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European Geriatric Medicine 6S1 (2015) S1–S4





Keynote lectures


Longevity for future Europeans

Genes and lifestyle

K. Christensen

The Danish Twin Registry, Odense C, Denmark

A rapidly increasing proportion of individuals in the Europe are

surviving into their tenth decade. While there is no doubt that

we are doing well in making the elderly survive better than

previously, the key questions are whether this will continue, what

the underlying mechanisms are, and whether we are also doing

good for the oldest-old. There is widespread concern that the basis

for the survival success is better survival of frail and disabled elderly

into the highest ages, the so-called “Failure of Success Hypothesis”.

An alternative hypothesis is that we are experiencing a “Success of

Success”, i.e., an increasing proportion of the population is living

to the highest ages in better health than previous generations.

The planning of and policy development for the future care of

the oldest-old will be highly dependent on whether one or both

genders are experiencing the “Failure of Success” or the “Success

of Success” as they may reach the highest ages. This scientific

knowledge is of fundamental importance for the sustainability of

modern societies.


The world is aging, but individuals are not: what can we expect

in the future?

L. Fratiglioni

Karolinska Institutet, Stockholm, Sweden

It is the first time in the history of mankind that the proportion of

the aged population (conventionally identified as 65+) is growing

steadily worldwide. This is a relatively new phenomenon that

started in the industrialized countries and has now also reached

less developed areas of the world. Unfortunately, we have mostly

focused our attention on the negative consequences linked to the

aging of the population. This increasing focus on the negative

aspects has already led to deleterious consequences for individuals

who are frightened, for example, at the appearance of the first

signs of memory decline that are not always related to the

development of Alzheimer’s disease. We need to implement a

more scientific attitude in our approach to health and illness

in old age. During recent decades population-based studies have

made tremendous progress showing that aging is not necessarily

linked to disease and disability. Health status in late life is a

result of the complex interaction of genetic susceptibility, biological

factors, and environmental exposure, experienced over the whole

life span. Current evidence strongly supports the important role

of lifestyles and health behaviors – including nutrition, physical

activity and psychosocial factors – and vascular burden in the

pathogenetic process and clinical manifestation of several age-

related diseases such as dementia and multimorbidity. It is expected

that interventions leading towards the promotion of healthy

behaviors, the optimal control of vascular factors; the maintenance

of a socially-integrated lifestyle and mentally-stimulating activities

may lead to a longer and healthier life after the age of 75.


Anti-aging medicine

V. Calabrese

University of Catania, Italy

Symptomatic Medicine operates only when the disease becomes

manifest, in the attempt to identify and contrast disease

progression. Even the concept of check up is based on biochemical

and instrumental analysis (echography, radiology,

. . .

) aims at

detecting (but not preventing) signals from factors triggering the

pathological process.

Preventive Medicine, on the contrary, invests in health by

implementing preventive strategies aimed at mitigating the risk

of disease and inverting the chronic pathological process.

Anti-aging medicine is a sort of preventive medicine, namely a

healthy aging medicine, which is the result of the gerontology

research on human aging and has the scope of keeping the patient

in a state of health and wellness.

Anti-aging medicine has been fairly developed over the last

decade due to discoveries in the field of genetics, pharmacology,

biotechnology, nano-technology and info-technology; as a

consequence, it has invaded the field of traditional symptomatic

medicine by progressively integrating the traditional with the

innovative approach, acquiring scientific dignity and restoring the

original intent of the medical mission, which is to prevent and/or

modify, rather than post-pone, the onset of disease.

Anti-aging medicine is not an end in itself, rather it is an

appropriate tool to determine the health level at any given time

and to implement preventive interventions to protect health from

a potential disease risk.

As a result, anti-aging medicine should be considered a healthcare

approach, which is focused on the prevention of disease and life

span increase, in contrast to symptomatic treatment; therefore, it

cannot be simply a medical procedure, nevertheless it should be

adopted from the health system and healthcare professionals.

In conclusion, anti-aging medicine is a predictive medicine because

it can predict, via genetic testing, the onset and development of

a pathological process in any cells of the organisms. In addition,

it is an holistic medicine as it considers the physiological and/or

pathological processes of our cells at a global level and in real

time. It is also a preventive medicine that enables to discover

what has been manifesting or will be manifest in the near or long

term future; along with this, it allows to implement interventions

that are able to prevent, modify, delay progression, postpone

the onset or block these biological processes. Moreover, it is a

regenerative medicine because it is capable of acting directly onto

mechanisms of cellular regenerations. Finally, anti-aging medicine

is a complementary medicine as it completes the traditional

medicine, although with different timing and modalities.

1878-7649//$ – see front matter © 2015 Elsevier Masson SAS and European Union Geriatric Medicine Society. All rights reserved.