anti-aging teleconference: what is anti-aging medicine?

JOURNAL OF ANTI-AGING MEDICINEVolume 6 Number 2 2003copy Mary Ann Liebert Inc

Roundtable

Anti-Aging Teleconference What is Anti-Aging Medicine

PARTICIPANTS ROBERT ARKING BOB BUTLER BRIAN CHIKO MICHAEL FOSSELLEONID A GAVRILOV JOHN EDWARD MORLEY S JAY OLSHANSKY

THOMAS PERLS RICHARD F WALKER

ABSTRACT

The concepts of ldquoanti-agingrdquo and ldquoanti-aging medicinerdquo in particular are hotly debated nowboth in the mass media and among some researchers This paper represents an open discus-sion of anti-aging terms and related ideas by nine leading experts in the field of aging stud-ies and it describes in detail the arguments presented by both supporters and opponents ofthese concepts Candid exchange of opinions makes it clear that more efforts are required be-fore a consensus on these issues can be reached The paper also presents evidence that theterm ldquoanti-agingrdquo is routinely used now in scientific literature as a legitimate scientific termincluding even the titles of publications in reputable scientific journals written by estab-lished researchers

91

INTRODUCTION

ldquoANTI-AGING MEDICINErdquo is a concept withmore argument that clinical substance

but one with enormous promise and implica-tion Unjustified claims prompt many to railagainst commercial ventures inspiring moredemagoguery than rational discussion Aging isnatural but for most of us undesirable Unfor-tunately our human inclination to avoid logicalreasoning is also natural but just as undesirableand perhaps even more unproductive

Recently for example one of our academicdiscussants (from a prominent and famous in-stitution) enjoyed a recurrent diatribe against afellow discussant He had justified his positionon the basis of his extensive list of publications(an ad hominem argument) The target of his

wrath quietly pointed out that what matteredin argument were data facts and logic not rep-utation publications or intelligence The sec-ond discussant (who spoke more than a dozenlanguages had perfect GRE scores and hadonce rejected faculty positions at StanfordYale and the University of Michigan in favorof a quieter life) then accurately pointed outthat onersquos background was no more guaranteeof omniscience than were long list of publica-tions (which both had) The relevant questionwas one of rational argument not priorachievement Oddly enough the first discus-sant concluded that the second discussant hadldquodelusions of grandeurrdquo Seldom had we seenpsychiatric double talk used to justify an adhominem argument So much for logical dis-cussion and the use of empirical data

ROUNDTABLE92

Michael Fossel received his MD and PhD from Stanford where he held an NSF fel-lowship and lectured in psychology neuroanatomy and medicine Currently the ed-itor of the Journal of Anti-Aging Medicine he has been the executive director of theAmerican Aging Association has lectured worldwide has taught in several univer-sities and is currently Clinical Professor of Medicine at Michigan State UniversityHe has numerous publications including the best selling Reversing Human Aging andhis upcoming Oxford University Press textbook Cells Aging and Human Disease anacademic exploration of the genetic and cellular mechanisms underlying all human age-related diseases (as well as their prospects for intervention) including 4250 ref-erences 150000 words and two dozen figures

Bob Butler is President and CEO of the International Longevity CentermdashUSA Pro-fessor of The Mount Sinai School of Medicine and Founding Director of the NationalInstitute on Aging

Robert Arking is Professor of Biological Sciences at Wayne State University in De-troit MI He is engaged in research on aging mechanisms in Drosophila He enjoyswriting on both the technical aspects of aging and longevity as well as on the broaderaspects of aging in general

Leonid A Gavrilov PhD is the Editorial Board member of the Journal of Anti-Ag-ing Medicine journal ldquoExperimental Gerontologyrdquo the Scientific World Journal anda referee (reviewer) for 19 scientific journals He is a Research Associate at the Cen-ter on Aging National Opinion Research Center University of Chicago and a Prin-cipal Investigator of the project ldquoBiodemography of Human Longevityrdquo supportedby the National Institute on Aging (USA) His scientific credentials are described inmore detail in ldquoWhorsquos Who in Science and Engineeringrdquo ldquoWhorsquos Who in Medicineand Healthcarerdquo and ldquoWhorsquos Who in Americardquo (Marquis Whorsquos Who)

Brian Chiko Photo and bio were unavailable at press time

ANTI-AGING TELECONFERENCE WHAT IS ANTI-AGING MEDICINE 93

John Edward Morley completed his medical degree at the University of Wit-watersrand in Johannesburg South Africa in 1972 He is board certified in internalmedicine endocrinology and geriatric medicine and has edited 16 books and haspublished over 850 papers He has received numerous prestigious awards and wasamong the 100 most-cited authors in the world from 1980 to 1988 He is editor of thegeriatrics section of the yearbook of Endocrinology He edits the geriatrics section ofCyberounds In January 2000 he became the Editor for the Journal of GerontologyMedical Sciences He has been an invited speaker at many key industry meetingsHe is the medical director of four nursing homes

Thomas Perls MD MPH is Associate Professor of Medicine at Boston UniversitySchool of Medicine and is Director of the National Institutes of Health funded NewEngland Centenarian Study

S Jay Olshansky received his PhD in Sociology at the University of Chicago in1984 He is currently a professor in the School of Public Health at the University ofIllinois at Chicago and a Research Associate at the University of Chicagorsquos Centeron Aging and the London School of Hygiene and Tropical Medicine The focus ofhis research to date has been on estimates of the upper limits to human longevityexploring the health consequences of individual and population aging and globalimplications of the re-emergence of infectious and parasitic diseases

Richard F Walker PhD is Research Professor of Biochemistry and Molecular Biology at the University of South Florida and currently serves as Senior Clinical Ed-itor for the Journal of Anti-Aging Medicine He worked in aging research for over 30years at institutions such as Duke University Medical Center for the Study of Agingand Human Development and the Sanders-Brown Research Center on Aging Uni-versity of Kentucky College of Medicine where he was tenured Associate ProfessorHe received support for his research from the NIH NSF and DOD as well as fromprivate industries and agencies

The same uncontrolled emotional tenor oftenpermeates discussions of the ethics and impli-cations of anti-aging medicine (see this issuesrsquoseditorial) resulting in occasionally bizarre po-sitions implying an almost medieval justifica-tion for and acceptance of human suffering anddisease The fault however derives not merelyfrom a lack of logic and compassion but fromtotally ignoring our lack of semantic agree-ment Aging means ldquobiological senescence andincreased pathologyrdquo but to many people italso means ldquoa gain in perspective experienceand maturityrdquo While the former has little torecommend it and the latter a great deal weconfute the two meanings and then wonderwhy we disagree so irrationally and even vi-ciously The same problem occurs in discussinglsquoldquoanti-aging medicinerdquo a term that variouslymeans ldquoresearch into biological senescencerdquo ldquoafield of clinical endeavor which aims to preventand cure age-related diseaserdquo ldquointerventionswhich may improve secondary age-related bio-markersrdquo ldquoproducts claiming to affect agingrdquoand even ldquothe snake-oil marketrdquo It is this lat-ter problem the meaning of anti-aging medi-cine that prompted us to bring together dis-parate discussants in the field What we askedour discussants is anti-aging medicine

