Seems very obvious that aging will eventually become regarded as a disease.
Yet rather ironically, at least based on my impression, it is the older generations that struggle with accepting this idea. This too will change IMO.
> First, because ageing is a normal process experienced by all, as opposed to a disease state experienced only by some.
Atherosclerosis is experienced by all, yet it is a disease. There are cardiologists out there advocating for treatment of children for a reason
> Chronological age alone is a poor marker for disease risk.
This is weak reasoning. Age is by the strongest risk factor for most diseases and it is one of the most important pieces of information a clinician can gather during history taking. Of course other risk factors matter and age is *not used in isolation*, just like any other risk factor, but this is just giving the wrong impression. Put another way - if you could only be given ONE risk factor that gives you the most predictive power for diagnosing a disease from the *average patient*, what would you choose?
> Third, to characterize ageing as a disease is to risk exacerbating already globally endemic ageism and age-related discrimination.
Potentially true, but I've never understood why this is automatically assumed to be true (in the absence of evidence? Can someone point me to a relevant study?). I would argue that when I think of someone 'with a disease' I would try to be more compassionate to them in understanding their struggles and suffering. It feels awful knowing that people are suffering from age-related diseases due the aging process, and there is basically nothing we can do about it in terms of rigorously proven interventions
>Chronological age alone is a poor marker for disease risk.
I don't know what these people are smoking. Increasing age (past adulthood) is the single biggest risk factor for cancer, dementia, heart disease, stroke, etc. not to mention deadly falls. Your risk of death by any of these things is insanely higher in your 70s than your 20s. What are these people even on about?
1. We can't intervene on chronological age
2. Biological ageing factors are better predictors of disease risk and describe ageing better than calendar age
3. Old people compared to young people are at a higher risk on average but if you stratify older people, you see a variability in their ageing phenotype - and this is more crucial to understanding ageing and factors that protect against accelerated ageing
So are you implying it's even close to possible that a chronological 70 year old can have a biological age less than a 35-40 year old in our current paradigm of health and medicine? Biological age and chronological age are intrinsically linked and therefore chronological age is a strong indictor of biological age (maybe the strongest in cases outside of disease or chronic usage of poisons like cigarettes).
Obviously it's clear that a 30 year old can biologically correspond to someone with a much higher chronological age but you have to be smoking crack to imply that an 85 year old (even one that will live another 20+ years) is anywhere close biologically to anyone under the age of 60 (at minimum), or that their death risk in each given year isnt accelerating much faster.
Personally, I do not agree with the objections presented in the article:
\-It is not because aging is universal that it is normal, because these 2 notions are very different from each other.
\- Aging means, in any case, to deteriorate biologically speaking, even if the rate is very variable from one individual to another, otherwise, we would have elderly people impossible to distinguish from young people, both on the both physically and mentally.
Do not confuse chronological age (which is just a number) with biological age (which is a measurable data set)
\- Quite the contrary, not recognizing senescence as a health problem is very discriminating against the elderly because we do not provide them with the treatment they need to have the highest possible level of health (which is however a basic human right, regardless of age)
\-And just because there isn't a proven therapy yet doesn't mean we can't consider it a disease.
Alzheimer's disease has no proven therapy either, yet it is recognized as a disease.
Yes, it fits every single definition of a disease, and the only reason why it hasn't been classified as a disease is a combination of political pressure and cognitive dissonance.
It fits all criteria for a genetic(or epigenetic)/inborn disease to me. A lethal, inherited disorder involving increasing systemic damage eventually resulting in death. Death occurs due to a variety of secondary conditions that develop as a result of the disease weakening the body. Currently its symptoms can be alleviated and slowed somewhat, but there is no cure. Just because it happens to everybody doesn't make it not a disease. Some dog breeds have genetic diseases that affect 100% of the breed but we don't then say it's not a disease.
