Opinion: Aging, Just Another Disease

No longer considered an inevitability, growing older should be and is being treated like a chronic condition. 

By | November 1, 2016

© STOCKILLUSTRATION/SHUTTERSTOCK.COMThe concept of aging is undergoing a rapid transformation in medicine. The question has long been asked: Is aging a natural process that should be accepted as inevitable, or is it pathologic, a disease that should be prevented and treated? For the vast majority of medicine’s history, the former position was considered a self-evident truth. So futile was any attempt to resist the ravages of aging that the matter was relegated to works of fantasy and fiction. But today, the biomedical community is rethinking its answer to this question.

The controversy has been fanned, to a great extent, by one Aubrey de?Grey, a Cambridge University–trained computer scientist and a self-taught biologist and gerontologist. Over the past decade, de Grey has undertaken an energetic campaign to reframe aging as a pathologic process, one that merits the same level of attention as, say, cancer or diabetes. Although many of de Grey’s claims remain controversial—notably, that the first person who will live to 1,000 years old is already among us—I agree that we can and should pathologize aging. In fact, it seems we already have.

“Aging” is a term we use to describe the changes our bodies undergo over time. Colloquially, we tend to refer to early changes, say from infancy to early adulthood, as maturation or development and reserve “aging” for changes that occur thereafter. The early changes are generally considered good: stronger muscles, wiser minds, and so on. The later changes are far less popular: thinning skin and hair, weakening bones, and other forms of decline.

In a biological sense, the mere passage of time is pathological.

To complicate matters, the human body comprises a number of different systems that each develop at its own pace. The nervous system seems to reach full maturity in our 20s, for instance, while the skeletal system may peak a decade later. Of course, this physiologic natural history is subject to environmental influence. For example, a diet rich in calcium and vitamin D, along with weight training, can increase bone density and strength. Nevertheless, these environmental factors ultimately act on a foundation that, beyond a certain age, is inexorably deteriorating. There is a finite limit beyond which environmental factors cannot save us.

The changes of aging vary in their specifics from one system to another, but common mechanisms are at work. For instance, wear-and-tear of joints results from depletion of articular cartilage, just as the thinning of skin is due to a loss of elastic connective tissue. Other age-related changes arise from errors in cellular activity or the accumulation of metabolic by-products, the probabilities of which rise over time.

As these natural changes proceed, they lead to readily recognizable disease. The accumulation of fat in blood vessel walls provides a particularly good demonstration of this. Lipids are an essential part of our diet, but as processed lipids continue to accumulate in vessel walls, these vessels harden and narrow, eventually failing to supply the heart with enough blood. If the narrowing blocks vessels entirely, the heart is starved of blood, causing heart muscle death, or heart attack.

This simplified example illustrates that perfectly normal processes that are critical to survival will quite naturally lead to disease. In a biological sense, the mere passage of time is pathological. Importantly, most of the early changes in this progression, such as high cholesterol, are symptomless. Yet they are precursors to life-threatening illness and are therefore considered pathologic entities in their own right, to be prevented and treated. The same can be argued of the more subtle and gradual damages of aging.

There are countless other conditions subject to this dynamic. They include some of the most common and debilitating ailments, such as osteoporosis, arthritis, stroke, diabetes, dementia, and even many forms of cancer. Given enough time, myriad diseases will afflict us as a direct result of the natural aging process.

We can and should view these diseases, whose prevention and treatment are standard medical practice, as the clinical manifestations of natural age-related changes. Doctors have long targeted such changes to prevent disease. For instance, by recommending their patients limit the fat and carbohydrate content of their diets or take statin medications, doctors have strived to stave off heart disease. In so doing they unknowingly have been battling aging itself.

Yet there are those who find this view of aging contentious, a reaction that likely stems from the misperception that the terms “natural” and “pathologic” are conflicting. There’s a common yet unwarranted sense that these two terms are mutually exclusive; that what is natural can only be right, and what is pathologic cannot be natural. This is untrue. Because “natural” typically describes what conforms to the usual course of events, and “pathologic” describes what is harmful, the question posed in the opening paragraph presents a false dichotomy. Both “natural” and “pathologic” describe aging fairly.

