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Longevidad Y Envejecimiento En El Tercer Milenio: Nuevas Perspectivas

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Longevidad Y Envejecimiento En El Tercer Milenio: Nuevas Perspectivas LONGEVIDAD Y ENVEJECIMIENTO EN EL TERCER MILENIO: NUEVAS PERSPECTIVAS JOSÉ MIGUEL RODRÍGUEZ-PARDO DEL CASTILLO ANTONIO LÓPEZ FARRÉ LONGEVIDAD Y ENVEJECIMIENTO EN EL TERCER MILENIO: NUEVAS PERSPECTIVAS José Miguel Rodríguez-Pardo del Castillo Profesor del Máster en Ciencias Actuariales y Financieras Universidad Carlos III, Madrid Antonio López Farré Profesor de la Facultad de Medicina. Departamento de Medicina. Codirector del Aula AINTEC Universidad Complutense de Madrid Fundación MAPFRE no se hace responsable del contenido de esta obra, ni el hecho de publicarla implica conformidad o identificación con las opiniones vertidas en ella. Reservados todos los derechos. Está prohibido reproducir o transmitir esta publicación, total o parcialmente, por cualquier medio, sin la autorización expresa de los editores, bajo las sanciones establecidas en las leyes. Imágenes de cubierta e interiores: ThinkStock Maquetación e impresión: Edipack Gráfico © De los textos: sus autores © De esta edición: 2017, Fundación MAPFRE Paseo de Recoletos, 23 28004 Madrid www.fundacionmapfre.org ISBN: 978-84-9844-648-7 Depósito Legal: M-18221-2017 «Los hombres son como los vinos: la edad agria los malos y mejora los buenos». Marco Tulio Cicerón «Solo la alegría es señal de salud y longevidad». Santiago Ramón y Cajal «No anheléis la inmortalidad, pero agotad el límite de lo posible». Píndaro Agradecimiento: Los autores quieren agradecer a Begoña Larrea Cruz su excelente y dedicada labor en la edición de esta obra, sin cuya ayuda no hubiera sido nunca finalizada. PRESENTACIÓN Desde 1975 Fundación MAPFRE desarrolla actividades de interés general para la sociedad en distintos ámbitos profesionales y culturales, así como ac- ciones destinadas a la mejora de las condiciones económicas y sociales de las personas y de los sectores menos favorecidos de la sociedad. Desde el Área de Seguro y Previsión Social trabajamos con el objetivo de pro- mover y difundir el conocimiento y la cultura del seguro y la previsión social. En cuanto a las actividades orientadas hacia la sociedad en general, creamos contenidos gratuitos y universales en materia de seguros que divulgamos a través de la página web Seguros y Pensiones para Todos. Organizamos ac- tividades educativas y de sensibilización mediante cursos de formación para el profesorado, talleres para escolares y visitas gratuitas para grupos al Mu- seo del Seguro. Asimismo publicamos guías divulgativas para dar a conocer aspectos básicos del seguro. Además de esta labor divulgativa, apoyamos la investigación mediante la elaboración de informes sobre mercados aseguradores y otros temas de inte- rés, la concesión de ayudas para la investigación en seguros y previsión so- cial, la publicación de libros y cuadernos de temática aseguradora y la orga- nización de jornadas y seminarios. Nuestro compromiso con el conocimiento se materializa en un Centro de Documentación especializado que da soporte a todas nuestras actividades y que está abierto al público en general. Dentro de estas actividades se encuadra la publicación de este libro Longevi- dad y envejecimiento en el tercer milenio: nuevas perspectivas que pretende aportar una nueva visión en el poliédrico asunto de la longevidad. Todas nuestras actividades se encuentran en internet disponibles y accesi- bles, para usuarios de todo el mundo de una manera rápida y eficaz a través de nuestra página web: www.fundacionmapfre.org Fundación MAPFRE PRÓLOGO Conocer, desde un punto de vista biomédico, cuáles son los factores que de- terminan la longevidad es quizás la mejor herramienta de la que se puede disponer para medir, posteriormente, cuál es la incertidumbre que pueden originar las consecuencias económicas y sociales que se asocian con el límite que puede tener la vida humana o con el constante aumento de la esperan- za de vida. Sólo a través de la comprensión de los mecanismos molecula- res de los que depende la senescencia es posible valorar cuáles pueden ser los escenarios futuros que marcará la longevidad humana, cuyo incremento puede comprometer los sistemas públicos de pensiones e, incluso, al propio sistema sanitario público. El análisis de estos trascendentales fenómenos es, seguramente, el objetivo que se han propuesto los autores de la obra «Longe- vidad y envejecimiento en el tercer milenio: nuevas perspectivas». En reali- dad, un estudio que se ha basado, en esencia, en dos pilares fundamentales: el conocimiento biomédico y la evaluación del impacto del riesgo. Conviene subrayar, en todo caso, que si publicar en el momento actual un libro cabal en cualquier ámbito de la medicina es una empresa ardua y harto difícil, la complejidad es aún mayor cuando lo que se pretende es realizarlo integran- do los conocimientos genéticos y moleculares con los aspectos personales, sociales y económicos que son propios de los países y los pueblos en los que