antibiotics

Pathophysiology of Aging and Its Socioeconomic Implications

Life expectancy has increased in most countries, particularly in western countries, as a consequence of advanced technology, vaccinations, antibiotics and other forms of therapies. The 20th Century saw a significant rise in life expectancy in wealthy population groups of developed nations. From an average of 50 years, life expectancy jumped to 75 years because of efficacious preventive measures against killer parasitic and infectious diseases. In most of these nations, every sixth person is 65 years old or above [1]. This is one of mankind’s momentous achievements and we congratulate these nations for it. Nations such as Japan, USA, France, East and West Germany, Sweden and UK, have a life expectancy averaging over 80 years [2]. Unfortunately, this bright picture is not universal. The developing world is experiencing the opposite of the above scenario due to the scourge of AIDS and other infectious diseases that have been ravaging it, relentlessly. However, although we all covet longevity, it does not always guarantee living well. Aging always comes with a gradual but progressive decline in biological functionality due to onset of age-related health conditions. For example, aging is often characterized by degeneration of cells. This loss of the cells’ regenerative ability can lead to morbidity that can impair the general vitality of the individual. Such changes can be frightening and can trigger feelings of loss of self-worth as well as feelings of insecurity. To prevent this, the aging individual needs to be surrounded by a strong support system. However, while in sub-modern cultures, old people are usually revered as repositories of cultural values and oases of generational wisdom, in most western societies they are more likely to be associated with lower social status and less power. There is an alarming growing negative stereotype and stigma against the elderly in western societies [3]. Because of the prevalence of such an attitude towards aging, a desperate effort to cling to youth has flooded and permeated these societies. Consequently, the demand for countless formulas, creams, pills and programs for discovering the fountain of youth and reversing signs of aging have established a foundation for a lucrative business that has blossomed into a multi-billion dollar industry. Propelled by fear of aging and ageism, all types and categories of cosmetics and hair styles meant to slow down or camouflage the aging process have saturated the market.
Ageism, which is prejudice and stigma directed at advancement in age, is evident in workplaces, in social life, and even in healthcare facilities where physicians and nurses’ expectancies and attitudes toward elderly people’s capabilities tend to shape the type of care they receive. For instance, an elderly person who is depressed is likely to be misdiagnosed with dementia. The belief that chronic illness is an inevitable consequence of the normal process of aging can cause the elderly to be overlooked for preventive or screening programs. A notorious job-related example of ageism was the mandatory retirement age that led to the creation of the Age Employment Discrimination Act of 1967.
Elderly people’s constant exposure to ageism can adversely impact their mental and physical health as well as their capability to execute normal activities of daily living. Research has demonstrated that elderly people exposed to negative stereotypes at subliminal levels can end up with increased systolic and diastolic blood pressure, and increased heart-rate to stress levels compared to their counterparts exposed to positive stereotype about their aging process in societies such as China, Japan and Africa [4]. Constant exposure to ridicule about their aging process has also been found to negatively affect elderly people’s will to live, their walking speed and even their handwriting. Furthermore, their memory can deteriorate quickly if constantly subjected to such derision. Although decline in cognitive abilities, and other physiological functions among the elderly may be an inevitable result of declining biological functions, these can be exacerbated by exposure to mocking and scornful language, negative stereotype, and stigma. Consequently, most elderly people feel safer when they confine themselves to groups of fellow elderly individuals who share the same fate such as those in assisted living facilities. Sadly, this usually means that they have lost their freedom to participate in matters that shape the destiny of their own society. But such a society deprives itself of the unique contribution these individuals can make based on the cumulative wealth of their experience.
To compound the problem of increased numbers of elderly people in developed nations, is the inevitable increased pressure and demand this exerts on social and health care systems. The increase in the population of the elderly means an increase in demand for long-term care facilities because elderly people are responsible for high utilization of these facilities. In the UK, the per capita utilization of health care services by old people is 3-5 times higher than for younger population groups [5]. The services and programs that were designed and implemented to support the elderly are financed by the population in the working age bracket. An increase in the numbers of elderly people means an increase in utilization of these resources, which makes the elderly an unwelcome burden to society. Obviously, there is need for better policies and interventions to help the elderly. For instance, not all the disabilities the elderly have should be considered as handicaps. Efficacious interventions can be conducted to help enhance their mobility and self-care. This can help them become less dependent on others. Primary preventive measures should be aggressively promoted to delay onset of debilitating health conditions such as type 2 diabetes, high blood pressure, heart disease, and stroke that can lead to morbidity and even mortality. A new paradigm is also needed to regard old age as a blessing not a curse, not only for the elderly individual but for the society as well, whether western or not.

