Aging and Performance Enhancing Drugs

Question 1

Where is population aging happening?

Answer 1

• in all regions and in all countries at various levels of development
• progressing fastest in developing countries

Question 2

What is the average length of human life? How is their time with health and compromised health affected?

Answer 2

• 75 to 78 years

- modest gain in healthy years but greater increase in years of compromised health

Question 3

Which physiological functions decline with age?

Answer 3

• all of them
• decline in cellular protein synthesis, immune function, muscle, strength, bone mineral density
• increase in fat mass, physical frailty

Question 4

How does BMI change with age?

Answer 4

• increases

Question 5

What becomes impaired as people age?

Answer 5

• glucose tolerance

- diabetes mellitus

Question 6

What are the 2 main factors in deterioration of glucose metabolism?

Answer 6

• decrease insulin secretion by beta cells

- increase insulin resistance (poor diet, physical inactivity, increase abdominal fat)

Question 7

What changes in the thyroid with age?

Answer 7

• small decrease in TSH secretion from pit

- large decrease in T4 metabolism in peripheral tissues (T4 stays same, T3 declines)

Question 8

What changes in GH with age?

Answer 8

• growth hormone effectively promotes the development of lean muscle

Question 9

What do we believe regulates aging?

Answer 9

• hypothalamus or higher brain

Question 10

What is DHEA? How is it affected by aging?

Answer 10

• steroid precursor
• plays a role in “feeling well”
• decreased in obesity and diabetes
• decreased with age

Question 11

What could affect both aging and obesity?

Answer 11

• perhaps caloric intact

Question 12

What results from overweight people cutting their calories by 25 percent for six months?

Answer 12

• reduced fasting insulin levels

- marker for lower levels have been associated with increased longevity in humans

Question 13

What is osteoporosis?

Answer 13

• disease of aging
• bone mineral density decrease with age
• associated with high glucocorticoids

Question 14

Why does osteoporosis especially effect women?

Answer 14

• because they have less androgen which increases bone and low estrogen after menopause

Question 15

What is the treatment for osteoporosis?

Answer 15

• supplementation with both calcium and vitamin D
• other nutrients play important roles: zinc, copper and iron
• bisphosphonates also effective antiresorptive agents

Question 16

How are bisphophonates anto-resorptive agents?

Answer 16

• inhibit osteoclast attachment to bone matrix and enhance osteoclast apoptosis

Question 17

Which two hormones decline with age in both males and females?

Answer 17

• testosterone and DHEA

Question 18

What happens if DHEA and testosterone is supplemented/replaced?

Answer 18

• no physiologically relevant beneficial effects on body composition, physical performance, insulin sensitivity or quality of life

Question 19

What are the negative effects of testosterone supplementation?

Answer 19

• acne, oily skin, hair loss

- increased hematocrit, sleep apnea, acceleration of pre-existing prostrate growth

Question 20

What are some of the dangerous effects of testosterone therapy?

Answer 20

• increased risk of heart attack, stroke, blood clots and heart-rhythm irregularities
• sleep apnea and prostate cancer risk

Question 21

What are the functions of ovarian estrogen and progesterone?

Answer 21

• maintain reproductive function
• modulate cardiovascular, neural, immune, gastrointestinal, musco-skeletal systems
• increase during pregnancy (good for uterine environment)

Question 22

What happens to estrogen and progesterone after menopause?

Answer 22

• vasomotor flushes, vaginal dryness, urinary symptoms
• risk for osteoporosis and coronary heart disease increases
• stroke and dementia risk increase (unsure if related)

Question 23

What could be the benefits of estrogen therapy?

Answer 23

• reduce coronary heart disease by 50%

- also decrease osteoporosis

Question 24

What was observed when testing estrogen therapy?

Answer 24

• increase breast cancer and cardiovascular problems (coronary heart disease and stroke)
• reduction in fractures and colon cancer
• only recommended to use hormone therapy for short time to manage menopausal symptoms

Question 25

When is estrogen (only) replacement therapy safe?

Answer 25

• for some menopausal women

- women who have had a hysterectomy (appears safe and may reduce risk of breast cancer)