Several of those we invited were unable to joinus as it was difficult to schedule a dozen promi-nent people from around the world for a singlehour together Nonetheless those joining us rep-resented not only different backgrounds and dif-ferent institutions but divergent opinions Ourdiscussants are from academic biotechnologyand clinical venues Some are vociferous propo-nents of anti-aging and its remarkable clinical po-tential while others rail against frequently fraud-ulent claims and intentional exploitation of a credulous public The only common threadamong our discussants was a passionate interestin the field and finally in the truth

TELECONFERENCE

MICHAEL FOSSEL I want to put out twosuggestions for beginning this discussion Thefirst is a series of questions One is ldquoIs thereany effective anti-aging medicine nowrdquo I thinkwe all have strong answers to that one Willthere ever be And what about in the labora-

tory or with animal models as opposed to clin-ical interventions that is laboratory anti-agingor aging interventions in the laboratory invitro for example The second issue that comesup is ldquoAre there different venues in which theterm may be valid while itrsquos not in anotheronerdquo For example what about discussing thisfrom the standpoint of biotech as in Brian orVenture Capital versus medicalclinical useversus academic investigation versus commer-cial ventures such as a number of things actu-ally

JAY OLSHANSKY Actually the first ques-tion you asked was ldquoIs there any anti-agingmedicine in existencerdquo I think it goes right tothe heart of the issue that yoursquore trying to getat and that is ldquoWhat is anti-agingrdquo I thoughtthat that would be a good point for discussion

RICHARD WALKER Let me jump in onthat I think the semantics are important I thinkthe issue of anti-aging is generally assumed tobe increased in absolute lifespan I think thatbefore we make that assumption we shouldlook at a reflection of the possibility that life ex-tension could include within the biological lim-its as well as outside of the biological limits Ifyou look first at within the biological limits orpopulation longevity then we can say yes infact anti-aging medicinemdashif you want to usethat termmdashhas been effective in increasing life-span during the past century During the nextcenturymdashor during this current centurymdashitrsquosgoing to increase it dramatically If we go be-yond that into extension of absolute lifespanthatrsquos a future endeavor and I think itrsquos quitedifferent from what wersquore talking about here

MICHAEL FOSSEL Let me ask you a ques-tion about what you just said You said thatanti-aging medicine is an extension of lifespanSeat belts extend lifespan but I donrsquot think thatthey are anti-aging medicine Would you liketo clarify

RICHARD WALKER Yes In terms of ex-tension of lifespan to biological limits safetymeasures like seat belts of course would workbut when we look at the causes of death interms of medical perspective initially and inthe early parts of the past century based on ex-trinsic disease as antibiotics and other thera-pies have come to sort of minimize extrinsicdiseaseintrinsic disease diseases of internaldisorder have become dominant Now wersquore

ROUNDTABLE94

working on that Effectively preventive medi-cinemdashthe process of ldquoletrsquos go to the very ba-sicsrdquo reducing free radicals preventing celldamage and stuff like thatmdashwill extend thetime before the intrinsic diseases appear Sothat approach to reaching absolute limits of bi-ological life is quite different from wearing seatbelts So thatrsquos what Irsquom talking about Also thefact that most people in our society even ourWestern society are considered old AARPstarts at 50 Wersquore not even halfway to the bi-ological limits So when wersquore talking aboutanti-aging medicine at the most elementallevel we can start talking about that whichwould achieve maximal age within the biolog-ical domain Then we can talk about the othersubject about going beyond that

MICHAEL FOSSEL Jay you said that itrsquoslargely a semantic issue as well though andthatrsquos part of what wersquore talking about now notonly what we can do in the lab but what wecall it Do you want to comment

JAY OLSHANSKY Yes I think there is a realproblem with the definition here If we exer-cise and modify our diet we can reduce ourrisk of a variety of diseases and perhaps inmany cases extend duration of life Have wealtered the basic biologic rate of aging at allwith any of these interventions I think thatthat would be a highly questionable assump-tion So I think itrsquos important to distinguish be-tween interventions that might intervene in thebasic biological rate of aging itself and inter-ventions that influence the manifestations ofaging such as preventive medicine whichmight influence the expression of diseases atany age I think itrsquos important to distinguishbetween those two I think that actually is afundamental difference in the way in whichsome people look at the notion of anti-agingmedicine and others Certainly itrsquos a funda-mental difference in the way in which I lookat it and the way in which others look at it

RICHARD WALKER Would you deny whatI proposed in my opening argument that pop-ulation longevity or acquisition of absolute lim-its of biological life is not anti-aging medicine

JAY OLSHANSKY First of all I donrsquot knowwhat absolute limits to biological life are thatyoursquore talking about I donrsquot know that there issuch a thing as a basic biological limit to theduration of life that evolved under the direct

force of natural selection Since I donrsquot reallybelieve that such limits exist Irsquom not quite surewhat yoursquore referring to

MICHAEL FOSSEL Let me ask something alittle clearer Letrsquos say that we talked about 120yearsmdasheven arbitrarilymdashno more than that Orletrsquos say 100 years as sort of a limit for what weexpect to get in the near future Letrsquos say weassume that Is anything up to 100 years anti-aging medicine or is it only things greater than100 years or whatever figure you pick like thatLetrsquos say that we pick an arbitrary figurearound that Is anti-aging medicine on one sidethe other or both

RICHARD WALKER Let me just say to Ol-shanskyrsquos comment itrsquos true that we donrsquotknow what the absolute limits are of biologicallifemdashhuman biological lifemdashbut letrsquos talk aboutthat now anyway We know that beyond cer-tain ages frailty becomes a very significant fac-tor in terms of survival I think Fosselrsquos com-ments about 120 years as an arbitrary numberare fine because we donrsquot expect humans to liveeven in the best conditions much longer thanthat I go back now to Fosselrsquos comments I sayanti-aging medicinemdashat least one componentof it is within this limit of 100 years or 120 yearsThere is another component that wersquoll talkabout maybe later

LEONID GAVRILOV I would like to sup-port Jay Olshansky with the statement thatthere is no limit to human lifespan and thereis nothing weird in this statement Itrsquos very sim-ple Itrsquos statistics If you study the age-depen-dence of mortality rate yoursquoll find that at extreme old ages the phenomenon of aging ap-parently disappears mortality rates are ex-tremely high but they do not increase muchfurther with age For example centenarians(1001 years) have extremely high death ratesso that about half of them die each year butthese death rates do not increase much furtherwith age Their survival curves follow the samepattern as described by the law of radioactivedecay For the law of radioactive decay fromstatistics it follows that there is no fixed limitfor lifespan so you can measure the half-lifetime but you cannot determine the absolutemaximal age which separates possible valuesof lifespan from impossible values I under-stand that this may sound as a paradoxicalstatement but thatrsquos demography and thatrsquos


statistics More detailed justification of this con-cept can be found in the book The Biology of Life Span A Quantitative Approach section 42ldquoIs there a Species-Specific Life Span Limitrdquo(Gavrilov and Gavrilova 1991)

RICHARD WALKER If that was validLeonid then you would expect there to be atleast some representatives of 500-year-olds and1000-year-olds around

