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Recognizing Ageing as a Disease

by Ben Fielding(more info)

listed in ageing, originally published in issue 264 - August 2020

Imagine a world where no one aged by default, except for in rare instances. Standing out in a crowd of the eternally young and healthy is an unfortunate soul; shuffling along with a hunched-over back, a face full of wrinkles, multiple chronic health conditions; pale skin and thin, wispy white hair. Wouldn’t you want to help that person?

Even with ageing as the norm, more and more scientists are looking at others – and themselves – and asking the same question. Now, the momentum is with a new generation of scientists, who are starting to think of ageing not as an inevitable process, but as a disease waiting to be cured.

 

Ageing as a disease

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Thinking of Ageing is a Disease

Traditionally, ageing was thought of as too broad of a concept to be reduced to a specific pathology, and even as a form of disease “maturation”.[1] But disease perception has a strong historical context [2] and some issues, such as osteoporosis and systolic hypertension, were in the past just thought of as ‘ageing’ and not diseases in their own right.

The biggest obstacle that exists to ageing reclassification seems to be its universality. But aside from this, there is no doubt that ageing in all other aspects meets the criteria for a disease, that it is a “harmful deviation from the normal structural or functional state of an organism”.[3] It is also becoming increasingly clear that certain cellular and molecular events cause ageing, along with its signs and symptoms[4] and that these symptoms (as we shall see below) may be treatable.

Even if not everyone is convinced by the declaration, labelling ageing as a disease may have wider societal benefits. The fact that obesity is recognized as a disease in the United States[5] shows how fluid the disease label can be. But such identification makes it easy to ‘target’ obesity as a problem and develop better treatments for it. Shifting the consensus to the ageing process may also pave the way for better and quicker treatments of the ailments associated with old age.

Understanding Why We Age

There are lots of contributing factors that have a hand in bodily ageing, but we may be close to a single, unifying theory. The most prevalent theory is the so-called ‘Information theory of ageing’.[6] This puts the process of senescence down to a simple loss of information over time.

Very briefly, epigenetic information in the body is stored differently to genetic information. Epigenetic data is stored in an analog format, while genetic data (DNA) is stored digitally. Like why CDs eventually replaced analog vinyls, over time the analog (epigenetic) information begins to corrupt. Epigenetic information can no longer then ‘read’ the digital DNA information and the body gets confused – over time, accumulated epigenetic/genetic confusion causes the ageing process.

One of the leading proponents of the information theory of ageing, David Sinclair, has even stressed that this singular cause means that “from the looks of it, ageing is going to be… far easier than curing cancer”.[7]

‘Treatments’ for Ageing – Fasting and Diet

If the information theory of ageing holds out – if there really is a singular reason behind the ageing process – then there is no reason why treatments cannot be developed to slow or even reverse ageing.

Actually, we are already aware of seven longevity genes called ‘sirtuins’.[8] These sirtuins act a little bit like emergency first-response crews,[9] meaning, they work to try and stop the cumulative damage to the genetic material that comes with information loss over time. Studies have shown there are various ways to ‘boost’ these sirtuins into action — something which slows down ageing. The trick is to put the body under a form of mild stress.[10] That is, to trick the body into thinking it is in a state of emergency, or that an emergency is forthcoming.

A great way to do this is by fasting. The medical community is slowly coming around to appreciate just how beneficial intermittent fasting is on the body, and specially as a way to delay ageing.[11] There are lots of theories behind why fasting might be good for us. The most compelling is that – up until the last half of the twentieth century – intermittent fasting was the norm. People often went hungry prior to the age of supermarkets, consumerism and globalization. It is actually unnatural to always have food at the ready, like is the case today.

As the body experiences the feeling of hunger, alarm bells start to ring. It begins to worry if the next meal might never come. This ‘state of emergency’ forces our sirtuins into action. The sirtuins then get to work repairing DNA damage.[12

In the modern world, we have to trick our bodies into uncertainty. But this should only ever be mild stress. Not starvation. Not malnourishment, but just feeling hungry from time to time. Studies have shown that fasting may extend the lifespans of mice and men by 40 and 20 per cent, respectively.[13] Fasting also improves general health and cardiovascular health[14] across the board, such reductions all help to keep people living healthier and longer.

 

Fielding 264 Ageing as a Disease Treatments

 

Other treatments – Exercise and Therapy

There are other ways to put the body under mild stress and therefore activate our longevity genes. That includes high-intensity interval (HIIT) training,[15] cold therapy[16] and hot therapy.[17] All of these conditions put our bodies in a minor state of emergency.

HIIT training is all about exercising very hard for short intervals (so as not to overdo it), triggering what is known as the hypoxic response. After a quick sprint, a runner might be expected to be sweating; have an elevated heart rate and deep, rapid breathing cycles, and be unable to finish a sentence without pausing for breath. That is the hypoxic response, the ‘state of emergency’ that gets sirtuins to work.

