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Aging Shares Disease Hallmarks, May Be Treatable

Is aging a disease? These authors reflect: “Disease is commonly defined as an abnormality of bodily structure or function, distinct from direct physical injury (Bulterijs et al., 2015). Whether ageing itself constitutes a disease has long been debated in the fields of gerontology, medicine, and bioethics. Ageing shares multiple features with pathological conditions, including progressive functional decline, accumulation of molecular damage, and increased susceptibility to chronic diseases, yet its universal and intrinsic nature has complicated its formal classification as a disease (Li et al., 2024, Tenchov et al., 2023). A major argument supporting the disease-like view of ageing is the recognition that ageing and chronic diseases are driven by overlapping biological mechanisms, including genomic instability, telomere attrition, epigenetic alterations, mitochondrial dysfunction, chronic inflammation, and cellular senescence, collectively conceptualized as the “Hallmarks of aging” (López-Otín et al., 2023). The modifiability of these processes by interventions such as caloric restriction, senolytics, and geroprotective agents has further reinforced the notion that ageing is a biologically regulated and potentially actionable process (Le Couteur et al., 2012). In parallel, the inclusion of “old age” as a health-related condition in ICD-11 (code MG2A) reflects increasing recognition of ageing within clinical and health policy frameworks, without formally defining it as a disease (Rabheru et al., 2022).“ They additionally note a “widely adopted intermediate framework in which ageing is conceptualized as a modifiable biological risk factor that predisposes individuals to multiple chronic diseases… [and that] the geroscience paradigm embodies this view by proposing that targeting core ageing mechanisms can delay or prevent a broad spectrum of age-related diseases without redefining ageing as a disease.” Ultimately, these authors argue that the practical value of targeting aging-related mechanisms stands on its own, regardless of whether aging is formally classified as a disease. Geroscience doesn’t depend on that debate. What makes it so powerful is its focus on the biology of aging itself, with the goal of extending both youthspan and healthy longevity.