Age Management Medicine
in Manasquan, NJ
Dr. Michael A. Lepis was certified in Age Management Medicine in 2014 by Cenegenics, the world leader in Age Management Medicine. The following description provided is directly from the Cenegenics website and The Textbook of Age Management Medicine: Volume 1, being presented here for educational purposes only.
By definition, anti-aging prevents the appearance of aging but Age Management Medicine combats the common challenges of aging including decreased energy, cognition, sleep, libido and inability to manage a healthy weight.
Age Management Medicine is a proactive – versus reactive – approach to optimizing health and quality of life. It is achieved by continuously measuring comprehensive biomarkers of aging. Biomarkers of aging can measure everything from cognitive function to physical strength, as well a person’s genetic makeup. These factors provide physicians with the most comprehensive overview of an individual’s wellness as possible, thereby giving them predictive insights which can be used to develop a targeted age management plan.
By collecting extensive diagnostic information and learning about a patient’s detailed lifestyle and medical history, age management physicians and clinical teams are able to develop customized nutrition, supplementation, exercise, and bioidentical hormone programs – taking a holistic approach for each individual patient.
Age Management doctors don’t simply treat the signs of aging which have already manifested (although they are experts in that area as well). Beyond addressing issues like lack of energy, hormone imbalances, struggles with weight loss programs, aging clinics also help individuals improve future health outcomes.
By understanding how bodily changes influence each patient’s health, Age Management clinical teams can provide better personalized care, focusing on the key factors that require the most attention first. This concentrated and continual effort brings significant value to a growing field of prevention-based medicine, as each individual’s risk factors are managed within optimal ranges over decades, thereby significantly lowering the risk of disease development.
Age Management physicians perform an all-encompassing individual assessment to form a detailed overview of current wellness levels and health history. Based on their findings, they generate a treatment plan encompassing to address the following five pillars of health.
- Energy Levels
- Sleep Quality
- Mental Acuity
- Weight Control
- Maintaining a Healthy Libido
Low energy levels are common in older adults. By the time people reach the age of 70, roughly 30% of the muscle mass they had at the age of 20 is gone. This often results in decreased strength, increased fatigue, and overall lower energy levels.
Yet, some causes of decreased energy cannot be attributed to age alone. From anemia to chronic disorders, there could be an underlying cause for persistent tiredness. Oftentimes, however, because exhaustion is typically perceived to some degree as a normal part of aging, it is not enough in itself to prompt older adults to see their physician.
For people who are always tired, however, the fix could be as simple as adopting a new supplement regimen. This is one of the key areas in which age management doctors specialize: determining whether lifestyle changes alone are enough to address declining energy levels associated with aging, or whether a more aggressive approach is needed to target an underlying cause of the symptom.
Disordered sleep is certainly not exclusive to older adults. In fact, it is of chief importance throughout a person’s youth, because ample, quality rest supports healthy childhood and adolescent development. Yet, while sleep is also critical to wellness in older adults, its importance is often overlooked. In fact, the consequences of untreated sleep disorders can take a physical and mental toll on this age group, contributing to functional limitations and a higher risk of death from any cause.
Inability to fall and stay asleep is fairly common: 38% of Americans report feeling poorly rested four or more days each week, and just over half (54%) are able to clock in the recommended seven to eight hours of sleep every night. Yet, just because an issue is common does not mean it should be ignored. Sometimes, individuals fall under the false assumption that common is synonymous with normal, and therefore neglect to seek medical help.
Both lack of sleep and poor sleep quality put an individual at risk for a broad range of short- and long-term health issues. On a short-term basis, sleep is needed for immune system functionality, metabolic function, and safety while completing daily tasks. Over the long-term, untreated sleep disorders are associated with increased risks of high blood pressure, heart disease, obesity, diabetes, and Alzheimer’s.
Specifically, there is a proven interplay between sleep and inflammation – particularly in the cardiovascular system. Sleep duration is inversely associated with plaque formation and coronary artery calcification among middle-aged adults, and is inversely associated with carotid intima media thickness.
Indeed, several pro-inflammatory markers are inversely associated with sleep duration, which confirms the fact that sleep deprivation is linked to morbidity and mortality, as well as increased cardiovascular disease.
There are many barriers to a good night’s sleep, with sleep-disordered breathing (SDB) being a main cause in older adults. Obstructive sleep apnea (OSA) in particular is an epidemic affecting up to 24% of the population, though the actual volume of cases could be even higher as many patients are undiagnosed.
OSA is a condition that largely affects obese individuals, but it can also afflict others. It is characterized by insufficient airflow, for which both noninvasive treatments such as weight loss, as well as surgery, may be recommended. No matter the speculated cause, a physician must assess each individual’s sleep-related issues to determine the best means of treatment. By addressing the sleep disorders themselves, instead of the byproducts they create, age management physicians can help patients improve both long- and short-term health.
The mind is something that changes with age. Yet, neural and cognitive functions are complex, and age-related changes in brain structure and function are not uniform across the population. Promoting cognitive function in middle-aged and older individuals is therefore an endeavor that requires an individualistic approach.
In Brain Aging: Models, Methods, and Mechanisms, author Elizabeth L. Glisky writes that “the basic cognitive functions most affected by age are attention and memory.” Yet, age alone is not the only factor which plays a role in the performance of these cognitive functions. Exercise, alcohol consumption, sleep, diet, and even caffeine intake can all contribute to brain health.
Determining the many ways in which these factors affect the mind as we age requires an extensive look into an individual’s current measures of health, medical history, and lifestyle. Through approaches such as nutraceuticals (natural compounds reported to enhance natural functions), and prescriptive lifestyle adjustments, physicians can advise a tailored preventive care treatment plan to help patients minimize the impact of age-related cognitive decline.
