Gerontology and Aging
- Over the past decade, the number of publications on aging and geriatric medicine has increased dramatically, and in 2018, there were more than 27,000 and 8,000 PubMed citations, respectively. Much of this interest has been generated by a more precise understanding of the mechanisms of primary aging processes, and remarkably, the early identification of potential targets for interventions. Concomitantly, formulation of the geroscience hypothesis has created a new paradigm shift for thinking critically about the relationship between chronic diseases and aging, with the now real possibility of simultaneously treating multiple age-onset conditions with the same intervention.
- Older drivers are putting more miles on the road during their “golden years” than generations prior. Many older adults have safe driving habits, but unique age-related changes increase the risk for crash-related morbidity and mortality. Generalists are poised to assess and guide older adults' driving fitness. Although there is no uniformly accepted tool for driving fitness, assessment of 5 key domains (cognition, vision, physical function, medical comorbidities, and medications) using valid tools can help clinicians stratify older drivers into low, intermediate, and high risk for unsafe driving.
- Exceptional longevity represents an extreme phenotype. Current centenarians are survivors of a cohort who display delayed onset of age-related diseases and/or resistance to otherwise lethal illnesses occurring earlier in life. Characteristics of aging are heterogeneous, even among long-lived individuals. Associations between specific clinical or genetic biomarkers exist, but there is unlikely to be a single biomarker predictive of long life. Careful observations in the oldest old offer some empirical strategies that favor increased health span and life span, with implications for compression of disability, identification and implementation of lifestyle behaviors that promote independence, identification and measurement of more reliable markers associated with longevity, better guidance for appropriate health screenings, and promotion of anticipatory health discussions in the setting of more accurate prognostication.