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  • “Healthy ageing is within reach for many of us”

    Ursula Müller-Werdan, Professor of Geriatrics and Director at Charité, on the best ways to stay younger, active substances against disease-causing zombie cells and very old people in the US election campaign.

    Professor Müller-Werdan, we are conducting this interview in the summer before the presidential elections in the USA. One candidate is 81 years old, the other 78. Is that too old for such a responsible office?
    Not necessarily. Before the last presidential election four years ago, a US study asked the same question and confirmed that Joe Biden would have a statistical life expectancy of a good nine years after his inauguration in 2021 and Donald Trump a good eleven years. After analysing representative data sets, this corresponded to the survival probability of white, academically educated people of their age. At the time, Biden’s healthy lifespan was estimated at 87 years and Trump’s at just over 85 years. These are not individual predictions, but average values, and life expectancy would probably be even better today due to the higher age reached. 

    Life expectancy is one thing, physical and mental fitness is another. How do you rate the candidates in this respect?
    I have to pass. Even if I knew more about their state of health, I wouldn’t allow myself to make a remote diagnosis. But high professional performance is possible even in old age, and there are a number of examples of this. Just think of Konrad Adenauer, who took office as the first Chancellor of the Federal Republic of Germany at the age of 73 and only retired at the age of 87. 

    When someone is so productive in old age, this is often attributed to a particularly good genetic make-up. Is that true?
    Only in part. Around a third of the ageing process is genetically determined, two thirds have to do with personal lifestyle – this is how the scientific studies can be roughly summarised. We are therefore by no means at the mercy of our inherited dispositions but have a great deal of room for manoeuvre. 

    If you want to grow old as healthily as possible, you will receive a lot of advice. Which are the most important?
    The eight recommendations of the American Heart Association are a good guideline. If you follow them, you will be on average about six years younger biologically than your chronological age. The recommendations will sound familiar to many: a healthy diet, sufficient exercise and sleep, no tobacco consumption, no severe obesity and normal values for blood pressure, blood sugar and cholesterol. 

    We have heard all this many times before, but what exactly does it mean?
    Here are three examples: The US Heart Association defines adequate exercise as 150 minutes of moderate physical activity per week, such as walking, or 75 minutes of increased activity, such as jogging. The daily sleeping time should be between seven and nine hours and the body weight should be below the body mass index value of 30. 

    At the GDNÄ meeting in Potsdam, you will be talking about facts and myths on the subject of healthy ageing. Which myth is particularly persistent?
    The one about a healthy glass of red wine. Alcohol is a neurotoxin, even in small quantities – there’s no way around it. However, there is evidence that alcohol is more harmful to us in the first half of life, i.e. up to around forty, than later. Another myth has to do with frailty in old age, which many believe is inevitable. In my presentation, I will explain how it can be prevented and, in some cases, reversed. 

    Unfortunately, it is not yet possible to reverse dementia, another disease of old age.
    But a lot can be done to prevent it. More than a third of cases can be prevented or delayed, as large-scale international studies have shown in recent years. It is particularly important to avoid depression and hearing loss and to acquire education as early as possible. Alcohol, concussions and air pollution have been shown to increase the risk of dementia.

    Eröffnung der Büros Postplatz 1 © Paul Glaser

    © Charité – Universitätsmedizin Berlin

    In the Clinic for Geriatrics and Geriatric Medicine on the Benjamin Franklin Campus of the Charité, patients with acute internal, neurological and orthopaedic diseases are treated in the sense of early geriatric rehabilitation.

    A lot of research is being carried out worldwide on the subject of ageing. Which approaches are particularly promising?
    I find a field of research called geroscience very exciting. It sees ageing as the main risk factor for diseases that are not purely genetically determined, such as cardiovascular diseases and most types of cancer. The idea is to prevent these diseases by slowing down the ageing process at an early stage. So-called senescent cells offer a starting point. These are body cells that have stopped dividing at some point. They no longer function properly but are not completely dead and can damage surrounding cells. The consequences are diseases and frailty. The older the person, the more such zombie cells there are in the tissue. 

    Do we stand a chance against the zombies?
    We can drive them to suicide and thus halt their age-related decline. This is possible with certain active substances, so-called senolytics, as animal experiments have shown. The first clinical trials have now been carried out on patients with diseases such as pulmonary fibrosis, kidney dysfunction or diabetes. The results so far are very encouraging. 

    When will the first drugs be available?
    That depends entirely on the further course of the clinical trials. If nothing comes up, we may have the first drugs in fifteen or twenty years. 

    Is your institute at the Charité involved in this research?
    Yes, one of our research groups is working on this topic as part of translational bio-gerontology. 

    What are the other research groups at the Institute working on?
    We have a lot of interesting topics, but let me pick out two examples. One is the question of the extent to which diet promotes or inhibits inflammation in the body. This is important to know because many diseases and the ageing process itself are associated with inflammation. In collaboration with the German Institute of Human Nutrition in Potsdam-Rehbrücke, employees are currently developing an inflammatory index that can be used to determine the inflammatory potential of food. Another working group is looking at smart home solutions for older people to help them live longer at home. 

    Finally, a myth-or-fact question: can we all live to be 150 years old or older, as is often claimed recently?
    No, I don’t think so. The maximum lifespan of every species is genetically determined. In humans, it is around the age reached by the French woman Jeanne Calment, who died in 1997 at the age of 122. 122 years for women, 118 years for men – we won’t be able to break these records in the future either. But what good are such records if you are ill? I think ageing in good health is something worth striving for.

    Günther Hasinger © Paul Glaser

    © Charité – Universitätsmedizin Berlin

    Prof. Dr. Ursula Müller-Werdan

    About the person

    Prof. Dr Ursula Müller-Werdan has been Director of the Medical Clinic for Geriatrics and Geriatric Medicine at Charité Berlin and Medical Director of the Protestant Geriatric Centre Berlin since 2016. Prior to this, the cardiologist and geriatrician worked at the University Hospital of RWTH Aachen and from 1996 to 2014 at the University Hospital Halle-Wittenberg. Born in Allgäu in 1961, she completed her medical studies and specialist training at Ludwig-Maximilians-Universität München – with scholarships from the Studienstiftung, the Maximilianeum Foundation and the Bayerische Begabtenförderung. Her research focuses on heart disease in old age, sepsis and multi-organ failure as well as multimorbidity in old age. Ursula Müller-Werdan is one of the deputy chairs of the German Society for Internal Medicine and was president of the German Society for Gerontology and Geriatrics.

    Further information

    Studies on initial therapeutic strategies against zombie cells: