Physiological Basis of Aging and Geriatrics, Fourth Edition

426 Pages·2007·35.72 MB·English

by  Paola S. Timiras

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Physiological Basis
of Aging and Geriatrics
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Physiological Basis
of Aging and Geriatrics
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y Fourth Edition
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m i Paola S. Timiras
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ar FrontandbackcoverillustrationspreparedbyEdMonroe.Theillustrationdepicts“Tounlockthesecretsofagingandlongevity”
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Physiologicalbasisofagingandgeriatrics/editedbyPaolaS.Timiras.–4thed.
p.;cm.
Includesbibliographicalreferencesandindex.
ISBN-13:978-0-8493-7305-3(hardcover:alk.paper)
ISBN-10:0-8493-7305-0(hardcover:alk.paper) 1. Aging–Physiologicalaspects.
2.Geriatrics.I.Timiras,PaolaS.[DNLM:1. Aging–physiology.2. Geriatrics.
WT104P5782007]
QP86.P5572007
612.6'7–dc22 2007016492
VisittheInformawebsiteat
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Preface
The publication of the fourth edition of Physiological Basis of presentsa synopsisofpharmacologic,nutritional,regenerative,
AgingandGeriatricscomesataparticularlyopportunetime.The and assistive interventions that promote successful aging and
lengtheningoflifeexpectancyatbirthandinoldage,whichbegan longevity. Using physiology as its unifying concept, the fourth
in the twentieth century, has reached both industrialized and, edition contains concise, explicit explanations and numerous
increasingly,developingcountries.Currently,individualsaged80 comprehensive tables and graphs. Clinical correlations are
yearsandolderappeartobethefastestgrowingsegmentofthe included as a practical reference for the geriatrician and as a
human population, and centenarians, once rarely seen, are guidetonormalagingforthegerontologist.
much more frequently encountered. Understandably, these Comparable books on aging target a professional and/or
0 demographic changes are being accompanied by a new way academicreadership;here,thegoalistoofferinformationthat
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0/ ofthinkingaboutaging. will be useful to a broad spectrum of readers from different
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8/ In the early twentieth century, the study ofaging focused biologicalandeducationalbackgrounds.Webelieveitwillnot
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n primarily on biomedical models of pathology, that is, how to only meet the needs of those preparing for a career in
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y diagnose the diseases and chronic disabilities afflicting the gerontology or geriatrics or interested in aging as a specific
brar elderly, and how best to treat them. It is safe to say that most topic in biological sciences, but also of older persons them-
Li scientists studying aging before the l980s regarded aging as a selves, along with their families and caretakers, who seek to
o
g risingwallofmortality.Sincethen,however,duetoamultiplicity better understand the aging-related changes and to gain new
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hic offactors,socialaswellasmedical,wehavewitnessedamajor insightsaboutthisstageoflife.
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of effort among researchers to reinterpret aging as a normal, When the elderly are viewed through the eye of the
y healthy, and even positive feature of the life span. Although clinician,theemphasisisontheneedforassessing,managing,
Universituse only. arfuegtniancigtniomsnuaafyfliccmoiemankpteepotlealdnstceierc,iatwdyhuailnctsdhmmreoagryeendseeurtsaectriemvpeitnicbealephaotobwidlisitusyectacoseese,snfmsuuollrsyet, aaangniddngrdedienvuicasiinnngegwriasplkipgfhraotc,ptoirsirasst.teEreqinnugtaetlhrlvyeneinmintipgoonprshtayansitim,oaleosdgwicaetcboiemmgippnreottoevnisnecgee
by nal ifnothowlong,agingpopulationsmaylive.Aswenowview quality-of-life. The concept of “continuity through change” is
care.com For perso terhensetemaailr,canhgueinmrsgetaroonudtusd,rnecaotthmhe,pimrleauxtctheinnltitekioreandctteiovoenthlsoepthpmahetynshtiaoavlnoedgimecnaacltouburarasatiigsoeondf, fsuuosncaidbelateympieatnssetta”lflthatogatea,claclnobnsiteoirnlvougeiitucyaslowfperplolrciinoesrssheesav.peniAntsgs fmiuntaduyirveipdfruuonavlcisdtieoann“sda.
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alt aging as well as the genetic and environmental factors that Indeed, in a 1972 book, Developmental Physiology and Aging,
e
ah alternately enhance and impair functional competence at (Timiras)identitywasshowntobeasdynamicaprocessamong
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or molecular,cellular,andorganismiclevels. theelderlyasitisintheyoung.Slowingorotherwisemitigating
nf Chapters are grouped into three main parts: In Part I, the effects of old age by strengthening physiological compe-
m i GeneralPerspectives,agingisviewedasanindividual’s“journey tence throughout life does not deny the inevitability of death,
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d fr taking place in a community setting.” It describes the but it does deny the inevitability of disability, disease, and
de demographic,epidemiologic,andcomparativeaspectsofaging despair. In this first quarter of a new century, we have every
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o anddiscussesmolecularandcellularaspectsofaginginrelation reason to rejoice in the vigorous declaration of the nineteenth
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w to several theories of aging, thus providing a comprehensive centuryEnglishpoet,RobertBrowning’s,“Growoldalongwith
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D profileofaginginindividualsandpopulations.PartII,Systemic me/Thebestisyettobe/Thelastoflifeforwhichthefirstwas

