The increase of human longevity along with the aging of the population (proportional increase of the elderly) can be considered the most important phenomenon in the world today, with serious social, economic, social security and health implications. Countries such as Brazil have been experiencing this phenomenon since the middle of the last century, but much faster than developed countries that began this process more than a century ago. The low socioeconomic and educational level of the majority of the Brazilian population should be seen as an aggravating factor in the equation of survival needs with health and quality of life of the growing elderly population. Public policies are necessary, but require knowledge about the living and health conditions of this population. Researches about the subject are incipient and specialized professionals do not even meet the existing demand. The exchange with countries and academic institutions that have experienced this problem for longer is a vital strategy so that we can move forward faster in finding solutions that fit our reality.
- The role of the immune system in the aging process and alternatives to healthy longevity;
There are several changes that occur in organs and tissues during the process of human aging. Changes that occur in the Immune System are indicated as cause and / or consequence of various diseases related to aging. The two arms of the immune response (innate and adaptive) undergo changes and as a result less effectiveness in responding to infections, immunization after vaccination and tumors, and increased autoimmune responses are observed. It is also reported a discrete process of chronic peripheral inflammation that has been related to diabetes, cardiovascular complications, Alzheimer’s, sarcopenia, among other diseases. Our group has evaluated peripheral blood cells of healthy individuals over 60 years old with the objective of evaluating the possible changes of the Immune System. Preliminary results show changes in proliferation rate, cytokine production, and T cell phenotype in individuals aged 60- 65 years, as well as in individuals aged 80 to 100 compared to individuals aged 20-30 years. In individuals between 60 and 65 years of age, the changes are more evident in men, while in the elderly over 80 years this difference disappears, but the changes are more vigorous. The next step is to assess the impact of strategies such as physical activity, supplements, and vaccine adjuvants on the immune response. Our project can be inserted in several other lines of research seeking the understanding of how changes in the Immune System can compromise other organs and tissues, and how strategies that maintain the integrity of the Immune System can contribute to healthy longevity.
- Health promotion and prevention of functional losses inherent to aging.
Our group has been conducting a longitudinal epidemiological study with elderly residents in the community since 1991, using a multidimensional methodology to evaluate the health and functionality of these elderly individuals, identifying the risk factors for mortality. Results from this cohort showed that functional and cognitive functional losses are the main risk factors for mortality and that there is a constant functional loss associated with aging. Preliminary intervention studies in this cohort showed that actions promoting physical activity and cognitive stimulation are able to significantly increase physical activity in leisure time and improve neuropsychological indicators of memory and cognition. The objective of the present project is to evaluate the effectiveness of these health promotion actions - physical activity and cognitive stimulation - in maintaining the functional capacity of the elderly reducing functional losses inherent to aging. Both have a potential positive impact on the quality of life, independence and autonomy of the aging population, but have not yet been duly evaluated together. In order to evaluate the independent effect of these actions on functional capacity, we must have an interdisciplinary approach evaluating economic and housing conditions, social and health integration that may influence functional losses. The project has a consortium within UNIFESP integrating professionals from the actuarial area, humanities and health sciences, the latter focusing on disciplines vital for understanding the biological functionality of the elderly, namely: immunity, sleep, neurocognition, renal function, hearing and vision. There are numerous theses, dissertations and papers published in the area based on a cohort of elderly people maintained for 27 years.