Thus, the controversy is largely semantic. If I were to replace the call for a “fight against aging” with an invitation to “combat age-related changes,” I would expect a far more positive response. A call to “prevent the early stages of disease” would surely receive virtually unanimous support. I contend that the three phrasings are synonymous. 

Mutaz Musa is a physician in the Department of Emergency Medicine at Albert Einstein College of Medicine/Montefiore Medical Center, a health-care consultant, and an entrepreneur in New York City.

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Avatar of: dumbdumb

dumbdumb

Posts: 80

November 9, 2016

Defining aging as a pathologic process, higlights the ludicrous ignorance about the fundamental reality that pervades the universe we leave in.

 

ENTROPY!

Avatar of: Jim Bacon

Jim Bacon

Posts: 2

Replied to a comment from dumbdumb made on November 9, 2016

November 9, 2016

Living organisms are not closed systems, they are open systems reliant on a thermodynamic flux...

Avatar of: Gilbert White

Gilbert White

Posts: 9

Replied to a comment from dumbdumb made on November 9, 2016

November 16, 2016

...So what? 2nd Law of Thermodynamics, Entropy, does not prevent the functioning of refrigerators or freezers, it only governs and limits their efficiency. LIfe exists by "cheating" Entropy. 

Avatar of: Amateur

Amateur

Posts: 1

November 16, 2016

While I read this article with interest, I have to express my skepticism - and perhaps cynicism. Too many people whom I know (and at my age of nearing 70, I know quite a few) enrich the pharmaceutical industry and the healthcare industry in general through a futile and ridiculous pursuit of endless life. The life they envision seems to focus primarily on "staying alive" at any cost (and assuming that someone else pays the cost - Medicare, insurance, etc.) 

Avatar of: Keith Loritz

Keith Loritz

Posts: 27

November 16, 2016

Man evolved this way for a reason. . . it works. We fight microbes ALL THE TIME: our evolved immune system works. We live in groupings: our evolved social nature works. We change to meet the needs in our environments: our evolved thought processes work.

Unfortunately an optimal system that self perpetuates may not be without issues AND limitations. . . like eventual obsolesence and death. These were acceptable tradeoffs for natural evolution such that the entity servived long enough to propagate.

However, we may be able to redesign this "optimized for a different environment" system by short circuiting evolution (we have solved many of natures inherent limitations with technology) and incorporating changes that solve the "new, most pressing" issue of limited life span.

I love seeing this big picture unfolding in the natural evolution of the human species!

Avatar of: James V. Kohl

James V. Kohl

Posts: 453

November 16, 2016

Natural selection for energy-dependent codon optimality links the biophysically constrained chemistry of RNA-mediated protein folding from autophagy to amino acid substitutions and healthy longevity via polycombic ecological adaptations. Ecological variation and ecological adaptation link morphological phenotypes to behavioral phenotypes via the physiology of reproducton and transgenerational epigenetic inheritance of chromosomal rearrangements. For example sexual differentiation of cell types is an energy-dependent biological variable.

See the Nobel Prize-winning works from 1933, 2004 and 2016 that led to the award for those who linked Physiology or Medicine to biologically-based cause and effect.

Virus-driven energy theft links the hecatombic evolution of all pathology from bacteria to archaea and from microbes to humans with Zika virus-damaged DNA. Issues of semantics can therefore be placed into the context of Combating Evolution to Fight Disease

See also: Virus-mediated archaeal hecatomb in the deep seafloor

Excerpt: We show here for the first time the crucial role of viruses in controlling archaeal dynamics and therefore the functioning of deep-sea ecosystems, and suggest that virus-archaea interactions play a central role in global biogeochemical cycles.

