Anti-Anti-Aging: Alternative Perspectives on Getting Older

In my last post, I explored the world of "brain training" and offered my opinion on some of the lofty claims of the burgeoning brain fitness industry. Although there are several such programs available on the market offering a variety of games and activities, each strives to accomplish a common end result: delay, if not reverse, the cognitive declines associated with aging. Much of their success comes from the fact that this promise is appealing to many people who view aging with trepidation and perhaps even disgust. Especially in the United States, to a society that prizes youth and beauty above all else, the stereotypical characteristics we associate with getting older are decidedly unpleasant. Although the millions of dollars generated by industries capitalizing on this public fear (anti-aging cosmetic products, plastic surgery, etc.) speaks volumes about the majority's view of aging, alternate views have emerged in recent years and are also enjoying increasing support within the aging communities.

Whether concerned with the physical or intellectual tolls of "normal" aging, much of the research emanating from laboratories today ultimately ends up being put to use to make a product available to the public for sale. The anti-aging industry is, after all, a business. New studies, however, have implications that go beyond the superficial aspects of aging and the preventative measures (such as diet and exercise and the prophylactic use of vitamins and supplements). In his post, "How a story reversed the aging process," Improved Lives blogger Stu describes the recent research showing that merely imagining yourself younger can often bring the health benefits of actually being younger. The post goes on to suggest the beneficial consequences of this "mind over matter" approach, illustrating one perspective that deviates away from the money-based solutions that dominate the current market. Money too is at the heart of the approach taken by guest essayist Dr. Daniel Callahan in a recent post featured on the New York Times New Old Age blog. "How old is too old for lifesaving surgery?" is distinct from other views on the aging process in that he asserts that risky and costly procedures are too often performed on elderly patients that in the past would have been turned down simply due to their age. It is Callahan's belief that our already cash-strapped Medicare system would benefit hugely from an "age-based rationing" of care, denying expensive surgeries to patients who most likely will only go on to develop another fatal complication of old age. Almost 20 years after he first published his proposal in his book (pictured below), Callahan updates and defends his controversial position, citing a Medicare system that has only gotten worse in the years since. Although the content of the posts themselves are distinct, both refuse to view aging as a disease to be avoided at all costs. In addition to posting them on their respective blog sites, I have included my comments to each below.

"How a story reversed the aging process"

Comment:

I would like to first thank you for your interesting and thought-provoking review of the recent experiments that have demonstrated aging to be as much of a state-of-mind as it is a physical process. Although it may simply be the implication that we have a considerable amount of control over the nature of getting older that is so appealing, these studies have the potential to dramatically change the approaches to aging we take. On one hand, it seems as though so much of the admittedly admirable work that comes out of the science and research communities focuses on the abnormal aspects of aging, while on the other, the booming cosmetic and plastic surgery industries bombard us with the notion that vigor and vitality are things we have to buy in a bottle. For so many left somewhere in between the two extremes, it is refreshing to learn that psychological as well as physiological benefits can be had using the power of thought. While the three "suggestions" you set forth might seem like common sense in achieving these ends, I believe they speak to a larger acceptance of aging as a journey within itself, rather than an obstacle to be overcome or an ending to be dreaded.

"How old is too old for lifesaving surgery?"

Comment:

While I may not agree entirely with your proposal to ration care to the elderly, I thank you for sharing a fascinating and provocative perspective I was previously unfamiliar with. As someone who is passionate about both the scientific and societal aspects of aging, I had yet to recognize the conflict created by advances of the former and inflicted upon the latter as an explanation for our floundering Medicare system. Although I am undeniably supportive of research efforts to diminish or altogether do away with the unpleasant physical declines of aging through use of surgery and other medical procedures, I am also of the opinion that aging overall ought not to be viewed as a disease to be eradicated completely. Instead of being grateful for the added years science and improved technology has brought us, we are all too quick to assume that human longevity can, and should, be infinitely drawn out. The argument that costly procedures are, for lack of a better word, wasted on individuals who have little chance of survival, and will likely face additional diseases even if they do, is a persuasive one, especially amid the staggering Medicare figures you cite. Although I would prefer an alternative path to fixing our health care system that does not include cutting off benefits to patients based solely on age, the fact remains that something has to change. That you first proposed this policy change almost 20 years ago only emphasizes the magnitude of the country's dilemma.

Aging Well: Is "Brain Training" the New Fountain of Youth?

