Facing the Truth of Growing Old

Kadi-Kai Eljaste is a graduate of the international master’s programme in Wellness and Spa Service Design and Management at the University of Tartu’s Pärnu College.

We are not immortal and losing spice in life as we age is natural – the question is how fast we will let it happen. Even though plenty of us are afraid of growing old, there is often no proactive and purposeful health behaviour seen. We still cannot prevent ageing, and the first signs we start to notice in ourselves and how we have suddenly aged is our appearance – the beauty of the skin, glow of the face, and the fitness of the body. It is a natural reaction to attempt to make changes after we start seeing the effects of the ageing process in the mirror. Conversely, practical evidence shows that people lead happier and healthier lives only after they finally give up on the idea that ageing can be undone by medical procedures and plastic surgery.

However, the more steps we take to implement a healthier lifestyle before the ravages of age start to appear, the better the chances of sustaining our quality of life as our age advances. It is for this reason that we should talk more about the power of prevention.

The effect of ageing

Ageing society – global and individual ageing

We are ageing not just as individuals or communities but as a world. According to the Natural Institute of Aging, in 2006 almost 500 million people worldwide were 65 or older. By 2030, that total is projected to increase to one billion – one in every eight of the planet’s inhabitants. Above all, the most rapid increases in the 65-and-older population are occurring in developing countries, which will see a jump of 140 per cent by 2030. According to the European Commission, approximately 18 per cent of the European population is currently 65 or older and by 2060 the elderly will outnumber children by more than two times. Moreover, the most senior group of people (80 or older) is growing faster than any other segment of the population.

The population in developed countries is living longer and life expectancies are steadily inching upwards. According to Westendorp and Kirkwood (The biology of ageing. Ageing in Society, 2007, pp. 15-37), human life expectancy has yet to settle at some ceiling imposed by genetic programming, which means that we are finding the basic mechanisms of ageing to be intrinsically more manipulative than had been previously thought. People are living longer in retirement, which results in increased travel, medical care, and medical tourism (travelling for health purposes). When we think about our increasing longevity, societies and economies need to be ready for an elderly population who wants to be part of an active living environment, work and travel, and all while being treated with respect.

Human ageing has many dimensions and at its heart it is a biological process. Physical ageing is its most visible face, yet human ageing is also a socio-cultural phenomenon. The way we perceive and interpret others’ comments and gazes, combined with their compassionate questions and well-intended considerations, may reflect our physical and functional age even more vividly than a mirror on the wall. So the community is ageing psychologically inside groups of individuals who are continuously reflecting each other and adopting lifestyle behaviours.

Individual ageing is characterised by progressive changes associated with increased susceptibility to many diseases and is influenced by genetic factors, lifestyle choices, and environmental exposures. According to Medical Doctor Rainer Arendt from Dolder Grand Spa in Zurich, the human ageing process can often be described by a loss of complexity – a general decline in physiological and behavioural function. He also claims that a person’s various body parts age differently; however, the ageing process can be delayed, accelerated or progress normally, and one’s biological age can best be seen from the outside – skin, hair, and nails.

Instead of waiting to see how our physical body loses all of its beauty and vitality, it is wise to take preventative measures and delay the ageing process. And here we are not only talking about how to live longer, but, even more importantly, how to prolong one’s health span – our years of healthy life. Extending one’s health span is what makes living longer a value well worth pursuing.

Behavioural and lifestyle factors such as smoking, physical inactivity, unhealthy diet, and obesity are commonly associated with the development of diseases such as cancer, heart disease, stroke, and diabetes. According to the World Health Organization, 80 per cent of premature deaths in Europe are caused by diseases such as cardiovascular diseases, cancer, and chronic obstructive pulmonary disease. These age-related lifestyle diseases are preventable and often avoidable, and there is much a person can do with the help of proper knowledge.

Another important factor that can greatly affect a person’s quality of life as he or she ages is his or her mental state. The physical toll that depression can have on an individual cannot be overstated. For example, the WHO stated that depression is the leading cause of years of healthy life lost to disability for both rich and poor countries alike across all regions in the world. This burden is only likely to increase in proportion to other diseases over the coming decades.

Researchers have found that based on telomere length, subjects in the study who suffered clinical depression for a period of two or more years actually aged seven to ten years, when compared to non-depressed people. To explain, telomeres are found in our chromosomes and their length provides researchers with useful information regarding one’s effective age. The longer the telomere length is the younger one’s effective age, so we can see why maintaining both our physical health and mental health are important to the quality of life that we lead while we age.

