VECCHIAIA. – Biologists and physicians today tend to differentiate the concept of senescence from that of senility or V. Thus, according to Pende, the first term is to be understood as the process of functional decline and structural deformation of the organism that naturally affects all its parts at different times and to varying degrees at a certain period of life; whereas senility or V. form.
According to biologists, senescence (v.) is a characteristic and essential property of life (v. CICLI BIOLOGICI), common to all complex organisms. death (v.), it forms part of the properties most distinctly specific to organized living matter, no less essential than metabolism, to which they are, moreover, intimately linked. The ever-deeper knowledge of the life of unicellular elements, the understanding of the transmission of life through the fertilized egg, CARROLL (v.), who succeeded in keeping a fragment of embryonic myocardium alive for 28 years by cultivating it under particular environmental conditions, have increasingly strengthened the hypothesis that the phenomenon of senescence and death should not be regarded as specific to living matter, but rather as a particular attribute of the process of organization through which the higher individual is constituted.
Senility was once regarded as a directly pathological phenomenon (senectus ipsa morbus); today, on the other hand, it is considered a physiological event proper to living organisms, since, although aggravated and hastened by the after-effects of previous illnesses and by countless other physical and psychological causes of decline that accompany human existence, it begins at a given period of life (60–70 years for men, 55–65 for women), independently of any concomitant morbid factor, with a set of involutionary and degenerative phenomena affecting the entire organism and profoundly modifying it both morphologically and from the biochemical and physiological points of view. Pende maintains that senility is characterized by multiple deficiency phenomena: circulatory stasis; toxic stasis in the interstitial lacunar system of the organs; gastrointestinal stasis with autointoxication of the organism by ptomaines, products of the incomplete digestion of albumins, and toxins from the intestinal bacterial flora; altered neurovegetative (v. NEUROVEGETATIVO SISTEMA) and metabolic (v. METABOLISMO) equilibrium, with a tendency toward hyperfunction of the sympathetic nervous system, acidosis, the accumulation in the blood of cholesterin, glucose, nitrogen, and uric acid, and a decrease in calcium; endocrine glands (v.), the liver, and the kidney; and others besides.
These phenomena are due to, or are accompanied by, alterations in certain tissues, systems, and apparatuses that are affected by the involutionary process of senescence earlier than others. Thus there is atrophy of the elastic tissue, whether of the skin (facial wrinkles), the vessels (arteriosclerosis), the lungs (senile emphysema), or the intestinal and abdominal walls (protrusion of the abdomen); the hypofunction of the reticuloendothelial system, which regulates trophism, vitality, and the organism’s powers of defense against external agents, is responsible for the senescence of the more specifically differentiated tissues of the organs; the entire apparatus of the endocrine glands is disturbed in its relationships of hormonal correlation, with phenomena of hypofunction (the insular gland, thymus, gonads), hyperfunction (especially the cortical adrenal gland, the basophilic portion of the pituitary, and the thyroid), or various variable alternatives (hyper- or hypoparathyroidism).
According to Viale, the physiological and biochemical phenomena characterizing senility are principally the quantitative diminution of functions and the reduced capacity to adapt to environmental changes.
Various hypotheses have been formulated to explain the onset of V. Some regard intestinal (Metchnikoff) or extraintestinal (Jeckeli-Ewald) toxicosis as the basis of the senescence process; others, an endocrine disorder of pituitary, adrenal, or complex origin (Simmonds, Lorand, Gley); others, a more or less complex metabolic disorder (Bornstein, Pende); others, the physicochemical differentiation of the tissues through dehydration and precipitation of the protoplasmic colloids; and still others, such as Carrel’s suggestive hypothesis, regard as the direct cause of senility an alteration in the humoral environment of the cells, which would thereby be deprived of the « quid » necessary for normal growth (« trefoni » di Carrel).
Concerning the possibility of prolonging life and making senility less burdensome, Legrand states that « il n'y a pour vivre vieux, ni règle, ni méthode, ni hygiène spéciale ». Hufeland, however, published in 1796 Microbiotica, or the art of prolonging life, and Lorand, in his book Ringiovanire (Turin 1926), listed 10 bad habits as causes of premature senescence and death (alcohol, excessive nutrition, tobacco, sexual abuse, dirtiness, ambition, avarice, anger, vanity, practices aimed at avoiding offspring). The importance of these and other factors, such as idleness, insomnia, and constipation, is undeniable; but in the onset of V. life, extraindividual factors also play a role, such as heredity, race, climate, and temperature. It may therefore be stated that each individual grows old in his or her own way, presenting, at a given period of life, one particular organ or another that is more predisposed to senile involution.
According to Marinesco, « la v., come la morte, sono fatalmente iscritte nella curva vitale dei colloidi e implicitamente nell'evoluzione delle cellule. Vita e morte sono fenomeni naturali e necessari e le ipotesi degli autori che vedono nei fenomeni della senescenza un accidente rimediabile, sono in discordanza con la legge universale che governa la vita dei colloidi » (jubilee volume in honor of L. Bianchi, Catania 1913). Many authors in all countries have nevertheless addressed the problem of the possibility of rejuvenating the individual, resolving it in ways that were sometimes suggestive, even if, at least for the time being, only temporary.
The first to arouse interest in the problem of rejuvenation, understood as a return of the old person’s bodily and spiritual condition toward youth, was Brown-Séquard. He conceived the idea of injecting beneath the skin of old and sick people juice extracted from the testicles of animals, first successfully testing it on himself when he was already 72 years old. Since then, numerous other researchers have concerned themselves with the same problem, resolving it in various ways: Steinach and Lichyeenstern by ligation of the vas deferens, Döppler by periarterial sympathectomy, Zucchi by a diathermic procedure, and so on, down to the present day, which has seen staunch defenders and bitter opponents of the method proposed by Voronoff and developed by Dartigues, based on the transplantation of a monkey’s testicle into man. Two other recent methods should also be recalled: that of Jawerski, based on the intravenous introduction of young blood, and that of Cavazzi, who advocates the injection of testicular venous blood taken from young and healthy animals.
At the present time, however, no proposed method has produced consistent and definitive results. According to Marinesco, although there is an undoubted relationship between life and the sexual glands, it cannot in any way be said that old age depends on the condition of these glands. For the author, the degeneration of the gonads is not the cause but rather one of the signs of old age.
Kotsawski too is convinced of the impossibility of obtaining rejuvenation of the individual through opotherapeutic and hormonal treatments; he maintains (Riv. Biol., 12 [1930], p. 40) that, in order to rejuvenate the organism, there is no alternative but to replace damaged and diseased organs with others that are healthier.
According to Pende, prolonging human life—active and free from infirmities—that is, adding life to years rather than years to life, by at least a quarter of a century, is scientifically possible; but it is a problem of constitutional, individual, biotypological medicine, whose solution requires hygiene and a complex and multiple medicinal and opotherapeutic treatment. In connection with the increased average lifespan (65–67 years) and the growing percentage of elderly people in the population, medicine is currently taking an ever greater interest in the problem of V. and its treatment, giving rise to the growing development of two new branches: “gerontology” and “gerontology.”