He began teaching medical students at Universiti Kebangsaan Malaysia (1981-1990) and Universiti Putra Malaysia (2000-2013).
Professor Nathan Vytialingam.
In 2013, Prof Nathan accepted a position as Dean of PUScOT.
“I got the programme internationally recognised by the WFOT, and was one of the nation’s earliest educators on the topics of sexuality, disability and aged care. I also increased the number of clinical hours in the syllabus. Experience is the best teacher!” he says.
In his spare time, Prof Nathan plays an active role as advisor of the Malaysian Healthy Ageing Society (MHAS), where he has also served a term as president. In 2012, he was instrumental in organising the 1st World Congress on Healthy Ageing in Kuala Lumpur, an issue close to his heart.
“We had speakers from the healthcare industry and holistic medicine who shared global solutions for healthy ageing.”
The event’s success led to South Africa hosting the 2nd World Congress in 2015, and Turkey is getting ready to host the third next month.
The professor’s expertise did not go unnoticed and, in 2015, he was appointed a member of the advisory council of the Global Coalition on Ageing in New York.
When asked about the state of aged care in Malaysia, he replied: “The MHAS advises on issues of healthy ageing – regionally and internationally. We’ve also organised a conference on healthy ageing in Sarawak.” This conference will take place on Sept 22 and 23, in Miri. Prof Nathan will be one of the speakers. He will give an overview of healthy ageing and longevity, and speak about carers’ issues.
“Malaysia is signatory to treaties like the Madrid International Plan of Action on Ageing (2002). I’m sure that, with this present government, aged care will be a priority. Look at our Prime Minister – he’s the perfect example of healthy ageing!”
As for his future plans, the professor answers optimistically, “I want to write a Masters programme for PUScOT and ensure that the standards of the programmes I’ve set up are rigorously maintained. The WFOT is strict on standards, and the beauty of being recognised by the organisation is that it puts us on par with developed nations.
“I also hope Malaysia engages in more community outreach rehab programmes, especially for the elderly. They deserve to live lives of purpose and quality”.
How does the professor himself “age gracefully”? He replies, “I keep myself mentally and physically engaged. I challenge myself with new ideas to keep mentally active.
“Also, having a good circle of family and friends. I have warm and jovial people around me – that keeps me going and keeps me young at heart.
“Unwinding at the end of the day helps me to manage and reduce stress.”
His sons Kashvin, 31, and Kavish, 28, and daughter Kashya, 30, are following in his footsteps, in the sense of helping people. “They have community service at heart and have learned to do community work,” says Prof Nathan.
He ends with these poignant thoughts: “Everything I do is out of passion, not ego. It’s my patients and family who continually inspire me to reach greater heights. Being an occupational therapist has made me realise that my problems are minor in comparison to those faced by people with disabilities. It’s important not to sweat the small stuff”.
For more information on, and to register for, the Secrets To Healthy Ageing – Practical Advice conference to be held at Pustaka Negeri Sarawak in Miri, on Sept 22 and 23, go to http://healthyageing.org/ The registration fee of RM50 includes refreshments and a goodie bag worth RM100.
Ageing might be perfectly natural. But as experienced by the human body, it is beginning to look more and more like a disease – and a treatable one at that.
In a new study, scientists reveal ageing to be a process set in motion by the rise of malign forces called senescent cells, which progressively hijack the body and take it on a nightmarish joyride.
With advancing age, senescent cells take the wheel and the human body careens into disease states ranging from cancer and diabetes to arthritis, vision loss and dementia.
As senescent cells mount, our walking pace and cognitive processing speed slow, our grips weaken and disabilities mount. Eventually, driven by this accumulation of insults, we are driven off a cliff.
The final plunge cannot be avoided. But scientists are exploring a range of tantalising new ways to make the odyssey of sickness and frailty that precedes it a little shorter and less degrading.
They may even put the cliff a bit further in the distance.
It’s a science called senolytics – the dissolution or gradual decline of old age.
In research published on July 9, 2018, in the journal Nature Medicine, a group led by Mayo Clinic anti-ageing researcher Dr James Kirkland not only offers a clear look at the power of senescent cells to drive the ageing process, but also a pharmaceutical cocktail that, in mice at least, can slow, and even reverse it.
Even in mice who were already well along ageing’s path, the senolytic cocktail – a dose of the leukaemia drug dasatinib and the dietary supplement quercetin – drove down senescent cells’ numbers, tamped down the inflammation they cause, and reduced the level of disability that comes with age-related diseases.
When given to younger mice in which the ageing process was jump-started with a transfer of senescent cells, the anti-ageing cocktail forestalled the onset of age-related diseases.