LEONID GAVRILOV No This paradox iswell discussed in the standard textbooks ofprobability theory such as An Introduction toProbability Theory and its Applications written byW Feller You can estimate the probability ofa given longevity record and then when youknow the population size yoursquoll find that eventhe longevity claim for Jeanne Calment (122years and 5 months) is in fact implausibleThis statistical paradox was recently discussedin the journal Population and Development Re-view (Gavrilov and Gavrilova 2000) Peoplecannot live so long not because they cannotpass a fixed bounding age limit but simply be-cause the probability of riding out the everpresent risk of death for that long is infinitesi-mal So although there is no fixed limit thatseparates possible numbers of lifespan fromimpossible numbers simply because of statis-tics it is quite implausible to have such a longlifespan This longevity record is suspiciousfrom the point of view of probability theoryThus if you apply probability theory it ex-plains nicely why the absence of the fixed limitto lifespan is perfectly compatible with the ab-sence of 500-year-olds and even 122-year-oldsaround

BOB ARKING I would like to first agreewith Leonid about the probability function oflongevity but I would also like to get back towhat Jay said about definitions They are actu-ally important I think in the conversation thatwersquove had here wersquore mixing together severalconcepts both aging and senescence Theyrsquoreall mixed in with longevity limits and thingslike that I think itrsquos important to understandwhat aging is Aging as I use itmdashI may be aminority of onemdashis a time-independent seriesof particular deleterious changes that occur inthe post-reproductive era and lead to a loss offunctionmdasha decreased loss of function Theycan be measured at least in the lab by changes

in biomarkers or gene expression changesThen the processes that drive the change fromone stage to the next are in fact senescenceprocesses Given that you defined this as atime-independent series of changes that arecorrelated ideally with loss of function then infact you can measure aging The question as towhether there is anti-aging science or anti-ag-ing medicine presupposes another questioncan we in our flies in our worms or in our pa-tients measure (slow down) the rate of loss offunction by some intervention If we can dothat and measure it then in fact there is an anti-aging effect If you canrsquot do that then thereisnrsquot

MICHAEL FOSSEL So what yoursquore sayingis that when Tom Perls in his clinic sees pa-tients dying they may be dying statisticallybut they are not dying of statistics There issomething a lot deeper going on

BOB ARKING Oh in terms of what Leonidsaid a rare event (living to 125 or some otherlarge number) is clearly a very rare event Youneed a starting size of population to make arare event become possible Maybe someonecan live to 200 years Maybe not I donrsquot knowBut in our present state itrsquos a function of thepopulation at risk

MICHAEL FOSSEL Is anti-aging then just amatter of trying to alter the statistical proba-bilities

BOB ARKING No I think anti-aging wouldbe trying to slow down the rate of change

TOM PERLS Just about the semanticsbriefly A very basic question for this confer-ence is addressing the appropriateness of theterm ldquoanti-aging medicinerdquo I think that withthe American Academy of Anti-Aging Medi-cine (A4M) and other high-profile entities itdoes pay to be very careful about what we callit To me the use of the word ldquomedicinerdquo isjust another attempt at adding credibility towhat I believe is mostly quackery Instead ofcalling it ldquoanti-aging medicinerdquo I feel prettystrongly about calling it ldquoanti-aging quack-eryrdquo The reasons for that are twofold reallyOne is that the term ldquoanti-agingrdquo I believehas the ultimate effect of being ldquoanti-oldrdquo Inits marketing the American Academy forAnti-Aging Medicine juxtaposes young veryfit-looking people against their image of old

ROUNDTABLE96

people that of very frail individuals in wheel-chairs staring at nursing home walls So theyhave this extremely pernicious message of be-ing anti-old and that you need to do every-thing you can to not be old On the other handI propose that there can be a very positiveenabling view of agingmdasha fountain of agingwell as opposed to a fountain of youth Thesecond point is that the term ldquomedicinerdquo lendsa feeling of credibility that the field does notdeserve The field should be really thought ofin two ways it is made up of those who areclaiming they have products that stop and re-verse aging when the science does not sub-stantiate their use and the products could po-tentially be quite dangerous Then there arethe scientists who are doing good work whoare not making those claims But I think forthat reason ldquomedicinerdquo should not be at-tached to the term ldquoanti-agingrdquo If we want tolook at anti-aging in terms of looking at thebasic biology of whatrsquos going on and what wedo to intervene with that thatrsquos a differentterm to start thinking about that

LEONID GAVRILOV I have made somesearch for the term ldquoanti-agingrdquo in scientific lit-erature to determine the current status of thisterm in science I have found more than 300 sci-entific articles that use the term ldquoanti-agingrdquo ei-ther in titles key words or abstracts This is ofcourse an underestimate because many morearticles using the term ldquoanti-agingrdquo are not de-tected by MedLinePubMed search if this termis used in the main body of text but not in thetitle key words or abstract The content anal-ysis of these publications is really interestingSome of the recent articles do criticize the abuseof this term which takes place outside the sci-entific domain (ldquoin the wildrdquo) but most of the scientific articles are using the term ldquoanti-agingrdquo as a self-explanatory legitimate termwhich does not require any justification Whatis particularly interesting is that sometimes theterm ldquoanti-agingrdquo is put even in the titles of thearticles as a legitimate term (over 40 scientificarticles) in such reputable journals as Scienceand Proceedings of the National Academy of Sci-ence of the United States of America There are atleast 26 professional journals and editions thatuse this term as a legitimate one even in the ti-tles of their publications

AgingmdashClinical and Experimental Research (Milano)

Annals of the New York Academy of SciencesBiogerontologyBioscience ReportsCellular and Molecular Life SciencesClinical and Experimental Pharmacology and Physiology

CNS Drug ReviewsEthnopharmacologyExperimental GerontologyExpert Opinion on Therapeutic TargetsImmunology LettersInternational Journal of Biochemistry amp Cell BiologyInternational Journal of NeuroscienceJournal of Anti-Aging MedicineJournal of GerontologyJournal of NutritionHealth amp AgingJournal of Reproduction and FertilityMechanisms of Ageing and DevelopmentMedical HypothesesMicroscopy Research and TechniqueNovartis Foundation SymposiumObesity ResearchProceedings of the National Academy of Sciences ofthe United States of America

ScienceScientific AmericanToxicologic Pathology

When you look for the authors who put theterm ldquoanti-agingrdquo as a legitimate term in the ti-tle of their publications you will find that theseare reputable scientists such as Steve AustadDonald Ingram Edward Masoro Arlan Richard-son George Roth and Richard Weindruch[Here is a partial alphabetic list of 18 particularlyprominent scientists who used this term as a le-gitimate one in the titles of their publicationsSN Austad E Bergamini (Italy) BF Clark(Denmark) RG Cutler AD de Grey (UK) AEveritt (Australia) AR Hipkiss (UK) DK In-gram K Kitani (Japan) DL Knook (Nether-lands) MA Lane EJ Masoro J Meites SI Rat-tan (Denmark) A Richardson GS Roth RWeindruch and BP Yu]