and Organismic Aging, surveys the aging of body systems, made/Growoldnorbeafraid!”
focusingonmaintenanceofoptimalfunctioningandadaptation
toenvironmentaldemands.PartIII,PreventionandRehabilitation, PaolaS.Timiras
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Acknowledgments
Ihavebeengreatlyencouragedinpreparingthisfourthedition processing, editing, and formulation of the many tables that
by the participation of several of the collaborators of the first, effectivelyintegratethediverseinformation.
second, and third editions and by the equal enthusiasm and I thank the editing team of Informa Healthcare and The
expertise of the first-time co-authors. All have willingly Egerton Group for their vigilance about the progress of the
accepted the task of reviewing, updating, or preparing anew book and its many drafts. In particular, I would like to thank
theirrespectivechaptersorsectionswithinstringentdeadlines. Sherri Niziolek, Sandra Beberman, Chris DiBiase, and Ginny
Tothem,Ioffermymostheartfeltthanksforanextraordinarily Faber.
well-accomplishedperformance. Finally,Iwouldliketorecognizethesilentencouragement
0 Special thanks to Dr. S. Oklund for the many drawings, of the many hundreds of students who have taken, over the
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0/ whicheffectivelyillustrate andintegrate thecomplex material years, my class, “Physiology of the Aging Process.” By their
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8/ presented. enrollment in the class, interest in the subject matter, their
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n Ialsowishtothankmyassistants,IreneThungandBrian criticism or praise, they have inspired me to continually
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y Bui, who competently prepared the manuscripts according to improve,streamline,andupdatethecoursematerial,aprocess
brar the specifications of the publisher and dealt with the word whichhasresultedinthesubsequenteditionsofthisbook.
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Contents
Preface iii
Acknowledgments v
Contributors ix
PartI GeneralPerspectives
1. OldAgeasaStageofLife:CommonTermsRelatedtoAgingandMethodsUsedtoStudyAging 3
PaolaS.Timiras
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8/ JohnR.Wilmoth
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y 3. ComparativeAging,GeriatricFunctionalAssessment,AgingandDisease 23
brar PaolaS.Timiras
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g 4. CellularSenescence,CellDeath,andTransgenicMouseModelsofAging 41
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hic JudithCampisi
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y 5. TheoriesofLifeSpanandAging 55
Universituse only. PartIJIameSsyRst.eCmariceyaannddOSirggeaZniosumicAging
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care.com For perso 6. TPhaoelaNSe.rTviomuisraSsyasntedmG:aSbteruJ.cMtuarlaelt,taBiochemical,Metabolic,andCirculatoryChanges 71
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alt 7. TheNervousSystem:FunctionalChangeswithAging 89
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ah PaolaS.TimirasandGabeJ.Maletta
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nf 8. SensorySystems:NormalAging,Disorders,andTreatmentsofVisionandHearinginHumans 109
m i EsmailMeisami,ChesterM.Brown,andHenryF.Emerle
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de 9. TheAdrenalsandPituitary—Stress,Adaptation,andLongevity 137
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o PaolaS.TimirasandOmerGersten
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D 10. FemaleReproductiveAgingandMenopause 159

FrancisBellino
11. TheEnsembleMaleHypothalamo-Pituitary-GonadalAxis 185
JohannesD.Veldhuis,DanielM.Keenan,AliIranmanesh,PaulY.Takahashi,andAjayNehra
12. TheThyroid,Parathyroid,andPinealGlands 205
PaolaS.Timiras
13. TheEndocrinePancreas,Obesity,andDiffuseEndocrineandChemicalMediators 219
PaolaS.Timiras
14. TheImmuneSystem 231
LiaGinaldiandHalSternberg
15. CardiovascularAlterationswithAging:AtherosclerosisandCoronaryHeartDisease 249
PaolaS.Timiras
16. Lipids,Lipoproteins,andAtherosclerosis 265
JohnK.BielickiandTrudyM.Forte