1. הכנס הרביעי של העמותה לעיכוב תהליכים התלויים בגיל במסגרת הכנס השני לרפואה בקהילה הכנס הרביעי של העמותה לעיכוב תהליכים התלויים בגיל במסגרת הכנס השני לרפואה בקהילה 11 בספטמבר 2002 - מלון דויד אינטרקונטיננטל, תל אביב עיכוב תהליכי הזדקנות – עובדות מול פנטזיות עיכוב תהליכי הזדקנות – עובדות מול פנטזיות

3. HEALTH PROMOTION IN A RAPIDLY CHANGING WORLD 18001800 19001900 20002000 B.C. THROUGHOUT HISTORRY, THE MAJOR FACTORS AFFECTING THE HEALTH OF THE GENERAL POPULATION WERE ENVIRONMENTAL WERE ENVIRONMENTAL THROUGHOUT HISTORRY, THE MAJOR FACTORS AFFECTING THE HEALTH OF THE GENERAL POPULATION WERE ENVIRONMENTAL WERE ENVIRONMENTAL HYGIENE & HYGIENE &SANITATION SANITATION NUTRITIONNUTRITION IMMUNIZATIONSAGAINSTINFECTIONSIMMUNIZATIONSAGAINSTINFECTIONS

4. HEALTH PROMOTION IN A RAPIDLY CHANGING WORLD 18001800 B.C. 21st. CENTURY IN THE 21st. CENTURY, THE MAJOR FACTOR AFFECTING HEALTH OF THE GENERAL POPULATION IN THE 21st. CENTURY, THE MAJOR FACTOR AFFECTING HEALTH OF THE GENERAL POPULATION IS BIOLOGICAL - A G I N G !!! 19001900 20002000

5. DEFINITION OF AGING Aging is the Process that Converts Fit Adults into Frailer Adults With a Progressive Increased Risk of Illness, Injury and Death. Aging is the Process that Converts Fit Adults into Frailer Adults With a Progressive Increased Risk of Illness, Injury and Death. Richard A. Miller J Gerontol, Biological Sciences 1999: 54A: B 297 - B 307. Richard A. Miller J Gerontol, Biological Sciences 1999: 54A: B 297 - B 307.

6. THE “BAD SIDE” OF AGING: AGE - RELATED DISEASES & DISFUNCTIONS IMPAIRED IMMUNITY INCONTINENCE OSTEOPOROSIS & OSTEOARTHROSIS ATHEROSCLEROSIS C A N C E R D E M E N T I A D E P R E S S I O N ATHEROSCLEROSIS C A N C E R D E M E N T I A D E P R E S S I O N DIABETES MELLITUS CATARACT, GLAUCOMA, AMD, RESBYOPIA, HEARING LOSS, PRESBYACUSIS PROSTATIC HYPERTROPHY, PARKINSON’S DISEASE DIABETES MELLITUS CATARACT, GLAUCOMA, AMD, RESBYOPIA, HEARING LOSS, PRESBYACUSIS PROSTATIC HYPERTROPHY, PARKINSON’S DISEASE

7. HEALTH PROMOTION IN A RAPIDLY CHANGING WORLD MEDIAL CARE CHANGES Better Treatment for Acute Diseases Increased Need for Chronic & Palliative Care

8. HEALTH PROMOTION IN THE 21 ST CENTURY HOW CAN WE PROMOTE HEALTH FOR PEOPLE IN ALL AGE GROUPS HOW CAN WE PROMOTE HEALTH FOR PEOPLE IN ALL AGE GROUPS IN THE PRESENCE OF THE GERIATRIC BOOM BURDEN ?

9. GERIATRIC BOOM BURDEN THE SUM OF THE EXPONENTIALLY ACCUMULATING MEDICAL, ECONOMIC AND SOCIAL AGE - RELATED PROBLEMS GARFINKEL 1997

10. SURVIVAL CURVES 7550 25 100 Survival%

11. SURVIVAL CURVES 7550 25 100 survival %

12. SURVIVAL CURVES 7550 25 100 survival % HYPOTHETICAL 21 ST. CENTURY

13. SURVIVAL CURVES 755025100 SURVIVAL %

14. HEALTH PROMOTION IN A RAPIDLY CHANGING WORLD DEMOGRAPHIC CHANGES A Rapid Increase in the Average Life Span More People Reach Advanced Age A Rapid Increase in the Average Life Span More People Reach Advanced Age

