10 Years of Gerontology: Then and Now


We hear often about how science and technology are making everything happen more quickly around us than ever before, but it is the ‘cutting edge’ part of these fields that is constantly moving. To the layman, it is often difficult to distinguish the advances over a decade in a field they do not understand very well in the first place. The field of gerontology is that way for many, so I thought it would be useful to take a look at some of the developments we have seen in the last 10 years.
Dementia and Alzheimer’s
A decade ago, our understanding of Alzheimer’s disease hinged on the discovery of a protein fragment that, in healthy brains, is flushed out without effect. In the brains of Alzheimer’s patients, the fragment folds in a way that, instead of getting flushed out like it should, accumulates into plaques on the brain. The previous assumption was that these plaques effectively were Alzheimer’s.
Today, we know that not only are those plaques made of more than just a single kind of misfolded protein, we also know that structures in the brain that we previously believed to be just structural support, called cytokine, are more than just a ‘brain skeleton.’ They also help neurons grow in the right direction; but for those with Alzheimer’s disease, the cytokine gets tangled. Finally, we’ve noticed that brains with Alzheimer’s have more than twice as many cells, on average (with the wrong number of chromosomes), and it is these cells that die first as the disease progresses.
Senior Depression
10 years ago, depression was under-diagnosed and under-treated in seniors. We had also just barely discovered that depression leads to more dire consequences from almost any adverse health event, from a fall to a heart attack. We had no idea what, in terms of electrical, chemical, or mechanical changes, caused depression.
Today…we still do not know what causes depression, but we have made enormous leaps in recognizing it in senior citizens, including currently recognizing four separate kinds of depression. We also now know that the number one most powerful way to fight depression is with social validation; people who feel like they are part of something bigger than themselves can conquer depression much more easily than those who feel isolated or stuck on the outside.
In 2006, the big nutritional discovery regarding seniors was that they were often malnourished due to altered eating habits. The assumption was that cholecystokinin, a hormone that regulates the movement of food from the stomach to the duodenum to the small intestine, was to blame.
Today, we have learned that the real culprit in seniors’ reduced food intake is nitrous oxide, which is the chemical that allows your abdomen to expand when you eat. Levels of nitrous oxide that are released in response to a meal drop as we age, meaning the stomachs of seniors do not expand as rapidly, they eat less and feel full faster (and for longer).
A number of drugs are currently being safety-tested to combat this issue. In the meantime, the best known solution is to encourage snacking and forbid empty calories; there is no point in ‘wasting’ good eating time by filling your stomach with stuff your body cannot put to good use.
Hormonal Replacement Therapy (HRT)
A decade ago, we were near-certain that HRT was going to make life longer, better, and healthier by keeping the body’s supply of sex hormones artificially high. The idea was that sex hormones have a powerful correlation with age (they go down as age goes up) so maybe we could essentially convince the body it was still young if we kept their levels buoyed. And it seemed to be working.
Today, we know that the promises of HRT were only half-real. Major studies have shown us that progesterone replacement in particular is dangerous for the elderly, increasing breast cancer and heart disease and decreasing cognitive function. Testosterone HRT, on the other hand, seems to have relatively minor or non-controversial side effects and does a passable job of reducing body fat, maintaining bone density, and improving muscle tone and mass in seniors.
Frailty, or ‘sarcopenia’ for the technically-minded, is very much like osteoporosis for your muscles; it is a loss of 8%-10% of your total muscle mass per decade, starting as early as age 30. It affects about 30% of people over 60, and 50% of people over 80. 10 years ago, we knew that frailty was most effectively combated by resistance exercise (e.g., weightlifting), and that cardiovascular disease and diabetes were both risk factors for the condition.
Today, we know that resistance exercise is effective, but it is much more effective when coupled with a dietary change; the consumption of 20-30 grams of high-quality protein at every meal, along with a Vitamin D supplement. Together, the two can ward off most of the effects of sarcopenia by putting your body into ‘maximum muscle rebuilding’ mode.
As you can see, while the changes might be hard to detect at times, our medical and scientific communities are hard at work tackling the issues most critical to the health and well-being of our honored elders. I encourage each of you, the next time you speak with your doctor (or your parents’ doctor), ask them if they keep up on the latest studies and experiments that are relevant to senior health issues. Progress never stops, and neither should our learning.

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About Peter Mangiola

Peter Mangiola is a senior care advocate with several decades of experience in the industry. Peter helps senior citizens by leveraging his vast knowledge of the healthcare industry and his expertise in identifying effective, affordable healthcare solutions. Peter has been a consultant, educator and regular speaker for many groups and organizations over the years covering a wide variety of topics; including Geriatric Care Management, Dementia, Alzheimer’s and Senior Care Health Service & Advocacy

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