I would be delighted to be on a team withsuch good scientists [Anyway the results ofthis bibliographic study are now published inthe form of an article with a self-explanatory


title ldquoScientific Legitimacy of the Term lsquoAnti-Agingrsquo (Gavrilov 2002) In updated form theresults of this bibliographic study are also avail-able at the following website wwwsrcuchicagoedu~gavr1antiaging-publicationshtml]

Thus we can conclude that the term ldquoanti-agingrdquo is accepted now as a legitimate scien-tific term by reputable journals and establishedresearchers This term is routinely used now inscientific literature (like the terms ldquoanti-oxi-dantrdquo or ldquoantibioticrdquo for example)

The term ldquoanti-agingrdquo is also accepted as alegitimate term by at least five dictionaries andencyclopedias including the most recent Ency-clopedia of Aging published by Macmillan Ref-erence USA (Ekerdt 2002)

You can also find this term in the medicaldictionary where it is listed as an adjective todescribe interventions ldquoused or tending to pre-vent or lessen the effects of agingrdquo (www2mer-riam-webstercomcgi-binmwmednlmbook5Medicalampva5antiaging)

The American HeritageregDictionary of the EnglishLanguage 4th ed (2000) also mentions ldquoanti-ag-ingrdquo as an adjective to describe interventionsldquodelaying or lessening the effects of agingrdquo(httpwwwbartlebycom6134A0333450html)

This term is also accepted by the Merriam-Webster Dictionary (wwwm-wcomcgi-bindictionaryva5antiaging)

In some cases claims are made that the termldquoanti-agingrdquo is an oxymoron because the no-tion of aging prevention defies fundamentallaws of physics and chemistry The ldquoexpertsrdquowho make such claims really need to educatethemselves by reading for example the articleldquoAntiaging Agentsrdquo published in the recentEncyclopedia of Chemical Technology (Kroschwitzand Howe-Grant 2001)

Yes it is true that this term is abused outsidethe scientific domain (ldquoin the wildrdquo) by charla-tans and quackery So what Charlatans are al-ways doing this with any other term and ideathat can be attractive and profitable For ex-ample there are great abuses over sex drugsand money but nobody suggests eliminatingthe terms ldquosexrdquo and ldquodrugsrdquo from biology andmedicine as well as the term ldquomoneyrdquo fromeconomy

MICHAEL FOSSEL Let me point out two

things One is that wersquove just taken a turnWersquore no longer talking really about whetherthere is really anything that affects aging Wersquoretalking about the use of the term Irsquom glad wechanged that Yoursquore defending it on thegrounds that itrsquos in use whether we like it ornot whether you think itrsquos a good term or notItrsquos in use Let me point out the opposite of thatBrian Chiko represents I think the interests insome ways of venture capital and biotech Theydonrsquot use the term for a similar very practicalvery pragmatic reason Itrsquos not useful fiscallyBrian can you comment on that

BRIAN CHIKO Yeah Briefly I agree whole-heartedly with Tom Perls I think if you lookat most of the biotech companies they have re-ally evolved to not adopt any of the currentnomenclature thatrsquos used such as ldquoanti-agingrdquoItrsquos been used for so long by high-profile orga-nizations such as the A4M that really have neg-ative undertones and some very questionablepractices So to avoid that association or thatconnotation is a goal of any company seekingrecognition and significant amounts of capitalto develop drugs that will ultimately be FDAapproved When you get a drug approvedthrough the FDA you need to be addressing adisease and not aging because aging isnrsquot rec-ognized as a disease So any new drug thatcomes out that does address aging will neverbe identified as that certainly not initially

TOM PERLS The reason I like the term ldquopre-ventive medicinerdquo so much is because societycan get so much more bang for its buck by look-ing at the older years beyond the age of 60 asa period of time that we should all be takingadvantage of and that we should maximize interms of our health Public health measures es-pecially education would facilitate many morepeople to live to older agemdashthat is to live totheir mid-to-late 80s compressing their mor-bidity toward the end of their lives living along period of time beyond the age of 60 ingood health Strength training achieving a leanweight an appropriate diet not smoking andother strategies such as these would have atremendous benefit in terms of doing much ofwhat I think a lot of people in this conversa-tion would like to see happen But as long aswe continue to feed into things like what A4Mis doing (ie giving a negative view of aging)

ROUNDTABLE98

people will fall for the anti-aging quackeryThey will reach for the things that these huck-sters promise rather than exert the significanteffort and will required to get to older age ingood health and take advantage of what shouldbe a wonderful time for us I just think that theterm ldquoanti-agingrdquo combined with a credibleterm like ldquomedicinerdquo is counter to the goal ofgetting many more people in good health at anolder age

MICHAEL FOSSEL Let me just underscorewhat you said by pointing out that there is noJournal of Anti-Alzheimerrsquos or anti-cancer oranti anything else that people donrsquot like Forthat reason the publishers and I have talkedfor a long time about changing it to the Journalof Aging Medicine Again the decision hasnrsquotbeen made but it is I think along some of thelines that yoursquove just raised

RICHARD WALKER Can I jump in here interms of the practicality on both sides of thisissue I have been in this field a long time Idonrsquot think that I ever heard the term ldquoanti-ag-ing medicinerdquo until the 1990s I donrsquot knowwho coined the term but it may very well havebeen Klatz and A4M Whether itrsquos used or notin the literature now is somewhat irrelevantBut in fact a decade before that there was agroup out of California who are also entre-preneurs Pearson and Shaw I believe whojumped on Catiarsquos work showing that L-dopamdashand also Wertmanrsquos workmdashextended life in ex-perimental animals That didnrsquot have much rel-evance to the general public because it didnrsquotrelate to humans I think the significance ofldquoanti-aging medicinerdquo the term is that itlinked to Rudmanrsquos clinical studies and sotherefore had a greater impact on the generalpublic But the initial thing that I started men-tioning when we began this discussion was infact a realization of life within biological lim-its We donrsquot have to argue about what thatmeans but I do agree with Tom in terms ofwhat he just said Anti-aging medicine interms of what we would all agree is realizationof a good quality of life within the lifetime thatwe have the difference between the other or-ganizations who promote sensationalism isthey counterpose pictures of youthful peopleyoung people against older people In factthese interventions that we attempt will never

make an 80-year-old or even a 50-year-old looklike a 20-year-old Theyrsquoll make you look likea good 50-year-old compared to a bad 50-year-old or a healthy 60-year-old compared to an un-healthy 60-year-old

BOB BUTLER This would probably be agood time for me to make a few comments Irsquovebeen listeningmdashand I came in late I apologizeif I wind up saying some things that have al-ready been said Well Irsquom pretty much inTomrsquos corner and agree with what Jay had alsosaid But I wanted to point out that we havedone a survey recentlymdashactually a cross-na-tional survey in other countries toomdashand peo-ple donrsquot believe in anti-aging medicine I thinkitrsquos maybe useful to point that out When askedif there are possibilities of retarding stoppingor reversing aging the public isnrsquot quite as un-aware as one might fear