15. POPULATION BALANCE 7550 25 100 ANCIENT ROME ANCIENT ROME POPULATION Garfinkel D., 1997 CHILDRENCHILDREN PRODUCTIVE

16. POPULATION BALANCE 7550 25 100 2 0 0 0 POPULATION Garfinkel D., 1997 PRODUCTIVE CHILDRENCHILDREN

17. GERIATRIC BOOM CATASTROPHE 7550 25 100 21 st. CENTURY 21 st. CENTURY POPULATION PRODUCTIVE Garfinkel D., 1997 CHILDRENCHILDREN DEPENDENT

18. Four Living Generations in Many Families. Four Living Generations in Many Families. A Rapidly Distorted Balance Between the Sick, Debilitated, Non-productive, Poor Elders - and the Young, Healthy, Productive Population that has to Bear the Burden. Four Living Generations in Many Families. Four Living Generations in Many Families. A Rapidly Distorted Balance Between the Sick, Debilitated, Non-productive, Poor Elders - and the Young, Healthy, Productive Population that has to Bear the Burden. HEALTH PROMOTION IN A RAPIDLY CHANGING WORLD POPULATION BALANCE & SOCIAL CHANGES & SOCIAL CHANGES

19. HEALTH PROMOTION IN A RAPIDLY CHANGING WORLD ECONOMIC / FINANCIAL PROBLEM Expenditures for the Elderly and Disabled are Growing Rapidly in an Alarming Rate Social Security Resources & Health Insurance may NOT Suffice Expenditures for the Elderly and Disabled are Growing Rapidly in an Alarming Rate Social Security Resources & Health Insurance may NOT Suffice

20. GLOBAL BURDEN OF DISEASE ETHICS LAWS MEDICINE HUMANITY COST

21. THE VISCOUS CIRCLE HEALTH PROMOTION IN A RAPIDLY CHANGING WORLD The Magnitude of the Geriatric Boom Forces Governments & Health Services to Divert Most Resources to the Task of “Putting Out Fires”. However, From the Point of View of Medical & Economic Cost/Benefit, The Investment in Inhibition & Prevention is Preferable to Investment in Treatment of Diseases and Their Complications. However, From the Point of View of Medical & Economic Cost/Benefit, The Investment in Inhibition & Prevention is Preferable to Investment in Treatment of Diseases and Their Complications. Therefore, Fewer and Fewer Resources are Made Available for Prevention, Health Promotion and Research into the Processes which Lie at the Root of the Problem.

22. I N H I B I T I O N OF GERIATRIC BOOM 7550 25 100 POPULATION PRODUCTIVE CHILDRENCHILDREN Garfinkel D., 1997 DEPENDENT

23. יעדי העמותה: * לחנך הציבור ולהביא למודעות כי ניתן לעכב חלק מהתהליכים והמחלות התלויות בגיל יעדי העמותה: * לחנך הציבור ולהביא למודעות כי ניתן לעכב חלק מהתהליכים והמחלות התלויות בגיל * להקים מרכזי מידע, בדיקה,טיפול וייעוץ למבוגרים במגוון נושאים: רפואה,פסיכולוגיה,סיעוד,דיאטה, פעילות גופנית, שירות סוציאלי, כלכלה ועסקים * להקים מרכזי מידע, בדיקה,טיפול וייעוץ למבוגרים במגוון נושאים: רפואה,פסיכולוגיה,סיעוד,דיאטה, פעילות גופנית, שירות סוציאלי, כלכלה ועסקים לגייס תרומות למחקרים שיתרמו לנושא עיכוב תהליכים ו/או עיכוב המחלות התלויות בגיל לגייס תרומות למחקרים שיתרמו לנושא עיכוב תהליכים ו/או עיכוב המחלות התלויות בגיל

24. EMBRYO CHILD YOUNG MIDDLE AGE ELDERLY EMBRYO CHILD YOUNG MIDDLE AGE ELDERLY EMBRYO CHILD YOUNG MIDDLE AGE ELDERLY EMBRYO CHILD YOUNG MIDDLE AGE ELDERLY EMBRYO CHILD YOUNG MIDDLE AGE HEALTH PROMOTION IN A RAPIDLY CHANGING WORLD PREVENTION SHOULD START AS EARLY AS POSSIBLE G E R I A T R I C I A N S P E D I A T R I C I A N S WHO IS GOING TO DO IT ??? TO WHOM ?? WHEN TO START ? HOW ? F A M I L Y P H Y S I C I A N S ?