Longevity concepts that give us the power of youth

Last year Angelina Jolie revealed in the New York Times that she had decided to go through a preventive double mastectomy – removing both breasts to prevent cancer. She had learned through preventive genetic testing that she had the so-called faulty gene, BRCA1, which sharply increases the risk of breast cancer and ovarian cancer. Angelina’s doctors estimated that she had an 87 per cent risk of developing breast cancer and a 50 per cent risk of developing ovarian cancer sometime during her lifetime.

The effect on society that Jolie’s decision had to undergo preventive genetic testing followed by preventive surgery is now called “The Angelina Jolie effect” – taking steps to prolong one’s health span by not only avoiding diseases through prevention but also knowing our individual health risks. This example illustrates how preventive health behaviour will benefit one’s health span and how it could save lives. Prevention is an investment in our health, which expects us to take responsibility for our own well-being, become aware of our individual weaknesses, and be proactive.

Our aim should not be to look like a 20-year old in our forties, but to feel as energetic and happy as possible, to live a fulfilling life, and age gracefully. Age management means overall movement from inner health to outer beauty – starting with proper motivation, mindset, and mental health improvements; incorporating suitable exercise, eating, and sleeping habits; improving appearance by using dermatologists and aestheticians; and learning how to take proper care of ourselves independently.

These are deep lifestyle changes to implement into our daily routines and practice throughout our entire lives. It is vital to start with proper diagnostics and an individual “game plan” before jumping into action, because the possibilities are virtually unlimited and age management can be tailored to meet one’s individual needs and budget to the finest detail.

Age management is a lifestyle concept that includes a serious medical approach. It is the basis for anti-ageing medicine that deals with reversing the ageing process via accessing every individual’s peak performance from the inside as well as from the outside. Currently, terms like age management and anti-ageing medicine can be still used mistakenly because of their novelty. It is important to distinguish between age management and anti-ageing treatment, as these are fundamentally different approaches. The following table summarises the key characteristics of both concepts:

Age Management – the concept of leading our own ageing process Anti-Ageing Treatment – the concept of reversing one’s ageing process
Retaining and optimising health and well-being to delay the ageing process Reversing the ageing process to promote as youthful a look as possible
Improving individual lifestyle while using preventive health care services as well as medical interventions Implementation of aesthetic surgery and technological interventions
Prolonging health span to age gracefully Aiming for “peak performance” at any age to prolong health span as well as normal lifespan
Long-term health-beneficial results offering satisfaction with self-image at a later age of life Short-term visual results to offer a fast, rejuvenating effect

People do not just want to cope with ageing, they also desire to stay young and energetic while living longer than ever before. This is why one should look at integrating age management and anti-ageing medicine services in order to achieve the best possible results in a healthy way – offering the possibility for individuals to go beyond simply re-balancing the normal ageing process. Longevity concepts always need to give an individual the option to choose the level of their current health program. The “secret” of preventing premature ageing lies in combining the following treatments:

  • Genetic medicine (gene tests for body analysis, measuring biological age, creating a personal genetic portfolio)
  • Nutrition/Dietetics (e.g. weight management, micro nutrition)
  • Physical exercise (e.g. cardiovascular and strength training, yoga)
  • Mental health assessments (e.g. stress assessment, burnout management, cognitive behavioural therapy, mind training)
  • Beauty enhancements and appearance medicine (e.g. plastic surgery, cosmetology, cell therapies)
  • Workshops for correct breathing (e.g. meditation)
  • Body function evaluations (e.g. biophysical evaluation, stress tests)
  • Health consultations and regular check-ups (doctors in endocrinology or with a general medical background)
  • Detoxifying programs
  • Massage therapies

Age management ought to serve many aims: lifestyle changes, beauty enhancements, health maintenance and optimisation, delaying the ageing process and postponing age-related diseases as well as disability, and embracing the normal ageing process to reach longevity and prolong one’s health span.

