Aging is a multifaceted process impacting cells, tissues, organs, and organ systems of the body. Like other systems, aging affects both the adaptive and the innate components of the immune system, a phenomenon known as immunosenescence. The deregulation of the immune system puts elderly individuals at higher risk of infection, lower response to vaccines, and increased incidence of cancer. In the Western world, overnutrition has increased the incidence of obesity (linked with chronic inflammation) which increases the risk of metabolic syndrome, cardiovascular disease, and cancer. Aging is also associated with inflammaging a sterile chronic inflammation that predisposes individuals to age-associated disease. Genetic manipulation of the nutrient-sensing pathway, fasting, and calorie restriction (CR) has been shown to increase the lifespan of model organisms. As well in humans, fasting and CR have also been shown to improve different health parameters. Yet the direct effect of fasting and CR on the aging immune system needs to be further explored. Identifying the effect of fasting and CR on the immune system and how it modulates different parameters of immunosenescence could be important in designing pharmacological or nutritional interventions that slow or revert immunosenescence and strengthen the immune system of elderly individuals. Furthermore, clinical intervention can also be planned, by incorporating fasting or CR with medication, chemotherapy, and vaccination regimes. This review discusses age-associated changes in the immune system and how these changes are modified by fasting and CR which add information on interventions that promote healthy aging and longevity in the growing aging population.
{"title":"Fasting and calorie restriction modulate age-associated immunosenescence and inflammaging","authors":"Anteneh Mehari Tizazu","doi":"10.1002/agm2.12342","DOIUrl":"10.1002/agm2.12342","url":null,"abstract":"<p>Aging is a multifaceted process impacting cells, tissues, organs, and organ systems of the body. Like other systems, aging affects both the adaptive and the innate components of the immune system, a phenomenon known as immunosenescence. The deregulation of the immune system puts elderly individuals at higher risk of infection, lower response to vaccines, and increased incidence of cancer. In the Western world, overnutrition has increased the incidence of obesity (linked with chronic inflammation) which increases the risk of metabolic syndrome, cardiovascular disease, and cancer. Aging is also associated with inflammaging a sterile chronic inflammation that predisposes individuals to age-associated disease. Genetic manipulation of the nutrient-sensing pathway, fasting, and calorie restriction (CR) has been shown to increase the lifespan of model organisms. As well in humans, fasting and CR have also been shown to improve different health parameters. Yet the direct effect of fasting and CR on the aging immune system needs to be further explored. Identifying the effect of fasting and CR on the immune system and how it modulates different parameters of immunosenescence could be important in designing pharmacological or nutritional interventions that slow or revert immunosenescence and strengthen the immune system of elderly individuals. Furthermore, clinical intervention can also be planned, by incorporating fasting or CR with medication, chemotherapy, and vaccination regimes. This review discusses age-associated changes in the immune system and how these changes are modified by fasting and CR which add information on interventions that promote healthy aging and longevity in the growing aging population.</p>","PeriodicalId":32862,"journal":{"name":"Aging Medicine","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11369340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<p>The exhaustive and rigorous study of aging, especially healthy aging, constitutes a highly interesting area of research today, due to the demographic transition the world is undergoing with a dramatic increase in the proportion of older persons. Due to the imprecise capacity of health systems to be able to respond to this scenario,<span><sup>1</sup></span> a transformation and restructuring of priorities in public health and global health have been considered. In recent years, the United Nations declared the period between 2021 and 2030 as the decade of healthy aging, defining four principles that have the potential to impact the human rights of healthy longevity,<span><sup>2</sup></span> and the health outcomes of older persons.<span><sup>3</sup></span> These principles, accompanied by some objectives of the World Health Organization on aging and health, propose strengthening research on healthy longevity to impact, more than life expectancy, on healthy lifespan.<span><sup>4</sup></span></p><p>The term “blue zone” was coined by Poulain et al.<span><sup>5</sup></span> who arbitrarily defined it as a geographical area with a higher proportion of male centenarians compared to female centenarians (which is commonly the opposite case) in Sardinia. Despite this, the term has been used heterogeneously in some studies on extreme longevity, referring to areas or populations with high rate of centenarians, high life expectancy/healthy lifespan, high proportion of octogenarians and nonagenarians (but not centenarians), or very low prevalence of age-related chronic diseases in aged over 80 years old.</p><p>Dan Buettner, an American explorer, and journalist, is known for disseminating information about some “well-documented” blue zones,<span><sup>6</sup></span> which can be explored through documentary films on National Geographic and the Netflix series called “Live to 100: Secrets of the Blue Zones.” These zones include Okinawa in Japan, Sardinia in Italy, Nicoya in Costa Rica, Ikaria in Greece, and Loma Linda in California.<span><sup>6</sup></span> In these documentary films, anecdotes and experiences related to lifestyles, customs, and social behaviors typical of areas, where octogenarians, nonagenarians, and centenarians with favorable health phenotypes can be found, are shared. However, just as there are similarities, there are also significant differences in the demographic and clinical characteristics of these populations, which must be examined and discussed considering the evidence.</p><p>In a nonsystematic search in PubMed, there are no more than 12 documents published to January 2024 that include the term “blue zones” in their titles. What is even more intriguing, most of the available documents are reviews or correspondences where claims are made about lessons, outcomes, and special considerations regarding extreme longevity. These analyses often include people starting from the age of 65 (who are not extreme longevity candidates).<span><sup>7