25. ANTI AGING “EXPERTS".... YES, TAKE THIS PILL AND YOU WILL BE YOUNG FOREVER !!! (HA, HA, HA…)

26. הועדה רואה במונח ”אנטי- אייג’ינג ” כמונח בעל קונוטציה שלילית כלפי הזקנה ועל כן יש לפעול לשנותו. ” סיכום והחלטות ועדת המדע והטכנולוגיה של הכנסת מישיבתה ביום 2/7/02 בנושא “אנטי-אייג’ינג” המינוח צריך לענות על היעד של הארכת תקופת הבריאות ודחיית תופעות התלויות בגיל

27. מהעדויות ששמעה, לרבות מבעלי המכונים הפרטיים עצמם - הועדה נדהמה לגלות שהמכונים… מתקיימים מחוץ לתחום הרפואה המוכרת … תחום המקצוע של ה”אנטי-אייג’ינג ”, אינו מוכר בישראל ובאף מקום בעולם ע ” י ההסתדרות הרפואית מהעדויות ששמעה, לרבות מבעלי המכונים הפרטיים עצמם - הועדה נדהמה לגלות שהמכונים… מתקיימים מחוץ לתחום הרפואה המוכרת … תחום המקצוע של ה”אנטי-אייג’ינג ”, אינו מוכר בישראל ובאף מקום בעולם ע ” י ההסתדרות הרפואית ” סיכום והחלטות ועדת המדע והטכנולוגיה של הכנסת מישיבתה ביום 2/7/02 בנושא “אנטי-אייג’ינג” (בארה”ב למשל, קיימת עמותה פרטית לנושא המכשירה, בוחנת ונותנת תעודות הסמכה פרטיות -ללא הכרה של גוף מוסמך אחר)

28. הועדה מוחה בפני שר הבריאות על חוסר הטיפול בסוגיות הקשורות לאכיפת החוק בתחום דחית הזקנה … הועדה תובעת ממשרד הבריאות… להתקין תקנות שיסדירו את רישוי העוסקים בתחום “עיכוב הזקנה” (אנטי-אייג’ינג ”) ” סיכום והחלטות ועדת המדע והטכנולוגיה של הכנסת מישיבתה ביום 2/7/02 בנושא “אנטי-אייג’ינג” כמו כן, התברר לועדה שהטיפולים כרוכים בתשלומים כספיים גדולים כמו כן, התברר לועדה שהטיפולים כרוכים בתשלומים כספיים גדולים

29. הועדה לא יכולה לקבל הטלת האחריות על הצרכנים בלבד והמתנת משרדי הממשלה לתלונות פרטניות הועדה לא יכולה לקבל הטלת האחריות על הצרכנים בלבד והמתנת משרדי הממשלה לתלונות פרטניות ” סיכום והחלטות ועדת המדע והטכנולוגיה של הכנסת מישיבתה ביום 2/7/02 בנושא “אנטי-אייג’ינג” הועדה תובעת לקבל ממשרד הבריאות והמשרד לביטחון פנים, את הליך האכיפה והעמדה לדין במצב בו מתקיימת עבירה על החוק

30. ALTERNATIVE MEDICINE - THE RISKS OF UNTESTED AND UNREGULATED MEDICINES ANTI AGING MEDICINE CHARACTERISTICS New England Journal Medicine 1998; 339: 839 - 841 ( Editorial ) New England Journal Medicine 1998; 339: 839 - 841 ( Editorial ) Marcia Angell & Jerome P. Kassier

31. THERE CAN’T BE TWO KINDS OF MEDICINE - CONVENTIONAL AND ALTERNATIVE… THERE IS ONLY MEDICINE THAT HAS BEEN ADEQUATELY TESTED AND MEDICINE THAT HAS NOT, MEDICINE THAT WORKS AND MEDICINE THAT MAY OR MAY NOT WORK New Eng J Med 1998 ANTI AGING MEDICINE CHARACTERISTICS

