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Once a doctor sets up an anti-aging practice, she stands to make major profits. Many age-fighting treatments aren't covered by insurance, which means the M. At a time when physicians are getting lower and lower reimbursements under managed care, it's little wonder that doctors of all stripes, from emergency-room medicine to radiology, are flocking to this lucrative new specialty.
So how do you know if your doctor is making promises he can't keep? Here are the top dangers Health's investigation uncovered:.
The biggest weapon in the anti-aging doctor's arsenal is the willy-nilly prescribing of hormones. It's also hazardous, because most age-erasing doctors aren't trained in using these powerful substances.
The main ingredient in that soup is HGH, which naturally declines in our bodies as we age. But "there is no scientific proof of this," Perls says.
In fact, HGH is only FDA-approved for use in a handful of conditions in adults including adult growth hormone deficiency, which is rare , and it is illegal to distribute a product containing HGH for anti-aging purposes. Another hot hormone is bioidentical estrogen.
For decades, women have relied on synthetic estrogen to relieve menopausal symptoms such as hot flashes and vaginal dryness. But when the Women's Health Initiative study on estrogen and progestin therapy was halted in -- due to a possible hormone-related increase in the risk of heart disease, stroke, blood clots, and breast cancer -- some doctors touted bioidentical versions, made from soy and yams, as safer though there's no proof they're less likely to raise your disease risk.
Bioidentical creams and pills made by pharmaceutical companies are available via prescription and regulated by the FDA.
Still, many anti-aging docs attempt to create their own bioidentical hormone cocktails tailored to their patients' special needs. Can supplements ease menopause symptoms? It's this customization that is most troubling to mainstream doctors. It involves taking a prescription to a compounding pharmacy, where pharmacists mix ingredients as outlined by your physician -- and the resulting concoctions are not approved by the FDA.
That means the drug you're getting may not work -- or may have unpredictable side effects. Whether there's even such a thing as an optimal hormone level is unclear, notes Cynthia Pearson, executive director of the National Women's Health Network, a nonprofit group that advocates for women's health issues: One of the newer anti-aging buzz phrases is adrenal fatigue.
The theory behind the syndrome is that chronic stress causes a decrease in the production of adrenal hormones, which can cause fatigue and sleep issues. In the transition countries, life evaluations were lower overall than in the Anglo countries, and the elderly do particularly badly, the opposite of the Anglo countries. Not being happy, which is uncommon in the Anglo countries, is quite common in the transition countries, particularly so among the elderly, where nearly 70 percent of those aged 65 and above did not experience happiness in the previous day.
Worry increases with age in the transition countries, and decreases in the Anglo countries. The Cantril ladder ranges from 0 worst possible life to 10 best possible life , and the graph shows the average.
Those aged 76 and above are excluded. There are 13, observations for happiness, and a little less than 25, for the other measures. Sample size is approximately proportional to the number of countries in the region. Happiness measures were not collected in all waves. There are 63, observations for happiness, and around , for the other measures. See also notes to Figure 1.
These features undoubtedly reflect the recent experiences of the region cohort effects , and the distress these events have brought to the elderly, who have lost a system that, however imperfect, gave meaning to their lives, as well as, in some cases, their pensions and their healthcare. The results and patterns elsewhere testify to the lack of globally universal age patterns.
In sub-Saharan Africa, Figure 3 , life evaluation is extremely low at all ages a reflection of the strong positive cross-country relationship between life evaluation and income 19 but there is little or no variation with age.
The prevalence of worry, stress, and unhappiness all rise mildly with age. The much richer region of Latin America and the Caribbean, Figure 4 , is different yet again, with life evaluation falling with age— though not as sharply as in the Eastern European countries—while worry and stress peak in middle age, though the age-profile is not as marked as elsewhere.
Even so, the Cantril ladder measures of overall life evaluation are almost identical for men and women, another indication of the importance of distinguishing different aspects of wellbeing. A strength of these new results is that they use identical questions on different aspects of subjective wellbeing for random samples for a large number of countries. One possible weakness compared with earlier results 12 , 14 , 20 —with which they are only partially consistent—is the lack of a time dimension, which cannot be realistically explored with only four years of data.
There are , observations in all, with country sample sizes ranging from nearly 7, Mauretania to 1, for six countries. There are 96, observations in all, with country sample sizes ranging from over 5, to There are many remaining challenges in understanding the patterns of age and wellbeing around the world.
A fundamental problem for this research area is obtaining funding for the continuation of worldwide polls, and this should not be underestimated, especially in fiscally difficult times.
Concerns have been voiced regarding potential methodological problems including ensuring comparability in the sampling techniques and standardizing the interpretation of questions and response scales across countries. Finally, there is work to be done on understanding the reasons for the observed age patterns. Current theories are not yet adequately accounting for the age patterns and country differences. In spite of these and other challenges, we believe that over the last decade there has been significant progress in documenting age differences in self-reported wellbeing.
