Ekaterina Tityanova is a professor of neurology, doctor of medical sciences, academician of the Bulgarian Academy of Sciences and Arts and secretary of the Academy's International Relations Department. In addition, she is the head of the Clinic for Functional Diagnostics of the Nervous System at the Military Medical Academy - Sofia. He is a member of the Faculty Council and heads a department at the Faculty of Medicine of the University of St. Kliment Ohridski". She specialized in prestigious universities in the USA, Finland, Austria, Germany and Mexico. He is the winner of national and international scientific awards, is a member of a number of organizations and foundations and is an external expert at the National He alth Insurance Fund. He is the coordinator of the postgraduate training programs at the World Federation of Neurology for Bulgaria and is the chairman of the Bulgarian Association of Neurosonology and Cerebral Hemodynamics.
Academician Tityanova, has the secret of aging already been revealed? We wish each New Year he alth and longevity. Is the time near when this wish will come true?
- The secret of aging is not fully revealed, but many elements that determine this process are known. It is known that life expectancy is encoded in telomeres - the ends of chromosomes, the length of which is associated with longevity. However, the natural length of human life is unknown. The oldest person on the planet, recorded in the Guinness book, is a French woman - Jeanne Calment, who died in 1997 at the age of 122 years and 164 days. Centenarians in the world total about 200. Those who are over 100 years of age and who are described in modern records are considered an exception. For them, there is no scientific explanation why they exceed 100 years. What is generally known about longevity is that until the mid-1840s, the average life expectancy was 35-40 years. After the discovery of vaccines and antibiotics, life expectancy began to increase significantly in the last century. Currently, for developed countries, the average life expectancy reaches 85-87 years. For Bulgaria as of 2012, it was only 74.5 years - 76.6 years for men and 77.6 years for women. There is also a positive trend to reduce mortality at a younger age - under 60.
This is good news
- Yes, this is good news. The modern treatment of cardiovascular diseases with the use of thrombolysis and endovascular treatment mainly for heart attacks contributes to it. Recanalization of the heart arteries by placing a stent or other procedure protects the sufferers from a fatal outcome, especially in the age range of 40-60 years.
And what does longevity actually depend on?
- It depends on good genes first, but that is not enough. To reach the predetermined longevity each person must
to live rationally
and to have a positive interaction between his genes and his environment. Thus, his chance of reaching old age relatively he althy increases.
And the telomeres you mentioned are the same length in every person at birth or do they depend on heredity?
- Each person's telomeres carry different information about their life span - from very short to very long. The disease progeria is taken as a model of aging. With it, the length of the telomeres is extremely short, which is why children are born "old men" and live on average from a few months to a few years. There are also intermediate genetic forms, in which the average life expectancy is about 40-50 years. A number of diseases, such as early atherosclerosis, diabetes mellitus, premature aging and graying, etc., are today accepted as progeroid diseases. Their average life expectancy is 10-20 years less than that of the general population. But through adequate prevention and treatment, satisfactory control of these conditions can be achieved, which increases the chance of prolonging their life.
Information has come out that Russian scientists have discovered a pill with the help of which we will live up to 120 years. Is it possible to create such pills for real or are they media fabrications?
- Yes, such attempts are being made to create an “immortality” pill. They are aimed, on the one hand, at stimulating the enzyme telomerase for longevity, and on the other - at blocking it in cases of cancer. Practically in every organism there are immortal cells - these are the stem, sex and cancer cells, which
are continuously renewed by division
and practically do not get old. However, due to the risk of transforming a normal cell into a cancerous one, these new drugs are mainly used to treat cancer. Their use in he althy experimental animals for the purpose of longevity shows that over 50% of them develop cancer if they take such a drug.
And is it true that women live longer than men?
- Yes! Worldwide, women live longer, on average between 5 and 7 years.
Why are we women so viable?
- Women are generally considered to have longer telomeres than men. In this sense, the female gender is genetically privileged.
What is endogenous neuroprotection and how does it relate to longevity?
- This is an extremely important function of the brain, because a brain cell can be reprogrammed against any external factor that threatens us, but is not strong enough to kill us. And if a person survives the encounter with this external factor, brain cells build endogenous neuroprotection. On a second encounter with the same factor, the brain does not recognize it as harmful because it has built up a tolerance. This also explains the need to increase the dose of some medications due to "habituation" with longer use, the "yo-yo" effect to diets, etc. By building an endogenous tolerance to everything that threatens us from the external and internal environment of the body, we increase the chance of keeping our he alth longer.