{"title":"What are blue zones? An argument in favor of its definition based on the most successful model of biological aging","authors":"Ivan David Lozada-Martinez, Juan-Manuel Anaya","doi":"10.1002/agm2.12343","DOIUrl":"https://doi.org/10.1002/agm2.12343","url":null,"abstract":"<p>The exhaustive and rigorous study of aging, especially healthy aging, constitutes a highly interesting area of research today, due to the demographic transition the world is undergoing with a dramatic increase in the proportion of older persons. Due to the imprecise capacity of health systems to be able to respond to this scenario,<span><sup>1</sup></span> a transformation and restructuring of priorities in public health and global health have been considered. In recent years, the United Nations declared the period between 2021 and 2030 as the decade of healthy aging, defining four principles that have the potential to impact the human rights of healthy longevity,<span><sup>2</sup></span> and the health outcomes of older persons.<span><sup>3</sup></span> These principles, accompanied by some objectives of the World Health Organization on aging and health, propose strengthening research on healthy longevity to impact, more than life expectancy, on healthy lifespan.<span><sup>4</sup></span></p><p>The term “blue zone” was coined by Poulain et al.<span><sup>5</sup></span> who arbitrarily defined it as a geographical area with a higher proportion of male centenarians compared to female centenarians (which is commonly the opposite case) in Sardinia. Despite this, the term has been used heterogeneously in some studies on extreme longevity, referring to areas or populations with high rate of centenarians, high life expectancy/healthy lifespan, high proportion of octogenarians and nonagenarians (but not centenarians), or very low prevalence of age-related chronic diseases in aged over 80 years old.</p><p>Dan Buettner, an American explorer, and journalist, is known for disseminating information about some “well-documented” blue zones,<span><sup>6</sup></span> which can be explored through documentary films on National Geographic and the Netflix series called “Live to 100: Secrets of the Blue Zones.” These zones include Okinawa in Japan, Sardinia in Italy, Nicoya in Costa Rica, Ikaria in Greece, and Loma Linda in California.<span><sup>6</sup></span> In these documentary films, anecdotes and experiences related to lifestyles, customs, and social behaviors typical of areas, where octogenarians, nonagenarians, and centenarians with favorable health phenotypes can be found, are shared. However, just as there are similarities, there are also significant differences in the demographic and clinical characteristics of these populations, which must be examined and discussed considering the evidence.</p><p>In a nonsystematic search in PubMed, there are no more than 12 documents published to January 2024 that include the term “blue zones” in their titles. What is even more intriguing, most of the available documents are reviews or correspondences where claims are made about lessons, outcomes, and special considerations regarding extreme longevity. These analyses often include people starting from the age of 65 (who are not extreme longevity candidates).<span><sup>7","PeriodicalId":32862,"journal":{"name":"Aging Medicine","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/agm2.12343","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142130353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Frailty is a multidimensional syndrome associated with a decline in reserve capacity across multiple organ systems involving physical, psychological, and social aspects. Weakness is the earliest indicator of the frailty process. Multi-morbidity is the state of presence of two or more chronic diseases. Frailty and chronic diseases are interlinked as frail individuals are more prone to develop chronic diseases and multi-morbid individuals may present with frailty. They share common risk factors, pathogenesis, progression, and outcomes. Significant risk factors include obesity, smoking, aging, sedentary, and stressful lifestyle. Pathophysiological mechanisms involve high levels of circulating inflammatory cytokines as seen in individuals with frailty and chronic diseases such as hypertension, cardiovascular diseases, type 2 diabetes mellitus, chronic kidney disease, and anemia. Hence, frailty and chronic diseases go hand in hand and it is of utmost importance to identify them and intervene during early stages. Screening frailty and treating multi-morbidity incorporate both pharmacological and majorly non- pharmacological measures, such as physical activities, nutrition, pro-active care, minimizing polypharmacy and addressing reversible medical conditions. The purpose of this mini-review is to highlight the interrelation of frailty and chronic diseases through the discussion of their predictors and outcomes and how timely interventions are essential to prevent the progression of one to the other.
{"title":"Frailty and chronic diseases: A bi-directional relationship","authors":"Urza Bhattarai, Bijaya Bashyal, Anu Shrestha, Binu Koirala, Sanjib Kumar Sharma","doi":"10.1002/agm2.12349","DOIUrl":"https://doi.org/10.1002/agm2.12349","url":null,"abstract":"<p>Frailty is a multidimensional syndrome associated with a decline in reserve capacity across multiple organ systems involving physical, psychological, and social aspects. Weakness is the earliest indicator of the frailty process. Multi-morbidity is the state of presence of two or more chronic diseases. Frailty and chronic diseases are interlinked as frail individuals are more prone to develop chronic diseases and multi-morbid individuals may present with frailty. They share common risk factors, pathogenesis, progression, and outcomes. Significant risk factors include obesity, smoking, aging, sedentary, and stressful lifestyle. Pathophysiological mechanisms involve high levels of circulating inflammatory cytokines as seen in individuals with frailty and chronic diseases such as hypertension, cardiovascular diseases, type 2 diabetes mellitus, chronic kidney disease, and anemia. Hence, frailty and chronic diseases go hand in hand and it is of utmost importance to identify them and intervene during early stages. Screening frailty and treating multi-morbidity incorporate both pharmacological and majorly non- pharmacological measures, such as physical activities, nutrition, pro-active care, minimizing polypharmacy and addressing reversible medical conditions. The purpose of this mini-review is to highlight the interrelation of frailty and chronic diseases through the discussion of their predictors and outcomes and how timely interventions are essential to prevent the progression of one to the other.</p>","PeriodicalId":32862,"journal":{"name":"Aging Medicine","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/agm2.12349","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142130329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}