Inflammaging: Connecting Aging and Chronic Diseases

Geroscience is a growing discipline that seeks to understand the relationship between aging and age-related diseases. Rather than just studying specific diseases in a silo, the guiding principle is to examine the underlying physiology of aging, how it makes older people more vulnerable to diseases, and what can be done to increase healthy years of life, not just length of life.

In short, researchers seek to understand if people get diseases from aging or are certain aspects of aging caused by diseases? When it comes to inflammation, it is a two-way street.

“Heart diseases, diabetes, arthritis, kidney disease, and obesity are among the chronic diseases that are associated with inflammation,” says Dana Hunnes, RD, MPH, PhD, Assistant Professor at the UCLA Fielding School of Public Health. “It is believed that many diseases are both exacerbated by inflammation and also increase it.

The Unfolding Story of Inflammation

Inflammation has long been associated with diseases that become more prevalent with age. Inflammation facilitates healing as part of the normal immune system response to injury or infection. A simple papercut, a torn ligament, surgical incisions, and various germs all can trigger an “acute” inflammatory response. In contrast, chronic inflammation is when the body’s defense system goes haywire and persists beyond healing needs. Healthy tissue can be destroyed in the process, and diseases can take hold.

The term “inflammaging” was coined in 2000 by gerontological researcher Claudio Franceschi and his team, who postulated that proinflammatory states are a major characteristic of the aging process. “The term describes chronic low-grade inflammation found in older adults, even in the absence of an overt disease,” explains Dominque Piber, MD, a research fellow at the UCLA Center for Psychoneuroimmunology who is currently based at the Department of Psychiatry, Charité—Universitätsmedizin, Berlin, Germany. “Epidemiological studies have shown that inflammaging substantially increases the risk for numerous diseases, including cardiovascular and metabolic diseases, as well as depression and dementia.” In a study published in October 2019 in the Journals of Gerontology: Biological Sciences, Dr. Piber, in cooperation with other researchers from the UCLA Cousins Center for Psychoneuroimmunology, analyzed associations between older age and various markers of inflammation. “We found that levels of certain nuclear proteins involved in inflammation, called STAT proteins, significantly increase as people grow older. These findings implicate that STAT proteins could serve as a useful new biomarker of aging, which might be related to the risk of chronic age-related diseases.” Moreover, Dr. Piber adds, “There are several clinical trials which have also suggested that the modulation of the inflammatory response is a promising strategy to mitigate inflammaging-related disease risk. The ultimate goal of our research is to discover novel ways to delay or prevent inflammaging-related diseases.”

Guiding Future Applications

Scientists worldwide have been investigating the role of inflammaging. Previous research has identified several behavioral factors that regulate inflammatory dynamics in older adults. For example, Dr. Piber says sleep disturbance has been shown to activate inflammation on multiple levels. “In the future, our group plans to evaluate the interactions of sleep disturbance with systemic, cellular, and nuclear indices of inflammaging. A better understanding of these interactions might help improve interventions that target sleep disturbance and inflammaging to potentially mitigate inflammatory disease risk in older adults.”

Researchers from Örebro University, Sweden, suggest that chronic inflammation may be a cause of age-related muscle loss. C-reactive protein (CRP) is measured in the blood and can be used as a marker for both inflammaging and infection in the body. The results of the study, in which women ages 65 to 70 participated, show a correlation between increased CRP levels in the blood and lower muscle mass. Specifically, they report that CRP affects the size of muscle cells by interfering with protein synthesis. Their next steps are to define study objectives that look at the impacts of exercise, CRP, and other inflammatory responses in older adults.

Researchers from NYU School of Medicine report that inflammaging diminishes the ability of stem cells, essential ingredients in bone repair, to multiply. According to the study authors, this results in a smaller number of stem cells in the aged skeleton and compromises their ability to help make new bone after a fracture. In addition, they found that the use of sodium salicylate, an ingredient in aspirin, repressed the age-induced chronic inflammation signaling. The researchers suggest that an immediate application of this finding may be to use anti-inflammatory drugs to build up stem cell pools, not after bone breaks, but during the weeks before elective orthopedic surgeries like hip or knee replacements. In these cases, anti-inflammatory drugs would be used leading up to a surgery, but then be cut off just before the procedure to make way for the acute inflammation necessary for normal healing. Obviously, this should only be done under a physician’s recommendation.

Quelling Inflammation

Diet and exercise play a pivotal role in inflammation. Dana Hunnes explains that ultra-processed foods/ carbohydrates, animal proteins/fats, casein (milk protein), saturated fats, and some polyunsaturated fats lead to a cascade of pro-inflammatory chemicals. And on the flip side, there are foods that reduce or don’t cause inflammation in the first place.

“There are a number of studies that show that a whole-foods, plant-based diet full of antioxidants, phytonutrients (plant nutrients), fiber, water, and a myriad of other nutrients and compounds we don’t even know enough about yet can both treat and reverse these chronic diseases and their associated inflammation,” she says.

According to a small study in the Nov. 19, 2019, issue of the Journal of Applied Physiology, exercise, particularly lifelong exercise, can temper inflammaging. The study examined the influences of aging and lifelong exercise on inflammatory markers in the blood and skeletal muscle at baseline and after a bout of resistance training. Researchers found that after exercise, the study participants had lower blood levels of some inflammatory factors. Participants included both older and younger men.

Lifestyle choices can and do make a difference in all aspects of health. Even if you haven’t exercised in a while, physical activity can boost mood, decrease fall risk, and increase energy. It’s never too late to experience the positive benefits of eating well and exercising. And it’s likely that you’ll improve your immune system, too.

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