Avatar of: James V. Kohl

James V. Kohl

Posts: 453

Replied to a comment from dumbdumb made on November 9, 2016

November 16, 2016

I wrote:

See also: Virus-mediated archaeal hecatomb in the deep seafloor

Excerpt: We show here for the first time the crucial role of viruses in controlling archaeal dynamics and therefore the functioning of deep-sea ecosystems, and suggest that virus-archaea interactions play a central role in global biogeochemical cycles.

The virucidal effect of UV light is the anti-entropic energy source that links the biological energy of the sun to all biodiversity on earth via nutrient energy-dependent changes that link angstroms to ecosystems in all living genera via their physiology of reproction and supercoiled DNA, which protects all organized genomes from virus-driven entropy.

 

Avatar of: JonRichfield

JonRichfield

Posts: 125

November 16, 2016

The key summary is "Thus, the controversy is largely semantic", but it also is incomplete.  It is more; it is context-sensitive. Human aging could be regarded as an instance of "planned obsolescence" (and the metaphorical "planning " is not even adapted to modern humanity. Basically, the selective penalty for fending off old age is traded off for living long enough to compete effectively in reproduction.

In many other species though, such as many insects and other invertebrates and plants, the programme for propagule, hatching, growing, reproduction, and dying is quite rigid, and it would be survival beyond the normal life span that would be regarded as a diseased state.

Avatar of: James V. Kohl

James V. Kohl

Posts: 453

Replied to a comment from JonRichfield made on November 16, 2016

November 16, 2016

Is there a model of biologically-based cause and effect that led to any of your claims? How is the Structural diversity of supercoiled DNA placed into any context whatsoever?

See also: MicroRNAs in the Host Response to Viral Infections of Veterinary Importance

Do you realize that my model has been used to link microbes to human via all invertebrates and vertebrates?

Role of olfaction in Octopus vulgaris reproduction Future work on O. vulgaris olfaction must also consider how animals acquire the odours detected by the olfactory organ and what kind of odour the olfactory organ perceives. The OL acting as control centre may be target organ for metabolic hormones such as leptin like and insulin like peptides, and olfactory organ could exert regulatory action on the OL via epigenetic effects of nutrients and pheromones on gene expression (Kohl, 2013; Elekonich and Robinson, 2000).

Avatar of: James V. Kohl

James V. Kohl

Posts: 453

Replied to a comment from Gilbert White made on November 16, 2016

November 16, 2016

The four laws of thermodynamics define fundamental physical quantities (temperature, energy, and entropy) that characterize thermodynamic systems at thermal equilibrium. The laws describe how these quantities behave under various circumstances, and forbid certain phenomena (such as perpetual motion).

Who created the energy, and which of you can tell me where it goes if it is never destroyed? I'm saying that in the context of the Laws of Biology (aka: conditions of life), viruses steal the energy. Life exists only when viral latency is biphysically constrained and RNA-mediated protein folding chemistry constrains life via the physiology of reproduction, which is nutrient energy-dependent. Schrodinger (1944) put that into this perspective, long betore I did: 

What is life when it is not protected from virus driven entropy

 

Avatar of: James V. Kohl

James V. Kohl

Posts: 453

November 16, 2016

This Perspective summarizes presentations at the 10th Congress of the International Association of Biomedical Gerontology, which was held in Cambridge, England in September 2003. The seminar topics ranged from telomeres to ethics, stem cells to limb regeneration. The meeting organizer, Aubrey de Grey, is a leading proponent of life extension through biological engineering.

I don't know enough about him. Do you think he know what happens when a biologically engineered organism is infected by a virus? Or, is his form of biological engineering based on speculation via computer models and the fact that none of his computers has ever been infected by a virus?

 

Avatar of: mlerman

mlerman

Posts: 71

November 16, 2016

Accelerating protein turnover rates (by increasing degradaton and synthesis rates, treatment with rapamycin) will lead to retardation of aging due to rejuvenation of the adult TSC compartments. Michael Lerman 

Avatar of: mlerman

mlerman

Posts: 71

November 16, 2016

Molecular and cellular renewal processes underlie growth and aging.

