Lecture 25 Aging Process 1

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AGING PROCESS AGING PROCESS RA TUTY KUSWARDHANI RA TUTY KUSWARDHANI IGP SUKA ARYANA IGP SUKA ARYANA GERIATRIC DIVISION, INTERNAL MEDICINE OF UDAYANA GERIATRIC DIVISION, INTERNAL MEDICINE OF UDAYANA UNIVERSITY/SANGLAH HOSPITAL, DENPASAR UNIVERSITY/SANGLAH HOSPITAL, DENPASAR MARIA ESTHER HEREDIA DE CAPOVILLA ,116 Y.O EKUADOR (GUINNESS BOOK – DEC’ 2005)

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Transcript of Lecture 25 Aging Process 1

  • AGING PROCESSRA TUTY KUSWARDHANI IGP SUKA ARYANA

    GERIATRIC DIVISION, INTERNAL MEDICINE OF UDAYANA UNIVERSITY/SANGLAH HOSPITAL, DENPASARMARIA ESTHER HEREDIA DE CAPOVILLA ,116 Y.O EKUADOR (GUINNESS BOOK DEC 2005)

  • KURIKULUM VITAENAMA: dr IGP SUKA ARYANA, SpPDSTAF PENGAJAR DIVISI GERIATRI, BAGIAN/SMF ILMU PENYAKIT DALAM FK UNUD DENPASAR, RSUP SANGLAH

    PendidikanDokter umum: FK Unud 1997Spesialis Penyakit Dalam: FK Unud 2005Visiting research fellow Kobe Jepang 2002Penghargaan:Nominator the Best Young Investigator Award AFES Singapura 2003Nominator the Best Young Investigator Award AFES Manila 2005The Best Mustafa-Varon Award for the Best Free Paper On shock and Critical Care 2005The Best Young Investigator Award, ASMIHA Surabaya 2005

  • TOPICSINTRODUCTIONGERIATRIC DEFINITIONDEMOGRAPHIC POPULATIONAGING DEFINITIONAGING AND SENESCENCETHEORIES OF AGING

  • INTRODUCTIONGERONTOLOGY : GERONTOS AND LOGOS

    GERIATRY SCIENCE :A SCIENCE WHICH LEARNS THE ELDERLY AND THE TREATMENTGEROS = ELDERLY

    IATRY = TO TREATTHE TERM : IGNAS LEO VASCHER (1909) PROGRESSIVE DEVELOPMENT :

    DR. MARJORI WARREN (THE PIONEER OF GERIATRY IN THE WORLD)

  • ELDERLY POPULATIONINDONESIA: 60 Y.OW H O: 60 Y.ODEVELOPED COUNTRY: 60 Y.OELDERLY PATIENT: 60 Y.O + MULTIPLE DISEASE/ COMPLEXITY

  • THE PREDICTION OF THE ELDERLY POPULATION 2020

    CHINA198. 343INDIA107.713INDONESIA 24.816BRAZIL21.945UK12.912MEXICO12.829NIGERIA9.115

  • INDONESIA DEMOGRAPHYYEARS BALITA (< 5 yrs) ELDERLY(> 60 yrs)

    1971 19,1 mil (16,1 %) 5,3 mil(4,5 %)1980 21,2 mil (14,4 %) 8,0 mil (5,5 %)1985 21,6 mil (13,4 %) 9,4 mil (5,8 %)1990 21,0 mil (11,7 %) 11,2 mil (6,3 %)1995 21,6 mil (11,0 %) 13,6 mil (6,9 %) 2000 21,2 mil (10,1 %) 15,9 mil (7,6 %) 2005 21,1 mil ( 9,5 %) 18,3 mil (8,2 %) 2015 18,8 mil ( 7,6 %) 24,4 mil (10,0 %)

  • BIOLOGIC AGINGThe importance of genetics in the regulation of biologic aging is demonstrated by the characteristic longevity of each animal species. Several theories of aging have been promulgated and recently reviewed (Goldstein, 1989; Abrass, 1991). These theories fall into two general categories: accumulation of damaged to informational molecules, or the regulation of specific genes

  • AGING PROCESS DEFINITIONAging is a process of the loosing of ability the tissue slowly to develop it self and to maintain the structure and the normal function; so it can not stand towards the trauma to develop the damage. (Constantine 1994)

    AGING: A process of gradual and spontaneus change resulting in maturation through childhood, puberty and young adulthood and then decline through middle and late aging

  • SENESCENCE: The process by which the capacity for cell division, growth and function is lost over time, ultimately leading to an incompatibility with life i.e the process of senescence terminates in death.

    DISEASE vs aging In both aging and senescence, many physiology function decline but normal decline is not usually considere the same as disease. So ??

  • Progressively the human will loose the defence of infection & it will accumulate more metabolic and structural distortion which is called :

    DEGENERATIVE DISEASE

  • WHY DO WE AGE?

    WHY DO WE LIVE AS LONG AS WE DO?

    WHY DO WE DIE?