A recent AARP.org article offers to seniors five keys to living longer, but it might be more accurate to call them five keys to living better. The advice, which includes encouragement to seek work and volunteer opportunities, spiritual fulfillment and self-awareness, seems to credit longevity to living with purpose. After centuries of working to increase human lifespan primarily by way of improved medicine, food production, and access to care, researchers and aging individuals alike are now focusing on adding worth to the years we've gained beyond the numerical values. Simply put, to those devoted to the science of aging, quality is as important now as quantity.

When it comes to living well, although we have seen some innovation, much of the "new" information we are inundated with lately appears to many to be common sense, or at the very least a rehashing of what has already been discovered and divulged. A separate AARP.org article entitled "50 Ways to Boost Your Noodle" is one such example of this. The article is yet another recitation of the recycled mantra commanding aging persons to "sleep" and "get support for stressors," as if this information is somehow new or different to most semi-intelligent individuals. Although it may be true that there is a disconnect between what the American public knows is good to do and what it actually does, pieces of advice similar to those offered here usually fail to deliver the dramatic opportunity for a lifestyle revolution so often promised. In addition to merely annoying the readership with their repetition, some of the information shared can be confusing and even contradictory. The perfect example of this of course is the oft-heard question of exactly how many glasses of red wine one is supposed to drink per day, in order to achieve the optimal health benefits. One? Two? 1,000 (perhaps some claims are more obviously flawed than others)? Along with the constant directives to eat right and exercise for better health in our aging years, of particular interest and focus has been the ways in which older individuals can "train" their brains, or improve their cognitive functioning abilities by way of simple daily tasks and games. While these programs can be entertaining, the health benefits they bring are far from revolutionary, and most likely do not exceed those achieved by performing any other minorly engaging cognitive task that is already present in everyday life (such as reading a paper).

One field that has benefited tremendously from the growing public awareness of brain health maintenance in old age has been the brain "training" websites and programs. The games produced by these research teams and companies are full of brightly animated colors and addicting tasks, and test memory, attention, processing speed, and other executive functions of the brain that have been found to decrease in efficiency as we age (a sample game can be found here, a screen shot of which is shown to the left). Web-based Lumosity.com is one such enterprise that has garnered both media attention and user adoration in the years since its conception. The research organization behind the games is Lumos Lab, whose Scientific Advisory Board includes neuroscientists from Stanford University and UCSF. Links from the site to ongoing research reveal that the program is just part of a larger study, and even allows users to volunteer to participate in testing the newest brain training tools. The home page boasts a sample of the prestigious publications and outlets that have featuring the site, such as the New York Times, Women's Health magazine, and the Martha Stewart show ("I've been having so much fun," Martha claims). Multiple graphs, such as the one shown below, accompany the site's study-based claims of proven memory and attention improvement in individuals that play the games. The site itself is clean, attractive, and user friendly, and older audiences were clearly in mind when the navigation and layouts were designed. The website additionally sponsors a blog that highlights recently published research on brain health, such as a recent post about the effects of smoking on the brain written by a cognitive neuroscience research at SFSU and UCSF. In a demonstration of the organization's efforts to stay current, the myBrain Facebook application was launched in September 2008, allowing users to access many similar features from the popular social networking site.

A New York Times article that reviews Lumosity.com also points out that the website is not the only brain training game in town. Similar products have enjoyed their success as well, including Nintendo's Brain Age 2, which has sold 14 million copies worldwide since its release in 2005, and Happy-Neuron.com, which has partnered with AARP and can be accessed by visitors to that site. In fact, the so-called "brain fitness software" industry is a booming one, and expected by one company head to "reach $2 billion by 2015." Despite the popularity of these programs, fellow researchers, however, are more skeptical of the claims they make. For one thing, the notion that humans can exercise their brains much in the same way we exercise our muscles to gain stamina and performance is not exactly a novel idea. According to a New Scientist article, commercial brain training has been around for a decade, but has only recently begun to achieve mainstream attention. Moreover, there remains no clear answers to several questions, one of which being whether the games enhance brain functioning or merely slow the decline. The answer to the most significant question, does it work? "It depends." Writer Graham Lawton goes on to cite problems in the research designs of Lumos Labs' studies, including a small number of participants and the lack of findings being published in a peer-reviewed journal. Overall, the article likens brain enhancing programs like Lumosity.com to anti-aging creams, an analogy I find to be applicable for nearly all of the advice and information on living better as we live longer. While there is no one study that can be conclusively pointed to as proof that these tools and tricks work, alternatively there is no study to prove that they do not. Games promising to train one's brain are perhaps no help, but are definitely no harm, so why not?