Medical Aspects of Increased Life Expectancy and Challenges of Aging

Evolutionary changes have led to a positive trend in average life expectancy at birth, and in the long-term historical perspective, this has become an evident fact. A new phenomenon that has developed in the last 150-200 years, namely during the period of the industrial revolution, is a significant increase in the average life expectancy after the age of 60. On one hand, this is a great boon as it extends the duration of life. On the other hand, the newly added period of life is often overshadowed by decreased functional capacity and dependence on external assistance.

This occurs due to new diseases where age plays a role as an etiological factor. Examples include age-related sarcopenia (reduction in muscle strength and mass) or age-related anorexia (reduced appetite and decreased nutrient intake). Such a significant increase in average life expectancy after the age of 60, leading to the emergence of new diseases, has sparked scientific discussions about where the boundary lies between age norms and pathology. For instance, after the age of 80, a significant decrease in muscle mass and strength occurs as a norm, which can be interpreted within the framework of age-related dynamics as sarcopenia. However, if this is age norm, then in such cases, the application of combined physical exercises, including resistance training, and a protein-rich diet are sufficient. If it is pathology, then it should be treated, including the use of appropriate pharmacological therapy, which requires a different approach in line with pharmaceutical market requirements.

To address these questions, the scientific community has proposed several concepts in the field of geriatric medicine. Among them, four concepts are particularly often highlighted: 1) geriatric asthenia, 2) age-related viability, 3) individual viability, and 4) premature aging. However, these efforts are primarily aimed at assessment, optimization of assistance, and achieving maximum functional capacity for patients. The dominant approach is functional, and diagnosis is mainly conducted using anamnestic methods.

From the perspective of classical therapeutic approaches in assisting patients with new age-related diseases, important components such as verification using laboratory and instrumental methods are still lacking. This logically necessitates the identification of a fifth concept in the development of geriatric medicine, based on the analysis of the body’s internal environment and its correction, taking into account existing national traditions and approaches. From our point of view, clinical peptidology could become such a concept.

Modern clinical peptidology represents a new interdisciplinary direction, studying peptides in regulating the human body’s internal environment, sources of peptides in the external environment, their application in diagnosis and therapy, as well as the use of various peptides in prevention and rehabilitation.