[SPEAKER UNKNOWN] I have to disagreewith you

BOB BUTLER Yoursquore not disagreeing withme Irsquom talking about data from a poll onAmerican representative data That doesnrsquotmean that there arenrsquot some who do believe itIrsquom just reporting a poll I think that somethinglike 20 thought there might be something toit I could send you the data if yoursquod like Thesecond point I wanted to make relates to cul-ture and history We have given up terms andscience before like ldquophlogistonrdquo for instanceThere are terms that have been extremely neg-ative and used before like ldquoabiotrophyrdquo andldquodegeneracyrdquo When I first had the responsi-bility of starting the National Institute on Ag-ing there was a very vibrant group that calledthemselves Life Extensionmdashwhich I might justadd parenthetically turned out to be extremelydifficult because they were perceived as so ir-rational by members of Congress that peoplefor example like Fritz Hollans of South Car-olina did not want to support the National In-stitute on Aging because they were afraid itwould be too perilously close to these strangepeople out there So there is a real danger inthe use of terminology or the expression of no-tions for which we donrsquot have any basis Thethird point I would like to make is that this isreally now under considerable legal pressureboth within Congress and the government ac-counting office There are a lot of moves to-


wards possible revision of the 1994 DietarySupplement and Health Education Act Sothere may be some remedies in store here It isI think another good reason to disassociategerontology in general from the concepts of so-called ldquoanti-aging medicinerdquo The next point Iwould like to quickly make is that we donrsquothave biomarkers of aging so the FDA has noway to even judge any putative claimed agentsthat retard or reverse aging Finally I think thatthe one thing that seems to unify much of whateverybody has said is the prospect that thereare preventive health methods as Tom pointsout There are behavioral aspects and there isthe prospect in the long view of being able toget some understanding of senescence So Ihave always thought that maybe a positiveterm like ldquolongevity medicinerdquo might carrysome weight thatrsquos not carriedmdashand withoutthe bad freight that ldquoanti-aging medicinerdquo car-ries

MICHAEL FOSSEL Bob you and I have hadthis discussion before What is different be-tween longevity medicine and just plain ordi-nary good internal medicine Irsquom not sure thereis a difference

BOB BUTLER Most internists donrsquot talk totheir patients frankly about good health habits

MICHAEL FOSSEL I think Tom Perls doesBOB BUTLER Some do But I would say a

great many physicians spend very little timefrom study after study even talking about to-bacco cessation So there isnrsquot much going onin standard practicing medicine thatrsquos very be-havior oriented or preventive oriented unfor-tunately

MICHAEL FOSSEL Are you just saying thenthat internal medicine is failing its patients

BOB BUTLER On the preventive side yesYou know part of it is I donrsquot totally blamethem Some of it has to do with reimburse-ments time pressures and HMO I recentlyhad a modest illness and saw my doctor andhe saw me for about three minutes Thatrsquosabout all he had time to see me

JOHN MORLEY I think a reasonable thingto point out is that the reason geriatrics devel-oped is that internists donrsquot do the things thatare good for preventing frailty or for improv-ing quality of life in older people

BOB BUTLER Correct

JOHN MORLEY All my internal medicinecolleagues tell me they are great geriatriciansbecause most of their patients are old How-ever when I get to see their patients they arenot doing the geriatric principles on the wholebecause you canrsquot do those in a short period oftime So I think there is a place for geriatricmedicine I donrsquot know that there is any needto invent another 22 terms for this area Wersquovegot ldquogerontologyrdquomdashwhich is a bad term mostprobablymdashand ldquogeriatricrdquomdashwhich is anequally bad term But we could live with thosebecause those are the official terms that havebeen adopted by the two very legitimate soci-eties I think that exist in this area To me itseems that the problem with anti-aging is whateverybody is sort of saying It has got a badname To perpetuate something with a badname allows people to sell themselves as do-ing anti-aging You canrsquot sell yourself as a geri-atrician if you havenrsquot certified I think there isa big difference If yoursquore certified as an anti-aging physician which I believe you canrsquot doI think thatrsquos fine But I struggle with the con-cept that they have certified in anything that isuseful But perhaps Irsquom wrong

MICHAEL FOSSEL Let me point out that theAmerican Medical Specialists Group will nottake anti-aging medicine as a specialty nor willthey ever where geriatrics is an accepted spe-cialty So when they say itrsquos a specialty thatrsquosby self-definition not by any other accepteddefinition

TOM PERLS I think it was Walter who re-cently said in the conversation that wersquoll neverbe able to take an 80-year-old and make themlook or be like a 40-year-old or a 50-year-oldSpeaking a little bit for the Kronos Institute andMitch Harmon I think that a lot of the researchthat theyrsquore aiming for is that they do in parthave this lofty goal of ldquoYeah we think wecould do something like thatrdquo They think thatif people did not set their sights high we wouldnever get a space shuttle out into orbit But re-alize that when some people say that somedaywe will see a lot of people achieve age 150 I dothink thatrsquos kind of like thinking wersquore goingto get some people out to Pluto whereas I dothink if we could get a lot of people getting totheir mid-to-late 80s in good health (not toPluto but rather in orbit around the Earth) that

ROUNDTABLE100

would be akin to devoting the resources thathave been put into something like the spaceshuttle program With regard to getting peo-ple who are 80 act feel and look like they are50 Irsquoll just give a quick example When I wason the wards recently I came across an 80-year-old man who was looking pretty good ex-cept for a medical condition he was there forSitting next to him was his 70-year-old wifewho I at first thought was his daughter Sub-jectively she looked like she was in her early50s to me She just looked remarkable Irsquom notsaying that older people donrsquot look remarkabletoo but just in terms of what Irsquom used to see-ing in terms of some subjective markers of ag-ing My hope is that with the science wersquore do-ing wersquore going to start dissecting out some ofthe reasons people age so differently When Ifurther asked what was going on there itturned out that she had an aunt who lived tobe 100 and another relative who had been inour study actually verified to be age 114 Itwas quite amazing I think that there shouldbe some credence some good science thatrsquosdone responsibly to start looking at the reasonswhy people can age so differently and beginto look at the basic biology However to allowthe anti-aging snakeoil salesmen to somehowattach themselves to good responsible sciencedoesnrsquot seem like something we should be try-ing to do

JOHN MORLEY I guess the real question isldquoDo we need the word anti-aging as a legiti-mate wordrdquo All of this can be done in therubric that is already there

TOM PERLS I agreeJOHN MORLEY The point of getting an-

other name whether itrsquos ldquolongevity medicinerdquoor ldquoanti-agingrdquo is because you think it willbring funding in some way or another I meanthatrsquos really the only usual purpose for invent-ing a new term that I can see when there arereasonable terms already there I think that weshould stick to the terms that are there andwork to increase the awareness of how we treatpeople to prevent frailty how we treat peopleto make them do better If I go back 40 yearsand we look at pictures of people in their early60s they looked really old They looked likemany of the modern 80-year-olds I think BobButler is a great example I mean Bob looks like

hersquos 22 compared to me [Laughter] I think thatwersquore moving towards that

JOHN MORLEY But I think the real ques-tion is ldquoDo we need a term or do we need tosay that this is a term that should not be usedby legitimate practitionersrdquo That would beone way to solve the problem of the illegitimateout there