la longevidad de las personas es mayor y es un hallazgo relativamente fre- cuente. Que duda cabe que comprender, hoy en día, los procesos o sistemas que subyacen al fenómeno del alargamiento de vida es algo que dista de ser fácil y que, por si fuera poco, es además laborioso y complejo. Los autores de esta obra, al analizar de modo tan particular la longevidad y el envejecimiento, no se han olvidado de valorar y describir aspectos tan diversos, además de los relacionados con enfermedades específicas, como las costumbres inherentes a los pueblos y las personas, los condicionantes geográficos y socio-económicos o los aspectos culturales relacionados con los hábitos dietéticos o relacionados con la actividad física. En su análisis también han hecho hincapié en descifrar la forma de entender la vida de las personas que han logrado superar, de manera casi siempre saludable, los 100 años de vida. En este sentido, como bien se señala en el libro, en la comprensión biomédica y social de la senescencia también tiene un papel destacado la reflexión, quizás cercana a la filosofía de la vida, sobre como afrontan las personas longevas los últimos días de su existencia. Una de las definiciones que puede encontrarse en el diccionario de la Real Academia Española para el término envejecer es el de «permanecer mu- cho tiempo». Probablemente, desde un punto de vista economicista, podría asociarse esta definición del término envejecimiento con la incertidumbre que, en el inicio del tercer milenio, está produciendo el aumento de la lon- gevidad al intuirse que puede comprometer la viabilidad de los sistemas internacionales de pensiones con los que se calculan los llamados «pasivos». Sin embargo, resulta obvio que todos queremos vivir más años y, cada uno de ellos, con el menor número posible de problemas que se relacionen con la salud. Por eso, en la presente obra se destaca como muchas de las personas que han superado los 100 años de edad han puesto su longevidad en rela- ción con aspectos de su vida de marcadas características costumbristas o, incluso, relacionados con su historia familiar. No obstantes, cuando estos as- pectos se valoran detenidamente cabe observar que muchos de ellos tienen un entorno en el que se combina un estrés moderado con hábitos dietéticos específicos y con una cierta actividad física. Cabe pensar que es posible que estas circunstancias afecten a fenómenos como la biogénesis mitocondrial, la longitud de los telómeros o el microbioma intestinal, todo lo cual puede dar lugar a un verdadero algoritmo, cuyo resultado final es la longevidad. El estrés moderado y la vida saludable son variables que ayudan a preser- var la salud. William Osler, quizás el padre de la medicina moderna, ya señalaba, en su libro «The principles and practice of medicine», publicado en el año 1982 y considerado como el primer tratado de medicina interna, que la edad de una persona se define, en realidad, por la edad de sus vasos sanguíneos. Hoy puede hablarse de conceptos tales como la edad biológica, en la que quiere averiguarse, a través de un algoritmo complejo, en el que también se incluyen factores relacionados con la funcionalidad vascular y la edad real del individuo, cuál es o cuál puede ser la edad biológica y no la edad cronológica. En cierto modo, por tanto, cuál puede ser, con la mayor precisión posible, la esperanza de vida de dicho individuo. Esta posibilidad, que por sí misma ya es potencialmente aplicable al cuidado de la salud de las personas, y, sobre todo, en el ámbito de la medicina predictiva, también puede serlo, en un futuro no muy lejano, en el ámbito actuarial para calcular las primas de riesgo al establecer un seguro de salud o de vida. En «Longevidad y envejecimiento en el tercer milenio: nuevas perspectivas» puede encontrarse un análisis detallado de las costumbres relacionadas con los hábitos de vida de los pueblos y los individuos más longevos. Cabe sub- rayar, en este sentido, que un denominador común en muchas de las perso- nas que viven más años se halla en el hecho de que la alimentación de la gran mayoría de ellas ha sido baja en calorías, rica en antioxidantes y baja en la ingesta de glucosa. Además, prácticamente en todos los casos han rea- lizado un ejercicio físico moderado, si bien constante, y han sufrido un estrés psicosocial relativamente bajo. Sirva como ejemplo el de los habitantes de la isla griega de Icaria, en la que más del 60% de la población supera los 90 años de edad y mantiene una cierta actividad física y en la que se atribuye la mayor longevidad de sus habitantes al aire fresco, a la vida sencilla, a la ingesta de vegetales frescos y de leche de cabra, y al reposo conveniente. Cabe citar que esas personas duermen una media hora de siesta cada día y que andan bastante también cada día por un terreno que tiene un perfil geográfico montañoso, lo que les obliga a subir y bajar cuestas de forma cotidiana. Pero, como anteriormente señalé, este libro es mucho más que un libro de análisis demográfico y de costumbres relacionados con la longevidad y el envejecimiento.
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