Institute of Chinese Medicine, The Chinese University of Hong Kong, HKSAR.
Abstract: Longevity is a blessing as long as good health is not lost. However, the tendency to have a decline on normal physiological activities is inevitable because of the natural processes of degeneration at all levels: molecular, cellular and organic. Hence, the elderly people frequently suffer from cardiovascular problems and skeletal deteriorations that gradually develop to disabilities. Awareness of factors leading to unhealthy aging has led to the formation of different professional groups that aim at the maintenance of health of aging community. The approach tends to be target orientated for the European and US groups, aiming at hormonal replacements and detoxification. In contrast, the oriental groups have been keeping their traditional belief of prevention and internal balance, using nutritional arrangements and non-strenuous exercise as means of maintaining health.
Keywords: chinese medicine, aging
The twenty first century is characterized by the successes of modern science which have brought about
apparently unlimited materialistic achievements. While people enjoy better health and remarkable means of healing which allow them to live to a much longer age, longevity and the increasing number of elderlies have produced new social problems (Buckwalther et al. 2003).
Figure 1 illustrate that the current expected age of survival for men and women all over the world is ever increasing, it has become clear that many of the surviving people with higher ages are in fact not in good shape, either socio-economically or physically (Lipsitz, 2004). In Hong Kong, for instance, the expected ages of survival have already increased to 79.3 for men and 85.4 for women, from the
2007 vital events by Census and Statistics Department. If these elderly citizens are in good health, they enjoy being senior and wise. On the contrary, if they are suffering from ill health, they become a burden to themselves, and their family and community needs to reserve huge resources to help them. Do we have healthy environments for the aging people to remain healthy?
The answer appears to be unfavorable. Firstly, the physically observable environment being presented to everyone is gloomy, particularly for Asia. The over-rapid economic growth in most regions have polluted the atmosphere, water sources, vegetations, living objects, the crops and the live-stocks. The direct effects could be the cause of general rise in the incidence of cancers. Economic growth has brought along socio-psychological tensions in the living environment of most inhabitants. The ever increasing stress has been rightly taken as the culprit of the ever declining mental health of all people, young and elderly alike.
The advances made in molecular biology has brought on the discovering and marking of the complete genomic picture, followed by the identification of specific genes responsible for rare, congenitally related disease entities. Optimists hurried to assume that sooner or later, all diseases and pathologies could be traced to a genomic origin and henceforth, be ultimately eliminated. Optimists have been predicting, that, individualized treatment according to different targets identified, would not be a remote practice. The different genomic make-up of different individuals, could certainly explain the commonly observed different responses to the similar treatment regime among patients labeled with the similar pathology. (Vaillancourt, 2002).
All appear well and another major medical advance in the direction of absolute core is expected, until again, further advances in molecular biology reveals much more complicated pictures. Pathologies and diseases, at molecular levels, i.e. beyond tissues, cellular and finer histomorphometric levels, viz,
Correspondence: Prof. Ping-Chung Leung, DsocS(Hon), D.Sc, M.S, Director, Centre for Clinical Trials on Chinese Medicine, 5/F, The School of Public Health Building, Prince of Wales Hospital, Shatin, NT, Hong Kong SAR. Tel: (852) 2252 8868; Fax: (852) 2632 5441; Email: firstname.lastname@example.org
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The Senior Boom
Number of Elderly People (in millions)
1990 2000 2010 2020 2030 2040 2050
Figure 1. Senior Boom in U.S.A.
proteomic levels, are under the influence and control of very complicated systems. These systems interact and remain in an unstable equi- librium. Once the unstable equilibrium is dis- turbed, the individual will be bothered with pathological changes which may or may not be linked with symptoms and signs. The mechanisms affecting the different systems of proteomic reactions are influenced not only by the genomic make-up of the individual, but also by the environ- ment the individual faces. The environment is both external and internal. The external environment has been discussed. The internal environment refers to the alimentary tract, the respiratory and excretory tracts, all in tubular forms of various shapes. The living organisms inside these tubular cavities are ever-changing and the personal habits, life-styles and individual activities are initiating environmental changes all the time. One might argue, whatever and whenever changes occur, counter-changes to bring stability and equilibrium are always possible. Be it true as it may, where is the concerted motivation and concerted dynamic which is expected to be essential for positive stability? (Vaillancourt, 2002). With aging, one
expects much higher chances of losing the stability. Keeping healthy with aging is therefore, of utmost importance.