The notion that impaired psychological wellbeing is associated with increased risk of physical illness is not new, since there is an established research literature linking depression and life stress with premature mortality, coronary heart disease CHD , diabetes, disability and other chronic conditions. There is also the issue of publication bias, with evidence that studies showing a favourable impact of wellbeing on health are more likely to appear in print.
However, stronger evidence is beginning to emerge, using both retrospective questionnaire assessments of eudemonic wellbeing and momentary hedonic measures taken repeatedly over the day. Eudemonic wellbeing was assessed with items from a standard questionnaire assessing autonomy, sense of control, purpose in life, and self-realisation see online supplement.
The cohort was divided into quartiles of wellbeing, and Cox proportional hazards regression was applied. The proportion of deaths was The regression analyses document the graded association between eudemonic wellbeing and survival Table 1. Other independent predictors of mortality in the final model were older age, being male, less wealth, being unmarried, not being in paid employment, a diagnosis at baseline of cancer, coronary heart disease, diabetes, heart failure, chronic lung disease and stroke, reporting a limiting longstanding illness, smoking and physical inactivity see supplementary Table 1 for the full model 5.
Figure 5 shows a Kaplan-Meier plot of survival in relation to baseline eudemonic wellbeing in the fully adjusted model. Survival in months from baseline is modelled after adjustment for age, gender, demographic factors, baseline health indicators, history of depressive illness and depression symptoms, and baseline health behaviours. Reference group is lowest eudemonic well-being group.
These results do not unequivocally demonstrate that eudemonic wellbeing is causally linked with mortality. There is a danger in overstating the evidence for a causal link, since people may feel that they are to blame for not seeing the meaning in life or perceiving greater control in the face of serious illness. But the findings do raise intriguing possibilities about positive wellbeing being involved in reduced risk to health. They also raise the question of whether wellbeing-selective mortality can help explain the age patterns of wellbeing in the previous section.
The US life table for shows a decadal mortality rate of If all this mortality came from those with the lowest life evaluation—which is the maximum possible effect—the average ladder rating would have risen from 6. Of course, we do not know the ladder scores of either survivors or decedents, but this calculation suggests that effects of selective mortality might be big enough to play a role.
Against this, however, is the fact that mortality rates from age 60 are higher in Latin America and sub-Saharan Africa than in the rich English speaking countries, which would lead to a stronger U, not the complete absence that we observe. Progress is also being made in understanding the behavioural and biological correlates of positive psychological wellbeing. Among lifestyle factors, physical activity is probably the most important link between psychological wellbeing and health.
Regular physical activity at older ages is already recommended for the maintenance of cardiovascular health, muscle strength and flexibility, glucose metabolism, and healthy body weight, and is also consistently correlated with wellbeing. Positive affect has been related to reduced inflammatory and cardiovascular responses to acute mental stress, and is associated with lower levels of inflammatory markers such as C-reactive protein and interleukin 6 in older women, and with higher levels of the steroid hormone dehydroepiandosterone sulfate.
Clinical and community studies show that a wide range of medical conditions are associated with raised levels of depression, including illnesses that are prevalent at older ages. A sizable proportion of individuals show increases in depressive symptomatology following diagnoses of diabetes, CHD, stroke, some cancers and chronic kidney disease, 35 - 37 while collaborative care that focuses both on mental health and physical illness has beneficial effects on both.
For example, one recent study of 11, older men and women in ELSA showed that chronic illnesses were associated with lower hedonic and eudemonic wellbeing. The reductions in happiness assessed over the previous week and eudemonic wellbeing increased progressively with number of comorbidities. These analyses were cross-sectional, so it is not known whether reduced self-reported wellbeing preceded or followed illness onset.
Firmer conclusions must await prospective analyses of these associations. Additionally, shifts in responses on patient reported outcomes are known to take place as people adapt to illness, leading to lower levels of distress and impairment of quality of life and possibly higher levels of happiness than might be expected.
The end of life is another setting where health clearly impacts psychological state, yet the medical establishment has struggled with ensuring optimal levels of wellbeing. Hospice care is associated with higher quality pain and symptom management, but aspects of wellbeing, such as a sense of dignity and relief of distress, are seldom addressed systematically.
The application of standardised measures of quality of dying, usually completed by relatives or carers, may encourage more direct evaluations of the experiences promoting optimal psychological wellbeing. Research into psychological wellbeing and health at older ages is at an early stage. Nevertheless, the wellbeing of the elderly is important in its own right, and there is suggestive evidence that positive hedonic states, life evaluation, and eudemonic wellbeing are relevant to health and quality of life as people age.
Health care systems should be concerned not only with illness and disability, but with supporting methods of improving positive psychological states. It is premature to contemplate large scale clinical trials to evaluate the effects of efforts to increase enjoyment of life on longevity; we do not yet know whether wellbeing is sufficiently tractable through psychological, societal or economic interventions to test effects on health outcomes.
Much of our knowledge about psychological wellbeing at older ages comes from longitudinal population cohort studies, and sustained investment in these research resources is essential. Novel methods of assessing hedonic wellbeing and time use are enhancing our understanding of the processes underlying positive psychological states at older ages. Most of the studies involve high income and not low or middle income countries.
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