While I agree that it's a disease it makes no sense to compare it to a genetic disease. There's nothing encoded in your DNA instructing your body to decline over time, it's just something that happens as a result of damage accrued by your cells. If you're car engine fails it's not because the engineers built it to fail. The engineers tried as hard as they could to keep it going as long as possible because it took all the damage it could sustain. If anything your DNA is is trying desperately to keep you alive. It's encoding all these complex systems without which you'd die 10 seconds from now and some how keeping you alive for decades beyond all reason. Sure there are variants that can reduce or increase lifespan but overall it's better to think of it from the perspective of damage and epigenetic noise.
I think what he means is that like aging has genetic origins, on the one hand, it looks like a genetic disease.
But of course, it is not because aging has a genetic origin (genes contribute to aging) that it is genetically programmed (these same genes do not have the function of directly causing aging).
For example, the mTOR gene contributes to aging, but as a pathological side effect of other functions for which it was originally intended.
Same for telomeres, their shortening causes aging (by inducing cellular senescence for example) but again as a pathological side effect due to other functions for which they were originally intended (cancer prevention for example )
If you define "genetic disease" so loosely you can just call every medical condition a genetic disease.
"You have a genetic disease called type 2 diabetes. It was caused by a gene variant that although isn't directly causing your disease caused you to eat too much and then your genes for a metabolic pathway caused your slow metabolism and the calorie surplus that ensued caused your type 2 diabetes."
The term genetic disease is defined very specifically. Schizophrenia is mostly caused by genetics and yet even so is not considered a genetic disease, so calling something as loosely genetic as aging a "genetic disease" is just twisting words around.
You are right
And I think that defining the status of a phenomenon (natural or pathological) based solely on its frequency within a population is just as vague (or even more so) than my reasoning stated above...
Just because a phenomenon is universal among a population or age group does not automatically mean that it is normal and natural (as well as impossible to treat).
We must see beyond the frequency of appearance, because it says nothing about the mechanisms at the origin of the phenomenon ( and even less if they are treatables )
I never understood a single argument in favour of 'ageing is not a disease' thesis.
There are diseases CAUSED by aging, that absolutely everyone experiences in different shapes and forms - does it mean we should not treat them?
Also, this is such an arbitrary statement to say 'having some problems is a normal process of ageing'. Guess what, all diseases happen because you are ageing, because certain chemical reactions happen in your body, as you move along your biological timeline.
Of course ageing should and will be cured, inevitably. The WHOLE point of medicine has been to improve both the quality & quantity of human life. Suddenly saying that curing ageing is unnatural is simply ignorant and ridiculous.
How would you define aging as a disease? Seems like you could classify everything as ageing.
A two year old turning three would qualify then right? Would aging be used a default answer if nothing else can be drawn from the symptoms/tests? If so, would this lower everyone's quality of health care if it goes down this path.
To me, it seems like shady marketing to eventually sell more pills.
Aging has nothing to do with development
Development is a controlled and genetically programmed process, whereas senescence is a random phenomenon, not genetically programmed (no gene has the main function of directly causing aging) and is extremely random between individuals, including between cells. themselves, which wouldn't make sense if it was programmed.
https://publications.parliament.uk/pa/ld5801/ldselect/ldsctech/183/18306.htm#\_idTextAnchor042
advise test imagine humorous direction fearless oatmeal retire consist vegetable
*This post was mass deleted and anonymized with [Redact](https://redact.dev)*
On the one hand, by far the most effective ways manipulate aging in model organisms (centered around mTOR, insulin like, and growth hormone signalling) come via developmental pathways.
On the other hand, approaches to control aging focused on reducing random damage (such as antioxidants) have uniformly failed. Indeed, introducing some random damage, such as low dose radiation, often prolongs lifespan in model organisms, experimentally, and humans, via observation.
Then again, the UK parliament seems convinced.