There is a general perception that few individuals ever succeed with long-term weight loss. Because metabolic rate declines by 2% or more per decade after the age of 25, it is also a widely held belief that weight loss becomes more challenging with age.
Yet, factors like age, and even exercise, are less important than the volume and types of food we eat. In fact, the belief that obesity is caused by a contemporary sedentary lifestyle and lack of exercise is a myth. Rather, obesity is a result of eating too much.
Obesity is the most preventable disease in the U.S. The question remains, then: What is the best way to lose weight? If the volume and types of food being consumed are contributing to obesity, which is directly linked to morbidity in the form of heart disease, cancer, diabetes, and high blood pressure, why do so many people continue to struggle with an eating plan that supports weight management? The CDC confirms that more than a third of all U.S. adults are obese, with the highest concentration of obese individuals falling within the middle age range (40.2%).
We tend to maintain the same weight over time. We do so by eating similar weight and/or volumes of food each week. However, because of processed foods, which are abnormally dense in energy, that similar weight and volume of food results in a constant insult to the body (inflammation and insulin surges).
While scientists are continuing to refine their understanding of how the human body interacts with our environment, we are still a long way from manufacturing the nutritional value of natural food. Thus, consuming whole foods (versus processed foods) is the best way to achieve sustainable weight loss.
Yet, this is complicated by the fact that a calorie is not just a calorie. Following a well-rounded diet geared toward weight management requires a precise balance of macronutrient intake, including being mindful of carbohydrate and protein levels in foods consumed. We must eat what we need, not what we want, which requires commitment to an active process that is achieved most effectively when overseen by nutritional experts.
Weight Loss – Quick Solutions?
Weight loss is one area in which age management and age-fighting approaches may vary most drastically. The age-fighting industry tends to prioritize “quick fixes” and those which yield the most noticeable cosmetic results.
Liposuction services, abdominoplasty, and anti-cellulite treatment devices are marketed as effective means of improving appearances for overweight individuals. Even bariatric surgery is sometimes positioned as a quick fix to obesity, allowing severely overweight individuals to shed pounds by surgically enforcing restrictive eating habits.
What’s important to remember is this: there is no way to achieve sustainable weight loss without maintaining a healthy diet. Even solutions which may reduce fat quickly will not have lasting results without long-term commitment to eat well on the patient’s part. More importantly, these quick fixes do not carry the same far-reaching health benefits of a nutritional eating plan to achieve an improved clinical state.
What About Exercise?
If nutrition is the single most important factor in maintaining a healthy weight, is it even worthwhile to pursue regular physical activity? The answer is a resounding yes. “Exercise is perhaps the least used but most effective and most thoroughly studied therapy we have against chronic disease and ailments of age.” It protects against decline in the physical, sexual, and emotional domains, and is especially powerful in reducing inflammation.
Yet, this still leaves many adults wondering: What types of exercise are best? How much exercise should I be getting each week? Or, for that matter, each day? Is high-intensity interval training (HIIT) more beneficial than moderate-intensity exercise? These answers will vary significantly based on each individual’s specific goals; strength, endurance, and flexibility levels; current health measures; and even their genetic markers. This is just yet another example of an instance in which a physician-led, comprehensive approach to age management is ideal.
Maintaining a Healthy Libido
A declining libido isn’t something that occurs overnight. Loss of sexual desire is impacted by physical and mental health factors, along with age. While it is something that is seldom discussed openly, declining sex drive can take its toll on an individual’s overall well-being, as well as the quality of a relationship.
Research shows that loss of libido impacts women more than men, with 34% of females and 15% of males reporting a noticeable decline in their sex drive. The challenge in addressing low sexual interest lies in the fact that the condition can stem from a host of contributing factors. Fatigue, poor mental health, and even relationship factors can affect sex drive for both men and women.
Additionally, the body experiences immense hormonal changes with age. In men, for instance, dwindling testosterone can have a negative impact on the physical, sexual, and emotional domains of wellness. Women, too, can face health risks when they become hormone deficient.
Like weight management, exercise, and sleep, addressing variances in sex drive necessitates a patient-centric approach. It requires physicians to perform a comprehensive analysis into overall physical and mental health to determine the best course of action.
Osteoporosis is a condition of the bone which affects both men and women weakened bone tissues and increased fracture risk. Osteoporosis leads to bones becoming more fragile and more susceptible to fractures resulting in severe pain and reduced function. Unfortunately, there are no outward signs or symptoms for osteoporosis until a fracture has occurred which is why screening for patients at increased risk is vital.
Comprehensive Pain Management provides onsite osteoporosis screening for those considered at risk and is advised for patients with any of the following:
- A current fracture or break
- Fractures or breaks in the past
- Family history of osteoporosis
- Diseases or other medical conditions that are known to lead to bone thinning
- Low estrogen levels in women
- Low testosterone and/or estrogen levels in men
- Women who are going through menopause
It is recommended that all women over the age of 65 routinely receiving osteoporosis screenings with most men and women having a base line test by age 50. Based on a patients risk factors for osteoporosis, screenings may be indicated much earlier.
Hormone replacement therapy is a treatment provided at Comprehensive Pain Management for symptoms that stem from hormonal imbalances. Hormone replacement is essential in regulating many of the systems of the body including the immune system, body metabolism required for weight control, brain function with prevention of depression as well as libido.
Benefits of hormone replacement include:
- Reduced Depression & Anxiety
- Improved Sex Drive (Libido) and Sense of Well-Being
- Prevention of Osteoporosis and Bone Restoration
- Prevention of Disease with improved Immune System Function
- Loss of Fat ( Weight Loss) and increased Lean Muscle Mass
- Increased metabolism and Energy Levels
Combined with diet and exercise, hormone replacement can be a life changing option for combating the ravages of the aging process.