Does every person build this endogenous tolerance in the same way?
- No. Here again, hereditary factors play a role. Highly adaptable people have a natural, genetically predisposed ability to do so.
However, the brain can also be trained
through targeted and gradual loading impact, which is the basis of modern neurorehabilitation. Fortunately, Bulgarian genetic information is resilient and highly adaptable. Our gene is strong, changeable, talented and positively adaptive. Bulgaria is in one of the first places in terms of longevity, and in regions where there is no modern medicine. The gene we carry gives us a chance for longevity and we must protect it by living preventively and as he althily as possible.
And why do we have no self-esteem after carrying such talented genes?
- To a large extent, the reason lies in the confused value system of the Bulgarian during the years of transition, the presence of strong individualism and a tendency to survive individually, and not as a social group. However, history shows that the Bulgarian nation has always survived and we should not lack self-confidence, as we come from a people with a rich history and great contributions to world development. This is layered into our genetic code. In this direction, we must also educate the young generation, which is confused and looking for realizations in other countries.
Is it only genes that determine longevity?
- After all, it turns out that genes only play a 30% role in successful longevity. The reason for this is that during the individual life of a person, successful or unsuccessful mutations occur that change the course of our life. That's why
the key to longevity is within each of us
If we manage to live in such a way as to limit to a minimum those factors that would prevent our genes from being realized successfully, we will be successful and long-lived people.
How to achieve active longevity?
- The greatest philosophy of longevity is contained in the maxim "A he althy mind in a he althy body". The latest theories about longevity after age 50 are related to learning new skills that are not typical of earlier life periods. Such skills mobilize stem cells in the brain and renew it. This is especially important for people of retirement age, where memory disorders usually occur.
Medications alone have been shown not to improve memory unless combined with retraining. In some countries, schools for pensioners have been established, where they learn the knowledge that is important for their social integration. This is also the modern way to achieve active aging and combat early dementia.
As the retirement age increases, we must prepare to resocialize people in late life and give them the opportunity to retrain and acquire new skills. This will contribute to preserving their intelligence as long as possible, but to achieve this, it is necessary for the whole society to participate in this process.
Where do you think medicine in our country is most weak?
- There are a number of issues that need to be addressed. On the one hand, they concern the he alth care system, and on the other - the population as a whole. In both directions, reforms are needed to benefit the he alth status of our nation.
In this regard, we must work together with you, the journalists, to promote positive reforms in he alth care and to increase people's awareness and he alth culture.
Ivanka Slaveeva from Veliko Tarnovo:
How to recognize risk factors for early death?
Human risk factors are defined as modifiable and non-modifiable. Immutable factors - gender, ethnicity, parents' origin, etc., cannot be changed. Modifiable external factors such as arterial hypertension, atherosclerosis, diabetes mellitus, obesity, smoking, infections, etc. can be controlled and this makes them leading in all preventive strategies. In this sense, identifying and controlling risk factors plays a key role in human longevity strategy. Here is the role of general practitioners which should not be neglected.
Stanimir Stoychev from the village of Beli Plast, Kardzhali region:
Is it really possible to slow down aging with the help of drugs?
“Drugs are part of treatment approaches and have their place in modern medicine. They should be prescribed only as indicated by the relevant specialists and, if possible, be original medications.
There are currently many generic products and dietary supplements, some of which are of dubious origin. They are a direct threat to he alth and carry the risk of further damage to the body."
What do centenarians die of?
This interesting question was de alt with by British scientists who published the results in the specialized journal "Plos Medicine". Surprisingly, the answer is neither cancer nor heart attack. These diseases are characteristic of younger pensioners. For the centenarians, other sufferings turned out to be more dangerous. Inflammation of the lung is more dangerous for them - after such an illness, they often could not fully recover.
However, here is the analysis made by Catherine Evans from King's College London, together with her team. They processed the data of 35,867 centenarians who died between 2001 and 2010. There were more women among them, which is not surprising given their longer life expectancy. Thus, inflammation of the lungs is among the most frequently noted causes of death - 18%. 6% had other respiratory diseases. Other common reasons were:
Cerebrovascular disorders, including strokes;
• 10% - coronary heart disease;
• 10% - dementia:
• 6% - Alzheimer's disease;
• 4% - cancer.
Now the surprise: the most common cause of death among centenarians was senility, i.e. senile weakness. It is noted in 28% of death certificates. The causes of death have changed over the years, the scientists wrote. For example, coronary heart disease is the leading cause of every fifth death among 80-85-year-olds, but affects only every tenth of those over 100 years old.
