Why we age – is it a disease?

‘I’m pretty sure that eating chocolate keeps wrinkles away because I have never seen a 10 year old with a Hershey bar and crows feet.’
Amy Neftzger

If only that was all we needed to keep this bag of bones ever youthful huh? Sadly even though chocolate (the good quality dark stuff that is) seems to offer some positive health benefits it sure ain’t the fountain of youth –though neither does it appear to be a contributory factor to the causes of aging. And doubtless the very fact of aging is a clearly visible and universal given but have you ever stopped to consider why we do it. You know, ‘Why is it we actually age?’

Though it’d be logical to assume there was a fairly round consensus on this fundamental question in the scientific communities (I did!) but you also might be more than a little surprised to hear that this appears not to be so (I was!). In digging a little deeper into why, it appeared to me that across this seemingly intractable divide were two fairly distinct camps staring warily and shaking their many peer reviewed articles in some frustration at each others glaringly obvious myopia.

Firstly there are those who are of the thinking that aging itself is simply yet another disease, like a bit of an unwelcome itch, and as such is both medically treatable and in fact like all disease potentially even curable. And though this may seem at first glance a little ‘out there’, it is a line proving popular amongst a certain number of leading scientists and researchers, many of whom also believe that funding has been devastatingly poor in the area of aging research simply because the grant-awarding bodies mostly refuse to pump research dollars into a condition which is seen as the inevitable and unstoppable end result of time itself. Our own inbuilt redundancy. As a result the buckeroos usually get corralled off to those other more instantly recognisable and well acknowledged diseases of aging and mortality: cancer, CVD, diabetes and on. To this camp, a simple reclassification of aging as disease would then render it both scientifically and medically able to be ‘manipulated, treated, and delayed’ and therefore a suitably welcome candidate for some of those desperately needed research smackers looking for a home.

What I found a little confusing in the rhetoric is that for a good many of these scientists it appears that it’s not so much a question of whether aging actually is a disease, rather than whether reclassification is a necessary evil to help leverage the eagerly sought after funding.

And even biogerentology’s own agent provocateur, the pleasingly flamboyant and amiable Aubrey de Grey, himself a vocal proponent of the ‘aging as disease’ hypothesis, in his fascinating 2007 treatise Ending Aging writes that,

‘aging is no more and no less than the collective early stages of the various age related diseases’

In an apparent counter to his own prolongevity proposal seeming to say that aging itself is, in a sense, a collection of all the ‘age related diseases’ we seem to suffer over time. Inside the cover de Grey goes on to methodically lay out a series of apparently (at least theoretically) do-able steps to clearing up and repairing the time-addled body and to potentially winding back the clock a good 30 years or more but even more tantalisingly dangling the possibility of yet far, far greater life extension.

To highlight how often nuanced the many views of this camp are, leading researcher Nir Barzilai of the Albert Einstein College of Medicine at Yeshiva University in New York tells us,

‘Aging is common for all of these diseases — and yet we’re not investigating the common mechanism for all of them. We are just looking at the specific diseases.’

A man who has a palpably less positive view of the ‘aging as disease’ theory is the biogeronotogical giant Leonard Hayflick, author of the 1994 bestseller ‘How and why we age’, who in a 2007 paper written in his trademark unequivocal style stated that aging is not a disease simply because there is no disease or pathology that shares six specific qualities of aging he describes (do read the article if you’re interested). Yet even Hayflick himself seems to go on to plead the case that far more research funding into the direct study of aging itself is necessary though not for him because treating it as a disease poses any problem but for Hayflick the reason is straightforward:

‘the resolution of age-associated diseases will not provide insights into understanding the fundamental biology of age changes’

Simply put, we have to study the biology of aging directly to understand it rather than simply plowing all the cash into understanding the diseases, an avenue which for him can’t possibly offer the necessary insights in the biology of aging itself.

Another even more trenchant critic of the ‘aging as disease’ hypothesis is Suresh Rattan of the University of Denmark who in a paper entitled ‘Aging is not a Disease’ (well no cause for misunderstanding there then!) and published in June of this year stated that,

‘ … the issues of aging, quality of life and longevity cannot be successfully approached with disease-oriented thinking’

And goes on to warn exactly why this might be by saying,

‘… a lack of interdisciplinary health discussion among scientists and other scholars has allowed the growth of numerous self-proclaimed anti-aging specialists and longevity-gurus, generating a lot of confusion, false promises, muddled thinking, and impractical and even harmful interventions.’

Frankly to me it seems that the last statement appears to strike at the heart of why so many highly respected researchers fear the disease hypothesis so much, a position which has far more to do with misappropriation rather than a gerontological lover’s tiff. In the simplistic pseudo-scientific jargon employed by so much of the anti-aging lobby, the naive x=y framing of age as a straightforward disease with an equally prosaic cure rather than the highly complex series of interwoven biological processes that it actually is, then the barn door is swung wide open to every snake oil merchant from here to Wichita and bank accounts empty at equally alarming rates. Often enough even apparent pro-longevists like de Grey are to themselves vexingly misunderstood or simply misappropriated by those with vested interests.

In a widely touted confrontation between de Grey in one corner and the famed US epidemiologist and disease-hypothesis denier Jay Olshansky of Chicago University in the other, which was aired on US based science and research non-profit AAAS and billed as a knock ‘em out, one-rounder with winner-take-all, in a possibly disappointing sucker punch to the life extension lobby de Grey stated,

‘We are NOT working to extend life for the sake of extending life. We are working to postpone the ill-health of old age, which will probably have the side-effect of extending life, but it’s no more than that, a side-effect’

And possibly equally disappointingly for those wanting a clear winner and outright Champeeen of the Woild, even Olshansky in a clear demonstration of academic fraternalism and mutual respect went on to say,

‘Although my friend Aubrey and I disagree on many things, most of what we disagree on is entirely irrelevant. It’s what we agree on that is far more important, and that is, the time has arrived to take an entirely new look at aging. We now spend an enormous sum of money attacking the diseases that arise at later ages, but comparatively little on the underlying risk factor for most of what goes wrong with us as we grow older – aging’

Showing clearly that once that bell rings there’s more in common here even with this contentious academic hot potato than meets the eye. And though there’s no conclusive answer from the scientific community about whether it is or isn’t (a disease that is), what they do seem unified about is firstly that many more research bucks are sorely needed and they need to be spent on the direct study of aging and not just the diseases of aging and  secondly – beware the marketing wizards! If a claim sounds too good to be true – even with the most sciencey sounding of credentials (and there a plenty of them about!) – well it most likely is.

In part two we’ll be looking deeper into the prevailing theories behind why science thinks it is we actually age. See y’all then.