Assessment and follow-up of normal aging

The ongoing increase in life expectancy is worthless unless we can retain our cognitive and physical health and autonomy. The aging process does not lead to a simultaneous functional decline in all organs and tissues. A global and interdisciplinary approach to human aging is needed. While the role of genes in aging is increasingly evident, lifestyle (exercise and nutrition) and hormonal status are also major determinants of the rate of functional decline. It is important to distinguish between physiological (i.e. normal) aging and age-related disease. Maximal exercise testing (V' O(2)max) is a good candidate for monitoring physical adaptation to aging, as it reflects not only heart, lung and muscle function but also autonomic and hormonal regulation. Such targeted tests could be used early in adulthood to determine whether aggressive preventive policies aimed at promoting successful aging are more cost-effective than a simple wait-and-treat attitude.