Neurological Reserve Kevin Spelman, RH(AHG), MCPP- Chair — Clinical Division Tai Sophia institute ‘The living organism does not really exist in the milieu exterieur but in the liquid milieu Interieur formed the circulating organic liquid which surrounds and bathes all the tissue elements, Claude Bernard Genetic Links? ‘oe se ss mre "...when we move beyond the terrain of relative diagnostic certainty represented by traditional neurological disorders, things become much murkier. Gene markers, if Not genes, associated with conditions such ‘88 schizophrenia or manic depression, have been prociaimed, amid great ballyhoo, only later to be quietly withdrawn We steep our genes in the broth of daily nutrient intake 88 non-repicable.” ‘The Web The Web Spin 2085 Reinet to Span 28 rag ts eee 5 = The imbalance of cellular Ce ee atiae aerate see communication leads to disruptions in «= Infiammatory the wellness of the system ‘Significant influence on endocrine status = A consequence is the deterioration of = Antigenic status: the “organ reserve” of the system ‘= Significant influence on the immunological statusBiological Entropy as a Continuum pnts cn ery tt se Health ‘TheWall Disease [eee Peresnion > Perception ===] [= Seornaeesss |. —-Bigvnd od aeeae | Abani Tater) [Gti Wines][Subcinien! [| ets [Seo intemal in Dips > [ssreprersa n> Why Do We Age? foe. Careton ity in ay Vie oh ‘cineca confict has been, Inhlcpne wigs. eas! oni eb advocates of free will and naw ‘Eeeeramcems Seems erases riceaace lem Organ Reserve Loss of . ‘In post-mitotic tissue like the heart, brain, or Muscle, itis not a good thing to lose cells at a rapid rate, particulary after infancy ‘and youth when a lot of new tissue is produced, ‘AS a 40- or 50-year-old individual, you want to slow the rate of untoward apoptosis in the brain, heart, and muscles. Oxidative injury can increase apoptotic loss of cell mass in those particular organs. Organ Reserved Defined * Despite the aging ofthe population, few People live past 95 years, «= Fries’s hypothesis was that there could be an increased health span of individuals after ‘middle age, with reduced need for medical intervention If they pracied the eight things, such as improving the reserves in their functional capability — which he called “organ, reserve.” Organ Reserve Fe Aon. ral death crn my. 1 Te 50509956 8 + Hone could eee eee peer eee ee eee Storm marr anvtomerial npeiree= would Se ee Sie uanseeeese eeOrgan Reserved Defined = The maintenance of organ reserve, according to Fries, is related directly to biological age. As we lose organ Teserve, our resilience declines, and our biological age increases. Organ Reserve Defined ‘ans tn Rear nt Hanecarie Daree Feta se = The more metabolic energy resources 2 person has, the more stable his or her system will be. «= It.can be compared to wires to a generator. if you lose a wire or two along the way and you have multiple. ‘connections between your energy source land your energy nec; you sil have @ functionally stable system. That redundancy is what is found in a homeodynamic, functionally capable physiological system, Organ Reserve Defined Sus Ce ere an tempat. a « Stress the individual or organism experiences that may place demands. an one specic pathway will have other, collateral routes for eae arourid a block or through a of stress to maintain function. Loss of Reserve/Adaptability Free JF 2000, Compression of merit inte ler Vacone esa = With the linear decrease in organ reserve in multiple organs the ability to respond physiologically to a perturbation decreases exponentially = Asa result, mortality rates increase ‘exponentially, with @ doubling of mortality rates each 8 years after age 30Declining Reserve and Loss of Adaptability ‘Fries JF. 2000. Comoresion of meray in the else, Vecone 1815845, An Existential Pondering Is “spiritual reserve” necessary for forgiveness? Organ Reserve Fee J, 200, Compression mori nthe ey, Varn 1315009 + Data from longitudinal Stiles of aging show a consistent deciine in the maximum function ofthe various organs with age, + the dectine being linear ata rate of 1.5% per year after age 20, + Data on maximal performance, such as Wor'd record marathon times, similarly show a