JAY OLSHANSKY There are plenty of clin-icians out there currently working in what theyrefer to as anti-aging or longevity clinics whoclaim to have adopted principles of anti-agingmedicine when in fact what theyrsquore selling isbasic preventive medicine mixed with a com-bination of hormones and antioxidants Thenyou have the legitimate research scientists whoare trying to understand the puzzle of agingand find ways to intervene in it I think theterms ldquoanti-agingrdquo and ldquoanti-aging medicinerdquohave been used by both I think when the clin-icians are selling preventive medicine as anti-aging medicine it is a misuse of the concept Ithink that the intent in many cases is to im-prove the health of their patients but I thinkin other instances these clinicians are just outto make money There are plenty of organiza-tions out there like this that are designed tomake six-figure incomes for clinicians who areselling anti-aging medicines to their clientsThe problem in part is the way in which itrsquosbeen misused by some and used appropriatelyby others Perhapsmdashand I know we discussedthis at the meeting in Tucson Bob I think itwas last year you came up with what was itmdashlongevity science and medicine

BOB BUTLER As a possibilityJAY OLSHANSKY Something like that The

problem is that while the term itself may notdate back that far the concept goes back thou-sands of years Itrsquos been misused Itrsquos been soldto the public Itrsquos tainted by quackery and huck-sterism While there may be legitimate scien-tists who insert the term into the titles of theirmanuscripts for legitimate research I think thatthe term itself is really misused and I thinksuffers terribly My personal feeling is that weshould be substituting it with something else

LEONID GAVRILOV May I comment on thisissue I have studied how the term ldquolongevitymedicinerdquo is used now to see whether it is lessabused by charlatans compared to the term


ldquoanti-agingrdquo I have done this study for the fol-lowing reasons When we wrote a consensus pa-per in Science together with Aubrey de GreyMichael Fossel Jay Olshansky and four other re-searchers we expressed the following concernsldquoThe term lsquolongevity science and medicinersquo wasrecently introduced by a group of scientists nowworking in the field but the fear remains thatthis term will be co-opted by the pseudoscien-tific antiaging industry as wellrdquo (de Grey et al2002) Our concerns proved to be propheticThatrsquos exactly what happened Now if you justtype ldquolongevity medicinerdquo in the Google searchengine you will find that this term is extensivelyabused All these ldquomiraclerdquo drugs supplementsand procedures including growth hormone de-hydroepiandrosteron (DHEA) melatonin andherbs are now being sold to the public asldquolongevity medicinerdquo Moreover the AmericanAcademy of Anti-Aging Medicine has recentlyestablished the American Board of LongevityMedicine and Science which ldquoadds to your cred-ibility by offering certification in longevity med-icinerdquo (wwwworldhealthnetindexphpp5200) Now every person who can afford to pay$645 to A4M and meet their requirements canbe certified in longevity medicine So they arein fact very quick because for them it is just amatter of choosing the next sexy word Now Iam receiving e-mail spam advertisements sug-gesting you can become 20 years youngerwhich use the terms ldquobiotechnologyrdquo and eventhe ldquoBioterrorism Personal Protection Planrdquoexploiting the most recent fears of the Ameri-can population It is simply impossible to com-pete with these masters of spam and if wechoose to avoid words just because somebodyabused them we will be mute We will haveno words to say Now may I also comment onanother issue One of the arguments against theuse of term ldquoanti-agingrdquo in the title of our jour-nal is based on the belief that there is no prece-dent for using the prefix ldquoantirdquo in the titles ofscientific journals for example it is believedthere is no scientific ldquoanti-cancerrdquo journal Ihave studied this issue and found that in factthere are at least four legitimate scientific ldquoanti-cancerrdquo journals

Anti-Cancer Drug Design (ISSN 02669536 Pub-lisher Oxford University Press)

Anti-Cancer Drugs (ISSN 09594973 PublisherLippincott Williams amp Wilkins)

Anticancer Research (ISSN 02507005 PublisherInternational Institute of Anticancer Re-search)

Journal of Anti Cancer Agents (ISSN 0167-6997)Publisher Kluwer Academic Publishers)

I have also found that terms such as ldquoanti-Alzheimer drugsrdquo and ldquoanti-Parkinson drugsrdquoare routinely used now even in the titles of sci-entific articles so it may simply be a matter oftime before these terms appear in the titles ofscientific journals too

Other scientific journals using the prefixldquoantirdquo in their titles include the following

Antiangiogenic Agents in Cancer Therapy (Pub-lisher Cancer Drug Discovery and Develop-ment)

Antibiotics and Chemotherapy (Publisher SKarger Ag )

Antiinfective Drugs and Chemotherapy (Pub-lisher European Society for Biomodulationand Chemotherapy)

Antimicrobial Agents and Chemotherapy (Pub-lisher American Society for Microbiology)

Antimicrobic Newsletter (Publisher ElsevierLtd)

Antimicrobics and Infectious Diseases Newsletter(Publisher Elsevier Ltd)

Antioxidants amp Redox Signaling (Publisher MaryAnn Liebert Inc)

Antioxidants in Health and Disease Series (Pub-lisher Marcel Dekker Inc)

Antisense and Nucleic Acid Drug Development(Publisher Mary Ann Liebert Inc)

Antiviral Chemistry amp Chemotherapy (PublisherBlackwell Science Ltd)

Antiviral Chemistry and Chemotherapy (Pub-lisher Blackwell Group)

Antiviral Research (Publisher Elsevier Ltd)Antiviral Therapy (Publisher International

Medical Press)Journal of AntibioticsJournal of Antimicrobial Chemotherapy (Oxford

University Press)International Journal of Antimicrobial Agents

Thus it is perfectly acceptable to use the pre-fix ldquoantirdquo in the title of a scientific journal

ROUNDTABLE102

This bibliographic study also alleviates someconcerns that the term ldquoanti-agingrdquo could bemisinterpreted as being against aging persons(ageism) We know for sure that the term ldquoanti-cancerrdquo does not mean being against cancer pa-tientsmdashquite the opposite Exactly the samereasoning is applicable to ldquoanti-agingrdquomdashit istargeted against the destructive aging processwith the intention to help older people to stayin better shape and to enjoy a productive life

JAY OLSHANSKY I tend to agree withLeonid I think he is right here No matter whatterm we come up with you know that peopleat some of these organizations are simply go-ing to substitute that word or phrase for what-ever phrase they are currently using Tom Perlsand I talked about this in New York a coupleof months ago I thought Tom really had a greatsuggestion If you remember Tom I asked youabout this very issue Your response wasldquoWell perhaps we should reserve anti-agingmedicine for researchers who are doing legiti-mate scientific work in the area and use thephrase lsquoThe anti-aging industryrsquo to refer tothose who are selling potions to the public un-der the false pretense that itrsquos somehow possi-ble to modify the biological rate of aging to-dayrdquo I thought that that was a particularlyuseful idea In other words we (as scientists)redefine what they are selling as inappropriate