Rapamycin may suppress aging by accelerating protein synthesis and protein degradation. Rapamycin could increase protein turnover thereby removing cellular faulty proteins leading to "eternal youth" of cell populations and retardation of organismal aging. M.I. Lerman, J. of Theoretical Biology, 73, 615-29, (1978).

Avatar of: mlerman

mlerman

Posts: 71

November 16, 2016

In the very near future, verily, humans may be genetically modified to carry an additional functional copy of the highly conserved gene, Fus1/Tusc2. On one hand it’s a classical tumor suppressor gene (TSG) on the other it’s a powerful regulator of the immune system. Over-expression of this gene will suppress and prevent tumor formation and boost the immune system leading to overproduction of hematopoietic stem cells (HSC) and most effector cells thus activating the immune attack on tumor cells. In addition, individuals with an extra functional copy of the gene will be resistant to immune diseases, infectious diseases including HIV and enjoy longevity.

 

Dante Alighieri, "Divine Comedy"

“At the age of 40, in the middle of my life pass, I got lost in a dark, dark wood; and was trying to explain myself to myself" (Dante Alighieri, "Divine Comedy")

Avatar of: mlerman

mlerman

Posts: 71

November 16, 2016

Lerman MI.

The biological essence of resting cells in cell populations

J Theor Biol. 1978 Aug 21;73(4):615-29.

In this paper I have argued that molecular turnover in resting stem cells define the rate of cellular and organismal aging.

Avatar of: James V. Kohl

James V. Kohl

Posts: 453

Replied to a comment from mlerman made on November 16, 2016

November 16, 2016

Is there a model for that? See for instance:

THIS MODEL DETAILS HOW CHEMICAL ECOLOGY DRIVES ADAPTIVE EVOLUTION VIA: (1) ecological niche construction, (2) social niche construction, (3) neurogenic niche construction, and (4) socio-cognitive niche construction. This model exemplifies the epigenetic effects of olfactory/pheromonal conditioning, which alters genetically predisposed, nutrient-dependent, hormone-driven mammalian behavior and choices for pheromones that control reproduction...

Nutrient-dependent/pheromone-controlled adaptive evolution: a model

Avatar of: James V. Kohl

James V. Kohl

Posts: 453

November 17, 2016

Re: Biologically engineered life extension.

------

Millions of dollars have been spent and billions of lives have been altered by the ignorance of theorists who never learned the difference between an energy-dependent RNA-mediated amino acid substitution and virus-driven energy theft, which causes all mutations.

See:  The flip side of personal genomics: When a mutation doesn't spell disease

Excerpt: "...geneticists don’t have an accurate understanding of how mutations behave in people who are not obviously sick. “This is a fascinating flashpoint in the field right now,” says Robert Green.... “Many people are deeply concerned that widespread screening of ostensibly healthy people could actually lead to harm.”

How does anyone justify allowing the practice of medicine to proceed unhindered by facts known to serious scientists about biophysically constrained energy-dependent RNA-mediated cell type differentiation and nutrient energy-dependent pheromone-controlled viral latency in the context of the physiology of reproduction and supercoiled DNA?

Avatar of: James V. Kohl

James V. Kohl

Posts: 453

Replied to a comment from James V. Kohl made on November 17, 2016

November 17, 2016

End of discussion. Right?

Editor In Chief Of World’s Best Known Medical Journal: Half Of All The Literature Is False

 

All of it that talks about beneficial mutations or biological engineering is false since the role of virus-driven energy theft was not considered.

Avatar of: dumbdumb

dumbdumb

Posts: 80

Replied to a comment from Gilbert White made on November 16, 2016

November 20, 2016

Darling,

the concept is way more pervasive than that.

things eventually break down (i.e. increase their entropy), no matter how much energy you put in it!

In the specific case at hand, it is the very concept of aging as a disease that is both conceptually and philosophically wrong!