32. ONCE TESTED…, IT NO LONGER MATTERS WHETHER IT WAS CONSIDERED WHETHER IT WAS CONSIDERED ALTERNATIVE AT THE OUTSET. ALTERNATIVE AT THE OUTSET. IF … FOUND TO BE REASONABLY SAFE AND EFFECTIVE, IT WILL BE ACCEPTED. EFFECTIVE, IT WILL BE ACCEPTED. ONCE TESTED…, IT NO LONGER MATTERS WHETHER IT WAS CONSIDERED WHETHER IT WAS CONSIDERED ALTERNATIVE AT THE OUTSET. ALTERNATIVE AT THE OUTSET. IF … FOUND TO BE REASONABLY SAFE AND EFFECTIVE, IT WILL BE ACCEPTED. EFFECTIVE, IT WILL BE ACCEPTED. New Eng J Med 1998 BUT ASSERTIONS, SPECULATION, AND TESTIMONIALS TESTIMONIALS DO NOT SUBSTITUTE FOR EVIDENCE. ANTI AGING MEDICINE CHARACTERISTICS

33. THE MOST DISTURBING ASPECT OF THE ANTI-AGING MEDICINE MOVEMENT IS IT’S CLEAR CUT COMMERCIALITY United States General Accounting Office (GAO), Report Sept. 2001 MANY OF THE ANTI-AGING PRODUCTS: MIGHT EVEN POSE PHYSICAL AND ECONOMIC HARM… SENIORS ARE PARTICULARLY SUSCEPTIBLE… RISK OF POSSIBLY DANGEROUS DRUG INTERACTIONS. MANY PRODUCTS WERE FOUND NOT TO MEET … CRITERIA GIVEN ON THE LABEL… ONE IN 10 HERBAL PRODUCTS MAY BE CONTAMINATED BY PESTICIDES AND HEAVY METALS ANTI AGING MEDICINE CHARACTERISTICS FALSE HOPES OF REJUVENATION BY ALTERNATIVE MEDICINE AND ANTI - AGING PRODUCTS… DELAYS APPROPRIATE PROFESSIONAL THERAPY

34. THE "ANTI AGING EXPERT" V S. THE FAMILY PHYSICIAN THE "ANTI AGING EXPERT" V S. THE FAMILY PHYSICIAN

35. THE "ANTI AGING EXPERT" V S. THE FAMILY PHYSICIAN THE "ANTI AGING EXPERT" V S. THE FAMILY PHYSICIAN EVIDENCE BASED & GOOD PRACTICE & GOOD PRACTICEMEDICINE EVIDENCE BASED & GOOD PRACTICE & GOOD PRACTICEMEDICINE MAKE MONEY !PUBLICITY,MARKETING MAKE MONEY ! PUBLICITY, MARKETING

36. USE AGGRESSIVE METHODS OF USE AGGRESSIVE METHODS OF MARKETING TO PROMOTE MARKETING TO PROMOTE THEIR CLINICS THEIR CLINICS (MEDIA, FAMOUS ACTORS & CELERITIES, Etc.) CELERITIES, Etc.) USE AGGRESSIVE METHODS OF USE AGGRESSIVE METHODS OF MARKETING TO PROMOTE MARKETING TO PROMOTE THEIR CLINICS THEIR CLINICS (MEDIA, FAMOUS ACTORS & CELERITIES, Etc.) CELERITIES, Etc.) UNLIKE THE FAMILY PHYSICIAN UNLIKE THE FAMILY PHYSICIAN ANTI AGING “EXPERTS" CHARACTERISTICS

37. * CLAIM TO SOLVE A PROBLEM THAT IS REALLY ESSENTIAL - INHIBITION OF AGING… REALLY ESSENTIAL - INHIBITION OF AGING… * CLAIM TO SOLVE A PROBLEM THAT IS REALLY ESSENTIAL - INHIBITION OF AGING… REALLY ESSENTIAL - INHIBITION OF AGING… * CLAIM TO BE EXPERTS IN THE FIELD AND THEREFORE SUPERIOR TO THE FAMILY THEREFORE SUPERIOR TO THE FAMILY PHYSICIAN THOUGH, IN MANY CASES ARE PHYSICIAN THOUGH, IN MANY CASES ARE NOT SPECIALISTS IN ANY MEDICAL FIELD NOT SPECIALISTS IN ANY MEDICAL FIELD * CLAIM TO BE EXPERTS IN THE FIELD AND THEREFORE SUPERIOR TO THE FAMILY THEREFORE SUPERIOR TO THE FAMILY PHYSICIAN THOUGH, IN MANY CASES ARE PHYSICIAN THOUGH, IN MANY CASES ARE NOT SPECIALISTS IN ANY MEDICAL FIELD NOT SPECIALISTS IN ANY MEDICAL FIELD THIS GOAL IS ACTUALLY INDISTIGUISHABLE FROM CONVENTIONAL HEALTH PROMOTION OFFERED BY THE FAMILY PHYSICIAN ANTI AGING “EXPERTS" CHARACTERISTICS