And the anti-ageing effects of a single five-day course of the cocktail lasted for months, the equivalent in humans of more than a decade.
Compared to mice who aged normally, those who started getting the dasatinib-quercitin cocktail at an age equivalent to 75 to 90 years in humans ended up living roughly 36% longer, and with better physical function.
That extra lifespan did not come with an extra dose of misery either: in their final two months of life, the physical function of the treated mice was at least as good as that period in the lives of normally-ageing mice who died earlier.
That was seen in tests of walking speed, grip strength and hanging endurance given to the animals in their last weeks and months of life.
And after all the mice in both groups had died, Dr Kirkland’s team could find no difference in the mix of diseases that had caused their demise.
In human cells in a test tube and in mice bearing human senescent cells, the dasatinib-quercitin cocktail showed equally promising results, targeting senescent cells while leaving other cells intact.
The senolytic cocktail used on mice in the new study is already being tested in a human clinical trial aimed at gauging its safety in patients with chronic kidney disease, one of many diseases linked to ageing. The trial is expected to be completed by 2021.
Other proposed trials may test senolytic compounds using “optimised derivatives” of dasatinib and quercitin in patients with a variety of age-related diseases, the study authors said.
Those trials may also explore the usefulness of senolytic compounds in younger patients, including certain cancer survivors who tend to develop age-related disease prematurely.
Researchers are also exploring the use of the diabetes drug metformin as a senolytic agent.
Does this suggest the researchers have found a fountain of youth?
No, said Dr Kirkland, who is a geriatrician at the Mayo Clinic in Rochester, Minnesota. “And we’re not looking for one.”
The objective, he said, is not so much to extend the human lifespan as to extend the “healthspan” – the period during which a person can live a life largely free of disease or other impairments.
“What my patients want, and what I want for myself, my mother and anyone I care for, is a way to be independent and as healthy as possible in later years,” he said.
“Most people don’t want to live to 130 and feel like they’re 130. They’d rather feel like they’re 60.”
Dasatinib and quercitin appear to work synergistically to target senescent cells, which do not seem to develop a resistance to them over time, Dr Kirkland said.
He cautioned, however, that people hoping to forestall ageing should not start taking either the leukemia drug or the dietary supplement on their own.
“This is not a place for self-experimentation,” he said. Until safety trials are completed, he added, “we don’t know what’s going to happen.”
If they do prove effective, senolytic drugs could not only change the way many diseases are treated, they could change the way we age, Dr Kirkland said.
“You’re not playing whack-a-mole,” he said – treating a patient’s cancer, for instance, only to have heart disease strike her a few years later.
That, in turn, could reduce the social and financial costs of caring for the frailest elderly.
The appeal is obvious.
Compounds that target ageing’s basic processes “have now become the hottest thing” in ageing research, said Harvard University ageing scientist Dr David Sinclair, who was not involved in the new study.
“There’s a really exciting potential of senolytic drugs being used to treat a whole range of aging-related diseases,” he added.
In March 2018, a team led by Dr Sinclair published research linking frailty and other diseases of ageing to a decline in the production of blood vessels that feed the muscles.
In elderly mice, the team showed that administering a compound called nicotinamide mononucleotide (NMN) improved blood flow, increased endurance and reversed signs of ageing.
It did so by boosting the very cellular processes that are, in younger animals, spurred by vigorous exercise.
A handful of biotech firms are aiming to coax basic findings like these into human clinical trials.
One of them, Unity Biotech, is set to launch an early clinical trial of a drug candidate for osteoarthritis, one of ageing’s earliest, most ubiquitous and most disabling diseases.
The firm’s candidate drug, dubbed UBX0101, is described by the company as “a potent senolytic” that eliminates senescent cells by disrupting a protein interaction they need to survive.
Unity Biotech is also working toward clinical trials of drugs for glaucoma, macular degeneration and diabetic neuropathy – all considered diseases of ageing.
Dr Sinclair is advising another firm in Barcelona, Spain, in the development of senolytic compounds that would restore the body’s mechanisms of cellular repair, which falter with age.
One obstacle all potential senolytics face is the US Food and Drug Administration, which would have to approve such drugs for sale in the United States, but does not recognise ageing as an illness to be treated.
“Our biggest problem is regulation,” Dr Sinclair said. “It’s no more difficult to make an anti-ageing drug than it is to make a cancer drug.”
But the potential reward is great, he said.
“These drugs offer the possibility of keeping every part of the body healthier for longer,” he said. In the end, people will die quickly, perhaps when their heart or kidneys give out.
“The chronic, slow processes of death are pushed out and the fast ones take over,” Dr Sinclair said. “The last thing we want to do is keep people sicker for longer.” – Los Angeles Times/Tribune News Service