Let us imagine a 75-year old woman running 11 km/h while receiving instructions from her personal trainer through Google glasses, and tracking her physical activity via Iphone and a heart rate monitor. This is possible even today; however, it is extremely uncommon and almost never seen because the elderly are often either not well enough to perform these tasks or not up to date with recent technological innovations such as these available for health care. What is possible in the near future is for the elderly to achieve this level of health, fitness, and knowledge, allowing them to reach beyond what is typically seen in people their age today – to make a career change, migrate to another country, participate in fitness competitions, using all the possibilities of high-tech, personalised medicine, and enjoying life as they did in their late thirties.

The best therapies to “grow back young” – losing years instead of just losing weight

In addition to our chronological age (age determined by the passage of time since birth), we have a biological age (age determined by physiology rather than chronology, estimating changes in the physical structure of the body, changes in the performance of motor skills, and sensory awareness). For example, a person can be chronologically 35 years old while biologically 38 years old. To help one look and feel younger than they really are does not mean a one-stop-shop treatment for the body, mind, and soul. Rather, these are therapies for a person to adopt into their lifestyle and turn into healthy habits so they will constantly influence their well-being, natural beauty, and thus delay the biological ageing process.

Before beginning to learn how to take our first steps towards the best version of ourselves, it would be useful to visualise the feeling of being old – becoming a bit overweight, apathetic, lacking vitality, being lethargic, and, moreover, losing interest in sex and having difficulties sleeping, concentrating, and remembering things. The elderly also tend to tire more easily. These are all common ageing signs that most of us will probably face in the future because they are mostly side-effects associated with the lack of human growth hormones.

This is certainly not the way most of us would like to envision ourselves in the future, especially when we imagine ourselves retired and finally having enough time to include all the hedonistic activities in our daily itineraries. While trying to reach Jeanne Calment’s age of 122 years old (the oldest age ever documented) or competing with Methuselah, it is better to do it gracefully, enabling us to feel energised and beautiful.

When creating our personalised anti-ageing regiment it is wise to follow an inside-out treatment order, which means starting with mental and spiritual well-being; continuing with physical health and fitness; and finally reaching aesthetic appearance improvements, if necessary. This order is advised because treatments influencing the well-being of mind and body will already have an effect on our beauty, potentially reducing the need for medical intervention in order to allow us to look better and be more content with ourselves.

As previously mentioned, depression is often considered a major health issue for all population groups and is a state that greatly accelerates the ageing process. To help alleviate the symptoms and effects of depression, micronutrition treatment could be looked into. This is an innovative treatment that has shown great promise and that could also be beneficial to our general mental well-being (dealing with chronic stress, burnout, eating disorders, anxiety).

Micronutrition treatment includes genetic testing and laboratory analysis of blood, urine, and saliva, which will be followed by a customised micronutrient blend. Personally prescribed micronutrients such as vitamins, amino acids, and minerals are designed to correct our brain chemistry. Deficits are balanced to achieve individual optimisation of mind health. These treatment programmes typically last a minimum of three months in order to properly re-balance the whole mental state. This process is usually overseen by a specialised psychiatrist who will include psychotherapy sessions as well. Regular physical activities such as walking, running, and dancing are also highly recommended, as exercise is one of the best natural ways to rid us of negative thoughts and tension.

In order fully to realise a better version of ourselves, it is necessary to become aware of how old we really are. This means undergoing gene testing in order to measure our biological age. In addition, gene testing enables us to measure food intolerance (revealing food allergies), athletic abilities (providing insight into the body’s metabolism that allows us to develop the best training programme for our body type), and disease risks (screening for inherited genetic risk factors that make it more likely for someone to develop certain cancers, type 2 diabetes, etc). Genetic testing can give us strong motivation for further lifestyle changes, and will provide us with a clear picture of “how we are really doing”.

Proper diagnostics is one of the key steps in the prevention process – it is equivalent to predicting the future of one’s health in a scientific way. In a rather interesting experiment, scientists were, for the first time ever, able to reverse the age of an animal in a laboratory environment. They demonstrated that mice actually became young again by turning on the telomerase gene. According to Jay Williams, it was found that anti-ageing medicine has the potential to allow people to live actively for up to 130 years. While practicing anti-ageing medicine, gene testing should usually be followed by a lifestyle modification which includes three months of adopting healthier habits, followed by a subsequent gene test after six months. So, there we have it – losing one or more years from our biological age.

Let us also discuss the so-called “fountain of youth”, which is what hormone replacement therapies are sometimes called. Lately, the wide-ranging health benefits of natural bio-identical hormone replacement therapy (BHRT) have been debated and are now widely considered a safe and effective therapy for maintaining youthful metabolism, physical and mental health, as well as emotional wellness and vitality at any age.

