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Aging as disease

Article-Aging as disease

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  • Seminal research points to the role of the protein BMAL 1 in the control of our circadian rhythms and in the very process of aging itself

Teresa A. McNulty
Seminal research from your oncology colleagues at the Cleveland Clinic seems to point to the role of the protein BMAL1 not only in the control of our circadian rhythms, but in the very process of aging itself. Compared to control animals, BMAL1-deficient mice exhibited classic signs of aging—from reduction of body weight, muscle and bone mass to decreased hair growth and thinning of subdermal fatty tissue. Sound like some of your boomer patients? This month's Special Report on anti-aging might just as readily be called "Cage Match: Cosmetic Surgeon Versus Father Time."

The implications of the very term "anti-aging"—and the expectations of the cosmetic surgeon's role as conduit of it— come with everything but spandex and a cape. But thwarting Villain Time in your patient's defense against His ravages puts the aesthetic practitioner in no small expectations pinch. As your San Francisco-based plastic surgeon peer Dr. James J. Romano puts it, cosmetic surgery is only one stop on the anti-aging circle continuum, right alongside lifestyle choices, diet and supplements, gene and hormonal therapy — and attitude.

While Dr. Romano elegantly enumerates the four chief theories of aging: wear and tear stresses to cells and organ systems, a lifetime's bombardment by free radicals, the pre-programmed life expectancy of our genes, and the inevitable drop in hormonal levels and their biologic activity—he concludes that the U.S. demographic wave will nevertheless continue to power patient expectations and even demands to, in essence, be treated for the "disease" of aging.

Add in the fact that life expectancy is increasing—this retiree generation will be the longest lived in history— and the expectation delta spikes even further. While you're at it, fold in some real concern about the nature of the raw material seated in your waiting room. According to research conducted at the University of Pennsylvania and Carleton University, American boomers report more problems with their health than the pre-boomers did when they were in their fifties. The study of more than 20,000 Americans compared boomers aged 54 to 59 with two cohorts, one aged 60 to 65 and the second aged 66 to 71. The youngest group reported having more pain, chronic health conditions and drinking and psychiatric problems than those of the same age 12 years earlier. Compared with the oldest group, the youngest group was more likely to have reported difficulty in walking, climbing steps, getting up from a chair and performing other normal daily physical tasks. One could wonder whether these study results are merely a manifestation of the '60s and '70s youthful "wretched excess" chickens coming home to roost, or, as one commentator on the Web site concluded, just further evidence of boomers' higher standards, narcissism and greater tendency to complain.

Either way, perhaps in lieu of "anti-aging," a clearer understanding of the multifactorial aspects of the aging process gained via research such as that on BMAL1 will permit a recasting of the role of the cosmetic surgeon from "Aging's Foe" to something more akin to "Ambassador to Vitality" for patients. Until then, we live in a culture that values youth over endeavor and beauty over talent—except, ironically, when it comes to the skill of the cosmetic surgeon to stop the clock. You remain on the hook for outcomes and evidenced-based treatments for this newest "disease" that dates to Adam.

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