You have many, many stem cells in your body. In fact, if you didn’t have them, you wouldn’t live long as they act as the “maintenance men” that help repair the damage that happens every day. While it’s true that the total number of stem cells in your body declines as you age, we’ve never been able to tie that to a poorer outcome from a stem cell procedure. Meaning that older patients don’t do any worse with these procedures than younger patients. Having said that, as we shift from active elderly to “old old,” it may make sense to infuse stem cells to help repopulate a rapidly declining number of cells. This is what happened in a recent small human trial of stem cell therapy.
Frailty as We Age
As a physician, I see many types of patients who are beyond retirement age. First, I see the impressive, very active elderly. They’re still out there riding bikes for many miles, hiking strenuous paths, pumping iron, or mastering their downward dog in yoga. Then there’s the inactive but healthy elderly. They aren’t taking care of themselves, but nothing big has gone south yet, and they can still do much of what they once did. Finally, there’s what I call the “old old.” Their bodies have shifted into a much lower gear. These patients typically have some amount of dementia, can do very little, and need help just getting by day to day. From a stem cell standpoint, while the first two types of elderly have a lower number than they did when they were young, they have enough to maintain their bodies. In addition, they tend to do just as well with orthopedic stem cell procedures as their younger counterparts.
The “old old” are also called “frail” by physicians. Frailty syndrome is a multisystem clinical condition that is associated with an increased risk of everything from chronic falls to death. Genetics, of course, has a lot to do with how we age, and so does our own personal lifestyle—diet, exercise, and so on. All of these and more can play into frailty as we age.
Key signs often found in frailty syndrome in aging are inflammation and a weakened immune system, evidenced by markers found in blood work. Symptoms often include physical declines, such as weakening of grip strength; cognitive declines, such as difficulty processing calculations; and/or endurance declines, such as energy loss (e.g., you used to be able to walk two laps around the block, but now you can barely manage one).
Small Study Investigates the Effects of Donor Stem Cells in Elderly Frail Subjects
Phase 1 of the new study looked at both the safety and effectiveness of using donor (allogeneic) adult mesenchymal stem cells as a therapy in elderly subjects for “aging frailty.” The study consisted of 15 elderly frail subjects who underwent an intravenous (IV) infusion of the bone marrow-derived stem cells (five received 20-million cells, five received 100-million cells, and five received 200-million cells). The results among all three groups included an increase in walking distance (10% farther during a six-minute walk), a decrease in an inflammatory marker (TNF-a), and no significant immune reactions to the donor tissue. Subjects who received 100-million cells had the best outcomes and experienced improvements in many of their frailty symptoms.
There was a phase 2 randomized controlled trial expansion of the study in which 30 “aging frail” subjects were randomized into three groups: one receiving 100 million cells, one receiving 200 million cells, and a placebo (control) group. In this one, only the 100-million group increased their distance on the six-minute walk and showed a decrease in the inflammatory marker TNF-a. Self-assessments in this same group also showed improvements in frailty syndrome. The study concluded the importance of following this small study with larger clinical trials.
Can Amniotic and Cord Stem Cell Products Replace My Lost Stem Cells?
While the focus of our feature study today was on the effect of bone marrow stem cell treatment on frailty syndrome with aging, I have to mention amniotic and cord “stem cell” therapy because of how aggressively marketed these “stem cells” are to older patients. Please know that amniotic and/or cord stem cell therapy is a scam! We have tested these products, and the Interventional Orthopedics Foundation has tested these products, and Amniotic and cord-blood products do not contain live and functional stem cells. Learn more about these marketing scams in my video below:
The upshot? If you’re part of the active elderly, you don’t need any donor stem cells. You also don’t likely need to have your own stem cells infused IV, as from a safety standpoint, it will be many years before we know that this is safe. However, it is interesting to see that the “old old” may one day benefit from stem cell infusions!