When will aging be reclassified as a disease? by Aubrey de Grey
Answer by Aubrey de Grey:
Aging (defined as the physiological decline that everyone currently experiences with advancing years after about 40) unquestionably causes astronomical amounts of suffering, in the modern world adding up to more than all other human experiences put together. Thus, it is exceptionally demoralizing to see educated people continuing to find such crass ways to put it out of their minds, like comparing it with left-handedness. Aging is unequivocally a medical condition that is potentially amenable to medical intervention, and as such it is vital that such interventions be developed as soon as possible and therefore that the quest to do so be supported, not trivialized.
Whether aging should be called a disease, however, is a question with additional ramifications. “Disease” – like “immortality” and “cure” – is a word that has an established meaning that has already been obfuscated to the detriment of progress: in particular, it has been extremely unfortunate that conditions such as Alzheimer’s are called diseases, because that gives the impression that they can be “cured” – eliminated from the body entirely, like an infection – when in fact they are parts of aging and as such are side-effects of being alive. I am OK with calling aging an “uber-disease” that encompasses all aspects of the ill-health of old age, but no more. But the thing that really matters is not whether we call aging a disease but whether we call it a condition for which treatments can be approved and reimbursed. That, I’m overjoyed to say, is a question on which there has recently been fantastic progress, spearheaded by Nir Barzilai and colleagues, in the form of the TAME trial for metformin. The definition of the endpoint, in terms of the presence of more than one of the key features of age-related ill-health, is a perfectly good practical definition of aging, and even if the TAME trial itself is unsuccessful, the precedent that it has laid down in terms of how to structure future clinical trials will stand and will be copied increasingly often. That makes me very happy.