Aging: Changes at Different Levels Aging is a normal life process which involves a complexity of objective changes in the pathologi- cal deterioration of cells and tissues in the phenomenon know as degeneration. Normally cells undergo repair and regeneration in response to wearing out. With aging, their proliferative capacity declines, their differentiation into specialized func- tions slows down, and their normal responses to growth factors become hazardous. Laboratory explorations have suggested that these degenera- tive changes could have resulted from free radical accumulations or abnormal protein productions.
Cellular degenerations lead directly to tissue and organ damages, either directly through declines in circulation, loss of muscle and bone masses, or indirectly through inactive hormonal activities, inefficient immunological reactions, or loss of stem cell supplementation.
Among the widespread, generalized phenomena, which leave no cells, tissues or organs unaffected,
there are areas, which are either more severely affected, or, when they are affected, would lead to readily expressed pathological changes, thus leading to immediate manifestations of health deterioration, followed shortly by the occurrence of diseases. The critical area include cardio-vascular degenerations as a result of abnormal cholesterol deposits leading to coronary and cerebral artery obstructions; abnormal cellular proliferations, leading to cancer development; musculoskeletal deteriorations lead- ing to physical weakness and pain, and proneness to injuries. One area that is becoming more promi- nent in recent years because of the further increases in survival age, is related to the loss of neurological regenerative power, leading to a variety of dementia. Beyond the tissues and cells, lower down at the molecular levels, normally the proteomic activities maintain a balanced signaling which keeps genera- tion and degeneration, anabolism and catabolism at a balance. Aging refers to a stage when deterioration becomes more rapid, thus giving manifestations of different degrees of frailty. Opposing couples of cell signaling are found (though not yet completely understood) in all the structural and function balance of the body tissues.
Assessing Patient Needs and Providing Treatment
With the serious challenges from aging, there is a
natural enthusiasm to positively respond to this urgent need of the new century. The enthusiasm comes not only from the elderlies themselves and the professional healers, but also from the Health Service providers on the Government level.
In the Affluent World, the market-driven economy has initiated the formation of special professional groups to provide services to the aging people. One remarkable blooming group has arisen from Europe -- the Anti-aging Medicine Specializa- tion (AAMS). Within a few years, this organization has been the most influential, first in Europe, then spreading to the United States. It holds frequent training courses for physicians and paramedicals. It facilitated the establishment of specific clinics that offer unique Healthy aging related advice, clinical investigations and treatment. The major areas of concern from the AAMS are related to Nutrition, Hormonal deficiencies, Psychological health, Environment and Physical Activities.
On the nutrition side: healthy food and healthy drinks are redefined. So are bad food and bad
drinks, so that followers would not take milk products, sugar, unsprouted grains, alcoholic and caffeinated drinks (Werbach, 1993). A new concept on food digestion is established, which emphasizes on subclinical food allergy related to specific good items which initiate a major change of intes- tinal flora(Gibson, 2006). To prove the postula- tions, specific tests are created. "Toxicity" of food items is also in the lime-light. A new disease syndrome -- "Chronic Fatigue Syndrome" has emerged, assuming that the cause is due to an imbalance produced by an insufficiency of the essential food substances and the excess of "toxic" chemicals. (Yoshimura, 1985; McKenna, 2006).
The Hormonal insufficiency school commands even greater respect since the scientific basis of the imbalance between…