  • THEORIES OF AGING PROCESS AGING IS EXTREMELY COMPLEX AND MULTIFACTORIAL PROCESS

    SEVERAL PROCESSES MAY INTERACT SIMULTANEOUSLY

    AGING PROCESS MAY OPERATE AT MANY LEVEL OF FUNCTIONAL ORGANISM

  • MAJOR THEORIES ON AGING(focus on proces)

    Theory Mechanisms Manifestations Accumulation of damaged to informational molecules (demage and error)Spontaneous mutagenesisFailure in DNA repair systemsErrors in DNA, RNA, and protein synthesis Superoxide radicals and loss of scavenging enzymesCopying errors

    Error catastrophe

    Oxidative cellular damageRegulation of specific genes (program)Appearance of specific protein(s) Genetically programmed senescene

  • CLASSIFICATION THEORIES OF AGING (focus on level)EVOLUTIONARYMUTATION ACCUMULATION mutation effect healht at older ageDISPOSABLE SOMAafter reproductive somatic cell become disposableANTAGONISTIC PLEIOTROPY genes beneficial at younger, deleterious at olderMOLECULARGENE REGULATION change regulating development and agingCODON RESTRICTION inability decode codonimpaired translation mRNAERROR CATASTROPHE decline fidelity of gene expresion increased abnormal proteinSOMATIC MUTATION accumulated molecular demage (DNA/genetic material)DYSDIFFERENTIATION accumulated molecular demage impairs gene expresionCELLULARCELLULAR SENESCENCE-TELOMERE THEORYFREE RADICALWEAR AND TEAR accumulation of normal injuryAPOPTOSISprogrammed cell dead from genetic event /genome crisisSYSTEMNEUROENDOCRINE alteration control homeostasis aging related physiological change IMMUNOLOGIC decline immune function increased autoimmunityRATE OF LIVING fixed amount of metabolic potential for every living (live fastdie young)

  • AGING PROCESS THEORY1. GENETIC CLOCK THEORYIn this theory aging has been programmed genetically for certain species.Every species has nucleus like a genetic clock which has been winded according to a certain replication.This clock will count the mytocys

    Mytocys will stop cell replication if it is not windedPROGRAMMED THEORY

  • Why on some species get a real different of life expectation

    Figure 1. Record in life span (Eudililin et al, 1993)

    Turtle 170 y.oElephant70 y.oHorse62 y.oGorilla48 y.oBear47 y.oCat30 y.oDog27 y.o

  • Theoritically it is possible to rewind this clock eventhough just for small time, with external interverences, such as :

    Health developmentDisease prevention with medicine/ treatment

    The theory supported by experiment : nucleus which determines the replication Aging Death

  • 2. THE SHORTENING OF TELOMERE THEORY.

    The shortening of DNA telomere will cause the death of the cell. The DNA replication leads to telomere shortening because DNA polymerase cannot replicated the very end of DNA molecule. Telomerase elongates the chromosome through de novo sequerell addition.

  • 3. THE DAMAGED BY FREE RADICAL.

    Teory was first proposed in 1957, its one of best teory

    All organism live contain free radical (ROS)

    For aerobic organism, the free radical is mainly formulated while respirating (aerob) in mitochondria.

  • The free radical are : super oxide (O2), Hydroxcyl radical (COH), Hydrogen peroxide (H2 O2).

    Free radical is destroyer it can react to DNA cumulative demage aging and senescence

    The body itself is able to prevent free radical with its enzymes : superoxide dismutase (SOD) : Zn, Cu, Mn

    2 O2- + 2H+ SOD H2 O2 + O2

  • *Catalase enzyme with Fe element in the haem to burst hydrogen peroxide become water & oxygen :

    CATALASE2H2 O2 2H2O + O2

    *Glutathion peroxide enzyme with selenium (Se) element burst peroxide hydrogen through the reaction :

    H2O2 + GSH GSSH +H2O

    Also can be netralised by vit C, A and E

  • 4. METABOLIC AGING THEORY

    From the experiment it get a longer life span caused by the retriction of the calorie. It is caused by one of metabolism process increase insulin sensitivity, neuroendocrine and immune respon

    The modification of under exercise to be more active will cause the longer life span

    Calaric retriction delayed growth and failure of sexual maturation

  • 5. THE DAMAGE OF IMMUNE SYSTEM

    The repeated mutation/ the changing protein post translation decrease the immune system decreased ability of self recognition

    The somatic mutation change antigen in the surface cell immune system treat the changing cell as a strange cell and destroy it AUTO IMMUNE PROCESS

    All somatic cell will set aging process, except sexual cell & cancer cell.

  • 6. WEAR-AND-TEAR THEORYSupports the concept that aging is a programmed process. each animal-each cell, has a specific amount of metabolic energy available to it & that the rate at whish this energy is used determines the animals length of life.In addition to the depletion of available energy, wear-and-tear theories include the effects of the accumulation of harmful by products of metabolism & of faulty enzymes due to random errors as contributing to aging changes

  • MODEL HEALTHY AGING

    Endogenic aging

    CellularTisue AnatomicalOrgan

    EnvironmentLife Style

    Exogenic factor Healthy aging(menua sehat)

  • HEALTY AGING CONCEPTGERONTOLOGY IS CONCERNED PRIMARILY WITH PROBLEM OF

    HEALTHY AGING RATHER THAN THE PREVENTION OF AGING