Sources
[1]. Pesic, L. (2007). Social and Health Problems of the Elderly. Accessed from http://publisher.medfak.ni.ac.rs/2007-html/2-broj/SOCIAL%20AND%20HEALTH%20PROBLEMS…pdf
[2]. National Institute on Aging (2015). Global Health and Living: Living Longer. Accessed from https://www.nia.nih.gov/research/publication/global-health-and-aging/living-longer
[3]. Richeson, J.A. & Shelton, J.N. (2006). A Social Psychological Perspective on the Stigmatization of Older Adults. National Academy of Sciences.
[4]. Levy, B. R., Hausdorff, J. M., Hencke, R., & Wei, J.Y. (2000). Reducing cardiovascular stress with positive self-stereotypes of aging. Journal of Gerontology: Psychological Sciences, 55(4):P205–P213
[5]. Rechel. B., Doyle, Y., Grundy, E. & Mckee, M. (2009). How Can Healthy Systems Respond to Population Aging? Health Systems and Policy Analysis. Policy Brief 10. Accessed from http://www.euro.who.int/__data/assets/pdf_file/0004/64966/E92560.pdf

Your Body’s Microbe Community-An Ecosystem of Its Own Kind

At the heels of the Human Genome Project came the National Institutes of Health Common Fund Human Microbiome Project aimed at encouraging and generating research resources for characterization of the human microbiota and the part they play in and on the bodies of both healthy and diseased individuals.
In a discipline called metagenomics, scientists are sequencing and analyzing the DNA of complex and uncultured microbial samples from different microbial communities. The human microbiome is a collection of microbes that inhabit the human body. Each human body is teeming with variant microbes belonging to a variety of species. They are so numerous that they outnumber the cells of the entire body by 10 to 1. This means that there are 10 microbes to one human cell. These microbes have about 100 times more genes than our genome!!! Your stomach and mine have each 100 billion bacteria for every one gram of their matter.1 The human body hosts all these microbes and many more, forming something of a microbial ecosystem. An assortment of microbes resides in the oral cavity, alimentary canal, nose, skin etc…
Scientists working with the Human Microbiome Project (HMP) are analyzing microbial genetic information in order to understand the role microbes play in etiology of disease. Each person’s microbiome is unique to them; as unique as their finger prints. Each individual can host different microbial communities on and in different sites of their body.
Scientists claim that each microbial community can be used to predict the body’s susceptibility to diseases, and other characteristics. For instance, by studying the microbiome of an individual, scientists can tell whether the person was breastfed as a child, and even their level of education. By sequencing and studying microbiomes from individuals with different diseases, they are able to establish associations between human microbiomes and disease. This is critical for identifying new diagnostic and treatment regimens.2 However, not all microbes are disease causing. Some microbes do a lot for us such as digesting food, and synthesizing vitamins.
Microbes from different sites of the body can also be predictive of other communities. This means that by examining microbes from a given site of the body, say, the mouth, we can tell what kind of community is in the person’s alimentary canal, too. This helps in the study of risk of diseases in people, and can lead to discovery of efficacious personalized therapies.
As for taking antibiotics, one has to be very careful as this can be similar to applying herbicides to the ecosystem. Sometimes, this can destabilize the system to our detriment. It can also become breeding ground for super-bugs.

Sources

Heather Kathryn Ross (2014). Is the Forest of Bacteria Inside You Your Most Precious Resource? Accessed from http://www.healthline.com/health/microbiome-discover-your-trillions-of-bacteria

Vincent B. Young, Robert A. Britton, & Thomas M. Schmidt (2008). The Human Microbiome and
Infectious Diseases: Beyond Koch. Accessed from Interdisciplinary Perspectives on Infectious Diseases
Volume, Article ID 296873, doi:10.1155/2008/296873

Age of Superbugs…

The current hospital outbreak of superbug carbapenem-resistant Enterobacteriaceae (CRE) connected to the death of two patients at a UCLA hospital is unnerving some patients scheduled to undergo the same procedure in other hospitals as well. CNN reported on Thursday, February 19, 2015 that the infection was caused by medical endoscopes or duodenoscopes manufactured by Olympus, which the FDA reportedly admits “cause challenges for cleaning and high-level disinfection.” The hospital has contacted other 179 patients who had undergone the same procedure from October 2014 to January 2015.
For almost a century now the medical profession has been using antibiotics to combat and control bacteria that make people sick. But in recent years these antibiotics seem to have lost their power to destroy some of the bacteria. The way these antibiotics have been used sometimes seems to have contributed in the creation of drug-resistant bacteria which we now know as superbugs. Superbugs are strains of bacteria that have developed the ability to resist many forms of antibiotics. The CDC claims that each year 2 million people are infected with a drug-resistant bacteria of some sort and 23,000 of them die due to the infection- in the United States alone.1
Antibiotics are among the most common types of medicinal drugs prescribed by clinicians to their patients. Sometimes antibiotics are given to livestock for disease prevention and for growth stimulation. But these antibiotics are not always a necessary treatment regimen, and their over-use as well as misuse ends up creating drug-resistant bacteria. Sometimes people take antibiotics when they come down with the flu, but antibiotics cannot destroy the flu-causing virus. They are not able to fight a viral infection. In these cases, the antibiotics only succeed in destroying a wide variety of bacteria in the body including the ‘good’ bacteria that help with the digestive process and general well-being. But some types of bacteria are tough enough to survive this form of “treatment.” They seize this as an opportunity to grow stronger and to multiply. Sometimes they even spread to other people.
As more people continue to take unnecessary antibiotics, the bacteria become more and more drug-resistant and spread, and may even share their drug-resistant characteristics or traits with other bacteria, making them stronger still while the antibiotics become less and less efficacious.
This places a responsibility on each one of us to take antibiotics only when necessary and in a manner prescribed by the healthcare provider. It is important to refrain from insisting on antibiotics against the advice of a provider.
Sources

1 National Institutes of Health (2014). Stop the Spread of Superbugs. http://newsinhealth.nih.gov/issue/feb2014/feature1

2 Ibid.