Likewise, therapies that push our bodies out of the thermo-neutral zone also work to create a mildly stressful atmosphere. Once the body gets too hot or too cold, it has to work to restore the body’s core temperature back to sustainable levels. This is why frequent sauna bathing and ice-baths also work to activate our longevity genes.

Prescribing for Old Age

None of the above treatments is revolutionary. Everyone knows that a good diet, limiting caloric intake, and exercise is good for the body. But what if the health effects of fasting and exercise could be mimicked with drugs?

What is interesting is that the most promising drugs are not novel. On the contrary, many of them are established and already widely used in circulation. From drugs are simple as aspirin, to Vitamin D and Kand metformin.

Metformin, for example, is widely used to treat people with diabetes. Yet in a study of over 41,000 people, it was revealed that metformin can slow the effects of ageing; reduce frailty, cancer and cardiovascular disease, and even increase overall lifespan by 6 per cent. One drug, NMN, feigns a state of emergency in the body and can boost our longevity genes by as much as 25 per cent.

Of course, more research needs to be done – and this is not an endorsement of any of the drugs in particular. But it does reveal that medicine could exist – and could be developed – to treat ageing. If only it were classified as a disease. As of right now, established drugs like metformin look very encouraging, but they are only prescribed for people with chronic health problems, such as diabetes.

But what if ageing was looked at in a new light, and what if we could prescribe drugs that slow ageing? At the very least, we could be hopeful that, by delaying ageing, we can also delay the chronic health problems that develop with it. Such as, as mentioned earlier, certain cancer types and frailty. This could widely improve peoples’ health spans as well as lifespans and could ease the burden on our healthcare systems.

The Ethics of ‘Curing’ Ageing and the Future

But even if we could cure ageing, should we? That is one of the fascinating questions now being asked in bio-gerontology.[18] It seems inevitable that we should pursue it, especially given the health benefits that will follow. Yet a true age ‘cure’ will transform society and perhaps even human nature itself. Therefore, a world post-senescence will be both tragic and delightful.

Medical advancements are already pushing the human lifespan further than what is previously known to humanity. The first 150-year-old is predicted to have already been born, and 100 might even become the new life expectancy number.[19] There are those who say they do not want to live forever, or that they want to die naturally at around the ‘expected’ age.[20] Most people do wish to live a bit longer, maybe double the typical lifespan if they are healthy enough. Meaning that most people turn down offers for immortality because they assume that we will not continue to make the medical advancements we are already building on.

Would a person ever want to die if they feel fine and healthy? If you suddenly found out tomorrow that there was a mistake on your birth certificate, and that your true age was 150, would you suddenly want to die? The answer is probably not.

Some Thoughts and Conclusions

Regardless of if we can ever definitely cure the ageing process, it is almost certain that medical advancements will continue to prolong our lives. Keeping us healthier for longer. This in itself will revolutionize our attitudes to work, reshape the economy and our lives. Major transformations are coming, no matter what lies ahead.

But it is hard to imagine anything other than positives when it comes to recognizing ageing as a disease. Most people suffer from chronic health problems or are debilitated in some way as they enter their sixties. Treating ageing – whether through supplements or proscribed diet and exercise programs – will at the very least increase global health spans, keeping people happier and feeling more independent than ever before.

References

1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6057778/

2. https://www.researchgate.net/publication/279861994_It_is_time_to_classify_biological_aging_as_a_disease

3. https://www.britannica.com/science/disease

4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3836174/

5. https://www.cdc.gov/obesity/data/adult.html

6. https://link.springer.com/article/10.1134/S0006350917050098

7.  https://www.nextavenue.org/harvard-geneticist-people-live-150/

8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5514220/

9. https://hms.harvard.edu/news/potentially-universal-mechanism-aging-discovered

10. https://www.ncbi.nlm.nih.gov/pubmed/11707916

11. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6284760/

12. https://www.ncbi.nlm.nih.gov/pubmed/24048020

13. https://eu.usatoday.com/story/news/2018/09/06/fasting-may-more-important-than-what-youre-eating-study-suggests/1206269002/

14. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6314618/

15. https://www.newscientist.com/article/2123825-best-anti-ageing-exercise-is-high-intensity-interval-training/

16. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3746174/

17. https://www.ncbi.nlm.nih.gov/pubmed/25705824

18. https://www.ncbi.nlm.nih.gov/pubmed/21115537

19. https://www.wsj.com/articles/is-100-the-new-life-expectancy-for-people-born-in-the-21st-century-11587041951

20. https://www.newscientist.com/article/2179903-why-wouldnt-you-want-to-live-forever-new-scientist-editors-debate/

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About Ben Fielding

Ben Fielding is a copywriter and researcher for GBS Clinic Ltd. He has written extensively about longevity, sirtuins and the ageing process, along with other issues to do with popular science, health and medicine on his website.

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