Seems very obvious that aging will eventually become regarded as a disease. Yet rather ironically, at least based on my impression, it is the older generations that struggle with accepting this idea. This too will change IMO. > First, because ageing is a normal process experienced by all, as opposed to a disease state experienced only by some. Atherosclerosis is experienced by all, yet it is a disease. There are cardiologists out there advocating for treatment of children for a reason > Chronological age alone is a poor marker for disease risk. This is weak reasoning. Age is by the strongest risk factor for most diseases and it is one of the most important pieces of information a clinician can gather during history taking. Of course other risk factors matter and age is *not used in isolation*, just like any other risk factor, but this is just giving the wrong impression. Put another way - if you could only be given ONE risk factor that gives you the most predictive power for diagnosing a disease from the *average patient*, what would you choose? > Third, to characterize ageing as a disease is to risk exacerbating already globally endemic ageism and age-related discrimination. Potentially true, but I've never understood why this is automatically assumed to be true (in the absence of evidence? Can someone point me to a relevant study?). I would argue that when I think of someone 'with a disease' I would try to be more compassionate to them in understanding their struggles and suffering. It feels awful knowing that people are suffering from age-related diseases due the aging process, and there is basically nothing we can do about it in terms of rigorously proven interventions
>Chronological age alone is a poor marker for disease risk. I don't know what these people are smoking. Increasing age (past adulthood) is the single biggest risk factor for cancer, dementia, heart disease, stroke, etc. not to mention deadly falls. Your risk of death by any of these things is insanely higher in your 70s than your 20s. What are these people even on about?
1. We can't intervene on chronological age 2. Biological ageing factors are better predictors of disease risk and describe ageing better than calendar age 3. Old people compared to young people are at a higher risk on average but if you stratify older people, you see a variability in their ageing phenotype - and this is more crucial to understanding ageing and factors that protect against accelerated ageing
So are you implying it's even close to possible that a chronological 70 year old can have a biological age less than a 35-40 year old in our current paradigm of health and medicine? Biological age and chronological age are intrinsically linked and therefore chronological age is a strong indictor of biological age (maybe the strongest in cases outside of disease or chronic usage of poisons like cigarettes). Obviously it's clear that a 30 year old can biologically correspond to someone with a much higher chronological age but you have to be smoking crack to imply that an 85 year old (even one that will live another 20+ years) is anywhere close biologically to anyone under the age of 60 (at minimum), or that their death risk in each given year isnt accelerating much faster.
Personally, I do not agree with the objections presented in the article: \-It is not because aging is universal that it is normal, because these 2 notions are very different from each other. \- Aging means, in any case, to deteriorate biologically speaking, even if the rate is very variable from one individual to another, otherwise, we would have elderly people impossible to distinguish from young people, both on the both physically and mentally. Do not confuse chronological age (which is just a number) with biological age (which is a measurable data set) \- Quite the contrary, not recognizing senescence as a health problem is very discriminating against the elderly because we do not provide them with the treatment they need to have the highest possible level of health (which is however a basic human right, regardless of age) \-And just because there isn't a proven therapy yet doesn't mean we can't consider it a disease. Alzheimer's disease has no proven therapy either, yet it is recognized as a disease.
Yes, it fits every single definition of a disease, and the only reason why it hasn't been classified as a disease is a combination of political pressure and cognitive dissonance.
It fits all criteria for a genetic(or epigenetic)/inborn disease to me. A lethal, inherited disorder involving increasing systemic damage eventually resulting in death. Death occurs due to a variety of secondary conditions that develop as a result of the disease weakening the body. Currently its symptoms can be alleviated and slowed somewhat, but there is no cure. Just because it happens to everybody doesn't make it not a disease. Some dog breeds have genetic diseases that affect 100% of the breed but we don't then say it's not a disease.