nearty linear deciine with age at the same rate from age 30 to age 60 Loss of Antioxidant Reserve ‘Sinn EF. 2 ronan ny nate wean oe Po haat Sa = Reactive oxygen species generated under various conditions of oxidative stress are able to oxidize nucleic acids, proteins, and lipids = Aging is associated with the accumulation of oxidized forms of cellular constituents Loss of Antioxidant Reserve Steanen ER. 2202 poten nny none ee and ‘oo Passos = There is an inverse relationship between the maximum life span of organisms and the age-related accumulation of oxidative damage nee 162 Menon an og Bi totay Aging differs not only from organ to organ, but from cell to cellOrgan Reserve ‘= Organ Reserve includes * Protan syne 1 Blood Few 2 Meccronces| += Loss of Organ Reserve involves * Lane of enzyme acre patel wh nes of Loss of Yo the chain dri + Cac tp itr chan tn sono ‘ney wed bo ono of fw tctrs respon (ES2 Shai cra near moss The Price of Adaptation esa 0, Mente en Pac 216- += Aged human tissues show deletions of the ‘mitochondrial genome in the Skeleton ‘= Myocardium = Brain += External eye muscles + Liver ‘other tissues Loss of Reserve/Adaptability Free JF 2000, Compression of rity te det Veco 115848 ‘= With the linear decrease in organ reserve in multiple organs, the ability to respond physiologically to a perturbation decreases exponentially = As a result, mortality rates increase ‘exponentially, with 2 doubling of mortality rates each 8 years after age 30 Organ Reserve Fe 8 Sienna ly, Vase The Process of Breakdown i J 2. Campin st mt nt iy, Ve = The human aging process, when not prematurely stopped by trauma or disease, moves towards multiple organ ‘system frailty = The immediate cause of death shifts from extemal towards intrinsic factors, underlying fraifty, the inability of the aging organism to withstand even 2 minor Perturbation. The Process of Breakdown FJ 28 Corgan troy nh ny, se Frailty is like an old curtain rotted by the sun, where an attempt to repair a tear in one piace is followed by a tear in another.Organ Reserve and Longevity os 200 Compre mri ty, vaca “cies Progression of alsabitty over ime Runners’ lub members comparec with community controls Ever-runners compared with nover- runners le. Fa A nen ed Wiewve J. Physical actvy,nctusing walking and copntie functon in cder woman. JAMA. 2006; 252: 1454-1481 ".. the apparent cognitive benefits of ‘greater physical activity were simiar in extent to being about three years younger in age and were associated with «a twenty percent lower risk of cognitive impairment. The association was not restricted to women engaging in vigorous ‘oe J, Py ety cing wang ad cate tn in cer woman Jae, 20450-15148 “In summary, in our study, as well as in ‘other epidemiologic investigations, higher levels of physical activity, inctuaing walking, are associated with better cognitive function and less ‘cognitive deciine.” ot RO. Wishing dome pp ate tity en ou, 20; 1479, * Elderly men ranging in age from 71 to 83 who Walked more than 2 miles a day were nearly half as likely to get dementia as men who ‘walked less than one-quarter mile @ day ' also @ reduction in the risk of death, heart disease, and fatal cancers was seen = “Physically capable elderly mon who walk more ‘regularly are less likely to develop dementis” Progression of aisabilty ver tm by sax LT. Ans en Med 9 Soe‘Survival analysis, Meaney MU, e (1896) nevidua ferences in hypotalampitaryasreal activ trea Tnppocampel aging. Exp Gerontol 30, 229-51 + Our studies over the past few years have ‘added support to the idea that individual differences in HPA axis activity can ‘account for part of the variation seen in ‘neurological function among the elderly «= Evidence suggests that the adrenal glucocorticoids can compromise hippocampal function and produce cognitive impairments. Negotiating the Environment ‘cara GA Vand a0 200 op J Prams 463228. 272 1 Some of he phyislogcal cmanges ssaocated wih he stress ‘reponse lise 1 iat of ergy mana amc etn, 1 Ghampenad ag foamed tert cine pred es + lores crt tne el ota ghost + (rnd pt nd n,n retin Seat ea ns nc ry sero mee + {natn nore tetoe 116 mint! oped pyectgy andzal Mer 1 crema agen apps i Resources Allocated, Resources Spent