RICHARD WALKER But we have no con-trol over the use of the word I understand howwersquore trying to work with semantics here butin fact itrsquos been said several times that there isno way to prevent other people from using thewords in the way that they mean I think itrsquosincumbent on us to understand what we aretalking about I think in the closing statementsMichael said that we would have a chance tosort of summarize it so Irsquoll save my commentsfor then I think that if one were to discrimi-nate between anti-aging medicine and the anti-aging industry it would be within our own lit-erature It would really be irrelevant to thegeneral public I think that ldquoanti-aging medi-cinerdquo persists and it permeates not only thepublic but the medical community I have hadthe opportunity for the last three years to beoutside of the academic arena and actually seehow many physicians in this country and out-side of the country recognize anti-aging med-

icine or feel that anti-aging medicine is an areaThey recognize A4M as being the authority un-fortunately in that area So itrsquos incumbent onus to present a legitimate side to that I donrsquotknow how that would finally be accomplishedbut thatrsquos our task more than worrying aboutsplitting hairs on names I think

TOM PERLS Reasonable and good scientistswho have used the term ldquoanti-aging medicinerdquoin the past might have done so in a lackadaisi-cal manner not realizing the unwarrantedcredibility they lend to the marketing of this in-dustry Now we need to combat the use of theterm and to say loudly and clearly that thereis no such thing and to say that the anti-agingindustry and its purveyors are hucksters Mygoal would be not to work with it but to pointout that the people who use this term are try-ing to lend credibility to an otherwise danger-ous message and field I donrsquot think itrsquos a mat-ter of ldquoIf you canrsquot beat them join themrdquo I thinkitrsquos much more the case of ldquoWersquove got to beatthemrdquo and to stop them cold

MICHAEL FOSSEL Itrsquos about time to startpulling this to a close unfortunately Let meask each one of you to make any summarycomments yoursquod like to Also if any one of youin doing so want to make any suggestion foran alternate title to the journal wersquod sure liketo hear it Normally at this point I think Iwould just start down the list with Tom Butsince Tom just finished talking let me jump tothe bottom of the list and move up John Mor-ley

JOHN MORLEY I think my summary is thatthe word ldquoanti-agingrdquo has bad connotationsthat we have legitimate areas of research in sci-ence both in using the terms ldquogeriatricsrdquo formedicine and ldquogerontologyrdquo for science thatwe should not look for new terms that weshould publicize fairly broadly that the use ofterms like ldquoanti-agingrdquo while not always asso-ciated with bad science often are But at thesame time we should recognize that some-times what we do within legitimate medicineis not necessarily good science We have to lookwithin as well Certainly we have had majorproblems with the pharmaceutical industry inthese areas So I think that we have to be verycareful but I donrsquot think that we should belooking for anything new at this stage but


rather to try and continue to legitimize whatwe already have

BOB BUTLER My main interest is the preser-vation of the best of science I agree that anyterm including the one that I had been think-ing ofmdashldquolongevity medicinerdquo and ldquolongevitysciencerdquomdashcan be misused Maybe itrsquos prema-ture to introduce anything new But ldquoanti-ag-ingrdquo for the reasons so well described by Tomand everyone is an exceptionally bad termFrom my point of view since we have a gov-ernment relations office here at the Interna-tional Longevity Center wersquore going to try topursue ways in which the Dietary SupplementHealth Education Act can be modified to bemade more stringent Wersquore going to be think-ing about ways in which the FDA can be ad-vised that there are no biomarkers of aging andtherefore some question about the so-called in-terventions that would either slow retard orprevent aging donrsquot exist And any other co-operation with the GAO or other organizationsthat speak to this Wersquore taking it very seriouslyin terms of what might be accomplished in or-der to avoid what I think is well described asthe ldquoanti-aging industryrdquo

RICHARD WALKER I donrsquot think wewould be talking today if ldquoanti-aging medi-cinerdquo didnrsquot have large name recognition andhave significance in the general population aswell as in the academic and medical commu-nities I think the name good or badmdashand Iagree with everyone who said that there aretainted sides to this and bad sides to thismdashstillhas significant name recognition and there isgood work going on in the area I think pre-ventive medicine obviously is anti-aging med-icine because it brings us to enjoy longer andbetter quality of life within the biological lim-its Let me just say I disagree with Tom whosaid that an 80-year-old can look like a 50-year-old I think that that 50-year-old appearancewould be very good Irsquom sure but if you stoodher next to a healthy 50-year-old there wouldbe a significant difference I think when itcomes to rejuvenation or maintenance of ayounger phenotype wersquore going to have to getinto genetic interventions where we actuallystop the process of change Right now wersquore ina replacement therapy mode I think thatrsquos ev-

idenced by the fact that I just received a mail-ing today from the American Association ofClinical Endocrinologists entitled ldquoPreventiveEndocrinologyrdquo Well in the years that Irsquovebeen in this area in experimental endocrinol-ogy and physiology itrsquos only recently that Ihave seen the idea of replacing hormonesrather than treating specific symptoms and dis-eases Irsquoll just close with that

BRIAN CHIKO Yes From the biotech per-spective ldquoanti-agingrdquo is not an acceptable termfor the long list of reasons that people have al-ready noted I think there wonrsquot be a true in-dustry in which people are shipping productsthat actually delay or improve maximumlongevity for at least 5ndash10 years So I think re-naming isnrsquot a big issue right now I think thatavoidance of the term ldquoanti-agingrdquo is a tacticmost of us take

LEONID GAVRILOV The term ldquoanti-agingrdquois a legitimate scientific term accepted by rep-utable scientific journals and established re-searchers This term has a clear self-explanatorymeaning and it is routinely used in scientificliterature like the terms ldquoantioxidantsrdquo andldquoantibioticsrdquo for example So it is perfectly fineto use such names for scientific journals suchas ldquoJournal of Anti-Aging Researchrdquo or anti-ag-ing studies or anti-aging science

The term ldquoanti-aging medicinerdquo is more con-troversial because it may create the wrong im-pression that a cure for aging has been foundand can be made available to patients Still thisterm could be used if we put a clarifying dis-claimer at the front pages of our journal We allunderstand that anti-aging medicine is the ul-timate goal (medicine of the future) of legiti-mate scientific research published in our jour-nal Why not to say this explicitly We just needa short clarifying disclaimer published in eachissue of our journal in its front pages (ldquomissionof the journalrdquo) Just two or three clarifying sen-tences may be sufficient to separate us fromanti-aging quackery

The question is whether we would follow thefive-year tradition of our journal or for somefiscal or legal reasons would change the titleThatrsquos not my decision I just convey to you theinformation regarding scientific legitimacy ofthe term ldquoanti-agingrdquo Political decisions are

ROUNDTABLE104

not where Irsquom an authority What I would liketo say is that it is important to be fair to our fel-low scientists who already use the term ldquoanti-agingrdquo in their publications and not to harmthem by discrediting this term For examplethe web site of Brian Chiko is advertising thefollowing damaging and incorrect statementldquoIf itrsquos lsquoanti-agingrsquo itrsquos quackery by definition(wwwjuvenewscomqahtmlterminology)Of course it does not help our fellow re-searchers who use this term in their scientificwork publications and research proposalsThis citation is quoted at the website as theopinion of Dr Jay Olshansky published in Sci-ence but as far as I understand this is not ex-actly his opinion now So we should not harmour fellow researchers and if they already usethe term ldquoanti-agingrdquo we should at least re-spect their choice I believe we can all agreewith the final conclusion of our consensus let-ter published in Science ldquowe urge the scientificand lay population to be sure that they under-stand that there are currently no scientificallyproven antiaging medicines but that legitimateand important scientific efforts are underwayto develop themrdquo (de Grey and Gavrilov et al2002)