Avatar of: lgm

lgm

Posts: 4

November 23, 2016

As a retired ex  biologist who used to work with gene expression I  maintain an interest in ageing. I have long thought that we will find a way of curing ageing.

My wife and most people I talk to firmly believe that eternal life means getting for ever older, weaker, decrepid etc. but never departing this world. She regards this possibility as totally abhorent. My definition of eternal life is different. I think that stopping ageing at, say 25 years, and never getting older would be great.

When people talk about curing ageing  we need to define these two viewpoints. Of course there may be another option such as slowing ageing.

I try but I can not get through to people that these different possibilities for eternal life exist. I think that current researchers ought to differentiate these possibilities more clearly. My guess is that finding a way of stopping ageing when someone is at their biolocial best would attract a lot more funds than just finding ways to keep people like myself alive for ever - not that I am decrepid yet.

Avatar of: primativebeliever

primativebeliever

Posts: 30

November 23, 2016

The thoughts are close to what the Bible talks about. The natural body gets diseased by sin( pathology). If therefore one could not sin, live completely in harmony with the laws of nature and nature's God, the natural body could continue for a longer period of time until entropy takes over, since all die.  

Avatar of: Cryptoprocta

Cryptoprocta

Posts: 2

November 25, 2016

How so very selfish! Why not accept death as part of life and be done with it? Part of this perverted attitude has to do with the fact that we aren't properly prepared for death and so we fear it with every inch of our being. I look forward to being the old decrepit and to feel death, this is a life lesson rather than something to run away from. And what if these radical ideas are true like 'reincarnation' are true? We don't know either way, and as evidenced by the work of pioneering scientists it could very well be true. Science makes a grave error in pretending it can understand the consequences of its actions when time and time again, it has proven disasterous, especially in terms of research being motivated by market pressures.

Avatar of: Cryptoprocta

Cryptoprocta

Posts: 2

November 25, 2016

How so very selfish! Why not accept death as part of life and be done with it? Part of this perverted attitude has to do with the fact that we aren't properly prepared for death and so we fear it with every inch of our being. I look forward to being the old decrepit and to feel death, this is a life lesson rather than something to run away from. And what if these radical ideas like 'reincarnation' are true? We don't know either way, and as evidenced by the work of pioneering scientists it could very well be true. Science makes a grave error in pretending it can understand the consequences of its actions when time and time again, it has proven disasterous, especially in terms of research being motivated by market pressures.

Avatar of: Taiji

Taiji

Posts: 3

February 9, 2017

I like the idea of staying around a bit longer to see what happens ... maybe reach for the stars too. Unfortunately I don't see it happening using our biological bodies - are way too fragile.

The other posters above are pretty much right about the entropy also.

The solution is being developed as we speak. To transfer our consiousness inside a machine will be a piece of cake in a decade or so. That will put an ending to aging and disease. I wonder how many will embrace it ... I will for sure.

Take a look at the 2045 project :) See what I'm talking about.

Avatar of: Taiji

Taiji

Posts: 3

February 9, 2017

 

 

I like the idea of staying around a bit longer to see what happens ... maybe reach for the stars too. Unfortunately I don't see it happening using our biological bodies - are way too fragile.

 

 

 

The other posters above are pretty much right about the entropy also.

 

 

 

The solution is being developed as we speak. To transfer our consciousness inside a machine will be a piece of cake in a decade or so. That will put an ending to aging and disease. I wonder how many will embrace it ... I will for sure.

 

 

 

Take a look at the 2045 project :) See what I'm talking about.

 

Avatar of: Taiji

Taiji

Posts: 3

February 9, 2017

I like the idea of staying around a bit longer to see what happens ... maybe reach for the stars too. Unfortunately I don't see it happening using our biological bodies - are way too fragile.

The other posters above are pretty much right about the entropy also.The solution is being developed as we speak. To transfer our consciousness inside a machine will be a piece of cake in a decade or so. That will put an ending to aging and disease. I wonder how many will embrace it ... I will for sure.

Take a look at the 2045 project :) See what I'm talking about.

 

 

 

 

 

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