But what does this magical treatment of bio-identical hormones really mean? Harvard Health Publications claim that the term “bio-identical” does not have a precise medical definition; however, the “endocrine society” explains bio-identical hormones as “compounds that have exactly the same chemical and molecular structure as hormones that are produced in the human body”. Health care specialists normally use the word “bio-identical” to describe preparations containing either progesterone or one or more of three different types of estrogens (estradiol, estrone, and estriol). Suzanne Somers, the author of “Ageless”, and other advocates of bio-identical hormones generally go beyond this and refer to the following regimen, called BHRT:

  • Hormones are measured via a saliva test to identify “deficiencies”.
  • A clinician prescribes a combination of hormones to bring the hormones into balance.
  • The prescription is filled at a compounding pharmacy using hormones derived from “natural” sources.
  • Besides estrogen and progesterone, the prescription may include other hormones, such as testosterone, dehydroepiandrosterone (DHEA), and adrenal hormones.
  • The hormone levels are re-tested periodically and the prescription revised if necessary.

Supplements play a vital role in age management and anti-ageing treatments – in addition to BHRT there is another source of youth called antioxidants. In one’s daily menu, we could include, according to a personalised prescription, antioxidants such as alpha-lipoic acid, Coenzyme Q10, Glutathione, and vitamins C and E. These are the so-called youth antioxidants, which can be found in various foods and are also available as food supplements. Antioxidants protect our body and its cells against oxidative stress that accelerates the cell ageing processes, which in turn weaken the immune system. Oxidative stress can easily manifest itself while living hectic, busy lives, while not paying attention to what we eat, drink, or breathe, or how much we move. Antioxidants are necessary to keep our cells vital and thus benefit our overall well-being.

Before we touch upon the much-desired aesthetic corrections, there is one additional lifestyle therapy worthy of consideration that affects our entire personality – it is called sophrology. We often hear people complaining about their body image, anxiety, fears in life, insomnia, concentration and memory problems, pain and tension, and respiratory issues, and sophrology is a relaxation technique which includes both physical and mental exercises that offer relief through its fundamental principles: working on positive thinking, objective reality, body image, and suspending judgment. Sophrology is something that helps individuals to improve the balance between body, mind, and soul. Sophrology drives us through dynamic relaxation exercises that are practiced individually with a therapist or within a group. It focuses attention on the body and its blockages, and teaches how to let go of tensions and guides us into deeper relaxation. Sophrology is a paramedical service like hypnosis or acupuncture, and mainly benefits our mental health. The hygiene of our body is important, but the hygiene of our emotions is as equally important – a healthy mind often creates a healthy body.

After treatments for our mind, soul, and physical well-being, it is appropriate to address some aesthetic changes. These treatments can be a shortcut to beauty. The first and most innovative is the Face Gym. It is exactly what you would expect it to be – exercising your face to improve blood circulation and skin metabolism. In beauty salons it is done by a specially trained beautician, who will go through stretching exercises and stimulate the face muscles to wake up blood circulation.

Another, somewhat more extreme treatment is the Vampire Facial, made famous by Kim Kardashian. A Vampire Facial is also referred to as a platelet-rich plasma treatment – a blood sample is taken from the patient and the portion of plasma containing a high concentration of platelets is injected back into his or her skin. The aim of the Vampire Facial is to speed up the renewal process of skin cells. It will give us a better face tone while rejuvenating and softening the skin. Above all it is important to have a proper daily face care regime at home – cleaning, protecting, and nourishing according to our personal skin type, something that can easily be prescribed by our beautician, dermatologist, or aesthetician.

It is important to bear in mind that every decision about our lifestyle and habits is for or against our youth. Anti-ageing treatments like micronutrition, various genetic testing, hormone replacement therapies, sophrology, antioxidant intakes, aesthetic procedures, as well as healthy lifestyle behaviors all work to benefit our beauty and provide us with youthful energy. Age management and anti-ageing medicine can save countless lives and delay deadly lifestyle diseases, which can become more important than just retaining beauty. For the first time in history, becoming aware and using the power of prevention available today gives us the ultimate chance to age gracefully, control our quality of life more than ever, and extend our years of healthy and fulfilling life. Let us use this opportunity.

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