Ed.- Dr. Krup is the medical director of the RejuvenAge Clinic in London's premier medical centre- Harley Street. She is board certified by A4M and is a keen advocate of Anti-Aging Medicine.
She shall also be a speaker at the Third Monte Carlo Antiaging Conference ™, set for September 7-8, 2002 on the topic of; "The differences between a family practice and an anti-aging clinic." (Please see back page of this Bulletin for further details of this breakthrough conference).
In this article, Dr. Krup discusses the application of Bio-markers as an assessment for anti-aging medicine and treatment for the aging patient.
You will hear a lot in the field of Anti Aging Medicine, (also known as Longevity Medicine), about the Biomarkers of Aging. What does this mean? What are they?
To answer this, we must first look at what we mean by a persons age. Are we talking about their chronological age, (i.e. the number of years that have passed since their birth?), or do we mean their biological age, (i.e. the actual age at which their body is functioning?) The biological age may be equal to their chronological age, or may be younger or unfortunately, at times, older.
What determines an individual's biological age?
Medical Anti-Aging Specialists have agreed upon several Biological Markers which when measured, give a better idea of an individuals true age.
At the RejuvenAge Centre in Harley Street, London, we try to define and measure these and use them as a guide to improving a patients aging status.
These include General Medical Information, such as a thorough Medical History and Physical Examination, with particular attention to disease risk factors. Molecular tests are also performed, as well as routine blood tests.
These tests measure the known risk factors for disease, such as Blood Sugar, Cholesterol, Anemia and evidence of kidney disease, liver disease etc.
A specialized hormonal assay measure the levels of hormones circulating in the body. As many of these hormones decline with age, many people experience improvements to the signs and symptoms of the aging process, as hormonal levels are returned to more youthful "norms."
These hormones include thyroid, DHEA, estrogen, progesterone, pregnenolone, testosterone, melatonin and human growth hormone. Also the body's levels of certain crucial enzymes may be declining and so further appropriate tests are performed. We also screen for cancers to evaluate a patient's particular risk and susceptibility.
The Physical Examination should also include Body Mass Analysis and body fat, as well as muscle mass is documented. As we age our body composition changes, we make less muscle and change muscle to fat more easily and of course we tend to accumulate more body fat. Not only does the strength of our muscles decline but so do our muscle and joint flexibility. Accordingly, our endurance in sport declines. Therefore, our goal is to measure these biological values and try to improve them with anti-aging treatments.
One particular evaluation is The Biological Age Scan Machine that tests twelve Biomarkers, (which have been shown to decrease with age,) these include:
Auditory Reaction Time: (This is a test of how quickly you react to stimulus that you hear).
Highest Audible Pitch: (As we age, our hearing declines, particularly in the high frequencies. Measuring the highest frequency we hear is one way of documenting this deterioration).
Vibrotactile Sensitivity: (This test measures your sense of vibratory touch in the palm of your hand).
Visual Reaction Time: (This test is combined with Test 5, which measures the speed at which you react to a visual stimulus).
Muscle Movement Time: (This test, with Test 4 measures the speed with which your muscles in your fingers move after a visual stimulus).
Lung Forced Vital Capacity (FVC): (This tests the volume of your lungs based on your sex, age and size).
Force Expiratory Volume in One Second (FEV1): (This tests the rate at which you are able to exhale in one minute. This test is affected by lung disease, asthma, smoking and bronchitis emphysema).
Visual Reaction Time with Decision: (This test is combined with test 9 and measures how quickly you respond to visual stimuli).
Muscle Movement Time with Decision: (This test is combined with Test 8 and measures how quickly you respond with muscle movement).
Memory Length of Sequence: (This is a test of memory, how many numbers you can remember in a sequence).
Alternate Button Testing: (This measures the speed with which you can move between two places on the machine).
Visual Accommodation in Diopters: (This test is used to measure how adaptable your lens is. The lens must expand and contract to alter the distant vision regardless of corrective lenses).
The functioning of all body systems tested contribute to the quality of life, especially in later life.
If the patient wants a thorough skin evaluation, then a skin biopsy can be performed and the skin is evaluated for collagen and elastin content, as well as cellular degradation. For skin hygiene, strict avoidance of the sun is essential. Creams to hydrate and nourish the skin help to preserve youthfulness. As a general rule, my belief is the skin will appear better if the body is in optimal health.
In the future, routine testing of a cells chromosomal damage will be possible, as well as evaluating the cells telemeres. Chromosomal evaluation will include looking at the DNA in the cells, to prevent or slow breakdown and improve and increase the speed of repair. Telemeres appear to determine the life span of a cell and as we age these telemeres shorten. There is much research being conducted on ways to lengthen telemeres, which should theoretically slow or reverse the overall aging process.
So what can we do today?
I recommend all my patients begin as a first step, a strong nutritional support program. This is based upon the results of their Biological Age Scan. I also recommend nootropic medication, herbal supplements and numerous anti-oxidants be started.
The patient's progress and improvement can then be monitored. Furthermore, based on the patient's blood tests any deficiencies of thyroid, estrogen, progesterone, testosterone, DHEA and growth hormone may be detected and also treated accordingly.
The ultimate goal in Anti-Aging Medicine is to preserve what we have and to improve, if possible, our bodies and our minds, so we may experience good health and youthful vigor well into a ripe old age.