Endocrinology Of Aging

Endocrinology of Aging: Clinical Aspects in Diagrams and Images presents chapters in a way that allows the reader to incorporate concepts and complex facts in a visual way. As the global population becomes older, the need for a deeper understanding of geriatric pathology increases, and with it, there becomes a greater need to access educational resources on the endocrinology and metabolism of aging. According to the United Nations, the number of people aged 60 years or over in the world is projected to be 1.4 billion in 2030 and 2.1 billion in 2050, hence this is a timely resource. Divided according to specific endocrine and metabolic systems, providing evidence-based content Addresses physiological changes that alter the pathophysiology of the clinical picture Considers the patient transitioning from young adult to elderly, discussing endocrinological challenges to discern physiology from pathology Focuses on age as an essential factor for diagnostic and endocrine management

Distinguished physicians critically review the clinical consequences of the endocrinological changes that occur with aging-in both men and women-and examine the use of hormonal therapy to reduce them. Topics range from bone disease and water balance in all older people, to androgen deficiency in aging males, gynecomastia, and menopause. The authors also discuss Type II diabetes in persons over 65, emphasizing the cognitive benefits of good glycemia control, and the interaction of nutrition and metabolism, focusing on hypocholesterolemia, obesity, the anorexia of aging, trace elements, and vitamins. The aging of the sympathetic nervous system and its impact on hypertension in the elderly is also covered. Timely and authoritative, Endocrinology of Aging offers endocrinologists, geriatricians, and primary care physicians critical insight into the endocrine problems of our rapidly growing elderly population.

One of the most demanding aspects regarding the endocrinology of aging is to determine the extent to which hormones change with age, independent of age-related pathologies, and the clinical significance of these changes. The emphasis of the present volume is on function, as it is of particular interest to many nonspecialists under what circumstances endocrine therapy may be useful in the elderly. For this purpose, leading investigators in their respective fields review the most important hormonal systems affected by aging. Furthermore, to facilitate the utility of the reviews particularly for nonspecialists, the book emphasizes the critical analysis of specific issues: The extent to which the hormones considered really do change with age, especially in humans; the physiological significance and the causes of these changes; and the prospects for treatment. Additionally, this volume also includes reviews on subjects such as cytokines, the sympathetic nervous system and leptin, which have not been traditionally considered in reviews of endocrine systems. However, while the concept of hormone replacement in the elderly is promising, as the chapters in the present volume indicate, much more research is necessary to determine under what circumstances such therapy is appropriate rather than counterproductive.

JOSEPH MEITES The idea that the endocrine system is involved in aging processes is as old as the beginnings of endocrinology. The first endocrine experiment related to aging was reported by Brown-Sequard, who is usually re garded as the "father of endocrinology. " In 1889, at the age of 72 years, he reported that he had succeeded in rejuvenating himself by injections of testicular extracts from dogs and guinea pigs. Although the favorable effects observed may have been due mainly to the powers of auto suggestion, his reports created a considerable interest in endocrinology and its relation to aging, and eventually led to the use of estrogens for treating certain pre-and postmenopausal symptoms in women, and an drogens for treating some symptoms in aging men. Up to about the 1960's, the relatively few studies on endocrine-aging relationships dealt mainly with changes in weight and histological appearance of endocrine organs in aging animals and human subjects, and included a limited number of measurements of endocrine function by bioassays and chem ical (for steroids) procedures. Within these limitations, gerontological investigators were unable to establish any definite relationships between endocrine functions and aging processes, with the exception of the con nection between reproductive decline and gonadal and pituitary activity.

This issue of Endocrinology Clinics brings the reader up to date on the important advances in research surrounding the role of aging on the endocrine system. Guest edited by Anne Cappola, the topics covered include reproductive aging in women, thyroid disorders, testosterone administration, osteoporosis in older adults, hormonal therapeutics and more.

One of the hallmarks of aging is the decreased capacity to adapt to changes in the environment. In a constant, controlled environment, it is often difficult to distin guish the functioning of the young organism from that of the old. However, when stresses are applied-temperature stresses, dietary stresses, infection, emotional stresses-the differences are more apparent. Frequently, the response ofthe old is delayed and may never reach the same mag'nitude as the young. These responses, in most cases, are mediated by the neuroendocrine system, which communicates via hormones, neurotransmitters, and related substances. Thus, it is important to understand the age-related changes that take place in the secretion and act ion of these substances and how these changes relate to the well-being of the whole organism. Indeed, the "neuroendocrine theory of aging" proposes that almost all of the characteristics of aging can be accounted for by dysfunction of the neuroendocrine system. A book on endocrine function and aging is particularly relevant at this time. With the advent of the techniques of molecular biology, there has bee~ an explo sion of knowledge concerning hormone secretion and action. Hormones, pro hormones, hormone receptors, and "second messenger" mediators rapidly are being cloned and sequenced. Such knowledge gives us important insights into the molecular workings of these substances as well as into the genetic hasis of endo crine dysfunction. These new tools are now being applied to the problem of age related changes in endocrine function.