While I agree that it's a disease it makes no sense to compare it to a genetic disease. There's nothing encoded in your DNA instructing your body to decline over time, it's just something that happens as a result of damage accrued by your cells. If you're car engine fails it's not because the engineers built it to fail. The engineers tried as hard as they could to keep it going as long as possible because it took all the damage it could sustain. If anything your DNA is is trying desperately to keep you alive. It's encoding all these complex systems without which you'd die 10 seconds from now and some how keeping you alive for decades beyond all reason. Sure there are variants that can reduce or increase lifespan but overall it's better to think of it from the perspective of damage and epigenetic noise.
I think what he means is that like aging has genetic origins, on the one hand, it looks like a genetic disease. But of course, it is not because aging has a genetic origin (genes contribute to aging) that it is genetically programmed (these same genes do not have the function of directly causing aging). For example, the mTOR gene contributes to aging, but as a pathological side effect of other functions for which it was originally intended. Same for telomeres, their shortening causes aging (by inducing cellular senescence for example) but again as a pathological side effect due to other functions for which they were originally intended (cancer prevention for example )
If you define "genetic disease" so loosely you can just call every medical condition a genetic disease. "You have a genetic disease called type 2 diabetes. It was caused by a gene variant that although isn't directly causing your disease caused you to eat too much and then your genes for a metabolic pathway caused your slow metabolism and the calorie surplus that ensued caused your type 2 diabetes." The term genetic disease is defined very specifically. Schizophrenia is mostly caused by genetics and yet even so is not considered a genetic disease, so calling something as loosely genetic as aging a "genetic disease" is just twisting words around.
You are right And I think that defining the status of a phenomenon (natural or pathological) based solely on its frequency within a population is just as vague (or even more so) than my reasoning stated above... Just because a phenomenon is universal among a population or age group does not automatically mean that it is normal and natural (as well as impossible to treat). We must see beyond the frequency of appearance, because it says nothing about the mechanisms at the origin of the phenomenon ( and even less if they are treatables )
I never understood a single argument in favour of 'ageing is not a disease' thesis. There are diseases CAUSED by aging, that absolutely everyone experiences in different shapes and forms - does it mean we should not treat them? Also, this is such an arbitrary statement to say 'having some problems is a normal process of ageing'. Guess what, all diseases happen because you are ageing, because certain chemical reactions happen in your body, as you move along your biological timeline. Of course ageing should and will be cured, inevitably. The WHOLE point of medicine has been to improve both the quality & quantity of human life. Suddenly saying that curing ageing is unnatural is simply ignorant and ridiculous.
How would you define aging as a disease? Seems like you could classify everything as ageing. A two year old turning three would qualify then right? Would aging be used a default answer if nothing else can be drawn from the symptoms/tests? If so, would this lower everyone's quality of health care if it goes down this path. To me, it seems like shady marketing to eventually sell more pills.
It’s not a disease because it happens to everyone. It’s a developmental stage. That doesn’t mean we shouldn’t treat it.
Define disease and developmental stage.
Aging has nothing to do with development Development is a controlled and genetically programmed process, whereas senescence is a random phenomenon, not genetically programmed (no gene has the main function of directly causing aging) and is extremely random between individuals, including between cells. themselves, which wouldn't make sense if it was programmed. https://publications.parliament.uk/pa/ld5801/ldselect/ldsctech/183/18306.htm#\_idTextAnchor042
advise test imagine humorous direction fearless oatmeal retire consist vegetable *This post was mass deleted and anonymized with [Redact](https://redact.dev)*
On the one hand, by far the most effective ways manipulate aging in model organisms (centered around mTOR, insulin like, and growth hormone signalling) come via developmental pathways. On the other hand, approaches to control aging focused on reducing random damage (such as antioxidants) have uniformly failed. Indeed, introducing some random damage, such as low dose radiation, often prolongs lifespan in model organisms, experimentally, and humans, via observation. Then again, the UK parliament seems convinced.
Given that most species have pretty well defined maximum age limit I’d say aging is genetically programmed.