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Charles T Ambrose
Along with various major illnesses or chronic afflictions, the elderly may also have minor complaints. These include general muscle weakness, cold intolerance; transient memory lapses for a name or word, wrinkled skin, and the slow healing of cuts and bruises. These five symptoms and signs are grouped together here because they may have a common vascular basis, which is the reduction of capillaries throughout the body in the elderly. This reduction is due to diminished levels of angiogenic growth factors, as reported in both aged people and animals. Recombinant forms of these factors given parenterally have elicited capillary production (angiogenesis) in numerous experimental studies and if chronically administered to the elderly, might, in theory, ease their lesser ailments. Angiogenesis has also been elicited in animal tissues by type-5 phosphodiesterase inhibitors - sildenafil (Viagra) and tadalafil (Cialis). These are widely prescribed orally for their vasodilatory effect. Tadalafil is discussed here as a potential proangiogenesis agent for modulating the lesser ailments of aging and possibly influencing the clinical course of senile dementias, such as AD.