JAY OLSHANSKY My goodness Wersquore allhere because wersquore excited about aging and ag-ing research I think that there is something tobe very excited about Ongoing research that Ihave seen in the past decade I think is terri-bly exciting I personally am very enthusiasticabout the prospect that at some time in the fu-ture we may be able to intervene in some wayin the aging process of humans We canrsquot do ittoday but perhaps some time in the future Jux-taposed to that exciting research is a ratherlarge and rapidly growing industry that hasbeen called ldquoanti-aging medicinerdquo by A4M andby a number of other organizations I think thatit is critically important to distinguish betweenthe two Personally I donrsquot see preventativemedicine as the same as anti-aging medicine Idonrsquot think it should be sold under that termi-nology although I think it certainly is I donrsquotknow whether or not the adoption of a newterm would make any difference at all I reallydonrsquot know I suspect that a new term wouldprobably be obfuscated by those who are sell-

ing anti-aging products But I think itrsquos incum-bent upon us as scientists to clearly distinguishbetween the exciting ongoing research in thefield and the anti-aging quackery that is outthere today

TOM PERLS There is no such a thing as anti-aging medicine so why use the term There issuch a thing however as anti-aging quackeryAnd the term ldquoanti-aging quackeryrdquo should bepopularized in every way we can so that it getsthe public to think and second guess thesehucksters ldquoAnti-aging medicinerdquo is dangerousin terms of its pernicious view of older peopleand it is dangerous because many of the thingsthat are advertised by these individuals are notproven to work and can be dangerous Theterm ldquoanti-aging medicinerdquo has become preva-lent in our society because of hucksterism anda huge amount of marketing dollars I do notthink that it is well accepted by the responsi-ble academic medical community and if it isperceived as such it is again because of thehucksterism and the marketing dollars I donrsquotwant my statement about 80-year-olds versus50-year-olds taken out of context I simplywanted to point out that aging is extremely het-erogenous People age very differently fromone another and have different susceptibilitiesto diseases associated with aging Part of geron-tology and geriatrics is trying to understandhow and why people are like that and to tryto understand the underlying causes and rea-sons Thatrsquos the science I want to help promote

BOB ARKING It seems to me that there is avalid field of anti-aging science There is novalid field today of anti-aging medicine Thereis an anti-aging industry as has been pointedout which is not based on any scientificmdashorany goodmdashscientific principles I was inter-ested in the point that Tom Bob and Brianbrought up that perhaps the most deleteriouscombination is that term of ldquoanti-aging medi-cinerdquo So that could be a problem We couldlook for other termsmdashldquoanti-senescent biologyand medicinerdquo ldquolongevity biology and medi-cinerdquo There are others out there But theywould probably co-opt in that sense So per-haps I think it was Tom and Brianrsquos sugges-tionmdashand Jayrsquosmdashthat we should make veryclear what constitutes valid science and how


and when they can translate that into a practi-cal medical environment and point out as ap-propriate from time to time that the industryis not based on any scientific principles

MICHAEL FOSSEL Thanks Bob Irsquoll justclose by saying a couple of things One is Ithink yoursquore right Bob There is such a thingas a field whatever we call it The name is ei-ther wrong or at the very least has significantcosts in lots of ways I think that most of uswould agree that there are interventions thatare effective in aging at least in vitro or in cer-tain animals I think that most of us here wouldagree that very few of those interventions havemuch clinical benefit or at the very least havevery little proven clinical benefit On the otherhand there are certainly interventions that sellRetin-A may or may not effect aging but to thepublicrsquos mind it affects something that they as-sociate with aging and donrsquot like I donrsquot thinkwersquore ever going to change either the percep-tion or the desire to buy those kinds of thingsFinally the journal whatever we end up call-ing it has a lot of different sorts of readers Wehave biotech industry workers and scientists

and clinicians and the general public It is dif-ficult if not impossible to address all of the dif-ferent ways of looking at these things

REFERENCES

De Grey ADN Gavrilov L Olshansky SJ et al Antiagingtechnology and pseudoscience Science 2002296656

Ekerdt DJ (ed) Encyclopedia of Aging New York Macmil-lan Reference USA 2002

Gavrilov LA Scientific legitimacy of the term ldquoanti-ag-ingrdquo J Anti-Aging Med 20025239ndash240

Gavrilov LA Gavrilova NS The Biology of Life Span AQuantitative Approach New York Harwood AcademicPublishers 1991

Gavrilov LA Gavrilova NS Validation of exceptionallongevity Population Dev Rev 20002640ndash41

Kroschwitz JI Howe-Grant M eds Kirk-Othmer ConciseEncyclopedia of Chemical Technology 4th ed New YorkWiley-Interscience 2001

Robert ArkingDepartment of Biological Sciences

Wayne State UniversityDetroit MI 48202

E-mail rarkingbiologybiosiwayneedu

ROUNDTABLE106

ROUNDTABLE92

Michael Fossel received his MD and PhD from Stanford where he held an NSF fel-lowship and lectured in psychology neuroanatomy and medicine Currently the ed-itor of the Journal of Anti-Aging Medicine he has been the executive director of theAmerican Aging Association has lectured worldwide has taught in several univer-sities and is currently Clinical Professor of Medicine at Michigan State UniversityHe has numerous publications including the best selling Reversing Human Aging andhis upcoming Oxford University Press textbook Cells Aging and Human Disease anacademic exploration of the genetic and cellular mechanisms underlying all human age-related diseases (as well as their prospects for intervention) including 4250 ref-erences 150000 words and two dozen figures

Bob Butler is President and CEO of the International Longevity CentermdashUSA Pro-fessor of The Mount Sinai School of Medicine and Founding Director of the NationalInstitute on Aging

Robert Arking is Professor of Biological Sciences at Wayne State University in De-troit MI He is engaged in research on aging mechanisms in Drosophila He enjoyswriting on both the technical aspects of aging and longevity as well as on the broaderaspects of aging in general

Leonid A Gavrilov PhD is the Editorial Board member of the Journal of Anti-Ag-ing Medicine journal ldquoExperimental Gerontologyrdquo the Scientific World Journal anda referee (reviewer) for 19 scientific journals He is a Research Associate at the Cen-ter on Aging National Opinion Research Center University of Chicago and a Prin-cipal Investigator of the project ldquoBiodemography of Human Longevityrdquo supportedby the National Institute on Aging (USA) His scientific credentials are described inmore detail in ldquoWhorsquos Who in Science and Engineeringrdquo ldquoWhorsquos Who in Medicineand Healthcarerdquo and ldquoWhorsquos Who in Americardquo (Marquis Whorsquos Who)

Brian Chiko Photo and bio were unavailable at press time








TELECONFERENCE







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BOB BUTLER Correct




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REFERENCES










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TELECONFERENCE







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BOB BUTLER Correct




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BOB BUTLER Correct




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ROUNDTABLE98

















BOB BUTLER Correct




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ROUNDTABLE104










REFERENCES










ROUNDTABLE106

















BOB BUTLER Correct




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anti-aging teleconference: what is anti-aging medicine?

Documents