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Old age medicine 

Old age medicine
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date: 28 February 2021

In 2017 there were, for the first time, more people older than 65 years than children under the age of 5 years. Despite the recent exponential increase in human lifespan, health-span has not kept pace, and variability between countries in healthy lifespan exceeds that of life expectancy. The increase in morbidity as people age is largely explained by loss of physiological reserve capacity in multiple systems simultaneously, which is termed frailty. Recent evidence suggests that different heritable (intrinsic factors) factors drive the ageing of different organ systems, but diverse systems share environmental (or extrinsic) drivers. Ageing is associated with macromolecular changes (molecular damage); changes in nutrient sensing, metabolism, and metabolic signalling; senescence in stem cells; altered intercellular communication, in particular changes associated with inflammaging; and changes in circadian rhythms and the hypothalamo-pituitary-adrenal axis.

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