38. * PERFORM (& SEND TO THE U.S.) MANY EXPENSIVE LABORATORY TESTS WITH EXPENSIVE LABORATORY TESTS WITH ATTRACTIVE NAMES : “ ALL MINERALS ATTRACTIVE NAMES : “ ALL MINERALS VITAMINS AND ANTI OXIDANTS ” … VITAMINS AND ANTI OXIDANTS ” … * PERFORM (& SEND TO THE U.S.) MANY EXPENSIVE LABORATORY TESTS WITH EXPENSIVE LABORATORY TESTS WITH ATTRACTIVE NAMES : “ ALL MINERALS ATTRACTIVE NAMES : “ ALL MINERALS VITAMINS AND ANTI OXIDANTS ” … VITAMINS AND ANTI OXIDANTS ” … FOR MANY OF THESE TESTS, FOR MANY OF THESE TESTS, NOTHING PRACTICAL CAN BE DONE NOTHING PRACTICAL CAN BE DONE WITH THE RESULTS ! WITH THE RESULTS ! FOR MANY OF THESE TESTS, FOR MANY OF THESE TESTS, NOTHING PRACTICAL CAN BE DONE NOTHING PRACTICAL CAN BE DONE WITH THE RESULTS ! WITH THE RESULTS ! ANTI AGING “EXPERTS" CHARACTERISTICS

39. * GIVE A VERY CLEAR PROMISE: “COME TO US, WE’LL MAKE YOU YOUNGER AND HEALTHIER!” WE’LL MAKE YOU YOUNGER AND HEALTHIER!” UNLIKE THE FAMILY PHYSICIAN * MIX CONVENTIONAL ACCEPTED REMEDIES WITH UNPROVEN BUT VERY POPULAR MEANS WITH UNPROVEN BUT VERY POPULAR MEANS WITH APPEALING NAMES (eg. ANCIENT, WITH APPEALING NAMES (eg. ANCIENT, ORIENTAL, REJUVENILE, YOUTH INJECTIONS etc) ORIENTAL, REJUVENILE, YOUTH INJECTIONS etc) ANTI AGING “EXPERTS" CHARACTERISTICS

40. * TAKE ADVANTAGE OF A UNIVERSAL HUMAN WEAKNESS, BASED ON THE HOPE AND WEAKNESS, BASED ON THE HOPE AND DESIRE OF EACH AND EVERY ONE OF US, DESIRE OF EACH AND EVERY ONE OF US, TO BE YOUNG AND HEALTHY FOREVER… TO BE YOUNG AND HEALTHY FOREVER… * TAKE ADVANTAGE OF A UNIVERSAL HUMAN WEAKNESS, BASED ON THE HOPE AND WEAKNESS, BASED ON THE HOPE AND DESIRE OF EACH AND EVERY ONE OF US, DESIRE OF EACH AND EVERY ONE OF US, TO BE YOUNG AND HEALTHY FOREVER… TO BE YOUNG AND HEALTHY FOREVER… * FIGHT SCIENTIFIC CRITICS USING POPULAR, * FIGHT SCIENTIFIC CRITICS USING POPULAR, PSYCHOLOGICALLY APPEALING MANS: PSYCHOLOGICALLY APPEALING MANS: “MANY GREAT INVENTIONS HAVE NOT BEEN PROVEN OR ACCEPTED INITIALLY… OBVIOUSLY, OTHER OR ACCEPTED INITIALLY… OBVIOUSLY, OTHER DOCTORS ARE ENVY BECAUSE OF OUR SUCCESS..” DOCTORS ARE ENVY BECAUSE OF OUR SUCCESS..” * FIGHT SCIENTIFIC CRITICS USING POPULAR, * FIGHT SCIENTIFIC CRITICS USING POPULAR, PSYCHOLOGICALLY APPEALING MANS: PSYCHOLOGICALLY APPEALING MANS: “MANY GREAT INVENTIONS HAVE NOT BEEN PROVEN OR ACCEPTED INITIALLY… OBVIOUSLY, OTHER OR ACCEPTED INITIALLY… OBVIOUSLY, OTHER DOCTORS ARE ENVY BECAUSE OF OUR SUCCESS..” DOCTORS ARE ENVY BECAUSE OF OUR SUCCESS..” ANTI AGING “EXPERTS" CHARACTERISTICS